Stress Interventions Organizations

What are the main types of stress interventions used by organizations? Critically evaluate the evidence for their effectiveness? How can stress interventions be made more effective?

1. Introduction

Stress management interventions (henceforth SMIs) have been defined as an activity, program or opportunity which aims to decrease the presence of work related stressors or to support individuals in coping more effectively with the adverse impacts of stress (Ivancevich, Matteson, Freeman and Philips, 1990). From an organizational perspective, stress interventions aim to improve the effectiveness of employees by reducing the levels of those phenomena (e.g. turnover, absenteeism and loss in motivation) which are believed to be caused by stress (Briner, 1997).

Throughout the following sections, I will argue that stress management interventions are not as effective, as organizations and the mainstream literature perceives them to be, mainly because of theoretical misconceptions of the concept of “stress”, methodological weaknesses in stress related studies and lack of effective evaluations of stress interventions. I will then discuss methodological and conceptual implications that may improve the effectiveness of stress interventions.

2. What are the main types of stress interventions used by organizations?

Stress interventions have been categorized by different researchers in a number of manners. For instance, Murphy (1988) categorized stress interventions into primary, secondary and tertiary whereas De Frank and Cooper, (1987) classified interventions as individual, individual/organizational interface and organizational. Individual based interventions together with secondary and tertiary interventions typically aim to equip individuals with skills that enable them to cope with stressors and include interventions such as Stress Management Training (henceforth SMT) and Employee Assistance Programmes (henceforth EAPs). Organizational focused interventions on the other hand are similar to primary interventions because they focus on changing the objective work environment and aim to reduce specific job stressors.

Identifying the “main” types of stress intervention techniques used in organizations, is not an easy task especially because there is not much evidence about what sort of stress management interventions are implemented within organizations (Briner, 1997). I will thus focus on those interventions that are mostly researched within the stress literature i.e. SMIs, EAPs and specific organizational interventions such as work schedule arrangements and other psychosocial interventions.

3. To which extent are stress management interventions effective?

How effective are stress management interventions in helping employees coping with occupational stress? If I had to answer this question by simply acknowledging the face validity of such interventions, I would confidently conclude that most interventions have been successful. But a more critical analysis of the situation seems to suggest that most conclusions have been drawn on anecdotal information and not on evidence based approach (Briner, 1997; Briner and Reynolds, 1999; Reynolds and Briner, 1994).

A major premise, which has to be pointed out before discussing the effectiveness of specific stress interventions, rests on the fact that although SMIs are assumed to reduce stress, the definition and conceptualization of stress is ambiguous and conflicting. This broad and vague conceptualization of “stress” contributed to a scientific fragmentation of the concept, inadequate theories, and confusion in research (Briner, 1997; Dewe 1989; Eulberg, Weekley and Bhagat, 1988; Newton 1988; Pratt and Barlin, 1988).

3.1. The Effectiveness of Individual based interventions

Briner (1997) identifies SMT and EAPs as the most common types of individual based interventions. Despite the fact that both interventions function within the same unit of analysis, SMT has been categorized as a secondary level intervention whereas EAPs as tertiary level intervention. This is because whereas SMT aims to give people skills to cope with stress, EAPs offer assistance to individuals who are already experiencing distress (Briner, 1997).

Throughout this section I will critically discuss the effectiveness of the above mentioned stress interventions i.e. SMT and EAPs as encountered in the literature.

3.1.1 Effectiveness of SMT

SMT takes the form of a short training course, typically based on a cognitive behavioral approach. It includes different forms of training such as relaxation techniques, time management skills, cognitive techniques, biofeedback and assertiveness skills.

SMT studies have reported moderate improvements in self reported perceptions of stress (e.g. Cecil, 1990; Grossman and Silverstein 1993; Hyman, 1993; Murphy, 1988). Yet there has been weak or no significant evidence, which suggests that SMT can have an impact on desirable employee behaviors such as job satisfaction, organizational commitment, motivation and reduction in sickness absence leave (Bond and Bunce 2000; Murphy and Soreson, 1988; Sallis et. al 1987; Reynolds, Taylor and Saphiro, 1993; Whatmore, Cartwright and Cooper, 1999).

