Introduction
This paper defines the rationale for a purely quantitative approach to the investigation of the protective effect afforded by a sense of coherence to counselors who may be subject to bullying by superiors, other colleagues and even their own patients. Three study instruments, developed and validated in the European setting, will be administered via an online survey. In brief, these structured questionnaires will measure the mediating variable sense of coherence (SOC), assess the incidence of counselors in the mental health and substance abuse settings being subjected to bullying, and the extent to which symptoms of post-traumatic stress disorder (PTSD) correlate with the experience of bullying.
Researcher’s Philosophy and Overview of Approach
The research philosophy underlying the recommended approach to the problem at hand rests on a logical positivist philosophy, an ontological and epistemological bias toward quantitative data gathered under control conditions, and the state of knowledge in the study of bullying effects. A further consideration, underlying the choice of subject matter, springs from the value placed on strengthening the capability of the profession for assisting victims of bullying when practitioners are themselves targets of a practice that has no place in a professional work environment.
The positivist tradition takes precedence over interpretive paradigms in this study because the subject matter has an objective reality not reliant on the researcher at all. Bullying in the workplace exists. Incidence and frequency have been measured in transnational settings, the psychic and manpower cost reckoned. To begin with, research reported in peer-reviewed publications estimated the incidence of bullying at a comparatively low incidence in the United States of from three to 13 percent in the recent past.
The upper end may be more realistic if the 12 percent tallied in the UK as subjected to bullying at least once in a prior five-year period is anything to go by (Institute of Personnel and Development, as cited in Ellis, n.d.). Extending the reference period infinitely to last an entire working life, a Staffordshire University Business School survey estimated that no less than half of UK employees were victimized at least once throughout their working life (1994, as cited in Ellis, n.d.)
Others with perhaps an agenda of their own to advance expanded the scope investigated to aggression and intimidation experienced as aggravated assault and thus asserted that no less than 22% of male workers and 15% of female employees in America had been victimized (Office for Victims of Crime (2002). The Workplace Bullying Institute (2007) puts lifetime bullying incidence at 37% while more recent work in the field suggests that bullying may affect as much as 75% of American workers, either as targets or witnesses (Fisher-Blando, 2008).
Aggression and the violence of verbal or physical bullying bear enormous costs for employers, workers themselves, the health and mental care sectors. Enterprises worried about sustainable competitiveness in an age of globalized business rivalry count no cost excessive when it comes to acquiring equipment and implementing processes that will raise staff productivity. And yet, employers overlook the loss of man-hours, estimated by the Department of Justice at three-and-a-half days per aggression or bullying incident in the workplace and aggregating to some 1.75 million man-days a year (Office for Victims of Crime, 2002).
The cost to businesses has been estimated at a minimum of $55 million, counting just the lost man-days when victims wait for injuries to heal or simply absent themselves because thoroughly intimidated by the perpetrator-colleague. Counting lost productivity, opportunity cost, medical and mental health care, the need to impose more stringent security, employee turnover, the damage to company reputation (carried on the books as goodwill), increased insurance premiums, attending to litigation by aggrieved employees and third-party awards, the true cost to American business may be much higher, between $126 million to $36 billion (Dept. of Justice, 2002; Atkinson, 2000; Kaufer & Mattman, 1997).
Secondly, the behavior has already been characterized in sufficient detail. Researchers in this specialty may have started by saying, as Einarsen (2000) does, that bullying constitutes “negative treatment” (albeit sustained and to a victim who cannot easily defend himself). But this does not quite do justice to the aftereffects of such treatment on bullying victims. Rather, the essential elements are that the perpetrator displays hostile verbal behavior, coercion, physical contact, and other actions that call into question the competence of a colleague at work and degrade the self-esteem of the latter (Keashly and Jagatic, 2003; Forsyth, 2006).
Epistemology determines method, as the above examples show, because of the overwhelming positivist emphasis on incidence, statistical regularities that define the profile of both perpetrator and victim, the extent of the behaviors that degrade the dignity of the latter (Wildemuth, 1993; Bradley, 1993), whether the observed aftereffects collectively comprise PTSD, and whether SOC has an ameliorating effect on the experience of bullying. It is not within the scope of the present research – as the interpretive mandate of qualitative research would have it – to gain insight into the social contexts of bullying, to describe in detail cognitive and symbolic actions, or to derive meaning from observed behavior.
Given the remote assignment of the researcher and the compelling need to reach widely dispersed participants, there is no scope for the kind of face-to-face contact that qualitative methods require. This refers primarily to the need for qualitative methods to observe behavior directly, to comprehend what is said as “objectively” as possible, and to interpret the sub-texts in context (Bradley, 1993).
