Using cognitive behavioural therapy to tackle work-related stress

Work-related stress is a notoriously difficult problem to deal with, but the growing availability of cognitive behavioural therapy means employers may be able to do more to help, says Nicola Sullivan

Cognitive behavioural therapy (CBT), often associated with acute mental health conditions, is finding its way into the workplace, where it is being used as a way to treat one of the most common occupational health issues: stress. CBT can be a rapid way to reduce the symptoms of stress, while keeping an employee at work.

Fiona Robson, absence management and wellbeing specialist at Newcastle Business School, says: “CBT can be effective over a fairly short period of time, which is useful for employees and their organisations because it may reduce absence levels or facilitate an earlier return to work for employees who have been absent owing to stress.”

CBT, which was developed in the 1960s, by American psychiatrist and psychotherapist Aaron T Beck, helps patients to change negative thought processes and behaviours to relieve the symptoms of mental health problems, such as stress, anxiety, depression, obsessive compulsive disorder and post-traumatic stress disorder. It is a short-term therapy, with approximately eight-to-20 sessions typically taking place over about six months, during which time participants are set exercises and goals to challenge their existing way of thinking.

At a time when many employers are making redundancies and economic uncertainty is casting a shadow over many other organisations, employee stress levels are likely to be high. According to the Health Uncovered survey published by Legal & General in 2007, one-in-five feel stressed at work. In addition, the Office for National Statistics’ Labour Force Survey showed that in 2007/08 an estimated 442,000 individuals believed they experienced work-related stress at a level that was making them ill. The survey also found 13.5 million working days were lost in the same period due to self-reported work-related stress, anxiety or depression.

As employers continue to look for ways to manage the problem, a number of healthcare providers are beginning to add CBT to their product range. Some group income protection providers, such as Legal & General, incorporate it into rehabilitation products, and, in some cases, it can be used to help employees return to work before a claim is made. Vanessa Sallows, underwriting and benefits director at Legal and General, says: “Stress often builds up and people find it difficult to say no to extra work. CBT could also be used for individuals who do not get on with colleagues. It helps people understand why rather than looking at it negatively, and concentrate on what is positive.”

Staff may also be referred for CBT through healthcare perks, such as an employee assistance programme or private medical insurance. It has yet to be offered widely as part of a healthcare cash plan, although some providers, such as Westfield Health, say employers are asking for CBT to be included in cash plans.

As a guide, CBT costs between £60 and £120 per session, but employers will need to identify which of their employees will benefit from it. Kate Bawden, an associate at Mercer, says: “Employers need to make sure CBT is available to the individual that needs it. An individual needs to have an [initial] assessment from a medical professional, such as a nurse or counsellor, who will establish whether CBT is suitable.”

Although CBT is becoming more widely recognised as a way of tackling workplace stress, the therapy is still under-used because of a lack of practising therapists. However, employers that have trouble sourcing therapists can still offer CBT by providing staff with access to computer-based CBT packages. These can include short introductory videos and allow the individual to take part in weekly interactive CBT sessions. The participant completes activities and then weekly progress reports which are sent to a GP or other medical professional who monitors the process. Some online packages offer real-time sessions with therapists or include 24-hour telephone support lines.

Communicating CBT, however, may be tricky because of the stigma that is sometimes associated with mental health problems, along with employees’ concern about confidentiality. “The fact treatment is provided independently should be highlighted so the employee knows that personal details will not be reported back to their line manager,” says Robson.

To gain the most from CBT, employers should concentrate on highlighting its advantages to staff, in particular, setting out that it is a therapy focused on the future and does not encourage them to dwell on the past

If you read nothing else, read this…

• Cognitive behavioural therapy (CBT) is a fairly quick and effective way to treat stress in the workplace by helping employees to reverse negative thought processes.
• Employers can provide staff with access to face-to-face CBT sessions, computer-based, or online therapy packages.
• CBT is used to treat a number of conditions, including stress, depression, anxiety, and post-traumatic stress disorder.