Studies also show that self reported perceptions of stress post SMT seem to be only effective for a short period (Giga Cooper and Faragher, 2003; Ivancevich et. al 1990). For instance, a study in a UK government department found that most beneficial outcomes of stress management techniques (personal stress awareness, exercise and cognitive restructuring) on the participants’ mental health were only evident at three months post training period but were not evident after six months (Whatmore et al. 1999). Briner (1997) posits that these brief effects may be simply attributed to the “good feeling factor” stemming from the mere participation in the training; rather than from its’ contents. Indeed the “equivalence paradox” (Stiles, Shapiro and Elliot, 1986) which occurs when conceptually different interventions obtain similar outcomes (e.g. Bond and Bunce, 2000; Sallis et al. 1987) may support Briner’s argument that non- specific factors such as positive feelings elicited from participating in the training, may be more beneficial than the technical content of the SMT itself.

SMT evaluative studies suffer from methodological problems such as the omission of follow up studies and control groups and small sample sizes (Cecil, 1990; Ganster et al. 1982; Grossman, 1993; Higgins, 1986; Hyman, 1993). Briner (1997) further argues that another major flaw rests in SMT evaluation designs because researchers tend to study SMT as if it was a treatment and not a preventative measure.

Another problem in SMT studies may stem from the principle of SMT itself. Briner (1997) suggests that SMT revolves around the assumption that if individuals learn how to use stress management skills, they should be able to minimize the adverse impact of stressors. However, such reasoning rests on the assumption that skills, despite their complexity, are being effectively transmitted to participants without addressing the competency of the trainer or any individual differences (Briner, 1997; Ivancevich et al. 1990; Palmer and Dryden, 2007). This maybe reflected in through the fact that SMT is being offered as a pre-programmed packaged format (Kahn and Byosieri, 1992), at the exclusion of a thorough assessment of what is actually required both at the individual and at the organizational level (Ivancevich et al. 1990). Moreover, SMT is based on the presumption that certain factors are more important than others in diminishing the negative effects of stress. For instance, it may be assumed that coping skills may be more useful that personality in dealing with stress. Yet research has suggested that certain personality traits such as negative affectivity, external locus of control and Type A personality can amplify one’s perceptions and predisposition to stress (Cassar and Tattersall, 1998; Spector and O’Connel, 1994).

Despite the apparent positive outcomes of SMT for individual participants, such results cannot be confidently generalized due to methodological and conceptual shortcomings. In practice, however the above mentioned problems may be difficult to eliminate especially because SMT tends to vary in content, duration and number of participants (Van der Hek and Plomp, 1997).

3.1.2 Effectiveness of EAPs

EAPs are broad programs aiming to assist employees by providing various services including counseling, health, legal and financial advice.

It seems that EAPs have been portrayed in a positive light and studies especially in the US have supported (e.g. Alexander and Alexander, 1989; Holder and Blose, 1992; Shneider, Casey and Kohn, 2000) this argument by suggesting that EAPs have improved the mental health, stress levels and effectiveness in employee performance. Despite the insistence of EAPs advocates that such programs are beneficial for the employee and the employer sound empirical evidence, accounting for EAPs effectiveness, seems to suggest otherwise (Arthur, 2000). The appraisal of EAPs has also been put in question because of conceptual and methodological weaknesses.

One of the few evaluative studies of the outcome of stress counseling took place in a UK Post Office (Cooper and Sadri, 1991). This study involved a sample of 250 employees working across all the hierarchical levels and who received counseling over a period of one year. Compared with a control group, those employees who received counseling services took less sickness absence leave, reported an increase in their self esteem and also claimed lower levels of anxiety and depression. This study also showed that there was no significant improvement in employees’ job satisfaction and organizational commitment. Thus it seems that although counseling has some positive impact on individuals, it proved to be less effective for the organization. Similar trends have been found in a study commissioned by the UK Health and Safety Executive on the effectiveness of counseling as part of an EAP (Berridge et al.. 1997). This study within nine companies concluded that apart from a reduction in sickness absence leave, there were no changes in turnover, morale, productivity and stress levels, which would have been beneficial to the organization.

The above mentioned studies together with others (e.g. Berridge, 1999; Blaze- Temple and Howat 1997; Caroll, 1996; Mc Donald et al. 1997; Murphy 1998) suggest that the effectiveness of EAPs has only been perceived as beneficial from the subjective perceptions of EAP users and counselors. However, research does not support the assumption that EAPs are sustainable for organizations. Such disappointing findings may be stemming from a conceptual limitation of EAPs suggesting that by reducing employees’ negative affectivity, performance will increase (Briner, 2000). However, research focusing on emotions at work does not support the notion that “a happy worker is a productive worker” (Briner and Reynolds, 1999). Indeed, research shows that positive affectivity may act as a distraction to performance (Schwartz and Bless, 1991). Moreover, Briner (2000) argues that employee performance is not simply restricted to how the employee is feeling, but is a hybrid of factors including the relationships at work, the task itself and the skills of the individual employee amongst other things. Similarly, Lazarus (1995) suggests that EAPs may be only addressing employee problems superficially while ignoring contextual differences in the nature of the problems and how people may react differently to stress.

