Stress is a contributory factor to serious ailments that can affect individuals such as coronary heart disease, high blood pressure, migraine, rheumatoid arthritis and diabetes. Today in the United Kingdom one person every 3 to 4 minutes die from coronary heart disease. Almost half of all Americans die of cardiovascular disease. Physical effects of stress on an individual include tiredness, lack of appetite, constipation or diarrhoea, insomnia, cramps, nausea and impotency. Behavioural effects include constant irritability with people, lack of interest in life, difficulties in concentrating, alcohol abuse and family breakdown. Psychological consequences of stress include mental illness, anxiety and depression.
Costs of stress to organisations include reduced job satisfaction, increased turnover and too much stress results in decreased performance. Absenteeism is one of the most obvious costs of stress to employers. By the 1970s it was recognised that time lost from work due to stress-related illnesses cost the United Kingdom far more than losses due to work stoppages and strikes. In 1984-5 16% of the days lost from work were due to mental health causes.
It is estimated that more than $700 million is spent by American employers to replace the 200 000 men aged 45-65 who die or are incapacitated by coronary heart disease every year. Organisations also have to pay directly for stress-related illnesses through compensation claims and in America employee health care costs. In 1986 top management at Xerox estimated that the cost of losing one executive to a stress-related illness was $600 000.
It can therefore easily be seen why researchers are interested in stress at work and how it can be managed to relieve these consequences. There are several models of stress at work. Cooper (1986) provides a good framework for stress at work from which much research has been generated, although it can’t really be called a model as it is more descriptive. He identifies the sources of stress at work which feed into individual characteristics. This may result in symptoms of occupational ill health (both individual and organisational symptoms) which can lead to disease. A criticism of the model is that a coping mechanism could be included after individual characteristics and before occasional ill health to take into account differences in coping strategies.
Cooper identifies the five major categories of work stress. One of these is factors intrinsic to the job, such as poor working conditions, shift work, long working hours, risk and danger associated with the job and work overload and underload. A second main source of stress is a person’s role in the organisation, critical factors being role ambiguity, role conflict and responsibility for others. Other categories of work stress are relationships at work, career development and organisational structure and climate. Research has commonly addressed one or some combination of the five main work stressor categories.
The person-environment (P-E) fit model of stress has been developed over the last twenty years by French and his colleagues (in Warr,1996). They believe stress ‘can result from the mismatch between the person and the environment on dimensions important to the well-being of the individual’. According to this model there are optimal levels of environmental demand for each individual. When these optimal levels are reached, stress is minimal, if there is either too little or too much demand stress increases. For example, if a task is too complex for the individual, i.e. there is too much demand, stress increases.
Implications of this model for stress management are individually based, the aim to match an individual to an appropriate working environment. However, although there is widespread acceptance of the idea that both environmental factors and individual characteristics determine stress, the P-E fit model has not provided much research.
A more influential model of stress at work is the job demand-decision latitude model (Karasek, 1979). This suggests that stress results from the interaction of the demands of a work situation and the range of decision-making freedom available to the worker facing those demands. The model consists of a grid showing different combinations of job demands and job decision latitude, the amount of control a worker has over his tasks and conduct. Stress can be seen to be the excess of demands over decision latitude. Evidence for this model comes from numerous studies including nationally representative data for the United States (the University of Michigan Quality of Employment Survey for 1972) and a random sample of the full adult population in Sweden between 1968 and 1974.
The implications of this model for stress management intervention are environmental/organisationally based. Stress can be reduced by redesigning work processes to allow increases in decision latitude for a broad range of workers without affecting job demands that may be associated with productivity and so is easy to implement. However, the model does have some limitations. The specific impact of different types of decision latitude and job demands is not distinguished and the impact of individual differences in perception of job demands is not assessed.
DeFrank and Cooper (1987) suggest that stress interventions can focus on the individual, the organisation or the individual-organisational interface. This corresponds to Murphy’s (1988 in Arnold et al, 1998) three levels of intervention. The primary level, or reducing the sources of organisational stress (the stressors) corresponds to the organisational focus mentioned by DeFrank and Cooper. The secondary level, or stress management training, and tertiary level, or health promotion and workplace counselling (employee assistance programmes) focus on the individual.
Most stress management interventions focus on the individual, either assisting employees to reappraise the stressfulness of their working conditions or helping them to cope with job-related stressors rather than trying to reduce the actual stressors themselves. Ivancevich and Matteson (1987) found only 18 studies which attempted to evaluate the impact of interventions, and that all of them had examined individual-focus interventions.