By force of circumstance (the isolation of the researcher from a widely-dispersed base of potential study participants) and the nature of the method chosen, this study enforces complete detachment between knowing the subject and the objects of the research and puts a premium on obtaining an objective, minimally-biased grasp of reality. This is the paradigm of social science research that, in emulating the scientific method of the natural sciences, best conforms to logical positivism.
In fact, the traditional paradigms of philosophy of science appear to have outlived their usefulness for failing to meet the goal of justification logic. Suppe (1977) argued that the modernist fascination with logical positivism and logical empiricism was never an accurate representation of real science (management science emulating physics). Relativism also failed management researchers in their drive to discover plausible theories that worked (Pfeffer, 1993).
Not surprisingly, many an alternative has been offered for this, the post-positivist era: ethnomethodology, historicism, radical humanism, naturalism, phenomenology, semiotics, literary explications, interpretivism, structuralism, poststructuralism, critical theory, and postmodernism. All these offer satisfactory social ontology but much-criticized justification logic, that knowledge is belief justified to be true.
Reflecting on the state of management theory – the ultimate goal of which is to fully understand and predict human motivation in organizations – McKelvey (2002) proposed a combination of complexity theory and agent-based modeling while keeping in mind that “good social science should include Aristotle’s material, final, and formal causes as well as his more ubiquitous efficient cause” (p. 23). How such a framework can be applied in the context of this study with just three main variables remains to be seen when data analysis issues are addressed.
Finally, addressing coherence among methodological assumptions, research strategy options, the given problem and research question, one realizes that the main considerations of the research process have to do with the stage at which bullying research is and the potential benefit to be had for assessing licensed counselors as victims.
So far as bullying research goes, the proposed research is already well advanced in the theoretical pathway from naturalistic inquiry to experimental testing. By this one means that Einarsen (2000) has already defined the nature of bullying, reliable research puts the incidence of workplace bullying in the United States at from 3 to 13 percent, and the Office for Victims of Crime (2002) has put a price tag on the aggregate organizational and health care costs of bullying and other aggression in the workplace. Hence, the discipline has transcended the stage when strictly qualitative research methods are necessary. At the same time, the absence of any proposed intervention in the research purpose of this study means even quasi-experimental methods are not called for as yet (Trochim & Donnelly, 2008; Creswell, 2009).
Theoretical Framework and Research Design Strategy
Where licensed counselors in America are concerned, the empirical record is so sparse that pilot research remains a viable option. The researcher has taken note of anecdotal evidence that Licensed Counselors, particularly in substance abuse treatment settings, experience bullying by clients, staff, administrators and peers in the profession.
The UK National Workplace Bullying Advice Line (2005) underlines the gravity of the problem with its observation that social workers and social services employees accounted for 10% of total calls to the Advice Line, ranking the profession third behind “teachers (20%) and healthcare employees (12%) and before workers from the voluntary sector (6-8%)” (para 1).
Having virtually exhausted the possibilities offered by secondary research, it is, therefore, important to move ahead with primary data collection, principally with a view to establishing whether Licensed Counselors are themselves subject to an incidence of bullying comparable to that experienced by white- and blue-collar workers in general around America. By virtue of requiring structure (see Study Instruments below), a research purpose that does not need disguising, and the potential participants being separated from the researcher by great distances, the quantitative path is the more valid option (Davis, 2004).
Despite the seeming complexity of the design strategy being replicated (see the following section), it should be obvious that the proposed study is at least capable of satisfying the first two steps in the management decision hierarchy described below. That is, establishing the incidence of counselors being bullied is itself a critical starting point. At the management question level, the study addresses the question of how to move toward a solution by investigating PTSD as hypothesized after-effect and SOC as a protective factor.
What matters at this point is the research purpose or objective. The benefit of this study begins, first of all, with learning how extensively counselors themselves experience bullying. The effectiveness of licensed counselors with respect to giving holistic treatment to other bullying victims will obviously be degraded if they themselves suffer demoralizing assaults and their proposed courses of action are called into question by those less qualified.
Research Design Guide or Model
The proposed study aims to replicate one undertaken by Nielsen, Matthiesen, and Einarsen (2008), likely around 2004, among members of two Norwegian bullying support associations. That study hypothesized that sense of coherence (SOC) might be a protective factor against posttraumatic stress endured by workplace bullying victims. At the time, the research team concluded that SOC seemed to offer some benefit when low levels of workplace bullying were inflicted. In any case, the study represented an advance for suggesting that PTSD is one bullying outcome to be concerned about.
