Teacher stress and coping strategies used to reduce stress

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1 Occupational Therapy International, 12(2), 63-80, 2005 Whurr Publishers Ltd 63 Teacher stress and coping strategies used to reduce stress VICKY AUSTIN Occupational Therapist, Bridgewater, Somerset, UK SURYA SHAH Professor, Occupational Therapy and Neurology, University of Tennessee Health Science Center, Madison, Tennessee, USA STEVEN MUNCER Reader, Department of Clinical Psychology, University of Durham, Thornby, UK ABSTRACT: This pilot study investigated teachers symptoms of stress and their coping strategies. Measurements of stress levels and coping strategies used were acquired by constructing a questionnaire made up of four individual standardized questionnaires. The data were analysed by a series of correlational analyses that highlighted significant relationships between ways of coping and levels of distress. Differences between the stress-related areas were measured using the Friedman test and Wilcoxon signed rank test for hierarchy. The findings implied that escape avoidance, accepting responsibility and uncontrolled aggression were used as negative coping strategies and only one strategy, exercise, was indicated to be an effective way of coping. The teachers strategies were examined for similarities and differences with those recommended by occupational therapists. This pilot study was limited to two schools and it is recommended that it be extended to better generalize the results. Furthermore, ways of coping, as measured by psychological measures, do not seem to reduce stress so it is possible that the activity-based Stress Management Questionnaire, as advocated by Stein et al. (2003), might be more advantageous. Key words: stress levels, coping strategies, classroom teachers, coping strategies, activity-based coping Introduction Stress is a difficult a term to define because it has different implications for each individual (Smith, 2004). Stein and Cutler (2002) define stress as a total response to one s environmental demands and pressures and theorize that stress is an unavoidable part of life that everyone has to deal with. The psychological demands of stress are the problematic outcomes referred to as the cause of

2 64 Austin, Shah and Muncer emotional distress, known as anxiety, depression, and psychosomatic complaints (Day, 1998). Burnout is defined as exhaustion, tendency to depersonalize others, and lowered self-esteem (Gelder et al., 1993; Hodge et al., 1994). It is important for occupational therapists to investigate coping strategies to eliminate stressful circumstances for teachers at work. Headlines such as Depression hits hard in schools (Thornton, 2000) and Teaching can make you sicker for longer (Dean, 2000) and the finding that more than 40% teachers have experienced serious symptoms of stress due to the pressures of excessive workload and abusive parents and pupils suggests that teachers are suffering from more stress. Furthermore the number of referrals of teachers to occupational therapists with stress-related disorders such as anxiety, depression, and burnout is increasing. When occupational therapists are presented with teachers who have stress-related disorders, they should consider coping strategies to minimize adverse effects. Studies such as those by Fimian (1984, 1988), Hodge et al. (1994), Pithers and Fogarty (1995), Seidman and Zager (1991), and Stein et al. (2003) have provided examples of how to measure stress or stress-related conditions. Hodge et al. (1994) investigated the work stressors and attitudinal and demographic variables that caused emotional distress and burnout in music and mathematics teachers. The authors used a four-part questionnaire: (1) biographical data and general satisfaction with the job; (2) questions relating to commonly perceived work stressors; (3) Goldberg s General Health Questionnaire (GHQ 28; Goldberg, 1981); and (4) the education survey version of the Maslach Burnout Inventory (Maslach and Jackson, 1986), testing for emotional exhaustion, depersonalization, and personal accomplishment. The findings showed that the work stress subscale scores were significantly positively associated with emotional exhaustion, personal accomplishment, and general health scores. Outside occupational therapy, past research has evaluated therapy sessions and stress management techniques and has found positive results in favour of these techniques (Hall et al., 1988; Timmerman et al., 1997). Dewe (1985) investigated teachers coping strategies and classified them as direct action strategies (used less often) and palliative strategies (used more often). Seidman and Zager (1991) noted several positive coping approaches used by teachers and found that competitive or low level physical exercise, meditation and relaxation, and hobby and vacation activities all correlated with lower rates of burnout. Chan and Hui (1995) found significant gender differences: males were more restricted in expressing emotions and females had a greater tendency to seek advice or social support. The authors also reported that avoidant coping strategies correlated with emotional exhaustion, depersonalization, and personal accomplishment and recommended that future studies evaluate a variety of coping strategies. Pithers and Fogarty (1995) found role overload to be one of the major and pervasive occupational work stressors for teachers. Boyle et al. (1995) evaluated the

