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Work, stress, coping, and stress management.

• Sharon Glazer Sharon Glazer University of Baltimore
•  and  Cong Liu Cong Liu Hofstra University
• https://doi.org/10.1093/acrefore/9780190236557.013.30
• Published online: 26 April 2017

Work stress refers to the process of job stressors, or stimuli in the workplace, leading to strains, or negative responses or reactions. Organizational development refers to a process in which problems or opportunities in the work environment are identified, plans are made to remediate or capitalize on the stimuli, action is taken, and subsequently the results of the plans and actions are evaluated. When organizational development strategies are used to assess work stress in the workplace, the actions employed are various stress management interventions. Two key factors tying work stress and organizational development are the role of the person and the role of the environment. In order to cope with work-related stressors and manage strains, organizations must be able to identify and differentiate between factors in the environment that are potential sources of stressors and how individuals perceive those factors. Primary stress management interventions focus on preventing stressors from even presenting, such as by clearly articulating workers’ roles and providing necessary resources for employees to perform their job. Secondary stress management interventions focus on a person’s appraisal of job stressors as a threat or challenge, and the person’s ability to cope with the stressors (presuming sufficient internal resources, such as a sense of meaningfulness in life, or external resources, such as social support from a supervisor). When coping is not successful, strains may develop. Tertiary stress management interventions attempt to remediate strains, by addressing the consequence itself (e.g., diabetes management) and/or the source of the strain (e.g., reducing workload). The person and/or the organization may be the targets of the intervention. The ultimate goal of stress management interventions is to minimize problems in the work environment, intensify aspects of the work environment that create a sense of a quality work context, enable people to cope with stressors that might arise, and provide tools for employees and organizations to manage strains that might develop despite all best efforts to create a healthy workplace.

• stress management
• organization development
• organizational interventions
• stress theories and frameworks

Introduction

Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived. Common terms often used interchangeably with work stress are occupational stress, job stress, and work-related stress. Terms used interchangeably with job stressors include work stressors, and as the specificity of the type of stressor might include psychosocial stressor (referring to the psychological experience of work demands that have a social component, e.g., conflict between two people; Hauke, Flintrop, Brun, & Rugulies, 2011 ), hindrance stressor (i.e., a stressor that prevents goal attainment; Cavanaugh, Boswell, Roehling, & Boudreau, 2000 ), and challenge stressor (i.e., a stressor that is difficult, but attainable and possibly rewarding to attain; Cavanaugh et al., 2000 ).

Stress in the workplace continues to be a highly pervasive problem, having both direct negative effects on individuals experiencing it and companies paying for it, and indirect costs vis à vis lost productivity (Dopkeen & DuBois, 2014 ). For example, U.K. public civil servants’ work-related stress rose from 10.8% in 2006 to 22.4% in 2013 and about one-third of the workforce has taken more than 20 days of leave due to stress-related ill-health, while well over 50% are present at work when ill (French, 2015 ). These findings are consistent with a report by the International Labor Organization (ILO, 2012 ), whereby 50% to 60% of all workdays are lost due to absence attributed to factors associated with work stress.

The prevalence of work-related stress is not diminishing despite improvements in technology and employment rates. The sources of stress, such as workload, seem to exacerbate with improvements in technology (Coovert & Thompson, 2003 ). Moreover, accessibility through mobile technology and virtual computer terminals is linking people to their work more than ever before (ILO, 2012 ; Tarafdar, Tu, Ragu-Nathan, & Ragu-Nathan, 2007 ). Evidence of this kind of mobility and flexibility is further reinforced in a June 2007 survey of 4,025 email users (over 13 years of age); AOL reported that four in ten survey respondents reported planning their vacations around email accessibility and 83% checked their emails at least once a day while away (McMahon, 2007 ). Ironically, despite these mounting work-related stressors and clear financial and performance outcomes, some individuals are reporting they are less “stressed,” but only because “stress has become the new normal” (Jayson, 2012 , para. 4).

This new normal is likely the source of psychological and physiological illness. Siegrist ( 2010 ) contends that conditions in the workplace, particularly psychosocial stressors that are perceived as unfavorable relationships with others and self, and an increasingly sedentary lifestyle (reinforced with desk jobs) are increasingly contributing to cardiovascular disease. These factors together justify a need to continue on the path of helping individuals recognize and cope with deleterious stressors in the work environment and, equally important, to find ways to help organizations prevent harmful stressors over which they have control, as well as implement policies or mechanisms to help employees deal with these stressors and subsequent strains. Along with a greater focus on mitigating environmental constraints are interventions that can be used to prevent anxiety, poor attitudes toward the workplace conditions and arrangements, and subsequent cardiovascular illness, absenteeism, and poor job performance (Siegrist, 2010 ).

Even the ILO has presented guidance on how the workplace can help prevent harmful job stressors (aka hindrance stressors) or at least help workers cope with them. Consistent with the view that well-being is not the absence of stressors or strains and with the view that positive psychology offers a lens for proactively preventing stressors, the ILO promotes increasing preventative risk assessments, interventions to prevent and control stressors, transparent organizational communication, worker involvement in decision-making, networks and mechanisms for workplace social support, awareness of how working and living conditions interact, safety, health, and well-being in the organization (ILO, n.d. ). The field of industrial and organizational (IO) psychology supports the ILO’s recommendations.

IO psychology views work stress as the process of a person’s interaction with multiple aspects of the work environment, job design, and work conditions in the organization. Interventions to manage work stress, therefore, focus on the psychosocial factors of the person and his or her relationships with others and the socio-technical factors related to the work environment and work processes. Viewing work stress from the lens of the person and the environment stems from Kurt Lewin’s ( 1936 ) work that stipulates a person’s state of mental health and behaviors are a function of the person within a specific environment or situation. Aspects of the work environment that affect individuals’ mental states and behaviors include organizational hierarchy, organizational climate (including processes, policies, practices, and reward structures), resources to support a person’s ability to fulfill job duties, and management structure (including leadership). Job design refers to each contributor’s tasks and responsibilities for fulfilling goals associated with the work role. Finally, working conditions refers not only to the physical environment, but also the interpersonal relationships with other contributors.

Each of the conditions that are identified in the work environment may be perceived as potentially harmful or a threat to the person or as an opportunity. When a stressor is perceived as a threat to attaining desired goals or outcomes, the stressor may be labeled as a hindrance stressor (e.g., LePine, Podsakoff, & Lepine, 2005 ). When the stressor is perceived as an opportunity to attain a desired goal or end state, it may be labeled as a challenge stressor. According to LePine and colleagues’ ( 2005 ), both challenge (e.g., time urgency, workload) and hindrance (e.g., hassles, role ambiguity, role conflict) stressors could lead to strains (as measured by “anxiety, depersonalization, depression, emotional exhaustion, frustration, health complaints, hostility, illness, physical symptoms, and tension” [p. 767]). However, challenge stressors positively relate with motivation and performance, whereas hindrance stressors negatively relate with motivation and performance. Moreover, motivation and strains partially mediate the relationship between hindrance and challenge stressors with performance.

Figure 1. Organizational development frameworks to guide identification of work stress and interventions.

In order to (1) minimize any potential negative effects from stressors, (2) increase coping skills to deal with stressors, or (3) manage strains, organizational practitioners or consultants will devise organizational interventions geared toward prevention, coping, and/or stress management. Ultimately, toxic factors in the work environment can have deleterious effects on a person’s physical and psychological well-being, as well as on an organization’s total health. It behooves management to take stock of the organization’s health, which includes the health and well-being of its employees, if the organization wishes to thrive and be profitable. According to Page and Vella-Brodrick’s ( 2009 ) model of employee well-being, employee well-being results from subjective well-being (i.e., life satisfaction and general positive or negative affect), workplace well-being (composed of job satisfaction and work-specific positive or negative affect), and psychological well-being (e.g., self-acceptance, positive social relations, mastery, purpose in life). Job stressors that become unbearable are likely to negatively affect workplace well-being and thus overall employee well-being. Because work stress is a major organizational pain point and organizations often employ organizational consultants to help identify and remediate pain points, the focus here is on organizational development (OD) frameworks; several work stress frameworks are presented that together signal areas where organizations might focus efforts for change in employee behaviors, attitudes, and performance, as well as the organization’s performance and climate. Work stress, interventions, and several OD and stress frameworks are depicted in Figure 1 .

The goals are: (1) to conceptually define and clarify terms associated with stress and stress management, particularly focusing on organizational factors that contribute to stress and stress management, and (2) to present research that informs current knowledge and practices on workplace stress management strategies. Stressors and strains will be defined, leading OD and work stress frameworks that are used to organize and help organizations make sense of the work environment and the organization’s responsibility in stress management will be explored, and stress management will be explained as an overarching thematic label; an area of study and practice that focuses on prevention (primary) interventions, coping (secondary) interventions, and managing strains (tertiary) interventions; as well as the label typically used to denote tertiary interventions. Suggestions for future research and implications toward becoming a healthy organization are presented.

Defining Stressors and Strains

Work-related stressors or job stressors can lead to different kinds of strains individuals and organizations might experience. Various types of stress management interventions, guided by OD and work stress frameworks, may be employed to prevent or cope with job stressors and manage strains that develop(ed).

A job stressor is a stimulus external to an employee and a result of an employee’s work conditions. Example job stressors include organizational constraints, workplace mistreatments (such as abusive supervision, workplace ostracism, incivility, bullying), role stressors, workload, work-family conflicts, errors or mistakes, examinations and evaluations, and lack of structure (Jex & Beehr, 1991 ; Liu, Spector, & Shi, 2007 ; Narayanan, Menon, & Spector, 1999 ). Although stressors may be categorized as hindrances and challenges, there is not yet sufficient information to be able to propose which stress management interventions would better serve to reduce those hindrance stressors or to reduce strain-producing challenge stressors while reinforcing engagement-producing challenge stressors.

Organizational Constraints

Organizational constraints may be hindrance stressors as they prevent employees from translating their motivation and ability into high-level job performance (Peters & O’Connor, 1980 ). Peters and O’Connor ( 1988 ) defined 11 categories of organizational constraints: (1) job-related information, (2) budgetary support, (3) required support, (4) materials and supplies, (5) required services and help from others, (6) task preparation, (7) time availability, (8) the work environment, (9) scheduling of activities, (10) transportation, and (11) job-relevant authority. The inhibiting effect of organizational constraints may be due to the lack of, inadequacy of, or poor quality of these categories.

Workplace Mistreatment

Workplace mistreatment presents a cluster of interpersonal variables, such as interpersonal conflict, bullying, incivility, and workplace ostracism (Hershcovis, 2011 ; Tepper & Henle, 2011 ). Typical workplace mistreatment behaviors include gossiping, rude comments, showing favoritism, yelling, lying, and ignoring other people at work (Tepper & Henle, 2011 ). These variables relate to employees’ psychological well-being, physical well-being, work attitudes (e.g., job satisfaction and organizational commitment), and turnover intention (e.g., Hershcovis, 2011 ; Spector & Jex, 1998 ). Some researchers differentiated the source of mistreatment, such as mistreatment from one’s supervisor versus mistreatment from one’s coworker (e.g., Bruk-Lee & Spector, 2006 ; Frone, 2000 ; Liu, Liu, Spector, & Shi, 2011 ).

Role Stressors

Role stressors are demands, constraints, or opportunities a person perceives to be associated, and thus expected, with his or her work role(s) across various situations. Three commonly studied role stressors are role ambiguity, role conflict, and role overload (Glazer & Beehr, 2005 ; Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ). Role ambiguity in the workplace occurs when an employee lacks clarity regarding what performance-related behaviors are expected of him or her. Role conflict refers to situations wherein an employee receives incompatible role requests from the same or different supervisors or the employee is asked to engage in work that impedes his or her performance in other work or nonwork roles or clashes with his or her values. Role overload refers to excessive demands and insufficient time (quantitative) or knowledge (qualitative) to complete the work. The construct is often used interchangeably with workload, though role overload focuses more on perceived expectations from others about one’s workload. These role stressors significantly relate to low job satisfaction, low organizational commitment, low job performance, high tension or anxiety, and high turnover intention (Abramis, 1994 ; Glazer & Beehr, 2005 ; Jackson & Schuler, 1985 ).

Excessive workload is one of the most salient stressors at work (e.g., Liu et al., 2007 ). There are two types of workload: quantitative and qualitative workload (LaRocco, Tetrick, & Meder, 1989 ; Parasuraman & Purohit, 2000 ). Quantitative workload refers to the excessive amount of work one has. In a summary of a Chartered Institute of Personnel & Development Report from 2006 , Dewe and Kompier ( 2008 ) noted that quantitative workload was one of the top three stressors workers experienced at work. Qualitative workload refers to the difficulty of work. Workload also differs by the type of the load. There are mental workload and physical workload (Dwyer & Ganster, 1991 ). Excessive physical workload may result in physical discomfort or illness. Excessive mental workload will cause psychological distress such as anxiety or frustration (Bowling & Kirkendall, 2012 ). Another factor affecting quantitative workload is interruptions (during the workday). Lin, Kain, and Fritz ( 2013 ) found that interruptions delay completion of job tasks, thus adding to the perception of workload.

Work-Family Conflict

Work-family conflict is a form of inter-role conflict in which demands from one’s work domain and one’s family domain are incompatible to some extent (Greenhaus & Beutell, 1985 ). Work can interfere with family (WIF) and/or family can interfere with work (FIW) due to time-related commitments to participating in one domain or another, incompatible behavioral expectations, or when strains in one domain carry over to the other (Greenhaus & Beutell, 1985 ). Work-family conflict significantly relates to work-related outcomes (e.g., job satisfaction, organizational commitment, turnover intention, burnout, absenteeism, job performance, job strains, career satisfaction, and organizational citizenship behaviors), family-related outcomes (e.g., marital satisfaction, family satisfaction, family-related performance, family-related strains), and domain-unspecific outcomes (e.g., life satisfaction, psychological strain, somatic or physical symptoms, depression, substance use or abuse, and anxiety; Amstad, Meier, Fasel, Elfering, & Semmer, 2011 ).

Individuals and organizations can experience work-related strains. Sometimes organizations will experience strains through the employee’s negative attitudes or strains, such as that a worker’s absence might yield lower production rates, which would roll up into an organizational metric of organizational performance. In the industrial and organizational (IO) psychology literature, organizational strains are mostly observed as macro-level indicators, such as health insurance costs, accident-free days, and pervasive problems with company morale. In contrast, individual strains, usually referred to as job strains, are internal to an employee. They are responses to work conditions and relate to health and well-being of employees. In other words, “job strains are adverse reactions employees have to job stressors” (Spector, Chen, & O’Connell, 2000 , p. 211). Job strains tend to fall into three categories: behavioral, physical, and psychological (Jex & Beehr, 1991 ).

Behavioral strains consist of actions that employees take in response to job stressors. Examples of behavioral strains include employees drinking alcohol in the workplace or intentionally calling in sick when they are not ill (Spector et al., 2000 ). Physical strains consist of health symptoms that are physiological in nature that employees contract in response to job stressors. Headaches and ulcers are examples of physical strains. Lastly, psychological strains are emotional reactions and attitudes that employees have in response to job stressors. Examples of psychological strains are job dissatisfaction, anxiety, and frustration (Spector et al., 2000 ). Interestingly, research studies that utilize self-report measures find that most job strains experienced by employees tend to be psychological strains (Spector et al., 2000 ).

Leading Frameworks

Organizations that are keen on identifying organizational pain points and remedying them through organizational campaigns or initiatives often discover the pain points are rooted in work-related stressors and strains and the initiatives have to focus on reducing workers’ stress and increasing a company’s profitability. Through organizational climate surveys, for example, companies discover that aspects of the organization’s environment, including its policies, practices, reward structures, procedures, and processes, as well as employees at all levels of the company, are contributing to the individual and organizational stress. Recent studies have even begun to examine team climates for eustress and distress assessed in terms of team members’ homogenous psychological experience of vigor, efficacy, dedication, and cynicism (e.g., Kożusznik, Rodriguez, & Peiro, 2015 ).

Each of the frameworks presented advances different aspects that need to be identified in order to understand the source and potential remedy for stressors and strains. In some models, the focus is on resources, in others on the interaction of the person and environment, and in still others on the role of the person in the workplace. Few frameworks directly examine the role of the organization, but the organization could use these frameworks to plan interventions that would minimize stressors, cope with existing stressors, and prevent and/or manage strains. One of the leading frameworks in work stress research that is used to guide organizational interventions is the person and environment (P-E) fit (French & Caplan, 1972 ). Its precursor is the University of Michigan Institute for Social Research’s (ISR) role stress model (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ) and Lewin’s Field Theory. Several other theories have since evolved from the P-E fit framework, including Karasek and Theorell’s ( 1990 ), Karasek ( 1979 ) Job Demands-Control Model (JD-C), the transactional framework (Lazarus & Folkman, 1984 ), Conservation of Resources (COR) theory (Hobfoll, 1989 ), and Siegrist’s ( 1996 ) Effort-Reward Imbalance (ERI) Model.

Field Theory

The premise of Kahn et al.’s ( 1964 ) role stress theory is Lewin’s ( 1997 ) Field Theory. Lewin purported that behavior and mental events are a dynamic function of the whole person, including a person’s beliefs, values, abilities, needs, thoughts, and feelings, within a given situation (field or environment), as well as the way a person represents his or her understanding of the field and behaves in that space. Lewin explains that work-related strains are a result of individuals’ subjective perceptions of objective factors, such as work roles, relationships with others in the workplace, as well as personality indicators, and can be used to predict people’s reactions, including illness. Thus, to make changes to an organizational system, it is necessary to understand a field and try to move that field from the current state to the desired state. Making this move necessitates identifying mechanisms influencing individuals.

Role Stress Theory

Role stress theory mostly isolates the perspective a person has about his or her work-related responsibilities and expectations to determine how those perceptions relate with a person’s work-related strains. However, those relationships have been met with somewhat varied results, which Glazer and Beehr ( 2005 ) concluded might be a function of differences in culture, an environmental factor often neglected in research. Kahn et al.’s ( 1964 ) role stress theory, coupled with Lewin’s ( 1936 ) Field Theory, serves as the foundation for the P-E fit theory. Lewin ( 1936 ) wrote, “Every psychological event depends upon the state of the person and at the same time on the environment” (p. 12). Researchers of IO psychology have narrowed the environment to the organization or work team. This narrowed view of the organizational environment is evident in French and Caplan’s ( 1972 ) P-E fit framework.

Person-Environment Fit Theory

The P-E fit framework focuses on the extent to which there is congruence between the person and a given environment, such as the organization (Caplan, 1987 ; Edwards, 2008 ). For example, does the person have the necessary skills and abilities to fulfill an organization’s demands, or does the environment support a person’s desire for autonomy (i.e., do the values align?) or fulfill a person’s needs (i.e., a person’s needs are rewarded). Theoretically and empirically, the greater the person-organization fit, the greater a person’s job satisfaction and organizational commitment, the less a person’s turnover intention and work-related stress (see meta-analyses by Assouline & Meir, 1987 ; Kristof-Brown, Zimmerman, & Johnson, 2005 ; Verquer, Beehr, & Wagner, 2003 ).

Job Demands-Control/Support (JD-C/S) and Job Demands-Resources (JD-R) Model

Focusing more closely on concrete aspects of work demands and the extent to which a person perceives he or she has control or decision latitude over those demands, Karasek ( 1979 ) developed the JD-C model. Karasek and Theorell ( 1990 ) posited that high job demands under conditions of little decision latitude or control yield high strains, which have varied implications on the health of an organization (e.g., in terms of high turnover, employee ill-health, poor organizational performance). This theory was modified slightly to address not only control, but also other resources that could protect a person from unruly job demands, including support (aka JD-C/S, Johnson & Hall, 1988 ; and JD-R, Bakker, van Veldhoven, & Xanthopoulou, 2010 ). Whether focusing on control or resources, both they and job demands are said to reflect workplace characteristics, while control and resources also represent coping strategies or tools (Siegrist, 2010 ).

Despite the glut of research testing the JD-C and JD-R, results are somewhat mixed. Testing the interaction between job demands and control, Beehr, Glaser, Canali, and Wallwey ( 2001 ) did not find empirical support for the JD-C theory. However, Dawson, O’Brien, and Beehr ( 2016 ) found that high control and high support buffered against the independent deleterious effects of interpersonal conflict, role conflict, and organizational politics (demands that were categorized as hindrance stressors) on anxiety, as well as the effects of interpersonal conflict and organizational politics on physiological symptoms, but control and support did not moderate the effects between challenge stressors and strains. Coupled with Bakker, Demerouti, and Sanz-Vergel’s ( 2014 ) note that excessive job demands are a source of strain, but increased job resources are a source of engagement, Dawson et al.’s results suggest that when an organization identifies that demands are hindrances, it can create strategies for primary (preventative) stress management interventions and attempt to remove or reduce such work demands. If the demands are challenging, though manageable, but latitude to control the challenging stressors and support are insufficient, the organization could modify practices and train employees on adopting better strategies for meeting or coping (secondary stress management intervention) with the demands. Finally, if the organization can neither afford to modify the demands or the level of control and support, it will be necessary for the organization to develop stress management (tertiary) interventions to deal with the inevitable strains.

Conservation of Resources Theory

The idea that job resources reinforce engagement in work has been propagated in Hobfoll’s ( 1989 ) Conservation of Resources (COR) theory. COR theory also draws on the foundational premise that people’s mental health is a function of the person and the environment, forwarding that how people interpret their environment (including the societal context) affects their stress levels. Hobfoll focuses on resources such as objects, personal characteristics, conditions, or energies as particularly instrumental to minimizing strains. He asserts that people do whatever they can to protect their valued resources. Thus, strains develop when resources are threatened to be taken away, actually taken away, or when additional resources are not attainable after investing in the possibility of gaining more resources (Hobfoll, 2001 ). By extension, organizations can invest in activities that would minimize resource loss and create opportunities for resource gains and thus have direct implications for devising primary and secondary stress management interventions.

Transactional Framework

Lazarus and Folkman ( 1984 ) developed the widely studied transactional framework of stress. This framework holds as a key component the cognitive appraisal process. When individuals perceive factors in the work environment as a threat (i.e., primary appraisal), they will scan the available resources (external or internal to himself or herself) to cope with the stressors (i.e., secondary appraisal). If the coping resources provide minimal relief, strains develop. Until recently, little attention has been given to the cognitive appraisal associated with different work stressors (Dewe & Kompier, 2008 ; Liu & Li, 2017 ). In a study of Polish and Spanish social care service providers, stressors appraised as a threat related positively to burnout and less engagement, but stressors perceived as challenges yielded greater engagement and less burnout (Kożusznik, Rodriguez, & Peiro, 2012 ). Similarly, Dawson et al. ( 2016 ) found that even with support and control resources, hindrance demands were more strain-producing than challenge demands, suggesting that appraisal of the stressor is important. In fact, “many people respond well to challenging work” (Beehr et al., 2001 , p. 126). Kożusznik et al. ( 2012 ) recommend training employees to change the way they view work demands in order to increase engagement, considering that part of the problem may be about how the person appraises his or her environment and, thus, copes with the stressors.

Effort-Reward Imbalance

Siegrist’s ( 1996 ) Model of Effort-Reward Imbalance (ERI) focuses on the notion of social reciprocity, such that a person fulfills required work tasks in exchange for desired rewards (Siegrist, 2010 ). ERI sheds light on how an imbalance in a person’s expectations of an organization’s rewards (e.g., pay, bonus, sense of advancement and development, job security) in exchange for a person’s efforts, that is a break in one’s work contract, leads to negative responses, including long-term ill-health (Siegrist, 2010 ; Siegrist et al., 2014 ). In fact, prolonged perception of a work contract imbalance leads to adverse health, including immunological problems and inflammation, which contribute to cardiovascular disease (Siegrist, 2010 ). The model resembles the relational and interactional psychological contract theory in that it describes an employee’s perception of the terms of the relationship between the person and the workplace, including expectations of performance, job security, training and development opportunities, career progression, salary, and bonuses (Thomas, Au, & Ravlin, 2003 ). The psychological contract, like the ERI model, focuses on social exchange. Furthermore, the psychological contract, like stress theories, are influenced by cultural factors that shape how people interpret their environments (Glazer, 2008 ; Thomas et al., 2003 ). Violations of the psychological contract will negatively affect a person’s attitudes toward the workplace and subsequent health and well-being (Siegrist, 2010 ). To remediate strain, Siegrist ( 2010 ) focuses on both the person and the environment, recognizing that the organization is particularly responsible for changing unfavorable work conditions and the person is responsible for modifying his or her reactions to such conditions.

Stress Management Interventions: Primary, Secondary, and Tertiary

Remediation of work stress and organizational development interventions are about realigning the employee’s experiences in the workplace with factors in the environment, as well as closing the gap between the current environment and the desired environment. Work stress develops when an employee perceives the work demands to exceed the person’s resources to cope and thus threatens employee well-being (Dewe & Kompier, 2008 ). Likewise, an organization’s need to change arises when forces in the environment are creating a need to change in order to survive (see Figure 1 ). Lewin’s ( 1951 ) Force Field Analysis, the foundations of which are in Field Theory, is one of the first organizational development intervention tools presented in the social science literature. The concept behind Force Field Analysis is that in order to survive, organizations must adapt to environmental forces driving a need for organizational change and remove restraining forces that create obstacles to organizational change. In order to do this, management needs to delineate the current field in which the organization is functioning, understand the driving forces for change, identify and dampen or eliminate the restraining forces against change. Several models for analyses may be applied, but most approaches are variations of organizational climate surveys.

Through organizational surveys, workers provide management with a snapshot view of how they perceive aspects of their work environment. Thus, the view of the health of an organization is a function of several factors, chief among them employees’ views (i.e., the climate) about the workplace (Lewin, 1951 ). Indeed, French and Kahn ( 1962 ) posited that well-being depends on the extent to which properties of the person and properties of the environment align in terms of what a person requires and the resources available in a given environment. Therefore, only when properties of the person and properties of the environment are sufficiently understood can plans for change be developed and implemented targeting the environment (e.g., change reporting structures to relieve, and thus prevent future, communication stressors) and/or the person (e.g., providing more autonomy, vacation days, training on new technology). In short, climate survey findings can guide consultants about the emphasis for organizational interventions: before a problem arises aka stress prevention, e.g., carefully crafting job roles), when a problem is present, but steps are taken to mitigate their consequences (aka coping, e.g., providing social support groups), and/or once strains develop (aka. stress management, e.g., healthcare management policies).

For each of the primary (prevention), secondary (coping), and tertiary (stress management) techniques the target for intervention can be the entire workforce, a subset of the workforce, or a specific person. Interventions that target the entire workforce may be considered organizational interventions, as they have direct implications on the health of all individuals and consequently the health of the organization. Several interventions categorized as primary and secondary interventions may also be implemented after strains have developed and after it has been discerned that a person or the organization did not do enough to mitigate stressors or strains (see Figure 1 ). The designation of many of the interventions as belonging to one category or another may be viewed as merely a suggestion.

Primary Interventions (Preventative Stress Management)

Before individuals begin to perceive work-related stressors, organizations engage in stress prevention strategies, such as providing people with resources (e.g., computers, printers, desk space, information about the job role, organizational reporting structures) to do their jobs. However, sometimes the institutional structures and resources are insufficient or ambiguous. Scholars and practitioners have identified several preventative stress management strategies that may be implemented.

Planning and Time Management

When employees feel quantitatively overloaded, sometimes the remedy is improving the employees’ abilities to plan and manage their time (Quick, Quick, Nelson, & Hurrell, 2003 ). Planning is a future-oriented activity that focuses on conceptual and comprehensive work goals. Time management is a behavior that focuses on organizing, prioritizing, and scheduling work activities to achieve short-term goals. Given the purpose of time management, it is considered a primary intervention, as engaging in time management helps to prevent work tasks from mounting and becoming unmanageable, which would subsequently lead to adverse outcomes. Time management comprises three fundamental components: (1) establishing goals, (2) identifying and prioritizing tasks to fulfill the goals, and (3) scheduling and monitoring progress toward goal achievement (Peeters & Rutte, 2005 ). Workers who employ time management have less role ambiguity (Macan, Shahani, Dipboye, & Philips, 1990 ), psychological stress or strain (Adams & Jex, 1999 ; Jex & Elaqua, 1999 ; Macan et al., 1990 ), and greater job satisfaction (Macan, 1994 ). However, Macan ( 1994 ) did not find a relationship between time management and performance. Still, Claessens, van Eerde, Rutte, and Roe ( 2004 ) found that perceived control of time partially mediated the relationships between planning behavior (an indicator of time management), job autonomy, and workload on one hand, and job strains, job satisfaction, and job performance on the other hand. Moreover, Peeters and Rutte ( 2005 ) observed that teachers with high work demands and low autonomy experienced more burnout when they had poor time management skills.

