Michelle K. Tucker

Is Group More Cost Effective than Individual Cognitive Behaviour Therapy? The Evidence is not Solid Yet

This paper critically evaluates the empirical evidence of 36 studies regarding the comparative cost-effectiveness of group and individual cognitive behaviour therapy (CBT) as a whole, and also for specific mental disorders (e.g. depression, anxiety, substance abuse) or populations (e.g. children). Methods of calculating costs, as well as methods of comparing treatment outcomes were appraised and criticized. Overall, the evidence that group CBT is more cost-effective than individual CBT is mixed, with group CBT appearing to be more cost effective in treating depression and children, but less cost effective in treating drugs and alcohol dependence, anxiety and social phobias. In addition, methodological weaknesses in the studies assessed are noted. There is a need to improve cost calculation methodology, as well as more solid and a greater number of empirical cost-effectiveness studies before a firm conclusion can be reached that group CBT is more cost effective then individual CBT.

The relevance of shared experiences: A multi-level study of collective efficacy as a moderator of job control in the stressor-strain relationship

Karaseks Job Demand-Control model proposes that control mitigates the positive effects of work stressors on employee strain. Evidence to date remains mixed and, although a number of individual-level moderators have been examined, the role of broader, contextual, group factors has been largely overlooked. In this study, the extent to which control buffered or exacerbated the effects of demands on strain at the individual level was hypothesized to be influenced by perceptions of collective efficacy at the group level. Data from 544 employees in Australian organizations, nested within 23 workgroups, revealed significant three-way cross-level interactions among demands, control and collective efficacy on anxiety and job satisfaction. When the group perceived high levels of collective efficacy, high control buffered the negative consequences of high demands on anxiety and satisfaction. Conversely, when the group perceived low levels of collective efficacy, high control exacerbated the negative consequences of high demands on anxiety, but not satisfaction. In addition, a stress-exacerbating effect for high demands on anxiety and satisfaction was found when there was a mismatch between collective efficacy and control (i.e. combined high collective efficacy and low control). These results provide support for the notion that the stressor-strain relationship is moderated by both individual- and group-level factors.

Change in Psychosocial Work Factors Predicts Follow-up Employee Strain: An Examination of Australian Employees.

Objective: This research undertook a time-ordered investigation of Australian employees in regards to their experiences of change in psychosocial work factors across time (decreases, increases, or no change) in the prediction of psychological, physical, attitudinal, and behavioral employee strain. Methods: Six hundred and ten employees from 17 organizations participated in Time 1 and Time 2 psychosocial risk assessments (average time lag of 16.7 months). Multi-level regressions examined the extent to which change in exposure to six demands and four resources predicted employee strain at follow-up, after controlling for baseline employee strain. Results: Increases in demands and decreases in resources exacerbated employee strain, but even constant moderate demands and resources resulted in poor employee outcomes, not just constant high or low exposure, respectively. Conclusions: These findings can help employers prioritize hazards, and guide tailored psychosocial organizational interventions.

Supervisors’ Ability to Manage Their Own Emotions Influences the Effectiveness of Their Support-Giving

Although supervisor support is generally considered a job resource that buffers the negative consequences of job demands, reverse-buffering effects have been found. It was proposed that supervisor support would be stress buffering when supervisors were skilled in emotion management and stress exacerbating when supervisors were low in emotion management. A sample of 210 US employees found three-way interactions on psychological strain, job burnout, and two stress-related intentions. Supportive supervisors high in emotion management buffered high emotional demands on psychological strain and medical advice intentions, but not burnout or turnover intentions. The stress-exacerbating hypothesis was not supported. Instead, employees with highly supportive supervisors low in emotion management reported low strain at low emotional demands. However, this benefit was diminished at high emotional demands.

Interaction effects among multiple job demands: an examination of healthcare workers across different contexts

ABSTRACT Background and Objectives: Simultaneous exposure to time, cognitive, and emotional demands is a feature of the work environment for healthcare workers, yet effects of these common stressors in combination are not well established. Design: Survey data were collected from 125 hospital employees (Sample 1, Study 1), 93 ambulance service employees (Sample 2, Study 1), and 380 aged care/disability workers (Study 2). Methods: Hierarchical multiple regressions were conducted. Results: In Sample 1, high cognitive demand exacerbated high emotional demand on psychological strain and job burnout, whereas the negative effect of high emotional demand was not present at low cognitive demand. In Sample 2, a similar pattern between emotional demand and time demand on stress-remedial intentions was observed. In Study 2, emotional demand × time demand and time demand × cognitive demand interactions again revealed that high levels of two demands were stress-exacerbating and low levels of one demand neutralized the other. A three-way interaction on job satisfaction showed the negative impact of emotional demand was exacerbated when both time and cognitive demands were high, creating a “triple disadvantage” of job demands. Conclusions: The results demonstrate that reducing some job demands helps attenuate the stressful effects of other job demands on different employee outcomes.