3 Teacher stress and coping strategies 65 dimensions of teacher stress: using a principal components analysis they determined that workload and student misbehaviour were the two major contributors to stress. Capel (1986) recommended the integration of specific methods to reduce role conflict and role ambiguity. The author suggested that administrators could create more opportunities for teachers to feel in control of their own actions by letting them take a more active role in deciding matters that concerned them and by reducing the amount of work they complete outside working hours. Hodge et al. (1994) recommended that schools provide guidance and counselling support for teachers and pupils; introduce procedures for teachers to give positive feedback on their work and achievements; provide opportunities for skill-sharing; and promote lifelong learning in practical stress-reduction strategies (e.g. relaxation and classroom and time management). Billings and Moos (1984) suggested that coping strategies are compensatory factors that help individuals maintain health. However, other investigators found coping strategies significantly correlated with high levels of burnout, implying that using certain coping strategies might be detrimental to an individual s health (Chan and Hui, 1995). Chan and Hui (1995) used the Ways of Coping Questionnaire (Folkman and Lazarus, 1988) to investigate burnout and coping and showed that using avoidant coping was significantly related to high levels of emotional exhaustion, depersonalization, and low personal achievement. Seeking social support reduced depersonalization. Moreover, feelings of personal achievement were positively related to positive appraisal and planful problem solving. These results suggest that seeking support, positive appraisal, and planful problem solving are all positive coping strategies, whereas avoidant coping is negative. However, Dewe (1985) concluded that palliative strategies (i.e. strategies concerned with reducing emotional discomfort) are important as they may enhance an individual s ability to initiate some direct action techniques. Using only one response to coping is usually insufficient; a variety of stress management techniques may be required (Seidman and Zager, 1991). The study by Hall et al. (1988) provided evidence that experiential in-service courses in human relations enable teachers to change their behaviours in a way that reduces stress. Brown and Ralph (1992) stated that stress management should be approached by identifying school stresses and planning and implementing stress management policies with opportunities to discuss shared experiences based on successfully adopted coping strategies. The theorists listed the strategies that might be included in inservice training: assertiveness techniques, communication skills, effective time management, delegation, relaxation techniques, and development of support networks. Occupational therapists could include similar stress management techniques to those identified by Brown and Ralph (1992); however, they

4 66 Austin, Shah and Muncer should consider addressing the root causes of stress. Menninger (1963) believed that the goal of therapeutic intervention is to facilitate the upward trend of the illness recovery process. Keable (1996) noted that coping involves learning mental as well as physical skills. Keable suggests that teaching positive and rational thinking and relaxation techniques is not sufficient, as individuals need time to practise applying these techniques. Occupational therapists tend to achieve this by setting homework tasks. Keable (1996) and Stein et al. (1999) emphasized that the important part of coping is educating individuals about the signs and symptoms of stress so that they know when to apply the learned techniques. The work of Murphy (1996), Schafer (1996), and Stein and Cutler (2002) identified the useful methods of relaxation, nutrition and sleeping patterns; prescriptive exercises; anger management; biofeedback; social skills training; and self-talk strategies to combat symptoms of stress. Cognitive-behaviour skills include education, correcting responses to coping, rehearsal, and coping techniques such as problem solving and application (Cecil and Forman, 1990; Long, 1988). Other formats consist of posttraumatic debriefing sessions, writing about traumatic events, social support programmes, and health education interviews. A number of health professionals have evaluated the outcomes of stressmanagement training programmes in which a variety of techniques were taught. Timmerman et al. (1997) found that their training programme significantly reduced distress, psychosomatic complaints, and trait anxiety in the short run. Eppley et al. (1989), Guzicki et al. (1980), Stein and Cutler (2002) and Strong et al. (1989) studied effects of relaxation and other techniques on anxiety. The authors found that transcendental meditation produced a significantly greater effect on trait anxiety than other forms of meditation, progressive relaxation, or other types of relaxation. The purpose of this exploratory pilot study is to identify the degree of stress prevalent in teachers, to examine the coping strategies that teachers use, and to evaluate the effectiveness of these strategies by looking at which appear to reduce stress. The study also seeks to compare teachers coping strategies to the activity engagement strategies recommended in occupational therapy stress management groups or sessions. In contrast to what teachers routinely use to combat stress, this study will explore the type of coping strategy in the form of activities engagement as formulated by Stein and Cutler (2002) for occupational therapists. Method Research design For this exploratory pilot study, a survey questionnaire and a correlational design were used to measure teachers work-related stress and their coping strategies.