Person-Organization Fit

Just as it is important for organizations to find the right person for the job and organization, so is it the responsibility of a person to choose to work at the right organization—an organization that fulfills the person’s needs and upholds the values important to the individual, as much as the person fulfills the organization’s needs and adapts to its values. When people fit their employing organizations they are setting themselves up for experiencing less strain-producing stressors (Kristof-Brown et al., 2005 ). In a meta-analysis of 62 person-job fit studies and 110 person-organization fit studies, Kristof-Brown et al. ( 2005 ) found that person-job fit had a negative correlation with indicators of job strain. In fact, a primary intervention of career counseling can help to reduce stress levels (Firth-Cozens, 2003 ).

Job Redesign

The Job Demands-Control/Support (JD-C/S), Job Demands-Resources (JD-R), and transactional models all suggest that factors in the work context require modifications in order to reduce potential ill-health and poor organizational performance. Drawing on Hackman and Oldham’s ( 1980 ) Job Characteristics Model, it is possible to assess with the Job Diagnostics Survey (JDS) the current state of work characteristics related to skill variety, task identity, task significance, autonomy, and feedback. Modifying those aspects would help create a sense of meaningfulness, sense of responsibility, and feeling of knowing how one is performing, which subsequently affects a person’s well-being as identified in assessments of motivation, satisfaction, improved performance, and reduced withdrawal intentions and behaviors. Extending this argument to the stress models, it can be deduced that reducing uncertainty or perceived unfairness that may be associated with a person’s perception of these work characteristics, as well as making changes to physical characteristics of the environment (e.g., lighting, seating, desk, air quality), nature of work (e.g., job responsibilities, roles, decision-making latitude), and organizational arrangements (e.g., reporting structure and feedback mechanisms), can help mitigate against numerous ill-health consequences and reduced organizational performance. In fact, Fried et al. ( 2013 ) showed that healthy patients of a medical clinic whose jobs were excessively low (i.e., monotonous) or excessively high (i.e., overstimulating) on job enrichment (as measured by the JDS) had greater abdominal obesity than those whose jobs were optimally enriched. By taking stock of employees’ perceptions of the current work situation, managers might think about ways to enhance employees’ coping toolkit, such as training on how to deal with difficult clients or creating stimulating opportunities when jobs have low levels of enrichment.

Participatory Action Research Interventions

Participatory action research (PAR) is an intervention wherein, through group discussions, employees help to identify and define problems in organizational structure, processes, policies, practices, and reward structures, as well as help to design, implement, and evaluate success of solutions. PAR is in itself an intervention, but its goal is to design interventions to eliminate or reduce work-related factors that are impeding performance and causing people to be unwell. An example of a successful primary intervention, utilizing principles of PAR and driven by the JD-C and JD-C/S stress frameworks is Health Circles (HCs; Aust & Ducki, 2004 ).

HCs, developed in Germany in the 1980s, were popular practices in industries, such as metal, steel, and chemical, and service. Similar to other problem-solving practices, such as quality circles, HCs were based on the assumptions that employees are the experts of their jobs. For this reason, to promote employee well-being, management and administrators solicited suggestions and ideas from the employees to improve occupational health, thereby increasing employees’ job control. HCs also promoted communication between managers and employees, which had a potential to increase social support. With more control and support, employees would experience less strains and better occupational well-being.

Employing the three-steps of (1) problem analysis (i.e., diagnosis or discovery through data generated from organizational records of absenteeism length, frequency, rate, and reason and employee survey), (2) HC meetings (6 to 10 meetings held over several months to brainstorm ideas to improve occupational safety and health concerns identified in the discovery phase), and (3) HC evaluation (to determine if desired changes were accomplished and if employees’ reports of stressors and strains changed after the course of 15 months), improvements were to be expected (Aust & Ducki, 2004 ). Aust and Ducki ( 2004 ) reviewed 11 studies presenting 81 health circles in 30 different organizations. Overall study participants had high satisfaction with the HCs practices. Most companies acted upon employees’ suggestions (e.g., improving driver’s seat and cab, reducing ticket sale during drive, team restructuring and job rotation to facilitate communication, hiring more employees during summer time, and supervisor training program to improve leadership and communication skills) to improve work conditions. Thus, HCs represent a successful theory-grounded intervention to routinely improve employees’ occupational health.

Physical Setting

The physical environment or physical workspace has an enormous impact on individuals’ well-being, attitudes, and interactions with others, as well as on the implications on innovation and well-being (Oksanen & Ståhle, 2013 ; Vischer, 2007 ). In a study of 74 new product development teams (total of 437 study respondents) in Western Europe, Chong, van Eerde, Rutte, and Chai ( 2012 ) found that when teams were faced with challenge time pressures, meaning the teams had a strong interest and desire in tackling complex, but engaging tasks, when they were working proximally close with one another, team communication improved. Chong et al. assert that their finding aligns with prior studies that have shown that physical proximity promotes increased awareness of other team members, greater tendency to initiate conversations, and greater team identification. However, they also found that when faced with hindrance time pressures, physical proximity related to low levels of team communication, but when hindrance time pressure was low, team proximity had an increasingly greater positive relationship with team communication.

In addition to considering the type of work demand teams must address, other physical workspace considerations include whether people need to work collaboratively and synchronously or independently and remotely (or a combination thereof). Consideration needs to be given to how company contributors would satisfy client needs through various modes of communication, such as email vs. telephone, and whether individuals who work by a window might need shading to block bright sunlight from glaring on their computer screens. Finally, people who have to use the telephone for extensive periods of time would benefit from earphones to prevent neck strains. Most physical stressors are rather simple to rectify. However, companies are often not aware of a problem until after a problem arises, such as when a person’s back is strained from trying to move heavy equipment. Companies then implement strategies to remediate the environmental stressor. With the help of human factors, and organizational and office design consultants, many of the physical barriers to optimal performance can be prevented (Rousseau & Aubé, 2010 ). In a study of 215 French-speaking Canadian healthcare employees, Rousseau and Aubé ( 2010 ) found that although supervisor instrumental support positively related with affective commitment to the organization, the relationship was even stronger for those who reported satisfaction with the ambient environment (i.e., temperature, lighting, sound, ventilation, and cleanliness).

Secondary Interventions (Coping)

Secondary interventions, also referred to as coping, focus on resources people can use to mitigate the risk of work-related illness or workplace injury. Resources may include properties related to social resources, behaviors, and cognitive structures. Each of these resource domains may be employed to cope with stressors. Monat and Lazarus ( 1991 ) summarize the definition of coping as “an individual’s efforts to master demands (or conditions of harm, threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources” (p. 5). To master demands requires use of the aforementioned resources. Secondary interventions help employees become aware of the psychological, physical, and behavioral responses that may occur from the stressors presented in their working environment. Secondary interventions help a person detect and attend to stressors and identify resources for and ways of mitigating job strains. Often, coping strategies are learned skills that have a cognitive foundation and serve important functions in improving people’s management of stressors (Lazarus & Folkman, 1991 ). Coping is effortful, but with practice it becomes easier to employ. This idea is the foundation for understanding the role of resilience in coping with stressors. However, “not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in relating to the environment” (Lazarus & Folkman, 1991 , p. 198). Furthermore, sometimes to cope with a stressor, a person may call upon social support sources to help with tangible materials or emotional comfort. People call upon support resources because they help to restructure how a person approaches or thinks about the stressor.

Most secondary interventions are aimed at helping the individual, though companies, as a policy, might require all employees to partake in training aimed at increasing employees’ awareness of and skills aimed at handling difficult situations vis à vis company channels (e.g., reporting on sexual harassment or discrimination). Furthermore, organizations might institute mentoring programs or work groups to address various work-related matters. These programs employ awareness-raising activities, stress-education, or skills training (cf., Bhagat, Segovis, & Nelson, 2012 ), which include development of skills in problem-solving, understanding emotion-focused coping, identifying and using social support, and enhancing capacity for resilience. The aim of these programs, therefore, is to help employees proactively review their perceptions of psychological, physical, and behavioral job-related strains, thereby extending their resilience, enabling them to form a personal plan to control stressors and practice coping skills (Cooper, Dewe, & O’Driscoll, 2011 ).

Often these stress management programs are instituted after an organization has observed excessive absenteeism and work-related performance problems and, therefore, are sometimes categorized as a tertiary stress management intervention or even a primary (prevention) intervention. However, the skills developed for coping with stressors also place the programs in secondary stress management interventions. Example programs that are categorized as tertiary or primary stress management interventions may also be secondary stress management interventions (see Figure 1 ), and these include lifestyle advice and planning, stress inoculation training, simple relaxation techniques, meditation, basic trainings in time management, anger management, problem-solving skills, and cognitive-behavioral therapy. Corporate wellness programs also fall under this category. In other words, some programs could be categorized as primary, secondary, or tertiary interventions depending upon when the employee (or organization) identifies the need to implement the program. For example, time management practices could be implemented as a means of preventing some stressors, as a way to cope with mounting stressors, or as a strategy to mitigate symptoms of excessive of stressors. Furthermore, these programs can be administered at the individual level or group level. As related to secondary interventions, these programs provide participants with opportunities to develop and practice skills to cognitively reappraise the stressor(s); to modify their perspectives about stressors; to take time out to breathe, stretch, meditate, relax, and/or exercise in an attempt to support better decision-making; to articulate concerns and call upon support resources; and to know how to say “no” to onslaughts of requests to complete tasks. Participants also learn how to proactively identify coping resources and solve problems.

According to Cooper, Dewe, and O’Driscoll ( 2001 ), secondary interventions are successful in helping employees modify or strengthen their ability to cope with the experience of stressors with the goal of mitigating the potential harm the job stressors may create. Secondary interventions focus on individuals’ transactions with the work environment and emphasize the fit between a person and his or her environment. However, researchers have pointed out that the underlying assumption of secondary interventions is that the responsibility for coping with the stressors of the environment lies within individuals (Quillian-Wolever & Wolever, 2003 ). If companies cannot prevent the stressors in the first place, then they are, in part, responsible for helping individuals develop coping strategies and informing employees about programs that would help them better cope with job stressors so that they are able to fulfill work assignments.

Stress management interventions that help people learn to cope with stressors focus mainly on the goals of enabling problem-resolution or expressing one’s emotions in a healthy manner. These goals are referred to as problem-focused coping and emotion-focused coping (Folkman & Lazarus, 1980 ; Pearlin & Schooler, 1978 ), and the person experiencing the stressors as potential threat is the agent for change and the recipient of the benefits of successful coping (Hobfoll, 1998 ). In addition to problem-focused and emotion-focused coping approaches, social support and resilience may be coping resources. There are many other sources for coping than there is room to present here (see e.g., Cartwright & Cooper, 2005 ); however, the current literature has primarily focused on these resources.

Problem-Focused Coping

Problem-focused or direct coping helps employees remove or reduce stressors in order to reduce their strain experiences (Bhagat et al., 2012 ). In problem-focused coping employees are responsible for working out a strategic plan in order to remove job stressors, such as setting up a set of goals and engaging in behaviors to meet these goals. Problem-focused coping is viewed as an adaptive response, though it can also be maladaptive if it creates more problems down the road, such as procrastinating getting work done or feigning illness to take time off from work. Adaptive problem-focused coping negatively relates to long-term job strains (Higgins & Endler, 1995 ). Discussion on problem-solving coping is framed from an adaptive perspective.

Problem-focused coping is featured as an extension of control, because engaging in problem-focused coping strategies requires a series of acts to keep job stressors under control (Bhagat et al., 2012 ). In the stress literature, there are generally two ways to categorize control: internal versus external locus of control, and primary versus secondary control. Locus of control refers to the extent to which people believe they have control over their own life (Rotter, 1966 ). People high in internal locus of control believe that they can control their own fate whereas people high in external locus of control believe that outside factors determine their life experience (Rotter, 1966 ). Generally, those with an external locus of control are less inclined to engage in problem-focused coping (Strentz & Auerbach, 1988 ). Primary control is the belief that people can directly influence their environment (Alloy & Abramson, 1979 ), and thus they are more likely to engage in problem-focused coping. However, when it is not feasible to exercise primary control, people search for secondary control, with which people try to adapt themselves into the objective environment (Rothbaum, Weisz, & Snyder, 1982 ).

Emotion-Focused Coping

Emotion-focused coping, sometimes referred to as palliative coping, helps employees reduce strains without the removal of job stressors. It involves cognitive or emotional efforts, such as talking about the stressor or distracting oneself from the stressor, in order to lessen emotional distress resulting from job stressors (Bhagat et al., 2012 ). Emotion-focused coping aims to reappraise and modify the perceptions of a situation or seek emotional support from friends or family. These methods do not include efforts to change the work situation or to remove the job stressors (Lazarus & Folkman, 1991 ). People tend to adopt emotion-focused coping strategies when they believe that little or nothing can be done to remove the threatening, harmful, and challenging stressors (Bhagat et al., 2012 ), such as when they are the only individuals to have the skills to get a project done or they are given increased responsibilities because of the unexpected departure of a colleague. Emotion-focused coping strategies include (1) reappraisal of the stressful situation, (2) talking to friends and receiving reassurance from them, (3) focusing on one’s strength rather than weakness, (4) optimistic comparison—comparing one’s situation to others’ or one’s past situation, (5) selective ignoring—paying less attention to the unpleasant aspects of one’s job and being more focused on the positive aspects of the job, (6) restrictive expectations—restricting one’s expectations on job satisfaction but paying more attention to monetary rewards, (7) avoidance coping—not thinking about the problem, leaving the situation, distracting oneself, or using alcohol or drugs (e.g., Billings & Moos, 1981 ).

Some emotion-focused coping strategies are maladaptive. For example, avoidance coping may lead to increased level of job strains in the long run (e.g., Parasuraman & Cleek, 1984 ). Furthermore, a person’s ability to cope with the imbalance of performing work to meet organizational expectations can take a toll on the person’s health, leading to physiological consequences such as cardiovascular disease, sleep disorders, gastrointestinal disorders, and diabetes (Fried et al., 2013 ; Siegrist, 2010 ; Toker, Shirom, Melamed, & Armon, 2012 ; Willert, Thulstrup, Hertz, & Bonde, 2010 ).

Comparing Coping Strategies across Cultures

Most coping research is conducted in individualistic, Western cultures wherein emotional control is emphasized and both problem-solving focused coping and primary control are preferred (Bhagat et al., 2010 ). However, in collectivistic cultures, emotion-focused coping and use of secondary control may be preferred and may not necessarily carry a negative evaluation (Bhagat et al., 2010 ). For example, African Americans are more likely to use emotion-focused coping than non–African Americans (Knight, Silverstein, McCallum, & Fox, 2000 ), and among women who experienced sexual harassment, Anglo American women were less likely to employ emotion focused coping (i.e., avoidance coping) than Turkish women and Hispanic American women, while Hispanic women used more denial than the other two groups (Wasti & Cortina, 2002 ).

Thus, whereas problem-focused coping is venerated in Western societies, emotion-focused coping may be more effective in reducing strains in collectivistic cultures, such as China, Japan, and India (Bhagat et al., 2010 ; Narayanan, Menon, & Spector, 1999 ; Selmer, 2002 ). Indeed, Swedish participants reported more problem-focused coping than did Chinese participants (Xiao, Ottosson, & Carlsson, 2013 ), American college students engaged in more problem-focused coping behaviors than did their Japanese counterparts (Ogawa, 2009 ), and Indian (vs. Canadian) students reported more emotion-focused coping, such as seeking social support and positive reappraisal (Sinha, Willson, & Watson, 2000 ). Moreover, Glazer, Stetz, and Izso ( 2004 ) found that internal locus of control was more predominant in individualistic cultures (United Kingdom and United States), whereas external locus of control was more predominant in communal cultures (Italy and Hungary). Also, internal locus of control was associated with less job stress, but more so for nurses in the United Kingdom and United States than Italy and Hungary. Taken together, adoption of coping strategies and their effectiveness differ significantly across cultures. The extent to which a coping strategy is perceived favorably and thus selected or not selected is not only a function of culture, but also a person’s sociocultural beliefs toward the coping strategy (Morimoto, Shimada, & Ozaki, 2013 ).

Social Support

Social support refers to the aid an entity gives to a person. The source of the support can be a single person, such as a supervisor, coworker, subordinate, family member, friend, or stranger, or an organization as represented by upper-level management representing organizational practices. The type of support can be instrumental or emotional. Instrumental support, including informational support, refers to that which is tangible, such as data to help someone make a decision or colleagues’ sick days so one does not lose vital pay while recovering from illness. Emotional support, including esteem support, refers to the psychological boost given to a person who needs to express emotions and feel empathy from others or to have his or her perspective validated. Beehr and Glazer ( 2001 ) present an overview of the role of social support on the stressor-strain relationship and arguments regarding the role of culture in shaping the utility of different sources and types of support.

Meaningfulness and Resilience

Meaningfulness reflects the extent to which people believe their lives are significant, purposeful, goal-directed, and fulfilling (Glazer, Kożusznik, Meyers, & Ganai, 2014 ). When faced with stressors, people who have a strong sense of meaning in life will also try to make sense of the stressors. Maintaining a positive outlook on life stressors helps to manage emotions, which is helpful in reducing strains, particularly when some stressors cannot be problem-solved (Lazarus & Folkman, 1991 ). Lazarus and Folkman ( 1991 ) emphasize that being able to reframe threatening situations can be just as important in an adaptation as efforts to control the stressors. Having a sense of meaningfulness motivates people to behave in ways that help them overcome stressors. Thus, meaningfulness is often used in the same breath as resilience, because people who are resilient are often protecting that which is meaningful.

Resilience is a personality state that can be fortified and enhanced through varied experiences. People who perceive their lives are meaningful are more likely to find ways to face adversity and are therefore more prone to intensifying their resiliency. When people demonstrate resilience to cope with noxious stressors, their ability to be resilient against other stressors strengthens because through the experience, they develop more competencies (Glazer et al., 2014 ). Thus, fitting with Hobfoll’s ( 1989 , 2001 ) COR theory, meaningfulness and resilience are psychological resources people attempt to conserve and protect, and employ when necessary for making sense of or coping with stressors.

Tertiary Interventions (Stress Management)

Stress management refers to interventions employed to treat and repair harmful repercussions of stressors that were not coped with sufficiently. As Lazarus and Folkman ( 1991 ) noted, not all stressors “are amenable to mastery” (p. 205). Stressors that are unmanageable and lead to strains require interventions to reverse or slow down those effects. Workplace interventions might focus on the person, the organization, or both. Unfortunately, instead of looking at the whole system to include the person and the workplace, most companies focus on the person. Such a focus should not be a surprise given the results of van der Klink, Blonk, Schene, and van Dijk’s ( 2001 ) meta-analysis of 48 experimental studies conducted between 1977 and 1996 . They found that of four types of tertiary interventions, the effect size for cognitive-behavioral interventions and multimodal programs (e.g., the combination of assertive training and time management) was moderate and the effect size for relaxation techniques was small in reducing psychological complaints, but not turnover intention related to work stress. However, the effects of (the five studies that used) organization-focused interventions were not significant. Similarly, Richardson and Rothstein’s ( 2008 ) meta-analytic study, including 36 experimental studies with 55 interventions, showed a larger effect size for cognitive-behavioral interventions than relaxation, organizational, multimodal, or alternative. However, like with van der Klink et al. ( 2001 ), Richardson and Rothstein ( 2008 ) cautioned that there were few organizational intervention studies included and the impact of interventions were determined on the basis of psychological outcomes and not physiological or organizational outcomes. Van der Klink et al. ( 2001 ) further expressed concern that organizational interventions target the workplace and that changes in the individual may take longer to observe than individual interventions aimed directly at the individual.

The long-term benefits of individual focused interventions are not yet clear either. Per Giga, Cooper, and Faragher ( 2003 ), the benefits of person-directed stress management programs will be short-lived if organizational factors to reduce stressors are not addressed too. Indeed, LaMontagne, Keegel, Louie, Ostry, and Landsbergis ( 2007 ), in their meta-analysis of 90 studies on stress management interventions published between 1990 and 2005 , revealed that in relation to interventions targeting organizations only, and interventions targeting individuals only, interventions targeting both organizations and individuals (i.e. the systems approach) had the most favorable positive effects on both the organizations and the individuals. Furthermore, the organization-level interventions were effective at both the individual and organization levels, but the individual-level interventions were effective only at the individual level.

Individual-Focused Stress Management

Individual-focused interventions concentrate on improving conditions for the individual, though counseling programs emphasize that the worker is in charge of reducing “stress,” whereas role-focused interventions emphasize activities that organizations can guide to actually reduce unnecessary noxious environmental factors.

Individual-Focused Stress Management: Employee Assistance Programs

When stress become sufficiently problematic (which is individually gauged or attended to by supportive others) in a worker’s life, employees may utilize the short-term counseling services or referral services Employee Assistance Programs (EAPs) provide. People who utilize the counseling services may engage in cognitive behavioral therapy aimed at changing the way people think about the stressors (e.g., as challenge opportunity over threat) and manage strains. Example topics that may be covered in these therapy sessions include time management and goal setting (prioritization), career planning and development, cognitive restructuring and mindfulness, relaxation, and anger management. In a study of healthcare workers and teachers who participated in a 2-day to 2.5-day comprehensive stress management training program (including 26 topics on identifying, coping with, and managing stressors and strains), Siu, Cooper, and Phillips ( 2013 ) found psychological and physical improvements were self-reported among the healthcare workers (for which there was no control group). However, comparing an intervention group of teachers to a control group of teachers, the extent of change was not as visible, though teachers in the intervention group engaged in more mastery recovery experiences (i.e., they purposefully chose to engage in challenging activities after work).

Individual-Focused Stress Management: Mindfulness

A popular therapy today is to train people to be more mindful, which involves helping people live in the present, reduce negative judgement of current and past experiences, and practicing patience (Birnie, Speca, & Carlson, 2010 ). Mindfulness programs usually include training on relaxation exercises, gentle yoga, and awareness of the body’s senses. In one study offered through the continuing education program at a Canadian university, 104 study participants took part in an 8-week, 90 minute per group (15–20 participants per) session mindfulness program (Birnie et al., 2010 ). In addition to body scanning, they also listened to lectures on incorporating mindfulness into one’s daily life and received a take-home booklet and compact discs that guided participants through the exercises studied in person. Two weeks after completing the program, participants’ mindfulness attendance and general positive moods increased, while physical, psychological, and behavioral strains decreased. In another study on a sample of U.K. government employees, study participants receiving three sessions of 2.5 to 3 hours each training on mindfulness, with the first two sessions occurring in consecutive weeks and the third occurring about three months later, Flaxman and Bond ( 2010 ) found that compared to the control group, the intervention group showed a decrease in distress levels from Time 1 (baseline) to Time 2 (three months after first two training sessions) and Time 1 to Time 3 (after final training session). Moreover, of the mindfulness intervention study participants who were clinically distressed, 69% experienced clinical improvement in their psychological health.

Individual-Focused Stress Management: Biofeedback/Imagery/Meditation/Deep Breathing

Biofeedback uses electronic equipment to inform users about how their body is responding to tension. With guidance from a therapist, individuals then learn to change their physiological responses so that their pulse normalizes and muscles relax (Norris, Fahrion, & Oikawa, 2007 ). The therapist’s guidance might include reminders for imagery, meditation, body scan relaxation, and deep breathing. Saunders, Driskell, Johnston, and Salas’s ( 1996 ) meta-analysis of 37 studies found that imagery helped reduce state and performance anxiety. Once people have been trained to relax, reminder triggers may be sent through smartphone push notifications (Villani et al., 2013 ).

Smartphone technology can also be used to support weight loss programs, smoking cessation programs, and medication or disease (e.g., diabetes) management compliance (Heron & Smyth, 2010 ; Kannampallil, Waicekauskas, Morrow, Kopren, & Fu, 2013 ). For example, smartphones could remind a person to take medications or test blood sugar levels or send messages about healthy behaviors and positive affirmations.

Individual-Focused Stress Management: Sleep/Rest/Respite

Workers today sleep less per night than adults did nearly 30 years ago (Luckhaupt, Tak, & Calvert, 2010 ; National Sleep Foundation, 2005 , 2013 ). In order to combat problems, such as increased anxiety and cardiovascular artery disease, associated with sleep deprivation and insufficient rest, it is imperative that people disconnect from their work at least one day per week or preferably for several weeks so that they are able to restore psychological health (Etzion, Eden, & Lapidot, 1998 ; Ragsdale, Beehr, Grebner, & Han, 2011 ). When college students engaged in relaxation-type activities, such as reading or watching television, over the weekend, they experienced less emotional exhaustion and greater general well-being than students who engaged in resources-consuming activities, such as house cleaning (Ragsdale et al., 2011 ). Additional research and future directions for research are reviewed and identified in the work of Sonnentag ( 2012 ). For example, she asks whether lack of ability to detach from work is problematic for people who find their work meaningful. In other words, are negative health consequences only among those who do not take pleasure in their work? Sonnetag also asks how teleworkers detach from their work when engaging in work from the home. Ironically, one of the ways that companies are trying to help with the challenges of high workload or increased need to be available to colleagues, clients, or vendors around the globe is by offering flexible work arrangements, whereby employees who can work from home are given the opportunity to do so. Companies that require global interactions 24-hours per day often employ this strategy, but is the solution also a source of strain (Glazer, Kożusznik, & Shargo, 2012 )?

Individual-Focused Stress Management: Role Analysis

Role analysis or role clarification aims to redefine, expressly identify, and align employees’ roles and responsibilities with their work goals. Through role negotiation, involved parties begin to develop a new formal or informal contract about expectations and define resources needed to fulfill those expectations. Glazer has used this approach in organizational consulting and, with one memorable client engagement, found that not only were the individuals whose roles required deeper re-evaluation happier at work (six months later), but so were their subordinates. Subordinates who once characterized the two partners as hostile and akin to a couple going through a bad divorce, later referred to them as a blissful pair. Schaubroeck, Ganster, Sime, and Ditman ( 1993 ) also found in a three-wave study over a two-year period that university employees’ reports of role clarity and greater satisfaction with their supervisor increased after a role clarification exercise of top managers’ roles and subordinates’ roles. However, the intervention did not have any impact on reported physical symptoms, absenteeism, or psychological well-being. Role analysis is categorized under individual-focused stress management intervention because it is usually implemented after individuals or teams begin to demonstrate poor performance and because the intervention typically focuses on a few individuals rather than an entire organization or group. In other words, the intervention treats the person’s symptoms by redefining the role so as to eliminate the stimulant causing the problem.

Organization-Focused Stress Management

At the organizational level, companies that face major declines in productivity and profitability or increased costs related to healthcare and disability might be motivated to reassess organizational factors that might be impinging on employees’ health and well-being. After all, without healthy workers, it is not possible to have a healthy organization. Companies may choose to implement practices and policies that are expected to help not only the employees, but also the organization with reduced costs associated with employee ill-health, such as medical insurance, disability payments, and unused office space. Example practices and policies that may be implemented include flexible work arrangements to ensure that employees are not on the streets in the middle of the night for work that can be done from anywhere (such as the home), diversity programs to reduce stress-induced animosity and prejudice toward others, providing only healthy food choices in cafeterias, mandating that all employees have physicals in order to receive reduced prices for insurance, company-wide closures or mandatory paid time off, and changes in organizational visioning.

