Stress can have a negative effect on practically all aspects of performance, as can the drugs used to treat anxiety and depression. Particular consideration should be given to those driving or operating machinery;
those in jobs where accuracy is critical; and those whose decisions have significant impact on the organisation.
Interventions
Interventions are traditionally divided into primary, secondary and tertiary. Primary interventions seek to remove or modify the cause at source; secondary interventions seek to equip people to deal more effectively with the pressures they encounter in life; tertiary inter-ventions seek to treat damage already done. The underlying model of stress emphasises the need to understand the sources of pressure and, as a consequence, focuses attention on primary interventions. However, because of the multifactorial nature of occupational stress, many organisations find it difficult to deal with the source of the problem and, instead, focus their attention on the visible outcome of the stress process, that is, those individuals who are suffering from stress-related illnesses. We therefore have a situation in many organisations where efforts to reduce workplace stress are misplaced, and interventions are concentrated at the remedial (tertiary) level, not the primary level.
Stress is then wrongly perceived as the problem of the individual and not of the organisation, whereas, in fact, like most health and safety issues, it is best seen as a shared responsibility.
Primary interventions
The Health and Safety Executive (1995) takes the view that psycho-logical pressure at work must be approached in the same way as any
other workplace hazard. It must be assessed and where found to be excessive, appropriately modified. The use of questionnaires such as the Pressure Management Indicator (Williams & Cooper, 1996) provides a structure for the analysis of the nature and extent of occupational stress and helps the design of interventions that meet the specific needs of the organisation. Relying exclusively on secondary and tertiary interventions is no more acceptable in the area of pressure than it is in the area of noise, where we are required to reduce noise at source before we resort to handing out ear defenders and hearing aids.
Some examples of primary interventions are improving job design, enhancing management skills, modifying organisational culture, introducing flexible systems of work and enhancing leadership skills.
Secondary interventions
Although primary interventions must never be overlooked, there is a place for secondary interventions as well. Because pressure is inevitable and because much of it arises outside the workplace and is therefore beyond the control of occupational physicians, it makes sense to teach people the skills to manage pressure effectively and positively. We have already established that work affects home and vice versa; therefore, if we can help people to manage pressure more effectively, then we can expect a resultant improvement in their ability to perform.
There are many types of ‘stress management’ course, from those that concentrate on the three ‘C’s of control, challenge and commitment to those that take the wider view that pressure management is a subset of self-management, and that if you manage yourself effectively then stress ceases to be an issue. Stress management also draws from the areas of assertiveness training and time management. Our experience shows that understanding the dynamics of the stress process should be a core component of any ‘pressure management’ training. Many people have little understanding of the physiological component of the stress reaction. Explaining the physiology of the fight-or-flight reaction helps employees to recognise that the way they feel is a function of an inappropriate evolutionary response. This understanding removes the
‘fear’ of stress and overcomes the common feeling that admitting to stress is a sign of weakness and individual failure.
A very effective approach to pressure management is the concept of building resilience at both the individual and organisational level. If we concentrate on the individual without attending to the organisation, we are simply cleaning up the fish only to put it back in the dirty pond.
The most successful approach is a two-pronged one in which we teach individuals the behaviours and competencies of personal resilience, while working on cultural issues and leadership competencies to improve the organisational environment. An example here is the issue
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of work–life balance. A characteristic of resilient people is that they consistently display the ability to balance their work and personal lives in a manner which is satisfactory to them; the organisation can support this behaviour by implementing flexible systems of work, supporting diversity and stamping out any long-hours culture.
Tertiary interventions
In the noise reduction analogy, these are the hearing aids. Examples are employee assistance programmes and counselling services. While these are in no way a satisfactory response to the stress issue on their own, they do provide the comfort of a safety net. They also cater for those whose primary stressors lie in their personal lives and are therefore beyond the company’s control, but the company can expect a payback in the form of a more speedily rehabilitated employee. The danger in an over-reliance on counselling is that organisations believe they have
‘dealt with’ stress, when in fact they have failed to move beyond the outward signs to get at the root causes.
Despite an enormous amount of work and numerous information campaigns, there is, in many organisations, still a stigma attached to mental health in general and stress in particular. Introducing the issue of stress under the banner of pressure management makes the subject more acceptable to employers and encourages employees to participate in programmes without admitting that they can no longer cope.
References
Health and Safety Executive (1995) Stress at Work. London: HSE.
Williams, S. & Cooper, C. L. (1996) The Pressure Management Indicator. Harrogate:
RAD Ltd.
Further reading
Cooper, C. L. & Williams, S. (eds) (1994) Creating Healthy Work Organisations.
Chichester: John Wiley & Sons.
Covey, S. (1989) The Seven Habits of Highly Effective People. London: Simon & Schuster.
Williams, S. (1994) Managing Pressure for Peak Performance. London: Kogan Page.