5 Teacher stress and coping strategies 67 Research questions The author was interested in evaluating: 1. The type of work stress experienced by high school teachers and if there was a significant difference in teachers coping strategies (positive or negative) with lower or higher stress levels, respectively. 2. If the frequency of coping strategies varied with lower or higher experienced levels of stress. 3. If there was a difference between the positive coping strategies used by teachers and those generally recommended by occupational therapists as measured by Stein s Stress Management Questionnaire (Stein et al., 1999). Participants This exploratory pilot study recruited 50 teachers from two high schools. The participants were a convenience sample of classroom teachers of both genders and of all ages. Those teachers in academic management and other administrative positions and those who were not in direct contact with students and classroom teaching were excluded from the study. Instrument Following verbal permission and/or payment of copyright when required, four questionnaire elements were compiled to measure teachers work-related stress; distress level, as measured by general health status, and morbidity; and two distinct approaches to possible coping strategies. All the questionnaire elements used a Likert scale. To measure work-related stress, the Total Teacher Concern Inventory (TTCI; Fimian, 1984; 1988) was used. This consists of 49 distinct statements. It is a valid and reliable (0.89 to 0.95) teacher measure of stress factors: personal/professional, professional distress, emotional manifestation, discipline and motivation, biobehavioural manifestation, and physiological fatigue. It asks teachers to identify a stressful situation in their present occupational position, decide how they feel about their job, and then indicate how strong their feelings of stress are when they experience them by circling the appropriate choice on a 5-point scale of not noticeable (no strength), barely, moderately, very, and extremely noticeable (major strength). To measure general health status, Goldberg and Williams (1991) General Health Questionnaire (GHQ 28) with 28 statements was used. Four areas of somatic symptoms: anxiety, insomnia, social dysfunction, and severe depression had seven descriptive statements each. It asked whether the teachers had any medical complaints and how their health had been in general over the past few weeks. Teachers circled a response from four choices: better than usual, same as

6 68 Austin, Shah and Muncer usual, worse than usual, and much worse than usual. The obtained scores from the four sections were summed to obtain a total score to estimate the degree of stress and morbidity. A number of studies in the GHQ 28 manual have shown it to be valid (Goldberg and Williams, 1991). Sensitivity ranges from 44% to 100% and test-retest correlation was 0.90 for the GHQ 28 and was significant at the level. To measure the style of the teachers coping strategies, the Ways of Coping Questionnaire (WCQ; Folkman and Lazarus, 1988) was used. Responses to the 66 questions are classified into eight categories. It asks teachers to think about the most stressful situation they experienced in the past week and then respond by circling 0 (does not apply or not used), 1 (used somewhat), 2 (used quite a bit), or 3 (used a great deal) to a list of coping mechanisms. For part four of the questionnaire, Stein and Cutler s (2002) Stress Management Checklist (SMC) of coping strategies entitled Activity Engagement was used. It has 46 dichotomous statements that ask teachers to state which activities helped them to combat stress. The SMC uses an activity engagement approach. It includes coping strategies not covered in the WCQ, such as the use of exercise and relaxation. Ethics Following Institutional Review Board approval, permission to conduct the study was obtained from the two lead teachers. The questionnaire was then distributed to all teachers with a notice that all participants could choose to participate or not. The teachers were also assured that the responses and information within the questionnaire would remain anonymous and confidential. Completion of the questionnaire was taken as willingness to participate in the study. Data analysis Descriptive statistics and correlation analysis were undertaken (0.05 significance). For question 1, total scores on the degree of distress and ways of coping were correlated. For question 2, the total scores of ways of coping and the level of distress were correlated with the TTCI using Spearman s rho. Finally, occupational therapy recommended activity strategies used by teachers for coping were evaluated with those in the WCQ, and significant correlations examined. Stein and Cutler s (2002) SMC was used independently of the above three measures and evaluated how the participants responded to an occupation-based approach. Results Of the 50 questionnaires distributed in internal mailboxes, 12 were not returned by the due date. This provided a 76% response rate. From the 38