Organization-Focused Stress Management: Organizational-Level Occupational Health Interventions

As with job design interventions that are implemented to remediate work characteristics that were a source of unnecessary or excessive stressors, so are organizational-level occupational health (OLOH) interventions. As with many of the interventions, its placement as a primary or tertiary stress management intervention may seem arbitrary, but when considering the goal and target of change, it is clear that the intervention is implemented in response to some ailing organizational issues that need to be reversed or stopped, and because it brings in the entire organization’s workforce to address the problems, it has been placed in this category. There are several more case studies than empirical studies on the topic of whole system organizational change efforts (see example case studies presented by the United Kingdom’s Health and Safety Executive). It is possible that lack of published empirical work is not so much due to lack of attempting to gather and evaluate the data for publication, but rather because the OLOH interventions themselves never made it to the intervention stage, the interventions failed (Biron, Gatrell, & Cooper, 2010 ), or the level of evaluation was not rigorous enough to get into empirical peer-review journals. Fortunately, case studies provide some indication of the opportunities and problems associated with OLOH interventions.

One case study regarding Cardiff and Value University Health Board revealed that through focus group meetings with members of a steering group (including high-level managers and supported by top management) and facilitated by a neutral, non-judgemental organizational health consultant, ideas for change were posted on newsprint, discussed, and areas in the organization needing change were identified. The intervention for giving voice to people who initially had little already had a positive effect on the organization, as absence decreased by 2.09% and 6.9% merely 12 and 18 months, respectively, after the intervention. Translated in financial terms, the 6.9% change was equivalent to a quarterly savings of £80,000 (Health & Safety Executive, n.d. ). Thus, focusing on the context of change and how people will be involved in the change process probably helped the organization realize improvements (Biron et al., 2010 ). In a recent and rare empirical study, employing both qualitative and quantitative data collection methods, Sørensen and Holman ( 2014 ) utilized PAR in order to plan and implement an OLOH intervention over the course of 14 months. Their study aimed to examine the effectiveness of the PAR process in reducing workers’ work-related and social or interpersonal-related stressors that derive from the workplace and improving psychological, behavioral, and physiological well-being across six Danish organizations. Based on group dialogue, 30 proposals for change were proposed, all of which could be categorized as either interventions to focus on relational factors (e.g., management feedback improvement, engagement) or work processes (e.g., reduced interruptions, workload, reinforcing creativity). Of the interventions that were implemented, results showed improvements on manager relationship quality and reduced burnout, but no changes with respect to work processes (i.e., workload and work pace) perhaps because the employees already had sufficient task control and variety. These findings support Dewe and Kompier’s ( 2008 ) position that occupational health can be reinforced through organizational policies that reinforce quality jobs and work experiences.

Organization-Focused Stress Management: Flexible Work Arrangements

Dewe and Kompier ( 2008 ), citing the work of Isles ( 2005 ), noted that concern over losing one’s job is a reason for why 40% of survey respondents indicated they work more hours than formally required. In an attempt to create balance and perceived fairness in one’s compensation for putting in extra work hours, employees will sometimes be legitimately or illegitimately absent. As companies become increasingly global, many people with desk jobs are finding themselves communicating with colleagues who are halfway around the globe and at all hours of the day or night (Glazer et al., 2012 ). To help minimize the strains associated with these stressors, companies might devise flexible work arrangements (FWA), though the type of FWA needs to be tailored to the cultural environment (Masuda et al., 2012 ). FWAs give employees some leverage to decide what would be the optimal work arrangement for them (e.g., part-time, flexible work hours, compressed work week, telecommuting). In other words, FWA provides employees with the choice of when to work, where to work (on-site or off-site), and how many hours to work in a day, week, or pay period (Kossek, Thompson, & Lautsch, 2015 ). However, not all employees of an organization have equal access to or equitable use of FWAs; workers in low-wage, hourly jobs are often beholden to being physically present during specific hours (Swanberg McKechnie, Ojha, & James, 2011 ). In a study of over 1,300 full-time hourly retail employees in the United States, Swanberg et al. ( 2011 ) showed that employees who have control over their work schedules and over their work hours were satisfied with their work schedules, perceived support from the supervisor, and work engagement.

Unfortunately, not all FWAs yield successful results for the individual or the organization. Being able to work from home or part-time can have problems too, as a person finds himself or herself working more hours from home than required. Sometimes telecommuting creates work-family conflict too as a person struggles to balance work and family obligations while working from home. Other drawbacks include reduced face-to-face contact between work colleagues and stakeholders, challenges shaping one’s career growth due to limited contact, perceived inequity if some have more flexibility than others, and ambiguity about work role processes for interacting with employees utilizing the FWA (Kossek et al., 2015 ). Organizations that institute FWAs must carefully weigh the benefits and drawbacks the flexibility may have on the employees using it or the employees affected by others using it, as well as the implications on the organization, including the vendors who are serving and clients served by the organization.

Organization-Focused Stress Management: Diversity Programs

Employees in the workplace might experience strain due to feelings of discrimination or prejudice. Organizational climates that do not promote diversity (in terms of age, religion, physical abilities, ethnicity, nationality, sex, and other characteristics) are breeding grounds for undesirable attitudes toward the workplace, lower performance, and greater turnover intention (Bergman, Palmieri, Drasgow, & Ormerod, 2012 ; Velez, Moradi, & Brewster, 2013 ). Management is thus advised to implement programs that reinforce the value and importance of diversity, as well as manage diversity to reduce conflict and feelings of prejudice. In fact, managers who attended a leadership training program reported higher multicultural competence in dealing with stressful situations (Chrobot-Mason & Leslie, 2012 ), and managers who persevered through challenges were more dedicated to coping with difficult diversity issues (Cilliers, 2011 ). Thus, diversity programs can help to reduce strains by directly reducing stressors associated with conflict linked to diversity in the workplace and by building managers’ resilience.

Organization-Focused Stress Management: Healthcare Management Policies

Over the past few years, organizations have adopted insurance plans that implement wellness programs for the sake of managing the increasing cost of healthcare that is believed to be a result of individuals’ not managing their own health, with regular check-ups and treatment. The wellness programs require all insured employees to visit a primary care provider, complete a health risk assessment, and engage in disease management activities as specified by a physician (e.g., see frequently asked questions regarding the State of Maryland’s Wellness Program). Companies believe that requiring compliance will reduce health problems, although there is no proof that such programs save money or that people would comply. One study that does, however, boast success, was a 12-week workplace health promotion program aimed at reducing Houston airport workers’ weight (Ebunlomo, Hare-Everline, Weber, & Rich, 2015 ). The program, which included 235 volunteer participants, was deemed a success, as there was a total weight loss of 345 pounds (or 1.5 lbs per person). Given such results in Houston, it is clear why some people are also skeptical over the likely success of wellness programs, particularly as there is no clear method for evaluating their efficacy (Sinnott & Vatz, 2015 ).

Moreover, for some, such a program is too paternalistic and intrusive, as well as punishes anyone who chooses not to actively participate in disease management programs (Sinnott & Vatz, 2015 ). The programs put the onus of change on the person, though it is a response to the high costs of ill-health. The programs neglect to consider the role of the organization in reducing the barriers to healthy lifestyle, such as cloaking exempt employment as simply needing to get the work done, when it usually means working significantly more hours than a standard workweek. In fact, workplace health promotion programs did not reduce presenteeism (i.e., people going to work while unwell thereby reducing their job performance) among those who suffered from physical pain (Cancelliere, Cassidy, Ammendolia, & Côte, 2011 ). However, supervisor education, worksite exercise, lifestyle intervention through email, midday respite from repetitive work, a global stress management program, changes in lighting, and telephone interventions helped to reduce presenteeism. Thus, emphasis needs to be placed on psychosocial aspects of the organization’s structure, including managers and overall organizational climate for on-site presence, that reinforces such behavior (Cancelliere et al., 2011 ). Moreover, wellness programs are only as good as the interventions to reduce work-related stressors and improve organizational resources to enable workers to improve their overall psychological and physical health.

Concluding Remarks

Future research.

One of the areas requiring more theoretical and practical attention is that of the utility of stress frameworks to guide organizational development change interventions. Although it has been proposed that the foundation for work stress management interventions is in organizational development, and even though scholars and practitioners of organization development were also founders of research programs that focused on employee health and well-being or work stress, there are few studies or other theoretical works that link the two bodies of literature.

A second area that requires additional attention is the efficacy of stress management interventions across cultures. In examining secondary stress management interventions (i.e., coping), some cross-cultural differences in findings were described; however, there is still a dearth of literature from different countries on the utility of different prevention, coping, and stress management strategies.

A third area that has been blossoming since the start of the 21st century is the topic of hindrance and challenge stressors and the implications of both on workers’ well-being and performance. More research is needed on this topic in several areas. First, there is little consistency by which researchers label a stressor as a hindrance or a challenge. Researchers sometimes take liberties with labels, but it is not the researchers who should label a stressor but the study participants themselves who should indicate if a stressor is a source of strain. Rodríguez, Kozusznik, and Peiró ( 2013 ) developed a measure in which respondents indicate whether a stressor is a challenge or a hindrance. Just as some people may perceive demands to be challenges that they savor and that result in a psychological state of eustress (Nelson & Simmons, 2003 ), others find them to be constraints that impede goal fulfillment and thus might experience distress. Likewise, some people might perceive ambiguity as a challenge that can be overcome and others as a constraint over which he or she has little control and few or no resources with which to cope. More research on validating the measurement of challenge vs. hindrance stressors, as well as eustress vs. distress, and savoring vs. coping, is warranted. Second, at what point are challenge stressors harmful? Just because people experiencing challenge stressors continue to perform well, it does not necessarily mean that they are healthy people. A great deal of stressors are intellectually stimulating, but excessive stimulation can also take a toll on one’s physiological well-being, as evident by the droves of professionals experiencing different kinds of diseases not experienced as much a few decades ago, such as obesity (Fried et al., 2013 ). Third, which stress management interventions would better serve to reduce hindrance stressors or to reduce strain that may result from challenge stressors while reinforcing engagement-producing challenge stressors?

A fourth area that requires additional attention is that of the flexible work arrangements (FWAs). One of the reasons companies have been willing to permit employees to work from home is not so much out of concern for the employee, but out of the company’s need for the focal person to be able to communicate with a colleague working from a geographic region when it is night or early morning for the focal person. Glazer, Kożusznik, and Shargo ( 2012 ) presented several areas for future research on this topic, noting that by participating on global virtual teams, workers face additional stressors, even while given flexibility of workplace and work time. As noted earlier, more research needs to be done on the extent to which people who take advantage of FWAs are advantaged in terms of detachment from work. Can people working from home detach? Are those who find their work invigorating also likely to experience ill-health by not detaching from work?

A fifth area worthy of further research attention is workplace wellness programing. According to Page and Vella-Brodrick ( 2009 ), “subjective and psychological well-being [are] key criteria for employee mental health” (p. 442), whereby mental health focuses on wellness, rather than the absence of illness. They assert that by fostering employee mental health, organizations are supporting performance and retention. Employee well-being can be supported by ensuring that jobs are interesting and meaningful, goals are achievable, employees have control over their work, and skills are used to support organizational and individual goals (Dewe & Kompier, 2008 ). However, just as mental health is not the absence of illness, work stress is not indicative of an absence of psychological well-being. Given the perspective that employee well-being is a state of mind (Page & Vella-Brodrick, 2009 ), we suggest that employee well-being can be negatively affected by noxious job stressors that cannot be remediated, but when job stressors are preventable, employee well-being can serve to protect an employee who faces job stressors. Thus, wellness programs ought to focus on providing positive experiences by enhancing and promoting health, as well as building individual resources. These programs are termed “green cape” interventions (Pawelski, 2016 ). For example, with the growing interests in positive psychology, researchers and practitioners have suggested employing several positive psychology interventions, such as expressing gratitude, savoring experiences, and identifying one’s strengths (Tetrick & Winslow, 2015 ). Another stream of positive psychology is psychological capital, which includes four malleable functions of self-efficacy, optimism, hope, and resilience (Luthans, Youssef, & Avolio, 2007 ). Workplace interventions should include both “red cape” interventions (i.e., interventions to reduce negative experiences) and “green cape” interventions (i.e., workplace wellness programs; Polly, 2014 ).

A Healthy Organization’s Pledge

A healthy workplace requires healthy workers. Period. Among all organizations’ missions should be the focus on a healthy workforce. To maintain a healthy workforce, the company must routinely examine its own contributions in terms of how it structures itself; reinforces communications among employees, vendors, and clients; how it rewards and cares for its people (e.g., ensuring they get sufficient rest and can detach from work); and the extent to which people at the upper levels are truly connected with the people at the lower levels. As a matter of practice, management must recognize when employees are overworked, unwell, and poorly engaged. Management must also take stock of when it is doing well and right by its contributors’ and maintain and reinforce the good practices, norms, and procedures. People in the workplace make the rules; people in the workplace can change the rules. How management sees its employees and values their contribution will have a huge role in how a company takes stock of its own pain points. Providing employees with tools to manage their own reactions to work-related stressors and consequent strains is fine, but wouldn’t it be grand if organizations took better notice about what they could do to mitigate the strain-producing stressors in the first place and take ownership over how employees are treated?

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ORIGINAL RESEARCH article

Coping strategies and self-efficacy in university students: a person-centered approach.

• 1 Department of Psychology, University of A Coruña, A Coruña, Spain
• 2 Department of Pedagogy and Didactics, University of Santiago de Compostela, Santiago de Compostela, Spain
• 3 Faculty of Psychology, University of Oviedo, Oviedo, Spain

In daily academic life, students are exposed to a wide range of potentially stressful situations which could negatively affect their academic achievement and their health. Among the factors that could be weakened by academic stress, attention has been paid to expectations of self-efficacy, which are considered one of the most important determinants for student engagement, persistence, and academic success. From a proactive perspective, research on academic stress has emphasized the importance of coping strategies in preventing harmful consequences. In recent years, there has been a growing interest in discovering the extent to which individuals are able to combine different coping strategies and the adaptive consequences this flexibility entails. However, studies using this person-centered approach are still scarce in the academic context. On that basis, this current study had two objectives: (a) to examine the existence of different profiles of university students based on how they combined different approach coping strategies (positive reappraisal, support seeking, and planning) and (b) to determine the existence of differences in general expectations of self-efficacy between those coping profiles. A total of 1,072 university students participated in the study. The coping profiles were determined by latent profile analysis (LPA). The differences in the self-efficacy variable were determined using ANCOVA, with gender, university year, and degree type as covariates. Four approach coping profiles were identified: (a) low generalized use of approach coping strategies; (b) predominance of social approach coping approaches; (c) predominance of cognitive approach coping approaches; and (d) high generalized use of approach coping strategies. The profile showed that a greater combination of the three strategies was related to higher general self-efficacy expectations and vice versa. These results suggest that encouraging flexibility in coping strategies would help to improve university students’ self-efficacy.

Introduction

The mental health of university students has been a growing concern in recent years ( Milojevich and Lukowski, 2016 ). Various studies have demonstrated the high frequency of psychological symptoms associated with this stage of education ( Blanco et al., 2008 ; Kim et al., 2015 ), with stress being one of the psychosocial problems that have become prevalent ( Deasy et al., 2014 ; American College Health Association, 2018 ; Gustems-Carnicer et al., 2019 ). In their daily lives, university students have to face a wide variety of demands, both academic and non-academic, that could affect their well-being. Academic demands include adaptation to a new context, overwork, insufficient time to do their academic tasks, preparation for and doing of exams, and the pressure to perform ( Beiter et al., 2015 ; Vizoso and Arias, 2016 ; Erschens et al., 2018 ; Webber et al., 2019 ). Non-academic demands include change of where they live; the need to create new social relationships; conflicts with partners, family, or friends; money worries; and concerns about future work ( Howard et al., 2006 ; Galatzer-Levy et al., 2012 ; DeRosier et al., 2013 ; Beiter et al., 2015 ). Stress can bring with it significant harm to the student’s academic performance (e.g., reduced ability to pay attention or to memorize, less dedication to study, and more absences from class) ( Chou et al., 2011 ; Turner et al., 2015 ), as well as to the student’s physical and psychological health (e.g., substance abuse, insomnia, anxiety, and physical and emotional exhaustion) ( Waqas et al., 2015 ; Schönfeld et al., 2016 ). These harmful effects have triggered interest in the identification of individual psychological resources that could be protective factors against the inherent stressors of the university context ( Tavolacci et al., 2013 ). These resources would modulate the relationship between the potential threats and the stress response, encouraging better psychological adjustment ( Leiva-Bianchi et al., 2012 ). Two of the most widely studied resources are coping strategies and self-efficacy.

Coping Strategies

Lazarus and Folkman (1984) thought of stress as an interactive process between the person and their surroundings, in which the influence of stressful events on physical and psychological well-being is determined by coping. From this widely accepted transactional approach, coping would come to be defined by cognitive and behavioral efforts employed in response to external or internal demands that the individual deems to be threats to their well-being.

Despite the documentation of more than 400 coping strategies ( Skinner et al., 2003 ), they are generally categorized into two broad types (for a complete categorization, see Zimmer-Gembeck and Skinner, 2016 ): approach (also called active) strategies and evasive (or disengagement) strategies. Approach strategies involve cognitive and behavioral mechanisms aimed at making an active response to the stressor, directly changing the problem (primary control) or the negative emotions associated with it (secondary control). This category includes strategies such as planning, taking specific action, seeking support (instrumental and emotional), positive reappraisal of the situation, or acceptance. Evasive strategies are those which involve cognitive and behavioral mechanisms used to evade the stressful situation, such as distraction, denial, and wishful thinking. Based on this classification, there is a broad consensus that approach strategies are related to good academic, physical, and psychological adjustment ( Clarke, 2006 ; Syed and Seiffge-Krenke, 2015 ; Gustems-Carnicer et al., 2019 ), whereas evasive strategies usually mean maladaptive consequences for the students ( Tavolacci et al., 2013 ; Deasy et al., 2014 ; Skinner et al., 2016 ; Tran and Lumley, 2019 ).

Self-Efficacy

Expectations of self-efficacy are a central element of the social cognitive theory proposed by Bandura (1997) . This construct is about a person’s beliefs about their ability to mobilize courses of action needed to achieve desired personal goals. It is, therefore, a fundamental psychological resource for exercising control over events in one’s life ( Wood and Bandura, 1989 ). In fact, self-efficacy is considered a powerful motivational, cognitive, and affective determinant of student behavior, with significant influence on their involvement, effort, persistence, self-regulation, and achievement ( Schunk and Pajares, 2010 ; Honicke and Broadbent, 2016 ; Ritchie, 2016 ; Zumbrunn et al., 2019 ). These characteristics make self-efficacy an important variable in controlling stress ( Bandura et al., 2003 ; Sahin and Çetin, 2017 ; Lanin et al., 2019 ), and it is a protection factor against the impact of day-to-day stressors at university ( Freire et al., 2019 ; Schönfeld et al., 2019 ).

Although self-efficacy has commonly been characterized as an expectation that is strongly linked to a specific task or situation, various studies have demonstrated the existence of a more generalized belief—that is, general self-efficacy—around perceived competence in the face of a broad range of demands ( Scholz et al., 2002 ; Feldman et al., 2015 ; Volz et al., 2019 ).

Current Study

The literature reviewed reiterated the importance of considering both coping strategies and expectations of self-efficacy in protection against stress. However, far from being independent resources, some studies have suggested that coping strategies and self-efficacy are related. They postulate that coping behaviors would influence an individual’s expectations of control ( Lazarus and Folkman, 1984 ), such that self-efficacy would be a mediator between coping strategies and the stress response ( Zimmer-Gembeck and Skinner, 2016 ).

Given that, our study aimed to examine the possible influence of coping strategies on the expectations of self-efficacy in a population that is particularly vulnerable to stress, university students. Some studies have shown a positive, significant influence of approach coping strategies on self-efficacy in infant samples ( Sandler et al., 2000 ) and in adults with rheumatoid arthritis ( Keefe et al., 1997 ). However, as far as we are aware, there have been none in the university context.

The main contribution of this study lies in the analysis of student coping strategies using a person-centered focus. Traditionally, research on coping strategies has attempted to determine the suitability of a given strategy, evaluating the benefit or harm that it produces for the individual. This variable-centered approach assumes that certain coping mechanisms are universally adaptive or maladaptive, an argument that has been called the “fallacy of uniform efficacy” ( Bonanno and Burton, 2013 ).

The very characterization of coping strategies as responses to a specific challenge demonstrates their situational specificity. This has led in recent years to the adoption of an approach based on the flexibility of coping, under the supposition that a single individual can combine different strategies, using one or the other depending on the specific situation they are facing ( Eisenbarth, 2012 ; Kobylińska and Kusev, 2019 ). In this vein, the benefits provided by approach coping strategies are maximized if the individual employs problem-focused coping strategies (e.g., planning and seeking instrumental support) or emotion-centered strategies (e.g., positive reappraisal and seeking emotional support) based on the perceived controllability of the stressor facing them ( Cheng, 2001 ; Siltanen et al., 2019 ). In contrast, people who are less flexible in their coping have a smaller repertoire of strategies, which are less effective adjusting to the specific demands of the situation ( Cheng and Cheung, 2005 ).

Studying individuals’ profiles in light of the flexibility of their coping is therefore adopting a person-centered focus ( Laursen and Hoff, 2006 ), making it possible to identify subgroups of students characterized by high internal similarity in their repertoire of coping strategies, who differ from the way that other students combine their strategies. An additional advantage over the traditional, variable-focused approaches is that studying profiles of flexibility of coping makes it possible to identify specific groups of individuals who can be prioritized in the design of interventions ( Kaluza, 2000 ).

Considering a perspective based on coping flexibility, the research question we posed in this study was whether the different student profiles—in the way they combine their coping strategies—would be related to significantly different levels of general self-efficacy. In the university context, various studies have demonstrated that, in comparison to those with less flexible profiles, students who are more flexible in their coping demonstrate lower vulnerability to stress ( Cheng, 2001 ; Kato, 2012 ; Doron et al., 2014 ; González Cabanach et al., 2018 ) and to depressive symptomatology ( Gabrys et al., 2018 ; Hasselle et al., 2019 ), as well as greater psychological well-being ( Freire et al., 2018 ). Based on that research, our hypothesis is that students who exhibit a more flexible profile of strategies will demonstrate significantly higher levels of self-efficacy than less flexible students.

Assuming that in the young population the use of approach coping strategies is more typical ( Cheng et al., 2014 ), in our study, we examined coping profiles based on the combination of three approach strategies that are very common in educational contexts ( Skinner et al., 2016 ): a primary control (planning), a secondary control (positive reappraisal), and a mixed type (seeking instrumental and emotional support). Similarly, given the extensive and varied range of demands faced by students in their daily lives (both academic and non-academic), we examined their level of general self-efficacy. Finally, in this study, we also tried to control for the effects of the variables gender, university year, and degree type. It would seem that men report higher levels of self-efficacy than women, with this difference emerging at the end of adolescence ( Huang, 2013 ). It may also be the case that students in their first year of university, because of their inexperience, may have lower levels of self-efficacy than students with more academic experience ( Honicke and Broadbent, 2016 ). As for the type of course, scientific disciplines have been related to lower levels of self-efficacy ( Findley-Van Nostrand and Pollenz, 2017 ).

Materials and Methods

Participants.

The study used a sample of 1,085 undergraduate students from the University of A Coruña (Spain). The inclusion criteria were for subjects to be undergraduate students at the time of the study. Exclusion criteria included failing to respond to more than 20% of the items. We excluded 13 cases because they failed to respond to enough items. There were a smaller number of missing values in 28 other cases, which were dealt with using full information maximum likelihood (FIML) via Mplus 7.11 ( Muthén and Muthén, 1998–2012 ). This means that the definitive sample was made up of 1,072 students aged between 18 and 48 years ( M = 21.09; SD = 3.16). Just over two thirds ( n = 729; 68%) were women, and 343 (32%) were men. The distribution by degree course was as follows: 383 (37.5%) were studying educational sciences (infant education, primary education, social education, physical education, language and hearing, speech therapy, and educational psychology); 203 (19%) were studying health sciences (physiotherapy, nursing, and sports science); 207 (19.3%) were studying legal and social sciences (law and sociology); and 279 (26%) were studying technical sciences (architecture, technical architecture, and civil engineering). The distribution of students in terms of their university year was 304 (28.4%) in their first year, 307 (28.6%) in their second year, 302 (28.2%) in their third year, 91 (8.5%) in their fourth year, and 68 (6.3%) in their fifth year.

Instruments

We used the coping scale from the Academic Stress Questionnaire to measure coping strategies ( Cabanach et al., 2010 ). This instrument has 23 items evaluating three approach strategies for coping: positive reappraisal, support seeking, and planning. Positive reappraisal is a secondary control strategy in which the student seeks to reassign the stressful event, highlighting the positive (e.g., “When I am faced with a problematic situation, I forget unpleasant aspects and highlight the positive ones”). The psychometric properties were acceptable, in terms of both reliability (α = 0.860; ω = 0.864; construct reliability = 0.857; composite reliability = 0.857) and validity (convergent validity = 0.483; construct validity: χ 2 = 119.87; df = 30; p > 0.05; GFI = 0.98; AGFI = 0.96; TLI = 0.96; CFI = 0.98; RMR = 0.03; RMSEA = 0.05). Support seeking is a mixed coping strategy, as the student can do that with the aim of seeking information and advice from others to resolve the issue at hand (e.g., “When I am faced with a problematic situation, I ask for advice from a family member or a close friend”) or they can seek consolation and emotional relief (e.g., “When I am faced with a problematic situation, I manifest my feelings and opinions to others”). The psychometric properties of this subscale were good, in reliability (α = 0.902; ω = 0.903; construct reliability = 0.900; composite reliability = 0.900) and validity (convergent validity = 0.566; construct validity: χ 2 = 35.43; df = 12; p > 0.05; GFI = 0.99; AGFI = 0.98; TLI = 0.99; CFI = 0.99; RMR = 0.02; RMSEA = 0.04). Planning is a primary control strategy, characterized by analysis and the design of a plan of action aimed at resolving the problematic situation (“When I am faced with a problematic situation, I draw up an action plan and follow it”). The psychometric properties were acceptable, in terms of both reliability (α = 0.81; ω = 0.81; construct reliability = 0.85; composite reliability = 0.82) and validity (convergent validity = 0.504; construct validity: χ 2 = 33.52; df = 8; p > 0.05; GFI = 0.99; AGFI = 0.97; TLI = 0.97; CFI = 0.98; RMR = 0.03; RMSEA = 0.05). The participants’ responses are recorded on a five-point Likert scale (1 = never to 5 = always).

We used the Spanish validation of the General Self-efficacy Scale from Baessler and Schwarzer (1996) . The scale has 10 items (e.g., “I can solve difficult problems if I try hard enough”) that the participants respond to on a Likert scale from 1 (never) to 5 (always). In this study, the psychometric properties were good, in reliability (α = 0.91; ω = 0.91; construct reliability = 0.909; composite reliability = 0.909) and validity (convergent validity = 0.514; construct validity: χ 2 = 121.36; df = 30; p > 0.05; GFI = 0.98; AGFI = 0.96; TLI = 0.98; CFI = 0.98; RMR = 0.02; RMSEA = 0.05).

The study protocol was designed and executed in compliance with the code of ethics set out by the university in which the research was done, with the informed consent of all participants, as required by the Helsinki Declaration. Data collection was carried out at the beginning of the academic year in order to avoid periods of high academic demands (e.g., work overload and preparation for exams) that could favor greater emotional activation in students and, therefore, influence their responses to the questionnaires. Before beginning the study, the participants were informed of the objectives and were asked to participate; they were assured of anonymity and the confidentiality of their responses. Likewise, the instructor explained that students who did not wish to participate in the study could leave the classroom until the end of the tests, without any repercussions or negative consequences. The questionnaires were administered in the classrooms where the students had their usual classes, during normal class hours, and in a single session without a time limit.

Data Analysis

To identify the student profiles according to the flexibility of their coping, we performed a latent profile analysis (LPA) ( Lanza et al., 2003 ) using the statistical program Mplus 7.11 ( Muthén and Muthén, 1998–2012 ). LPA allows the identification of latent categorical variables to group the subjects into classes (profiles), establishing what fits best from a finite set of models. The following were used as reference parameters to determine the optimum model: the Akaike Information Criterion (AIC), the Schwarz Bayesian information criterion (BIC), the BIC adjusted for sample size (SSA-BIC), the formal adjusted maximum likelihood ratio test from Lo et al. (2001) (LMRT), the parametric bootstrap likelihood ratio test (PBLRT), and the sample size for each subgroup. The AIC, BIC, and SSA-BIC indices are descriptive, the lowest values indicating the best fit of the model, whereas LMRT and PBLRT are the indices that allow the final decision to be made. The values of p associated with LMRT and PBLRT indicate whether the solution with more ( p < 0.05) or fewer classes ( p > 0.05) is the one with the best fit to the data. Another of the exclusion criteria was the existence of spurious classes ( n ≤ 5% of the sample), which would indicate excessive extraction of profiles ( Hipp and Bauer, 2006 ).

