30 million working days per year are lost through stress in then UK: What can and should employers do about this? This essay provides some answers to this question.
Absenteeism is one of the most obvious costs of stress to employers (Arnold, 1991). Thus high levels of absenteeism (above around 2%; Sargent, 1989) should indicate to the management team that work-induced stress is significantly affecting their "bottom line" accounts and profit margins.
What, then, can employers do about this? The answer is simple - change! But
change is rarely easy, sometimes frightening and often has high short-term costs,
one of which, ironically, is the stress of change itself (Karasek, 1990). A
possible reluctance to change by managers, worker representatives and workers
alike may be especially strong to something as intangible as "stress".
The idea that "stress management" is just another fad from the States
may be a major obstacle, as could the belief that absentees are either sick
(i.e. they have genuine physiological illnesses or injury) or are malingering.
The first lesson that must be learned, before change can take place, is that
some (perhaps most) of the "malingerers" are absent due to occupational
stress, and that some (perhaps most) of the "genuinely" sick are ill
because stress has contributed to either accidents, mental ill-health or psychophysiological
illness. (The literature concerning the effects of stress on physiological illness
is large and growing e.g. Sarafino, 1994).
Assuming employers have digested the first lesson, they should now treat worksite
stress seriously, placing it high on their agenda, and can begin to disseminate
knowledge of their commitment to their workforce. Lesson number two is that
for stress-management initiatives to be effective and long-lasting requires
the full co-operation of staff and staff representatives, good communication
channels and worker participation in decision making.
But there is a danger here that must be avoided. In an effort to reduce absenteeism
and improve performance, organisations may rush to make changes, running the
risk of prescribing inadequate ones. It takes time and skilful exploration of
the problem before solutions can be found. It takes even more time and investment
to implement any recommendations responsibly and sensitively (Lisle & Newsome,
1988). The third lesson is that without expert advice and assistance on identifying
where stress is causing problems, what stressors are involved, how the people
affected are reacting to the stressors, how they are coping with stress and
what options are available to help alleviate these factors, then employees run
the risk of making ineffective, and possibly amaging, changes.
What advice and assistance, then, might an expert offer? First, what works for
one organisation may not work for another, even if they are in identical businesses.
Differences in organisational structure, ethos, values, goals, strengths and
weaknesses all matter (Lisle & Newsome, 1988). The particular needs of employees
is also crucial. Nurses have different needs to electricians, who have different
needs to accountants. Stress is not a white-collar "disease" - indeed
there is evidence that it affects blue-collar workers even more (Arnold, 1991).
Second, individual differences matter. Stress is a psychological state brought
about by a discrepancy between a person's perception of the demands placed upon
them and their ability to cope (Cox, 1987). Hence, what may help alleviate stress
for one employee may be very different from his/her colleague's requirements.
Third, there are a range of measures that can be instigated, some of which may
require full-scale reorganisation, job re-design, or costly changes to the work
environment. Others, require very little intervention but can still produce
considerable improvements in the health, morale and efficiency of the workforce.
Fourth, it is essential to make changes which have good track records, fit a
solid theoretical framework, are sustainable until the rewards are reaped, have
the full backing of all involved and have effects which can be monitored. The
latter is probably the most essential, not only for the organisation itself
to know which measures are relieving stress, which need improving, re-shaping
or abandoning, but for the study of occupational stress as a whole, which relies
on real-life intervention programmes for its database. It is advisable, also,
to run a controlled trial if practically possible, since benefits may be simply
due to the Hawthorne effect. Unfortunately, stress cannot be measured directly
(Cox, 1985); however, it can be assessed using such methods as questionnaires,
interviews and diaries, as well as with more indirect corroborative evidence,
such as improved performance and (hopefully) reduced absenteeism.
It should be noted that the proper classification of absenteeism is essential.
It is all too easy to classify real malingerers (all organisations have some)
as taking time off due to stress. This can affect morale of work mates who may
know when certain individuals are "skiving". Making the workplace
a better place to attend may have little effect on such people, and a more relaxed
atmosphere may in fact permit more malingering. Hence the need for line managers
and supervisors to be concerned with every episode of absence or poor time-keeping,
and to establish a good rapport and relationship with their team. The role played
by line managers and supervisors in identifying, facilitating and monitoring
stress management programmes cannot be overstated (Sargent, 1989). It is essential
to make "people management" a top priority in the recruitment, placement,
promotion, training and appraisal of line managers and supervisors.
What specific stress-management interventions can be made? Ivancevitch et al
(1990) identify three categories into which these can fall depending on which
points in the stress cycle they are targeting:
In addition, programmes associated with these targets can focus on the individual, the organisation or the individual/organisation interface. Ivancevitch et al (ibid) go on to make the point that existing research has disproportionately concentrated on individual interventions, hence stressor appraisal and coping strategies have been far more common intervention targets than have situational stressors. One explanation for this is that management see stress as being predominantly due to personal factors, such as personality, lifestyle behaviours, interpersonal relationships and familial problems (Neale et al, 1982). Another reason is that stressor reduction activities can be costly and difficult to implement in organisations (Murphy, 1988).
Let us look more closely at the kinds of intervention programmes that have proved
successful in a number of organisations, starting with stressor reduction, then
moving on to look at stress management training and counselling programmes.
