Stress and Counselling in the Workplace

What is Workplace Stress and how can Counselling help to reduce it?

Abstract

Job-related stress has a detrimental effect on both organisations and employees. This article explores the extent of these outcomes and examines the possible causes of workplace stress. Methods for reducing stress are evaluated, including occupational redesign and Employee Assistance Programmes (EAPs). This latter group is split into relaxation techniques, cognitive-behavioural approaches and multimodal interventions. Current research indicates that cognitive-behavioural approaches are the most effective form of counselling. It is suggested that combining this method with occupational redesign may help target the causes and consequences of Work-related stress.

Key Words

Stress, Work, Employee Assistance Programme, Counselling

Introduction

Stress in the workplace is a major concern, not just for organisations and employees, but also for the public in general (Health and Safety Commission, 1999). It is of such concern that in order to comply with UK law, the government’s Health and Safety Executive (HSE) state that employers have a duty to assess the risk of work activities causing ‘stress-related ill health’ and to take appropriate control measures.

In 2007/2008 approximately 13.5 million days absence were caused by work-related stress, depression or anxiety, an average of 30.6 days per case. In fact, over a third of all new cases of ill health in the UK are thought to be related to workplace stress according to The Labour Force Survey (LFS). This is a continuous self-report survey, which also estimates that 442,000 working individuals in Britain 2007/2008 suffered from work-related stress at a level high enough to be classified as illness.

Organisations and Individuals Suffer

These levels of ill health have an unsurprising impact on the productivity of organisations, not just in terms of absenteeism but also in less direct ways, most notably the cost to employers. The Stress Management Society (SMS) estimates this cost at £1.24 billion a year in the UK alone. In addition, low employee morale often leads to poor efficiency of staff. This can result in a decreased combined output, contributing to customer complaints and subsequent decreased profits. A high turnover of staff is also a common indicator of stress in the workplace (SMS), causing a less stable working atmosphere which can, in turn, become a stressor itself.

Whilst the effect of stress is felt by the organisation, it is the individual who feels it on a personal level. Stress often manifests itself in physical symptoms like increased mental fatigue, a more frequent need to urinate and in extreme cases asthma, back pain or coronary problems (SMS); all factors which will necessarily impact on the productivity of the organisation. Increased levels of depression, anxiety, tension, sleep disturbances and anger are also thought to be caused by work-related stress (Van der Klink et al., 2001). Job-related stress is not just confined to the workplace. It can be intuitively deducted that there will be some degree of impact on home life. For example, Jackson and Maslach (1982) noted that American police officers experiencing stress (as measured by the Maslach Burnout Inventory) were less likely to be generally involved in family matters or spend time with their family, and were more likely to become angry quickly and to have an ‘unsatisfactory marriage’.

Some possible causes

It seems clear that stress in the workplace causes considerable difficulties, not just for individuals but also for the organisation they are employed by. Why is it then that work-related stress is so common? Armstrong (2000) argues that it is due to the increasing demands of a modern work environment exceeding the individual’s ability to cope. In other words, organisations continually demand more than an employee can reasonably be expected to achieve. This hypothesis is supported by the European Foundation who found that in 31 European countries, 12% of employees surveyed reported having insufficient time in which to complete their job tasks, with 15% needing to work for more that 48 hours each week and 23% spending 6 or 7 days a week in the workplace (EFILWC 2006). These kind of recent changes to the working environment (Teasdale, 2006) have been thought to contribute highly to the increase in job-related stress since the 1980’s (Tennent, 2001).

For some, high work load and long hours are not stressful issues, providing that the individual feels in control of their work and gains a positive sense of achievement from it (Spector, 2002). Perhaps the more pertinent issue lies within the concept of the psychological contract. This notion is an attempt to describe the internal contract believed by any individual to lie between himself and his employers. While usually discussed in motivation research, Conway & Briner’s (2002) study into the emotional consequences of breaking the psychological contract noted intense distress was often the result. It may be the case ...

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How to combat the issue

It should be highlighted that since 2001, self-reported workplace stress has not significantly increased (LFS). Perhaps this is in part due to increased public awareness of the issue (Arthur, 2004), a shift in individuals expectations as part of their psychological contract, and the introduction of schemes designed to combat job-related stress. Irrespective, it seems providing stress management strategies can only be in the positive interest of organisations and employers.

How to implement such strategies is an issue of much debate amongst theorists and practitioners alike. Within current literature there appear to be two distinct approaches to understanding - and hence treating - workplace stress. The more theory-based methodology of occupational psychologists suggests that as stress is often caused by flaws in workplace design and organisation it can be eliminated through creation of carefully planned work environments (Sanders, 2001). A benefit of this type of intervention is that, with forethought, the presence of stress can be all but eliminated prior to occurrence (Kompier & Cooper, 1999). If it is necessary to implement such a scheme after the fact, however, it can be costly and somewhat disruptive to the workplace during its execution. Arthur (2004) suggests that these are two of four reasons why the method is often passed over in favour of counselling, in the form of Employee Assistance Programmes (EAPs). The remaining reasons are that EAPs are perceived as ‘high visibility’ stress management and, with their intention of assisting individual employees, are seen by many stress professionals as preferable to a more generalised approach (Cooper & Cartwright, 1997).