Once the optimal model was selected based on the above criteria, we moved on to determining its classifying accuracy using the entropy statistic and calculation of a posteriori probabilities as references. Another criterion for evaluating the validity of the model was a MANOVA analyzing the differences between classes in the three criterion variables (positive reappraisal, support seeking, and planning). Statistically significant differences between the three variables would indicate that the latent classes suggested by the model were distinct. Finally, the differences in self-efficacy between the different coping profiles were established using an ANCOVA, with gender, year, and degree type as covariables. The effect size of the differences between the groups was determined using partial eta squared and Cohen’s (1988) d : null, η p 2 < 0.01 ( d < 0.09); small, η p 2 = 0.01 to η p 2 = 0.058 ( d = 0.10 to d = 0.49); medium, η p 2 = 0.059 to η p 2 = 0.137 ( d = 0.50 to d = 0.79); and large, η p 2 ≥ 0.138 ( d ≥ 0.80). These analyses were performed using SPSS 26.0 ( IBM Corp, 2019 ).

Preliminary Analysis

Descriptive statistics and the values of (Pearson) correlations between the variables are given in Table 1 . The asymmetry and kurtosis data indicate that the variables followed a normal distribution (all values between −1 and 1). Similarly, all of the correlations were statistically significant ( p < 0.001). Statistically speaking, the results of the Bartlett sphericity test indicate that the variables were sufficiently intercorrelated [χ 2 (6) = 1,066.75; p < 0.001)], an important requirement for subsequent multivariate analysis.

Table 1. Means, standard deviations, and correlations for the three strategies for coping with stress and general self-efficacy ( N = 1072).

Identification of Coping Profiles

The fit of various latent profile models was examined (models from two to five classes). In the model fit, it was assumed that variances could differ between indicators within each group, with the restriction specifying that they be equal between the groups. Similarly, a restriction was set on the independence between indicators, both within and between groups.

Table 2 gives the results of the model fit. The analysis of fit was stopped at the five-class model for various reasons: (a) the values of BIC and SSA-BIC were higher in the five-class model than in the four-class model, and the AIC was almost the same in the two models; (b) the values of LMRT and PBLRT for the five-class model were not statistically significant ( p > 0.05, in both cases), which indicated that the fit of this model was not better than that of the four-class model; (c) the five-class model included a group made up of fewer than 5% of the total sample, which indicated excessive extraction of profiles. In contrast, in the four-class model, all of the groups made up more than 5% of the total sample. Similarly, all of the data summarized in Table 2 indicated that the four-class model demonstrated better fit than the two- and three-class models, leading to the selection of the four-class model as the optimum.

Table 2. Statistics for the identification of fit of latent class models and classifying accuracy.

Table 3 gives the classifying accuracy of the four-class model, as well as the number of participants (overall sample and by gender) making up each class in that model, both in absolute terms ( n ) and as a percentage (%). The means associated with the groups the participants were assigned to are given in the main diagonal in the table in bold. The first group demonstrated a classification coefficient of 85%, whereas the other three groups had coefficients a little below 80%. Overall, these data indicate that the four-class model demonstrates adequate classification accuracy. Similarly, the value of the entropy statistic of this model (0.639) ( Table 2 ), although modest, is acceptable ( Nylund et al., 2007 ).

Table 3. Characterization of the latent profiles and classifying accuracy of the individuals in each profile.

As an additional criterion for assessing the suitability of the four-class model, the results of the MANOVA showed statistically significant differences between the four classes in the three criterion variables: positive reappraisal [ F (3, 1068) = 391.49; p < 0.001; η p 2 = 0.524], support seeking [ F (3, 1068) = 770.37; p < 0.001; η p 2 = 0.684], and planning [ F (3, 1068) = 463.61; p < 0.001; η p 2 = 0.566]. The effect size was large in all cases.

Description of Coping Profiles

The mean scores (direct and standardized) of the members of each of the latent classes (coping profiles) in the selected model are given in Table 4 . The same profiles are shown graphically in Figure 1 .

Table 4. Description of latent profiles (means, standard errors, and confidence intervals).

Figure 1. Graphical representation of coping profiles (standardized scores). LACS: profile of low approach coping strategies; HACS: profile of high approach coping strategies; SAC: profile with a prevalence of social approach coping strategies; CAC: profile with a prevalence of cognitive approach coping strategies.

The first group ( n = 296; 27.61%) was made up of students with low scores in the three approach coping strategies (profile of low approach coping strategies, LACS), who demonstrated low flexibility in the use of these strategies. The second group ( n = 290; 27.05%) demonstrated the opposite, scoring highly in the three coping strategies (profile of high approach coping strategies, HACS). Compared to the other profiles, these were the students who demonstrated the most flexibility in deploying approach coping strategies. The third group was the largest ( n = 355; 33.12%) and was made up of students with high scores in support seeking and low scores in positive reappraisal and planning. Given the overwhelmingly social nature of support seeking, we called this the social approach coping (SAC) profile. Finally, the smallest group in quantitative terms ( n = 131; 12.22%) was made up of students demonstrating the opposite pattern to SAC, high scores in positive reappraisal and planning and low scores in support seeking. We called this the cognitive approach coping (CAC) profile as these students seemed to prefer more cognitive approach strategies, rather than social strategies.

Relationship Between Coping Profiles and Self-Efficacy

Once the effects of gender, year, and degree course had been controlled for, the results of the ANCOVA demonstrated statistically significant differences between the coping profiles in the variable self-efficacy [ F (3, 1065) = 140.638, p < 0.001, η p 2 = 0.284), with a large effect size. The a posteriori tests (Scheffé) showed that the HACS profile scored highest in self efficacy, with statistically significant differences between it and the SAC and LACS profiles, the effect size being large in both cases ( d = 0.98 and d = 1.55, respectively). The CAC profile also had significantly higher scores in self-efficacy than the SAC and LACS profiles, with large effect sizes ( d = 0.88 and d = 1.46, respectively). The self-efficacy scores from the SAC profile were significantly higher than those from the LACS profile, with a medium effect size ( d = 0.58). These data indicate that the LACS profile scored significantly lower in self-efficacy than the other coping profiles identified in this study. Table 5 gives the descriptive statistics for the four coping profiles with respect to the self-efficacy variable. When we looked at the covariables, there was no statistically significant effect found with the year variable, but there was with the degree type [ F (1065) = 5.163, p < 0.05, η p 2 = 0.005] and gender [ F (1065) = 50.405, p < 0.001, η p 2 = 0.045], although the effect size was null for the degree type and small for gender. Having noted the small effect of gender on self-efficacy, we looked more deeply at this interaction in each of the coping profiles. In the LACS [ t (294) = 6.56, p < 0.001, d = 0.45], HACS [ t (288) = 4.17, p < 0.001, d = 0.27], and SAC profiles [ t (353) = 3.43, p < 0.01, d = 0.26], men scored significantly higher in self-efficacy than women, whereas the effect of gender on self-efficacy was not significant in the CAC profile.

Table 5. Descriptive statistics (means and standard deviations) corresponding to coping profiles in general self-efficacy.

Although previous research has demonstrated the importance of coping strategies and self-efficacy in the prevention of stress, the relationship between these two psychological resources has not been the focus of attention previously in the university context. The main contribution of this study is in the analysis of the relationship between coping strategies and general self-efficacy in university students in light of coping flexibility.

From this person-centered focus, it is assumed that coping strategies are not mutually exclusive categories but instead operate together ( Eisenbarth, 2012 ; Kobylińska and Kusev, 2019 ), such that their functionality depends on the individuals having a repertoire of strategies available that would allow them to respond specifically to the challenge they have to deal with ( Cheng et al., 2014 ; Siltanen et al., 2019 ). The results of our study are consistent with this approach, we have identified four profiles of university students which differ in the extent of their flexibility in approach coping with stress. One of the profiles we identified (HACS) has a coping repertoire which combines high levels of positive reappraisal, support seeking, and planning. This is a group of highly flexible students when it comes to coping with problems, bringing together strategies for primary control of stressors (planning and instrumental support seeking) with others aimed at secondary control (positive reappraisal and emotional support seeking). In general, research suggests that when facing problems, the most effective method is to use primary control strategies when the situation is deemed controllable, whereas relying on secondary control strategies is more beneficial when the challenge is perceived as uncontrollable ( Zimmer-Gembeck and Skinner, 2016 ). From this perspective, the HACS profile would be highly adaptive, as the students in this group would have both types of strategy available. Our findings also demonstrated the existence of two profiles of students who displayed lower levels of coping flexibility than the HACS profiles, as their repertoires included high levels of some but not all of the three approach coping strategies we examined. One group was characterized by the combination of high levels of positive reappraisal and planning, with low levels of support seeking (the CAC profile). The other, in contrast, combined high levels of support seeking with low levels of the other two strategies (the SAC profile).

These two profiles are, to a certain extent, opposites, as students in the SAC group exhibited predominantly social coping, prioritizing their sources of support as the routes to find advice and/or emotional consolation about their problematic situations, whereas students in the CAC group preferred to opt for a more cognitive coping (i.e., focus on the positives of the situation and plan how to deal with it) rather than sharing their problems socially. According to this characterization, the students with a SAC profile would have a much smaller repertoire of approach coping strategies, which could indicate excessive instrumental and emotional dependence on their significant social circle when they have to deal with academic and non-academic stressors. Students with a CAC profile would choose to respond to stressors more autonomously, either because of a lack of interpersonal skills to ask for help or because they feel they do not have this social support or because they feel the advantages of seeking help are outweighed by the disadvantages ( Scharp and Dorrance Hall, 2019 ), such as being considered incompetent or weak. Finally, in this study, we identified the existence of a group of students characterized by a low use of positive reappraisal, support seeking, and planning (the LACS profile). Assuming that these three strategies are highly functional in academic contexts ( Skinner et al., 2016 ), the reduced availability of them in this profile would seem to indicate the students’ lack of flexibility to respond adaptively to the various demands of day-to-day university life.

The identification of these four profiles adds to the growing line of work which supports the benefits of analyzing coping with stress in the university context with a person-centered approach (e.g., Cheng, 2001 ; Kato, 2012 ; Doron et al., 2014 ; Freire et al., 2018 ; Gabrys et al., 2018 ; González Cabanach et al., 2018 ; Hasselle et al., 2019 ). To be specific, the four-profile solution in our study coincides with results from González Cabanach et al. (2018) , in a study which also examined flexibility of coping based on the combination of positive reappraisal, support seeking, and planning strategies. This may point to a potential generalization of the profiles identified when the flexibility of approach coping with stress is examined in a university context.

Beyond affirming the existence of student profiles characterized by differences in the flexibility of coping, the objective of our study was to determine whether these groups diverged in their expectations of self-efficacy. In accordance with our hypothesis, the greater the flexibility in approach coping with stress, the higher the students’ levels of general self-efficacy and vice versa. The student profiles that had most flexibility in their coping (HACS and CAC) exhibited notable differences (i.e., large effect sizes) in self-efficacy compared to less flexible profiles (SAC and LACS). Additionally, the SAC profile exhibited moderately higher self-efficacy (i.e., medium effect size) than the LACS profile.

These results could indicate, in line with other studies from the healthcare context (e.g., Haythornthwaite et al., 1998 ), that flexibility in coping enhances university students’ perception of control over their day-to-day challenges, making them feel better able to handle them. This explanation may be connected with what Hobfoll’s conservation of resources theory ( Hobfoll et al., 2018 ) postulates. According to this theory, individuals who have high levels of personal resources (e.g., a variety of approach coping strategies) participate in an upward spiral of acquisition, development, and preservation of new resources (e.g., self-efficacy). In contrast, scarce resources in the face of a given challenge (e.g., low flexibility in coping) would put the individual into a downward spiral of losing resources (e.g., low self-efficacy) which would make them more vulnerable to stress. In this way, personal resources would act in “convoy” ( Holmgreen et al., 2017 ), one after the other, whether upward or downward. In addition, the fact that we did not find significant differences between the HACS and CAC profiles with regard to general self-efficacy suggests that, in terms of developing generalized self-referential beliefs about personal competency in response to the demands of university life, the combination of cognitive strategies (positive reappraisal and planning) is more important than social strategies (support seeking). This idea is in line with the lower potency that Bandura’s (1997) social cognitive theory ascribes to social sources in making up expectations of self-efficacy. Thus, it is possible that the low availability of cognitive coping resources exhibited by students with the SAC profile would negatively affect their beliefs of competency for dealing with stressors, which would lead them to seek feedback from their sources of support that would give them some degree of self-efficacy, albeit significantly less than students with HACS and CAC profiles, but still somewhat higher than students with the LACS profile.

Implications of the Results of the Study

University stress is a growing psychosocial concern, both because of its prevalence and because of the negative consequences it can have for the student. Although this scenario highlights the need to implement effective coping interventions in the entire university population, this need is even more pronounced in students who are studying healthcare-related degrees ( Saeed et al., 2016 ), in which stress levels are significantly higher ( Heinen et al., 2017 ; Zeng et al., 2019 ). In line with that, the results of our study may represent a significant contribution, in that they help increase our understanding of how two important psychological resources, flexibility of approach coping strategies and general self-efficacy, function in the prevention of stress.

To be more specific, our findings allow the identification of those students who, depending on the level of their flexibility in the use of approach coping strategies, are more (LACS and SAC profiles) or less (HACS and CAC profiles) vulnerable with respect to developing their expectations of generalized self-efficacy.

Not only does self-efficacy play an important role in the prevention of university stress ( Freire et al., 2019 ; Schönfeld et al., 2019 ), it is also one of the most influential factors in the motivational, cognitive, and behavioral responses of the student to the teaching–learning process ( Schunk and Pajares, 2010 ). Consequently, in light of our results, students in the SAC and particularly in the LACS profiles should be the focus of priority intervention in order to enhance flexibility in their repertoire of approach coping strategies as a way of improving their generalized expectations of self-efficacy. In recent years, interventions aimed at improving the coping skills of university students have proliferated. Most of these initiatives have adopted an approach based on cognitive behavioral therapy ( Houston et al., 2017 ), mindfulness ( Kang et al., 2009 ), or a combination of the two ( Recabarren et al., 2019 ). In these programs, students learn to identify the main symptoms associated with stress, as well as the external (environmental demands) and internal (thoughts and emotions) factors that contribute to its appearance. Furthermore, students acquire various primary control (e.g., planning and problem solving) and secondary control (e.g., positive reappraisal and meditation) adaptive coping strategies.

Although these types of interventions have shown their effectiveness both in reducing stress ( Regehr et al., 2013 ; Yusufov et al., 2019 ) and in increasing self-efficacy ( Molla Jafar et al., 2015 ; Phang et al., 2015 ), they have limited influence by themselves on the students’ abilities to be flexible in their coping strategies ( Cheng and Cheung, 2005 ). Prior research offers us evidence of the efficacy of focused training to enhance both individuals’ repertoires of strategies and their metacognitive abilities to evaluate and select the best coping strategies in each situation ( Cheng et al., 2012 ).

From this, it would seem that metacognitive self-regulation and executive functioning skills (e.g., planning, organization, emotional management) constitute an important resource for improving students’ abilities to make their repertoires of strategies more flexible, in addition to specific training aimed at increasing their coping strategies ( Bettis et al., 2017 ; de la Fuente et al., 2018a ). Some online tools in this area, such as e-Coping with Academic Stress TM , have demonstrated good results in the improvement of self-regulating skills (e.g., self-evaluation and decision making) in students when facing potentially stressful situations in the university context ( de la Fuente et al., 2018b ). These results also have important implications at the classroom level, given that if teachers encourage the development of self-regulation skills in university students, they increase the tendency for students to autonomously use approach coping strategies, such as establishing a plan of action, assessing the positive aspects of the situation, or seeking advice and emotional support from other people ( de la Fuente et al., 2020 ). These self-regulatory skills have also been shown to be effective in increasing students’ self-efficacy beliefs ( Cerezo et al., 2019 ).

Limitations of the Study and Lines for Future Research

The contributions of this study should be assessed, taking into account the limitations inherent in its design. First, the transversal nature of the study does not allow causal relationships to be established between the variables studied. Therefore, although our results suggest that flexibility in coping with stress influences the generalized expectations of self-efficacy, the causal order between these variables must be examined in the light of more rigorous study designs (e.g., longitudinal studies). A second limitation lies in the composition of the sample, which was dissimilar in terms of gender representation, university year, and degree type. In this study, those three variables were considered as covariates to statistically control their effect, with degree type and gender exhibiting a null effect and a small effect, respectively. However, new studies are needed that would be able to corroborate the extent to which these variables are important, or not, in the configuration of the profiles of coping flexibility and in the relationship between these profiles and self-efficacy. In fact, based on our findings, the levels of general self-efficacy were significantly higher in men (albeit with a small effect size) in all of the coping profiles except the group which had similar levels of representation of both sexes (the CAC profile), where there were no differences. Therefore, in order to make the results more generalizable to the university student population, future studies should use more thorough recruitment procedures that would give more balanced samples in terms of gender, university year, and degree type. In the same vein, future work should consider the extent to which variables not addressed in this study, such as students’ previous academic performance, their socioeconomic status, or their intellectual abilities (e.g., cognitive and attention level), may be relevant in the relationship between stress coping profiles and general self-efficacy in the university context. The fact that all of the participants were recruited from the same university constitutes a third limitation of our study. In order to facilitate generalization of the results, new studies are needed which involve students from other geographical and cultural contexts.

Fourth, the use of self-reports as a data collection method may limit the veracity of the results, since participants may have response biases, ranging from a misunderstanding of the items to social desirability bias (i.e., the tendency of survey respondents to answer questions in a manner that will be viewed favorably by others, even if the survey is anonymous) ( Rosenman et al., 2011 ). These biases may have been increased by the effect of the data collection method used (collective and pencil-and-paper condition). In fact, this type of method can increase the perception of a lack of privacy and confidentiality when other participants are present ( van de Looij-Jansen and de Wilde, 2008 ), encouraging the social desirability response effect and a higher rate of questions not answered, especially with sensitive questions such as those related to mental health ( Raat et al., 2007 ). These and other limitations—for example, data collection costs and data entry errors ( Colasante et al., 2019 ), physical and emotional fatigue of the participants at the time data collection, and absence of a rigorous control over the time taken to complete the questionnaires ( Díaz de Rada, 2018 )—could be minimized by using computerized administration of questionnaires. Likewise, future studies should corroborate our findings using a combination of methods that include not only questionnaires but also classroom observations and in-depth interviews with the students.

There is another limitation with respect to the questionnaires used, specifically the questionnaire we used to evaluate coping strategies. Although the three strategies evaluated by this instrument (positive reappraisal, support seeking, and planning) are widely used in academic contexts, that does not preclude the possibility of students using other types of strategies. Future research should examine the possible makeup of flexible coping profiles considering other strategies that were not assessed in this study.

Finally, another limitation lies in the operationalization of the concept of coping flexibility. Our results seem to be consistent with the conceptualization of coping flexibility in terms of balanced profiles, according to which the student deploys various strategies at similar levels ( Kaluza, 2000 ). Despite this idea of coping flexibility being widely adopted in the educational field, there are other ways to operationalize this construct (e.g., a broad repertoire or cross-situational variability; for a more precise characterization, see Cheng et al., 2014 ), which might impede comparison between studies and the generalization of the results.

Data Availability Statement

The datasets generated for this study are available on request to the corresponding author.

Ethics Statement

The studies involving human participants were reviewed and approved by the Ethics Committee at the University of A Coruña. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

CF and MF contributed to the conceptualization, investigation, methodology, writing, and supervision of this study. BR and SR contributed to the investigation, writing, and supervision of this study. AV and JN contributed to the methodology, writing, and supervision of this study.

This work was financed by the research projects EDU2013-44062-P (MINECO), EDU2017-82984-P (MEIC), and the Consejería de Empleo, Industria y Turismo del Principado de Asturias (Department of Employment, Industry and Tourism of the Principality of Asturias, Spain) (ref. FC-GRUPIN-IDI/2018/000199).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

The authors would like to thank the students who participated in the study.

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Keywords : coping strategies, coping flexibility, stress, self-efficacy, university students

Citation: Freire C, Ferradás MdM, Regueiro B, Rodríguez S, Valle A and Núñez JC (2020) Coping Strategies and Self-Efficacy in University Students: A Person-Centered Approach. Front. Psychol. 11:841. doi: 10.3389/fpsyg.2020.00841

Received: 29 January 2020; Accepted: 06 April 2020; Published: 19 May 2020.

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Copyright © 2020 Freire, Ferradás, Regueiro, Rodríguez, Valle and Núñez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: María del Mar Ferradás, [email protected]

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A Qualitative Study of How Adolescents’ Use of Coping Strategies and Support Varies in Line With Their Experiences of Adversity

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• Emily Stapley   ORCID: orcid.org/0000-0003-2935-4438 1 ,
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Adolescence is associated with a rise in the incidence of mental health issues. Thus, the factors, processes, and contexts that protect and promote positive mental health in adolescence are of key interest to policymakers.

Our aim was twofold: First, to explore the coping strategies and sources of support that adolescents identify as protective (or not) in the face of difficulty over a three-year period; second, to examine how and why this may vary in line with the levels of adversity that they report experiencing in life.

Participants were attending schools in England implementing a mental health prevention programme called HeadStart. 93 semi-structured interviews were conducted with 31 adolescents (age 11–12 at the outset of the study; 58% female) once per year over three years. The interviews were analysed using thematic analysis.

Six coping strategy themes (e.g., ‘Disengaging from problems’) and five support themes (e.g., ‘Parents as a source of comfort and advice’) were derived from the interviews. The types, quality, and consistency of reported coping strategies and support varied in line with whether adolescents were experiencing higher or lower levels of adversity in life over time, and according to the resources that they had available within their physical and social contexts.

Conclusions

Our findings underscore the importance for mental health prevention programmes of bolstering both individual-level coping strategies and the resources available within adolescents’ environments to help them to manage adversity.

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Adolescence is a period of major life change, characterised by physical transformations, psychological and cognitive development, and changes to peer and family relationships (Blakemore, 2012 ). Adolescence is also associated with a rise in the incidence of mental health issues, with the latest statistics in the UK indicating that among 11- to 16-year-olds, 17.6% had a diagnosable mental disorder in 2020, as compared to 14.4% of 5- to 10-year-olds (Vizard et al., 2020 ). It has been calculated that the cost of ‘late intervention’ to combat the problems that young people experience, such as mental disorders, is nearly £17 billion (Chowdry & Fitzsimons, 2016 ). Therefore, developing effective early intervention programmes, and ascertaining the factors, processes, and contexts that protect and promote adolescent wellbeing and positive mental health, is of key interest for policymakers seeking to prevent the onset of mental health issues in adolescence.

Researchers have distinguished between protective factors, which are associated with positive outcomes in the face of risk and adversity, and promotive factors, which are associated with positive outcomes generally (Masten & Barnes, 2018 ). The study of such factors features prominently in research seeking to explain why some individuals show resilience in the face of trauma, adversity, and risk, whereas others show poorer outcomes (e.g., Luthar, 2015 ; Masten & Barnes, 2018 ). Resilience can be broadly defined as the complex and dynamic process of adaptation to adversity (Luthar, Cicchetti, & Becker, 2000 ; Masten, 2014 ; Ungar, 2012 ), though we note that there are various subtleties and variations in how resilience can be understood (for an overview, see Southwick, Bonanno, Masten, Panter-Brick, & Yehuda, 2014 ).

Recent theory and research in this area has increasingly focused upon the embedded nature of resilience, whereby adaptation is facilitated through interactions between the individual and aspects of their ecological environment. For example, Ungar ( 2008 ) has defined resilience as a process whereby individuals navigate towards the resources to sustain their wellbeing that are available to them within their physical and social contexts. Thus, rather than putting the onus solely on the individual’s ability to cope, this definition underscores the role of both the individual and their environment in promoting wellbeing (Ungar, Brown, Liebenberg, Cheung, & Levine, 2008 ). Similarly, Masten ( 2021 ), advocating for a systemic perspective on resilience, has argued that the degree to which young people are able to respond adaptively in the face of disaster depends on the resilience of the interconnected systems around them, including family, school, community, and policy. Such definitions are underpinned by Bronfenbrenner’s ( 1979 ) ecological systems theory, which emphasises the role in child development of the child’s interaction with the interrelated, nested systems around them (Ungar, Ghazinour, & Richter, 2013 ).

Following early pioneers in the study of resilience (e.g., Garmezy, 1974 , 1985 ), researchers have tended to distinguish between three broad categories of protective factors: individual factors, such as effective coping skills or high self-esteem; family factors, such as a positive caregiver-child relationship or family climate; and environmental or community factors, such as prosocial peers or a positive school environment (e.g., Eriksson, Cater, Andershed, & Andershed, 2010 ; Fritz, de Graaff, Caisley, van Harmelen, & Wilkinson, 2018 ; Olsson, Bond, Burns, Vella-Brodrick, & Sawyer, 2003 ). Thus, the concepts of coping and social support have prominence within the study of protective factors. Coping can be defined as the “constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person” (Lazarus & Folkman, 1984 , p.141), and social support as the resources that the individual’s social network provides to help them to handle difficulties (Cohen, 2004 ).

Research investigating protective factors has often been quantitative in design. For instance, numerous studies have examined what factors protect young people in the face of adversity (e.g., Askeland et al., 2020 ; Eriksson et al., 2010 ), which factors reduce the likelihood of young people developing mental health issues (e.g., Fritz et al., 2018 ; Fritz, Stochl, Goodyer, van Harmelen, & Wilkinson, 2020 ), which factors predict resilience following trauma (e.g., Lai, Lewis, Livings, La Greca, & Esnard, 2017 ; Masten, 2021 ), and in what ways the impact of protective factors varies by the level of adversity experienced (e.g., Bowen, Lee, & Weller, 2007 ; Kassis, Artz, Scambor, Scambor, & Moldenhauer, 2013 ). However, quantitative research in this area has been criticised for its lack of attention to how, why, and when particular factors, or combinations of factors, may be more or less protective for young people from their own perspectives and in their own words (Eriksson et al., 2010 ; Ungar, 2003 ). Qualitative research designs are well suited for answering such questions, including offering greater nuance in understanding the complex protective processes that are ecologically embedded within each individual’s world.

Previous qualitative studies have explored young people’s identification of the protective factors and processes that contribute to resilience in the context of academic attainment (e.g., Chee, 2019 ; Morales, 2008 ), economic disadvantage (Smokowski & Reynolds, 1999 ), and specific mental health difficulties (e.g., Everall, Altrows, & Paulson, 2006 ; Las Hayas et al., 2016 ), as well as young people’s ways of coping with adversity or stress in daily life (e.g., Stapley, Demkowicz, Eisenstadt, Wolpert, & Deighton, 2020a ; Ungar et al., 2008 ). For example, through interviews with 13 young adults in Canada who overcame suicidality in adolescence, Everall et al. ( 2006 ) identified four domains of resilience: (a) social processes - having consistent, supportive relationships with others (such as family members, peers, teachers, and professionals); (b) emotional processes - being aware of and able to express feelings; (c) cognitive processes - gaining new perspectives and having a sense of control; and (d) taking action with purpose and specific goals in mind. In another Canadian study, Ungar et al. ( 2008 ) identified seven experiences that 19 adolescents described as enhancing their mental health, which they each had varying access to within their environments: material resources; supportive relationships; a desirable sense of self; a sense of power and control; cultural traditions; a meaningful role within the community; and feeling part of something bigger.

