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How Bullying Manifests at Work — and How to Stop It

• Ludmila N. Praslova,
• Ron Carucci,
• Caroline Stokes

It’s a systemic problem that requires systemic solutions.

The term workplace bullying describes a wide range of behaviors, and this complexity makes addressing it difficult and often ineffective. For example, most anti-bullying advice, from “anger management” to zero-tolerance policies, deals with more overt forms of bullying. Covert bullying, such as withholding information or gaslighting, is rarely considered or addressed. In this piece, the authors discuss the different types of bullying, the myths that prevent leaders from addressing it, and how organizations can effectively intervene and create a safer workplace.

While the organizational costs of incivility and toxicity are well documented, bullying at work is still a problem. An estimated 48.6 million Americans, or about 30% of the workforce, are bullied at work. In India, that percentage is reported to be as high as 46% or even 55% . In Germany, it’s a lower but non-negligible 17% . Yet bullying often receives little attention or effective action.

• Ludmila N. Praslova , PhD, SHRM-SCP, uses her extensive experience with neurodiversity and global and cultural inclusion to help create talent-rich workplaces. The author of The Canary Code , she is a professor of graduate industrial-organizational psychology and the accreditation liaison officer at Vanguard University of Southern California. Follow Ludmila on LinkedIn .
• Ron Carucci is co-founder and managing partner at  Navalent , working with CEOs and executives pursuing transformational change. He is the bestselling author of eight books, including To Be Honest and Rising to Power . Connect with him on Linked In at  RonCarucci , and download his free “How Honest is My Team?” assessment.
• CS Caroline Stokes is a stakeholder capital business sustainability coach and strategist, and CEO of FORWARD , working with leaders and teams in AI, cybersecurity, and digital entertainment.

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Workplace Bullying: 24 Examples & Ideas to Support Adults

According to Dr. Gary Namie (2021), workplace bullying is the only form of abuse in the United States that is not yet taboo. Because it is legal, it remains invisible.

The US Workplace Bullying Survey (Namie, 2017) states that 19% of Americans have experienced abusive conduct at work and another 19% have been witnesses. A whopping 63% are aware that bullying in the workplace occurs.

In this article, we define workplace bullying and share approaches on what can be done about it.

Before you continue, we thought you might like to download our three Work & Career Coaching Exercises for free . These detailed, science-based exercises will help you or your clients identify opportunities for professional growth and create a more meaningful career.

This Article Contains:

Bullying and harassment in the workplace, 21 examples of bullying at work, how to foster a safe work environment, anti-bullying policies in the workplace, supporting your employees: best guidelines, 3 ideas and activities for adults, training in anti-bullying interventions, 3 best books on the topic, resources from positivepsychology.com, a take-home message.

One thing we know about workplace bullying is that it is eerily similar to school bullying and domestic violence (Kohut, 2008).

Bullying in the workplace is a sublethal and nonphysical form of psychological violence . Namie and Namie (2009) state several criteria must exist for negative behavior to be considered bullying, including a pattern of repeated behavior and health-harming mistreatment of an employee by one or more coworkers that prevents the target from accomplishing work tasks.

Mistreatment can take the form of threatening conduct, including verbal abuse, intimidation, humiliation, or sabotage. Specifically, behaviors might include being ridiculed in front of others, being lied about, continually being left out, and receiving repeated criticism without just cause (Kohut, 2008). These aggressions can leave employees feeling on guard, anxious, intimidated, fearful, powerless, incompetent, and ashamed (Kohut, 2008).

Harassment, on the other hand, violates a target’s civil rights and occurs when the target is a member of a protected status group. In the United States, there are seven protected classes: race, color, religion, sex, national origin, disability, and sexual orientation (Cotterell, 2018).

According to Namie and Namie (2009, p. 299), illegal harassment is status based, whereas “Bullying cuts across boundaries of status group membership.” In other words, “bullying happens when harassment is same-gender or same-race or when the bully enjoys potential legal protection because he or she is a member of a status-protected group” (Namie & Namie, 2009, p. 299).

Workplace torment is complicated, insidious, and ubiquitous.

• Profane, threatening, or disrespectful language or any form of verbal abuse.
• Degrading or demeaning remarks that might include insults or name calling.
• Harsh criticism in the presence of other employees.
• Comments that have a negative effect on work performance.
• Behavior that diminishes psychological safety , such as withholding vital job-related information, refusing to answer questions, or refusing to assist when requested.
• Routinely making unfavorable or unreasonable assignments.
• Retaliation against a whistleblower.
• Using position or authority to talk down to or demean another.
• Deliberate exclusion of individuals from meetings or activities they should be attending.
• Shunning, excluding, marginalizing, or using the silent treatment.
• Personal attacks or threatening comments.
• Setting someone up to fail.
• Not providing important assignment-related information.
• Racial, ethnic, sexual, gender, or religious slurs.
• Circulating private correspondence (emails, messages, texts) without permission.
• Rude nonverbal behaviors and/or gestures (e.g., eye rolling, snickering, finger pointing, staring).
• Taking credit for the work of another.
• Gossip mongering or rumor spreading.
• Interrupting.
• Telling personal jokes about a coworker (Bartlett & Bartlett, 2011).
• Forms of manipulation (Bartlett & Bartlett, 2011).

Indicators of being bullied

Namie and Namie (2009) include some signs that the target may be experiencing bullying:

• Feeling ill at the start of the work week.
• Loved one’s request that they stop obsessing about work.
• Favorite activities with friends and family no longer appeal to them.
• Days off are spent exhausted and lifeless.
• Others in the workplace have been told to stop associating with them.
• Constant agitation and anxiety.
• Being accused of incompetence, despite an excellent history.
• A transfer request mysteriously being denied.

How can we protect employees from uncivil workplace behavior?

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Although the United States is slowly waking up, it lags behind European countries when it comes to addressing workplace bullying (Davenport, Schwartz, & Elliott, 1999). In this endeavor, Salin et al. (2020) provide ideas for creating a safe work environment.

1. Redesigning the work environment

Reducing role ambiguity and providing opportunities for increased control and latitudinal decision-making can help reduce bullying and manage high-stress jobs. All of these factors have been correlated with workplace bullying (Salin et al., 2020).

2. Institute effective conflict management/resolution systems

Salin et al. (2020) identified interpersonal conflict as one cause of bullying. Developing a system for addressing conflict in relationships and problem-solving in the workplace can lead to a reduction in bullying issues (Salin et al., 2020). Leadership and emotional intelligence training can focus on improving self-awareness and interpersonal skills.

3. Effective leadership

Leadership style has been identified as an important predictor of workplace bullying (Salin et al., 2020).

4. Anti-bullying policies and codes of conduct

Anti-bullying policies should contain a clear statement coming from the top of the organizational chart regarding intolerance for bullying. In addition, the policies should identify what constitutes workplace bullying and the consequences for such behavior (Salin et al., 2020).

5. Raising awareness in the workplace

By raising awareness, organizations demonstrate a workplace culture that won’t tolerate bullying behavior.

Other ideas include addressing the workplace culture and values and developing a positive communication climate.

Kohut (2008) provides ideas for fostering a safe work environment, including:

• Zero-tolerance policies against bullying
• Encourage confidential communication with management
• Annual briefing on signs of workplace bullying
• Upper management reviews all complaints carefully and fairly
• Employee assistance programs
• Conflict resolution training for all employees
• Value all employees equally

The good news is that there are resources available to help organizations determined to affect change.

Using Utah Administrative Code r. 477-16 as a framework, Clark and Ritter (2018) outlined criteria to create a healthy academic workplace environment, which can and should be considered for cross-discipline application. Below are portions of their report.

Examples of desired behaviors (management responsibility)

• Be respectful and model civility.
• Take responsibility and be accountable.
• Celebrate and reward civil encounters and initiatives.

Examples of desired behaviors (employee responsibility)

• Participate and encourage ongoing civility training.
• Practice prevention strategies.
• Recognize and report acts of civility.

Example policy procedures

• Clearly written, comprehensive, easily accessible workplace bullying policies
• Specific step-by-step procedures for addressing bullying
• Wording that includes the reporting responsibility of all who witness bullying behaviors

Kohut (2008) offers an example workplace policy, outlined here.

• Our organization considers workplace bullying to be unacceptable and intolerable under any circumstance. This behavior degrades, harms, intimidates, offends, or humiliates employees. Bullying results in substantial turnover rates, training costs, and loss of productivity in addition to creating a lawsuit risk.
• Our organization adheres to a safe working environment for all employees, free of bullies.
• Our organization has/is creating an internal grievance and investigation system to deal with bullying allegations. Reports of bullying are treated seriously and investigated promptly and impartially.
• Our organization encourages employees (target or witness) to report incidents immediately. Managers will ensure that reportees are not retaliated against in any way. (Be sure to include contact person’s name and information.)

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The Workplace Bullying Institute (n.d.) was first developed in 1997 by Drs. Gary and Ruth Namie and is a bountiful resource for targets of bullies, witnesses, managers, and human resources personnel.

Some of the resources for targeted parties include the first steps to take in this situation, books that can help, coaching, and ideas for creating an action plan.

To fight workplace bullying, the institute offers help for writing policies and procedures, ideas for intervention with bullies, and training for all employees.

Other resources that may be of interest on their website include workplace bullying statistics and current legislation. Interestingly, only Utah and California in the United States have legislation for training mandates (Clark & Ritter, 2018).

This website includes a bevy of resources for stressed workers. What if you happen to work for a stressful boss? This website provides ideas on how to work under these conditions and strategies for interacting with your boss.

This practical workplace bullying guide  originating from the Government of South Australia provides information and insight and includes definitions, behaviors, and factors that contribute to workplace bullying.

The Professional Institute of the Public Service of Canada has published this website of resources to help combat workplace bullying. In it, you can find information on the impact of workplace bullying, organizational factors , working arrangements, and ideas to address bullying.

Exploring past resilience

Resilience in the Workplace aims to strengthen the abilities to negotiate adverse circumstances and bounce back effectively.

This worksheet provides an opportunity to reflect on a past setback and examine the strategies used to overcome it. A series of questions help guide the client to a deeper understanding of their holistic experience.

Self-Care Checkup

During adversity, self-care is crucial for mental wellbeing. When overwhelmed with issues, we can become complacent and even negligent in areas of self-care, which can decrease wellbeing.

This worksheet helps clients identify which domain – emotional, physical, social, professional, or spiritual – is lacking and in need of support.

A Time You Felt Different

This exercise is for all employees and is intended to build empathy.

Workplace bullies are defined by their lack of empathy, making exercises that address and build empathy crucial. The goal of this exercise  is to enhance empathy by practicing empathic listening with a coworker.

The exercise begins by mentally preparing to listen to another person. Listeners are asked to quiet the mind, listen beyond words, and set aside judgments to be fully present for the speaker.

There are a variety of training topics that can help reduce workplace bullying. Below are just a few.

Workplace Bullying and Violence: Training for Supervisors and Employees

J.J. Keller & Associates offers courses for every size organization. Their Workplace Bullying and Violence: Training for Supervisors and Employees includes an introductory video. They also provide online training.

Cultural intelligence

David Livermore has been writing and speaking about cultural intelligence for years. Cultural intelligence is an individual’s ability to function across national, ethnic, and organizational cultures. Livermore offers cultural intelligence assessments, online learning, workshops, and certification for course completion.

Cultural intelligence includes relational skills, tolerance of uncertainty, adaptability, empathy, and perceptual acuity – all necessary for an inclusive workplace. Culturally intelligent employees can help coalesce people and groups in the workplace.

Workplace training modules

Neil Katz and Associates have been providing a variety of organizational training topics for many years. Dr. Katz is a prolific writer, trainer, professor, and conflict resolution expert.

He and his team have provided training for an array of organizations, institutions, and community partners. They cover topics such as leadership, communication (conflict resolution) , teamwork , and emotional intelligence – all skills that can help reduce workplace bullying through better interpersonal interactions and intrapersonal insight.

1. The Bully at Work: What You Can Do to Stop the Hurt and Reclaim Your Dignity on the Job – Gary Namie and Ruth Namie

One of the first books I used to learn about workplace bullying was The Bully at Work, written by Gary and Ruth Namie, a husband and wife team passionate about workplace bullying. For years, they have led the march against workplace bullying.

The Bully at Work extols the impact of workplace bullying on the lives, careers, and families of millions of bullying targets. They are the founders of the Workplace Bullying Institute, established in 1997 to fight bullying.

Their book teaches targets, witnesses, administration, and human resources personnel what workplace bullying is, how to deal with bullies, actions people can take, and how targets can make themselves safe.

Find the book on Amazon .

2. The Complete Guide to Understanding, Controlling, and Stopping Bullies & Bullying at Work – Margaret Kohut

This comprehensive text by Margaret R. Kohut begins with a definition of workplace bullying along with the scope of the issue, then pivots into Profiles of Workplace Bullies .

To explain this toxic behavior in the workplace, this section of the book breaks workplace bullying down by personality disorders such as the narcissist, the antisocial, the paranoid, and the histrionic.

It is both riveting and helpful, as Kohut describes common character traits of each disorder and what to expect from this personality as a boss, coworker, or subordinate.

The toll and types of workplace bullying are included, along with how to survive and what the law says (or doesn’t say) about it. Readers can find experiential exercises and a special section in the appendix on notoriously bad famous bosses. Spoiler alert: Leona Helmsley is included.

3. Mobbing: Emotional Abuse in the American Workplace – Noa Davenport, Ruth Schwartz, and Gail Pursell Elliott

This book describes mobbing as emotional assault inflicted on one person by a group of coworkers.

In addition to disrespectful and harmful behavior, mobbing often escalates into abusive and terrorizing behaviors. This book is a must-read.

Empathy, assertive communication , and team-building skills benefit all employees.

Working on these skills will allow personnel to have insight into their behavior and the behavior of others. The resources below are recommended to build on these skills.

This worksheet encourages participants to imagine the perspective of someone with whom they are experiencing difficulty or discomfort and to notice their thoughts and feelings in a quiet and controlled environment.

Looking at any situation through multiple perspectives allows insight and empathy. This exercise could benefit bullies, targets, and witnesses.

Stories and narratives have played a crucial role in society since people began speaking. This exercise helps encourage empathy by asking participants to step into the shoes of another to tell their story. Explaining what the subject of the story thought or felt adds an added empathic layer to the narrative.

Assertive communication

This worksheet outlines individual rights while acknowledging the role that others’ rights and opinions play.

The “right to make mistakes,” which acknowledges the human condition of making mistakes regardless of what others think, is particularly interesting.

This worksheet outlines strategies to help understand and use assertive language. Included in the worksheet is empathy, which is crucial to solving escalating conflict.

Team building

This exercise requires participants to build a degree of vulnerability in order to create trust. Trust in the workplace can help strengthen teams and open lines of communication.

This worksheet creates an opportunity for team members to move beyond their comfort zone and become better acquainted with those outside their immediate circle. The goal of this exercise is to build rapport, strengthen teams, and enhance team performance.

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

Some bullying dynamics have existed in organizations so long that the behaviors have become ingrained as part of the workplace culture. As a result, affected employees are resigned to believing that nothing can be done because the culture is too far gone (Clark & Ritter, 2018).

This is simply not true. Just as we have witnessed deeply troubling sociological issues evolve, workplace bullying, which transcends all demographics, is making strides.

Employees are finding their voice and standing up for their rights. Although the United States lags behind other European countries on this issue (Davenport et al., 1999), creating safe workspaces for all employees is gaining momentum through lawsuits, budding legislation, publicized narratives, and more.

Using the resources provided in this article, each of us can mobilize for safety. Join the movement.

We hope you enjoyed reading this article. Don’t forget to download our three Work & Career Coaching Exercises for free .

• Bartlett, J. E., & Bartlett, M. E. (2011). Workplace bullying: An integrative literature review. Advances in Developing Human Resources , 13 (1), 69–84. https://doi.org/10.1177/1523422311410651
• Clark, C. M., & Ritter, K. (2018). Policy to foster civility and support a healthy academic work environment. Journal of Nursing Education , 57 (6), 325–331. https://doi.org/10.3928/01484834-20180522-02
• Cotterell, T. (2018). Understanding Title VII: What organizations need to know about employees in protected classes . Forbes.com. Retrieved October 20, 2021, from https://www.forbes.com/sites/forbeshumanresourcescouncil/2018/08/22/understanding-title-vii-what-organizations-need-to-know-about-employees-in-protected-classes/?sh=5b720cf53a32
• Davenport, N., Schwartz, R. D., & Elliott, G. P. (1999). Mobbing: Emotional abuse in the American workplace.  Civil Society.
• Kohut, M. R. (2008). The complete guide to understanding, controlling, and stopping bullies and bullying at work . Atlantic.
• Namie, G. (2017). 2017 Workplace Bullying Institute U.S. Workplace Bullying Survey [National statistics on workplace bullying]. Workplacebullyinginstitute.org. Retrieved October 2021, from https://workplacebullying.org/download/2017-wbi/?wpdmdl=2024&refresh=619558c1d89731637177537
• Namie, G. (2021). Workplace bullying: Introduction by Dr. Gary Namie [YouTube video]. Retrieved October 26, 2021, from https://www.youtube.com/watch?v=3w1Xx7skPxs
• Namie, G., & Namie, R. (2009). The bully at work (2nd ed.). Sourcebooks Inc.
• Salin, D., Cowan, R. L., Adewumi, O., Apospori, E., Bochantin, J., D’Cruz, P., … Zedlacher, E. (2020). Prevention of and interventions in workplace bullying: A global study of human resource professionals’ reflections on preferred action. The International Journal of Human Resource Management , 31 (20), 2622–2644. https://doi.org/10.1080/09585192.2018.1460857
• Workplace Bullying Institute. (n.d.).  About us.  Retrieved December 6, 2021, from https://workplacebullying.org/about-us/

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Article feedback

What our readers think.

Your article is helpful. I was a victim of Bulling by a very narcissistic woman. management did nothing and believe all her BS and so did HR . I finally quit. It was making me sick. She was doing things behind my back, changing things and getting into my personal stuff on my day off. She even thought my Calander was hers on my desks and wrote in it what she needed to do. She took credit for things she did do. the list goes on. Shame on the company for letting her do all this with no consequences.

Am learning everyday. As l read the article. It help me a lot to know when act of bullying is used on me by a coworker or by customer. It also give an insight to when is used against me. Bullying is very terrible l don’t Wish to anyone.

Great article. Thank you for many new insights on how to recognize and defuse bullying in the workplace.

Hi, I run a group for dually diagnosed adults with developmental disabilities in an Adult Day Program. I plan to use this article in my vocational skill building group. I look so forward to adapting this content, and have them also look at my company’s policy for bullying. Thank you so much!

Hi Amica Id love more information on tour program. Im based in Australia.

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Interventions for prevention of bullying in the workplace

Bullying has been identified as one of the leading workplace stressors, with adverse consequences for the individual employee, groups of employees, and whole organisations. Employees who have been bullied have lower levels of job satisfaction, higher levels of anxiety and depression, and are more likely to leave their place of work. Organisations face increased risk of skill depletion and absenteeism, leading to loss of profit, potential legal fees, and tribunal cases. It is unclear to what extent these risks can be addressed through interventions to prevent bullying.

To explore the effectiveness of workplace interventions to prevent bullying in the workplace.

