Study evaluates effects of psychological program to improve teachers' mental health

The aim of this study was to evaluate the effects of a manual-based psychological group program to improve teacher's mental health. Participation in the intervention resulted in a significant improvement in the General Health Questionnaire score. With respect to the Symptoms Check List-27, the values of the GSI (Global Severity Index) and of 3 subscales (those for depressive, dysthymic and mistrust symptoms), compared with the control group, improved significantly upon participation in the group program. Although these findings suggest a protective effect of such a short manual-based psychological intervention program on teachers' health, some considerations (such as drop-out rate) must be taken into account.

Previous studies have shown that coping with interpersonal processes or problems which teachers are continuously confronted with, is one of the primary factors influencing the health of teachers. Teachers' health prevention must aim at improving social and emotional competences. For this purpose, a group of German investigators have developed a manual-based program comprising 10 sessions. The program focuses on 5 topics dealing with stress biology, reflection and the management of interpersonal relationships. The aim of this study was to evaluate the effects of this psychological group program. Teachers (n = 2,484) of 2 school types, 'Hauptschule' (n = 70) and 'Gymnasium' (n = 19) in 3 neighboring school districts in southwest Germany received invitations to participate in our intervention program. All teachers declaring interest (n = 337) in the intervention program were randomly assigned either to the intervention (n = 171) or to the control group (n = 166). The intervention group took part in a training program that lasted 1 year. The control group participated in the intervention trial during the following year. In order to describe the mental health state of the teacher sample and to detect eventual effects of the intervention the General Health Questionnaire (GHQ)-12 and the SCL-27, a short version of the SCL-90-R, both in their German versions, were used. The inventories were applied both times before the intervention (pre) and 12 months after the intervention (post) at the end of the school year. The intervention program consisted of 10 group sessions (1 session per month) of 90 min each.  The manual is composed of 5 modules dealing with the following issues: (1) basic knowledge on stress physiology and the effects of interpersonal relationships on health parameters, and Jacobson's relaxation training; (2) mental attitudes with particular respect to aspects of authenticity (being congruent with oneself) and identification (with the professional role); (3) competence in handling relationships with pupils; (4) competence in handling relationships with parents; (5) strengthening collegiality and social support among the staff (detecting and fending off splitting tendencies). In order to analyze the effects of our intervention program, the investigators compared the intervention and control groups with respect to the changes that could be detected in the scales of  the two inventories (GHQ-12, SCL-27). They conducted several variance analyses with general linear model repeated measures using the statistical analysis program SPSS (version 15.0).

Participation in the intervention resulted in a significant improvement in the GHQ score. With respect to the SCL-27, the values of the GSI (Global Severity Index) and of 3 subscales (those for depressive, dysthymic and mistrust symptoms), compared with the control group, improved significantly upon participation in the group program. However, the effects were small to moderate with respect to both the GHQ-12 and the SCL-27. Analyzing for effects of covariates, any effect on gender, age or preceding health impairment was found. Although these findings suggest a protective effect of such a short manual-based psychological intervention program on teachers' health, some considerations must be taken into account. Seventy-four of the 166 teachers who started the program took part in less than 5 of the 10 group sessions. Significant improvements in health parameters could only be proven for those who participated in at least 5 of the 10 sessions. These effects partly remained when the data were subjected to a best-case intention-to-treat analysis; however, they disappeared when a worst-case scenario was assumed. While, e.g. in pharmacological studies, the intention-to-treat analysis serves as a valuable indicator of the potential risks or strains that are connected to certain treatments, in this case the investigators neither have evidence that the program exerted any negative effects nor that such effects were causative of the dropouts (primary reasons for the withdrawal of participants were lack of time, moves or changes of workplace). Therefore, the fact that the beneficial effects could only be proven for those who actually participated in the intervention program does not diminish the usefulness of the program under investigation  in a real-world situation.