By illuminating protective factors and processes, and exploring how and why they may vary by context, resources, or the level of adversity experienced, qualitative research findings can inform the development of interventions seeking to bolster young people’s resilience and prevent the onset of mental health issues (Eriksson et al., 2010 ; Luthar, 2015 ). For instance, Ungar, Hadfield, and Ikeda ( 2018 ) interviewed 85 adolescents in Canada, who had different levels of exposure to risk and varying access to resilience-promoting resources (e.g., a supportive adult), about their experiences of service use. They found that adolescents at higher risk and with low resilience voiced a preference for professional support with more relaxed boundaries, such as contact outside of official therapy time, implying that this type of therapeutic relationship may be a protective factor for these adolescents (Ungar et al., 2018 ). On the other hand, adolescents with high resilience and at low risk described less need for professional support in general due to the social capital that they already had in their lives, implying that the social support networks that these adolescents already have access to may be protective enough without additional therapeutic support (Ungar et al., 2018 ).

Given the rising rates of mental health issues among adolescents in the UK (Vizard et al., 2020 ), recent UK government policy has moved towards schools being key sites from which to deliver interventions to promote wellbeing and prevent the onset of mental health issues (Department of Health and Social Care & Department for Education, 2018 ). The significant proportion of time that young people spend in school means that schools can reach a much wider range of young people than clinical services and can overcome barriers associated with attending clinical services, such as travel, timing, and cost issues (Masia-Warner, Nangle, & Hansen, 2006 ). As studies of resilience are inevitably contextually situated because what is experienced as protective in one context may not be available or seen as adaptive in another (Ungar, 2008 ), there is a need for qualitative research specifically in a UK context to explore the factors and processes that young people find to be protective in the face of difficulties in life, including how, why, and in what circumstances these may vary. Such findings can then be used to inform the development of effective school-based prevention and early intervention programmes to meet a range of needs.

Consequently, in the current study, we sought to build on existing understanding in this area by taking a qualitative approach to inquiry and exploring the factors, processes, and contexts (with a focus on the concepts of coping and social support) that are deemed protective from adolescents’ own perspectives and in their own words, within the setting of a school-based mental health prevention programme in the UK. Specifically, our study sought to address the following aims using qualitative methods: (1) To explore the coping strategies and sources of support that adolescents identify as protective (or not) in the face of difficult situations and feelings over a three-year period; (2) To examine how and why this may vary in line with the levels of adversity that they report experiencing in life.

Research Design

We used an interpretive, qualitative research design to explore, through semi-structured interviews, young people’s lived experiences of and perspectives on problems and difficulties in daily life, coping strategies, and accessing or receiving support both from formal sources, including professionals, and informal sources, including family and friends. Our analysis primarily draws on Braun and Clarke’s ( 2006 , 2021 ) guidance for conducting thematic analysis and is underpinned by a critical realist epistemological perspective. This takes the view that while there is a real world that exists independently of our perceptions and constructions of it, our understanding of it is a construction from our own point of view (Maxwell, 2010 ). This means that we see our analysis of the data as being an interpretation of participants’ reality, which we have constructed from our own perspectives, contexts, and views of the world. We are experienced researchers in the child and adolescent mental health research field, currently working in the context of evaluating interventions seeking to enhance young people’s resilience, mental health, and wellbeing, to learn about what helps to manage and prevent mental health difficulties.

Setting for the Study

HeadStart is a six-year, school-based, mental health prevention programme, which launched in 2016 in six local authorities in England. The aim of HeadStart is to promote resilience, wellbeing, and positive mental health through the delivery of a range of preventive and early intervention approaches seeking to boost young people’s coping strategies and environmental resources (Evidence Based Practice Unit, 2018 , 2019 ). A five-year qualitative longitudinal study is being conducted to explore young people’s experiences of HeadStart and, in doing so, examine the role and place of HeadStart more broadly within young people’s perspectives on coping and receiving support. Young people were invited to take part in the study by school staff or HeadStart staff if they had already received support from HeadStart by the first timepoint of the study or if they were identified as likely to receive it in future. To date, 82 interviews with the same cohort of young people have been conducted at Time 1 (2017 or 2018), 78 at Time 2 (2018 or 2019), and 55 at Time 3 (2019). Data collection in 2020 (Times 3 and 4) was paused due to Covid-19 restrictions.

Ethical Considerations

Ethical approval for this study was granted by the University College London (UCL) Research Ethics Committee (ID number 7963/002). As all participants were under the age of 16, written informed consent was sought from the young people’s parents/carers and written assent to take part and for the publication of their anonymised data was sought from the young people at the outset of the study. It was made clear in study information sheets that participation was voluntary, and that participants could withdraw at any time without consequence. Participants received a £10 voucher after each interview as a thank you for taking part. To protect participant confidentiality, interview transcripts were anonymised (e.g., with names of people and places removed).

Participants

A subsample of 31 participants from the wider qualitative longitudinal study sample was selected for inclusion in the present study. The subsample represented nine secondary schools across four of the HeadStart areas. Demographic information about the subsample can be seen in Table  1 . All 31 participants had taken part in Time 1, 2 and 3 interviews, yielding a total subset of 93 interviews. 25 participants from the wider study sample were excluded from the subsample as they were missing interviews at Time 2 or 3. Given our study’s focus on adversity, 14 participants were excluded because they did not discuss coping strategies and support in the context of experiencing any mental health difficulties, family strain, or bullying, nor did they not report receiving any targeted support from HeadStart at Time 1. Targeted (indicated or selective) support is offered to select students, including those with mild or subclinical symptoms of a mental disorder or those with experience of particular risk factors, such as parental mental health issues (Campbell, 2004 ; Werner-Seidler, Perry, Calear, Newby, & Christensen, 2017 ). 12 participants from one HeadStart area were excluded because they were up to two years younger (age 9–10 years) than the majority of the young people (age 11–12 years) at Time 1, thus they did not align with our study’s focus on adolescence.

Data Collection

The interviews were conducted by four members of the research team (including the first and last authors). The interviews took place in a private room at participants’ schools. Where possible, the same researcher interviewed each participant at all three timepoints. All interviews were audio recorded and transcribed verbatim. The interviews in our subsample ranged in length from 20.47 to 60.05 min at Time 1 ( M  = 40.3, SD  = 9.86), 21.39 to 68.43 min at Time 2 ( M  = 38.05, SD  = 12.95), and 22.55 to 63.23 min at Time 3 ( M  = 41.83, SD  = 11.16).

The interview schedule developed by the research team was semi-structured, which meant that while there were core questions asked by the researcher in each interview, the conversation around these key areas was led by participants’ responses. Core interview questions asked about participants’ experiences of and perspectives on coping with problems and difficult situations or feelings in life, including strategies that they drew on and social and professional support that they accessed (and their opinions on this). At Times 2 and 3, the interview schedule also asked about any changes over time in relation to topics raised previously. For example, ‘You mentioned when I met with you last year that you were having arguments with your friends, how are your friendships this year?’.

Reflexivity

Reflexivity is a means for the researcher to critically engage with their role in the research process, including remaining self-aware and cognizant of their own influence on the research and in turn how the research may be affecting them (Probst, 2015 ). The research team designed an interview reflection tool to facilitate interviewers in debriefing following each interview. Reflections were audio-recorded and discussed further with the research team lead (the first author) when the interviewer deemed this to be helpful. The intention was to provide a space for interviewers to offload their immediate thoughts and feelings following each interview, and to encourage them to develop their interview skills through reflecting on their technique in each interview.

We reflect that our approach to data collection and analysis is inevitably influenced by our own understanding and experiences of the research area. For instance, our approach to asking young people about their experiences of coping and support was influenced by our theoretical grounding as researchers within systemic theories of resilience. Thus, in each interview, we specifically explored young people’s experiences within the context of key systems, including family, peers, and school. We also recognise that our approach to data collection and analysis is influenced and limited by our own understanding and experiences of the world, including sociodemographic differences between ourselves and the young people, such as in terms of age, ethnicity, and gender identity. For example, the age gap between ourselves and participants, in conjunction with the interviews taking place on school premises, could have reinforced hierarchical structures inherent in schools (Ozer, Newlan, Douglas, & Hubbard, 2013 ), and thus inhibited participants from speaking openly in their interviews about their experiences and opinions. Therefore, we endeavoured at each interview to establish a secure, non-hierarchical space for the young people to speak to us in, emphasising confidentiality (unless any safeguarding issues arose), young people’s right to withdraw at any time, and that there were no right or wrong answers. Our interview schedules were also developed in conjunction with young people to ensure that the questions were meaningful to and understood by our target audience.

Data Analysis

To address our study aims, our analysis sought to answer two research questions sequentially: (1) What helps adolescents to manage difficult situations and feelings over a three-year period? (2) How does ‘what helps’ vary depending on the level of adversity that adolescents report experiencing in their lives over time?

To answer the first research question, a hybrid deductive/inductive thematic analysis was conducted by the first and second authors using NVivo (version 12) to identify the coping strategies and sources of support that participants reported drawing on at Times 1, 2, and 3. An existing thematic framework of young people’s coping behaviour was used to facilitate this, which was derived through an earlier inductive thematic analysis, guided by Braun and Clarke’s ( 2006 ) methodology, of all 82 interviews conducted at Time 1 with the young people taking part in the wider qualitative longitudinal study (see Stapley et al., 2020a ). The framework consisted of the following main themes: Activities and strategies; Disengaging from problems; Standing up for yourself; Acceptance of problems; Social support; HeadStart support; Other professional support; Hiding feelings or problems (Stapley et al., 2020a ).

We used this existing framework to guide our coding of the interviews in the present study, but also renamed and restructured themes, and created new themes, as necessary to best reflect the Time 1, 2, and 3 interview data. The coding process involved collating relevant transcript extracts under each theme. For instance, a new subtheme of ‘Support from boyfriends or girlfriends’ was developed from coding participants’ Time 2 and 3 interviews and included within a new main theme of ‘Support from close and trustworthy friends’. ‘Hiding feelings or problems’ ceased to be a main theme in the present study, as it became apparent when exploring the data across all three timepoints that this was typically spoken about in relation to particular groups of people, principally parents, friends, and school staff. Thus, in our study, participants’ references to finding it difficult to talk to or hiding problems or feelings from others have been captured as relevant when describing their experiences and perceptions of support from these groups.

To answer the second research question, an inductive thematic analysis was conducted, again by the first and second authors using NVivo (version 12), guided by the six steps outlined by Braun and Clarke ( 2006 , 2021 ): becoming familiarised with the data; systematically coding the data or applying descriptive labels to transcript extracts; collating similar codes (labels) to generate initial themes; developing and reviewing themes; refining and giving names and definitions to themes; and the report. The interviews were re-coded in NVivo to develop new themes, which this time delineated the difficult situations and feelings that participants reported experiencing at Times 1, 2, and 3.

Braun and Clarke ( 2021 ) take a reflexive approach to thematic analysis, which can be distinguished from codebook or coding reliability approaches to thematic analysis. We view our analysis as primarily reflexive, but at times reflecting elements more akin to a codebook approach. Our use of an existing thematic framework, for example, when answering our first research question perhaps more closely reflects a codebook approach, whereby the themes were developed using the Time 1 dataset and then used to guide our analysis of the Time 2 and 3 datasets, with refinements made as necessary in light of new data. By contrast, the analysis process for our second research question took an entirely open and bottom-up approach to both coding and theme development, which aligns more closely with a reflexive approach.

The first and second authors worked together throughout the analysis for both research questions to code the data and develop themes, using a collaborative approach to facilitate rich, in-depth engagement with the data (Braun & Clarke, 2019 ), and to ensure that our interpretations remained grounded within the data. However, we did not seek to assess interrater reliability during our analysis, thus our analysis was not aligned with a coding reliability approach to thematic analysis. This is because, in line with Braun and Clarke’s ( 2021 ) reflexive approach, we view researcher subjectivity as a “resource for knowledge production which inevitably sculpts the knowledge produced, rather than a must-be-contained threat to credibility” (p. 334–335), thus interrater reliability is not seen as a marker for quality of analysis.

Braun and Clarke ( 2021 ) also distinguish between themes defined as patterns of shared meaning organised by a central concept, which is a core part of their reflexive approach, and themes defined as summaries of participant responses in relation to particular topics within the data, which is more aligned with a codebook approach. Researchers taking a reflexive approach to thematic analysis need to justify their use of the latter (Braun & Clarke, 2021 ). Due to the large volume of data that we were working with and our aim of drawing relatively broad, concrete comparisons between groups of participants, we reflect that some of our themes align more closely with what Braun and Clarke ( 2021 ) describe as ‘shared-topic’ themes (e.g., ‘Varying trajectories of HeadStart and other professional support’), rather than ‘shared-meaning’ themes (e.g., ‘Disengaging from difficulties’).

As the final step in our analysis, by examining the transcript content coded to each theme delineating the difficult situations and feelings that each participant reported experiencing at each timepoint, participants were then divided into three groups by the first and second authors, each representing a different level of adversity. The three groups were: Group A - participants who reported that their levels of difficulty in life had improved or were manageable by Time 3; Group B - participants who reported experiencing some ongoing difficulties and some areas of improvement by Time 3; Group C – participants who reported that their levels of difficulty had deteriorated or were hard to manage by Time 3. The authors initially separately allocated each participant to one of the three groups and then checked each other’s allocations, with discussion of any instances of disagreement until agreement was reached.

Table  2 ; Fig.  1 show the difficult situations and feelings reported by participants in each of the three groups at any timepoint.

Frequencies ( N ) of participants in each group who reported experiencing particular difficult situations and feelings at any timepoint

As can be seen in Table  2 ; Fig.  1 , comparatively high proportions of participants across the three groups reported experiencing feelings of sadness and anxiety, as well as experiences of being bullied at any timepoint. However, Group C contained the highest proportions of participants who reported experiencing difficulties with anger, self-harm, arguments with parents and/or siblings, parental abuse, parental mental health issues (such as depression), getting into trouble at school, and arguments with peers. By contrast, the highest proportion of participants who reported lacking in confidence and self-esteem could be seen in Group A. Groups B and C contained the highest proportions of participants who reported experiencing some form of family or parental stress (such as animosity between parents or family financial difficulties) at any timepoint.

Table  3 ; Fig.  2 present the coping strategies and sources of support (organised in terms of individual-, family-, and environment-level protective factors and processes) that participants across the three groups reported drawing on at two or more timepoints to manage difficulties in life. Reports at two or more timepoints was considered a proxy for participants’ consistency in usage of specific coping strategies and sources of support over time. Previous quantitative longitudinal research has identified stability in adolescents’ reports of using particular coping strategies over at least a two-year period (Valiente, Eisenberg, Fabes, Spinrad, & Sulik, 2015 ).

Frequencies ( N ) of participants in each group who reported drawing on particular coping strategies and sources of support at two or more timepoints. (Note. Current or historic targeted support received from HeadStart or other professionals (e.g., CAMHS is shown as reported at any timepoint by participants)

Individual-level Factors and Processes

Engaging in activities.

Participants described engaging in different activities (e.g., playing video games, drawing, and playing football) to take their mind off their problems, have fun, or relax: “When I’m thinking about the worries and when I’m, like, drawing, it’s, like, makes me a lot, like, do you know, thinking about the worries, it makes them go somewhere else” (Group A, Time 2). The prevalence of this theme, in terms of references at two or more timepoints, was higher in Groups B (73%) and C (75%) than Group A (50%).

However, participants in Groups B and C also reported that engaging in activities did not always help. Reasons for this included that some problems (such as a grandparent dying) can make you feel so sad that engaging in an activity does not help, some activities (e.g., boxing) can make you feel angrier instead of calmer, and some activities (e.g., eating comfort food) are not necessarily good for you: “I realised me doing boxing has made me more angry and then, then when people are annoying me, then I know that I have the power to do something” (Group C, Time 3).

Using Techniques

Participants described using different techniques or specific strategies (e.g., deep breathing techniques, stress balls, and counting to 10), sometimes suggested by a professional, to try to regulate their emotions: “ When I was clicking my fingers I always… I just, when I got nervous or I got angry or something like that, I feel like that calmed me down” (Group C, Time 3). The prevalence of this theme, in terms of references at two or more timepoints, was higher in Groups B (55%) and C (67%) than Group A ( N  = 13%).

Yet, participants in Groups B and C also reported limitations in the efficacy of strategies, such as forgetting to take deep breaths to manage their anger in the heat of the moment. Participants in Groups B (18%) and C (33%) also mentioned engaging in self-harm as a coping strategy at various points in their lives. However, self-harm was only identified as a current coping strategy by the third timepoint by participants in Group C: “[My sister] just tells me I’m an idiot, (chuckles) and I need to stop doing it” (Group C, Time 3).

Disengaging from Difficulties

Almost all participants across the three groups described instances at two or more timepoints when they had dealt with problems by deliberately disengaging from them, such as through distracting themselves, forgetting problems, choosing to put problems out of their mind, or ignoring the existence of problems and individuals who were upsetting them (e.g., bullies): “I just try my best to not listen to them and just ignore them” (Group A, Time 2).

Positive Thinking

Participants described engaging in positive thinking in the face of difficulty, including trying to see the positive side of difficult situations, thinking positive thoughts to cheer themselves up, and persevering and not giving up: “Make something happy out of it or just think about generally something that makes you happy and then like… sort of like post the angry feelings out with the happy feelings” (Group B, Time 1). The prevalence of this theme, in terms of references at two or more timepoints, was highest in Group A (75%), as compared to Groups B (45%) and C (33%).

Accepting Difficulties

Participants described how over time they had become used to difficult situations or had simply accepted the existence of particular aspects of life that they found hard, which could eventually make such situations less stressful and easier to handle: “I was really shy, and like, I was scared to talk to other people, I kind of got used to it and, like, I’m not as shy anymore” (Group A, Time 3). This theme also included participants’ references to waiting for problems or difficult feelings to pass or ‘blow over’. The prevalence of this theme, in terms of references at two or more timepoints, was higher in Groups A (50%) and B (27%) than Group C ( N  = 8%).

Self-defence

Participants described situations (principally arguments with friends, family members, or teachers) at two or more timepoints that in their view required them to challenge unwanted behaviour from others or defend themselves (verbally or physically): “I ain’t just going to stand there and have everyone call me a wimp when they hit me, and I don’t hit them back. I’m just going to stand there and hit them back” (Group B, Time 1). The prevalence of this theme was higher in Groups B (64%) and C (58%) than Group A (38%).

Family-level Factors and Processes

Parents as a source of comfort and advice.

Participants in Group A often referred to both of their parents (63%) as being a supportive presence in their lives: “The first people I would go to are my parents if there was a problem. Which is really good, and they would give me their honest opinion” (Group A, Time 2). This included feeling able to and wanting to talk to their parents about their problems, with reference to their parents making them feel better, giving them advice, or helping them to see another perspective or reach a solution. Similarly, 45% of participants in Group B described both of their parents, at two or more timepoints, as being a source of support, comfort, and advice in difficult situations. A higher proportion of participants in Group C identified one of their parents (58%), usually their mother, as being a supportive presence in their lives, as opposed to both parents (17%). This parent was described as being a source of advice and comfort.

Parents at Arms-length

Only a minority (25%) of Group A participants perceived one parent as being a more prominent source of support than the other at two or more timepoints. Both of these participants self-identified as female and described feeling more able to talk to their mothers about problems than their fathers, who they felt may not understand their problems to the same degree that their mothers would: “If it’s to do with girls or problems at school, I probably wouldn’t necessarily speak to [my dad] about it but sometimes, I do” (Group A, Time 2). Similarly, participants in Group B (36%) who described one parent as being a more prominent source of support than the other indicated that they had a closer relationship with one parent (usually their mother). By contrast, the other parent for participants in Group C was often seen as being a source of difficulty in their lives or as less available to talk to (such as because they were busy or they did not live with them), and so was considered to be a less suitable source of support for these reasons.

Participants in Group B also described instances of not always feeling able to, not always wanting to, or hesitating to talk to their parents about their problems. For instance, if they thought that they might worry or upset their parents, if their parents were not available to talk to, if they thought that a problem was not major enough to warrant talking to their parents about, or if, in general, they preferred trying to resolve problems on their own first. Similarly, participants in Group C described finding it hard to speak to their parents about some issues, such as feeling sad or having low self-esteem, because, for example, they felt that their parents did not understand what they were going through.

My mum is always like, ‘Toughen up’. I literally can’t and like I don’t know what to say to my mum when she says to me, ‘Toughen up’, when she’s like, ‘You need to stop crying, you need to grow up’, and I don’t know if I can. (Group C, Time 3)

Other Family Members as a Supportive Presence

Participants also described drawing on support from other members of their families. The prevalence of this theme, in terms of references at two or more timepoints, was higher in Group B (73%) than Groups A (38%) and C (33%). There were participants in all three groups who saw their siblings (and also, in a small number of cases, their cousins) as ‘having their back’ and as being someone to talk to about problems and seek advice from because, for example, they had had similar experiences to each other: “If there’s any problems with me, like, s- I, I could talk to [my sister]. And like, she’ll listen. Like, I’ll, I can trust her […] she won’t, like, tell my mum if I don’t want her to” (Group B, Time 2). In terms of support from extended family, participants across the three groups most often referred to their grandmother as a source of support, describing them as another person to talk to about problems and seek advice from, in the absence of or in addition to parental support. Participants in Groups B and C also described their pets as being a source of comfort and as cheering them up when they were feeling sad, worried, or angry.

Environment-level Factors and Processes

Support from close and trustworthy friends.

Similar proportions of participants across Groups A (75%), B (73%), and C (67%) described at two or more timepoints how their friends (including, for a minority, boyfriends or girlfriends) were a source of support in times of difficulty. Friends were referred to as cheering you up, standing up for you in arguments or against bullies, and being someone to talk to and receive relatable advice from, for example for problems that your parents would not understand. However, while trust in family members was more implicit, there were participants across all three groups who mentioned having specific or close friends whom they trusted more than others to keep their problems confidential: “I have one friend […] she’s like really… we talk about everything. When I told, when I say something to her, it then doesn’t come out anyone’s mouth” (Group B, Time 3).

School Staff as a Double-edged Sword

Higher proportions of participants in Groups B (55%) and C (58%), as compared to Group A (38%), reported drawing on or being given support, when needed, from school staff (teachers and/or pastoral care staff) at two or more timepoints. Participants in Group A primarily described school staff as mediating in situations of bullying or arguments with peers, and felt that particular school staff members were supportive or were there for them to talk to if they needed to. However, Group A participants also reported that generally they felt more comfortable seeking support from family and friends, although they would consider talking to a school staff member if a problem was really serious: “If we’re talking about like school, no, not really, because um I just feel like that’s, that’s not what I do, that’s not how I deal with things. Like, I, I, I’d rather go to my friends or my mum” (Group A, Time 3).

Participants in Group B similarly described school staff as intervening in difficult situations with peers, and also described seeking support from specific school staff members if they were upset or if they wanted someone to talk to. However, Group B participants also mentioned times when school staff had not always been able to provide effective support. For instance, school staff were not always available to talk to about problems, they did not always listen or take action, or they could not always be trusted to keep problems confidential. Talking to a teacher about issues with peers could also result in you being labelled as a ‘snitch’, which was not helpful: “If I do tell on the people who do it, they w- they will A, start calling me a snitch, and B, start making fun of [me] even more” (Group B, Time 1).

Participants in Group C described having arguments with and feeling blamed by teachers, but also described instances when they had been given support by particular members of school staff, including seeing them as someone to speak to about difficult family situations, bullying, or managing anger. However, Group C participants also described times when they had struggled to trust school staff, including having an awareness that there may be consequences of speaking to school staff (such as an investigation happening), worries about teachers forming an opinion of you, and experiences of or anticipation of not feeling understood by school staff: “I find it a bit difficult to tell teachers because I know that their policy is obviously they can’t tell pupils, but they can tell like people if it’s a major problem like anyone [is] in danger” (Group C, Time 3).

Varying Trajectories of HeadStart and Other Professional Support

Group C contained the highest proportion of participants who reported receiving targeted support from HeadStart at any timepoint (75%), followed by Group A (63%) and Group B (45%). On the other hand, Group B contained the highest proportion of participants who reported receiving current or historic support from other professionals (outside of HeadStart) at any timepoint (73%), followed by Group C (58%) and Group A ( N  = 0).

At Time 1, four participants in Group A reported meeting with a peer mentor (an older student at school). They described the positive impact of this type of HeadStart support, including learning coping strategies, having someone relatable to talk to, and boosting their confidence. At Time 2, none of these participants reported still being in receipt of peer mentoring. Three had been offered additional HeadStart support (such as involvement in co-producing their area’s programme). However, one had decided not to take part as none of her friends had signed up this year, another’s support had stopped because of school staff strikes, and the other participant’s support had never begun. One participant in Group A mentioned receiving HeadStart support for the first time at Time 2 (counselling). At Time 3, no participants in Group A reported receiving any HeadStart support: “I just stopped it because I didn’t think I’d need it anymore” (Group A, Time 3).

At Time 1, four participants in Group B reported receiving HeadStart support, including one-to-one (peer mentoring or counselling) and small group-based support (psychoeducational sessions or co-production meetings). They described receiving useful advice about coping with being bullied and handling difficult feelings (such as anger and anxiety), enjoying being involved in HeadStart, and finding it helpful to have someone to speak to about their worries.

They give some really good ad- advice, like when we was learning about worrying and stress, there was like some stuff that we can do to like help deal with that, and then things that we do, like, that are maybe bad and like how we can stop that like happening, and like a better way to cope with it. (Group B, Time 1)

At Times 2 and 3, only one participant in Group B was still receiving HeadStart support. This participant reported feeling more confident and less anxious as a result, but also felt that some of their group sessions had been disrupted by other students misbehaving. Two participants in Group B did not feel at Times 2 and 3 that they needed support from HeadStart anymore, as they were feeling better. However, two other participants (one of whom also described receiving ongoing support from a professional at CAMHS to manage her anxiety across Times 1, 2, and 3, and the other of whom mentioned seeing a school counsellor at Time 2) stated that they would like to receive support from HeadStart again at Time 2. One of these participants still felt the same at Time 3, whereas the other felt that they did not need any support from HeadStart by Time 3.

Two participants did not report receiving support from HeadStart at any timepoint, but did mention taking medication to manage attention deficit hyperactivity disorder (ADHD) across Times 1, 2, and 3. Five participants also described historic contact with social services, counselling, and/or therapy to manage such issues as school-related stress or difficult family situations. Four of these participants identified aspects of this support that had been unhelpful, such as finding it boring, finding it hard to talk about difficult feelings or situations, or having their trust betrayed. Only one of these participants stated that his therapy had had a positive impact on his levels of worry and stress at the time. However, he also said that he would not necessarily want to receive therapy again.

Nobody wants to be the person who’s, like, gone to therapy three years in a row. And um ‘cause I don’t want to miss school as well because last time I had to go to therapy I, I, I missed a lot of school. (Group B, Time 2)

At Time 1, five participants in Group C reported receiving one-to-one (peer mentoring) or small group-based HeadStart support (psychoeducational sessions or co-production meetings). Participants described getting things off their chests through talking to others about their problems, and learning how to manage their worries and anger. One of these participants also reported receiving ongoing small group and one-to-one support from HeadStart support workers across Times 2 and 3. However, the other four participants reported no longer receiving HeadStart support at Time 2 because it had ended or because they had not found it helpful.

Of the latter four participants, one participant did not report receiving any HeadStart support at Time 3 either. Another reported receiving HeadStart support again at Time 3 in the form of co-production meetings, as well as having contact with social care and a school counsellor, which he described as limited in its utility. The remaining two participants described receiving support from statutory CAMHS, social care, and/or a counsellor instead of HeadStart at Time 2. Both felt that this support was more helpful. By Time 3, one of these participants was still receiving ongoing counselling, and the other had stopped receiving support from statutory CAMHS, but had been referred to another form of small group-based HeadStart support at school.

Why do you think the CAMHS course has been more helpful than [HeadStart]? They explained it more in detail and like, I don’t know. Talking to like other people with ADHD and stuff and I found than better than. ‘Cause like not really much people has ADHD in this school. (Group C, Time 2)

Two participants in Group C reported receiving HeadStart support for the first time at Time 2 (counselling). For one of these participants, this support had continued at Time 3, although with a new counsellor, as her previous counsellor at Time 2 had not managed to help her. For the other participant, this support (which had also included therapeutic work with her parents) had ended by Time 3. However, both of these participants also mentioned receiving support from statutory CAMHS in relation to feelings of anxiety, depression, and self-harm at Time 3.