Search methods

We searched: the Cochrane Work Group Trials Register (August 2014); Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1); PUBMED (1946 to January 2016); EMBASE (1980 to January 2016); PsycINFO (1967 to January 2016); Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus; 1937 to January 2016); International Bibliography of the Social Sciences (IBSS; 1951 to January 2016); Applied Social Sciences Index and Abstracts (ASSIA; 1987 to January 2016); ABI Global (earliest record to January 2016); Business Source Premier (BSP; earliest record to January 2016); OpenGrey (previously known as OpenSIGLE‐System for Information on Grey Literature in Europe; 1980 to December 2014); and reference lists of articles.

Selection criteria

Randomised and cluster‐randomised controlled trials of employee‐directed interventions, controlled before and after studies, and interrupted time‐series studies of interventions of any type, aimed at preventing bullying in the workplace, targeted at an individual employee, a group of employees, or an organisation.

Data collection and analysis

Three authors independently screened and selected studies. We extracted data from included studies on victimisation, perpetration, and absenteeism associated with workplace bullying. We contacted study authors to gather additional data. We used the internal validity items from the Downs and Black quality assessment tool to evaluate included studies' risk of bias.

Main results

Five studies met the inclusion criteria. They had altogether 4116 participants. They were underpinned by theory and measured behaviour change in relation to bullying and related absenteeism. The included studies measured the effectiveness of interventions on the number of cases of self‐reported bullying either as perpetrator or victim or both. Some studies referred to bullying using common synonyms such as mobbing and incivility and antonyms such as civility.

Organisational/employer level interventions

Two studies with 2969 participants found that the Civility, Respect, and Engagement in the Workforce (CREW) intervention produced a small increase in civility that translates to a 5% increase from baseline to follow‐up, measured at 6 to 12 months (mean difference (MD) 0.17; 95% CI 0.07 to 0.28).

One of the two studies reported that the CREW intervention produced a small decrease in supervisor incivility victimisation (MD ‐0.17; 95% CI ‐0.33 to ‐0.01) but not in co‐worker incivility victimisation (MD ‐0.08; 95% CI ‐0.22 to 0.08) or in self‐reported incivility perpetration (MD ‐0.05 95% CI ‐0.15 to 0.05). The study did find a decrease in the number of days absent during the previous month (MD ‐0.63; 95% CI ‐0.92 to ‐0.34) at 6‐month follow‐up.

Individual/job interface level interventions

One controlled before‐after study with 49 participants compared expressive writing with a control writing exercise at two weeks follow‐up. Participants in the intervention arm scored significantly lower on bullying measured as incivility perpetration (MD ‐3.52; 95% CI ‐6.24 to ‐0.80). There was no difference in bullying measured as incivility victimisation (MD ‐3.30 95% CI ‐6.89 to 0.29).

One controlled before‐after study with 60 employees who had learning disabilities compared a cognitive‐behavioural intervention with no intervention. There was no significant difference in bullying victimisation after the intervention (risk ratio (RR) 0.55; 95% CI 0.24 to 1.25), or at the three‐month follow‐up (RR 0.49; 95% CI 0.21 to 1.15), nor was there a significant difference in bullying perpetration following the intervention (RR 0.64; 95% CI 0.27 to 1.54), or at the three‐month follow‐up (RR 0.69; 95% CI 0.26 to 1.81).

Multilevel Interventions

A five‐site cluster‐RCT with 1041 participants compared the effectiveness of combinations of policy communication, stress management training, and negative behaviours awareness training. The authors reported that bullying victimisation did not change (13.6% before intervention and 14.3% following intervention). The authors reported insufficient data for us to conduct our own analysis.

Due to high risk of bias and imprecision, we graded the evidence for all outcomes as very low quality.

Authors' conclusions

There is very low quality evidence that organisational and individual interventions may prevent bullying behaviours in the workplace. We need large well‐designed controlled trials of bullying prevention interventions operating on the levels of society/policy, organisation/employer, job/task and individual/job interface. Future studies should employ validated and reliable outcome measures of bullying and a minimum of 6 months follow‐up.

Plain language summary

Are there ways in which workplace bullying can be prevented?

Bullying in the workplace can reduce the mental health of working people. It can also harm the organisations where these people work. There has been much research about bullying in the workplace. However, most studies have looked at how to manage bullying once it has happened, rather than trying to stop it happening in the first place. Many people who have been bullied choose to leave their job rather than face up to the bully. It is important to know if the actions workplaces take to prevent bullying are effective.

Our review question

What are the benefits of different ways of trying to prevent bullying in the workplace?

What the studies showed

We included five studies conducted with 4116 participants that measured being victim of bullying or being a bully and consequences of bullying such as absenteeism. We classified two interventions as organisational‐level, two as individual‐level and one as multi‐level. There were no studies about interventions conducted at the society/policy level.

Organisational‐level interventions

Two studies found that organisational interventions increased civility, the opposite of bullying, by about five percent. One of these studies also showed a reduction in coworker and supervisor incivility. They also found that the average time off work reduced by over one third of a day per month.

Individual‐level interventions

An expressive writing task with 46 employees, showed a reduction in the amount of bullying. A cognitive behavioural educational intervention was conducted with 60 employees who had a learning disability, but there was no significant change in bullying.

Multilevel interventions

One study evaluated a combination of education and policy interventions across five organisations and found no significant change in bullying.

What is the bottom line?

This review shows that organisational and individual interventions may prevent bullying in the workplace. However, the evidence is of very low quality. We need studies that use better ways to measure the effect of all kinds of interventions to prevent bullying.

Summary of findings

Summary of findings for the main comparison.

1 We would have downgraded the quality of evidence twice due to high risk of bias caused by study limitations (lack of randomisation and blinding, and use of self‐reporting instrument) and once due to imprecision (limited sample available for outcome measurement, limited matching pre‐ and post intervention). However, once was enough to reach very low quality evidence as we started at low quality evidence because the included studies used a controlled before‐after design. We found no reason to upgrade the quality of the evidence.

Summary of findings 2

1 We would have downgraded the quality of evidence once due to high risk of bias caused by study limitations (lack of blinding and use of self‐reporting instrument) and twice due to imprecision (study conducted in mixed settings and with unclear number of participants). However, once was enough to reach very low quality evidence as we started at low quality evidence because the included studies used a controlled before‐after design. We found no reason to upgrade the quality of the evidence.

Summary of findings 3

1. We would have downgraded the quality of evidence twice due to high risk of bias caused by study limitations (lack of randomisation and blinding, and use of self‐reporting instrument) and once due to imprecision (small sample size). However once was enough to reach very low quality evidence as we started at low quality evidence because the included studies used a controlled before‐after design. We found no reason to upgrade the quality of the evidence.

Summary of findings 4

1. We would have downgraded the quality of evidence twice due to high risk of bias caused by study limitations (lack of randomisation and blinding, and use of self‐reporting instrument) and once due to imprecision (small sample size). However, once was enough to reach very low quality evidence as we started at low quality evidence because the included studies used a controlled before‐after design. We found no reason to upgrade the quality of the evidence.

Numerous terms and concepts have been used as synonyms for bullying. These include psychological terror ( Leymann 1990 ), and work abuse ( Bassman 1992 ). Bullying in the workplace has also been described as: "harassment, intimidation, aggression, bad attitude, coercive management, personality clash, poor management style, brutalism and working in a funny way" by Adams 1992 . In the United States (US) and Canada, terms such as 'harassment' ( Brodsky 1976 ), 'workplace trauma and employee abuse' ( Wilson 1991 ), 'petty tyranny' ( Ashforth 1994 ), and 'incivility' ( Cortina 2001 ), are used. The term 'bullying' is now visible in the literature ( Vessey 2009 ), and 'mobbing' is also used when describing harassment or bullying of employees ( Einarsen 2000 ; Vandekerckhove 2003 ). In the context of the workplace, 'mobbing' can also indicate behaviour by a group of people against an individual, or as a synonym for bullying. In Australia, the most commonly used term is 'horizontal violence', which refers specifically to bullying by peers or colleagues at the same organisational level ( McKenna 2003 ). Occasionally, the term 'harassment' has been used interchangeably with bullying. A differentiation between bullying and harassment has been proposed by McMahon 2000 , who stated that bullying is abuse of power and this is the factor that differentiates harassment from bullying. It is important to note that there is legislation against 'harassment' within the United Kingdom (UK) and European law, which relates specifically to behaviour directed at individuals because of their colour, race, creed, gender, or sexual orientation ( European Foundation 2010 ). As noted above, the terms incivility and bullying are increasingly being used interchangeably. According to Namie 2003 visualising organisational disruption on a 10‐point continuum incivility is located between 1 and 3 and workplace bullying between 4 and 9. Clark 2011 developed a 'continuum of incivility' of unacceptable workplace behaviours, based primarily on interactions with work colleagues. They argue that incivility that goes unchallenged may be perceived as bullying.

Health‐service unions have classified bullying in the workplace as "humiliating an individual, especially in front of colleagues, picking on someone; belittling someone, undermining someone’s ability to do their job; and abusive or threatening behaviour" ( RCM 1996 ; Royal College of Nursing 2002 ; UNISON 1997 ). Major work in this area has been undertaken by Einarsen 2009 , with the result that work‐related, person‐related, and physical intimidation‐type behaviours have been incorporated into the Revised Negative Acts Questionnaire . However, some concerns have been raised about the limitations of a definitive list of bullying behaviours, as there are a number of ways in which bullying can manifest itself, and these are difficult to encapsulate in a single measure, even if the instrument has good validity and reliability ( Carponecchia 2011 ). Another issue of importance is the misconception that managers and supervisors are the sole perpetrators of bullying. There is evidence that employees can also bully managers ( Gillen 2008 ).

Schreurs 2010 argues that before bullying takes place, several antecedents need to be present. These have been identified in the literature as role conflict, role ambiguity, level of workload, and level of autonomy in the job ( Baillien 2009 ; Samnani 2012 ). Stress inherent in the job or the environment has also been named as a triggering factor ( Hauge 2007 ; Hauge 2009 ). Organisational change can also lead to bullying ( Skogstad 2007 ). This is manifest in situations where managers enforce change or conformity by bullying their employees ( Beale 2011 ; Vartia 1996 ). Gillen 2008 identified perception of the victim, an individual's locus of control, power, distance, and a permissive culture in the workplace as precursors to bullying. The workplace culture influences how employees behave towards one another ( Cleary 2009 ; Keashly 2010 ). Lutgen‐Sandvik 2014 argue that when bullying is not recognised and prevented, organisations will not meet their full potential. There is also evidence that employees emulate behaviour that they see in other colleagues, so that they can fit in with the workplace culture, thus coming to perceive bullying as normal ( Gillen 2007 ).

There is wide variation in the reporting and recording of bullying around the world. This may be due to a number of factors, such as: lack of clarity in definition, variation in time frames assigned by the researcher, problems with validity and reliability of measurement, and organisational culture and structures ( Zapf 2011 ). In the first study of workplace bullying in France, Neidhammer 2007 reported that 10% of the population studied had been exposed to bullying within the previous 12 months (N = 3132 men and 5562 women). A survey on working conditions by the European Foundation 2010 reported rates as high as 11% in Belgium and 10.7% in Luxemburg, and as low as 2.7% in Montenegro and 3% in Poland, in response to the question: "Have you been subjected to bullying or harassment in the last year?" It is clear that the criteria set by researchers, such as duration and frequency of bullying behaviour, invariably impact on the incidence levels recorded. Two studies of NHS Trust employees in the UK help to demonstrate this, with a prevalence of between 11% (self‐reported exposure to bullying in the preceding six months ( Hoel 2000 )), and 38% (exposure to one or more types of bullying behaviours during the previous year ( Quine 1999 )). More recently, in a cross‐sectional study by Carter 2013 , 20% of 2950 Health‐service staff reported having been bullied in the previous six months. However, other factors may also impact on these findings, such as workplace and gender ( Zapf 2011 ). Nielsen 2009 reported on a study of 2539 Norwegian employees, where the incidence of workplace bullying ranged from 2% to 14.3%, depending on how the behaviour was measured and frequency estimated. In the US, a 70% rate of exposure to bullying behaviour was recorded among registered nurses (N = 212), although a time criterion was not set by the researchers ( Vessey 2010 ). An Australian workplace project included responses from 5743 workers from six states and territories, and reported that 6.8% of respondents had experienced bullying in the last six months ( Safe Work Australia 2012 ).

The consequences of bullying have implications for the individual and the organisation. Berry 2012 reported the negative impact of bullying on novice nurses' ability to manage their workload. Generally, employees who have been bullied have lower levels of job satisfaction, higher levels of anxiety and depression, and are more likely to leave their job ( Ball 2002 ; Quine 2001 ; Vessey 2010 ). Tehrani 2004 noted that of the 67 healthcare professionals who they had identified as having been bullied, 44% were experiencing high levels of post‐traumatic stress disorder (PTSD). For the individual, the effects of bullying are considered to be more devastating than all other types of workplace stress put together ( Hogh 2011 ). Building on the work of Kivimäki 2003 , Nielsen 2012 suggested that early intervention was necessary to prevent bullying and subsequent psychological distress becoming a 'vicious circle' in which the victim of bullying becomes susceptible to more bullying. Indeed, prolonged exposure to workplace bullying has been identified as a key predictor of mental ill‐health five years later ( Einarsen 2015 ). The consequences for the organisation are most often reported in financial terms. A report commissioned by the Dignity at Work Partnership has estimated that the total cost of bullying for organisations in the UK in 2007 was approximately GBP 13.75 billion ( Giga 2008 ). In real terms, these costs arise from higher levels of sickness absence, recruitment costs associated with a propensity for staff to leave, and decreased productivity ( Johnson 2009 ). However, Beale 2011 has argued that some employers do not tackle bullying because they benefit from its existence in the workplace. They suggest that a certain level of bullying by managers in organisations is tolerated, as it is seen as an effective means of controlling the workforce.

It is clear that workplace bullying and its prevalence, manifestations, and consequences has been the subject of a growing body of research throughout the world. There are an increasing number of organisations that provide employee assistance programmes, including counselling, as a means of dealing with the consequences of bullying ( Tehrani 2011 ). Such management approaches are costly, deal with the aftermath of bullying, and have been largely ineffective, with high financial, individual, and organisational costs ( Hoel 2011 ). However, what is less clear are the measures that can be put in place before the onset of bullying. Simply put, prevention of bullying requires a proactive approach and management tends to be reactive and problem‐focused.

Description of the condition

Three attributes are commonly assigned to bullying: first, the behaviour is repeated (this excludes one‐off events or personal attacks); second, the bullying behaviour has a negative effect on the victim; and third, the victim finds it difficult to defend him or herself ( Einarsen 2011 ; Gillen 2007 ; Zapf 2011 ). There is also a fourth attribute, 'intent' of the bully, but as yet, there is no consensus about including it in definitions. Nevertheless, 'intent' is sometimes used to differentiate incivility from bullying. It has been suggested that incivility is unintentional and often circumstantial, such as a result of workplace pressures ( Clark 2011 ). Commonly ascribed definitions of bullying used by researchers at an international level include the identification of physical actions, disruptive, psychological behaviours, and acts of incivility ( Einarsen 1996 ; Einarsen 2011 ). Feblinger 2009 described various behaviours associated with incivility, similar to those listed in instruments that measure bullying ( Einarsen 2009 ; Gillen 2007 ).

Bullying has been defined as: “the often intentional, repeated, persistent, offensive, abusive, intimidating, malicious or insulting behaviour, abuse of power, or unfair penal sanctions against which the victim finds it difficult to defend him or herself. It has a negative effect on the recipient, which makes them feel upset, threatened, humiliated or vulnerable; undermines their self‐confidence; and which may cause them to suffer stress” ( Gillen 2008 ). This is similar to the Einarsen 2011 definition: "Bullying at work means harassing, offending, socially excluding someone, or negatively affecting someone’s work tasks. In order for the label bullying (or mobbing) to be applied to a particular activity, interaction or process it has to occur repeatedly and regularly (e.g. weekly) and over a period of time (e.g. about six months). Bullying is an escalating process in the course of which the person confronted ends up in an inferior position and becomes the target of systematic negative social acts. A conflict cannot be called bullying if the incident is an isolated event, or if two parties of approximately equal strength are in conflict". Although universally accepted, the Einarsen 2011 definition does not include reference to the negative effect of the bullying behaviour on the victim, i.e. that it causes stress, nor does it include reference to the issue of intent. We used the Einarsen 2011 definition of bullying in this review as it is more commonly known, and has been used extensively in research studies.

Description of the intervention

We considered all interventions within the workplace that were aimed at preventing bullying. Prevention of bullying can be more difficult to define (than bullying itself), as it may occur indirectly from other actions, such as achieving a positive workplace culture. Interventions may be targeted at individual employees, groups of employees, or organisations as a whole, and aim to prevent new cases of bullying or to prevent further instances of bullying of those who have already suffered from it. We used the levels of 'society/policy', 'organisation/employer', 'job/task' and 'Individual/job interface' to classify prevention interventions according to Vartia 2011 .

Interventions aimed at preventing bullying in the workplace may be internally derived and developed, but more often are influenced by local, national or international policy ( Leka 2008 ). According to Lamontagne 2007 interventions may be classified as primary (preventative), secondary (ameliorative), or tertiary (reactive). For the purpose of this review, we considered only primary interventions.

Vartia 2011 identified four different levels of bullying interventions as follows:

Society/policy

These interventions are normally law‐ or regulation‐based, with agreements of individual companies, for example, the Dignity at Work Partnership 2007 , or European Legislation, such as the Framework Agreement on Harassment and Violence at Work ( European Social Dialogue 2007 ). These set the standards of accepted behaviour, which are cascaded to employers who are actively encouraged to implement them.

Organisation/employer

These interventions are derived most often from law‐ or regulation‐based initiatives such as health and safety directives and the legislation described above. By definition, they are workplace‐specific and deal with the organisation's policy, aims, and expectations for the culture of the workplace, setting out clearly expected and agreed levels of behaviour. Such policies and procedures are often the first step that workplaces take when trying to influence workplace bullying ( Carponecchia 2011 ). These documents should clearly indicate the types of behaviour that are considered unacceptable and describe a reporting mechanism for those who perceive themselves to be 'bullied' ( Salin 2008b ). Pre‐intervention surveys may also be carried out to establish baseline levels. Although it should be remembered that reports of bullying often rise following the introduction of a new intervention. This is perhaps because workers are now more aware of what bullying is.

These interventions relate specifically to the job that employees are expected to do and the psychosocial environment in which they work. A risk assessment, including the identification of antecedents of bullying within the organisation, is used to inform a risk‐reduction intervention.

Individual/job interface

These interventions relate specifically to training, such as assertiveness training, or educational interventions aimed at altering behaviour or perception.

Interventions may operate at one or more of these levels. They may be targeted at individuals, in particular managers or supervisors, using a prevention perspective. They may focus on policy, procedures, and guidelines, or on locally designed and implemented education and training, which may be facilitated by occupational health departments.

How the intervention might work

Interventions to prevent workplace bullying may work by:

• strengthening the policies and culture of intolerance of bullying in the workplace by processes of engagement with employees;
• providing a safe environment within which mediation and negotiation may take place when problematic behaviour (not bullying) is first identified;
• undertaking risk assessments of job‐related precursors to bullying; and
• providing awareness‐raising or education sessions that will encourage employees to reconsider their behaviour and how they interact with colleagues.