7 Teacher stress and coping strategies 69 TABLE 1: Mean scores for the five stress-related areas of the TTCI (n = 38) Stress areas Mean ±SD Work-related stress Time management Discipline and motivation Professional distress Professional investment Valid n (listwise) 38 TTCI: Total Teacher Concern Inventory TABLE 2: Mean scores from the WCQ (n = 38) Way of coping Mean ±SD Planful problem solving Self controlling Seeking social support Confrontive coping Distancing Accepting responsibility Positive reappraisal Escape avoidance Valid n (listwise) 38 WCQ: Ways of Coping Questionnaire (76%) participants who responded, 22 (58%) were from school A and 16 (42%) from school B. The mean scores of the 38 participants in the five identified areas of stress from within the TTCI are presented in Table 1. As can be seen from Table 1, there are significant differences between the five stress-related areas on a Friedman test ( χ 2 = 61.95, df = 4, p = ). Post hoc tests show that workrelated stress is significantly higher than time management on a Wilcoxon signed ranks test (z = 3.96, p = ) and, therefore, also significantly different from all other stressors. Time management, discipline, and motivation are not significantly different from each other (z = 0.435, p = 0.663), but they are significantly different from professional distress and professional investment (z = 3.438, p = 0.001). Professional distress and professional investment are not significantly different (z = 1.676, p = 0.094) from each other. The mean scores of all participants who completed the questionnaire were computed for the WCQ (Table 2). With a mean score of 1.352, planful problem solving is the most popular way of coping with stress, and escape avoidance is the least popular with a mean score of There are significant differences overall between the WCQ on a Friedman test ( χ 2 = 52.01, df = 4,

8 70 Austin, Shah and Muncer TABLE 3: Mean scores for TTCI, GHQ, and WCQ Scale (n = 38) Scale Mean ±SD TTCI GHQ Total WCQ Total Valid n (listwise) 38 TTCI: Total Teacher Concern Inventory; GHQ: General Health Questionnaire; WCQ: Ways of Coping Questionnaire p = ). Planful problem solving is not significantly different from either self-control or seeking social support but is significantly different from confrontive coping (z = 3.268, p = 0.001), and the other ways of coping such as distancing. Escape avoidance is not significantly different from positive reappraisal but is significantly different from accepting responsibility (z = 2.194, p = 0.028) and all of the other ways of coping. The total scores for the TTCI, the WCQ, and the GHQ are presented in Table 3. There is a strong positive correlation between the total on the TTCI and the total on the GHQ 28 (Spearman s rho = 0.555, p = ), but not between the WCQ and the GHQ 28 (rho = 0.257, p = 0.120) nor between the WCQ and the TTCI (rho = 0.03, p = 0.85). It is interesting to note that although workrelated stress is the most important stressor for teachers, it does not have a significant correlation with GHQ 28 total score (rho = 0.177, p = 0.288). Time management (rho = 0.442, p = 0.005) and professional investment (rho = 0.412, p = 0.01) have the strongest relationship to GHQ 28 total score. The correlation between GHQ 28 total score and the different ways of coping is presented with the correlation between TTCI and different ways of coping in Table 4. As can be seen, there is no significant relationship between the TTCI and any of the WCQ subscales. There are, however, significant positive relationships between the GHQ 28 and using escape-avoidance and acceptance of responsibility. These findings indicate that higher stress levels are more associated with these strategies. Furthermore, two of the other WCQ subscales, self-control and positive reappraisal, are also significantly correlated with GHQ 28 score using a one-tailed test. Only the planful problem solving technique has a negative relationship with the GHQ 28 score, indicating that those who use this strategy may reduce distress as measured by the GHQ 28; however, the trend in this relationship is weak (rho = 0.179), and in this case not significant (p = 0.281, or p = 0.140). As regards the three questions posed in this study, question 1 asked whether there is a relationship between stress levels and the different ways of coping that are used. Those with low stress levels were expected to use positive coping strategies, which would mean a negative relationship between GHQ 28 score and strategies such as planful problem solving, seeking social support, and