[My previous counsellor] couldn’t cope with the situation. It was too hard for her to deal with because, she, she, she was too young […] like, she couldn’t help, she didn’t know what to do with it. Um, and that’s why we had to go with a different person. (Group C, Time 2)

Two participants in Group C reported receiving HeadStart support (e.g., online counselling) for the first time at Time 3. One of these participants also mentioned receiving professional support at Time 1 for ADHD. The other participant mentioned historic contact with social care at Time 2 and current support from social care at Time 3. This participant described having recently been referred to a youth worker by her social worker for additional emotional support, which she felt had been helpful.

Our sample consisted of adolescents who were attending schools in England implementing a mental health prevention programme, HeadStart. Within our sample, we identified three groups of participants: those who reported that their levels of difficulty in life had improved or were manageable by the third year of the study (Group A); those who reported experiencing some ongoing difficulties and some areas of improvement (Group B); and those who reported that their levels of difficulty had deteriorated or were hard to manage (Group C). Young people who reported experiencing higher and/or persistent levels of difficulty in life over time, as compared to their counterparts, more often described using such coping strategies as self-defence and self-harm, referred to limitations in the efficacy of particular activities and strategies, voiced reasons why they were reluctant or unable to seek support from their parents, perceived limitations in support from school staff, and reported more mixed experiences of support from professionals, in terms of the timing of support and their perceptions of its efficacy. This aligns with findings from a previous qualitative study conducted to examine change over the first two years of HeadStart in young people’s experiences of difficulties and support, drawing on the wider qualitative longitudinal study sample of 78 participants (Stapley, Eisenstadt, Demkowicz, Stock, & Deighton, 2020b ). This study found that young people who described having more difficult experiences in general over the two-year period were more likely to report having sources of support characterised by uncertainty or ambiguity (Stapley et al., 2020b ).

The findings of the current study also reflect previous quantitative findings, which have similarly identified variation in the incidence and impact of protective factors according to the level of adversity that young people are experiencing (e.g., Fergusson, Lynskey, & Horwood, 1996 ; Kassis et al., 2013 ). However, our qualitative findings also add to this previous quantitative research by showing when, how, and why particular factors and processes may be more or less protective from the perspective of young people who are experiencing varying levels of adversity. For instance, in previous research, friendships have been found to mitigate against the negative effects of bullying (Kendrick, Jutengren, & Stattin, 2012 ), and family adversity (Criss, Pettit, Bates, Dodge, & Lapp, 2002 ). Yet, while comparatively high proportions of participants across all three groups in our study referred to their friends as a source of support in times of difficulty, the proportion of participants who also described having arguments with their friends was highest in Group C. This could suggest that the quality of support may influence the level of protection that it can offer. Indeed, high quality friendships, defined in terms of perceptions of supportiveness, have been found to predict lower levels of future victimisation by bullies (Kendrick et al., 2012 ).

Quality may also be relevant when considering the limitations in the efficacy of particular coping strategies that participants in Groups B and C reported, as well as the use of self-harm as a coping strategy in a minority of cases. The coping strategy of positive thinking, on the other hand, employed by a majority of participants in Group A, has been identified in previous research as being an individual-level protective factor implicated in promoting young people’s resilience (Masten & Barnes, 2018 ), and as an adaptive coping strategy (Losoya, Eisenberg, & Fabes, 1998 ; Zimmer-Gembeck & Skinner, 2011 ). Yet, disengagement or withdrawal from problems has been found in previous studies to be associated with poorer mental health outcomes (e.g., (Seiffge-Krenke, 2004 ; Seiffge-Krenke & Klessinger, 2000 ). By contrast, our findings indicate that this is a strategy that the majority of young people engage in, regardless of their levels of difficulty in life (see also Stapley et al., 2020a ). Perhaps this alternatively reflects previous findings from the emotion regulation literature that the use of distraction can enhance adolescents’ levels of positive affect and reduce their levels of negative affect, which may be a solution in the short-term (Wante, Van Beveren, Theuwis, & Braet, 2018 ).

While parental support was drawn on by young people in all three groups in our study, the majority of participants in Group C cited one parent, rather than both, as a source of support, with the non-supportive parent described as less available to talk to because for example, they were busy, they did not live together, or they were a source of difficulty in their lives. By contrast, the majority of participants in Group A referred to both of their parents as being a supportive presence in their lives. Previous qualitative studies have similarly highlighted the importance, from young people’s perspectives, of familial support in protecting against adversity or promoting recovery from mental health issues (e.g., Las Hayas et al., 2016 ; Smokowski & Reynolds, 1999 ). Indeed, close caregiver-child relationships have frequently been identified as a key family-level protective factor for young people in the face of adversity (Masten, 2021 ). The higher levels of familial stress reported by young people in Groups B and C, as compared to Group A, may explain the differences in the levels of familial support that they reported. For example, previous research has identified a negative association between interparental conflict and parental emotional support provision for young people (Riggio, 2004 ).

In terms of support from HeadStart, 61% of participants reported receiving some form of targeted HeadStart support by the end of the three-year period of our study: three-quarters of participants in Group C, just under half of Group B, and just under two-thirds of Group A. In Groups A and B, the majority of participants reported receiving support from HeadStart at Time 1 only. By contrast, in Group C, participants described a range of interactions with HeadStart, with some participants only reporting receiving support at one timepoint and others reporting receiving multiple forms of support across or at different timepoints. Our findings suggest that more long-term, regular, or sustained preventive intervention may be needed for young people who are experiencing higher levels of difficulty in life (see also Stapley et al., 2020b ), such as those within Groups B and C, with perhaps more ‘light touch’ engagement for those experiencing less difficulty over time, such as those within Group A. The latter reflects Ungar et al.’s ( 2018 ) finding that adolescents with high resilience and low risk describe less need for professional support in general, potentially due to the social support that they already have.

School staff nominations are often a starting point for the identification of students for targeted interventions (Campbell, 2004 ). However, research has shown that teachers have less accuracy in identifying young people with emotional problems, compared to behavioural problems (e.g., Cunningham & Suldo, 2014 ; Splett et al., 2020 ), and with moderate or subclinical levels of symptoms, compared to severe (Splett et al., 2019 ). This could offer a potential explanation for why just under 50% of participants in Group B, for example, reported ever receiving HeadStart support, and why, for participants in Group C, the timing of their interactions with HeadStart varied. Thus, instating a regular wellbeing and mental health symptom check-in (such as using standardised self-report outcome measures) with young people each school year, and at the end of support interventions, could help to ensure that young people are offered additional support as and when it is needed (Humphrey & Wigelsworth, 2016 ; Stapley et al., 2020b ).

On the other hand, it is possible that some participants were offered support and chose not to engage with it. Indeed, participants in Groups B and C identified both positive elements and limitations of the HeadStart and professional support that they had received, and described ways in which school staff could be supportive, but also voiced concerns about trusting school staff, or instances of not feeling listened to or understood by school staff. Previous qualitative studies of young people’s help-seeking behaviour have similarly identified young people’s perceptions of issues around school staff trustworthiness and availability as barriers to help-seeking (Helms, 2003 ; Lindsey & Kalafat, 1998 ). Such concerns could thus present a barrier to young people’s engagement with preventive interventions led by trained school staff or implemented within a school setting. Therefore, reviews of evaluations of existing programmes have highlighted the important role that a programme component focusing on promoting a supportive school environment or ethos can have in maximising engagement with and the effectiveness of school-based prevention and early intervention programmes (Weare & Nind, 2011 ).

Training in coping and problem-solving skills is often a key component in psychological interventions (Horwitz, Opperman, Burnside, Ghaziuddin, & King, 2016 ). Some of the coping strategies that participants described appear to align with treatment components across a range of evidence-based prevention and treatment approaches; for instance, positive thinking echoes aspects of cognitive restructuring activities within cognitive behavioural therapy (CBT) approaches (Clark, 2013 ). Yet, interventions that primarily aim to effect change at the level of the individual may have more limited efficacy for those who are experiencing high levels of contextual stress. Indeed, higher levels of family dysfunction have been found to predict poorer mental health treatment outcomes for adolescents (Phillips et al., 2000 ). This could explain why participants in Group C, approximately 90% of whom reported experiencing various sources of familial stress, were experiencing difficulties with their mental health and relationships by Time 3, despite 75% of them reporting receipt of HeadStart support by that point. Thus, following a review of resilience research, Luthar ( 2015 ) concluded that to maximise the potential for success, resilience-enhancing interventions should focus on invoking change in both the child and in their wider environment. For instance, the UK-based Thrive Framework is a needs-based approach to mental health and wellbeing support, which “provides a set of principles for creating coherent and resource-efficient communities of mental health and wellbeing support for children, young people and families” (Wolpert et al., 2019 , p.2).

In a review of school-based mental health services, Rones and Hoagwood ( 2000 ) found that effectiveness was associated with multi-component programmes that targeted the ecology of the child, such as through involving parents (e.g., in parenting skill development sessions) and teachers (e.g., in classroom management techniques training). Similarly, in a systematic review, Weare and Nind ( 2011 ) found that the involvement of parents was cited in multiple reviews as a key ingredient in school-based preventive interventions. However, only one participant in our study mentioned receiving a HeadStart intervention that involved therapeutic work with their parents. Thus, particularly for young people who are experiencing higher levels of adversity in life (e.g., familial strain), our findings suggest that mental health prevention programmes like HeadStart could benefit from placing emphasis on implementing interventions that seek to effect change and boost the resources available within young people’s wider contexts, as well as within young people themselves. This reflects theories of resilience that emphasise the role of the individual’s connections and relationships with external systems in promoting resilience, as well as their own capacity to cope (e.g., Masten & Barnes, 2018 ; Ungar et al., 2008 ).

Strengths and Limitations

Our study illuminates the different coping strategies and sources of support that adolescents experiencing varying levels of adversity in life view as protective (or less so) in relation to handling difficult situations and feelings over a three-year period – and why. A limitation of our study relates to the transferability of our findings. Most notably, our sample consisted of adolescents who were identified and invited to take part by school staff or HeadStart staff, based on current or potential future engagement in some aspect of HeadStart. Thus, our findings may overlook wider experiences, including those experiencing adversity without the school’s awareness, whose experiences of coping and social support may well be different. Similarly, there may be individuals who declined to take part, and we do not know how their experiences relate to those reported here.

Furthermore, our sample includes only those who chose to take part in all three interviews over the three-year period of the study. We do not know whether additional themes would be identified from interviews with adolescents who were unable to take part in all three interviews, such as if they had moved to a different school and were uncontactable by the research team. It is possible that the latter may be those who are experiencing particularly high levels of adversity. In terms of demographic information, we note that the majority of our sample identified themselves as being from a White ethnic background. Future research would benefit from an emphasis on sociodemographic representativeness in sampling, including direct exploration of how ethnicity may play a role in the protective factors and processes identified by adolescents in the UK. We note too that our findings are by nature specific to England, but may nevertheless offer value to researchers in other countries when considered in conjunction with research specific to their locality.

The findings solely reflect participants’ reports of experiences of difficulties in life, coping, and engagement with support that they remembered to or chose to share in their interviews. While every effort was made to help participants to feel comfortable and secure in the interview situation, including building rapport during each interview and ensuring where possible that the same researcher interviewed the same participant across all three timepoints, some participants may have felt less comfortable about sharing their experiences with a stranger, or sharing experiences that might have led to them feeling upset or embarrassed in their interviews (Docherty & Sandelowski, 1999 ). Lack of reference in an interview is not an objective indication that a participant definitely did not draw on a particular coping strategy or support source. For this reason, we did not seek to explore change over time in the minutiae of young people’s usage of particular coping strategies and support. Participants were also not explicitly asked about change over time in relation to each individual coping strategy and source of support mentioned in each interview.

The interview questions focused on participants’ experiences of coping and seeking or receiving support over each year of the study. Thus, it is important to note that while a broad range of protective factors have been identified in resilience research, including for example ‘skilled parenting’ and ‘connections with well-functioning communities’ (Masten & Barnes, 2018 ), our study focused specifically on the types of coping strategies and sources of support that young people report as being protective in the face of difficulty, as this was the focus of the interviews. In addition, there were a minority of problems (e.g., physical health issues) and sources of support (e.g., support from adults outside of the family and school) that were referenced so infrequently and by such a small number of participants that they were not included in our final list of themes.

Participants were grouped in our analysis based on their subjective experiences of the levels of difficulty in their lives that they were experiencing by the third timepoint of the study. We are unable to report objectively on the levels of mental health difficulties that would meet clinical thresholds within our sample. However, we reflect on the possible circularity of grouping participants in this way, in that individuals with higher levels of mental health concerns may be more likely to perceive situations as stressful or notice stressful aspects of their environment, or individuals experiencing more stressful situations or situated within a more stressful environment may be more likely to experience higher levels of mental health concerns.

Our findings add to previous research by showing that the types, quality, and consistency of reported coping strategies and support, as described by adolescents in a UK context, varies in line with whether adolescents report experiencing higher or lower levels of adversity in life over time, and according to the resources that they have available within their physical and social environments. Future research in this area could qualitatively explore the additional factors and processes, both internal and external to the individual, beyond coping strategies and sources of support, that adolescents in this context describe as protective, and examine how these may also vary in line with the level of adversity experienced. Future research could also seek to further disentangle the differences between the presence and quality of different support sources and coping strategies as protective factors. Understanding the specific support and coping processes that are perceived to be most helpful by adolescents could indicate important areas for intervention.

Our findings suggest that more long-term, regular, or sustained early intervention may be needed for young people experiencing higher levels of difficulty in life. School staff and practitioners implementing regular reviews with young people regarding their support needs and preferences could help to ensure that young people receive timely support that is best suited to their needs. This aligns with a needs-based approach to providing support for young people’s mental health and wellbeing. Finally, for maximum effectiveness with young people who are experiencing high levels of contextual adversity, preventive interventions could benefit from being multi-component, such as incorporating family, school, and individual elements to boost the resources available within young people’s wider contexts, as well as within young people themselves.

Availability of Data and Material

Access to data is restricted to the HeadStart Learning Team to comply with the study’s ethical approval. Materials (e.g., interview schedules) are available upon request to the corresponding author.

Code Availability

Not applicable.

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Acknowledgements

We are indebted to the young people who generously shared their experiences with us.

With thanks to other members of the HeadStart Learning Team (Mia Eisenstadt, Rosa Town, Alisha O’Neill, and Parise Carmichael-Murphy) for their vital role in the collection, management, and analysis of data used to inform our research publications.

With thanks also to our colleagues in the National Institute for Health Research (NIHR) Children and Families Policy Research Unit (Ruth Gilbert, Kevin Herbert, Tanya Lereya, and Sarah Cattan) for their helpful feedback on earlier drafts of this paper.

HeadStart is a six-year, £67.4 m National Lottery funded programme set up by The National Lottery Community Fund, the largest funder of community activity in the UK. The interview data analysed in this study were collected as part of the Learning Team’s national evaluation of HeadStart, funded by The National Lottery Community Fund. The views expressed are those of the author(s) and not necessarily those of The National Lottery Community Fund.

This study was funded by the National Institute for Health Research (NIHR) Policy Research Programme. ES was also partly supported by the NIHR ARC North Thames. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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ES conceived of the study, led on in its design, coordination, and data collection and analysis, and drafted the manuscript; SS participated in the study design and data analysis, and contributed to the drafting of the manuscript; JD led on the acquisition of funding, participated in the study design and coordination, and contributed to the drafting of the manuscript; OD participated in data collection and analysis, and contributed to the drafting of the manuscript. All authors read and approved the final manuscript.

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As all participants were under the age of 16, written informed consent was sought from the young people’s parents/carers and written assent was sought from the young people themselves for them to take part and for the publication of their anonymised data.

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Stapley, E., Stock, S., Deighton, J. et al. A Qualitative Study of How Adolescents’ Use of Coping Strategies and Support Varies in Line With Their Experiences of Adversity. Child Youth Care Forum 52 , 177–203 (2023). https://doi.org/10.1007/s10566-022-09682-0

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DOI : https://doi.org/10.1007/s10566-022-09682-0

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The Science of Coping: 10+ Strategies & Skills (Incl. Wheel)

We all have trouble coping at some points in life. We don’t get the promotion we hoped for; our relationship breaks down; a presentation is overdue.

Whether you cope or not depends on how you think. Stress is a feeling of emotional or physical tension, and it arises from how you interpret life’s events as they unfold.

Our coping skills have evolved to help us survive in environments very different from those in which most of us now live, work, and play (Cosmides & Tooby, 2013). While we have a body and mind well adapted to overcome the challenges faced by hunters running down a kudu in the African savannah, we are a poor match for the difficulties found in modern life (Li, Vugt, & Colarelli, 2017).

Psychological research in the fields of sports, business, and beyond has identified approaches, skills, and tools that can help us cope, overcome, and even flourish.

The strategies that follow take us beyond a focus on repairing weaknesses and attending only to what is wrong, and instead view growth as default, mental wellbeing as expected, personal strengths to be built up, and an authentic existence to be lived.

Before you continue, we thought you might like to download our three Resilience Exercises for free . These engaging, science-based exercises will help you to effectively cope with difficult circumstances and give you the tools to improve the resilience of your clients, students, or employees.

This Article Contains:

A look at the coping wheel, 5 strategies for coping with stress, a real-life example, teaching coping to children: 3 ideas, 2 ways to cope with anxiety, how to cope with anger, 7 books on the topic, realizing resilience masterclass tools, a take-home message.

Coping strategies are processes used to manage stress. They help to control your thoughts, feelings, and actions before, during, and after challenging situations.

And there are plenty of them.

Research into coping has identified over 400 strategies and multiple classifications (Machado et al., 2020), including:

• Problem focused (proactively dealing with the source of the stress) versus emotion focused (reducing stress by regulating emotion)
• Approach (alleviating the problem directly) versus avoidance (distancing oneself from the stressor)

In an analysis of 44 studies, researchers found that coping strategies fit under 12 mutually exclusive coping families , represented in the diagram below (Skinner & Zimmer-Gembeck, 2007).

Source: The Positive Psychology Toolkit© (The Coping Strategy Wheels)

Techniques and strategies have a focus (e.g., actions, social resources), a coping family that shares the same action tendency (e.g., problem solving, negotiation), and a way of coping (e.g., surrender, emotion regulation).

Psychological stress arises in response to social and physical environments (Monroe & Slavich, 2016).

The stressor can be mild or intense: walking to the office on a hot day or traveling through the Kalahari Desert on foot, a pre-lunch rumbling stomach or failure of a vital food crop, an awkward conversation with a coworker or a hostage negotiation.

Such events cause a state of strain; impact our psychological and physical wellbeing; and vary in magnitude, timescale, and use of coping mechanisms.

The tools that follow can be adopted and adapted as needed to assist coping in difficult times, promoting growth, and supporting mental toughness and resilience .

They reframe a present or future situation, reduce or remove negative thoughts, or foster learning how to think positively.

1. ABCDE model

The ABCDE model, developed by Albert Ellis in the 1950s, provides a reflective framework. It supports us in changing our emotions and behaviors by identifying irrational beliefs and swapping them with rational ones.

Recognize, write down, and then challenge beliefs that are irrational or unhelpful.

The process of disputing irrational beliefs can lead to a more authentic, beneficial belief system. You may not have control over your environment, but you do have control over your reactions.

2. Positive thinking

Everything we know, believe, and feel is based on our internal thoughts. Positive thinking gives us extraordinary power over our thinking and ourselves (Strycharczyk & Clough, 2015).

Affirmations are used widely within sports. The repetition of short statements provides a way for the athlete to mirror the uplifting effects of hearing positive messages from a friend or coach.

Spend some time thinking about situations that you have faced or expect to encounter in the future. For each, write down a few short, supportive statements that provide strength during a challenge.

There is also growing evidence that the use of positive internal conversations, known as self-talk, can significantly improve how we tackle a challenge or approach a situation.

Talk to yourself as though a friend, coach, or supportive colleague is offering you positive advice.

A good practice at the end of each day for positively reinforcing successful performance is to write down and review three achievements, small or large, from the last 24 hours.

This daily closure activity helps you focus on what went well, rather than dwelling on disappointments or perceived failures.

Use the achievements to take that positivity through to the next day.

3. Visualization

It is common practice for athletes to use imagery while they prepare for an event, practice a movement, or train while injured. Swimmers mentally rehearse a perfect dolphin kick, and endurance runners imagine pulling extra miles from the depths of their mental and physical resources (Meijen, 2019; McCormick, Meijen, & Marcora, 2015).

Focusing on positive mental images can favorably impact both our mind and body and increase self-belief in our ability to cope with change.

The mind offers a safe and flexible environment for practicing a stressful task. Mentally rehearsing a daunting performance prepares the individual by asserting control over a (sometimes harmful) inner voice (Strycharczyk & Clough, 2015).

4. Control the controllable

Athletes often talk about controlling the controllable.

Adequate preparation will increase the perception of control, which is crucial to our mental toughness and motivation, and improve performance.

Write down a list of outcomes, real or imagined, to an important situation on sticky notes.

For example, when reviewing a challenging meeting:

• Did attendees arrive prepared?
• Were accurate notes and actions taken?
• Was the agenda followed and all points covered?
• Was everyone heard?
• Was agreement reached over the critical decisions?

Place each note on a large copy of the following graph:

• What went well goes at the bottom and less well, at the top.
• What can be controlled goes in the left-hand column and what cannot be controlled, in the right-hand column

Review the completed graph.

Outcomes in the bottom-left quadrant – went well and can be controlled – require no action. Though it can be useful and increase self-belief to regularly review successes.

Outcomes in the top-left quadrant were within our control but unsuccessful. Ask yourself how you could have handled the situation better or differently. Once reviewed, consider how best to approach it next time, then let go of it. Do not dwell.

Anything on the right-hand side of the table is outside of our control. Revisit to confirm that it is still the case. Focus on what can be controlled and accept what cannot.

5. Three steps to handle stress

People who adopt the mindset that “stress is enhancing” experience more exceptional performance and less negative health symptoms (Crum & Crum, 2018).

If view positively, physical and mental stress are essential to moving from a fixed to a growth mindset.

Having worked with athletes and Navy SEALS, Crum and Crum (2018) propose a three-step approach to harnessing the positive aspects of stress while minimizing any negative health impacts.

Step one – “See your stress”

Don’t attempt to ignore stress. Label it.

Seeing it as something positive, rather than to be avoided, can change our physical, cognitive, and behavioral response to it.

See it, and label it: “ I am stressed because I haven’t completed the report yet.”

Step two – “Own it”

When you are at risk of being overwhelmed by stress, own it.

Own it: “ I recently got the promotion I wanted; this is part of my new role.”

Step three – “Use it”

Your body and mind have evolved to respond to stress; use that energy, alertness, and heightened concentration to boost your mind.

Use it: Be open to the opportunity. Use the stress to energize and motivate yourself.

Reframing stress to something positive can enable you to overcome existing and future obstacles (Crum & Crum, 2018).

Download 3 Free Resilience Exercises (PDF)

These detailed, science-based exercises will equip you or your clients to recover from personal challenges and turn setbacks into opportunities for growth.

Download 3 Free Resilience Tools Pack (PDF)

By filling out your name and email address below.

The following real-life example exemplifies the human capacity to cope. Csikszentmihalyi (2009) describes this ability as follows:

“the same stressful event might make one person utterly miserable, while another will bite the bullet and make the best of it.”

Against all odds

When Carmen’s estranged husband broke into her home, he beat her so severely that the police said it was more brutal than anything they had ever seen. Following the horrific injuries to her head, she remained in a coma for three months (Hooper, 2019).

When she regained consciousness and was finally able to get out of bed, she was in terrible pain, blind, and required multiple skin grafts. Surprisingly, rather than feeling sorry for herself, she realized she had been given a gift: the opportunity to help people.

Despite, as she describes it, “looking shocking,” she became a speaker and an inspiration to many.

And the story doesn’t end there. The tight skin grafts on Carmen’s face continued to cause her immense pain, and she became only the seventh person to have a face transplant. To give further insight into her character, she connected and struck up a close friendship with the daughter of the donor. They now see each other regularly.

Carmen’s story of resilience is incredible. Not only did she survive injuries she could have died from, but she overcame the challenges to flourish in her new life.

He has worked closely with British Olympic athletes and supported British Cycling in their considerable successes.

His bestseller, The Chimp Paradox , explains the inner workings of the brain using what he describes as the “Chimp Model.” It consists of three elements: the human, the chimp, and the computer.

The human – you – uses a logical and rational approach to solving problems. The chimp represents the fast-reacting, instinctual parts of the brain. It interprets information emotionally and often responds impulsively, frequently causing us problems.

The final element, the computer , stores previous experiences and uses them to advise the human and the chimp. It represents your memory and a set of learned, automatic responses.

In My Hidden Chimp: Helping Children to Understand and Manage Their Emotions, Thinking, and Behaviour With Ten Helpful Habits , Peters and Battista (2018) use the same model to help children develop healthy habits for life.

Understanding when the chimp tries to take over

Identify words that describe you and your chimp, trying new things.

Sometimes we get scared to try new things.

Can you think of three things you would say to your friend’s chimp to help it try something new?

Encourage the chimp to try something new:

• If you try something new, you might enjoy it.
• Something new could be fun, and you could share it with friends.
• You could become more confident if you try new things.

Working through each of the above examples, with or without an adult, can help the child understand their feelings better and identify when the chimp tries to take over.

Psychological research has proven the importance of relaxation as an effective technique for managing anxiety. As psychology has confirmed, we can influence our minds by taking control of our bodies (Strycharczyk & Clough, 2015).

Exercises for managing anxiety include the following.

1. Controlled distraction

Similar to self-talk, controlled distraction reduces anxiety by redirecting attention away from a negative situation.

When a quick fix is required, take your mind off your anxiety by focusing on something that doesn’t cause you upset.

For example, before giving a presentation, count lights or ceiling tiles, listen to music, or imagine a past or future vacation.

2. The Laura Mitchell Relaxation Method

The Mitchell Relaxation Method (Mitchell, 1990) has been around for decades but remains a successful and widely used treatment for patients with anxiety.

The client is asked to ‘pull’ each muscle group in turn, stopping in between; for example, ‘pull your shoulders toward your feet,’ ‘stretch out your fingers and thumbs.’ They must remain mindful of their body position, breathing, muscles, joints, and skin.

The initial rush of adrenaline leads to physical indicators that you may become aware of before you spot emotional changes: increased heart rate, faster breathing, tension, and a clenched jaw and fists.

Simple techniques can quickly be adopted and buy extra thinking time: a short walk, counting to 10, or talking to a friend for independent advice.

Breathing techniques can also help you to find calm and reduce escalating feelings.

Box breathing is practical and easy to learn. Imagining each side of a box, breathe in (side 1), hold (side 2), breathe out (side 3), and hold (side 4). Each side should last approximately four seconds.

Exercise, distraction, and mindfulness are other positive ways to handle tension or release anger.

To learn more about coping, mental toughness, resilience, and our evolutionary background, check out these 7 books available on Amazon:

• On Mental Toughness by Harvard Business Review ( Amazon )
• Mindset: Changing the Way You Think to Fulfill Your Potential by Carol Dweck ( Amazon )
• Positivity: Groundbreaking Research to Release Your Inner Optimist and Thrive by Barbara Fredrickson ( Amazon )
• Evolutionary Psychology: The New Science of the Mind by David Buss ( Amazon )
• The Chimp Paradox: The Mind Management Program to Help You Achieve Success, Confidence, and Happiness by Dr. Steve Peters ( Amazon )
• Self-Determination Theory: Basic psychological needs in motivation, development, and wellness by Richard Ryan and Edward Deci ( Amazon )
• Developing Mental Toughness: Coaching Strategies to Improve Performance, Resilience, and Wellbeing by Doug Strycharczyk and Peter Clough ( Amazon )

17 Tools To Build Resilience and Coping Skills

Empower others with the skills to manage and learn from inevitable life challenges using these 17 Resilience & Coping Exercises [PDF] , so you can increase their ability to thrive.

Created by Experts. 100% Science-based.

The Realizing Resilience – Coaching Masterclass is an excellent resource for practitioners. Teach your clients how to become more resilient and mentally tough with the science-based techniques and tools in this online masterclass.

If you’re looking for more science-based ways to help others overcome adversity, this collection contains 17 validated resilience tools for practitioners . Use them to help others recover from personal challenges and turn setbacks into opportunities for growth.

The human mind is impressive. It has evolved the potential to solve complex problems and successfully manage unexpected and novel situations.