Why it is important to do this review

Bullying has been shown to cause widespread emotional harm and distress ( Gillen 2008 ; Hogh 2011 ). It is viewed as a negative behaviour in the workplace that leads to increased absences, lower productivity ( Fisher‐Blando 2008 ), or continuing inability to work ( Hogh 2011 ). Mental health and well‐being issues are increasingly recognised as being responsible for employee absence and turnover. This is a crucial factor in recruiting and maintaining a healthy workforce, which is currently of particular importance in healthcare services in particular ( World Health Organization 2008 ), and in business in general, when organisations are attempting to keep costs low ( CIPD 2013 ). It was important to do this review in order to determine the effectiveness of interventions that currently exist to prevent bullying in the workplace. Prevention is important, as often the damage that is caused by bullying is difficult to undo, and has long‐term consequences on employees' health and well‐being ( Gillen 2012 ; Butterworth 2013 ).

To evaluate the effectiveness of workplace interventions to prevent bullying in the workplace.

Criteria for considering studies for this review

Types of studies.

We included all studies that evaluated the effectiveness of interventions to prevent bullying in the workplace (those targeted at individual employees, groups of employees, and organisations as a whole). We included randomised controlled trials (RCT) and cluster‐randomised controlled trials (cRCT) of person‐directed interventions. As it is more difficult to randomise whole companies or work units, we also included controlled before and after (CBA) studies and interrupted time‐series (ITS) studies of organisational interventions.

Types of participants

We included all studies where participants were employees in paid work within private, public, or voluntary organisations.

Types of interventions

We considered for inclusion all interventions aimed at primary prevention of bullying in the workplace. We excluded interventions that were focused on managing behaviours associated with bullying. Prevention is a proactive approach, which aims to reduce the incidence of bullying, while management of bullying is reactive in nature, often only responding when the detrimental impacts on individuals, groups of employees, and organisations are evident.

The interventions may have been targeted at an individual employee, a group of employees, or an organisation as a whole. We excluded interventions that were not clearly defined or that did not have a theoretical underpinning. We included studies that compared interventions with each other, with usual practice, or with no intervention. We also included interventions where groups acted as their own control. We classified included interventions according to the four levels identified by Vartia 2011 (see Description of the intervention ) where possible and as multilevel interventions when they engaged multiple levels. We included studies that reported:

• clearly stated aims for the implementation of interventions;
• clear and detailed description of the content and nature of the intervention that enabled the reader to fully understand it; and
• an explanation of the intervention's theoretical underpinnings.

We considered for inclusion all interventions aimed at individuals to prevent bullying by means of:

• informational or educational interventions aimed at altering behaviour or perception;
• organisational policy or incentives that discourage bullying;
• enhancements to reporting mechanisms that make it easier for individuals to report problematic behaviour: and
• health and safety policies that include identification of bullying as a risk.

We also considered for inclusion all interventions targeted at groups of employees or organisations as a whole to prevent bullying by means of:

• Informational or media campaigns to change policy;
• Incentives to change policy or encourage adherence to policies (either positive or negative); or
• Interventions that will alter the accepted culture of the organisation.

Types of outcome measures

Bullying is a complex phenomenon. Hence outcome measures should reflect that complexity. We included studies that used outcome measures related to prevention of workplace bullying, i.e. outcomes that showed a change in the number of reported cases of bullying perpetration, victimisation, or level of absenteeism. Self‐reported outcomes were taken in preference to secondary observations.

Primary outcomes

We included studies that reported on the number of cases of self‐reported bullying, whether recorded by perpetrator or victim. Hence we defined the primary outcome as the number of occurrences of bullying perpetration or victimisation, or both. Perpetration refers to a measurable act of bullying, while victimisation refers to recipients' reports of such action. We also accepted common synonyms such as mobbing and incivility and antonyms such as civility. We included dichotomous, categorical, integer and continuous measures of bullying.

Secondary outcomes

When included studies reported intervention effectiveness with consequential measures of bullying, namely stress, depression, absenteeism or sick leave, in addition to our primary outcome, we included these data.

We used only the primary outcomes as inclusion criteria. We used the secondary outcomes only to explain the findings of the primary outcomes because the included studies using our secondary outcomes are only a subset of all studies that reported our primary outcomes.

Search methods for identification of studies

We systematically searched for reports on the effectiveness of one or more interventions to prevent bullying in the workplace. The search strategy consisted of key words, including commonly used synonyms for bullying, the workplace setting, employees, and workplace interventions.

Electronic searches

We conducted a search in the following databases:

• The Cochrane Work Group Trials Register (August 2014; update search not undertaken as small number of papers were retrieved in the original search).
• The Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1).
• PUBMED (1946 to January 2016).
• EMBASE (1980 to January 2016).
• PsycINFO (1967 to January 2016).
• Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus; 1937 to January 2016).
• Applied Social Sciences Index and Abstracts (ASSIA; 1987 to January 2016).
• ABI Global (earliest record to January 2016).
• International Bibliography of the Social Sciences (IBSS; 1951 to January 2016).
• Business Source Premier (BSP) (earliest record to January 2016).
• OpenGrey (Previously known as OpenSIGLE‐System for Information on Grey Literature in Europe; 1980 to December 2014; update search not undertaken as small number of papers retrieved in original search).

We used an initial strategy developed by the Cochrane Work Group's Information Specialist, outlined in Appendix 1 , which we adapted as required for each database. Our search focused primarily on titles and abstracts, with the aim of reducing the number of irrelevant articles retrieved. The Cochrane Work Group's Information Specialist and PG conducted the literature searches.

Searching other resources

Initially, we used a common online search engine to locate relevant websites to access otherwise unpublished material. We also searched the reference lists of all returned studies to identify potential additional studies. We also contacted experts in this area of research (frequently cited authors) to minimise potential studies being missed and to identify unpublished material that may be relevant. We also handsearched proceedings of conferences that focused on the issue of workplace bullying that we found during our database and website searches.

Selection of studies

We discarded all duplicate publications of studies. To identify potentially eligible studies, at least two review authors (PG and one other review author by rotation) screened all titles and abstracts. All authors (PG, MS, GK, CB, AL) undertook a calibration exercise to ensure consistency in selection of potentially eligible papers. Then two review authors (all authors were involved) independently read the abstracts and titles selected for possible inclusion. We screened the references without conferring, against the inclusion criteria. We only conferred once we had individually decided which papers should be included in the review. When a pair of authors could not agree, a third member of the review team arbitrated. We did not blind ourselves to authors, journal, or date of publication.

Data extraction and management

We designed a data extraction form based on forms developed for other Cochrane Work Group reviews. Two review authors extracted data using the agreed form (PG and one other review author by rotation). We resolved disagreements through discussion with at least one other review author. We filed all studies that had data extracted along with the data extraction forms for the purpose of an audit trail. One review author (PG) transferred all data into RevMan 5.3 ( RevMan 2014 ), and another review author (GK) checked the accuracy of the data transfer.

Assessment of risk of bias in included studies

For randomised controlled trials, three review authors (PG, MS, GK) independently assessed the risk of bias of the included studies according to the methods described in the Cochrane Handbook for Systematic Reviews of Interventions ( Higgins 2011 ).

For non‐randomised designs, we adapted the approach advocated by Downs 1998 , and supported by Deeks 2003 . We based our assessment of risk of bias solely on the two internal validity scales consisting of 13 items, as they were the most appropriate in this case ( Verbeek 2012 ). In order to report the ROB outcome in RevMan 2014 , we had to adapt the scoring slightly. Instead of using scores 1 or 0 we assessed each item as 'high risk', 'low risk', or 'unclear risk', depending on the study information provided. We independently assessed the internal validity of studies using the Downs 1998 Checklist. For the non‐randomised studies allocation concealment is not applicable so we judged them to have a high risk of bias. Pairs of review authors independently examined the risk of bias of the included studies. We resolved disagreements by discussion.

Measures of treatment effect

We calculated risk ratios (RRs) for dichotomous outcomes and means and standard deviations (SD) for continuous outcomes. When the results could not be entered in the data tables, we described them in the Characteristics of included studies and in the text.

We did not identify any interrupted time‐series studies (ITS) that met our inclusion criteria. If these are included in future versions of the review, we will extract data from the original papers and re‐analyse them according to the recommended methods for analysis of ITS designs for inclusion in systematic reviews ( Ramsay 2003 ).

Unit of analysis issues

Although the included studies' interventions operated in very different ways, they all worked at the level of the individual, that is, aiming to achieve individual outcomes to reduce the level of victimisation, perpetration, or both. Hence the unit of analysis was the individual. One study was a cluster‐randomised trial but it reported insufficient data to assess the cluster effect. If future updates of this review find cluster‐randomised studies that report sufficient data to be included in the meta‐analysis, but the authors do not make an allowance for the design effect, we will calculate the design effect based on a fairly large assumed intra‐cluster correlation of 0.10. We base the assumption that 0.10 is a realistic estimate on studies about implementation research ( Campbell 2001 ). We will follow the methods stated in the Cochrane Handbook for Systematic Reviews of Interventions for the calculations ( Higgins 2011 ).

Dealing with missing data

We contacted the authors of three of the studies included in this review. For the McGrath 2010 study, we clarified whether the participants were in paid work. We also contacted one of the authors of the Hoel 2006 study to seek clarification on the process of randomisation and to ask for data in a format that could be more easily included in the analysis. However, we did not receive a response. In addition, communication with Leiter 2011 provided clarification on data from their multivariate analysis.

Assessment of heterogeneity

We could combine results data from different studies in a meta‐analysis for just one comparison. Hence we needed to assess heterogeneity between just two studies ( Leiter 2011 ; Osatuke 2009 ). If more studies are included in future versions of the review, we will group them based on similar study designs, interventions, and outcome measures. We will test for statistical heterogeneity by means of the Chi² test as calculated in Review Manager 5.3 software ( RevMan 2014 ). We will use a significance level of P < 0.01 to indicate whether or not there is a problem with heterogeneity. Moreover, we will quantify the degree of heterogeneity using the I² statistic, where an I² value of 0% to 40% may be not important, 30% to 60% may represent important heterogeneity, 50% to 90% may indicate substantial heterogeneity and over 75% to indicate considerable heterogeneity ( Higgins 2003 ).

Assessment of reporting biases

We assessed reporting biases based on publication, time lag, location and language as recommended by Higgins 2011 and looked for signs of reporting biases within articles by checking that all stated outcomes had been reported. We prevented location bias by searching across multiple databases. We prevented language bias by including all eligible articles regardless of publication language.

Data synthesis

We pooled data from two studies judged to be clinically homogeneous (similar intervention, research design and outcome) in a meta‐analysis using Review Manager 5.3 software ( RevMan 2014 ). Because these studies were statistically heterogeneous, we used a random‐effects model. Should we identify more statistically homogeneous studies to include in meta‐analyses in future updates of this review we will use a fixed‐effect model. We conducted a sensitivity check by using the fixed‐effect model to reveal differences in results. We included a 95% confidence interval (CI) for all effect estimates.

Should we find ITS studies in future updates, we will use the standardised change in level and change in slope as effect measures. We will perform meta‐analyses using the generic inverse variance method. We will enter the standardised outcomes into Review Manager 5.3 as effect sizes, along with their standard errors (SEs).

Quality of the evidence

We used the GRADE approach, as described in the Cochrane Handbook for Systematic Reviews of Interventions, and GRADEproGDT software to present the quality of evidence in ‘Summary of findings’ tables ( Higgins 2011 ). The quality of a body of evidence for a specific outcome is based on five factors: 1) limitations of the study designs; 2) indirectness of evidence; 3) inconsistency of results; 4) imprecision of results; and 5) publication bias.

The GRADE approach specifies four levels of quality (high, moderate, low and very low), incorporating the factors noted above. Quality of evidence by GRADE should be interpreted as follows:

• High quality: We are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different;
• Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect;
• Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

Subgroup analysis and investigation of heterogeneity

Given the paucity of studies included in this review, we could not perform subgroup analyses. In future updates, if there are sufficient data, we will undertake subgroup analyses based on gender, occupation, type of intervention for prevention, type of organisation, location (country of origin), as well as type and duration of interventions.

Sensitivity analysis

We did not find a sufficient number of studies to permit us to conduct sensitivity analyses, that is, to test if our findings were affected by the choice of studies included in analyses. If we have sufficient studies in future updates, we will conduct sensitivity analyses in which we exclude studies we judge to have a high or unclear risk of bias.

Description of studies

Results of the search.

Our systematic search generated 19,544 references ( Figure 1 ). We identified 125 references that we considered potentially eligible for inclusion and accessed the full text articles. Following further scrutiny, we excluded 86 of these. We read the remaining 39 in greater detail and we excluded 34 as they did not meet our inclusion criteria. Five studies ( Hoel 2006 ; Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ) met the inclusion criteria for this review.

PRISMA Study flow diagram.

Included studies

Each of the included studies reported on at least one intervention that was clearly defined or had a clear theoretical underpinning. See Characteristics of included studies .

Study Design

Of the five included studies, one was a cluster‐RCT (cRCT) ( Hoel 2006 ), and the other four were CBA studies ( Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ).

Two CBA studies used a group intervention with surveys before and after the delivery of the intervention ( Leiter 2011 ; Osatuke 2009 ). One of these was followed‐up at 12 months and reported separately ( Leiter 2011 ). One other CBA study compared reported levels of incivility, perpetration, and victimisation before and after the intervention ( Kirk 2011 ). In another CBA study, victimisation and bullying behaviour were measured at three time points, one before and two after intervention ( McGrath 2010 ).

In the cRCT, clusters were randomly allocated to four different bullying intervention programmes or a control condition.

Setting and participants

One study was carried out with a large healthcare organisation with employees dispersed across Canada ( Leiter 2011 ; N = 907), and another with five organisations with employees across several US states ( Osatuke 2009 ; N = 2062).

In Hoel 2006 , the 1041 participants were employees from five public sector organisations in the UK: three NHS trusts (one focused specifically on mental health), one civil service department, and one police force).

The Kirk 2011 study was carried out in Australia. Of the 46 participants 48% were in managerial or professional positions, 15% were employed psychology students, and details of the remaining participants' employment were not given.

The McGrath 2010 study was carried out in Ireland. The 60 participants were adults with a borderline, mild, or moderate learning disability, based in a work centre. We contacted the authors of the paper to determine whether or not the participants in this study were paid for the work. The authors responded that the participants received 'therapeutic earnings' but not enough to affect their benefits. We decided that while these participants could not be considered to be representative of most paid workers, they did meet the inclusion criteria for this review.

The five included studies had altogether 4116 participants.

Interventions

All included studies took account of background literature about bullying and how to prevent it. Two studies were conducted within a framework for Civility, Respect, and Engagement in the Workforce (CREW; Leiter 2011 ; Osatuke 2009 ). One study was clearly informed by the intervention literature especially when it comes to the design of the intervention programme, the need to account for organisational context, and to include employee participation ( Hoel 2006 ). The expressive writing intervention was based on the theory of self‐efficacy and the demonstrated potential for behaviour change that may result from 'poor emotional processing' ( Kirk 2011 ). The final included intervention was based on cognitive behavioural therapy (CBT), which is suitable for effecting behaviour change ( McGrath 2010 ). According to the authors their intervention was based on "...other‐bullying programs, anger management programs and relaxation training programs adapted to meet the needs of adults with a learning disability".

Society/policy level interventions

None of the included studies reported on interventions at the society/policy level.

Organisation/employer level interventions

Two studies reported on the effectiveness of a culture change intervention, which was intended to address Civility, Respect and Engagement at Work (CREW) at the organisational or employer level ( Leiter 2011 ; Osatuke 2009 ). The core elements of the CREW intervention are included in the Characteristics of included studies . This was a substantial intervention, demanding organisational commitment to a process that lasted longer than six months.

Job/task level interventions

None of the included studies reported on interventions aimed solely at the job/task level.

One study described the effects of an educational programme that included a three‐hour negative behaviour awareness intervention on acceptable and unacceptable behaviours within the workplace ( Hoel 2006 ). We judged the intervention to operate at the individual/job interface level.

One study used an educational intervention aimed at enhancing self‐efficacy to reduce workplace incivility victimisation and perpetration through a self‐administered writing intervention, which was completed by participants over a three‐day period ( Kirk 2011 ). The control group completed a sham writing task.

One study described a cognitive‐behavioural educational intervention developed from other unstipulated bullying, anger management and relaxation programmes, which was adapted to meet the needs of adults with a learning disability ( McGrath 2010 ). The intervention lasted 90 minutes and was delivered once a week, at the same time each week, for ten weeks. The intervention included information on bullying and its consequences, raised awareness of personal triggers, and taught participants ways to deal with bullying. The intervention was directed at bullies, victims, and bystanders (those who had witnessed bullying of others).

One study described an educational intervention programme operating at three levels: organisation/employer level, job/task and individual/job interface levels ( Hoel 2006 ). The programme was comprised of three intervention components: policy communication, stress management, and negative behaviour awareness training. These were implemented in various combinations that always included policy communication which we judged to operate at the organisation or employer level. We judged the stress awareness session to operate at the job/task level, whilst we judged the negative behaviour component of the programme to operate at the individual/job interface level.

Studies used several outcomes to establish the effectiveness of interventions that were aimed at preventing bullying in the workplace.

Bullying victimisation was measured in all of the included studies. Two studies measured bullying victimisation through self‐report questionnaire ( Hoel 2006 ) or interview ( McGrath 2010 ).

The studies by Kirk 2011 and Leiter 2011 recorded experiences of incivility. Kirk 2011 defined incivility as "discourteous interactions between employees that violate norms of mutual respect. Such behaviour can involve expression of hostility, privacy invasion, exclusionary behaviour, and gossiping". The study by Leiter 2011 reported extending previous work and used a similar pre‐existing definition of incivility. We regarded the behaviours covered by this definition as common bullying behaviours.

Two studies reported on experiences of civility ( Osatuke 2009 ; Leiter 2011 ) using a five‐point Likert type scale that averaged the answers on eight questions concerning respect, cooperation, conflict resolution, co‐worker personal interest, co‐worker reliability, anti‐discrimination, value differences, and supervisor diversity acceptance. We regarded these behaviours as the inverse of incivility and therefore an indirect measure of bullying victimisation. The scale scores ranged from one to five.

In both Leiter 2011 and Osatuke 2009 there were differences in baseline scores between the intervention and the control group. Both studies used a multivariate linear regression analysis for taking these differences into account. We used the betas from the regression analyses as the mean differences of the change values and the associated standard errors (SE). For Leiter 2011, we received the Standard Errors (SE) belonging to the betas on request from the authors. For Osatuke 2009, we calculated SE using beta divided by the square root of the reported F‐value.

Bullying perpetration was measured in four of the included studies. Two studies measured bullying perpetration through self‐report questionnaire ( Hoel 2006 ) or interview ( McGrath 2010 ). We regarded the incivility measures reported as incivility perpetration ( Kirk 2011 ) and instigated incivility ( Leiter 2011 ) as bullying perpetration.

