Effectiveness of Stress Inoculation Therapy in Managing Occupational Stress and Trauma Among Morticians in Selected Mortuaries in Nairobi County, Kenya.

Abstract

Human beings inherently fear death, and sustained exposure to deceased bodies exerts profound psychological strain on individuals tasked with managing death-related practices. Morticians, by virtue of their professional obligations, are continually confronted with mortality, grief, and trauma, rendering them highly susceptible to occupational stress and trauma. Recognizing the paucity of empirical inquiry into this occupational group, the study sought to determine the levels of occupational stress and trauma among morticians in relation to their socio-demographic characteristics, examine their coping strategies, explore the interrelationship between stress, trauma, and coping, and assess the effectiveness of Stress Inoculation Therapy (SIT) as a therapeutic intervention. The study was guided by the salutogenesis and empowerment theoretical frameworks, which emphasize individuals’ capacity to mobilize adaptive or maladaptive coping strategies when confronted with adversity. Employing a convergent mixed-methods design, the study, through census sampling, involved 18 morticians, 10 males and 8 females, from two teaching and referral mortuaries in Nairobi, Kenya. Data collection entailed structured interviews, behavioral observations, and the administration of standardized measures: the Work Stress Screener (WOSS-13) assessed occupational stress, the PTSD Checklist for DSM-5 (PCL-5) measured trauma, and the Brief COPE Inventory evaluated coping strategies. SIT was introduced as an intervention to mitigate stress and trauma. Quantitative data were analyzed using SPSS version 31, employing descriptive statistics, Pearson correlation, and Analysis of Variance (ANOVA). Qualitative data were thematically analyzed using NVivo software. Findings indicated that 66.7% of morticians reported high occupational stress (M = 27.1, SD = 4.2), while 55.6% met the cut-off for clinically significant trauma symptoms (M = 22.3, SD = 5.1). Socio-demographic factors, such as age (F(2, 15) = 4.12, p < .05) and work experience (F(2, 15) = 3.87, p < .05), significantly influenced stress and trauma levels, with younger and less experienced morticians reporting higher scores. A strong positive correlation was found between occupational stress and trauma (r = .72, p < .01). Adaptive coping strategies were negatively correlated with both stress (r = –.54, p < .05) and trauma (r = –.49, p < .05). Paired-sample t-tests revealed that Stress Inoculation Therapy (SIT) significantly reduced occupational stress (pre-intervention M = 27.1, post-intervention M = 20.6; t (17) = 4.12, p < .001, d = 0.89, 95% CI [3.1, 9.9]) and trauma (pre-intervention M = 22.3, post-intervention M = 17.1; t (17) = 3.67, p < .01, d = 0.77, 95% CI [1.7, 8.7]). These findings confirmed SIT’s effectiveness in alleviating psychological burden among morticians by lowering stress and trauma levels while promoting adaptive coping. The study provides empirical evidence underscoring the mental health risks inherent in mortuary practice, while simultaneously demonstrating the therapeutic utility of SIT. The findings carry important implications for clinical practice, policy formulation, advocacy, and the urgent need to prioritize mental health interventions and institutional support systems for morticians. Ultimately, the study contributes to scholarship on occupational health psychology by elucidating stress dynamics in death-care professions and offering practical pathways for intervention.