And yet, coping is less about what is happening in the world, and more about how our minds interpret the situation. Perception is everything. This is why coping mechanisms focus on managing, reframing, or avoiding how we perceive the stressors.

If we can see stress not as something to be shied away from, but rather an opportunity to embrace, we can live a more complete, authentic life. After all, although evolution has shaped our minds and bodies, we are free to choose how we react and behave.

While we often lack control of our environment, we decide what affects us and how we respond.

It is not possible and would not be enjoyable to live a life without stress. Overcoming the challenges, pitfalls, and failures in life are just as crucial as celebrating the wins and enjoying happy outcomes. Stress is a valuable force for growth.

However, if our inability to cope is getting in the way of living a full life, achieving what we want, or causing damage to others, then we must adopt and adapt the tools that work best to overcome the situation and flourish.

Thank you for reading.

We hope you enjoyed reading this article. Don’t forget to download our three Resilience Exercises for free .

• Buss, D. (2014).  Evolutionary psychology: The new science of the mind  (5th ed.). Psychology Press.
• Cosmides, L., & Tooby, J. (2013). Evolutionary psychology: New perspectives on cognition and motivation. Annual Review of Psychology , 64 (1), 201–229.
• Crum, A., & Crum, T. (2018). Stress can be a good thing if you know how to use it. In Harvard Business Review, HBR’s 10 must-reads: On mental toughness . Harvard Business Review Press.
• Csikszentmihalyi, M. (2009). Flow: The psychology of optimal experience. Harper Row.
• Dweck, C. S. (2017). Mindset :  Changing the way you think to fulfill your potential  (6th ed.). Robinson.
• Fredrickson, B. (2010).  Positivity: Groundbreaking research to release your inner optimist and thrive . Oneworld Publications.
• Hooper, R. (2019). Superhuman: Life at the extremes of mental and physical ability. Abacus.
• Li, N. P., Vugt, M. V., & Colarelli, S. M. (2017). The evolutionary mismatch hypothesis: Implications for psychological science. Current Directions in Psychological Science , 27 (1), 38–44.
• Machado, A. V., Volchan, E., Figueira, I., Aguiar, C., Xavier, M., Souza, G. G., … Mocaiber, I. (2020). Association between habitual use of coping strategies and posttraumatic stress symptoms in a non-clinical sample of college students: A Bayesian approach. PloS One, 15 (2).
• McCormick, A., Meijen, C., & Marcora, S. (2018). Effects of a motivational self-talk intervention for endurance athletes completing an ultramarathon. The Sport Psychologist , 32 (1), 42–50.
• Meijen, C. (2019). Endurance performance in sport: psychological theory and interventions. Routledge.
• Mitchell, L. (1990). Simple relaxation: The Mitchell method of physiological relaxation for easing tension. Murray.
• Monroe, S. M., & Slavich, G. M. (2016). Psychological stressors: Overview. In G. Fink (Ed.), Stress: Concepts, cognition, emotion, and behavior: Handbook in stress series (vol. 1) (pp. 109–115). Academic Press.
• Peters, S. (2016). The chimp paradox: The mind management program to help you achieve success, confidence, and happiness . Vermilion.
• Peters, S., (Author) & Battista, J. (Illustrator) (2018). My hidden chimp: Helping children to understand and manage their emotions, thinking, and behaviour with ten helpful habits. Studio Press Books.
• Ryan, R. M., & Deci, E. L. (2018).  Self-determination theory: Basic psychological needs in motivation, development, and wellness.  Guilford Press.
• Skinner, E. A., & Zimmer-Gembeck, M. J. (2007). The development of coping. Annual Review of Psychology , 58 , 119–144.
• Strycharczyk, D., & Clough, P. (2015). Developing mental toughness: Coaching strategies to improve performance, resilience, and wellbeing. Kogan Page.

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Chinese school adolescents’ stress experience and coping strategies: a qualitative study

• Xiaoyun Zhou   ORCID: orcid.org/0000-0002-3903-4166 1 , 2 ,
• Matthew Bambling   ORCID: orcid.org/0000-0002-9684-5184 3 , 4 ,
• Xuejun Bai   ORCID: orcid.org/0000-0003-3491-6861 5 &
• Sisira Edirippulige   ORCID: orcid.org/0000-0001-6196-5437 1 , 2  

BMC Psychology volume  11 , Article number:  91 ( 2023 ) Cite this article

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Stress in adolescence is associated with adverse mental health outcomes. Coping resources have been proved by literature to have buffering effects on the impact of stress on mental health. It is imperative to understand the stress and coping strategies of adolescents. However, to date, there has been a scarce of qualitative examination of stress and coping strategies in adolescents in a Chinese population.

This study aimed to understand the stress experience and coping strategies of high school students in China.

This study adopted a qualitative design involving three focus group interviews. A purposive sampling method was used to recruit high school students who were enrolled in grades 10 to 11, and their teachers, at a Chinese high school which resulted in 20 students and 9 teacher participants. Data were analysed using inductive thematic analysis.

A total of 4 themes were identified: (i) sources of stress; (ii) impacts of stress (iii) coping strategies used by students; and (iv) recommendations for stress management programs. Students experienced excessive stress in their daily lives. The primary source of stress came from high expectations for academic achievement. Other sources of stress were peer relationships and family issues. The stress had negative impacts on students’ emotions, sleep, study, and mental wellbeing. The students demonstrated various coping strategies, with the most common being avoidant coping. Students and teachers agreed that the coping strategies were not effective in reducing stress in the long run and that more coping skills training was needed.

Conclusions

This study is the first to assess the perceptions of Chinese high school students and their teachers regarding adolescent stress experiences and coping strategies. Chinese high school students experienced significant stress in their daily lives and demonstrated unhelpful coping strategies. Participants demonstrated consensus that they did not have the skills to cope. There is a demonstrated need for interventions that focus on increasing coping skills in this population.

Peer Review reports

Adolescents undergo diverse challenges in their daily lives, including schoolwork, coping with puberty, and building social relationships among peers. These challenges constitute acute or chronic stressors for adolescents. Extensive research has shown that stress has profound impacts on adolescents’ brain development [ 1 ], mental health well-being [ 2 , 3 ]and academic performance [ 4 ]. According to the World Health Organization, one in seven adolescents experiences a mental disorder, which accounts for 13% of the global burden of disease in this age group [ 5 ]. Previous studies have shown that stress-coping resources have a buffering effect on the impact of stress on mental health [ 6 ]. It is therefore imperative to provide adolescents with programs that assist them with developing stress-coping skills. Thus, understanding the stress experience of adolescents and coping behaviours plays a critical role in the development of such programs.

In the past decade, several studies have been conducted in the westernised countries to investigate adolescents’ stress experiences and their coping behaviours. These studies showed that adolescents experienced school life (e.g., long hours of doing homework and materials being too difficult) as the main source of stress [ 7 , 8 , 9 , 10 , 11 , 12 ]. Adolescents were also reported to experience stress from sources such as family issues [ 7 , 8 , 10 , 11 , 13 ], and peer relationships [ 7 , 8 , 11 , 13 , 14 ]. While there is some research showing students though that some amount of stress could have positive impact on their performance [ 9 , 10 ] such as increased motivation to do schoolwork and leisure activities and self-esteem [ 14 ], most studies have shown that adolescents perceived stress as negative experience which affected their emotional and physical wellbeing [ 7 , 8 , 14 ]. Compared with the amount of literature which investigated the stress experience of adolescents, disproportionately fewer studies have investigated the coping strategies used by adolescents [ 7 , 8 , 9 , 15 ]. Regardless of the diverse coping strategies reported, students rarely mentioned that they used professional help (i.e., counselling services) as coping strategies. In addition, of particular concern is that the use of maladaptive coping behaviours is common among adolescents, such as internalising stress [ 9 ] and engaging with substance use including consumption of alcohol, smoking, marijuana, and other simulants [ 8 , 9 ].

Previous studies have found that Chinese adolescents experience stress differently from westernised countries, which may be embedded in cultural difference [ 16 ]. Chinese adolescents are suggested to show higher mental health issues and lower life satisfaction in comparison with their European counterparts due to the family and education systems’ emphasis on academic performance [ 17 ]. According to a national survey, Chinese adolescents are at a high risk of depression, with grades 9 to 11 having at the highest rate of depression. This survey showed that 40% of senior high school students have symptoms of depression, and 11-12.6% of senior high school students have major depressive disorder [ 18 ]. However, this is also the age group that are least likely to seek professional help for mental health problems [ 19 ]. In addition, previous study also showed that 19.3% of Chinese adolescents had suicidal ideation, and it is significantly associated with stressful life events, among which academic stress and family conflicts were main risk factors [ 20 ]. It is therefore essential to understand Chinese adolescent stress experience and coping strategies, so effective programs can be developed and provided. However, at this time no qualitative research has been identified that examines the stress experience and the coping strategies among Chinese adolescents. This study aimed to understand Chinese senior high school students’ experience relating to stress, sources of stress and the impact of stress on their daily life and their coping strategies. As one of the aims of this study was to inform intervention development for Chinese high school students; understanding the needs and preferences of the most important stakeholders—head teachers—is critical for successfully implementing such interventions. In addition, considering it may be difficult for Chinese adolescents to disclose some private stressful experiences, for example, romantic relationships, with stranger peers in focus groups or with the interviewers [ 21 , 22 ]. Teachers, who usually have years of experience interacting with students, would be a good data source for researchers to comprehensively understand adolescents’ stress experiences [ 23 ]. Thus, teachers were involved as an additional data source.

This study will shed light on the Chinese adolescents’ stress and needs and inform program development that aims to manage stress among this population.

Study design

This study employed an inductive qualitative design [ 24 ] involving focus group interviews. The data were analysed with qualitative thematic analysis. We followed Consolidated Criteria for Reporting Qualitative Research (COREQ) [ 25 ] while reporting this study (see Appendix 1 ).

Participants

Inclusion and exclusion criteria.

Participant recruitment occurred in May 2021 at a boarding school in Mianyang city in China. Mianyang city is a moderately sized city located in Sichuan province in southwest China, with a population of around 5.3 million, of which around half live in the urban area. Mianyang city is also an economically moderately developed city with its per capita GDP approximately equal to that of whole China [ 26 ]. For students, the inclusion criteria were (i) they should be enrolled in grade 10–11 at the time of interview, (ii) and they should be aged 15–19 years old. After consulting school administrators, as grade 12 students were engaged with preparing for Chinese college entrance examination, involving them will be impractical, therefore, students who were enrolled in grade 12 at the time of interview were excluded. In Chinese high school education system, each class has a head teacher and subject teachers. Unlike subject teachers who are only responsible for teaching a subject (e.g., Mathematics and History), head teachers are responsible for the students’ study and class management, they also interact with the students’ family members constantly. Head teachers have a comprehensive understanding about the study and life of their students and therefore were included as an alternate data source. Subject teachers were excluded.

We used a purposive sampling method to recruit students and teachers. The recruitment.

strategies involved announcement and posters in each classroom by the first author, purpose.

of the study was illustrated. Twenty students and 9 teachers agreed to participate. For the 20.

students, their age ranged from 15 to 17 years old, half of them were female, and half students.

were from grade 10 and the other half were from grade 11. For teachers, the age ranged from 28 to 49 years (mean = 37.9, SD = 6.3). All of them were males, which could be explained by the fact that most head teachers were males in the school. The years of teaching ranged from 5 to 29 years (mean = 15.3, SD = 7.1), slightly more teachers (n = 5) were teaching grade 10 than those who were teaching grade 11 (n = 4) at the time of interview.

Data collection

Three semi-structured focus group interviews were conducted to collect data. The first focus group involved all 9 teachers. Students (n = 20) were randomly divided into two groups, with each group involved 10 students. The three focus group interviews were conducted by the first author who was a female PhD students with master’s degrees in mental health and psychology, and a male research assistant who was a high school psychology teacher (not within the study site) with master’s degree in psychology at the time of interview. Both of them were trained by experts in qualitative research methods. There were no formal relationships established prior to recruitment of the participants. The focus group interviews were conducted in Mandarin and in person at a meeting room at the school. Three focus group interviews were conducted on three different weekdays at moral education classes where students were normally engaged with non-academic activities.

At the start of each interview, the moderator restated the purpose of the study and asked for permission for recording. Two semi-structured interview guides were developed to understand the experience of teachers and students separately (Table  1 ). The semi-structured interviews comprised of open questions to facilitate in-depth exploration into adolescents’ stress and coping behaviours. All questions covered the following aspects: (i) what makes adolescents stressed? (ii) how does stress impact adolescents? (iii) what coping strategies do adolescents use to cope with stress? (iv) what are needed from stress management programs? The interview guides were developed by qualitative researchers (MB, SE, XB), who specialised in education, mental health, and psychology. The focus-group interviews lasted between 50 and 65 min. Field notes were made during the interviews. During each focus group interview, before asking the next question, the interviewer summarised the answers from participants to participants, only when there were no more information added, did the interviewer ask the next question. All the interviews were audio-recorded with permission and transcribed and translated to English for subsequent analysis. The transcription and translations were conducted by a professional service, the first author who speaks both Mandarin and English reviewed the transcripts to ensure the quality. Participants were all anonymised by assigning pseudonyms.

Data analysis

The qualitative data in this study were analysed using thematic analysis [ 27 ]. All the anonymised transcripts were imported to Nvivo 12 software for coding and generating themes. Two authors (XZ & SE) independently performed the analysis. XZ has the background of mental health and school psychology and SE has a background of education and health research. The researchers first familiarise themselves with the data by reading and re-reading the transcripts, notes were made where necessary at this stage. Secondly, initial coding was conducted. To ensure the intercoder reliability, the researchers met regularly during the coding process to double check whether or not they were coding consistently. Adjustments were made as necessary. Third, a coding framework was developed. The initial coding framework was discussed and refined among the research team members. Fourth, themes were generated from the coding framework by grouping codes featuring similar contents, yielding themes that described “source of stress”, “impact of stress”, “coping strategies” and “needs for programs”. Fifth, the analysts reviewed and refined the main themes and identified subthemes. In the final step, the subthemes were refined. The analysis began since data collection. Reflective journals were kept by both analysts throughout the analysis process to reflect how they made decision about which code to use and the process of generating themes. The reflective journal was reviewed by a senior analyst (XB) to ensure that there was no personal bias. XB has a background of psychology and education. The two analysts meet weekly to discuss their codes and themes, any disagreement was resolved by involving a senior qualitative analyst (XB or MB).

Results from student interviewees

The results from focus interviews with students were categorised into four themes: [ 1 ] sources of stress; [ 2 ] impact of stress; [ 3 ] stress management; and [ 4 ] recommendations for professional help (Table  2 ). School adolescents’ stress involved various sources including academic stress, conflict with peers and conflict with parents. These sources of stress negatively impacted school adolescents’ emotion, study and sleep. In response to the stress and its impact, students actively used diverse strategies to manage stress, and they thought that these strategies help relieve stress in a short period of time but not in the long run. They, therefore, suggested various recommendations for professional help that will be provided to them.

Theme1: sources of stress

Most adolescents in this study experienced stress. They identified a variety of sources of stress, and all these sources made them feel stressed:

Then I have a lot of pressure from my grades, from my parents, and from my classmates. I feel that none of them are easy (Zhao, Group one, boy).

These sources of stress were categorised into three subthemes.

Subtheme1.1 academic stress

Most of the stress was experienced at the school. Students felt that there were expectations for them to perform well academically, which included getting high scores in examinations, and ranking top in school. These expectations came from teachers, parents, other family members, and themselves. They wanted to meet these expectations. However, they were not always capable of doing so. When they could not meet others’ expectations, they felt guilty:

I think my biggest pressure came from my studies. Because, generally, I am aware that our teachers have high expectations for me, I am very afraid of letting them down, and this causes a relatively large psychological pressure… I can’t stand others being disappointed in me. (Qian, Group one, girl)

I think my stress comes mainly from the fact that my family’s expectations for me don’t match my actual situation.... my parents have accomplished so much, and they are very successful. I admire them. But they expect me to take another leap of social class as my parents did, but I feel like…according to my current academic performance, it is very unlikely. (Sun, Group two, boy)

The adolescents experienced academic stress also because high schools are highly competitive environments, they felt that there were too many brilliant students, and it was difficult for them to be outstanding:

…Sometimes I feel that the difference in intelligence between the genders is too great. It may be true that sometimes hard work can’t make up for this gap. It made me feel very powerless. (Li, Group two, girl).

It is worth mentioning that, even though, this female adolescent thought that the intelligence difference, especially for science subjects, such as mathematics, physics, and chemistry, may be due to gender differences. Boys in our focus groups also mentioned the intelligence difference caused stress for them.

I think my stress mainly comes from [examination] grades, studies, and possibly individual intelligence differences. This gap is so big that…. I may have worked hard…. My study time was longer than theirs, and I often felt that when I was studying, they were playing, but in the end, their [examination] grades were better than mine. (Zhou, Group two, boy)

Subtheme1.2 peer stress

Peer-inducted stress is another major concern among our participants. Our participants felt that peer stress came from the fact that they could not find a way to outlet their dissatisfaction or anger amid conflicts with their peers. They felt the need to suppress the feelings in order to maintain good interpersonal relationships at school, which caused stress for them.

My stress also comes from interpersonal relationships... For example, a while ago, I had an issue with a classmate, …he was in a certain position in our class. He was stopping me from doing something in the classroom, but because the way he managed me was extreme, he frequently punished and yelled at me… I was very angry, although I knew that he was just doing his duty, and I should not blame him, I still felt [angry].. . Because there were times when he criticized me, but not the other person, I felt it was unfair, and that caused stress for me. (Wu, Group one, boy)

Some of our participants also stated that their interpersonal stress came from the fact that it was difficult to make close friends in high school. They could not talk to anyone when they needed to share their feelings, which caused stress for them.

In addition to my study, the interpersonal relationship among classmates is also a factor that may cause some pressure on me. Sometimes I felt that even though I had a lot of friends, in some specific situations, it seemed that I had no friends to whom I could turn for help or talk about my feelings. (Zheng, Group two, boy)

Subtheme1.3 family stress

Family is another source of stress identified by our adolescent participants. The school adolescents sometimes had conflicts with their parents, and these conflicts mainly focused on the study, a few conflicts related to peer relationships as well. They felt that their parents tend to put their own pressure on their children. The adolescents felt hurt by the words said by their parents however, they could not refute their parents.

My grades have been good since I was a child, and my parents had high expectations for my future. Then after entering high school, my test scores were not very ideal, there were too many brilliant students here, and then my parents felt very upset, and then they would vent their dissatisfaction and say how brilliant other people’s children were, and they would not consider how I felt or could I stand that. They would also say some very hurtful words to me, and I felt really hurt, and I would not dare to refute them, because if I really refute them, my parents might cry, etc. (Zhao, Group one, boy)

…including aspects like study. Parents always say they are creating a relaxed learning environment for me. What they actually did was putting a lot of pressure on me, making it impossible for me to really get that kind of inner relaxation. (Wong, Group two, girl)

The school adolescents also felt that their parents were too controlling. They felt that their parents wanted to control every aspect of their life, leaving no privacy for them. This caused a lot of stress on them.

For example, my parents controlled me very strictly. Then, just like many parents, they say one thing but do opposite things, they said they didn’t control too much about their children’s personal life and kept their children’s private spaces. In fact, it felt like my parents had invaded every aspect of my life, and then I have no privacy at all. (Wong, Group two, girl)

Theme 2: impacts of stress

Stress coming from diverse sources together impacted every aspect of school adolescents’ study and life. Even though the interview question asked about the general impact of stress. Almost all students naturally talked about the negative impacts of stress on them. The impacts were categorised into the below subthemes:

Subtheme 2.1: negative impacts on emotions

Our student participants felt that they experienced anxiety, upset, low mood, anger, and depression when they felt stressed.

As the college entrance examination gets closer, there is a feeling that my goal is getting further and further away. Then I got anxious every time I went back to school after holidays. Then I would be very anxious, and sometimes I could not even stop feeling anxious and could not concentrate on studying. (Zhou, Group two, boy) … In fact, it caused a lot of pressure, and many times it still made me feel very anxious. For example, when I was in a class, I felt that I didn’t finish the homework in the last class, and I had to make it up in this class, as a result, I did not finish the homework for this class. At night, when I thought back about the whole day, I felt very upset. (Pang, Group two, boy)

Subtheme 2.2: negative impacts on the study

All our participants agreed that stress had a negative impact on their study. The stress coming from all sources caused a burden for these adolescents. They could not help thinking about the stressful situations, which could be conflicts with parents and peers that happened in the past, which could also be coming examinations. These thoughts impacted their capacity to focus on the homework or lecture they were doing or attending:

I usually sat there in class and thought about the hurtful things my parents said to me at home, and all those scenes and sounds were repeated in my head, and then I couldn’t concentrate on the study material. (Zhao, Group one, boy)

The academic stress coming from “intelligence differences” decreased students’ motivation. They felt that regardless of the amount of effort they put into study, it was impossible to catch up with those “intelligent” peers. This gap dampened their self-confidence. As a result, they doubted themselves and did not feel like studying anymore.

The [intelligence] gap between peers is too big, and it feels like it is something innate. There is no way to make up for it, so I felt that I couldn’t narrow the gap between others through my own efforts…Sometimes I suddenly didn’t want to study anymore. …[silence] I just didn’t want to study anymore. (Qin, Group two, boy) …. Then the gap between me and others is too big, and I might have worked hard, I studied longer than them… and I felt that they were playing while I was studying, but their test results were still better than me…that’s how I began to doubt myself. (Chen, Group two, girl)

Subtheme 2.3 negative impacts on sleep

Two of our student participants felt that stress had caused sleep difficulties for them, which included difficulty in falling asleep, and poor sleep quality.

…. when I went to school, I sometimes would think of unpleasant things that happened at home, especially when I was resting, for example, it would affect my sleep. (Hu, Group two, girl)

Theme 3: stress management

Student participants disclosed a broad range of strategies they used when they felt stressed. Generally, when they felt stressed, they used informal ways to deal with stress and none of the students mentioned the use of professional services, such as mental health services inside and outside school, which were available to them. The stress coping strategies were categorised into three subthemes.

Subtheme 3.1: internalising stress as the primary strategy

Almost all student participants mentioned that they tended to suppress the unpleasant feelings when they felt stressed. They might think of the reason why they were stressed, or stay alone turning off their phones, or just had a good cry, as they did not want to bring these unpleasant feelings to others. They also encouraged themselves or blamed themselves while feeling stressed. They thought that these strategies were useful for a short period of time, but the stress will come back:

[When I’m stressed] I usually went to a place just by myself, and then talked to myself, and turned off the phone because when I was under a lot of pressure, I didn’t like to infect others with my emotions. I usually internalised it by myself. I felt that my regulation of stress was a kind of self-deception, I felt that I had suppressed the feelings, but these feelings might be temporarily suppressed, but they came back after a period of time. (Chen, Group two, girl)

Subtheme 3.2: engaging in leisure activities

Our student participants also indicated that they tried to divert their attention from a stressful situation to leisure activities that they enjoyed. These included a variety of activities, such as doing sports, hanging out and joking with friends, listening to music, having a good sleep, having a bath etc. Some students thought that these strategies help them feel better. However, several students believed that these strategies could help them forget about stress for a short period of time, however, stress remained when fundamental problems were not solved:

First, I feel that I am an optimistic person and feel less stressed. If I found that I was a little stressed, for example, I was very upset while doing homework, I then washed my face and went to sleep. If it did not work, I had happy friends, then I would spend some time with them doing things irrelevant to studying. I also listened to music in the bed, and then took a shower, which was actually a very good way for me to relieve stress. (Pang, Group two, boy)

[With these methods] Most of the pressure can be solved, but some essential problems cannot be solved, such as deep-rooted conflict with parents– ways of thinkings are very different between parents and us. (Meng, Group two, girl)

Subtheme 3.3: talking to friends, parents, and teachers

In addition to relieving stress by themselves and diverting attention to other activities. Our student participants also tended to talk to their friends, as they felt that their friends could listen to them and understand them. They found that talking to friends was an effective way to outlet unpleasant feelings. The same as the above-mentioned strategies, they felt that talking to friends helped them forget about stress for a short period of time, but the stress could come back.

When I encountered some really stressful situations or felt sad, I would call my best friend to talk about my troubles, and then I would feel much better…But in fact, I felt that I might forget about the stress in the short term, but sometimes if I occasionally see something that resonates, all the previous sadness and pressure would come out again. (Hu, Group two girl)

Students also turned to their parents and teachers for suggestions and comfort when they felt stressed. If the parents understood them and gave them practical suggestions, the students felt relieved. However, if the parents used the opportunity to judge students, the students would feel worse.

When I felt stressed about studying and interpersonal relationships, I usually chose to talk to my parents. My parents were the kind of people who understood me. After listening, they would give me a lot of suggestions and comfort me. They would not judge me either, then I wouldn’t feel that stressed anymore. (Wu, Group one, boy)

[When I was under pressure] I would also ask my parents or teachers to give me some guidance or advice. Then I felt that [after I told them] they even put more pressure on me, re-stress me, for example, they would say, they believe in me, and then it will be better next time, etc., as a result, I felt more stressed. (Hu, Group two, girl) …Many times when I told my parents about my stress, they would analyse the situation from a different perspective and tried to prove that it was my problem, and it made me very annoyed. (Pang, Group two, boy)

Theme 4: recommendations for stress management programs

As this study will inform the development of a stress management program, we asked the student participants what would be needed if we provide a program to them for stress management. Students made a broad range of recommendations that would help them manage their stress. These recommendations were categorised into the following subthemes:

Subtheme 4.1: emotion-regulation and problem-solving skills should be trained

Students were aware that they lacked the skills to manage stress. They recommended that we provided skills training for them to regulate their negative emotions when they felt stressed:

The most important thing is to teach us how to change our moods. In fact, if we thought about stress, it is mostly about emotions. When my parents scolded me, I felt worst at that moment, but after so long, it seemed that there was not so much stress. So, I think the program should teach us how to feel better when we are stressed. (Zhao, Group one, boy)

They also suggested that problem-solving skills were needed, as they thought it was impossible to reduce stress in the long run if the fundamental problems were not solved.

I think solving the problem that caused stress for us is the most important thing... The program should teach us how to solve our problems. If the problems are not completely resolved after attending the program, the stress will continue and even get worse. And we may not want to seek help anymore. (Qian, Group one, girl)

Subtheme 4.2: psychoeducation should be delivered

The psychoeducation our student participants needed had four facets. First, our student participants felt that they were not always aware of the fact that they were stressed. Occasionally, they only cried and felt bad. It, therefore, was important to educate them about symptoms of stress so that they knew they were stressed. Second, they felt that they wanted to know the reasons that caused stress for them so that they could figure out ways to reduce their stress. Third, these students felt the need to understand the severity of their stress, in order for them to seek professional help. Fourth, they needed to have knowledge about the resources of mental health services that were available to them.

For example, one of my friends I knew in our previous dormitory once had some problems, and then she was sad. It was obvious that she needed help. We tried to help her and suggested she talk to the school counsellor. But she kept saying that she was ok. But if we left her to herself, she got more upset… So, I felt that it is important to let us know that we already need to go for help at that stage. And if some students do not want to talk to a school counsellor, where else can we go for such help. (Huang, Group one, girl)

Subtheme 4.3: an understanding and supportive atmosphere should be created

Students agreed that regardless of the type of program that will be delivered, it was of most importance to create an understanding and supportive atmosphere. This atmosphere should comprise of a safe and confidential environment, program-delivers being active listening, non-judgemental, thinking from the students’ perspective, and motivating them to change their status.

