EMPLOYEE COUNSELLING TODAY

I N S I G H T

Stress Management in the Workplace

Taking Employees Views into Account
Jennifer R. Bradley and Valerie Sutherland
Work plays a central role in the lives of many people, and thus the impact of occupational stress is an important issue both for individual employees and the organizations in which they work. Occupational ill-health statistics, collected as part of the 1990 Labour Force Survey, found that 55 per cent of all reported cases of stress/depression and half of all reported cases of exhaustion were perceived as being caused by work. The category of stress/depression accounted for an estimated 100,000 cases in England and Wales over a 12-month period, and was among the top three categories for the greatest absolute number of cases of illness caused by work. Although the mechanisms through which work can cause or contribute to illness are complex, there is strong evidence to indicate that stress experienced at work can have adverse outcomes for the wellbeing of individual employees. However, the adverse effects of stress are not confined to the individual employee. The potential cost of stress to organizations, through, for example, high turnover, absenteeism, low morale, and reduced productivity has been noted frequently (McHugh and Brennan, 1993). Increasing recognition of the implications of such costs has contributed to a growth in the number of organizations considering ways of reducing and preventing negative stress outcomes (Elkin and Rosch, 1990). However, the task of selecting and implementing stress management interventions is not a simple one. Stress management programmes may include a heterogeneous range of activities, which extend from training an individual in relaxation techniques to the redesign of a job. In response to this complexity, some researchers have suggested ways of classifying stress management interventions. For example, Ivanevich et al. (1990) describe three broad categories of stress management intervention. The first type of intervention focuses on the situation and aims to reduce the stressors present. The second and third categories focus on the employee, and aim either to change the employees cognitive appraisal of the situation, or to help employees cope more effectively with the consequences of stress by increasing their coping resources. Similarly, DeFrank and Cooper (1987) suggest that stress management may be conceptualized according to taken possible levels of intervention. Thus, while relaxation techniques focus on the individual, interventions to increase employee autonomy focus on the interface between the individual and the organization. On the other hand, the third possible level of intervention is the organization itself through, for example, changes in the structure of the organization. Although there is likely to be overlap between these categories they do provide a useful framework within which to consider occupational stress management. It is apparent, therefore, that an organization embarking on a programme which aims to reduce the adverse effects of stress is faced with a range of possible approaches to the problem. Michie (1992) notes that although staff support and stress management services are increasing, high quality evaluation of such services is not. This contributes to the challenges faced by management in making informed decisions about how best to deploy limited resources to tackle the problems of occupational stress within a

Employee Counselling Today, Vol.6 No. 1, 1994, pp. 4-9, MCB University Press, 0955-8217

VOLUME 6 NUMBER 1 1994

particular organization. In addition, the discussion of occupational stress may raise sensitive personal and interpersonal issues, and there is likely to be concern among both managers and employees about the implications of focusing on stress in the organization. Thus, careful planning would seem an essential part of implementing a stress management programme if it is to be acceptable both to individual employees and to the organization. One important aspect of this planning process must be employee attitudes towards various types of intervention. The views of employees about the usefulness and relevance of different programmes is likely to have considerable impact on the success or otherwise of any action taken. A better understanding of this area is highly relevant not only to practitioners in the field of stress management, but also to those managers who are involved in making decisions about how best to tackle negative outcomes of stress in an organization. However, despite the vast research literature in the field of occupational stress, this issue has received relatively little attention. One related area which has been investigated is the use of employee assistance programmes (EAP). For example, Harris and Fennell (1988) found that employees were more likely to indicate willingness to participate in an EAP if they were familiar with the programme, and if they believed that the agency would be discreet, and would give them personal attention. However, these researchers also note the lack of empirical research in this area. In the field of health psychology, an individuals beliefs have been identified as important factors in the prediction of health behaviours such as participation in health screening programmes and compliance with medical treatments. For example, Rosenstocks health beliefs model suggests that people are more likely to take preventive health action if they believe that the costs of such action are not greater than the benefits, and that they are personally susceptible to a condition which will have consequences of moderate severity (Gatchel et al., 1989). Thus, in the context of stress management, this model would suggest that employees attitudes to different types of stress management interventions is an important factor in their potential success.

department of a local authority in the north-west of England.

Method
Data were obtained as part of a stress audit of the organization, designed to identify the causes and outcomes of occupational stress for employees, and thus provide empirical evidence as the basis for planning future stress management interventions. The sample comprised employees who were engaged in front-line work with clients. Subjects were randomly selected from five occupational groups, namely administration staff, residential child-care staff, home helps, social workers and support staff Almost 90 per cent of the sample was female, with ages ranging from 18 to 25. Subjects were presented with a list of 18 possible stress management interventions, and asked to choose one of three responses (yes/no/ dont know) to each of the following four statements: (1) I feel the organization would benefit. (2) I would personally participate. (3) I feel I would personally benefit. (4) I would recommend others to use. The list of stress management interventions was generated both from the interview data, obtained during the first phase of the study, and from a review of the existing literature. Thus, although, for example, assertiveness training might be included in the category of training in interpersonal skills, it was presented separately in the list on the basis of the interview data analysis. Respondents were also given the opportunity to suggest other interventions not included in the list.