One reason for this is that it is considered easier and less disruptive to change the individual rather than bring fundamental changes to an organisation that may prove more expensive and the outcome of which may be uncertain. Another reason is that individual focused interventions provide a high-profile means by which organisations can be seen to be doing something about stress. This not only communicates good intentions to employees, but also to the external environment, as given the increasing litigation fears it may become an effective defence. They may also serve to deflect management from accepting responsibility for excessive stress experienced by their employees.
Hence the focus of most stress management interventions has been to help employees as individuals learn to cope with any stressors that occur at work. Interventions aimed at the individual include techniques such as relaxation, biofeedback and meditation, which target physical accompaniments of stress such as blood pressure and muscle tension. Other techniques such as cognitive coping strategies and time management reflect attempts to alter the ways people organise and structure their worlds. Exercise is another strategy that has been found to improve mood.
Increasingly stress management interventions focused on the individual have been in the form of employee assistance programmes (EAPs). EAPs normally involve a range of activities, but most commonly involve counselling. In 1986 the Post Office was one of the first organisation to introduce specialist counselling services at work in the UK. It was thought that the counsellors would have the benefit of a broad knowledge of the Post Office’s business and methods and so would be more able to help employees, particularly where the problem was work related. The counselling service was found to provide a brief and rapid intervention for a wide range of employee groups with broadly satisfactory results. When the giant copper corporation Kennecott introduced a counselling programme absenteeism dropped by nearly 60% and medical costs were reduced by 55% (in Cooper, 1986)
Although EAPs have shown some promise as an approach to deal with stressors, evidence is generally confusing. For example, studies evaluating the outcome of stress management training, frequently a component of EAPs, have found a modest improvement in self-reported symptoms of stress, but little or no change in job satisfaction, work stress or blood pressure (Reynold’s et al, 1993 in Arnold et al, 1998). Also, although these approaches may yield short-term gains, these approaches have questionable benefits for long-term mental health and well being as they don’t treat the cause of the stress.
Organisational level stress-management interventions aim to reduce the sources of organisational stress. Elkin and Rosch (1990 in Arnold et al, 1998) summarise a range of organisational-directed strategies. These include redesigning tasks, training, redesigning the work environment, establishing more flexible work schedules and job rotation, providing feedback and establishing fair employment polices. Strategies focusing on the individual-organisational interface concern relationships at work, role issues and goals (for example, conflict among varied roles and ambiguity over the content and responsibilities of these roles may cause increased job stress), and including the employee in career development. Also, the lack of fit between an environment and an individual may produce significant stress (corresponding to the P-E fit model mentioned earlier). Many of these approaches are directed at increasing employee autonomy, participation and control, which Karasek’s job demand-decision latitude model of stress at work found to be important moderators of the stressor-strain relationship.
Burke (1993 in Warr 1996) summarised research on several organisational strategies, including goal setting and increasing communication between management and employees, and found that they had positive benefits for employees. However, only a small number of studies have been published that have assessed changes at the organisational level, and little long term follow up studies have been carried out for both individual and organisational focused stress management interventions, so it is therefore difficult to know what exactly does work.
Cooper’s (1986) framework of stress, the P-E fit model and Karasek’s (1979) job-demand decision latitude model have all contributed to the understanding of stress at work, and have generated research into stress management interventions. Stress interventions have most commonly focused on the individual, although organisational focused interventions, despite being more costly and difficult to implement, may prove to produce the best long-term results. More research is needed.
References
Allison, T.I, Cooper, C.L., & Reynolds, P. (1989). Stress Counselling in the Workplace: the Post Office Experience. The Psychologist, 2, 384-388
Arnold, J., Cooper, C.L., & Robertson, I.T. (1998). Work Psychology 3rd Edition Chapters 17 & 18.
Cooper, C.L. (1986). Recent research and the emerging role of the clinical occupational psychologist. Bulletin of the British Psychological Society, 39, 325-331
DeFrank & Cooper (1987). Worksite stress management interventions: Their effectiveness and conceptualisation. In C.L. Cooper (Ed). Stress Management Interventions at Work.
Ivancevich, J.M. & Matteson, M.T. (1987). Organisational stress management interventions: a review and recommendations. Journal of Organisational Behavioural Management, 8, 229-248.
Karasek, R.A. (1979). Job demands, job decision latitude and mental strain: implications for job redesign. Administrative Science Quarterly, 24, 285-309
Warr,P. (1996). Psychology at Work. 4th Ed. Harmondsworth: Penguin.