I think it is more important to feel being listened to. I know that some counselling services are face-to-face and one-on-one. Many things are kept confidential, so we feel safe to talk about whatever we want. Sometimes we talked to our teachers and classmates, and they may tell others, and some teachers may tell our parents. (Li, Group two, girl) …When I was stressed, it was because I couldn’t open my heart and mind. And I really wanted to find someone to talk to, I actually hoped that this person could understand and support me no matter I was right or wrong. In fact, many times I knew that I did the wrong thing, but if this person could support me, I would feel much better. (Pang, Group two, boy)

Results from teacher interviewees

The results from a focus group interview with teachers were categorised into four themes: (i) the discrepancy between expectations and reality of the source of stress. (ii) impact of stress on students; (iii) coping strategies used by students; and (iv) recommendations for stress management programs (Table  3 ). Almost all teachers agreed that students were stressed in high school settings. Even though the interviewer and moderator did not give any direction in the discussions, all teachers perceived that the level of stress students experienced had negative impacts on their studies and life. Most teachers thought school adolescents lack the skills to deal with stress. The reasons were: First, parenting methods were inappropriate—either spoiling children or being too strict with children. The children, therefore, did not have a chance to develop the capacity to deal with setbacks. Second, social media had negative impacts—children interacted more with mobile phones than with real people, these adolescents, therefore, did not have adequate experience with interpersonal relationships.

Teacher theme 1: sources of stress

Teacher participants thought that there were three main sources that caused stress for the school adolescents. Regardless of the sources that caused stress, overall, teachers thought the stress came from the fact that the expectations did not match the realities. And these sources are illustrated as three subthemes:

Teacher subtheme 1.1 academic stress

Teachers all agree that school life was the main reason that caused stress for adolescents. These included examination scores, rankings, and understanding of materials. Teachers all agreed that expectations coming from parents, students and even teachers caused stress for students. Students were expected to get high scores, rank high in examinations, and finally, go to a great university. However, materials in high schools were much more difficult than that in secondary schools. In addition, there were more smart and hardworking students in high schools than in secondary schools. Students who performed well in secondary schools, sometimes including their parents, could not accept the fact that they could not be outstanding anymore. This caused a lot of stress for students.

The main stress of students comes from study, which is manifested in self-cognition, positioning, and expectations for themselves, especially from the parents of students and the students themselves. They [students and their parents] did not have the right understanding of the students’ intelligence, the studying context, or children’s thinking ability. So, they have high expectations for the students. Then after entering high school, in the stressful competitive learning environment, the results of the students’ efforts may not be as expected, and the conflict between this reality and expectations led to stress. (Fei, teacher group, 42 years old, 20 years of teaching experience)

Teacher subtheme 1.2: peer stress

Teacher participants thought that interpersonal relationships are another main stressor for student adolescents. For student adolescents, their interpersonal relationships included peer relationships, teacher-student relationships, and romantic relationships. The teachers thought that students wanted to maintain good interpersonal relationships, however, they were not adequately equipped with interpersonal skills, especially communication skills, and therefore constantly had challenges in interpersonal life. Students’ interpersonal stress was manifested in three domains. The first domain is conflicts with peers. Adolescents put great importance on trust in peer relationships, they needed peers to keep secrets for them and back up them. When accidental things happened, and they felt betrayed, this caused conflicts with their peers.

For example, there was a case in our class: in fact, the two students had a very good relationship, but when someone suddenly betrayed him, he was about to explode, and after the eruption, he became severely depressed. (Yue, teacher group, 42 years old, 20 years of teaching experience)

Another source of interpersonal stress comes from the teacher-student relationship. Teacher participants mentioned that when the students did wrong things, they educated them and sometimes criticized the students. Some students could be very unhappy, but they chose to suppress their feelings instead of communicating with teachers. This caused interpersonal stress for the students.

There is a student in our class. His teacher criticized him, and then he was depressed for several years. It was not until later in the process of getting along with him that the teacher discovered this problem and took the initiative to talk to him, and he then talked about it, his situation got better after that... The interpersonal stress of students is basically a problem of communication. (Yi, teacher group, 33 years old, 9 years of teaching experience)

Teachers also mentioned that romantic relationships are another source of interpersonal stress for student adolescents. It is normal for adolescents to have romantic feelings toward others, however, most of the time, they could not express their feelings to that person. One of the reasons was that schools’ rules do not encourage high school students to develop romantic relationships. The other reason was that some students were homosexual, even though the society was not against homosexuals, it did not encourage it either. These students were under more pressure.

Take a student in our class as an example. He had always liked a girl in our class from secondary school to high school. In addition, the boy was from a divorced family. He needed emotional support very much, but he was a very introverted child. He dared not to tell this girl. Because this girl was a straight-A student and had a very optimistic and cheerful personality. Later, when other students found out, they all laughed at him, saying that he was “unworthy”, and then caused a lot of stress on him. And that girl transited to another school last semester, in the end, he never had the opportunity to express his feeling to that girl. So, he has been very confused and stressed till now. (Wei, teacher group, 38 years old, 17 years of teaching experience)

Teacher participants thought that the reasons why students lack interpersonal skills were three facets: (i)the excessive use of mobile phones reduced students’ chance to practice interacting with real people; (ii) the interpersonal skills that were demonstrated by television programs and novels were misleading; (iii) many of these students did not have siblings, they lacked natural environment to acquire and practice interpersonal skills at home.

People like us have siblings, the environment in which we lived and grew up was harsher than today’s adolescents, and we communicated more with real people all the time. Nowadays, children use mobile phones to communicate with each other. When they go home, they play games behind closed doors... (Lin, teacher group, 49 years old, 29 years of teaching experience) … For example, when these children watched some episodes of TV dramas or movies, they felt that “it seems that, in real life, when I deal with interpersonal problems, I can follow the methods in TV dramas and movies”.. . but in real life, they found that the effects they received were diametrically opposite. So, they couldn’t accept it, and they had doubts about this society and the world around them. (Xiao, teacher group, 33 years old, 11 years of teaching experience)

Teacher subtheme 1.3: family stress

Teacher participants thought that family issues are another source of stress for student adolescents. As the school was a boarding school, some students came from places that were far away. The students only went home once per month. They, therefore, lacked in-personal interactions with their parents and lacked love and care that they needed from their parents, which caused stress for them. In addition, teachers thought that the divorce of parents could also cause stress for adolescents.

… especially in high schools, some students are far away from home. It is this kind of leaving home and parents, lack of care, and sometimes there caused stress for them. (Guo, teacher group, 28 years old, 5 years of teaching experience) … For example, when the relationship among the family members and between the parents are not harmonious, or the parents are divorced. These all kinds of family issues could cause stress for the children, and sometimes… mental diseases. (Sheng, teacher group, 37 years old, 14 years of teaching experience)

Teacher theme 2: impacts of stress on students

Teachers thought that the amount of stress the high school students were experiencing mainly had two kinds of impacts. The first impact was related to study, and the second impact was related to students’ mental health.

Teacher subtheme 2.1: losing motivation in study

Teacher participants thought that students had unrealistic expectations for their study outcomes, and they lacked the ability to deal with setbacks. They could lose motivation to study when stressed.

Many students thought that they were genius because they did very well from elementary school to secondary school. However, after entering high school, they found that there were many problems in the study that he could not solve. At that time, they began to doubt themselves, lost motivation, and even gave up on themselves. (Fei, teacher group, 42 years old, 20 years of teaching experience)

Teacher subtheme 2.2: mental health issues

Teacher participants agreed that stress could cause severe mental health issues, such as depression, self-harm, suicide attempts etc. for the students.

A girl in our previous class, had physical issues, such as cervical spondylitis, and lumbar spondylitis, but that girl liked to study very much, but after sitting in the classroom for a long time, she was always in pain. She wanted to continue with her study… receiving acupuncture and moxibustion, but all of these made her very painful. This caused her to want to commit suicide, to end all of this. Later, in the third year of high school, there was more stress from studying, and her thought of committing suicide became stronger. (Yuan, teacher group, 43 years old, 20 years of teaching experience) … Later, he felt that his mother didn’t trust him, so he adopted a very extreme method, that was, self-harm, cutting his wrists. (Zhang, teacher group, 38 years old, 13 years of teaching experience)

Teacher theme 3: coping strategies used by students

Teacher participants mentioned a range of coping strategies that were commonly used by students. There were adaptive coping strategies such as talking to the school counsellors, playing sports, hanging out with friends, talking to parents and friends and so on. The students also frequently used maladaptive coping strategies such as avoidance of problems, overeating, and addiction to novels and computer or mobile games.

Some students, especially some girls, choose to eat crazily when they were under stress. Really.. some students felt they were venting their unpleasant emotions by eating. (Yue, teacher group, 42 years old, 20 years of teaching experience) …Some outgoing students liked to do sports to release their pressure. (Guo, teacher group, 28 years old, 5 years of teaching experience) … for some students with poor grades or the students who did not receive many affirmations, their method was to give up on themselves by indulging in reading novels, playing [computer or mobile] games, and releasing pressure in that way. For example, in the game, they could kill anyone, and vent as much as they liked. (Yue, teacher group, 42 years old, 20 years of teaching experience)

Teachers thought that the coping strategies, including both adaptive and maladaptive strategies, adopted by students were mostly ineffective. Because the teachers thought the only effective method to reduce stress was closing the gap between their expectations, which could be achieved by either decreasing their expectations relating to study and interpersonal relationships or by increasing their study strategies and interpersonal skills.

My understanding is that stress is actually the gap between expectations and reality, including academic expectations and interpersonal expectations. For example, in terms of interpersonal relationships, students want all their classmates to recognize them, but they did not have that ability. In order to solve the stress, no matter what coping strategies they used, like singing, dancing and eating, these strategies do not bridge the gap between ideal and reality. What they really need to do is to change themselves or lower their expectations. (Sheng, teacher group, 37 years old, 14 years of teaching experience)

Teacher theme 4: recommendations for stress management programs

Teacher participants agreed that, in order to manage stress among Chinese high school students successfully, stress management programs were needed. They outlined the contents and features of such programs. First, the programs should train students with stress coping skills, such as emotion regulation skills and interpersonal skills. Second, career development guidance should be provided to guide students explore their potential future careers and thus make a good choice about universities and majors after graduating from high school. Third, an understanding and support environment in programs. Fourth, parents should be involved.

On the one hand, in dealing with interpersonal relationships, the program should help students to achieve a certain interpersonal goal and provide students with skills in dealing with interpersonal relationships, enabling them to better deal with conflicts in interpersonal relationships. On the other hand, it would be good to help students learn how to plan their careers. (Zhang, teacher group, 38 years old, 13 years of teaching experience) … But some of the stress is passive, and I think it’s more of a need for an understanding. Whether it is from the parents, or the teachers, no matter how much stressed they feel, as long as there is one person or a group who can think from the students’ perspective, they will feel very happy. (Lin, teacher group, 49 years old, 29 years of teaching experience)

Discussions

This is the first study to qualitatively examine the stress experience, stressors, coping strategies and needs of Chinese high school students from the perspectives of both students and teachers. The results of our study suggested that Chinese high school students experienced stress which came from high expectations for academic performance, interpersonal relationships, and family issues. The amount of stress experienced by students had negative impacts on students’ study, emotions, relaxation, and mental health wellbeing. The diverse coping strategies used by students were effective in relieving from stress only in the short term, therefore, more stress coping trainings are needed to assist students manage stress effectively in the long run.

Stress and stressors

In China, high school education is essential for preparation for College Entrance Examination (CEE) in which the score determines the prestige of university the students can enter. The more prestigious university the students graduate from, the higher salary and better hiring opportunities the students will obtain in labour market [ 28 ]. In accordance with previous quantitative findings [ 16 ], our study showed that both teachers and students agreed that academic performance is the primary stressor experienced by Chinese high school students. The academic stressors are manifested as highly competitive school environments which put top priority on successes in academic life, including getting good scores and ranking high in exams. Our findings are distinguished from several studies that were conducted in other countries [ 8 , 10 , 11 , 13 ], in which family issues and peer relationships were experienced as primary stressors. Previously a study argued that Asian students are under more academic stress because of cultural difference (i.e., the Confucius Heritage Culture in China, Singapore, Japan and Korea) [ 29 ]. Our unique study shed light on this difference and pointed out that expectations rather than difficult materials, which is the source of academic stress in Westernized countries, contributed most to academic stress of Chinese high school students.

Both teachers and students agreed that interpersonal stress was another type of stress experienced by Chinese high school students, which was primarily manifested as supressing feelings (e.g., anger in conflicts) in interpersonal relationships. However, only teachers mentioned supressing feelings in romantic relationships as a source of interpersonal stress. The reason might be that adolescents were reluctant to share their romantic relationships/feelings among strangers in focus group interviews. The suppression of feelings revealed in our study distinguished from previous studies, which showed that adolescents from westernized countries experienced interpersonal stress in the form of bullying, teasing and intimidation. This might be explained by cultural difference. Chinese culture value the Confucius harmony (he xie) concept in interpersonal relationships [ 30 ], which means having physical or verbal conflicts with others is violating and people frequently use emotional suppression in interpersonal relationships [ 31 ]. This, nevertheless, indicates the lack of communication skills (e.g., assertive skills) among students. Previous studies have shown that better communication skills is significantly associated with higher social self-efficacy [ 32 ], which correlates with lower interpersonal stress [ 33 ]. Family stress is another type of interpersonal stress suggested by our study, previous quantitative studies showed that Chinese adolescents frequently experienced family stress [ 34 ], our study provides further in-depth information relating to adolescents’ perceptions and experiences regarding how family stress generated and should be addressed. Family environment can buffer stress or be a source of stress for adolescents depending on the parenting styles, family relationships (e.g., harmonious or harsh) [ 15 , 35 , 36 ]. For example, several studies [ 7 , 8 , 13 ] found that when parents adopted strict parenting style, had poor communication skills or divorced, adolescents tend to experience family stress. Similarly, our study showed that most Chinese adolescents experienced family stressor, this includes family issues (e.g., discordant family atmosphere and parental divorce). Additionally, our unique finding suggests that Chinese adolescents also had family stress when they experienced lack of care from parents (for boarding students) and inappropriate parenting styles (e.g., spoiling or too strict). In contrast, our study also showed that when parents are understanding and supportive, adolescents felt that their stress was relieved, suggesting the importance of building understanding and supportive environment in Chinese families.

Impact of stress on students

According to Yerkes-Dodson law, the right amount of stress can increase motivation and performance, however if the amount of stress exceeds the ability of the individual to cope, it can cause decreased performance and mental health issues [ 37 ]. Previous research has shown that stress demotivate high school students in their studies [ 38 ], decrease individual’s performance [ 39 ] and correlate with self-harm among adolescents [ 40 ]. Our study confirms these findings, both teachers and students believed that the stress experienced by students caused study and mental health issues for students. The triangulation of findings from teachers and students revealed the mechanism where students’ cognitive process (i.e., constantly thinking about stressful events during bed time and classes, maladaptive thinking styles) played a critical role. This implies that providing students with strategies to stop rumination and cognitive restructuring is needed in stress coping programmes. In addition, few qualitative research found that some students were aware that stress could motivate them [ 10 , 13 ]. However, our study did not show this trend. A possible explanation for this might be that the amount of stress experienced by Chinese high school students was excessive.

• Coping strategies

Previous studies have shown that stress coping resources have a buffering effect on the impact of stress on mental health [ 6 ]. Previous research has distinguished two kinds of coping strategies: active coping versus avoidant coping, where active coping was defined as improving the situation and thinking of the situation from a different perspective, whilst avoidant coping was defined as avoiding the situation. Previous studies have shown that avoidant coping was significantly associated with increased risk for internalising and externalising problems whilst active coping was associated with reduced risk for these problems [ 41 ]. Our findings suggest that regardless of diverse coping strategies that have been used by Chinese adolescents, the primary coping strategies belong to avoidant coping (e.g., engaging in leisure activities), and both students and teachers agreed that these coping strategies were helpful in the short term but not in the long run. The triangulation of results from teachers and students revealed that, firstly, only teachers stated talking to counsellor was an adaptive coping strategy used by students, however, students did not mention that. This might be due to the stigma associated with using mental health services and students were reluctant to admit using mental health services in focus groups. Secondly, teachers thought talking to parents and teachers was an adaptive coping strategy used by students. However, students regarded it as ineffective and sometimes harmful as teachers/parents would not understand them. This difference might be due to the Chinese classroom/family culture where teachers/parents are regarded as authority whereas students are expected to be obedient [ 42 ]. This difference also reveals that more equal and effective communications between teachers/parents and students are needed. Previous studies also suggested that adolescents would also use substance (e.g., alcohol, cigarettes, marijuana) as a coping strategy [ 8 , 9 ]. The deficiencies in effective coping strategies highlights the importance of providing adolescents with effective coping strategies.

Recommendations for programs

A meta-analysis conducted in 2020 [ 43 ] found that school-based programs targeting universal samples were not effective in reducing stress. However, it is important to provide preventive programs for those with emerging problems at schools. Our study revealed important insights into the perspectives of students and teachers regarding their needs and expectations from those preventive programs. According to our results, first, it is important to provide coping skills training including emotion regulation, problem solving and interpersonal skills. These skills have been proven by previous research as vital to reducing stress and improving mental health wellbeing [ 44 , 45 , 46 ]. Second, it is crucial that adults (e.g., teachers, parents, and counsellors) think from students’ perspectives without judging them while providing social support for them, otherwise, such support might not be effective and can prevent students from seeking further help. Third, according to the bioecological model proposed by Bronfenbrenner and Ceci [ 47 ], children’s development is dynamically influenced by their families, school settings and subculture. Therefore, in order to provide a program that causes dynamic changes in students’ stress experience and coping behaviours, it is important to build a school environment and family culture that values the mental-health well-being of children the same as their academic performance. This requires the involvement of stakeholders in such programs.

Strengths, limitations, and future research

The strengths of our study include that we recruited both head teachers and students and there was a high degree of confluence in participant responses. Head teachers have many years of teaching experience and have wide contact with a large number of high school students and their families. Involving them enables us to confirm themes identified in the modest number of student focus groups. In addition, involving stakeholders in the development of interventions has been suggested by previous research as valuable process [ 48 ]. Another strength is that our sampling was largely based on chance (i.e. randomization), which allows us to recruit most representative participants. Several study limitations should be noted. First, we did not recruit grade 12 students due to administrative restrictions, the reason provided was that grade 12 students were preparing for the college entrance examination, and which made their involvement impractical. However, this population is also the subgroup of high school students under the most stress. Therefore, apply the results of this study to grade-12 students should be done with caution. Future research is warranted to investigate this group of students’ stress experience and needs for support. Second, as head teachers in our participating school were all male, we lack perspectives from female teachers who might hold different opinions regarding students’ stress, coping strategies and needs for support. We suggest future studies to recruit more balanced gender representatives. Third, our study was conducted in a moderate city in China, the results might not be generalised to other big cities and remote areas. Lastly, as each focus group interview lasted around one hour and some participants might need more time to organise their answers, thus some participants might not have enough opportunity to talk about their experiences. Therefore, more confirmatory studies are needed to have a more comprehensive understanding of Chinese high school students’ stress and needs.

Practical implications

The results of current study shed light on the experience of stress has impact students’ study, health, and wellbeing. Our study also highlights the fact that students are lack of adaptive and effective coping strategies among Chinese high school students. These findings have implications for stakeholders. Most importantly, education system should place the same priority on students’ mental health wellbeing as on academic performance. Second, as our research showed that students feel more stress from expectations and comparison with other students compared with the schoolwork itself, therefore, it is recommended that, when assessing students’ academic performance, Chinese high schools focus more on the improvement of individual student, rather than comparison with other students via ranking. Third, school educators can set regular courses teaching stress coping skills, which address different type of stressors in students’ lives. As our study showed that students have difference preference for stress coping, such courses should cover various types of coping strategies, for example, somatic skills, cognitive skills, behavioural skills to suit the characteristics of different students. Fourth, school counselling centres should help students identify the symptoms of severe stress and provide individual counselling services for such students. To assist parents of high school students, educators can provide online or offline education sessions or posters, which illustrate sources of stress and effective ways to reduce stress for students. Finally, stakeholders should provide an environment which encourage students to talk about their stress and understand students stress experience from the perspectives of students.

This study is the first to assess perceptions of Chinese high school students and their teachers of students’ stress experience and coping strategies. Chinese high school students experience excessive stress in their daily lives. Their stress comes from school, family, and peer relationships. The stress experience has negative impact on their study, mental health, and wellbeing. However, they are not adequately equipped with necessary effective coping skills to deal with those stressors. Coping skills trainings are needed for Chinese high school students.

Data Availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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This study was funded by The University of Queensland, Research Training Scholarship.

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XZ participated in funding acquisition, the conceptualization and development of semi-structured interview questions, conducting focus group interviews, translating the scripts, formal analysis, and writing the original draft. MB participated in the conceptualization and development of semi-structured interview questions, resolving disagreements during analysis, and reviewing and editing the draft. XB participated in the conceptualization and development of semi-structured interview questions, resolving disagreements during analysis, and reviewing and editing the draft. SE participated in the conceptualization and development of semi-structured interview questions, conducting formal analysis, reviewing and editing the draft and administrating the project. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

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The ethics approvals were obtained from two institutions: Human Ethics Office at The University of Queensland (#2020002275) in Australia and Research Ethics Office at Tianjin Normal University (#No. 20201016) in China. For teachers, informed consent forms were obtained from themselves. For student participants, as most of them were under the age of 18 at the time of interview, informed consent forms were obtained from both their guardians and themselves. Participation was voluntary and all students and teachers were ensured that their answers would remain confidential. All methods carried out in this research followed the 1964 Helsinki Declaration and its later amendments. These procedures also complied with institutional and national research committee ethical requirements for research involving human subjects.

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Zhou, X., Bambling, M., Bai, X. et al. Chinese school adolescents’ stress experience and coping strategies: a qualitative study. BMC Psychol 11 , 91 (2023). https://doi.org/10.1186/s40359-023-01137-y

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Coping Strategies for Stress

From Meditation to Journaling, Try These Effective Ways to Manage Stress

Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

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• Calming Strategies
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• Solution-Oriented Strategies
• When to Seek Help

The American Psychological Association's 2022 "Stress in America" report reveals that, on a scale of one to 10, the average American has a stress level around a five. However, more than one in four survey respondents also indicated that on most days, their stress was so high that they were unable to function.

Although survey results tend to fluctuate a little each year, the findings generally show the same pattern. People face a variety of stressors , which also means that they need to find effective ways to relieve stress in their lives. With that in mind, here are a few proven coping strategies for stress. 

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We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

Calming Coping Strategies for Stress

Calming our physiology can help reverse the stress response . When our stress response is triggered, we process information differently and can feel physically and emotionally taxed. If this state is prolonged, it can escalate to chronic stress.

One way to calm our bodies, therefore also calming our minds, is to go to a quiet place and take deep, long breaths. Breathe in, hold for five seconds, then exhale slowly. Repeat several times. This breathing exercise can help soothe our nerves and slow a racing heart.

Other calming strategies include:

• Engaging in aromatherapy
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Emotion-Focused Coping Strategies for Stress

With emotion-focused coping strategies, the situation doesn’t change but our perception of it does. These strategies are great to use when we have little ability to control what happens. They help us see stressors as a challenge instead of a threat.

Research has found that maintaining a sense of humor can help people better cope with stress. Another helpful strategy is to stay optimistic. Cultivating optimism works by reducing our rates of perceived stress while also increasing our resilience.

Other emotion-focused techniques for coping with stress include:

• Journaling our emotions
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While these techniques can be time-consuming, reducing stress is necessary to improve our well-being and mental and physical health.

Solution-Focused Coping Strategies for Stress

Sometimes there’s nothing we can do to change a situation, but often we can find an opportunity to take action and change the circumstances we face. Solution-focused coping strategies can be very effective for stress relief.

Often a small change is all that’s required to make a huge shift in how we feel. One change can lead to other changes, creating a chain reaction of positive change in which opportunities open up and life changes significantly. Also, once an action is taken, the sense of being trapped with no options —a recipe for stress—can dissipate quickly.

It’s important to be thoughtful about which actions to take, as each situation may call for a unique solution. A less-stressed mind can more easily choose the most beneficial course of action.

Solution-focused techniques good for reducing workplace stress but that can also be beneficial in other situations include:

• Implementing time-management strategies when feeling overwhelmed by a busy schedule
• Reaching out to others for help, such as contacting human resources (HR) if work demands feel overwhelming or if being harassed
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When to Seek Help for Stress

Through coping strategies and good self-care , we can manage our stress healthfully and avoid long-term issues. However, if stress levels do not decrease, it may be a good idea to talk to a therapist or primary healthcare provider.

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Stressors and coping strategies in the new normal: a case study of teachers in a higher education setting.

Janine Marie Balajadia , Ateneo de Manila University Maria Micole Veatrizze Dy , Ateneo de Manila University Lukas Pariñas , Ateneo de Manila University Christine Leila Taguba , Ateneo de Manila University Alessandra Grace Tan , Ateneo de Manila University Maxine Therese Tuazon , Ateneo de Manila University Jerome Patrick Uy , Ateneo de Manila University Genejane M. Adarlo , Ateneo de Manila University Follow

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When governments restricted holding in-person classes to contain the spread of COVID-19, many higher education institutions turned to digital technology to continue the education of their students. This abrupt change in the delivery of teaching and learning posed pedagogical and technological challenges to the teachers. And as governments have gradually allowed the return of students to physical classrooms with the decline in COVID-19 cases and the rollout of vaccines, teachers must adapt once more to a different arrangement for teaching and learning. Using the Job Demands-Resources Model as a theoretical framework, this case study examined the stressors (i.e., job demands) encountered by teachers in a higher education setting as students have returned to physical campuses. It also explored their coping strategies (i.e., job resources) that helped them adjust to the demands of using a different arrangement for teaching and learning in the new normal. Thematic analysis of responses to open-ended questions in a survey of 100 teachers in an institution of Catholic higher education in the Philippines showed demands related to teaching as a job and other competing concerns were brought up as stressors when in-person classes resumed after two years of fully online teaching. It also revealed seeking social support, focusing on teaching and research, and practicing self-care as their ways of coping with the demands of the new normal. Findings from this study can contribute to policies that can cater to faculty development.

Recommended Citation

Balajadia, J. M., Dy, M. M. V., Pariñas, L., Taguba, C. L., Tan, A. G., Tuazon, M. T., Uy, J. P., Adarlo, G. (2023). Stressors and Coping Strategies in the New Normal: A Case Study of Teachers in a Higher Education Setting. In N. Callaos, J. Horne, B. Sánchez, M. Savoie (Eds.), Proceedings of the 17th International Multi-Conference on Society, Cybernetics and Informatics: IMSCI 2023, pp. 92-98. International Institute of Informatics and Cybernetics. https://doi.org/10.54808/IMSCI2023.01.92

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Bullying against Healthcare Professionals and Coping Strategies: A Scoping Review

Affiliations.

• 1 Faculty of Human and Social Sciences, University Fernando Pessoa (UFP), 4249-004 Porto, Portugal.
• 2 Fernando Pessoa Research, Innovation and Development Institute (FP-I3ID), Observatory Permanent Violence and Crime (OPVC), University Fernando Pessoa (UFP), 4249-004 Porto, Portugal.
• 3 Research Centre on Child Studies (CIEC), University of Minho, 4710-057 Braga, Portugal.
• PMID: 38673370
• PMCID: PMC11050285
• DOI: 10.3390/ijerph21040459

Violence against healthcare professionals is an event that further burdens the daily lives of those who try every day to care for and assist those who need it most. In an attempt to overcome these events, there are coping strategies that can be used to reduce the stress caused. Therefore, this study aims to analyse the phenomenon of violence against healthcare professionals and the relationship between the bullying suffered by these professionals and the coping strategies they developed to overcome these moments. To this end, a scoping review was conducted in which eight articles were selected for final analysis from a total of 276 articles found in three electronic databases (EBSCO, PubMed, and Web of Science). This review concludes that the most common workplace bullying behaviours include excessive workloads, humiliation and ridicule, impossible deadlines, and verbal attacks. Professionals reported negative impacts, such as helplessness, depression, stress, insomnia, and the desire to change jobs. Victims of workplace bullying often expressed their intention to leave their current job or even abandon the profession. Problem-focused coping strategies are the most used. The studies indicated that workplace bullying negatively affects professionals in physical and mental terms, as well as in terms of quality of life at work, requiring more research and adoption of preventive measures to identify and combat the problem.

Keywords: Negative Acts Questionnaire—Revised (NAQ-R); coping strategies; healthcare professionals; workplace bullying.

Publication types

• Adaptation, Psychological*
• Bullying* / psychology
• Coping Skills
• Health Personnel* / psychology
• Workplace / psychology

Grants and funding

• UIDB/00317/2020 and UIDP/00317/2020/Fundação para a Ciência e Tecnologia