Results
The survey showed that attitudes to stress management interventions were generally positive, with relatively high proportions of employees indicating that they would personally participate in such programmes (see Table I). Although the employees were constrained by categorical responses, the data indicate that the most popular interventions were those which focused on the individual and group levels, with health screening and training in coping skills being particularly favoured. From the standpoint of the practitioner, one of the key questions is the extent to which these attitudes would be reflected in actual participation

How Do Employees View Stress Management Interventions?

This article describes the results of a survey of the attitudes of 231 employees in the social services

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>80 Learning about different ways of coping with stress Health screening

60-80 Training to increase awareness of own stress Training in relaxation techniques Team building Training in interpersonal skills Assertiveness training Staff support groups

40-60

<40

Training for team leaders Opportunity to take unpaid to recognize stress in leave team members Counselling within social services Counselling independent of social services Career sabbaticals Assistance with care of dependants Keep-fit programmes Help with career planning More flexible work patterns Job redesign

Table I. Respondents Who Would Participate in these Interventions (%)

in the programmes selected. This issue of the usefulness of attitudes in predicting behaviour is one which has been extensively discussed in psychology. Although it has been recognized that behaviour is complex and multidetermined, the evidence suggests that attitudes are more likely to predict behaviour when the focus is specific (Deaux et al., 1993). In this study respondents were asked to make choices in respect of specific types of intervention. According to the health beliefs model, employees perceptions of their own susceptibility to adverse effects on their health as a result of stress experienced at work would also be an important factor. This would suggest that it is not just employees current or past experience of stress which should be taken into account, but also their beliefs about whether they might be negatively affected by stress in the future. However, beliefs about susceptibility to stress were not measured directly in this study. Nevertheless, the high proportion of employees who reported that they would be willing to participate in such programmes strongly suggests that many of these employees view stress management as being personally relevant to them. When considering ways of reducing occupational stress, it is also important to take into account the possible impact of the social and

organizational setting into which interventions are being introduced. As noted above occupational stress management programmes must be suited not only to the individual but also to the organization. Table II shows employees views of which stress management interventions would benefit the organization. It is interesting to note that over 90 per cent of the sample indicated that they felt that the organization would benefit from increased awareness of stress among team leaders. This suggests that it is important that stress is acknowledged in the organization, and that team leaders have the necessary training to enable them to recognize stress among members of their team. One result which is perhaps particularly surprising relates to employees attitudes to counselling. One might expect that counselling which was independent of the organization would be favoured in comparison with counselling within the organization, since this has been emphasized in the literature (Bull, 1992). Although the results indicated this trend, only 5 per cent more of respondents reported that they would personally participate in counselling independent of the organization, in comparison with counselling within the organization. In addition, a higher proportion of the sample felt that the organization would benefit from counselling within social

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>80 Training for team leaders to recognize stress in team members Health screening Learning about different ways of coping with stress

60-80 Training to increase own awareness of stress Training in relaxation techniques Counselling within social services Training in interpersonal skills Team building Assertiveness training Staff support groups Help with career planning More flexible work patterns

40-60 Counselling independent of social services Opportunity to take unpaid leave Career sabbaticals Assistance with care of dependants

<40 Job redesign

Table II. Respondents Who Felt that Organization Would Benefit from Intervention (%)

services in comparison with counselling independent of social services. Although the reasons for this are not clear, it may be that independent counselling is perceived as being more costly to the organization, and thus the benefit to the individual, which would also benefit the organization, is outweighed by the cost. Other studies have shown that although employees see counselling as being of benefit to the organization, they may be reluctant to participate themselves. For example, Sutherland and Davidson (1990), in a study of construction managers, found that only a quarter of respondents indicated that they would personally participate in counselling, although nearly twothirds felt that the company would benefit from such interventions. Although one might expect that individual counselling would be more acceptable to social services employees in comparison with some other occupations, attitudes towards counselling are likely to be influenced by a combination of personal, organizational and societal factors. In this particular study, there were strong indications from the interview phase of the research that employees were very concerned about the potential consequences of admitting to stress and seeking outside help including counselling.

Such concerns are aptly illustrated in the words of one employee:

[counselling] should be part of the job you see a counsellor on a regular basis its very stigmatized the people who do feel they need it well youre going for counselling because you cant cope whats wrong social workers need to accept that the job does affect us.

More generally, this underlines the importance of recognizing and dealing with some of the barriers to reducing stress in the organization. For example, if the existing organizational climate makes it difficult for employees to discuss stressrelated issues, interventions to reduce stress may be perceived as a means of shifting the blame onto the individual employee.