Ståle Einarsen is a recognized thought leader in the field of workplace bullying not only in Norway – where he is Director of the Bergen Bullying Research Group and Work and Organisational Psychology Professor at the University of Bergen – but also in the UK and America (International Association on Workplace Bullying and Harassment, 2010). Postgraduate work spanned Clinical Psychology and a Ph. D. with a focus on workplace bullying. Besides workplace bullying, Einarsen has published on leadership, creativity, innovation, and workplace psychosocial factors beginning in 1993 and as recently as this year.
At the time the study was mounted, the authors report, there was mounting evidence that workplace bullying did harm to the health and emotional wellbeing of victims. The combination of symptoms reported by the hapless targets seemed to point to PTSD.
Extant research did not, however, clarify why the progression to PTSD was variable. Some victims were severely affected, others seemed to cope handily enough without reporting the signposts of PTSD. Hence, Nielsen et al. hypothesized that some disposition was a mitigating factor and took a cue from Antonovsky (1987) that a sense of coherence (SOC) seemed a likely candidate. The latter had suggested that pronounced SOC is strongly associated with better health and presumably coping better with bullying on account of an explicit resistance to stress.
The Norwegian sample ranged from 28 to 75 years of age but was decidedly middle-aged (mean = 50.5 years, SD = ± 9.04 years). By occupation, the 221 study participants tended to be in the administrative and health care sections of the bullying support groups. Owing to the age distribution, less than half were in full- or part-time work at the time of the study.
The authors found, among others, that workplace bullying victims registered high on self-reported PTSD (the variable definitions and study instruments used are detailed in the section, “Study Instruments and Operationalizing the Variables” below), although the authors concede that DSM-IV criteria on face-to-face assessment were beyond the scope of study methods.
Secondly, SOC evinced substantial correlation both with PTSD symptoms (r = 0.41, p <.01) and being a bullying victim (r = 0.14, p <.05). Employing hierarchical regression analysis, the authors tested for linear and interaction effects of SOC as a mediator or protective factor between the experience of bullying and PTSD symptoms. The independent variables explained slightly more than one-fourth of the total variance (R2 = 0.27, p < 001) in the emergence of PTSD symptoms. Interaction effects brought the variance explained to nearly one-third (R2 = 0.31, p <.001).
Graphical treatment at mean levels of the predictor variable (experience of bullying), one SD up and down from the mean revealed a weaker relationship between PTSD symptoms and those in the low-bullying group, suggesting that SOC shows up best as a protective factor when the frequency or severity of bullying is less.
The authors explained the greater effect of more severe bullying on those with more pronounced SOC as possible due to a “reverse buffering effect”, in that greater levels of social support may be at work. Secondly, the team suggested that those who would otherwise be fortified by a more pervasive and enduring feeling of confidence experience cognitive dissonance, at least, when they encounter more frequent or degrading bullying. By definition, after all, SOC means the conviction that the world is meaningful, comprehensible and manageable (see also the section, “Study Instruments and Operationalizing the Variables” below for other elements of SOC).
Research Questions and Hypotheses
Proceeding from the research purpose formulated above and relevant learning in the literature review, the research questions and null hypotheses that shall be tested in the proposed research may be formulated as follows:
RQ1 What is the past-year incidence of workplace bullying that Licensed Counselors are subjected to?
H01: There is no difference in self-reported bullying incidence between licensed counselors and typical American workers.
RQ2 Do counselors subjected to bullying evince symptoms of PTSD?
H02: There is no difference in self-reported PTSD symptoms whether counselors endure workplace bullying or not.
RQ3 Does SOC ameliorate the PTSD-linked aftereffects of being a bully victim?
H03: High, moderate or low SOC makes no difference in the development of PTSD-linked aftereffects in response to bullying.
Study Instruments and Operationalizing the Variables
The central intervening variable in the proposed study, a sense of coherence (SOC) is a personality disposition defined as a “global orientation that expresses the extent to which one has a pervasive, enduring (although dynamic) feeling of confidence” that one’s environment is “comprehensible, manageable, and meaningful” (Antonovsky, 1987; Eriksson & Lindström, 2005). Antonovsky elaborates on this by detailing the three central components (see below) and asserting that, since this disposition crystallizes in early adulthood, little can be done to buttress it among adults experiencing bullying.
Source: Antonovsky, 1987.