9 Teacher stress and coping strategies 71 TABLE 4: Spearman correlation between WCQ, GHQ, and TTCI Scale Confrontive Distancing Self-control Seek social support GHQ (p = 0.058) TTCI Accept Escape and Planful Positive responsibility avoidance problem solving reappraisal WCQ 0.398* 0.426** (p = 0.073) TTCI WCQ: Ways of Coping Questionnaire; GHQ: General Health Questionnaire; TTCI: Total Teacher Stress Inventory *p < 0.05; **p < 0.01 two-tailed accepting responsibility. There is limited support for this view, with only planful problem solving showing a negative correlation with GHQ 28. Indeed, positive reappraisal is significantly associated with higher levels of stress on a one-tailed test. Those with higher stress levels were expected to use negative strategies, which would mean a positive correlation between GHQ 28 score and, for example, distancing, confrontive coping, and escape avoidance or having no coping strategies. There is some support for this view with escape avoidance significantly related to higher levels of stress; a finding that supports previous work of Chan and Hui (1995). For question 2, the activity engagement results based on Stein and Cutler s (2002) SMC, section III, and are shown in Figure 1. Participants threw something when higher stress levels ( ) were experienced. A greater percentage of teachers (41%) in the two lower stress levels ( and ) used exercise to reduce stress compared with 25% of teachers in higher stress levels. Exercising was also the most popular activity with 80% of teachers in the lowest stress category. Relaxation was also one of the other popular activities and equally used across all four stress levels with no noticeable differences between the perceived levels of stress. Engagement activities, as measured by the SMC, were the popular choices to relieve stress. Ways of coping did not correlate with distress, work-related stress, or frequency of coping scores (r = , p < 0.01). Therefore, in response to the second question, teachers with lower stress levels did not necessarily use coping strategies more frequently. Question 3 postulated a difference between the coping strategies used by teachers and those generally recommended by occupational therapists as measured by the SMC category Activity Engagement. Trends analysis of the

10 72 Austin, Shah and Muncer Percentage of participants utilizing 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Being active in social club Being by myself Being busy Bicycling Crying Deep breathing Eating Exercising Hot bath/shower Jogging Listening to music Prepare for work Relax (lie down) Running long distances Screaming Sleeping Talk to a friend Throw something Visit friends Walking Stress score categories Stress score categories Stress score categories Stress score categories FIGURE l: Activities utilized by the participants in different stress level categories.

11 Teacher stress and coping strategies 73 use of this category by participating teachers in reducing stress showed that the majority of teachers with a lower intensity of stress used exercise. Teachers in the higher stress category used exercise significantly less. However, teachers within the higher stress categories ( and ) used throwing something or a negative strategy as a way of coping with stress. Relaxation techniques showed no distinguishable difference among the four stress categories. Levitt (1998) and Stein and Nikolic (1989) suggested that the progressive relaxation approach that incorporates specific action components could decrease intensity of stress and make the stress stage more distinguishable. Discussion The aim of this exploratory pilot study was to assess the stress experienced by high school teachers and to evaluate the effectiveness of their coping strategies. Among the surveyed teachers, work-related stress had the highest mean score and was the main stressor, followed by time management, discipline, and motivation. The stressors can be seen as being in three blocks: work-related stress is the most important to these participants, time management and discipline and motivation form the second block, and professional distress and professional investment comprise the least important block. The results suggest that teachers with high levels of stress are more likely to use negative coping strategies such as escape avoidance. This finding is evident from the observed correlations between the total scores of the GHQ 28, the TTCI, and the WCQ strategies used. Teachers with high levels of distress used negative strategies more frequently. These palliative or emotional expressive strategies allow the teacher to ride the situation or decrease involvement (Dewe, 1985; Chan and Hui, 1995). On the other hand, participants with lower stress more frequently used positive coping strategies. However, the tendency just missed reaching significance at Of the positive strategies, planful problem solving was the most frequently used coping strategy. It is worth noting that this was the only way of coping that had a negative relationship to stress. Main source of stress The TTCI scores correlated significantly with the distress scores of the participants. Work-related stress was found to be the most prevalent stress among the teachers. The work-related stress section categorizes the causes of stress into excessive caseload, administration, preparation, parental involvement, and hours worked outside work. Boyle et al. (1995) recommended what workrelated stress be renamed workload, as it does not define the type of work-related stressors that it is categorizing. The other four subscales from the

