Promoting Health and Well-Being: A Review of the Effectiveness of Interventions to Prevent Workplace Bullying

Globally, research about bullying in workplaces including healthcare institutions has been shown to reduce the physical and mental health of employees. Generally, employees who have been bullied have lower levels of job satisfaction, higher levels of stress and are more likely to leave their job with the effects of bullying considered to be more devastating than all other types of workplace stress put together 1. A recent survey by the Trade Union Congress in the UK 2 identified that 46% of those who responded had reported that bullying had negatively affected their performance at work and their mental health. In the US, a 70% rate of exposure to bullying behaviour was recorded among 212 registered nurses 3 with bullied novice nurses' reporting a negative impact on their ability to manage their workload4.

To date, most research has focused on how to manage bullying once it has happened, rather than preventing it. Indeed those who have been bullied choose to leave their job rather than face up to the bully 5. At a time when recruitment and retention of staff is particularly challenging, it is important to know what can be done to prevent bullying.

Purpose:

To review of the effectiveness of workplace interventions in preventing bullying in the workplace using a Cochrane Systematic Review approach.

Methods:

We searched a wide range of databases and found 19,544 references of which 125 were considered to be of some relevance. More detailed reading, and data extraction, excluded all but five studies that reported on the effectiveness of interventions to reduce the incidence of workplace bullying. The outcomes of bullying such as workplace absenteeism were also explored.

Results:

Two studies reported on organisational interventions that consisted of policy measures and stress management and measured bullying as incivility 6-7. One of the studies also showed a reduction in incivility and absenteeism. An expressive writing task 8, showed a reduction in the amount of bullying. Cognitive behavioural therapy was used with employees who had a learning disability, and showed a reduction in bullying 9. The overall effects of these interventions were small. One study evaluated education and policy interventions in combination, across five organisations, resulting in a small non-significant increase in bullying 10.

Conclusion:

This review showed that organisational and individual interventions can prevent bullying in the workplace but, like many interventions to address complex phenomena, the evidence is of very low quality. We suggest that the small effects of interventions in large populations might represent stronger outcome in small subsets of those who suffer in silence from bullying in the workplace. More focussed studies are needed with better outcome measurement to evaluate the effect of all preventive interventions.