Similar to SMT, research on EAPs faces a number of methodological weaknesses such as an immediate evaluation of counseling interventions, the omission of longitudinal follow ups and control groups. These factors are particularly important because they allow the researcher to be able to determine whether the desirable changes are attributable to the EAPs (Csiernik, 1995).*

Perhaps Briner’s (2000) less orthodox views may be insightful when assessing EAPs. For instance he stipulates that EAPs, specifically counseling interventions, may have indirect positive outcomes to the client’s team through the process of emotional contagion in Briner, 2000). Perhaps this view may stimulate a needed change in the way EAPs are evaluated leading to a more holistic evaluation of EAPs.

3.2 Effectiveness of organizational based interventions

Organizational based interventions have been considered as primary interventions because they aim to reduce strains believed to be generated by the characteristics of the organization, the role and the task (Newman and Beehr, 1979). Although considered by some researchers as the most ethical and effective types of interventions in the long term (Ganster et al.; Murphy, 1996; van der Hek & Plomp, 1997; Cox, Griffiths and Randall, 2002), paradoxically they have also been the least popular. This may be explained by the fact that they require thorough planning and tend to be disruptive, and costly for the organization (Dewe, 1994).

Research on organizational based interventions, similarly to EAPs and SMT, faces a number of methodological limitations, including the lack of a control group or the use of a randomly assigned group when carrying out a quasi-experimental method (Randall, Griffiths and Cox, 2005). The use of self report measures, the sample size as well as the allocation of only a brief period after which interventions are assessed may also hinder an evidence based assessment of such interventions (Parks and Sparks, 1998).

Parkes and Sparkes (1998) reviewed a number of studies implementing both socio-technical and psychosocial interventions. Studies using socio-technical interventions such as changing the work overload (e.g. Parkes et al..1986; Parkes, 1995) or work schedules (e.g. Dunham, Pierce and Castanada, 1987) were reviewed. These did not provide strong evidence that socio-technical interventions are effective, especially because most benefits acquired from the intervention were short-lived. For instance a research in the UK amongst 30 driving examiners (Parkes et al.. 1986; Parkes 1995) studying the effects of reducing the examiners’ workload, showed that following this intervention, the participants perceived less anxiety, reported greater job satisfaction and also improved their cognitive performance. However a follow up study assessing the long term effects of this workload reduction, five years later, showed that most of the benefits reported earlier were no longer evident.

Parkes and Sparks (1998) also reviewed a number of psychosocial interventions, typically based on the principle of increasing employee involvement as to improve work related behaviors, affective well being and performance. A number of studies reviewed have used Participation Action Research (henceforth PAR) as a way to involve employees in the process of identifying stressors, implementing ways how to reduce them and also in evaluating the impact of the selected intervention/s (Parkes and Sparkes, 1998). For instance, a simultaneous research in two departments in a public health agency by Landsbergis and Vivona Vaughhan (1995) studied the effects of a PAR intervention on a number of identified stress related outcomes. The study concluded that for the first department the PAR intervention did not increase any of the variables measured nor reduced physical strain and depression. However, findings for the second department were mixed. This study, although utilizing a control group for each department as well as a follow up period, showed that increasing employee involvement (through PAR) had no impact in reducing stress related outcomes or improvements in desirable work attitude and behaviors. Other studies making use of a PAR intervention also had similar disappointing results (e.g. Heaney et al. 1993); Terra, 1995; Wahlstedt and Edling, 1997).

Studies evaluating the impact of other job redesign interventions gave similar inconsistent evidence. For instance an experimental study by Logan and Ganster, (2005) amongst a trucking company, studied the effects of a control intervention and supervisor support amongst a group of project managers. The study concluded that perceptions of control amongst participants only increased for those who had supportive supervisors.