12 74 Austin, Shah and Muncer same questionnaire also measure work-related stress. The results of this subscale are similar to the findings by Pithers and Fogarty (1995) who found that unnecessarily large workloads and often few resources were the major cause of occupational stress for teachers. In our study, the largest correlation was between time management and overall GHQ 28 score, which suggests that role overload or too many tasks with too little time is the main cause of stress for teachers. The implication that workload is the most prevalent cause of stress requires a rethinking of ways to eliminate or reduce this stress within the teacher population, especially since the measured coping strategies did not have a significant relationship with the type of work stress. Possible coping strategies that could be adopted or taught include delegating responsibility; taking up a hobby; or an activity suggested by Stein and Cutler (2002) that is enjoyable such as gardening, listening to music, or playing a musical instrument. Other strategies that can be used in challenging situations include knowing your personal limitations; assertiveness, as indicated by the ability to say no, for example; responding appropriately; and having personal achievement values which could be used as a break from the stressful environment or when work becomes excessive. However, Pithers and Fogarty (1995) suggested that to reduce stress associated with role overload, an on-going management strategy is needed for the education system as a whole and should not be limited to newly appointed teachers. Kenyeri (2002) found that lack of support, particular school policies, time, and money, could be contributing factors to stress, and developing and implementing strategies to improve the work environment (Hodge et al., 1994) could contribute to reduced stress. This research also found that professional distress and professional investment were the least prevalent stressors among teachers who participated in the study. Borg and Falzon (1989) earlier found that, despite the high prevalence of stress, the majority of teachers regarded their profession as highly rewarding. Evaluation of coping strategies We proposed that problem solving, seeking social and emotional support, noncompetitive exercise, relaxation, and an effort to create positive meaning are possible positive coping strategies. Although none of these strategies correlated significantly with the measured stress levels, planful problem solving was the most frequently used coping strategy despite its unknown effectiveness. Chan and Hui (1995) found that planful problem solving might increase personal accomplishment. The implications of not knowing the effectiveness of planful problem solving are detrimental to occupational therapists evidence-based practice, as planful problem solving is a coping technique that is quite frequently incorporated in learning. Possible reasons for planful problem solving not correlating with distress could be the small sample size,

13 Teacher stress and coping strategies 75 randomized frequency usage of the coping strategy, or teacher stress being an ongoing problem so that the teachers felt they were unable to problem solve. It is still worth highlighting that this correlation was in the right direction, suggesting that planful problem solving may reduce stress. Both escape avoidance and accepting responsibility correlated significantly with the teachers distress scores. The use of these types of coping strategies increased with greater distress levels. Chan and Hui (1995) earlier found a similar result teachers who employ escape avoidance techniques to cope with stressors may be prone to the three aspects of burnout (emotional exhaustion, depersonalization, and lack of personal achievement). After controlling for age and gender, Pisanti et al. (2003) concluded that job control and social support at various levels contributed to teacher well-being. However, there is a dearth of evidence to suggest that people who accept responsibility are more prone to stress. A speculative explanation for this occurrence is that people who use this coping strategy blame themselves for the presenting problem and therefore increase their degree of stress. From the analysis of the activities used to respond to stress, it was evident that the teachers with lower stress levels used both competitive and noncompetitive exercise more often than those with higher stress levels. Exercise was also used by the greatest percentage of teachers in the lower stress category. Seidman and Zager (1991) concluded that noncompetitive physical exercise might be associated with low degrees of burnout. Therefore, these exploratory pilot study results could be considered as acceptable. The teachers within the two higher stress categories used only the coping activity of throwing something. Participants with lower stress levels did not think of this activity as an adequate solution. This result is not surprising due to the activity s nonachievement nature. The activity can also be described as an uncontrollable assertion of anger, which can lead to regret and increased stress if something is broken in the process. Eppley et al. (1989) and Levitt (1998) have previously shown that relaxation techniques reduce stress and improve physical and mental health. Although no conclusions could be drawn as to which teacher stress category best referred to this activity, relaxation techniques were applied independently of the status of stress. Perhaps when the stress is external and less confrontable than an internal stress, relaxation might be more effective (Stein and Smith, 1989; Strong et al., 1989). Question 1 aimed to prove that teachers with low stress use positive strategies whereas teachers with high stress use negative strategies. Referring to the results discussed earlier in this section, the question cannot be completely resolved, due to the positive implications of exercise and the negative implications of escape avoidance and uncontrollable aggression. Although these results coincided with the apposed question, there were several predicted coping methods that failed to support the question. Part two of the question can be rejected because none of the types of work stressors significantly correlated with