It is not only those with stress management training who see the benefits of counselling on a one-to-one basis. Several studies have found that while managers acknowledge an effect of organisational design on stress levels, there is also a general belief that it is an abnormal reaction to a stimulus which dictates whether an individual will become stressed (e.g. Sharpley & Gardner, 2001). Dewe & O’Driscoll (2002) and Cooper et al. (2001) claim that this is simply a way of decreasing the accountability of an organisation. Whether or not this is the case, these findings surely demonstrate another reason why EAPs are proving a popular choice to combat job-related stress.

Evidence for EAP efficacy

However popular the provision of EAPs may be, the question of their effectiveness must necessarily be addressed. Throughout the 1990s researchers have been critical of methodologically uncertain research in this area, particularly as much of it was completed by the companies running EAPs (Cooper & Cartwright, 1994). What little research was conducted appears to be rather subjective, with very few studies taking place in the UK (Carrol, 1996). In a review of this early evidence Arthur (2000) agrees that many investigations had been methodologically inconsistent, but argues that there was an overall trend where individuals suffering ‘psychological problems’ benefited from using employee counselling services. This appraisal is certainly useful, but the procedural variations of studies reviewed, along with the qualitative nature of this review, calls for more detailed investigation.

Briefly, an EAP can be described as a free and confidential counselling service, provided by employers and run by qualified mental health professionals in an associated EAP company. There is often a cap on the number of sessions one employee is entitled to free of charge (anywhere between four and eight) with each session around 50 minutes in length (Arthur, 2000). This seems to limit their efficacy, particularly if an individual has not resolved their psychological discomfort before reaching the cap. Because counsellors are mental health specialists, however, it may generally be assumed that, if needed, a referral to outside services would be made. In fact, this is not always the case as some EAPs are unregulated. In a recent study Arthur (2005) found that when assessed by a psychiatric team 86% of employees who self-referred for counselling were suffering from severe mental health problems. This highlights the importance of frequent training to allow counsellors to distinguish between moderate stress and severe psychological problems, in order that suitable treatment can be delivered (Quick & Cooper, 2003).

There are several different types of EAP commonly available. Among current reviews they are often split into the following categories: relaxation techniques, multimodal interventions and cognitive-behavioural approaches. Relaxation techniques, as the name suggests, attempt to reduce the effects of stress through mental or physical relaxation; multimodal interventions equip participants with active and passive coping skills in order to cope with the consequences of stress; cognitive-behavioural approaches try to alter unhealthy cognitions so that behaviour will be positively influenced. Van der Klink et al. (2001) conducted one of few qualitative meta-analyses comparing the efficacy of these three counselling techniques with each other and against an organisational change condition. Overall, a small significant effect was found. The least effective intervention appeared to be organisational change, which had a non-significant result. All counselling conditions were effective to some degree with relaxation being the least useful and cognitive-behavioural the most.

Richardson and Rothstein (2008) replicated these results in a similar meta-analysis noting that although cognitive-behavioural approaches are consistently the most effective form of EAP, it is relaxation techniques that are most commonly used. This is probably because they are less costly and time-consuming. An interesting point made by Richardson and Rothstein is that variation in treatment period and occupation did not change the effectiveness of a method, meaning that their results might be useful to any organisation looking to implement an EAP.

Something else which should be considered when assessing the efficacy of workplace counselling is whether employees will actually use such a service. Despite the views of many employees that stress will be the highest presenting issue, for numerous EAPs stress sufferers are actually the smallest client group (Walton, 2003). Having a negative view of seeking psychological help; perceiving one’s organisation as unsafe; and the worry that managers will know an employee is having counselling are key reasons why EAPs are avoided (Athanasiades, 2008). And without participation the counselling can clearly have no benefit. In seems important then, that the confidentiality and supportive nature of counselling services should be emphasised. This is in the interest of both employee and employer, to ensure the content of sessions will not be used in the tricky context of legal proceedings (Morris & Raabe, 2002).

Counselling’s Limitations

So far, the majority of evidence presented has emphasised the positive aspects of workplace counselling, but there can be some pitfalls. Full-time workers are known to be less likely to visit a GP about mental health problems that other groups. EAPs allow employees to remain at work while combating their stress, thus alleviating the difficulty of fitting private appointments around company time (Bebbington et al., 2003). However, those who do stay in employment when stressed suffer from increased levels of depression (Arthur, 2005). A fact which needs to be accounted for when training counsellors to deal specifically with workplace stress.

It is not always job stress that causes employees to seek counselling. Arthur (2002) surveyed mental health problems among a sample of EAP users and noted that under 30% of stress cases were work-related, with over 70% classed as ‘personal’. This begs the question ‘is it worth employers spending large amounts of money to cater for problems from outside the workplace?’. The answer from a psychological perspective is a resounding ‘yes’. Wherever the stress originates its outcomes are likely to be similar and, in the long run, detrimental to organisational productivity.

Conclusion

Overall, the evidence suggests that counselling is relatively effective at combating workplace stress, with cognitive-behavioural approaches being the most useful.

As an end note it should be mentioned that treating the consequences of stress through EAPs can never completely eradicate it in the workplace without some form of organisational change alongside, to combat the actual causes. Prevention is better than a cure.

Word Count: 2006

(excludes headings, abstract, key words, references)

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