CBT is not the only solution to workplace stress

Middle managers can be particularly at risk of stress and mental ill health

Cognitive behavioural therapy (CBT) can be effective in managing workplace stress, but it is not the only solution. Dr Paul Avis, marketing director of Canada Life Group Insurance explains alternative approaches that can be provided via an employee assistance programme (EAP).

CBT is an evidence-based therapy endorsed by the National Institute for Health and Care Excellence (NICE) for use in treating common mental health conditions. NICE recommends CBT for the treatment of stress, anxiety, depression and obsessive compulsive disorder.

CBT often focuses on cognition or thoughts, with particular attention paid to those that are irrational or unhelpful. Related behaviours are identified, and methods of changing maladaptive behaviours are subsequently implemented.

CBT was pioneered by Dr Aaron T Beck in the 1960s, initially as a result of his research into depression. It received a great deal of support, which demonstrated it as an effective intervention for common mental health issues; a trend which has continued with the research used by NICE to inform its guidance. However, according to a study published in the British Journal of Psychiatry in 2009, which compared individuals taking antidepressants with individuals receiving CBT as well as antidepressants, CBT has no added benefit.

This, along with other research, has begun to challenge the assumption that CBT is the “best” form of therapy, leading to a dramatic shift in the popularity of CBT and a lessening in the belief of a wonder cure for depression.

Nonetheless, one in five people suffers from workplace stress and CBT is often provided as an option to help with them. It is believed that CBT offers techniques to help individuals in alleviating stress, but is this the most appropriate choice, given that there are other options available?

Having a workplace wellbeing programme has a significant impact on company culture. This can be achieved through promoting an awareness of healthy work culture and acknowledging the pressures of day-to-day life.

For example, by providing an employee assistance programme (EAP) to staff (all staff, not just those that are insured), which allows access to therapeutic support and practical advice, employers can be more proactive in tackling workplace stress and other mental health issues. As stress can be a way of our brain avoiding a situation, what better way to deal with it than to confront it head on? This can be achieved in a number of ways.

A solution-focused approach

The solution-focused approach was developed in America in the 1980s by Steve de Shazer and Insoo Kim Berg. Solution-focused therapy can be used for individuals struggling with low mood, anxiety, bereavement or relationship breakdown.

It is a time-limited approach that enables you to move forward with your problems in a short space of time. A limited-session model has been established as the industry standard for EAPs, as this has been found to be an effective timeframe for resolving a wide range of issues without the need for long-term interventions.

The time-limited sessions allow individuals to identify their current issue, acknowledge how the past may have influenced it and how they can move forward by taking action. Emphasis is placed on what is changeable and possible, therefore a main driver of the therapy is the client’s desire to change. The counsellor and client will work together, building on resources and strength to find a solution. A key element of this is to understand what the client wants to accomplish in the future, and building hope by working towards it in a structured way.


Coaching is another option that enables both individuals and corporate clients to achieve their full potential. The Association for Coaching defines coaching as a “collaboration of solution-focused, results-orientated and systematic process in which the coach facilitates the enhancement of work performance, life experience, self-directed learning and personal growth of the coachee.”

Coaching can also focus on one particular area of the individual’s life such as stress, anxiety or fear of presenting in front of a group. Coaching differs from counselling as it is much more direct, and it helps people work towards achieving their goals without addressing the issue directly from an emotional perspective.

Regardless of the benefits of the various interventions for work-related stress and common mental health issues, it is important to be aware of the role of choice. No single therapy will work with every client every time, nor will any one approach suit all personality types.

Many people feel uncomfortable with the concept of “homework” between sessions, which is central to CBT. Other clients may struggle with the concept of identifying links between cognition and emotion, and prefer to focus on the issues at hand, as with a solution-focused approach.

In conclusion then, it is in both the EAP’s and the individual’s interest to allow for a range of options when providing support, rather than following a single set of guidelines and attempting a one-size-fits-all approach. By doing so, the likelihood of making appropriate referrals and helping clients to feel happy with their therapist are increased.


About Paul Avis

Paul Avis is marketing director of Canada Life Group Insurance.
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