14 76 Austin, Shah and Muncer the measured coping strategies. A possible explanation for this is that the measured coping strategies were generalized strategies and not specific to workrelated stress. Question 2 set out to prove that teachers with low stress levels use coping strategies more frequently than teachers with high stress levels. This supposition was supported in part because teachers with high levels of stress were found to have a significant relationship between the frequency of use of positive coping strategies or direct action strategies and the low levels of distress and compensatory strategies. The frequency of use of a variety of coping strategies could depend on time available and amount of responsibility rather than the teachers level of distress or their tolerance to stress or personality. Implications for occupational therapists The literature reports that stress management techniques are taught in mental health, and most are adopted by occupational therapists. These techniques include relaxation, aerobic exercises, visualization, cognitive-behaviour skills, assertiveness, post-traumatic debriefing sessions, lifestyle changes, and social support programmes. Relaxation with progressive elements was used by the majority of the teachers who participated in the study, whatever the level of stress. Past research (Eppley et al., 1989) has contributed a substantial amount of evidence to prove that this method is effective and should continue to be used in stress management programmes. Anger management could be useful for highly stressed teachers to channel aggressive behaviour in a positive way. More specifically, anger management would eliminate the uncontrolled anger that is demonstrated by throwing objects. Applying cognitive-behaviour skills is a good approach to eliminating negative coping responses and replacing them with positive strategies. This study noted the possibility that escape avoidance had a negative effect on reducing stress. Therefore, highly stressed teachers might benefit from learning not to (1) feel guilty; (2) ignore the problem by sleeping; (3) take a day off; (4) try to feel better by eating, drinking, smoking, taking drugs or medication; (5) avoid people; or (6) deny the problem. These responses could be replaced with purposeful activities or coping strategies that have a sense of achievement for individuals with stress. The participants of this study with low stress used exercise as a main activity to relieve stress. The question then arises; do occupational therapists need extra funding to promote this activity? The study s findings have identified exercise as a possible positive coping strategy. However, the coping process is complex (Folkman and Lazarus, 1988). The authors conclude that evaluating strategies is difficult because what is thought of as a generally positive strategy can become disruptive. For example, humour could be considered a good coping strategy; however, ill-timed humour could be maladaptive. Therefore, although trends can be identified, it is possibly not suitable to generalize the findings of such a complex process.

15 Teacher stress and coping strategies 77 Because of the proportion of the study s nonsignificant results, perhaps the effectiveness of coping depends on the individual concerned. The study s findings are nevertheless important because they present significant trends and suggest focused areas for new research. Also, if trends are identified, it is easier for health professionals to conduct stress management programmes for groups (with reference to published research to inform the content). Schools could consider adopting strategies that facilitate teacher effectiveness such as reducing the amount of work outside set working hours, providing guidance and counselling for teachers and scholars, providing positive feedback of achievements, providing opportunities for skill sharing, and promoting lifelong learning (Hodge et al., 1994; Stein and Cutler, 2002) Limitations and future research Including more schools would have allowed a larger sample size and better generalization of results. Because of the expressed concern that recording participants ages and length of teaching experience might identify a small number of teachers in the two schools, these data were not recorded. Examining age and length of teaching experience could contribute significantly to estimating the degree of stress and associated burnout among teachers. Adding a role checklist would help identify nonwork stressors more clearly. If the teachers in non-teaching positions were also included in the study, their responses could have pointed to possible sources of stress for participating teachers. Further research could follow up on the findings of this study, e.g. the relationship between using escape avoidance and stress. Does escape avoidance occur across other professions and other teachers that are affected by work stress? Is exercise a good activity for reducing work-related stress? There is a gap in occupational therapy evidence-based practice on the differences between individual and group stress management programmes. Conclusions From the findings of this exploratory pilot study, certain trends and relationships were conclusive. The first was the fact that the population of teachers selected for this study had a normal distribution of stress levels. The most prevalent work stress among teachers who participated in the study was work overload. Purposeful problem solving was the most frequently used coping strategy; however, the results could not distinguish its effectiveness in reducing teachers stress. Effective and non-effective strategies were analysed and the following conclusions were drawn: (1) Escape avoidance and accepting responsibility both had negative implications as the more highly stressed teachers used them both more frequently. (2) The reliability of a significant correlation between accepting responsibility and distress was queried when accepting responsibility