Comparison between the Groups

Table III presents the top six stress management interventions for each of the five occupational groups, and indicates the percentages of each group who felt they would benefit from these programmes. Although there was some similarities between the groups, for example in ratings of training in coping skills and health screening, there were also some differences.

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Administration

Residential child (%) care

(%) Home help

(%)

Social work (%) Training in 91 coping skills Awareness 86 training for team leaders Team building Health screening 86

Support Health screening Team building Interpersonal skills training Stress awareness training Training in coping skills Staff support groups/help with career planning

(%) 78

Health screening 82

Training to increase 93 awareness of own stress Training in coping skills Team building 93

Training in 76 coping skills Health screening 73

Training in coping skills

79

74

Awareness 76 training for team leaders Assertiveness training Keep-fit programmes Training on awareness of own stress 74

93

Staff support 71 groups Relaxation training 66

74

Health screening

86

82

74

68 67

Awareness training 82 for team leaders Assertiveness/ interpersonal skills training/help with career planning 79

Keep-fit 65 programmes Training to 60 increase own/team leader awareness of stress

Assertiveness 79 training Relaxation training 78

67 63

Table III. Comparison among Occupational Groups: Respondents Who Felt that They Would Benefit from Interventions (%)

Team building was rated among the top three interventions by the residential child-care, social work and support worker groups, while over 70 per cent of the home-help group felt that they would benefit from staff support groups. This probably reflects the different demands of the job, since home helps, most of whom worked with elderly clients in their own homes, are more likely to be isolated from work colleagues. Similarly, help with career planning was among the top six stress management interventions cited by both the support work group and the residential child-care group. Again, this reflects not only the demands of the job, but also the impact of structural changes resulting from new government policy, such as Care in the Community. Such changes are likely to lead to role ambiguity, job insecurity, and demands for new skills Although over 70 per cent of the social work group felt they would benefit from career sabbaticals less than a third of the administration, support and home-help groups felt that they would benefit from this type of intervention. These comparative data underline the importance of tailoring stress management not

only to the needs of the organization, but also to the different demands of various occupational groups within the organization. Thus, if stress management interventions are to be effective, they must be considered in the context of both individual, occupational and organizational factors.

Conclusion
It is clear that the introduction of stress management interventions into an organization involves taking into account complex individual and organizational issues. In addition, social factors both within and outside of the organization are likely to have an impact on employee participation (Sommenstuhl, 1982). A better understanding of these issues is important for the design and implementation of effective stress management programmes. Moreover, since the workplace provides a unique opportunity to address wider concerns about the escalating cost of health care, interventions to address and prevent ill-health among employees will benefit individual employees, the organization and society as a whole.

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References
Bull, A.D. (1992), Confidential Counselling: A New Breed of EAP?, Employee Counselling Today, Vol. 4 No. 2, pp. 25-8. Deaux, K., Dane, F.C. and Wrightsman, L.S. (1993), Social Psychology in the 90s, 6th ed., Brooks Cole, CA, p. 155. DeFrank, R.S. and Cooper, C.L. (1987), Worksite Stress Management Interventions: Their Effectiveness and Conceptualization, Journal of Managerial Psychology, Vol. 2 No. 1, pp. 4-10. Elkin, A.J. and Rosch, P (1990), Promoting .J. Mental Health at the Workplace, Occupational Medicine, Vol. 5 No. 4, pp. 739-54. Gatchel, R.J., Baum, A. and Krantz, D.S. (1989), An Introduction to Health Psychology, 2nd ed., Random House, New York, NY. Harris, M.M. and Fennell, M.L. (1988), Perceptions of an Employee Assistance Program and Employees Willingness to Participate, The Journal of Applied Behavioral Science, Vol. 24 No. 4, pp. 423-38. Ivanevich, J.M., Matteson, M.T., Freedman, S.M. and Philips, J.S. (1990), Worksite Stress Management Interventions, American Psychologist, Vol. 45 No. 2, pp. 252-61. McHugh, M. and Brennan, S. (1993), Managing Work Stress: A Key Issue for all Organization

Members, Employee Counselling Today, Vol. 5 No. 1, pp. 16-21. Michie, S. (1992), Reducing Stress in NHS Staff, Employee Counselling Today, Vol. 4 No. 1, pp. 4-7. Sommenstuhl, W.J. (1982), Understanding EAP Self-referral, Contemporary Drug Problems, Vol. 11, pp. 269-93. Sutherland, V. and Davidson, M.J. (1990), Stress among Construction Site Managers A Preliminary Study, Stress Medicine, Vol. 5, pp. 221-35.

Further Reading
Employment Department Group (1992), Health and Safety Statistics 1990-91: Occupational Health, Employment Gazette, Occasional Supplement No. 2, Vol. 100 No. 9, pp. 75-99.

Jennifer R. Bradley is a Lecturer in Organizational Psychology at University College, Salford, and Valerie Sutherland is Director of the Centre for Business Psychology at the University of Manchester Institute of Science and Technology (UMIST), Manchester, UK.