As a resource for resisting stress, SOC is thought to be supportive of health in general and analogous to hardiness, self-esteem, and dispositional optimism (Bengel, Strittmatter, & Willmann, 1999). Accordingly, SOC should predispose to general mental health, resilience and appropriate selection of resources in response to stimuli from the environment. Poor or nonexistent SOC, on the other hand, is associated with rigidity and disproportionate reactions.
Prior to this work by Nielsen et al., there had been no attempt to demonstrate the moderating effect of SOC on the relationship between workplace bullying and PSTD symptoms. However, a mediating effect had been repeatedly shown for other workplace stressors and indicators of physical or mental health.
The independent variable in this study is workplace bullying, generally defined as all forms of behavior and omissions that betray hostility to the victim, attempt to degrade or otherwise intimidate him. Aggressive verbal or nonverbal behavior can routinely extend to physical assault (Fox & Stallworth, 2005; Einarsen, Hoel, Zapf, & Cooper, 2003). Between them, the two research teams complete the definition of bullying as follows:
Table 1: Detailed Definition of Bullying.
PTSD as an outcome of workplace bullying was hypothesized because researchers, beginning with Zapf, Knorz and Kulla (1996), reported signals of diminished well-being. There are, of course, some gaps vis-à-vis the three clusters of clinically-recognized PTSD, although Matthiesen and Einarsen (2004) report from a low base of 102 Norwegians that no less than three-fourths experienced some PTSD symptoms above the threshold for clinical diagnosis. Significantly, a majority of victims in another study continued to experience such symptom levels even five years after the last experience with bullying (Einarsen, Matthiesen, & Mikkelsen, 1999).
Source: National Institute of Mental Health (2009), Matthiesen & Einarsen (2004).
Like the Nielsen et al. research being replicated, the proposed study will employ three study instruments, all self-administered and therefore amenable to adaptation for the intended online survey format.
- The Einarsen and Raknes Negative Act Questionnaire (NAQ), originally a 22-item inventory but has since been revised to 28 items.
- The Impact of Event Scale-Revised (IES–R) by Weiss and Marmar.
- The Orientation to Life Questionnaire (OLQ; Antonovsky, 1987) assesses the degree of SOC.
To avoid the appearance of value judgments, the NAQ is worded as a series of behavioral descriptors – e.g. “Being humiliated or ridiculed in connection with your work” or “Spreading of gossip and rumors about you” – for each of which the respondents need to indicate the frequency of occurrence thus: “never,” “now and then,” “about monthly,” “about weekly,” and “about daily.” As such the variable type is continuous ordinal. The authors claim high internal consistency (Cronbach’s α = 0.91).
In addition, the key element of unequal relationships between perpetrator and victim was addressed with a definition that takes up the term “bullying” for the first time:
Bullying takes place when one or more persons systematically and over time feel that they have been subjected to negative treatment on the part of one or more persons, in a situation in which the person(s) exposed to the treatment have difficulty in defending themselves against them. It is not bullying when two equally strong opponents are in conflict with each other. (Einarsen et al., 1994, p. 20)
This time, respondents are asked to indicate severity by choosing from among the scale items: “no,” “to a certain extent,” and “yes, extremely.”
Factor analysis conducted by a third party suggests that the factor loadings in the NAQ have to do with personal attacks, social isolation, work-related issues, and outright violence or assault.
The second study instrument, the IES-R, was formulated to measure subjective distress and three classes of PSTD symptoms: hyperarousal, avoidance, and intrusive re-experiencing of distressing events. Responses are solicited on a four-point ordinal scale of past-week frequency: 0 = “not at all,” 1 = “seldom,” 3 = “a little bit,” and 5 = “often”. Weiss and Marmar reported an even higher internal consistency (Cronbach’s α = 0.95) than Nielsen et. al. (2008) could claim for the NAQ in the study being replicated.
Thirdly, the Nielsen et. al. (2008) investigation employed Antonovsky’s (1987) Orientation to Life Questionnaire that assesses the three core components of SOC:
- The world as comprehensible, e.g. “When you talk to people, do you have the feeling that they don’t understand you?”
- View of one’s environment as manageable, e.g. “Has it happened that people whom you counted on disappointed you?”
- The environment makes sense, e.g. “Do you have the feeling that you don’t really care about what goes on around you?” (Antonovsky, 1987).
Since responses are solicited on a seven-point Likert-type scale of agreement-disagreement, this variable is also ordinal.
Sampling Design
Based on this study is on sending invitations to participate to the entire membership of the American Counseling Association (ACA), the sampling frame is a rented list that is effectively a complete enumeration of the universe. Realistically speaking, the initial email solicitation will presumably be segmented so as to exclude those that specialize in university students, marriage counseling, sexuality issues (LGBT), and appropriate training for entry into the profession.