Stressor reduction programmes can target five major categories of stressors
(Payne, 1980; Jenkins, 1988; Arnold, 1991):
However, the idea that reducing such stressors will inevitably result in reduced absenteeism is fallacious. The relationship between stress and absenteeism is far more complex. For instance, in one study with nurses, a better P-E fit correlated with higher absenteeism (Furnham and Walsh, 1991) and, in another study, absenteeism was seen as the cause of stress, rather than vice versa (Manning & Oswald, 1989). Another major problem for stressor reduction interventions is that of the few well-designed intervention studies reported in the literature, none report significant reductions in absenteeism (Murphy, 1988). One non-intervention study, however, did find such a link. Karasek (1990) undertook a large scale, cross-sectional survey of white-collar workers in Sweden, some of which had experienced job redesign programmes aimed at improving productivity, and others not. Though, as a whole, job reorganisation actually increased absence rates, those workers who had redesigned jobs with more control had significantly lower absence rates (and significantly lower risk of illness) than those whose control had decreased. The importance of more job control (or perception of control) is not only key to stress reduction (Murphy, 1988; Karasek, 1990) but it is an important element in job redesign theories (e.g. the core dimension of autonomy in Hackman & Oldman's self-motivation model, 1980).
Let us now move on to look at stress management training. Successful programmes
have included such things as relaxation training (including biofeedback), meditation,
exercise, smoking cessation, hypertension screening/control, nutritional counselling,
selective medical referrals, cognitive appraisal training, goal-setting and
time-management training (e.g. Manuso, 1980; Carrington et al, 1980; Bruning
& Frew, 1987). However, none of these programmes showed any data that stress
management training actually reduces absenteeism. Seamonds (1982, 1983), though,
did find that a single health education interview, followed by selective referrals,
exercise and relaxation information, resulted in significantly lowered absenteeism
rates. Far more research needs to be done before any firm conclusions can be
drawn.
Finally, let us look at counselling and in particular employee assistance programs.
In a recent review of Canadian corporations, it was found that those corporations
using EAPs had reduced absenteeism (Loo & Watts, 1993). Of the programs
surveyed, 68% gave a range of services, the most frequent being information
such as brochures (85%) and substance abuse services (85%). In addition, it
was found that 31% used external counselling services, 27% used internal services
and 23% used a mixture. The choice of whether to use 'in-house' or 'out-of-house'
counselling services can be a crucial one (Lisle & Newsome, 1988). Although
the former are likely to indicate more management commitment, be better informed
and be able to identify, thus help reduce, special areas of stress, they can
frighten off some employees suspicious that confidentiality may be lost and
may adversely affect career prospects. External services do not suffer from
such confidentiality problems. In addition, they are particularly attractive
to small organisations for short-term cost reasons, have round the clock availability,
have large computerised databases and are viewed as being 'professional'. The
drawback of external counselling, however, is that it tends to be reactive rather
than proactive; i.e. more crisis-oriented rather than geared to the development
of staff.
In summary, employers can do much to reduce stress - but should seek expert advice and assistance before investigating and implementing changes. This, however, costs. Unfortunately, in times of recession such investment can be the first to be axed. Ironically, it is during recession that stress is probably at its highest (due to a host of reasons, including job insecurity, short-sighted goals and poorer management style). Perhaps the new threat of having to pay huge sums in worker compensation cases may be the trigger for employees to take stress seriously, and to realise that it not only lowers their precious profits, but may be affecting their health as well !
Arnold, J. (1991). Work, stress and psychological well-being. In Work Psychology, J. Arnold, et al (eds). London: Pitman.
Cox, T. (1985). The nature and measurement of stress. Ergonomics, 28, 1155-1163.
Cox, T. (1987). Stress, coping and problem solving. Work and Stress, 1, 5-14.
Furnham & Walsh, T. (1991). Consequences of person-environment incongruence: absenteeism, frustration and stress. Journal of Social Psychology, 131(2), 187-204.
Hackman, J. R. & Oldman, G. R. (1980). Work Redesign. Reading, Ma: Addison Wesley.
Ivancevitch, J. M., Matteson, M. T., Freedman, S. M. & Phillips, J. S. (1990). Worksite stress management interventions. American Psychologist, 45, 252-261.
Jenkins, R. (1988). Mental health of people at work. In Waldron, H. A. (ed) Occupational Health Practice. London: Butterworths.
Karasek, R. & Theorell, T. (1990). Healthy Work: stress, productivity, and the reconstruction of working life. New York: Basic Books.
Lisle, J. R. & Newsome, A. (1988). Health promotion and counselling. In Waldron, H. A. (ed) Occupational Health Practice. London: Butterworths.
Loo, R & Watts, T. (1993). A survey of employee assistance programs in medium and large Canadian organisations. Employee Assistance Quarterly, 8(3), 65-71.
Manning & Oswald, T. (1989). The relationship between absenteeism and stress. Work and Stress, 3, 223-235.
Murphy, L. R. (1988). Workplace interventions for stress reduction and prevention. In Cooper et al (eds), Causes, coping and consequences of stress at work.Chichester: Wiley.
Payne, R. (1980). Organisational stress and social support. In Cooper & Payne (eds), Current concerns in occupational stress. Chichester: John Wiley
Sarafino, E. P. (1994). Health Psychology: biopsychosocial interactions. (2nd edition), Chichester: John Wiley.
Sargent, A. (1989). The Missing Workforce: managing absenteeism. London:
Institute of Personnel Management.