16 78 Austin, Shah and Muncer was not a significant predictor of distress. (3) Uncontrolled aggressive activities such as throwing objects were concluded also to have a negative implication as only the teachers with high stress levels used them. (4) Disappointingly, the only conclusive positive strategy utilized by the majority of teachers with lower stress levels was exercise. Finally, we can conclude that the stressed teachers of this study would benefit from selected stress management techniques. Anger management was also thought to be a relevant coping strategy. This technique might eliminate adopted negative strategies, such as throwing objects, and provide more positive solutions for the release of anger. A cognitive-behavioural approach could also be beneficial to educate the teachers about stress, as well as to replace negative strategies highlighted in the results of this study with positive strategies that are suitable to the individual. These results have the implication, for occupational therapists, that anger management and applying a cognitive-behaviour approach could be part of effective stress management for combating teachers work-related stress. The proposition to occupational therapists is, therefore, to teach coping techniques in individual sessions that are person-centred. Overall, a correlation is difficult to interpret with regards to ways of coping. Clearly a negative relationship between a coping strategy and stress would be beneficial by suggesting that using this reduces stress. The meaning of a positive relationship is very unclear, however. Only one of the psychological ways of coping had a negative relationship with stress and that trend was not significant, so perhaps we need more activity-based coping as recommended by Stein and Coulter (2002). Participants noted that the process of filling out the questionnaire was beneficial to them. They also stated that the time taken to think about the ways in which they cope was an essential reminder of the coping strategies unconsciously employed. It also gave them time to evaluate the effectiveness of their own ways of coping. All teachers were provided with a support telephone number and occupational therapists were available in their school. References Billings AG, Moos RH (1984). Coping, stress, and social resources among adults with unipolar depression. Journal of Personality and Social Psychology 46: Borg MG, Falzon JM (1989). Stress and job satisfaction among primary school teachers in Malta. Educational Review 32: Boyle GJ, Borg MG, Falzon JM, Baglioni AJ (1995). A structural model of the dimensions of teacher stress. British Journal of Educational Psychology 65: Brown M, Ralph S (1992). From time management to aromatherapy orthodox and alternative in-service training strategies for managing teacher stress. British Journal of In-Service Education 18: Capel SA (1986). The incidence of and influences on stress and burnout in secondary teachers. British Journal of Educational Psychology 57:

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18 80 Austin, Shah and Muncer Smith JF (2004). Stress. Online: Accessed May 13. Stein F, Grueschow D, Hoffman M, Natz M, Taylor S, Tronbak R (2003). Stress Management Questionnaire: An instrument for self-regulating stress. Clinton Park, NY: Delmar Learning. Stein F, Bentley D, Natz M (1999). Computerized assessment: The Stress Management Questionnaire, In B Hemphill-Pearson (ed.) Assessment in Occupational Therapy Mental Health: An Integrative Approach. Thorofare, N.J.: Slack, pp Stein F, Cutler S (2002). Psychosocial Occupational Therapy: A Holistic Approach (2nd edn.) San Diego: Singular Publishing. Stein F, Nikolic S (1989). Teaching stress management techniques to a schizophrenic patient. American Journal of Occupational Therapy 43: Stein F, Smith J (1989). Short-term stress management program with acutely depressed inpatients. Canadian Journal of Occupational Therapy 56: Strong J, Crammond T, Mass F (1989). The effectiveness of relaxation techniques with patients who have chronic low back pain. Occupational Therapy Journal of Research 42: Thornton K (2000). Depression hits hard in schools. Times Education Supplement, May 26: 9. Timmerman GH, Emmelkamp PMG, Sanderman R (1997). The effects of a stress-management training program in individuals at risk in the community at large. Behavior Research and Therapy 36: Address correspondence to Surya Shah PhD, OTR, Professor Occupational Therapy and Neurology, University of Tennessee Health Science Center, 930 Madison, Suite 618, Memphis, TN 38163, USA. Tel: (901) , Fax: (901) sushah@utmem.edu