Since participation rate (“returns” in the traditional terminology of mail surveys) is beyond the control of the researcher, respondent profiles will be compared with corresponding information about the aggregate membership of the ACA. This should enable an assessment of whether significant skew or mismatch is likely to affect generalizability to the profession, at least for the United States.
Data Collection Procedures
Among the three forms online surveys can take, the researcher opts for interactive, HTML-form surveys (such as those run by the established service Survey Monkey.com) rather than emailed or downloadable surveys. The latter raises cybersecurity questions, no small matter in these days of virus, worm, Trojan, and phishing attacks. Both email and downloadable forms also give the recipients the option to park the study instruments in their hard disks for another, more convenient time. This affects response rates adversely.
The researcher intends to leverage the ease, potentially fast turnaround and convenience of an online survey service (surveymonkey.com). Recipients of the emailed invitation need only click on an embedded link to be taken to the survey website and read a short set of instructions on response mechanics before proceeding to answer the three study instruments item by item. Given the composition of each of the study instruments, the study proponent does not anticipate having to build in automatic skip instructions or validation routines for inconsistent answers.
In general, it is reasonable to expect that openness about the study being conducted by a peer in the profession offers the best potential for building trust and cooperation. In addition, it can only help that the online survey service being contemplated has a facility for exchanging secure digital signatures or certificates of identity. Thirdly, the solicitation email will optimize participation by holding out the promise of being an initial step towards making working conditions for the profession better for
- drawing attention to the plight of victimized colleagues;
- replicating in the local setting the construct of SOC as a protective disposition; and,
- being given access to the final report and detailed findings which may have construct validity for clients themselves being victimized.
Online surveys have come of age and become solid options for market segments and professions that enjoy the benefit of near-saturation Internet penetration. Hence, there can be no question that wide-enough participation in the contemplated survey will mean the study is representative of the universe and therefore replicable in the future. In addition, ready access to the survey Web site by both the study proponent and all study participants maximizes the convenience of administering standardized checklists and scales to even tens of thousands of ACA members. An online survey is always interactive and permits some variety in presenting (or rotating) a given set of scales.
As well, target respondents can proceed at their own pace and take up where they stopped despite the constant interruptions inherent in a busy practice. For a study participant, therefore, an online survey is not only engaging but also convenient. Owing to technological progress, in brief, a well-designed online survey can now approximate the rapport, trust and eagerness to participate that Fig. 2 below portrays as essential to successful face-to-face surveys (Davis, 2004).
The initial email contact with ACA members will offer a drawing for a $200 AMEX gift cheque, an incentive meant to drive both participation rate and response time. This is part of best practice in the online survey industry, as attested to by MarketResearchTech.com (2007) reporting “significant” response increases when offering a raffle for a single valuable prize; Cobanoglu & Cobanoglu (2003) revealing that a drawing for a PDA raised adjusted response rate to 41% versus 31% for universal receipt of a branded (but low perceived value) luggage tag; and, Preece, Johanson and Hitchcock (2009) suggesting that a drawing for a cash prize works best when target respondents are somewhat needy and could use the extra cash. Happily, a cash incentive has no biasing effect one way or the other on the quality of responses being sought.
Ethical Issues
The investigator will ensure the privacy of all survey participants by assuring them, first of all, that the study is about the experience of the profession with bullying, that no personal identification will be collected by the survey Web site (save for the email address which will be used to notify the winner two weeks after the survey commences), and that the email database of names and email addresses will never be merged with the survey data itself.
Field and/or Pilot Testing
There is no requirement for pilot testing since the three study instruments employed by Nielsen et al. are already standardized instruments.
Data Analysis Procedures
Data from all three study instruments shall be subjected to the automated range, consistency, and “halo bias” checks. Subsequently, the stated research purpose and continuous measurement type of all three scales permit the use of correlation, t-test and ANOVA to test the null hypotheses in SPSS version 16.
Conclusion
The greater benefit of this proposed study lies precisely in moving on to the subsequent decision stages outlined in Figure 1 (page 8). Progressing from merely descriptive to commencing the generation and evaluation of solutions is an important contribution. By demonstrating that counselors are at greater risk for PTSD but that SOC is a valid protective factor, this study will have shown one principal drawback to tolerating the bullying of counselors and a viable intervention – strengthening SOC – for those already under severe stress from bullying by peers, superiors, administrators, other colleagues and patients. The challenges of mental health and substance abuse therapy are grave enough without having to endure thoughtless persecution.
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