Self-help for stress and burnout without therapist contact: An online randomised controlled trial

Interventions designed to reduce stress and burnout may be costly and access is limited. This study examined the effectiveness of a self-help book, using Acceptance and commitment therapy (ACT) to target stress and burnout in a randomised controlled online trial without any therapist contact. Participants were recruited through a newsletter of a health insurance company. Participants (N=119) who reported at least moderate levels of stress were randomly assigned to an immediate intervention (n=61) or a waitlist group (n=58). Measures before and after the intervention assessed stress, burnout (primary outcomes), depression, well-being, emotion regulation (secondary outcomes) and ACT-specific constructs. Compared to the waitlist group, participants in the immediate intervention group reported lower stress and burnout and higher psychological flexibility at post-assessment. Effects between groups were large for stress (d=0.9), moderate to large for burnout (d=0.5-0.8) and large for psychological flexibility (d=0.8). All primary and most secondary outcomes and ACT processes continued to improve in the 3-month-follow-up period. Results suggest that an ACT self-help book without any therapist contact is effective in reducing stress and burnout for various occupations. Thus, it may provide a cost-effective public health intervention for reducing stress and burnout.