In addition to reporting intervention effects on one or more of our primary outcomes, two studies reported intervention effects on absenteeism from work ( Hoel 2006 ; Leiter 2011 ). Leiter 2011 reported absenteeism using self‐report and 'aggregate institutional data' and Hoel 2006 used self‐reports to measure time off work. We did not identify the secondary outcomes stress or depression in any of the included studies.

Follow‐up

Follow‐up ranged from two weeks ( Kirk 2011 ) to 12 months or longer. Commonly, longer interventions were associated with longer follow‐up, from three to six months ( Hoel 2006 ; McGrath 2010 ), to 11‐14 months for culture change interventions ( Osatuke 2009 ; Leiter 2011 ). Longer follow‐up was associated with greater loss of participants.

Excluded studies

There is considerable literature on workplace bullying, most of it focused on the nature, manifestations, consequences, and management. This is reflected in the number of papers that we initially found ( Figure 1 ) and subsequently excluded. We screened and excluded 86 full‐text papers.

Twelve papers were literature reviews ( Bartlett, 2011 ; Beech 2006 ; Branch 2013 ; Carroll 2012 ; Dollard 2007 ; Hodgins 2014 ; Hutchinson 2013 ; Illing 2013 ; Johnson 2009 ; Stagg 2010 ; Vessey 2010 ; Wassell 2009 ).

Nine papers reported on the implementation or proposed application of anti‐bullying policies or strategies but did not include testing of their effectiveness ( Bulutlar 2009 ; Duffy 2009 ; Hollins 2010 ; Leka 2011 ; Meglich‐Sespico 2007 ; Ng 2010 ; Rasmussen, 2011 ; Sheehan 1999 ; Srabstein 2008 ).

Thirteen papers were surveys and reported on the frequency and nature of bullying behaviour, its impact and outcomes ( Baillien 2009 ; Duncan 2001 ; Hogh 2011 ; Mangione 2001 ; O'Driscoll 1999 ; Oluremi 2007 ; Salin 2008a ; Salin 2008b ; Spector 2007 ; van Heughten 2010 ; Vessey 2010 ; Walrafen 2012 ), or on the impact of leadership style on frequency of bullying ( Nielsen 2013 ).

Six papers focused on the management of workplace bullying ( Appelbaum 2012 ; Bentley 2012 ; Gardner 2001 ; Kahl 2007 ; Speery 2009 ; Steen 2011 ), and three on interventions with school children ( Dawn 2006 ; Farrington 2009 ; Halleck 2008 ).

Eleven papers focused on theoretical frameworks or models but did not include an intervention ( Baillien 2011a ; Djurkovic 2006 ; Djurkovic 2008 ; Johnson 2011 ; Laschinger 2012 ; Law 2011 ; Nielsen 2008 ; Olender‐Russo 2009 ; Ramsay 2011 ; Saam 2010 ; Schat 2000 ).

Two papers reported on case studies ( Lippel 2011 ; Namie 2009 ), one reported on a trial in a court of law ( Weber 2009 ), and one reported on the use of a participatory theatre action research approach to deal with bullying ( Quinlan 2009 ).

Twenty papers were opinion papers ( Al‐Daraji 2009 ; Christmas 2007 ; Cleary 2010 ; Dal Pezzo 2009 ; DelBel 2003 ; Egues 2013 ; Farrell 2007 ; Gerardi 2007 ; Gilmore 2006 ; Hubert 2003 ; Kolanko 2006 ; Longo 2007 ; Lutgen‐Sandvik 2012 ; Mahlmeister 2009 ; Namie 2004 ; Rayner 1999 ; Resch 1996 ; Shreeavtar 2002 ; Tehrani 1995 ; Yamada 2009 ), seven focused on workplace violence directed at healthcare workers by patients ( Arnetz 2000 ; Carter 1997 ; Farrell 2005 ; Molloy 2006 ; Viitasara 2004 ; Voelker 1996 ; Zampeiron 2010 ), and one study focused on assertiveness training for nurses but did not have a control group ( Karakas 2015 ).

We subjected the remaining 37 potentially eligible papers to a more detailed review against the inclusion criteria, and subsequently excluded all of them because their study design did not meet our inclusion criteria, primarily due to lack of control ( Barrett 2009 ; Beirne 2013 ; Bortoluzzi 2014 ; Bourbonnais 2006a ; Brunges 2014 ; Ceravolo 2012 ; Chipps 2012 ; Collette 2004 ; Cooper‐Thomas 2013 ; Crawford 1999 ; Egues 2014 ; Feda 2010 ; Gedro 2013 ; Gilbert 2013 ; Grenyer 2004 ; Griffin 2004 ; Holme 2006 ; Karakas 2015 ; Lasater 2015 ; Latham 2008 ; Leiter 2011 ; Longo 2011 ; Léon‐Pérez 2012 ; Mallette 2011 ; Meloni 2011 ; Melwani 2011 ; Mikkelsen 2011 ; Nikstatis 2014 ; Oostrom 2008 ; Osatuke 2009 ; Pate 2010 ; Probst 2008 ; Stagg 2011 ; Stevens 2002 ; Strandmark 2014 ; Wagner 2012 ; Woodrow 2014 ).

Further details of these studies are presented in the Characteristics of excluded studies table.

Risk of bias in included studies

We provide an overview of our risk of bias judgements across studies in Figure 2 and per study in Figure 3 .

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies using the Downs 1998 checklist.

Risk of bias summary: review authors' judgements about each risk of bias item for included studies.

Blinding of subjects and outcome assessors was not evident in any of these studies. Therefore we judged all studies to have a high risk of bias in both domains.

Retrospective unplanned subgroup analyses

We did not find evidence of data dredging or additional retrospective unplanned subgroup analyses. Therefore we judged all studies to have a low risk of bias in this domain.

There was wide variation in follow‐up with Kirk 2011 using only two weeks, McGrath 2010 using three months, Hoel 2006 using approximately six months, Leiter 2011 using 12 to 24 months. Pre‐ and post‐intervention matching was reported to be difficult. Furthermore, Osatuke 2009 reported a 'chronological mismatch' between the comparison and intervention groups. We calculated their follow‐up to be 11 to 14 months. We judged Leiter 2011 and McGrath 2010 to have a low risk of bias and the remaining three to have an unclear risk of bias in this domain.

Statistical tests

We judged statistical tests to be clearly described and appropriately applied in almost all cases. We found that Hoel 2006 failed to clarify in sufficient detail the main effects of the intervention. Other authors reported descriptive statistics and analysis of variance. Accordingly we judged Hoel 2006 to have an unclear risk of bias and all other studies to have a low risk of bias in this domain.

We found a wide variation with compliance across the range of interventions. We judged the resulting risk of bias to be unclear for the educational intervention ( Hoel 2006 ), and low for the expressive writing and cognitive behavioural intervention ( Kirk 2011 ; McGrath 2010 ). Due to lack of data on compliance, we judged risk of bias for the CREW Intervention to be unclear ( Osatuke 2009 ; Leiter 2011 ).

Outcome measures

The very nature of workplace bullying and its assessment pre‐ and post‐intervention is complex and we judged outcome measurement to be at high risk of bias in two studies ( Hoel 2006 ; McGrath 2010 ) and unclear in three ( Kirk 2011 ; Leiter 2011 ; Osatuke 2009 ). We judged the risk of bias for all of the outcome measures to be affected by the use of self‐report. This is because the sensitivity and stigma associated with perpetrating or experiencing bullying has an intrinsic risk of bias due to social desirability. Self‐reported measures are therefore likely to be biased against reporting true levels. On the other hand, investigators in raising the topic will increase awareness and create bias in the other direction (Hawthorne effect). We judged all of the studies to be susceptible to these latent risks of bias.

Selection bias (population)

One study was drawn from a well‐defined population ( McGrath 2010 ) and we judged it to be at low risk of selection bias. Three studies were drawn from disparate healthcare workplaces and we judged them to have an unclear risk of bias ( Hoel 2006 ; Leiter 2011 ; Osatuke 2009 ). The remaining study used a convenience sample of employees from a variety of unspecified workplaces and we judged it to be at high risk of bias ( Kirk 2011 ).

Selection bias (time)

We judged four studies to have a low risk of selection bias with regard to the time frame for recruitment ( Hoel 2006 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ). We judged the study by Kirk 2011 to have an unclear risk of bias because we were unable to determine the time frame.

Randomisation

We judged four studies to be at high risk of bias due to lack of randomisation ( Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ). We judged the single cluster‐randomised trial to be at low risk of bias ( Hoel 2006 ).

Allocation concealment

We judged four controlled before‐after studies to be at high risk of bias due to lack of allocation concealment ( Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ). We judged the single cRCT to have an unclear risk of bias on this domain because the study did not report having concealed allocation ( Hoel 2006 ).

Adjustment for confounding

One study described relevant confounders ( Hoel 2006 ). However, we found no evidence of adjustment in the statistical analysis and this lead to our judgement of high risk of bias due to confounding. We were unable to identify confounders in the other four studies ( Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ) and therefore we judged them all to have a high risk of bias due to confounding.

Incomplete outcome data

Details on participant loss to follow‐up was provided in two studies and we deemed them to be at low risk of bias ( Kirk 2011 ; McGrath 2010 ). Three studies by Hoel 2006 ; Leiter 2011 ; Osatuke 2009 reported numbers of participants lost to follow‐up but we were unable to determine whether this had been taken into account in analyses. Consequently, we judged them to be at unclear risk of bias.

Overall risk of bias

We judged all five included studies to have a high risk of bias overall based on: lack of blinding of subjects and outcomes assessors ( Hoel 2006 ; Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ), unreliable outcome measures ( Hoel 2006 ; McGrath 2010 ), selection bias ( Kirk 2011 ), lack of randomisation ( Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ), open allocation ( Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ) and lack of adjustment for confounding ( Hoel 2006 ; Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ). See Figure 3 for a summary of our judgements about each risk of bias for each included study.

Effects of interventions

See: Table 1 ; Table 2 ; Table 3 ; Table 4

See: Table 1 ; Table 2 ; Table 3 ; Table 4 .

Society/policy level

None of the included studies reported on the effects of interventions at the society/policy level.

Organisational/employer level

Workplace culture intervention versus no intervention, effects on bullying in general.

Two controlled before‐after studies reported on the effects on civility of the same organisational Intervention titled Civility, Respect, and Engagement in the Workforce ( Leiter 2011 ; Osatuke 2009 ). In the meta‐analysis of the two studies, the CREW intervention produced a small increase in civility at a follow‐up time between 6 and 14 months (Mean Difference (MD) 0.17 95% CI 0.07 to 0.28; scale range from 1 to 5; Analysis 1.1 ; 2 studies).

Comparison 1 CREW intervention vs no intervention, Outcome 1 Self‐reported civility.

Effects on bullying perpetration

Leiter 2011 reported a small reduction in co‐worker incivility (MD ‐0.08; 95% CI ‐0.22, to 0.06; scale range from 1 to 6; Analysis 1.2 ; 1 study), and a small non‐significant reduction in supervisor incivility (MD ‐0.17; 95% CI ‐0.33 to ‐0.01; Analysis 1.3 ; 1 study) at the 6‐month follow‐up ( Leiter 2011 ). The CREW intervention also produced a small non‐significant reduction in the frequency of incivility perpetration (MD ‐0.05; 95% CI ‐0.15 to 0.05; scale range from 1 to 6; Analysis 1.4 ; 1 study).

Comparison 1 CREW intervention vs no intervention, Outcome 2 Self‐reported co‐worker incivility.

Comparison 1 CREW intervention vs no intervention, Outcome 3 Self‐reported supervisor incivility.

Comparison 1 CREW intervention vs no intervention, Outcome 4 Self‐reported frequency of incivility perpetration.

Effects on secondary outcomes

Leiter 2011 reported a reduction in absenteeism during the previous month (MD ‐0.63 days per month; 95% CI ‐0.92 to ‐0.34); Analysis 1.5 ; 1 study) at 6‐month follow‐up.

Comparison 1 CREW intervention vs no intervention, Outcome 5 Self‐reported absenteeism in previous month.

We rated the overall quality of evidence about the effectiveness of the CREW intervention as very low ( Table 1 ).

Job/task level

None of the included studies reported uniquely on the effects of interventions at the job/task level, although one multilevel study incorporated one intervention at this level ( Hoel 2006 ). We were unable to determine the effect of this intervention specifically at the job/task level.

Individual/job interface level

Expressive writing intervention versus control writing, effects on bullying victimisation.

A controlled before‐after study reported results of an expressive writing intervention ( Kirk 2011 ) taking account of baseline scores. The authors found that the expressive writing intervention reduced incivility victimisation for participants who initially scored low (MD ‐5.74; 95% CI ‐9.88 to ‐1.60; Analysis 2.1 ) and moderate (MD ‐3.44; 95% CI ‐6.51 to ‐0.37; Analysis 2.2 ) on the incivility victimisation pre‐test. The expressive writing intervention had no significant effect on incivility victimisation with participants with high scores on the pre‐test (MD ‐0.73; 95% CI ‐4.23 to 2.77; Analysis 2.3 ) nor when we pooled the data (MD ‐3.30; 95% CI ‐6.89 to 0.29) ( Analysis 2.4 ).

Comparison 2 Expressive writing vs. control writing, Outcome 1 Incivility victimisation (25th percentile pre‐test).

Comparison 2 Expressive writing vs. control writing, Outcome 2 Incivility victimisation (50th percentile pre‐test).

Comparison 2 Expressive writing vs. control writing, Outcome 3 Incivility victimisation (75th percentile pre‐test).

Comparison 2 Expressive writing vs. control writing, Outcome 4 Incivility victimisation (pooled).

After controlling for pre‐test scores, participants in the expressive writing intervention arm scored significantly lower on workplace incivility perpetration than participants in the control writing arm in one study ( Kirk 2011 ) (MD ‐3.52; 95% CI ‐6.24 to ‐0.80; Analysis 2.5 ).

Comparison 2 Expressive writing vs. control writing, Outcome 5 Incivility perpetration.

This study did not report effects on absenteeism.

We rated the overall quality of evidence about the expressive writing intervention as very low ( Table 3 ).

Cognitive‐behavioural intervention versus no intervention

A controlled before‐after study reported results of a cognitive‐behavioural intervention ( McGrath 2010 ). The authors evaluated the intervention's effectiveness using the number of people who reported they had been victims of bullying. The authors took measurements at baseline, following completion of the intervention, and at three months post‐intervention. The likelihood of being bullied was similar at baseline across the intervention and control groups. Following the intervention, there was no significant difference in the risk of being bullied (Risk Ratio (RR) 0.55; 95% CI 0.24 to 1.25; Analysis 3.1 ), and there was no change at three‐month follow‐up (RR 0.49; 95% CI 0.21 to 1.15; Analysis 3.1 ).

Comparison 3 Cognitive Behavioural intervention vs. no intervention, Outcome 1 Victimisation.

The risk of bullying others was not significantly lower following the intervention (RR 0.64; 95% CI 0.27 to 1.54; Analysis 3.2 ), or at the three‐month follow‐up (RR 0.69; 95% CI 0.26 to 1.81; Analysis 3.2 ). However, the wide confidence interval and the small sample size leaves a lot of uncertainty about the true effect.

Comparison 3 Cognitive Behavioural intervention vs. no intervention, Outcome 2 Perpetration.

We rated the overall quality of evidence about the cognitive‐behavioural intervention as very low ( Table 4 ).

Multilevel Intervention

Effects on primary outcomes.

A five‐arm cluster‐randomised controlled study of three interventions in different combinations, using a partial factorial design, conducted at five sites, reported outcomes as percentages with small non‐significant changes post‐intervention ( Hoel 2006 ). Trends in the data were difficult to see as the authors report increases and decreases in outcomes separately for all five settings. Of the 1041 participants who completed the pre‐intervention survey, only 150 employees completed the training intervention. We wrote to the authors requesting access to their raw data so that we could have conducted our own analysis but received no response.

The authors found no effect on self‐reported absenteeism.

We rated the overall quality of evidence about the multilevel intervention as very low ( Table 2 ).

Summary of main results

None of the included studies explored the effectiveness of interventions at society/policy‐level.

We found two large CBA studies with 2969 participants that evaluated organisational/employer level interventions. These studies evaluated the effectiveness of a workplace culture intervention to achieve Civility, Respect, and Engagement in the Workforce (CREW) ( Leiter 2011 ; Osatuke 2009 ). The meta‐analysis of the two studies showed a small increase in civility (MD 0.17; 95% CI 0.07 to 0.28). This is a 5% increase from the baseline score. One of the two studies reported that the CREW intervention produced a small decrease in supervisor incivility victimisation (MD ‐0.17; 95% CI ‐0.33 to ‐0.01) but not in co‐worker incivility victimisation (MD ‐0.08; 95% CI ‐0.22 to 0.08) or in self‐reported incivility perpetration (MD ‐0.05 95% CI ‐0.15 to 0.05). The study did find a decrease in the number of days absent during the previous month (MD ‐0.63; 95% CI ‐0.92 to ‐0.34) at 6‐month follow‐up.

At the individual/job interface level, we found evidence from one study comparing an expressive writing intervention with a control writing exercise ( Kirk 2011 ). After controlling for pre‐test scores, participants in the intervention arm scored significantly lower on workplace incivility perpetration (MD ‐3.52; 95% CI ‐6.24 to ‐0.80). There was no difference in bullying measured as incivility victimisation (MD ‐3.30 95% CI ‐6.89 to 0.29). Another controlled before‐after study with 60 participants who had a learning disability, compared a cognitive‐behavioural intervention with no intervention ( McGrath 2010 ). There was no significant difference in bullying victimisation after the intervention (risk ratio (RR) 0.55; 95% CI 0.24 to 1.25), or at the three‐month follow‐up (RR 0.49; 95% CI 0.21 to 1.15), nor was there a significant difference in bullying perpetration following the intervention (RR 0.64; 95% CI 0.27 to 1.54), or at the three‐month follow‐up (RR 0.69; 95% CI 0.26 to 1.81).

Although none of the included studies explored the effectiveness of interventions solely at job/task‐level, we found one multilevel intervention that had addressed this level in addition to the organisation/employer level and the individual/job interface levels. This was a five‐site cluster‐RCT with 1041 participants that compared the effectiveness of different combinations of policy communication, stress management training, and negative behaviours awareness training ( Hoel 2006 ). The authors reported that their intervention did not yield a significant effect but we cannot confirm this as the study authors report insufficient data.

Overall completeness and applicability of evidence

We found five studies providing evidence of the effectiveness of bullying prevention interventions aimed at individuals and groups or organisations. However, we did not find all predicted bullying intervention types, such as at the level of society/policy. Four studies employed a CBA design and one used a cluster‐randomised controlled trial design. All the included studies had been conducted in high‐income countries: Australia, Ireland, North America, and the UK. The participants were diverse, ranging from healthcare workers ( Leiter 2011 ; Osatuke 2009 ); employees from public sector organisations ( Hoel 2006 ); and unspecified employees ( Kirk 2011 ), to adults with a learning disability employed in a work centre ( McGrath 2010 ). Whilst previous studies have shown that bullying predominates in the healthcare, education and public services professions ( Namie 2003 ), we did not find studies that evaluated interventions among teachers or other public service workers. We found no studies conducted in lower and middle income countries.

We did not find any studies that had evaluated the effectiveness of bullying prevention interventions on our secondary outcomes stress, depression, or sick leave.

