Nichole Faller

A Randomized Controlled Trial of an Online Psychoeducation Course for Improving Knowledge and Access to Mental Health Accommodations

Doctoral Dissertation, Nichole Faller, 2021

Background: Available research on mental health accommodations within the workplace  suggests that employees with mental health concerns require  accommodations to improve work functioning. Unfortunately, only a  fraction of employees requiring mental health accommodations will  receive the accommodations they have requested. Reported barriers to  receiving mental health accommodations include lack of knowledge about  appropriate accommodations, concerns regarding stigma, and financial  constraints of the employer. There is a paucity of research available on  interventions aimed at improving accommodation knowledge and usage for  mental health concerns.

Method: The primary goal of the current study was to assess the efficacy of a  four-lesson, online, psychoeducational course developed to provide  information on anxiety/depression symptoms in the workplace, appropriate  accommodations to help manage symptoms, considerations for disclosure  of a mental health concern and accommodation requests, and general tips  for symptom management. A total of 89 participants with  anxiety/depression symptoms that were negatively impacting work  functioning were randomly assigned to a treatment group that received  access to the Workplace Coping Strategies (WCS) course or an eight-week  waiting list group. All participants received questionnaires at four-  and eight-weeks post randomization. Primary outcomes of interest  included the impact of the WCS course on requesting/receiving  accommodations, employee knowledge of accommodations, self-stigmatizing  attitudes, and workplace relationships. Organizational inclusivity and  supervisory leadership were also examined to determine how these  variables impacted accommodation usage and disclosure rates. Secondary  outcomes assessed the efficacy of the WCS course on comfort levels  disclosing and rates of disclosure. Exploratory analyses examined the  impact of the WCS course on absenteeism/presenteeism scores,  self-efficacy, and symptomology. Finally, quantitative content analyses  were used to examine qualitative data on accommodations identified,  barriers/facilitators to requesting/receiving accommodations, and  participant feedback on the course.

Results: Results suggest that those who participated in the WCS course relative  to the waiting list group had large improvements in accommodations  knowledge, increased self-efficacy, and improved presenteeism scores.  Both groups reported reduced internalized mental health stereotypes and  increased disclosures of mental health concerns over time. Regression  analyses further demonstrated that partial disclosures were associated  with organizational inclusiveness and supervisory leadership. The  results suggest that the intervention did not have an impact on  accommodation usage, symptomology, workplace relationships, or comfort  level disclosing a mental health concern. Qualitative analyses showed  that participants most frequently identified accommodations related to  scheduling flexibility and job description modification with limited  mention of communication facilitations and/or modifications to physical  space. The most frequently cited barrier was poor relationships with  management, while supportive relationships were considered a facilitator  for requesting/receiving an accommodation. Participants reported liking  the clarity and conciseness of the course content the most and disliked  aspects of the  course structure, such as a lack of video options. Areas  for improvements included changes to questionnaires (e.g., less  frequent), addition of employer-centered material (e.g., tips for  discussing mental health), and the use of persuasive design to increase  engagement.

Conclusions: Participants were satisfied with this treatment modality and were able to establish a strong working alliance with their online therapist. Results from the current study provide emerging evidence for transdiagnostic ICBT in the treatment of postpartum anxiety and depression.