Learning How to Recover From Stress - Pilot RCT
Condition: Adjustment Disorders
MeSH terms: Adjustment Disorders
Study type: Interventional

Summary: 
      This randomized, controlled pilot trial evaluated the efficacy of a brief internet-based
      recovery training intervention targeting distressed employees. This pilot trial is one of the
      first to examine a brief recovery training program's efficacy, suggesting that employees
      across a wide range of professions could learn how to recover from elevated stress symptoms.
      This type of accessible and brief recovery intervention might shape the future of stress
      prevention, but more research is needed with larger samples before further conclusions can be
      drawn.
    

Detailed description: 
      In recent years, work-related stress and burnout have received more attention, with a higher
      prevalence observed within the working population. Today, every fourth employee has
      experienced stress during most of their working days. Employees exposed to prolonged stress
      in their work situations experience more strain and suffer from poor well-being; higher risk
      of severe health implications, such as coronary artery disease; and problems in work
      participation, such as sickness absences, including long-term sick leave.

      Empirical research suggests that recovery from work is important in reducing the negative
      effects on employees from stress and strain, as well as preserving their well-being and work
      performance. Recovery refers to the restoration processes during which a person's stress
      level returns to its pre-stress level. Recovery as a process refers to the activities and
      experiences that elicit change in stress and strain indicators. Recovery as an outcome
      captures a person's psychological or physiological state reached after a recovery period
      (e.g., at the end of a workday). Confirmatory factor analysis has proposed four distinct
      experiences in recovering from work processes: psychological detachment; relaxation; mastery;
      and control. Extant studies confirm that these experiences are related positively to
      well-being indicators such as the Recovery Experience Questionnaire.

      Although extensive research has been devoted to stress intervention programs, and evidence
      suggest that these are effective in reducing stress within the working population, few
      studies have evaluated interventions aimed at stress prevention, e.g., by removing stressors
      and/or enhancing well-being factors, such as recovery. Most stress interventions have focused
      on reducing participants' cognitive, emotional, and behavioral symptoms when coping with
      stress. However, some promising results on stress prevention have been observed from recovery
      training programs.

      Despite the evidence on the efficacy of stress management interventions and some promising
      results from recovery training interventions , only a small percentage of distressed
      employees actually receive stress interventions. This calls for further development and
      evaluation of interventions that are accessible and has the potential in preventing chronic
      stress in the working population.

      The internet has the potential to disseminate interventions broadly, and a growing body of
      literature has demonstrated internet-based stress interventions' efficacy, with small to
      moderate effects on outcomes from stress, burnout, insomnia, depression, and anxiety.

      The present, controlled pilot study aim to examine the efficacy of a brief, five-week,
      internet-based recovery training program for employees experiencing elevated symptoms of
      stress and/or a stress-related disorder burnout in a randomized, controlled pilot trial. We
      hypothesize that the internet-based recovery program would produce greater improvements in
      recovery experiences (primary outcome) compared with a wait-list control group. We also
      hypothesize that the intervention group will differ with regard to important health-related
      (perceived stress, burnout, exhaustion, depression, alcohol consumption, and quality of life)
      and work-related (work experience, work ability, sickness absences) outcomes. Finally, we
      investigate whether the initially achieved changes in the intervention group would remain
      stable at six- and 12-month follow-ups.
    

Intervention name(s): Internet-based recovery training program
Intervention type(s): Behavioral
Intervention description(s): The iRTP was based on recovery experiences (psychological detachment, relaxation, mastery, and control), converted into a recovery training intervention, and inspired by Hahn et al. (2011). The iRTP comprised five modules distributed over five weeks, with modules lasting 60-120 minutes per week. Each module contained psycho education, worksheets, images, cases, audio and video files, and homework assignments.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study was a two-armed controlled trial in which an internet-based recovery training program (iRTP) was compared with a wait-list control group (WLC). The study followed Consolidated Standards of Reporting Trials (CONSORT) guidelines (Schulz et al., 2010) and was conducted between February 2018 and May 2019. Since this was a pilot trial, no power calculation and estimates of sample size were conducted.
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Recovery; Stress; Internet-based; Prevention; Intervention; Work