We found three studies that focused on education ( Hoel 2006 ; Kirk 2011 ; McGrath 2010 ) and two that we categorised as culture‐change projects ( Leiter 2011 ; Osatuke 2009 ). One study covered three intervention levels but we found no programmes of interventions that covered all four levels as defined by Vartia 2011 (see Description of the intervention ). Although all included studies reported the demographic details of participants, none of them used any of these demographic factors as potential explanatory variables.

The follow‐up times for all but one study were relatively short, ranging from two weeks to 14 months.

We assessed the overall quality of the evidence provided by the included studies to be very low. We downgraded the quality of evidence due to high risk of bias caused by study limitations (lack of randomisation and blinding, and use of self‐reporting instruments) and imprecision (limited sample available for outcome measurement). Where large populations were involved, studies used variable subsets of these populations with little consistency before and after the intervention. We were able to combine the results of two studies using the same outcome measurement in a meta‐analysis. We found no reason to downgrade the quality of evidence due to indirectness as all included studies measured bullying or incivility. Due to the small number of included studies, it was not possible to assess publication bias. Only one of the five included studies was a cluster‐randomised trial ( Hoel 2006 ). The other four included studies used a less rigorous CBA design ( Kirk 2011 ; Leiter 2011 ; McGrath 2010 ; Osatuke 2009 ). One of the five included studies reported too little data for secondary analysis ( Hoel 2006 ). Blinding and allocation concealment was not possible for participants or outcome assessors in any of the studies. Outcome measures were wholly self‐reported, although using valid and reliable instruments. The small number of included studies and the wide range of interventions in terms of both level and type means that individual study results were unverified except for the CREW intervention.

The overall outcome of very low quality evidence underlines the fact that there is substantial room for improvement in future studies.

Potential biases in the review process

We used a very broad search strategy to ensure that all intervention types, all synonyms for workplace bullying, and all employees were included. We ran the search in a wide range of electronic reference databases and set no language limitations. We also conducted a trawl of websites that focus on bullying in the workplace. In addition, we contacted a number of cited authors to increase the likelihood of finding all relevant studies. We also set up email search alerts with Zetoc and the National Center for Biotechnology Information (NCBI) databases. Altogether, this resulted in a large number of references (19,544) to be screened for inclusion. Given more high‐quality primary research, it may be possible to further refine our inclusion criteria and thereby increase the precision of the search. In any case, we are fairly certain that we have not missed any published studies that would have met our inclusion criteria and should have been included.

In drawing the evidence together, we accepted a range of terms describing the outcome of bullying prevention interventions. We included bullying perpetration, bullying victimisation, incivility victimisation, incivility perpetration, experienced incivility, incivility instigation and civility as primary outcome measures. We assumed these terms to be sufficiently similar to represent a form of bullying or its inverse in the case of civility. This range demonstrates the current lack of agreed definition for outcome measures and associated potential for bias, especially where meaning varies along a continuum of organisational disruption or unacceptable work behaviours.

We were able to report only limited findings from the Hoel 2006 study due to the way in which the authors presented their results. Although we contacted the author to obtain raw data in order to conduct our own analyses, we did not receive a response.

We included studies using self‐reported outcome measurement scales despite the potential risk of bias, namely from social desirability in response to a sensitive topic. Self‐report, even when anonymised may lead to less reporting of bullying perpetration and bullying victimisation; neither of which are socially desirable. This might have affected the results of the interventions, particularly those that used a no‐intervention control group. This is less likely to have occurred in the Kirk 2011 study that used an active control. In addition, for the CREW intervention the effects were measured in several different ways and were supported by a decrease in absenteeism. Hence, the inclusion of evidence based on self‐report did not affect our conclusions adversely.

Agreements and disagreements with other studies or reviews

Our search retrieved 12 reviews related to bullying in the workplace. Following close inspection, we considered four of them to be focused on prevention of bullying in the workplace.

Stagg 2010 identified best practices from 10 studies that aimed to prevent and manage workplace bullying and violence. The authors included school‐based studies, a mentor‐mentee programme, a survey of students and employees, a study that focused on the development of a personal plan to help deal with psychosocial problems, a patient aggression study, a study that focused on addressing adverse working conditions of healthcare home workers, and a cognitive rehearsal initiative to respond to bullying behaviour. We explicitly excluded the latter ( Griffin 2004 ) from our review as it focused on the management and not the prevention of bullying. Although Stagg 2010 deals with a very diverse body of evidence, we concur with the authors' conclusions about the need for standardised means of developing, implementing, and evaluating bullying programs to enable better comparisons.

Illing 2013 synthesised the evidence about the occurrence, causes, consequences, and management of bullying and inappropriate behaviour in the workplace. The authors focused on how this information could be used to inform decision‐making on bullying in the NHS. They highlighted the importance of commitment from senior management if interventions are to be successful, and stressed the importance of preventing bullying as well as managing it and supporting those who have experienced it.

Branch 2013 aimed to articulate the state of the knowledge in the workplace bullying field. The authors designed a model to describe the processes of workplace bullying. They made suggestions for further research that focus on agreeing a definition, a guiding theory, the wider sociology of bullying, and determining the effectiveness of preventative and management interventions.

Hodgins 2014 critically reviewed 12 papers that reported on studies "designed to reduce workplace bullying or incivility", concluding that there was a lack of evaluated interventions in the area. Unlike our Cochrane review, the authors did not focus solely on prevention nor did they limit their inclusion criteria to particular study designs. However, they included evidence of the effectiveness of the CREW intervention as we did in our review.

We highlighted the limited number of well designed studies that have investigated the effectiveness of interventions to prevent bullying in the workplace. Some of the reviews included studies that focused on interventions to prevent bullying among school children. However, it was clear that these participants, their behaviours and the context are very different to those encountered in workplace bullying, limiting transferability of their findings.

These other reviews also reflected the predominance of secondary and tertiary prevention interventions as defined by Lamontagne 2007 . Interventions that address prevention rather than ameliorative or reactive practices are needed to help change the culture of bullying that persists in many workplaces.

Implications for practice

We found very low quality evidence from two large‐scale studies of small improvements in civility after an intensive and long‐term organisational intervention in healthcare organisations. There were no studies of organisational interventions in other occupations or branches of industry.

We found only one study evaluating an intervention at the individual level. It engaged a diverse range of individual employees using an expressive writing intervention. The study found very low quality evidence of a reduction in the incidence of incivility victimisation for those participants who showed a low or moderate pretest score. There was one other study that found very low quality evidence of a cognitive behavioural intervention having no effect on the occurrence of bullying.

We found no studies evaluating societal or policy level interventions to prevent bullying at work.

Implications for research

We recommend that future studies should follow the UK Medical Research Council Complex Interventions Framework ( MRC 2008 ; Moore 2014 ). Whilst the randomised controlled trial design is still regarded as the preferred design to elicit efficacy, future trials need to ensure the appropriate unit of randomisation, which, depending on the nature of the intervention, may be the individual, the work group, or an entire organisation. However, randomisation is difficult at the group level in workplaces. Controlled before‐after studies that take account of the workplace context and fully understand the mechanisms of action to maximise the benefits of interventions are a more feasible approach. Bearing all this in mind, we suggest that future studies should combine the benefits of randomised controlled trials with more realistic evaluation methods to bring the benefits of efficacy together with the understanding of contextual factors and mechanisms of action, for example, following a realist approach ( Bonell 2012 ). In particular, assessing how the various components of an intervention interact with each other and with local contextual factors is important, as is examining the effects of the separate components. This can be done effectively using multi‐arm studies and factorial trials ( Bonell 2012 ). The complexity of workplace bullying calls for a multi‐level approach to prevention, which may start with policy but ultimately needs to meet the needs of employees and organisations within a diverse and ever‐changing context that is the workplace. We do not know if successful prevention interventions need to operate across all the levels advocated by Vartia 2011 . Therefore, we need rigorous assessment of the effectiveness of legal and regulation frameworks (society/policy level); interventions focused on workplace culture (organisation/employer level); interventions to address the psychosocial environment (job/task level); and training and educational interventions (individual/ job interface level).

We recommend that studies of interventions at the society/policy level and those addressing the psychosocial environment at job/task level be conducted, as we found none to include in this review. We recommend further research on the CREW intervention ( Leiter 2011 ; Osatuke 2009 ) as it aims to improve workers’ behaviours at the level of workplace culture. Interventions at individual/job interface level could include a similar expressive writing task to that used by Kirk 2011 , as it is a simple, cost‐effective intervention to implement. Cognitive‐behavioural interventions should also be tested with a larger sample size and longer follow‐up period to that used by McGrath 2010 . Ideally, interventions would be drawn from a comprehensive evidence‐based 'menu' to address all affected levels from individual to organisational. When a specific intervention has been shown to be effective, a cost‐benefit analysis should be instigated. The proliferation of online communication within workplaces adds a new dimension to an already complex context. Hong 2014 has reported that online cyber‐bullying can occur within organisations, which may require special attention by researchers. On the other hand, the online environment may also provide suitable tools for conducting and evaluating interventions.

In considering the treatment that control group participants should receive, a consideration of research ethics is required. This means taking full account of ethical principles such as beneficence, non‐maleficence, autonomy and justice ( Beauchamp 2012 ). We agree that when there is a known issue of bullying, there are ethical implications of including a control group which denies participants benefits from interventions. However, increasingly the proven effectiveness of interventions is being demanded and this is difficult to demonstrate without a control or comparison group. Future studies on prevention of bullying can circumvent claims regarding the unethical treatment of half the randomised participants by using a wait‐list control group. Here no one is denied the possible benefits of the intervention, as the control group receives the same intervention after a waiting period.

Simple effective outcome measures, such as bullying victimisation and perpetration, should continue to be used but they require standardisation. For example, the Civility scale ( Leiter 2011 ; Osatuke 2009 ), the Workplace Incivility Scale, documented rates of absenteeism ( Leiter 2011 ), or rates of reported victimisation ( McGrath 2010 ) could all be useful outcome measures. Although it would be desirable to establish long‐term outcomes, we recognise the inherent difficulties in this, due to the highly dynamic nature of employment in all settings. However, in keeping with Leiter 2011 , we recommend a minimum of 6 months follow‐up, preferably 12 months, in order to demonstrate a sustained change. Giving feedback to employees, or providing continued small amounts of intervention input, may help participants to stay motivated and continue in the process. Future work should include demographic factors as potential explanatory variables as this may assist in targeting interventions to those most susceptible to bullying victimisation and perpetration.

Acknowledgements

We would like to acknowledge the following people who have contributed at different stages to the development of this review, and also for their constructive criticism and feedback:

From the Cochrane Work Group:

Mr Jani Ruotsalainen, Managing Editor;

Dr Jos Verbeek, Co‐ordinating Editor;

Dr Consol Serra, Editor;

Mr Wim van Veelen, Reviewer;

Ms Leena Isotalo, Information Specialist;

Mrs Kaisa Neuvonen, Information Specialist;

Dr Anneli Ojajärvi, Statistician;

Vicky Pennick, Copy Editor.

We would also like to thank:

Jenny Bellorini from the Ear, Nose and Throat Disorders Group for copy editing the protocol text;

Dr Deirdre FitzGerald, Occupational Physician, Cork, for her help and support with the updated search strategies;

Dr Paul Slater for statistical advice.

Appendix 1. Search Strategies

Osh (international bibliographic, cisdoc, hseline, nioshtic, nioshtic‐2, rilosh; osh update; via the cochrane library).

• DC{ OUBIB or OUCISD or OUHSEL or OUNIOC OR OUNIOS or OURILO}
• GW{bullying OR bully OR bullie* OR harassment* OR intimidat* OR aggression* OR personality clash OR horizontal violence}
• GW{cross over* or double blind* or singl* blind* or clinical trial*}
• GW{random* or factorial* or crossover* or placebo* or assign* or allocat* or volunteer*}
• #3 OR #4 #1
• AND #2 AND #5
• GW{controlled trial* or evaluation or intervention stud* or comparative stud* or controlled stud* or experiment* or time series or impact* or intervention* or chang* or evaluat* or effect*}
• GW{before and after}
• #1 AND #2 AND #9
• GW{((work* or occupation* or prevention* or protect*) and (effect* or control* or evaluation* or program*))}
• #1 AND #2 AND #12
• #13 NOT (#6 OR #10)
• #6 OR #11 OR #14

CENTRAL (The Cochrane Library)

bullying OR bully OR bullie* OR harassment* OR Mobbing* OR intimidat* OR aggression* OR "Personality clash" OR "horizontal violence"

2. MeSH descriptor Work, this term only

3. MeSH descriptor Workplace, this term only

4. MeSH descriptor Employment, this term only

5. MeSH descriptor Health Personnel, explode all trees

6. MeSH descriptor Occupational Health Services, explode all trees

7. MeSH descriptor Health Care Sector, explode tree 1

8. ( workplace* OR worksite* OR "workplace" OR "workplaces" OR "worksite" OR "worksites" OR "work setting" OR "work settings" OR "work environment" OR "work location" OR "work locations" OR Job):ti,ab,kw or (work*):ti

9. (worker* OR Staff OR personnel OR "human resources" Or colleague* OR Nurse* OR doctor* OR Physician* OR midwife* OR midwives* OR "allied health professionals" OR employee* OR employer*):ti,ab,kw

10. (small AND medium* AND enterpri*):ti,ab,kw

11. (company OR Companies OR business* OR factory OR factories OR Office* OR organisation* OR organization*):ti,ab,kw and(scheme OR strategy OR strategies OR policy OR policies OR climate OR culture OR sociocultural OR program OR programs):ti,ab,kw

12. (legislati*):ti,ab,kw

13. (#2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12)

14. (#1 AND #13)

PUBMED (via Ovid)

1 .bullying OR bully OR bullie* OR harassment* OR mobbing* OR intimidat* OR aggression* OR "personality clash" OR "horizontal violence"  

2.Work[Mesh] OR Workplace[Mesh] OR Employment[Mesh] OR Health personnel[Mesh] OR Occupational Health Services[Mesh] OR Health Care Sector[Mesh] 

3.workplace*[tiab] OR worksite*[tiab] OR "work place"[tiab] OR "work places"[tiab] OR "work site"[tiab] OR "work sites"[tiab] OR "work setting"[tiab] OR "work settings"[tiab] OR "work environment"[tiab] OR  "work location"[tiab] OR "work locations"[tiab]  OR job[tiab] OR work*[ti]

4.worker*[tiab] OR staff[tiab] OR personnel[tiab] OR "human resources"[tiab] OR colleague*[tiab] OR nurse*[tiab] OR doctor*[tiab] OR physician*[tiab] OR midwife*[tiab] OR midwives*[tiab] OR "allied health professionals"[tiab] OR employee*[tiab] OR employer*[tiab] 

5. small[tiab] AND medium*[tiab] AND enterpri*[tiab] 

6.(company[tiab] OR companies[tiab] OR business*[tiab] OR factory[tiab] OR factories[tiab] OR office*[tiab] OR organisation*[tiab] OR organization*[tiab]) AND (scheme[tiab] OR strategy[tiab] OR strategies[tiab] OR policy[tiab] OR policies[tiab] OR climate[tiab] OR culture[tiab] OR sociocultural[tiab] OR program[tiab] OR programs[tiab])  

7.intervention* OR legislati*[tiab] 

8. 2 OR 3 OR 4 OR 5 OR 6 OR 7 

9.1 AND 8 

10. (randomized controlled trial[pt] OR controlled clinical trial[pt] OR randomized[tiab] OR placebo[tiab] OR drug therapy[sh] OR randomly[tiab] OR trial[tiab] OR groups[tiab] NOT (animals [mh] NOT humans [mh])) 

11 . 9 AND 10 

12."Controlled Clinical Trial"[pt] OR "Evaluation Studies"[pt] OR "Comparative Study" [pt] 

13."Intervention Studies"[Mesh] OR "Random Allocation"[Mesh] OR "Evaluation Studies as Topic"[Mesh] OR "Controlled Clinical Trials as Topic"[Mesh] 

14. "pre test"[tw] OR "post test"[tw] OR pretest[tw] OR posttest[tw] OR impact[tw] OR intervention*[tw] OR chang*[tw] OR evaluat*[tw] OR  effect*[tw] OR "before and after"[tiab] OR randomized[tiab] OR randomised[tiab] OR placebo[tiab] OR randomly[tiab] OR trial[tiab] OR groups[tiab] 

15. Animals[Mesh] NOT Humans[Mesh] 

16. (12 OR 13 OR 14) NOT 15 

17 . 9 AND 16 

18. 17 NOT 11 

19. (effect*[tw] OR control[tw] OR controls*[tw] OR controla*[tw] OR controle*[tw] OR controli*[tw] OR controll*[tw] OR evaluation*[tw] OR program*[tw]) AND (work[tw] OR works*[tw] OR work*[tw] OR worka*[tw] OR worke*[tw] OR workg*[tw] OR worki*[tw] OR workl*[tw] OR workp*[tw] OR occupation*[tw] OR prevention*[tw] OR protect*[tw]) 

20 . 9 AND 19 

21. 20 NOT (11 OR 17) 

22. 11 OR 17 OR 20

EMBASE (via Ovid)

1. 'bullying'/exp

2. bullying:ab,ti OR bully:ab,ti OR bullie*:ab,ti OR harassment*:ab,ti OR mobbing*:ab,ti OR intimidat*:ab,ti OR aggression:ab,ti

3. 'personality clash' OR 'horizontal violence'

4. #1 OR #2 OR #3

5. 'work'/exp OR 'employment'/exp OR 'health care personnel'/exp OR 'occupational health service'/exp OR 'named groups by occupation'/exp OR 'work environment'/de

6. workplace*:ab,ti OR worksite*:ab,ti OR 'work place':ab,ti OR 'work places':ab,ti OR 'work site':ab,ti OR 'work sites':ab,ti OR 'work setting':ab,ti OR 'work settings':ab,ti OR 'work environment':ab,ti OR job:ab,ti OR work*:ti

7. small NEXT/5 medium* AND enterpri*

8. worker*:ab,ti OR staff:ab,ti OR personnel:ab,ti OR 'human resources':ab,ti OR colleague*:ab,ti OR nurse*:ab,ti OR doctor*:ab,ti OR physician*:ab,ti OR midwife*:ab,ti OR midwives*:ab,ti OR 'allied health professionals':ab,ti OR 'allied health personnel':ab,ti OR employee*:ab,ti OR employer*:ab,ti

9. (company:ab,ti OR companies:ab,ti OR business*:ab,ti OR factory:ab,ti OR factories:ab,ti OR office*:ab,ti OR organisation*:ab,ti OR organization*:ab,ti) AND (scheme:ab,ti OR strategy:ab,ti OR strategies:ab,ti OR policy:ab,ti OR policies:ab,ti OR climate:ab,ti OR culture:ab,ti OR sociocultural:ab,ti OR program:ab,ti OR programs:ab,ti)

10. legislati*:ab,ti OR intervention*:ab,ti

11. #5 OR #6 OR #7 OR #8 OR #9 OR #10

12. #4 AND #11

13. #12 AND [embase]/lim NOT [medline]/lim

14. random* OR factorial* OR crossover* OR cross NEXT/1 over* OR placebo* OR doubl* NEXT/1 blind* OR singl* NEXT/1 blind* OR assign* OR allocat* OR volunteer*

15. 'crossover procedure'/exp OR 'double blind procedure'/exp OR 'single blind procedure'/exp OR 'randomized controlled trial'/exp

16. 'clinical trial (topic)'/exp

17. #14 OR #15 OR #16

18. #13 AND #17

19. 'evaluation'/exp OR 'intervention study'/exp OR 'comparative study'/exp OR 'controlled study'/exp

20. 'pre test':ab,ti OR pretest:ab,ti OR 'post test':ab,ti OR posttest:ab,ti

21. experiment*:ab,ti OR 'time series':ab,ti OR impact*:ab,ti OR intervention*:ab,ti OR chang*:ab,ti OR evaluat*:ab,ti OR effect*:ab,ti OR 'before and after':ab,ti OR trial:ab OR groups:ab

22. #19 OR #20 OR #21

23. #13 AND #22

24. #23 NOT #18

25. (effect* OR control* OR evaluation* OR program*) AND (work* OR occupation* OR prevention* OR protect*)

26. #13 AND #25

27. #26 NOT (#18 OR #23)

28. #18 OR #23 OR #26

PsycINFO (via Ovid)

1. bullying/

2. exp Harassment/

3. (bullying or bully or bullie* or harassment* or intimidat* or aggression*).ab,ti.