Similar to individual based interventions, organizational based interventions, rest on the assumption that organizational stress may cause undesirable work related behaviors such as absenteeism, illness and a reduction in performance and motivation. However, based on the fact that the stress literature lacks rigorous studies, one cannot simply conclude that the relationship between these variables is conclusive. Moreover, it appears somewhat naïve to assume that human behaviors function in such a simple cause and affect fashion, while ignoring the other contextual factors such as the labour market which may also have an impact on how the individual perceives his/her work environment (Briner and Reynolds, 1999).

It seems that there is not much evidence suggesting that organizational based interventions are effective mainly due to inconsistent results, leaving organizations without any scientific evidence as to determine when and how interventions are most likely to be successful (Briner and Reynolds, 1999; Parks and Sparks, 1998).

4. How can stress interventions be made more effective?

Throughout this section I will discuss two major implications; theoretical and methodological which may improve the effectiveness of stress management interventions.

A major priority in this field is the development of a sound theoretical framework, explaining clearly the concept of stress. Because stress has never been clearly conceptualized under a comprehensive theoretical framework, it has erroneously collected a number of phenomena under the same term, leading to vagueness and ambiguities in our understanding (Briner et al 2004; Briner and Reynolds,) Development of a sound theoretical framework is needed to allow a clearer explanation of how and why the relationship between stress and work related phenomena exists (Briner and Reynolds, 1999). Researchers have also repeatedly ignored other factors such as emotions and moods despite the fact that these factors may add to our understanding of work related behaviors.

A new approach in improving SMIs may be inspired by the principles of positive psychology. These aim to increase the focus on positive emotions, rather than focusing on negative affect. In the working context, this is seen as an attempt to increase employee well-being by identifying what induces happiness rather than by reducing organizational sources of stress or introducing programs to help individuals cope with stress.

The stress literature is further limited by “methodological pluralism” (Dewe and Trenberth, 2004 p.155) stemming from the widespread use of self report measures and cross-sectional data (Briner et al. 2004,; Daniels, 2006; Daniles Hartley and Travers, 2006; Cooper et al. 2001 as cited in Daniels et al 2006; Dewe and Trenberth 2004; Rick et al 2002; Jex and Beehr, 1991; Spector 1992). Alternatively, other research designs such as longitudinal studies, the use of a “true” control group and larger samples may contribute to sound inferences. The use of other data collection methods such as objective report measures may replace or supplement the recurring and methodologically limited self report measures. Briner and Reynolds (1999) for instance suggested the use of quantitative daily diaries in which both self- reports and objective assessments will be collected.

Perhaps a paradigm shift beyond the traditional normative perspective, may further contribute to the effectiveness of stress management interventions. Normative studies, forming the bulk of the research in this area, have separated the individual from its stressors, and simply analyzed the relationships amongst variables, however failing to explain such findings (Briner et al; Briner and Reynolds).

The normative paradigm has also failed to take into account the impact of both the organizational and the socio-cultural context in which stress interventions have been implemented (Meyerson, Briner and Reynolds). Indeed, most stress management interventions have been applied as if they were some form of panacea, without taking into account for whom and when such interventions are most likely effective (Briner and Reynolds, 1999; Kahn and Byosiene, 1992 as cited in Kompier and Cooper and Geurts, 2000).

The move beyond the normative paradigm, may contribute to our understanding of how employees perceive and conceptualize the notion of stress (Barley and Knight, 1992; Kinman and Jones, 2005; Dewe and Driscoll, 2002; Sharpley and Garmer 2001) as cited in Kinman and Jones, 2005). For instance, Barley and Knight (1992) suggest that whereas management tends to perceive stress as an individual problem, employees who are at a lower hierarchical status seem to perceive stress as attributable to their work environment. Such implications suggest that the way employees perceive stress may ascertain how stress is responded to and managed (Kinnman and Jones, 2005). This may further determine the extent to which a SMI is successful in the long term, whether employees offer resistance to the SMI being implemented, who is more likely to offer resistance to the SMI and who is most likely to make use of SMIs (Kinnman and Jones, 2005).

5. Conclusion

Having reviewed the effectiveness of the main types of SMIs, it seems that from an organizational point of view the costs involved to implement these interventions may not be justifiable. As regards to employees, it seems that although interventions do have some positive outcomes these are not maintained in the long term. It has also been recognized that SMIs, as the name implies, are used to deal with stress, an undefined term which has led to their popularity but which has also limited their effectiveness. More research on the indirect benefits of SMIs for both the organization and the individual may provide further insight, perhaps leading to the justification of their monetary costs, energy and time consumption.