Managing job stress among teachers of children with autism spectrum disorders: A randomized controlled trial of cognitive behavioral therapy with yoga

Immaculata N Akanaeme, Felicia Ngozi Ekwealor, Clara N Ifeluni, Charity N Onyishi, Chizoba L Obikwelu, Nkiru Christiana Ohia, Loveline N Obayi, Chinyere Theresa Nwaoga, Agnes E Okafor, Vera Victor-Aigbodion, Toochukwu E Ejiofor, Ifeoma C Afiaenyi, Chinyere I Ekomaru, Ibiwari Caroline Dike, Immaculata N Akanaeme, Felicia Ngozi Ekwealor, Clara N Ifeluni, Charity N Onyishi, Chizoba L Obikwelu, Nkiru Christiana Ohia, Loveline N Obayi, Chinyere Theresa Nwaoga, Agnes E Okafor, Vera Victor-Aigbodion, Toochukwu E Ejiofor, Ifeoma C Afiaenyi, Chinyere I Ekomaru, Ibiwari Caroline Dike

Abstract

Background: Job-related stress undermines occupational, personal, and organizational outcomes. Stress symptoms are common among teachers of children with autism spectrum disorders and affect the academic progress of the children. This study investigated the effectiveness of yoga-based cognitive behavioral therapy in reducing occupational stress among teachers of children with autism in Lagos states, Nigeria.

Methods: The current study adopted a group-randomized waitlist control (WLC) trial design with pre-test, posttest, and follow-up assessments. Participants included 58 teachers of children with autism in public and private special schools in Lagos state. Participants were randomly assigned to combined cognitive behavioral therapy and yoga (Y-CBT) (N = 29) and WLC (N = 29) groups. The Y-CBT group participated in a 2 hours Y-CBT program weekly for 12 weeks. Three instruments - Demographic Questionnaire, Single-Item Stress Questionnaire, and Teachers' Stress Inventory (TSI) were used to collect data. Data were collected at baseline; posttest and follow-up evaluations. Data were analyzed using means, standard deviations, t test statistics, repeated measures analysis of variance, and bar charts.

Results: Results revealed that all dimensions of job stress (perception of stress sources, stress manifestation, and total TSI scores) reduced significantly at posttest and follow up assessments among the Y-CBT group, compared to the WLC.

Conclusion: It was concluded that Y-CBT modalities could help to minimize the perception of stress sources and stress manifestation as well as total TSI scores among teachers of children with autism spectrum disorders.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1
Figure 1
Flowchart showing research methodology. The figure indicates that a group randomized waitlist control design was used for the study. Randomization grouped 29 participants each into Y-CBT and control groups. Baseline data were collected from both groups, after which Y-CBT group received intervention. Thereafter, postintervention data were collected, followed by a 3-months follow-up, intervention for the waitlisted participants and then data analyses. Y-CBT = combined cognitive behavioral therapy and yoga.
Figure 2
Figure 2
CONSORT Diagram.
Figure 3
Figure 3
Bar chart representation of participants’ demographic distribution across Y-CBT and WLG. BD = Bachelors’ Degree, NCE = National Certificate in Education, WLG = waitlist group, Y-CBT = combined cognitive behavioral therapy and yoga.
Figure 4
Figure 4
Line graph showing sample size estimation using power analysis. α err prob = Alpha Error Probability, β err prob = Beta Error Probability, d = effect size, N1 = number of participants in group 1, N2 = number of participants in group 2.
Figure 5
Figure 5
Interaction effect of time and group on the study variables. Figure 3 shows that the Y-CBT and WLG did not vary significantly in their SS, SM, and TSI scores during the baseline evaluation (Time 1). At the posttest (Time 2) and follow-up (Time 3), there were significant differences in SS, SM, and TSI scores between Y-CBT and WLG groups. SM = stress manifestations, SS = stress sources, TSI = Teachers’ Stress Inventory, WLG = waitlist group, Y-CBT = combined cognitive behavioral therapy and yoga.
Figure 6
Figure 6
Changes in scores based on Time for Y-CBT group. Figure 4 shows a significant difference in SS, SM, and TSI scores across Times 1 and 2, but not Times 2 and 3. SM = stress manifestations, SS = stress sources, TSI = Teachers’ Stress Inventory, Y-CBT = combined cognitive behavioral therapy and yoga.
Figure 7
Figure 7
Changes in scores based on time for waitlist group. Figure shows that the mean ratings of the participants on the SS, SM, and TSI did not vary significantly across Times 1, 2, and 3 evaluations. SM = stress manifestations, SS = stress sources, TSI = Teachers’ Stress Inventory, WLCG = waitlist control group.

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