4. personality clash.mp.

5. horizontal violence.mp.

6. 1 or 2 or 3 or 4 or 5

7. exp Health Personnel/

8. exp Occupational Health/

9. exp Occupations/

10. personnel/

11. employee interaction/

12. (workplace* or worksite* or work place* or work site* or work setting* or work environment* or job).ab,ti.

13. (small* adj5 medium* adj5 enterpri*).mp.

14. (worker* or staff or personnel or human resources or colleague* or nurse* or doctor* or physician* or midwife* or midwives* or allied health professionals or

allied health personnel or employee* or employer*).ab,ti.

15. work*.ti.

16. 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15

17. ((company or companies or business* or factory or factories or office* or organization* or organisation*) and (scheme or strategy or strategies or policy or

policies or climate or culture or sociocultural or program or programs)).ab,ti.

18. legislati*.ab,ti.

19.16 or 17 or 18

20. 6 and 19

21. (random* or factorial* or crossover* or placebo* or assign* or allocat* or volunteer*).mp.

22. (cross over* or double blind* or singl* blind*).mp.

23. clinical trials/

24. 21 or 22 or 23

25 . 20 and 24

26. (controlled trial* or evaluation or intervention stud* or comparative stud* or controlled stud*).ab,ti.

27. (experiment* or time series or impact* or intervention* or chang* or evaluat* or effect*).ab,ti.

28. (before and after).ab,ti.

29. intervention/

30. 26 or 27 or 28 or 29

31. 20 and 30

32. 31 not 25

33. ((work* or occupation* or prevention* or protect*) and (effect* or control* or evaluation* or program*)).mp.

34. 20 and 33

35 . 34 not (25 or 31)

36. 25 or 31 or 34

CINAHL Plus (via EBSCO host)

1. TX bully*

2. TX bullies

3. AB harass*

4. AB intimidat*

5. TX mobbing

6. AB aggress*

7. TX "personality clash"

8. TX "horizontal violence"

9. 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8

10. AB work*

11.AB employ*

12. AB occupation*

14. AB staff

15. AB personnel

16. TX "human resources"

17. AB colleague*

18. TX enterpri*

19. TX compan*

20. TX business*

21. TX factory

22. TX factories

23. TX office*

24. TX organisation*

25. TX organization*

26. 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25

27. AB random*

28. AB control*

29. AB therapy

30. AB placebo

31. AB trial

32. AB evaluat*

33. TX study

34. TX impact

35. TX intervention*

36. TX chang*

37. AB effect*

38. AB prevent*

39. AB protect*

40. AB program*

41. 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40

42. 9 and 26 and 41

IBSS (via EBSCO host)

#1. bullying OR bully OR bullie* OR harassment* OR mobbing* OR intimidat* OR aggression* OR "personality clash" OR "horizontal violence"

#2. Work OR Workplace OR Employment OR Health personnel OR Occupational Health Services OR Health Care Sector

#3. AB,TI(workplace*) OR AB,TI (worksite*) OR AB,TI (work place) OR AB,TI (work places) OR AB,TI (work site) OR AB,TI (work sites) OR AB,TI (work setting) OR AB,TI (work settings) OR AB,TI (work environment) OR AB,TI (work location) OR AB,TI (work locations) OR AB,TI (job) OR AB,TI (work*)

#4. AB,TI(worker*) OR AB,TI(staff) OR AB,TI(personnel) OR AB,TI(human resources) OR AB,TI(colleague*) OR AB,TI(nurse*) OR AB,TI(doctor*) OR AB,TI(physician*) OR AB,TI(midwife*) OR AB,TI(midwives*) OR AB,TI(allied health professionals) OR AB,TI(employee*) OR AB,TI( employer*)

#5. AB,TI(small) AND AB,TI(medium*) AND AB,TI(enterpri*)

#6. (AB,TI(company) OR AB,TI(companies) OR AB,TI(business*) OR AB,TI(factory) OR AB,TI(factories) OR AB,TI(office*) OR AB,TI(organisation*) OR AB,TI(organization*)) AND (AB,TI(scheme) OR AB,TI(strategy) OR AB,TI(strategies) OR AB,TI(policy) OR AB,TI(policies) OR AB,TI(climate) OR AB,TI(culture) OR AB,TI(sociocultural) OR AB,TI(program) OR AB,TI(programs))

#7. AB,TI(intervention*) OR AB,TI(legislati*)

#8. #2 OR #3 OR #4 OR #5 OR #6 OR #7

#9. #1 AND #8

#10. (randomized controlled trial OR controlled clinical trial OR AB,TI(randomized) OR AB,TI(placebo) OR drug therapy OR AB,TI(randomly) OR AB,TI( trial) OR AB,TI(groups) NOT (animals NOT humans))

#11. #9 AND #10

#12. (Controlled Clinical Trial) OR (Evaluation Studies) OR (Comparative Study)

#13. (Intervention Studies) OR (Random Allocation) OR (Evaluation Studies) OR (Controlled Clinical Trials)

#14. “pre test” OR “post test” OR pretest OR posttest OR impact OR intervention* OR chang* OR evaluat* OR effect* OR AB,TI(“before and after”) OR AB,TI(randomized) OR AB,TI(randomised) OR AB,TI(placebo) OR AB,TI(randomly) OR AB,TI( trial) OR AB,TI(groups)

#15. Animals NOT Humans

#16. (#12 OR #13 OR #14) NOT #15

#17. #9 AND #16

#18. #17 NOT #11

#19. (effect* OR control OR controls* OR controla* OR controle* OR controli* OR controll* OR evaluation* OR program*) AND (work OR works* OR work'* OR worka* OR worke* OR workg* OR worki* OR workl* OR workp* OR occupation* OR prevention* OR protect*)

#20. #9 AND #19

#21. #20 NOT (#11 OR #17)

#22. #11 OR #17 OR #20

ASSIA (via EBSCO host)

Abi global (via ebsco host), business source premier (via ebsco host).

1. 'Bullying in the workplace'

2. Scholarly Peer Reviewed Journals

3. S1 & S2

OpenGrey (Previously OpenSIGLE‐System for Information on Grey Literature in Europe)

1. (bullying OR bully OR bullie* OR harassment* OR intimidat* OR aggression*) AND (workplace* OR work site* OR work setting* OR work environment* OR job OR worker* OR staff OR personnel OR human resources OR colleague*) AND (scheme OR strategy OR strategies OR policy OR policies OR climate OR culture OR sociocultural OR program OR programs OR interven* OR legislati*)

Data and analyses

Comparison 1.

Comparison 2

Comparison 3

Characteristics of studies

Characteristics of included studies [ordered by study id].

Characteristics of excluded studies [ordered by study ID]

Differences between protocol and review

1. British Nursing Index (BNI) has now been amalgamated into CINAHL (which is now known as CINAHL Plus), so we did not search BNI separately.

2. ABI Global replaced the Emerald database search.

3. An initial search of the databases 'Index to Theses' and 'Health Management Information Consortium' (HMIC) did not retrieve any studies to include so we excluded these from further searches.

4. In Types of interventions , we broadened the inclusion criterion from "enhancements to reporting mechanisms that make it easier for individuals to report bullying ".to "enhancements to reporting mechanisms that make it easier for individuals to report problematic behaviour" , in order to include all such prevention interventions.

5. We expanded the primary outcomes to include self‐report measurement. In the protocol we had assumed that we would have data from employers, but this was not always available.

Contributions of authors

Patricia Gillen led the writing of the protocol and the review with contributions from Marlene Sinclair, George Kernohan, Cecily Begley, and Ans Luyben. All authors screened references for studies to include, and extracted data. George Kernohan led on the analysis and all authors contributed to the final drafting of the review.

Sources of support

Internal sources.

Awarded Patricia Gillen a Research Fellowship to undertake this review.

Supported Ans Luyben in the preliminary stages of this review.

External sources

• No sources of support supplied

Declarations of interest

Patricia Gillen: I was awarded the Royal College of Midwifery Ruth Davies Research Bursary in 2004 for PhD study into the nature and manifestations of bullying in midwifery. However, the RCM did not influence the study or findings reported. The definition used at the beginning of my PhD study was one used by the RCM in their research in 1996.

Marlene Sinclair: None known.

George Kernohan: None known.

Cecily Begley: None known.

Ans Luyben: None known.

References to studies included in this review

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• Bullying in the Workplace

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What is workplace bullying, is bullying a workplace issue, what are examples of bullying, what might not be considered bullying, how can bullying affect an individual, how can bullying affect the workplace, are there any laws addressing bullying in the workplace in canada, what can you do if you think you are being bullied, what can an employer do, what are some general tips for the workplace.

Bullying is usually seen as acts or verbal comments that could psychologically or 'mentally' hurt or isolate a person in the workplace. Sometimes, bullying can involve negative physical contact as well. Bullying usually involves repeated incidents or a pattern of behaviour that is intended to intimidate, offend, degrade or humiliate a particular person or group of people. It has also been described as the assertion of power through aggression.

Yes, bullying is a workplace issue. In Canada, occupational health and safety laws include the concept of due diligence. Due diligence means that employers shall take all reasonable precautions, under the particular circumstances, to prevent injuries or incidents in the workplace. Every person should be able to work in a safe and healthy workplace. The legislation in your jurisdiction will describe the roles and responsibilities for workplace parties with respect to workplace harassment and violence, including developing and implementing policies and programs. Definitions of harassment and violence often formally include bullying, but can be implied if not.

Please refer to the following OSH Answers documents for more information:

• Internet Harassment or Cyberbullying
• Violence and Harassment in the Workplace
• Violence and Harassment in the Workplace – Family (Domestic) Violence
• Violence and Harassment in the Workplace – Legislation
• Violence and Harassment in the Workplace – Dealing with Negative Interactions
• Violence and Harassment in the Workplace – Parking Lot Safety
• Violence and Harassment in the Workplace – Warning Signs
• Violence and Harassment in the Workplace – Working Late

While bullying is a form of aggression, the actions can be both obvious and subtle. It is important to note that the following is not a checklist, nor does it mention all forms of bullying. There is no way to predict who may be the bully or the target.

This list is included as a way of showing some of the ways bullying may happen in a workplace. Also remember that bullying is usually considered to be a pattern of behaviour where one or more incidents will help show that bullying is taking place, but it may be one incident, especially one that has a lasting effect.

Examples include:

• Spreading malicious rumours, gossip, or innuendo.
• Excluding or isolating someone socially.
• Intimidating a person.
• Undermining or deliberately impeding a person's work.
• Physically abusing or threatening abuse.
• Removing areas of responsibilities without cause.
• Constantly changing work guidelines.
• Establishing impossible deadlines that will set up the individual to fail.
• Withholding necessary information or purposefully giving the wrong information.
• Making jokes that are 'obviously offensive' by spoken word or e-mail.
• Intruding on a person's privacy by pestering, spying or stalking.
• Assigning unreasonable duties or workload which are unfavourable to one person (in a way that creates unnecessary pressure).
• Underwork – creating a feeling of uselessness.
• Yelling or using profanity.
• Criticizing a person persistently or constantly.
• Belittling a person's opinions.
• Unwarranted (or undeserved) punishment.
• Blocking applications for training, leave or promotion.
• Tampering with a person's personal belongings or work equipment.

If you are not sure an action or statement could be considered bullying, you can use the "reasonable person" test. Would most people consider the action unacceptable?

It is sometimes hard to know if bullying is happening at the workplace. Bullying can be very subtle and may be more obvious once a pattern of behaviour is established.

Also, many studies acknowledge that there is a "fine line" between strong management and bullying. Comments that are objective and are intended to provide constructive feedback are not usually considered bullying, but rather are intended to assist the employee with their work.

As described by WorkSafeBC, bullying and harassing behaviour does not include:

• Expressing differences of opinion.
• Offering constructive feedback, guidance, or advice about work related behaviour.
• Reasonable action taken by an employer or supervisor relating to the management and direction of workers or the place of employment (e.g., managing a worker's performance, taking reasonable disciplinary actions, assigning work).

Prince Edward Island also adds that when done reasonably and fairly, the following actions are generally not considered workplace bullying or harassment:

• with good reason, changing work assignments and job duties;
• scheduling and workloads;
• inspecting the workplace;
• implementing health and safety measures;
• delivering work instructions;
• assessing and evaluating work performance;
• disciplinary actions; and/or
• any other reasonable and lawful exercise of a management function.

People who are the targets of bullying may experience a range of effects. These reactions include:

• Feelings of frustration and/or helplessness.
• Increased sense of vulnerability.
• Loss of confidence.
• Inability to sleep.
• Loss of appetite.
• Stomach pains.
• Panic or anxiety, especially about going to work.
• Family tension and stress.
• Inability to concentrate.
• Low morale and productivity.

Bullying affects the overall "health" of an organization. An "unhealthy" workplace can have many effects. In general, these effects include:

• Increased absenteeism.
• Increased turnover.
• Increased stress.
• Increased costs for employee assistance programs (EAPs), recruitment, etc.
• Increased risk for incidents.
• Decreased productivity and motivation.
• Decreased morale.
• Reduced corporate image and customer confidence.
• Poor customer service.

Many jurisdictions have defined bullying separately or have included bullying as part of the definition of behaviours associated with harassment or violence. For example, Prince Edward Island has defined harassment in their Workplace Harassment Regulations as:

(b) "harassment" means any inappropriate conduct, comment, display, action or gesture or any bullying that the person responsible for the conduct, comment, display, action or gesture or the bullying knows, or ought reasonably to know, could have a harmful effect on a worker's psychological or physical health or safety, and includes (i) conduct that is based on any personal characteristic such as, but not limited to, race, creed, religion, colour, sex, sexual orientation, marital status, family status, disability, physical size or weight, age, nationality, ancestry or place of origin, gender identity or pregnancy, and (ii) inappropriate sexual conduct that is known, or ought reasonably to be known, to the person responsible for the conduct to be unwelcome, including, but not limited to, sexual solicitations or advances, sexually suggestive remarks, jokes or gestures, circulating or sharing inappropriate images, or unwanted physical contact.

Other resources include in British Columbia, WorkSafeBC has developed policies and resources related specifically to workplace bullying and harassment. The Treasury Board of Canada has published “ People to People Communication – Preventing and Resolving Harassment for a Healthy Workplace ”.

If there is no legislation which specifically addressed bullying, the general duty clause to provide a safe and healthy workplace establishes the duty of employers to protect employees from risks at work. These risks can include harm from both physical and psychological health aspects.

In addition, federal and provincial human right laws prohibit harassment related to race, national or ethnic origin, colour, religion, age, sex, marital status, family status, disability, pardoned conviction, or sexual orientation. In certain situations, these laws may apply to bullying.

If you feel that you are being bullied, discriminated against, victimized or subjected to any form of harassment:

• Firmly tell the person that his or her behaviour is not acceptable and ask them to stop. You can ask a person you trust, such as supervisor or union member to be with you when you approach the person.
• The date, time and what happened in as much detail as possible.
• The names of witnesses.
• The outcome of the event.

Remember, it is not just the character of the incidents, but intent of the behaviour and the number, frequency, and especially the pattern that can reveal the bullying or harassment.

• Keep copies of any letters, memos, e-mails, etc., received from the person.
• Report the bullying or harassment to the person identified in your workplace policy, your supervisor, or a delegated manager. If your concerns are minimized, proceed to the next level of management.
• Do not retaliate. You may end up looking like the perpetrator and will most certainly cause confusion for those responsible for evaluating and responding to the situation.

(Adapted from: Violence in the Workplace Prevention Guide . CCOHS)

The most important component of any workplace prevention program is management commitment. Management commitment is best communicated in a written policy. Since bullying is a form of violence and harassment in the workplace, employers may wish to write a comprehensive policy that covers a range of incidents (from bullying and harassment to physical violence).

A workplace violence and harassment prevention program should:

• Be developed by management and employee representatives.
• Apply to management, employee's, clients, independent contractors and anyone who has a relationship with your company.
• Define what you mean by workplace bullying (and harassment and violence) in precise, concrete language.
• Provide clear examples of unacceptable behaviour and working conditions.
• State in clear terms your organization's view toward workplace bullying and its commitment to the prevention of workplace bullying.
• Precisely state the consequences of making threats or committing acts.
• Outline the process by which preventive measures will be developed and implemented.
• Encourage reporting of all incidents of bullying or other forms of workplace harassment and violence.
• Outline the confidential process by which employees, including witnesses, can report incidents and to whom.
• Assure no reprisals will be made against employees who choose to report their experiences.
• Outline the procedures for investigating and resolving complaints.
• Maintain confidentiality during the resolution process.
• Describe how information about potential risks of bullying and violence will be communicated to employees.
• Make a commitment to provide support services to victims.
• Offer a confidential Employee Assistance Program (EAP) to allow employees with personal problems to seek help.
• Make a commitment to fulfill the prevention training needs of different levels of personnel within the organization.
• Make a commitment to monitor and regularly review the policy.
• State applicable regulatory requirements, where possible.
• Encourage everyone at the workplace to act towards others in a respectful and professional manner.
• Have a workplace policy in place that includes a reporting system.
• Educate everyone that bullying is a serious matter.
• Try to work out solutions before the situation gets serious or "out of control".
• Educate everyone about what is considered bullying, and whom they can go to for help.
• Treat all complaints seriously, and deal with complaints promptly and confidentially.
• Train supervisors and managers in how to deal with complaints and potential situations. Encourage them to address situations promptly whether or not a formal complaint has been filed.
• Have an impartial third party help with the resolution, if necessary.
• Do not ignore any potential problems.
• Do not delay resolution. Act as soon as possible.

(Adapted from: Comprehensive Workplace Health Program Guide . CCOHS)

• Fact sheet last revised: 2020-12-22

Additional WBI Services for Healthy & Safe Workplaces

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WBI Workplace Bullying Education

(1) comprehensive training — wbi workplace bullying university® (17-hr. program), (2) awareness education for all (6-hr. program), (3) an overview of workplace bullying (80 min), (4) workplace bullying for managers & leaders — coming fall 2023.

Workplace bullying thrives on shame and secrecy. Targeted employees need to recognize it quicker to avoid severe health harm.

