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Psychosocial Benefits of Three Formats of a Standardized Behavioral Stress Management Program

From Williams LifeSkills, Inc. (E.D.K., V.P.W., M.C.H.), Durham, North Carolina; and the Department of Psychiatry and Behavioral Sciences (J.D.L., R.B.W.), Duke University Medical Center, Durham, North Carolina.

Address correspondence and reprint requests to Redford B. Williams, MD, Behavioral Medicine Research Center, 2212 Elder Street, Box 3926, Duke University Medical Center, Durham, NC 27710. E-mail: redfordw{at}duke.edu

Objective: Psychosocial factors are associated with increased morbidity and mortality in healthy and clinical populations. Behavioral interventions are needed to train the large number of people in the community setting who are affected by stressors to use coping skills that will reduce these risk factors. The aim of the current study was to evaluate the efficacy of three forms of delivery of a standardized, behavioral intervention—the Williams LifeSkills program—designed to reduce levels of psychosocial risk factors in nonclinical populations.

Methods: One hundred ninety-six participants screening positive for elevated psychosocial distress were randomized to either a waitlist control group or one of three intervention groups: the LifeSkills Workshop, the LifeSkills Video, or the LifeSkills Video and Workshop combined. Psychosocial risk factors were evaluated at baseline and at 10 days, 2 months, and 6 months after the training/wait period.

Results: At 10 days follow up, the workshop + video and video-only groups showed significant improvements over control subjects in trait anxiety and perceived stress. Moreover, the workshop + video group maintained benefit over control subjects throughout 6 months follow up in both of these measures, whereas the video-only group maintained benefit in trait anxiety.

Conclusions: Because the psychosocial well-being of two of the treated groups improved over that of the control group, it appears that the Williams LifeSkills program accelerates and maintains a normal return to low distress after a stressful time. This is the first study to show that a commercially available, facilitator- or self-administered behavioral training product can have significant beneficial effects on psychosocial well-being in a healthy community sample.

Key Words: psychosocial risk factor • stress management • evidence based behavioral medicine • cognitive behavioral therapy • LifeSkills • translational research

Abbreviations: CHD = coronary heart disease; CAD = coronary artery disease; MI = myocardial infarction; CBSM = cognitive–behavioral stress management; WLS = Williams LifeSkills; CABG = coronary artery bypass graft; STAI = State and Trait Anxiety Inventory; CESD = Center for Epidemiological Study Depression scale; ISEL = Interpersonal Support Evaluation List; CM-Ho = Cook-Medley Hostility scale; PSS = Perceived Stress Scale; VO = LifeSkills Video only; WO = LifeSkills Workshop only; WV = LifeSkills Workshop plus LifeSkills Video.

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