Review confirms workplace counselling reduces stress

Counselling can achieve a reduction in work related stress in more than 50% of people, according to a systematic review published last week.

It showed that levels of work related symptoms and stress returned to the normal range for more than 50% of clients in two thirds of the studies included. Levels of sickness and absence also fell by 25-50% in trials evaluating these factors. Counselling interventions had smaller, but significant, positive effects on levels of job commitment, work functioning, job satisfaction, and substance misuse.

The report's author, Professor John McLeod, professor of counselling at the University of Abertay, Dundee, commented: “Taken as a whole, there are now several plausible studies that show that short term counselling brings at least half of clients back into the normal range of functioning.”

The study reviewed all research evaluating workplace counselling published over the past 50 years; it was funded by the British Association for Counselling and Psychotherapy as part of an ongoing systematic review of different areas of counselling research. It included more than 80 studies published between 1954 and 2000 covering various aspects of counselling at work and reflected the experiences of more than 10 000 people using work related counselling services.

The review found high levels of baseline symptoms in people with work related stress. “People who needed workplace counselling showed similar levels of psychological distress to those found in patients attending psychiatric outpatients,” Professor McLeod reported. “They were clearly at some level of crisis.”

Results from several studies showed that relatively short term interventions—as few as three to eight sessions of counselling—achieved effective stress reduction. This approach proved to be cost effective in studies looking at economic costs and benefits.

There was no evidence that any one counselling approach was more effective than any other. Positive results were found with various models of counselling. Only the most severely disturbed clients seemed to require long term counselling or referral to specialist services.

Professor McLeod acknowledged that counselling has been criticised in the past for lack of rigorous evaluation. “Blinded, randomised trials are obviously very difficult to carry out with counselling. Studies that have tried to do this have ended up being so remote from everyday practice that the results are difficult to interpret.”

He suggested that there had been a move to more evaluation of counselling interventions based on naturalistic effectiveness studies—evaluating clients before and after counselling.

Professor Cary Cooper, BUPA professor of organisational psychology and health and pro-vice chancellor at University of Manchester Institute of Science and Technology, said of the review: “It makes a significant contribution to the literature and gives a unique insight into the scientific evidence behind it.”

He pointed out that the fast pace and long hours worked by many people today are having a major impact on the health of stressed individuals and their families. “Counselling has a role to play as part of a bigger strategy to deal with workplace stress. But it provides treatment not prevention. It helps people who are stressed to cope better but doesn't prevent or identify the structural sources of workplace stress, which can only be dealt with by systematic audit.”

Counselling in the Workplace: The Facts is published by the British Association for Counselling and Psychotherapy and is available from Book Orders Department, British Association for Counselling and Psychotherapy, 1 Regent Place, Rugby CV21 2PJ, price £12 to BACP members, £18 to non-members.