Employers should realize it is a non-physical form of workplace violence, though more harmful, with most costly organizational consequences preventable

Witnessing coworkers need to understand the extensive health harm it causes colleagues and how doing nothing is not a neutral act.

Employees and managers need to have a common understanding of its negative impact on people and the organization.

Sadly, official organizational representatives who hear the bullying stories typically fail to respond appropriately. They need to understand the seriousness of harm inflicted on workers and the preventable costs to the organization.

Bullying is not yet illegal in the U.S. It operates differently than illegal forms of discrimination and harassment. Everyone – employers and employees alike – need education about this destructive phenomenon.

All three WBI programs can accomplish all of these goals.

The program choices vary in depth, leadership’s commitment to correction and prevention, and cost.

The programs are created and delivered by Dr. Gary Namie, North America’s foremost authority on workplace bullying. This is world-class training available only from the Workplace Bullying Institute with its 26 years experience in the consulting field it is credited with originating. Learn from the best.

(1) Comprehensive Training: Workplace Bullying University®

Available in 2 formats — The Complete University Package and Online Streaming

Updated June 2023 — 1039 min, 17 hours of content in 14 parts

About University …

We created the first WBI Workplace Bullying University® program in 2008. Individuals attended the quarterly public sessions in subsequent years — spread over a 3-day weekend — from around the world and from a variety of professional disciplines. University training was also delivered to unions and organizations on site. The curriculum and ancillary resources were updated before each session. The pandemic forced delivery into live, remote sessions. In June 2023, the newest presentation and support materials were updated and recorded. For the first time, University was made available to individuals and organizations in two new formats — the Complete Package on thumb drive and online Streaming. For a single modest fee, organizations can make the intensive, evidence-based program available to an unlimited number of employees. Additional program details and testimonials are available at this site, on the University page.

University Program Parts

0. University themes and to Drs. Namie, program creators (23 min)

1. Introduction to Workplace Bullying, the Phenomenon (53)

2. National 2021 WBI U.S. Workplace Bullying Survey Findings (32)

3. An International Movement (17)

4. Relationships with Other Negative Conduct (59)

5. Why Bullying Happens (59)

6. Deciphering Perpetrators (126)

7. Who Gets Bullied (103 min)

8. Impact on People: Stress-Related Health Harm (168)

9. Impact on People: Disruption of Social Support (152)

10. Economic Impact on People & Organizations (42)

11. The Employer Solution (109)

12. There’s Gonna Be A Law (66)

13. The Moral Imperative (19)

The Complete University Package Includes:

• Digital resources — video & audio ancillary material to support participants’ education or organizational initiatives. Video clips to supplement training. Documentaries. Podcasts. Media coverage of bullying. Lots more to help University program graduates achieve proficiency in knowledge of all aspects of Workplace Bullying. 

View the directory of Digital Resources

University Digital Resources

• The WBI Research Library, an 895-item curated collection of academic journal research articles & book chapters

BONUS for Purchasers of Complete Package and Streaming University

We will host free Live/Remote/Interactive sessions quarterly in which Dr. Gary Namie will answer questions.

The Complete University Package

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(2) Awareness Education for All Employees

To educate everyone, we created a library of seven (7) learning modules covering essential aspects of the phenomenon. The total set runs 6 hours in total, with modules varying in length from 37 to 67 min. Workplace culture is built on common language and shared values. The WBI Workplace Bullying Education modules accomplish this.

Purchase the program, delivered on a thumb drive, to upload the modules to your non-public, password-protected server to allow 24/7 access for employees. People can watch, pause, and return to the information that can trigger strong emotional responses in individuals directly experiencing bullying.

The Education Program Modules

1. Workplace Bullying: Defined, Why It Happens, Differences & Similarities (65 min) Workplace bullying is defined clearly. We introduce how academic researchers define bullying. We explain why bullying happens and what sustains it. Bullying belongs in the context of workplace violence, moreso than with harassment. We contrast it with incivility and disrespect. Lessons gleaned from the #MeToo movement.

2. Who are the Perpetrators? (50 min) We see an illustration of bullying highlighting interpersonal control as a dominant characteristic. Lying, gaslighting, and DARVO by perpetrators is covered. Then we explore the defining traits of people with dark personalities. Reasons why bullies bully are given. The goals of scapegoating for bullies and coworkers are explored.

3. Who Gets Bullied? Targets (56 min) Statistics about the rank and gender of bullied individuals are shared. Recognizing bullying is not as simple as assumed. Target traits are described. Theories of hypersensitive persons and empaths shed light on the superior interpersonal skills possessed by some targets which also carry personal risk of exploitation. The myth of “personality clash” with the bully is shattered. Research shows that targets pay the price when bullying stops.

4. Workplace Bullying’s Impact on People: Stress-Related Physical Ill Health (43 min) Indicators of distress are given. The various physical health consequences of frequent bullying incidents experienced of a long period of time are discussed — neurological, cardiovascular, gastrointestinal, sleep disorders, musculoskeltal, immunological, and cellular DNA. Most time is spent explaining how the stressed brain is rendered incapable of past performance, the biology underlying what a bully does to a target.

5. Workplace Bullying’s Impact on People: Psychological-Emotional Ill Health (38 min) Two types of safety — psychological safety and psychological safety climate — are defined. Without safety, workers are vulnerable to emotional injury. Post-traumatic stress disorder (PTSD) and Complex-PTSD are defined. The need for finding trauma-informed mental health professionals is emphasized.

6. Workplace Bullying’s Impact on People: Disruption of Social Support (67 min) The adverse effects of ostracism and social exclusion are discussed. Multiple explanations for coworker inaction when colleagues are bullied are reviewed — from the bystander effect to groupthink. Blaming victims (bullied targets) is common in society. The underlying reason for this is discussed. Ultimately, targets are betrayed when bullies are portrayed as victims.

7. Workplace Bullying’s Impact on People & Organizations: Economic Losses (39 min) Targets of bullying suffer greatly. Few move on to higher paying jobs with safety from bullying. Organizations pay in both tangible and intangible ways. The cost of preventable turnover from bullying is calculated. Featured jury awards in court cases and the threat of high profile worker suicides or “going postal” on-site massacres could compel employers to act on bullying before public relations disasters.

Cost is dependent on the size of the organization and its nonprofit or for-profit status. Minimum fee is $5,000.

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Signs and Effects of Workplace Bullying

Sherri Gordon, CLC is a published author, certified professional life coach, and bullying prevention expert. She's also the former editor of Columbus Parent and has countless years of experience writing and researching health and social issues.

Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change.

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• What Employers Can Do

Frequently Asked Questions

Workplace bullying is persistent mistreatment that occurs in the workplace. It can include behaviors such as verbal criticism, personal attacks, humiliation, belittling, and exclusion. It's important to note that anyone can be a bully or be bullied, regardless of the role they have in the workplace.

Unfortunately, bullying in the workplace is far from uncommon. According to a survey by the Workplace Bullying Institute, 30% of workers have directly experienced bullying while at work. People who work remotely were more likely to report such bullying, with 43.2% responding that they had been bullied on the job.  

Workplace bullying hurts the health and well-being of employees. It can also damage workplace productivity and performance. "Bullying's pernicious nature creates long-lasting scars that have an effect on the victim's sense of self-worth, self-assurance, and general mental health," says Azizi Marshall, LCPC , a licensed clinical professional counselor and founder of the Mental Health at Work Summit and Center for Creative Arts Therapy.

This article discusses some of the signs and effects of workplace bullying. It also covers its impact on the workplace and what people can do to help prevent this type of behavior.

Signs of Workplace Bullying

If you're a target of bullies in the workplace, you probably start each week with a pit of anxiety in your stomach. Then, you count down the days until the weekend or next vacation. Inappropriate behavior by adult bullies may include:

• Berating people
• Coercing people to do things they don't want to do
• Dismissing someone's efforts
• Embarrassing people in front of their employer, co-workers, or clients
• Excluding others
• Intimidating people
• Lying to others
• Making snide remarks
• Minimizing others' concerns
• Taking credit for other people's work
• Threatening others
• Criticizing others unfairly

Workplace bullying is not always overt or openly hostile. It can also take more subtle forms, including gaslighting , where the bully engages in abusive behaviors but then denies the abuse. The goal of gaslighting is to make the victim of bullying doubt their reality and experiences.

Subtle workplace bullying can hide in plain sight, but recognizing its more subtle signs can empower individuals to reclaim their worth.

According to Marshall, some of these more subtle types of workplace bullying can include:

• Deliberately excluding people from conversations, decision-making, or work-related events
• Purposely ignoring, disregarding, or avoiding someone, such as by "forgetting" to invite them to work meetings
• Concealing or distorting information to achieve personal goals
• Feigning ignorance, changing the subject, or canceling meetings to divert attention from an issue
• Emotionally manipulating people by using shame or guilt to cause feelings of inadequacy, undue responsibility, or unworthiness
• Undermining someone's work to hamper their progress or ability to succeed
• Pitting people against one another to create a competitive, divisive environment
• Changing someone's responsibilities to disrupt their work and interfere with their sense of purpose
• Creating unrealistic or unattainable expectations or constantly shifting expectations to ensure failure
• Unfairly criticizing people's work to hurt the other person's self-esteem

Effects of Workplace Bullying

Workplace bullying can have a range of negative effects. Research on bullying in the workplace quantifies the personal consequences for the victim and the fiscal consequences that affect the company's bottom line.

Health Risks

The effects of workplace bullying don't end when you leave the office. Experiencing bullying can cause physical and psychological health problems, including high blood pressure, mood changes, panic attacks, stress , and ulcers.

People who are bullied at work may also experience physical symptoms such as headaches, muscle tension, and changes in appetite. Bullying can impact sleep quality and duration as well.

Workplace bullying can contribute to increased stress, low self-esteem , and feelings of anxiety and depression. "One's sense of security is undermined by ongoing unpleasant interactions, which can cause anxiety, tension, and even melancholy," Marshall says.

Researchers have found that the coworkers of those who are bullied also experience negative effects, even when they themselves are not bullied. One study showed that victims of bullying and those who witness it are more likely to receive a prescription for psychotropic medications such as antidepressants, tranquilizers, and sleeping pills.

Bullying in the workplace can increase the risk of negative physical health effects and lead to decreased mental well-being for both the victims of bullying and their co-workers.

Effect on Job Performance

"Bullying at work has a negative impact on a person's ability to do their job. Due to the mental discomfort brought on by the bullying, victims frequently exhibit decreased productivity, increased absenteeism, and difficulties concentrating," explains Marshall.

Bullied workers cannot perform their jobs to the best of their ability. Performance issues include:

• Inability to work or concentrate
• Loss of self-esteem
• Trouble making decisions
• Lower productivity

Bullied workers not only lose motivation, they lose time because they are preoccupied with:

• Avoiding the bully
• Networking for support
• Making plans to deal with the situation
• Ruminating about the situation
• Trying to defend themselves

Targets of bullying feel a sense of isolation.  Workplace bullying can leave the victim so traumatized that they feel powerless, disoriented, confused and helpless.

Changes in the Workplace

Workplace bullying has detrimental effects on employers, not just the victim and their co-workers who witness it. In addition to disrupting the work environment and impacting worker morale, it can also:

• Create a hostile work environment
• Impact workers compensation claims
• Promote absenteeism
• Reduce productivity
• Result in costly, and possibly embarrassing legal issues​

Other effects on the employer include:

• Additional costs to recruit and train new employees
• Erosion of employee loyalty and commitment
• Increased use of sick leave, health care claims, and staff turnover
• Increased risk of legal action
• Poor public image and negative publicity

Coping With Bullying in the Workplace

"To effectively respond to workplace bullying, it’s important to adopt an assertive and direct approach. Confronting the issue head-on and establishing clear consequences for unacceptable behavior is a must," explains Avigail Lev, PsyD , founder and director of the Bay Area CBT Center.

If you are being bullied at work, there are strategies that you can use to cope. Being proactive may help you feel better.

Set Boundaries

When a bully engages in abusive behavior, tell them what they have done and that it is unacceptable. Let them know that their behavior will not be tolerated and that if it occurs again, you will take action. Setting boundaries lets others know what type of behavior you are willing to accept. 

Marshall says that setting these boundaries to establish what is acceptable and improper can help you defend your rights and protect against future abuse.

Confront the Behavior

Once you establish a boundary, following through with the consequences is essential. Marshall suggests always remaining professional, avoiding retaliation, and utilizing "I" statements to assertively voice your concerns and address the specific behaviors that upset you.

If the abuse continues, call out the behavior the next time it happens. Ask them to leave until they can behave in a professional, work-appropriate manner. 

Therapist-Recommended Strategies

Other strategies that Lev recommends to cope with workplace bullying include:

• Detached empathy : It can be helpful to detach yourself emotionally from the other person's actions while maintaining a certain level of empathy. According to Lev, this allows people to become less reactive while staying grounded.
• Reverse DARVO: This self-defense strategy can be utilized to combat manipulation. "This involves recognizing and challenging the Deny, Attack, Reverse Victim and Offender tactics employed by the bully. It stands for Detach, Assert, Validate, and Observe. This helps people cultivate detached empathy and helps them stay non-reactive," Lev explains.
• The BIFF technique : BIFF stands for Brief, Informative, Friendly, and Firm. Lev suggests it can be an effective way to cope with gaslighting in the workplace. "When confronted with gaslighting, responding in a BIFF manner involves keeping interactions brief and to the point, providing factual information without engaging in lengthy debates, maintaining a friendly tone, and asserting your position firmly," she explains.

Keep Track of the Abuse

Whenever you feel that you have been bullied at work, document the details including the time and exactly what happened. Write down any witnesses who were present and save any documents or records that can corroborate the abuse.

Talk to Management or Human Resources

If you've tried resolving the bullying on your own without success, it is time to involve your employer. Check with your workplace employee handbook to learn more about what steps you will need to take to file a complaint.

Marshall notes, however, that not all companies are great at addressing bullying. In such instances, it may be helpful to get outside assistance from legal counsel or an employee assistance program.

Care for Yourself

In addition to taking decisive action to protect yourself from bullying, it is also important to take steps to care for yourself. Seek out social support , practice relaxation strategies for stress, and consider talking to a mental health professional if you are experiencing symptoms of depression, anxiety, or distress.

Creating boundaries and directly confronting the behavior are two strategies that may stop bullies from targeting you. Recording and reporting the bullying is also important. You can also help care for yourself by seeking social support and talking to a therapist.

What Can Employers Do?

It's always in your best interest to confront workplace bullying and maintain a bullying-free workplace because prevention is more cost-effective than intervention or mediation. It's also the right thing to do if you care about your employees.

Workplaces can safeguard their employees' mental health and provide a pleasant and productive atmosphere for all by developing rules and procedures that condemn bullying, offering assistance options, and encouraging open communication.

Employers must offer education opportunities for managers, supervisors, and other authority figures, because the majority of workplace bullying comes from bosses. Strive to create a workplace environment that cultivates teamwork, cooperation, and positive interaction instead.

Employers should also take steps to reduce bullying in the workplace. Educate employees and managers about bullying and outline steps that workers can take if they are experiencing abuse in the workplace.

Workplace bullying can be openly hostile at times, but it can also take more subtle forms. In either case, it can take a serious toll on employee well-being and productivity. It is important to be able to recognize the signs of workplace bullying so that you can take action to protect yourself. Organizations can also take steps to reduce bullying, including helping employees learn how to respond when they witness someone being bullied at work.

Calling out the behavior and making it clear that it will not be tolerated are important actions, but it is also critical to care for yourself outside of the workplace. Talk to friends and loved ones, spend time doing things you enjoy, and look for ways to help relax. Talking to a therapist can also be helpful.

Check your employee handbook to see if it describes steps you should take to report bullying. This may involve talking to your manager or reporting the behavior to human resources (HR) so they can investigate. If your manager is the one engaging in bullying, you might need to report the behavior to HR or to someone who is a position higher up the chain of command.

Workplace bullying can involve a range of damaging actions that can involve verbal, nonverbal, psychological, or physical abuse. Examples can include threats, humiliation, excessive monitoring, unjustified criticism, intentionally lying about work duties, and intimidation.

Employers can help prevent bullying by making it a priority to create a supportive workplace and refusing to tolerate bullying behaviors. Co-workers can help by being supportive and speaking up if they witness abuse in the workplace.

Wu M, He Q, Imran M, Fu J. Workplace bullying, anxiety, and job performance: choosing between "passive resistance" or "swallowing the insult"? .  Front Psychol . 2020;10:2953. doi:10.3389/fpsyg.2019.02953

Workplace Bullying Institute. 2021 WBI U.S. Workplace Bullying Survey .

Nielsen MB, Magerøy N, Gjerstad J, Einarsen S. Workplace bullying and subsequent health problems . Tidsskr Nor Laegeforen . 2014;134(12-13):1233-1238. doi:10.4045/tidsskr.13.0880

Glambek M, Skogstad A, Einarsen S. Take it or leave: a five-year prospective study of workplace bullying and indicators of expulsion in working life .  Ind Health . 2015;53(2):160–170. doi:10.2486/indhealth.2014-0195

Canadian Centre for Occupational Health and Safety. Bullying in the workplace .

Lallukka T, Haukka J, Partonen T, Rahkonen O, Lahelma E. Workplace bullying and subsequent psychotropic medication: a cohort study with register linkages . BMJ Open . 2012;2(6). doi:10.1136/bmjopen-2012-001660

Robert F. Impact of workplace bullying on job performance and job stress .  J Manag Info . 2018;5(3):12-15. doi:10.31580/jmi.v5i3.123

Einarsen S, Skogstad A, Rørvik E, Lande ÅB, Nielsen MB. Climate for conflict management, exposure to workplace bullying and work engagement: a moderated mediation analysis .  Int J Hum Resour Manag . 2016;29(3):549-570. doi:10.1080/09585192.2016.1164216

By Sherri Gordon Sherri Gordon, CLC is a published author, certified professional life coach, and bullying prevention expert. She's also the former editor of Columbus Parent and has countless years of experience writing and researching health and social issues.

How to Stop Workplace Bullying

Set boundaries and start reporting to stop bullying in the workplace..

Posted November 9, 2022 | Reviewed by Vanessa Lancaster

• How to Handle Bullying
• Take our Anger Management Test
• Find a therapist to support kids or teens
• Research finds an increase in bullying at work since the pandemic, with emotional, physical, career and financial implications for victims.
• Workplace bullying can occur in the forms of relational, physical, verbal, and damage to property.
• A new study shows that bystanders exist in 88 percent of workplace bullying incidents but fail to say anything.

Childhood bullying is a common topic of discussion and concern. Unfortunately, bullying doesn’t stop after you leave school. A 2021 WBI U.S. Workplace Bullying Survey revealed some startling statistics: About 48.6 million Americans have been bullied at work, translating into 30 percent of all adults. During the pandemic, harassment rose higher to 43 percent. Bullying is considered harassment when it is based on an employee’s race, color, religion, sex, sexual or gender orientation, age, disability, or national origin.

Studies show workplace bullying can take emotional, physical, career , and financial tolls as it causes anxiety and hinders job performance. Bullying in the workplace can be defined as:

• Unwanted aggressive behavior that causes psychological or physical harm.
• An observed or perceived power imbalance.
• A repetition of behaviors or a high likelihood of repetition.

Common Characteristics of a Workplace Bully

Overall, men have more power in the workplace and, thus, are more likely to bully. However, women are more likely to bully other women because they often experience marginalization and discrimination and tend to become competitive with one another.

It is a common misconception that only bosses or supervisors can be bullies because they are in a position of power and control, but individuals with greater seniority, in higher positions of authority, in the dominant social cliques, or individuals with various levels of privilege may also be in positions of power and control and susceptible to bullying.

Bullies typically:

• Lack empathy.
• Have few friends.
• Have a need for exploiting power and control.
• Struggle with interpersonal differences.
• Feel empowered by causing conflict or making others feel threatened, fearful, or hurt.
• Suffer from low self-esteem .
• May have been bullied themselves.
• May be a trauma survivor.

Types of Workplace Bullying

• Relational bullying: Gossiping, ignoring, excluding, or participating in cliques.
• Physical bullying: Dirty looks, invading personal space , offensive gestures or facial expressions, physical assault.
• Verbal bullying: Passive-aggressive comments, negative or critical comments about appearance or personality , demanding, bossy behavior, rumors, hostile language, name-calling.
• Damage to property: Stealing or damaging items.

Examples of workplace bullying

• A boss who puts you down, swears at you, calls you names, or physically intimidates you by standing behind you while you work at your desk.
• A group of coworkers that makes snarky comments, makes faces at you, excludes you from social activities, and makes you feel unwelcome.
• A colleague who backstabs you by spreading rumors and prevents you from accessing resources that you need to get your work done, including causing a paper jam in your printer the day your big report was due.

Healthy workplace environments can make you feel like you are part of a community. Meanwhile, unhealthy workplaces where bullying is tolerated can have the opposite effect and can be detrimental to your self-esteem and mental health–possibly triggering or exacerbating conditions such as depression , anxiety, substance use disorders, trauma, PTSD , and more.

Bullying in Virtual Workplaces

Bullying in virtual environments might look like demeaning behaviors, belittling, or talking over somebody during meetings or video calls. The same types of verbal bullying, such as passive aggression , critical comments, gaslighting , and personal attacks that can happen in person, can happen over video platforms.

Steps to Stop Bullying at Work

1. Remember that your safety comes first.

• Keep safe–create physical distancing.
• Keep your distance and keep your options open.
• Keep your cool, breathe deeply, and avoid being reactive.
• Avoid interrupting or provoking bullies to deescalate the situation.
• Practice empathy in an effort to diffuse them.
• Detach, don’t get hooked, and avoid defensiveness.
• Be consciously responsive, not emotionally reactive.
• Hang onto your confidence .
• Remove yourself and seek assistance.

2. Say something to the bully and document it. Maintain eye contact. Stand tall with your shoulders back. Hold your ground. Speak honestly, assertively, and diplomatically. Use “I” statements to express your feelings and set healthy boundaries . Demonstrate respect for yourself and others with a tone that is professional and firm. Be direct and neither passive nor aggressive when setting boundaries with statements such as:

• “I am not comfortable with the volume of this conversation. If we can’t both speak calmly, I will need to end this call.”
• “It is not okay to call me that name.”
• “I feel uncomfortable being blocked by you. I need you to please move.”

Document what you said by writing it down or emailing yourself so you have a time-stamped record in case the event happens again and you need to file a formal report. Keep it factual, objective, and true. “Today, Sue said, “you are a loser” and I replied, “It is not okay to speak to me that way. That is workplace bullying, and I will not tolerate it.”

3. Tell someone and file a report. Tell somebody else what happened. Tell your boss. If it’s your boss that’s the bully, tell your boss’s boss. If you feel comfortable going to HR do so. If you do not, tell a trusted mentor or even coworker who may have a trusted boss or supervisor higher up in the organization. Some organizations even allow anonymous reporting of bullying or harassment in the workplace, so look at your company’s employee policies and procedures.

4. Practice self-care.

• Seek therapy or counseling to heal and recover from the harmful effects of workplace bullying. Remember, you may have some free and confidential sessions through your employer’s Employee Assistance Program (EAP).
• Work a confidence or assertiveness training program.
• Cultivate equanimity and emotional intelligence by practicing mindfulness like meditation , deep breathing, and yoga. Studies reveal mental and physical health benefits include improving stress regulation and decreasing emotional reactivity.
• Create a support system at work by seeking out like-minded colleagues and finding a trusted mentor.
• Work a mental fitness program for recovery, such as The Financial Mindset Fix: A Mental Fitness Program for an Abundant Life .
• Visit stopbullying.gov for more information and resources.
• Seek legal advocacy.

Empowering the Bystander

A recent study shows that bystanders exist in 88 percent of workplace bullying incidents, and the usual response is apathy and overlooking what they have observed rather than having the moral courage to say something and file a report. Fear is what prevents these silent observers from stepping in–fear of becoming a target, fear of retaliation, and fear of making the situation worse.

Empowering the bystander is one of the most effective ways to stop workplace bullying.

Bystanders need to do one of three things:

• Say something right then and there in front of everyone: “That’s not okay!”
• Say something in private to either the bully (“That wasn’t cool”) or the victim (“Are you okay? Do you want help filing a report?”).
• Tell a supervisor or HR rep.

Don’t ignore workplace bullying, or nothing will change.

“The world will not be destroyed by those who do evil, but by those who watch them without doing anything.” —Albert Einstein

https://workplacebullying.org/2021-wbi-survey/

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.02953/full

https://journals.sagepub.com/doi/abs/10.1177/0149206315617003

https://www.researchgate.net/publication/359395200_The_Connection_betwe…

https://www.joyce-marter.com/book/the-financial-mindset-fix/

Joyce Marter, LCPC, is a psychotherapist, entrepreneur, mental health thought leader, national speaker, and author.

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Workplace Bullying and Harassment: What's the Difference?

Workplace civility policies can cover both unlawful and inappropriate conduct

​As HR professionals strive to ensure a safe and inclusive workplace for everyone, they should note that some harmful bullying behaviors that aren't technically unlawful harassment can still be addressed in a workplace civility policy .

An employer's policies can be more protective of employees than the law can, said Ann Fromholz, an attorney with The Fromholz Firm in Pasadena, Calif. "If having a workplace free from bullying is important to employers, they can go a long way to achieving that by modeling behavior, having a good policy and enforcing that policy."

What Is Bullying?

Bullying is generally defined as unwelcome behavior that occurs over a period of time and is meant to harm someone who feels powerless to respond.

Verbal bullying includes teasing and threatening to cause harm, according to stopbullying.gov, a website managed by the U.S. Department of Health and Human Services.

Social bullying in the workplace might happen by leaving someone out of a meeting on purpose or publicly reprimanding someone.

A 2017 survey by the Workplace Bullying Institute estimated that 61 percent of U.S. employees are aware of abusive conduct in the workplace, 19 percent have experienced it and another 19 percent have witnessed it.

These behaviors may or may not constitute unlawful harassment. Bullying is actionable under federal law only when the basis for it is tied to a protected category, such as race or sex, explained Jessica Westerman, an attorney with Katz, Marshall & Banks in Washington, D.C. Specifically, Title VII of the Civil Rights Act of 1964 prohibits harassment on the basis of color, national origin, race, religion and sex. Other federal laws prohibit such behavior on the basis of age, disability and genetic information. 

Additionally, if bullying amounts to some other civil or criminal wrong, such as assault or battery, it could amount to a claim under state law, Fromholz noted.

So a manager who is mean to everyone—who is sometimes known as the "equal opportunity harasser"—might not be engaging in unlawful conduct. But that doesn't mean it must be tolerated in the workplace. Bullies can create morale problems and other workplace issues, noted Kate Gold and Philippe Lebel, attorneys with Drinker Biddle in Los Angeles, in an e-mail. 

"Employers can have codes of conduct that address respect in the workplace and hold employees accountable if they do not treat others with respect," Fromholz said.

State Law Trends

"In the absence of federal legislation prohibiting generic workplace bullying, several states are considering legislation that would provide severely bullied employees with a claim for damages if they can prove that they suffered mental or physical harm as a result of the bullying," Westerman said.

Legislatures in 29 states have introduced workplace anti-bullying bills in recent years, according to the Healthy Workplace Campaign.

For example, S.B. 1013, a bill that was introduced in Massachusetts in 2017, would prohibit all "abusive conduct" against employees—even if it isn't based on a protected characteristic.

Tennessee's Healthy Workplace Act prohibits workplace bullying that is not tied into a protected category, but it only applies to public employers, Gold and Lebel said. Public employers are immune from liability if they adopt a policy that is compliant with the statute, though individuals would remain liable despite the adoption of the policy.

There is pending legislation in Tennessee to extend protections to the private sector, they noted.

Since Jan. 1, 2015, California businesses have been required to train supervisors on how to identify abusive conduct as part of their sexual harassment prevention training. "So far, however, there is no private right of action for bullying in the workplace," Fromholz said.

[SHRM members-only toolkit: Complying with California Sexual Harassment Training Requirements ]

"It would not be surprising to see more states pass laws requiring employers to train employees on anti-bullying," Gold and Lebel said. However, legislation that creates a separate cause of action for bullying unconnected to a protected class could open the floodgates for lawsuits by employees who feel their boss is abusive or even just unfair or mean." 

HR's Role

Even without a law against general bullying, employers can create policies and practices to prevent and prohibit such behavior. Westerman suggests that employers:

• Conduct a climate survey to learn about the problems in their particular workplace and use the survey's findings to tailor policies and procedures to that workplace. 
• Adopt clear, written anti-bullying policies in as many languages as are spoken in the workplace.
• Foster an organizational culture that prioritizes inclusion and doesn't tolerate bullying by regularly demonstrating a commitment to anti-bullying policies.
• Conduct bystander intervention training, which empowers co-workers to intervene when they witness bullying or harassing behavior. This "helps create a sense of collective responsibility for eliminating bullying and other problematic behavior in the workplace," Westerman said.
• Conduct workplace civility training, which may reduce the likelihood that bullying will occur by promoting respect among employees from different backgrounds and at different job levels.
• Implement clear and straightforward procedures so that employees know how and where to report incidents. These procedures should include multiple confidential reporting channels.
• Make an effort to maintain employees' confidentiality throughout the investigation. If employees need to be identified, investigators should notify employees about the possibility that co-workers will learn about their complaints.

Workers who are victims of bullying or harassment should know they can promptly report incidents to their supervisors, management-level employees, human resource representatives or other employees designated to receive reports, Westerman said.

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Addressing Bullying and Intimidation in Education

This course allows for acquisition of deeper knowledge underlying issues leading to bullying and intimidation how they impact on students. The course will offer substantial help and benefit to a wide range of individuals, such as. school principals, (directors) heads of department, teaching and lecturing staff, researchers, psychologists as well as those working with specific projects and initiati

Description

Bullying is a complex notion and takes various forms, such as physical violence, verbal intimidation and relational aggression. In general, physical bullying seems to be somehow on the decrease, unlike emotional bullying. Over the last couple of decades, cyber bullying has emerged and taken worrying proportions, as a direct consequence of lightning-fast developments of technology and marketing in the digital world and, hence, the near to unlimited access of children to digital communication means.

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Learning objectives

• To understand how to develop comprehensive school policies and strategies to instil a non bullying culture in schools.
• Acquire deeper knowledge underlying issues leading to bullying issues and how they impact on students.
• Understanding the dynamics of groups and impacts on personal identity in today’s society
• Clarify and understand the role of the Educator in supporting interventions.
• Identify support strategies for classroom settings and working with risk.
• Identification and interventions for changing and modern day issues in the classroom
• To recognise the ‘dos and don’ts of addressing bullying in the classroom
• How to work with Parents and external teams

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• Language: English
• Target audience ISCED: Upper secondary education (ISCED 3) Post-secondary non-tertiary education (ISCED 4) Other
• Target audience type: Teacher Teacher Educator Higher education institution staff
• Learning time: 25 hours or more

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School operations

Victorian Teaching and Learning Model 2.0

• Revised Victorian Teaching and Learning Model (VTLM 2.0)
• The previous Victorian Teaching and Learning Model

On this page:

Structure of the vtlm 2.0, elements of learning, elements of teaching, explicit teaching – an overview, student agency in the vtlm 2.0, implementation.

The VTLM 2.0 introduces an emphasis on the evidence about how students learn as the basis for effective teaching. It provides increased clarity for teachers about the elements of teaching that have the strongest evidence base. The VTLM 2.0 links to best practice approaches from existing frameworks that contribute to effective student wellbeing and classroom management, such as the Positive Classroom Management Strategies External Link (PCMS).

The VTLM 2.0 provides a streamlined presentation, reducing the previous VTLM External Link ’s 5 components to 2 elements:

• Elements of learning – the process of human learning, based on cognitive science, neuroscience and education psychology.
• Elements of teaching – representing the evidence-based teaching practices that most effectively support learning: planning, enabling learning, explicit teaching and supported application.

Guidance will be published from Term 4 2024 outlining the strategies and practices that are located within each VTLM 2.0 element of teaching.

The four elements of learning in the VTLM 2.0 are based on insights into the process of learning from cognitive science, neuroscience and education psychology.

The four elements of learning in the VTLM 2.0 represent these key findings from the evidence-base:

• Attention, focus and regulation : Learning requires students’ active engagement and focused attention in order to move new information from working memory to long-term memory. Student learning can be supported by minimising distractions, setting appropriate levels of challenge, using rules and routines, and establishing learning environments where students feel accepted, valued and that they belong.
• Knowledge and memory: Working memory is the active workspace for engaging with knowledge, skills and concepts. Learning happens when new knowledge moves from working memory to long-term memory. Long-term memory is where information, including our memories, are stored and new knowledge is linked to existing mental models.
• Retention and recall: As working memory has limited capacity, it is best supported if new information is introduced in small, manageable chunks, a task is not too difficult for the current level of knowledge, there are no visual or auditory distractions and there are clear expectations and consistent rules and routines. Practice using new information facilitates transfer to long-term memory and retention. Recalling new knowledge strengthens the connections in long-term memory and makes it easier to apply.
• Mastery and application: Spaced, varied and repeated practice consolidates learning, builds neural connections, supports transfer of learning to new situations and leads to ever more complex mental models in long-term memory. This in turn supports retrieval and application of knowledge. Students can more effectively engage in problem solving and generate new learning once they have acquired the relevant knowledge.

An overview of each element is at VTLM 2.0 (PDF) External Link .

The four elements of teaching in the VTLM 2.0 are Planning, Enabling Learning, Explicit Teaching and Supported Application. An overview of each element is at VTLM 2.0 (PDF) External Link . Further guidance on the practices aligned to each of the VTLM 2.0 elements of teaching will be progressively released from Term 4, 2024.

Each of the VTLM 2.0’s 4 elements of teaching cascades down into 3-5 strategies. The following example outlines an element of teaching and practices located within it:

Practices in the explicit teaching element

Practices located within this element of teaching include:

• Focus the learning
• Explicit explanation and modelling
• Scaffold practice
• Monitor progress

Links to existing frameworks and guidance materials

Guidelines provided with the original VTLM, such as the High Impact Teaching Strategies (HITS) and High Impact Wellbeing Strategies (HIWS), will be incorporated into the VTLM 2.0 guidance materials where they are supported by the evidence-base of the VTLM 2.0.

Many of the HITS have a place within these strategies. For example, one strategy of explicit teaching is scaffolding. HITS practices that are relevant to scaffolding include worked examples, collaborative learning and multiple exposures.

Once the full suite of VTLM 2.0 guidance is released, previous resources will be retired.

The VTLM 2.0 has explicit teaching practices at its core. Evidence demonstrates that explicit teaching practices are most effective at delivering strong learning outcomes for the majority of students, including priority cohorts.

Explicit teaching is an evidence-based approach to teaching that is designed to manage the cognitive load of students as they learn new content. It involves fully explaining and effectively demonstrating what students need to learn.

Explicit teaching also involves being clear about learning objectives, building on students’ existing knowledge, providing new knowledge in manageable ‘chunks’, scaffolding learning, modelling practice and providing clear feedback to students as they apply their new knowledge and practise new skills. The Australian Education Research Organisation (AERO) describes explicit teaching like this:

“ Teachers directly explain to students how to complete a task, why the task is important, and how the task relates to and extends their previous knowledge. Demonstrations of how to perform tasks or solve problems are provided, often using worked examples. Regular checks for understanding are undertaken to allow teachers to identify and address misconceptions and support students’ learning progress.”

Explicit teaching is not all teacher talk. At its best, it is a high participation model. In practice, it includes implementing techniques such as:

• Activating prior knowledge and ensuring that it is sound enough to build on
• Stating clear learning objectives (informed by the curriculum)
• Providing explicit explanations of new knowledge in manageable ‘chunks’
• modelling new learning through worked examples
• scaffolding learning by providing opportunities for students to practise with timely corrective feedback
• providing opportunities for students to apply their new knowledge, practise new skills and deepen their understanding
• interacting with your students as they practise, providing prompts and additional scaffolds as required.

Many Victorian government schools are already achieving strong learning outcomes using explicit teaching.

Explicit teaching applied as part of the VTLM 2.0 is teacher directed but does not use either scripted lessons or the uniform lesson structures to the extent that characterises the Direct Instruction teaching approach.

More information about explicit teaching can be found here External Link .

The objective of the approaches and practices in the VTLM 2.0 is to support effective learning for all students and to empower students to exercise agency in their learning. Greater student agency in learning will lead to enhanced student voice over time.

Building student understanding of the learning process and developing self-regulation and self-efficacy is a key focus of the Enabling learning element of teaching in the VTLM 2.0.

Self-regulated learning techniques equip students to gradually take more control of their learning over time using deliberate strategies to plan, monitor and evaluate. (AERO) A key focus in self-regulated learning is developing metacognitive knowledge, which supports students to:

• identify when they have successfully developed new knowledge
• recognise when there are barriers to their learning and address these
• have informed discussions with their teachers about their learning.

Student self-efficacy is enhanced when students have confidence in their ability to complete a learning task and deploy metacognitive strategies. (Education Endowment Foundation)

Explicitly explaining content and scaffolding students’ application of learning builds their knowledge and confidence. Teachers can support students in achieving content mastery through spaced recall and opportunities to apply knowledge in varied learning activities and contexts. Students who have mastered content have greater agency in applying their knowledge to new tasks, and to problem solving and critical and creative thinking.

All Victorian government schools are expected to use the VTLM 2.0 to inform and refine the planning of their teaching and learning programs from 2025, working to fully implement the VTLM 2.0 from the start of the 2028 school year.

Supports for implementation of the VTLM 2.0 in schools

The department will support schools during the implementation process and is working to provide a range of resources tailored to different stages in the implementation and change process.

Initially, schools will be provided with self-evaluation questions in the 2024 Annual Implementation Plan (AIP) end-of-year assessment to evaluate their level of alignment with the revised VTLM 2.0 and F-2 reading approach (where appropriate). Schools can use their responses to help determine their next steps to work towards full implementation of the VTLM 2.0 in their 2025 AIP. Further information can be found at Annual Implementation Plan (AIP) .

Further VTLM 2.0 guidance will provide insight into specific practices aligned to each of the elements of teaching and will be progressively released from Term 4, 2024.

Victorian Lesson Plans will support teachers to implement VTLM 2.0 approaches in Mathematics, English, Science and Digital and Design Technologies.

Reviewed 07 October 2024

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