This handout assumes a working knowledge of the relationship
between occupational stress and both psychological and physical
strain, including cardiovascular disease. We will also assume
that you have identified some of the organizational costs of high
stress levels to your workplace and employees. Another key assumption,
is that you are interested in a change strategy that includes
structural, or organizational change. The approach discussed in
this handout views individual approaches as augmenting, not replacing
organizational change. Finally, we will assume that you have the
opportunity to improve the quality of work in your organization.
If these assumptions are correct, congratulations. You have already taken the first steps toward improving the health and possibly the productivity of your employees. This handout will detail this process of healthy organizational change. Basically, this handout has two goals:
1. Identifying the major features of healthy organizational
2. Developing organizational and individual change strategies.
We will also provide you with some examples of successful organizational
change efforts. One general note is in order. This handout will
not review various theoretical models of change. It is intended
to be a concrete and practical guide for healthy organizational
change. For a review of theoretical models and references for
additional examples, you can refer to the companion piece to this
handout, Interventions to Reduce Job Strain (Landsbergis, Cahill
& Schnall, 1995).
Where to Start:
When you think about it, a serious organizational change effort
has two important levels to it. The first is the content of the
change and the second is the process of the change. In common
sense terms, the content of change is what you want to do and
the process is how you are going to do it. In practical terms,
the process of the change effort is the more crucial aspect. The
primary goal of any change process needs to reflect that overarching
Making a Real Commitment to Stress Reduction
Probably the most important step in healthy organizational
change is to make a serious and sustained commitment to it. In
non-unionized workplaces, this commitment should be made by top
management. In unionized workplaces, both top management and union
representatives need to be involved.
Healthy organizational change takes time. Lots of time. No
serious change effort should be initiated with a time frame limited
to weeks or a few months.
Healthy organizational change includes employee health and
satisfaction as an explicit and independent outcome measure. These
outcomes should be the key goals of the change effort, not potential
Broad Organizational Goals
Healthy organizational change can include:
· Changes that will increase employees'
autonomy or control.
· Changes that will increase the skill levels of employees.
· Changes that will increase levels of social support (both supervisory support and coworker support).
· Changes that will improve physical working conditions.
· Changes that will make a healthy use of technology.
· Changes that provide a reasonable level of job demands.
· Changes that provide for job security and career development.
· Changes that provide for healthy work schedules.
· Changes that improve the personal coping mechanisms of employees.
· Changes that will do no harm (i.e. do not have the unintended side effect of degrading the quality of work).
Obviously, we need to translate these broad objectives into concrete steps and programs, but it is sometimes useful to first see the forest and then the trees. Broadly speaking, reducing unhealthy job stressors involves a workplace in which employees have a sense of control, connectedness, where they are working at a reasonable pace, where they are challenged and motivated, where they have a sense of support and security. We'll get back to specific ideas along these lines shortly.
For now, we want to outline some workable steps to begin this
process of change. You can't change everything at once, so you
need to prioritize what it is you want to tackle first. There
are several useful ways to start this process, but perhaps the
most manageable strategy is to offer an occupational stress workshop.
Offer an Occupational Stress Workshop
The workshop strategy has several advantages. It sends a message
to employees that you are concerned about them and their stress
levels. It will help to educate them so that you are all speaking
a common language about stress. Finally, it can help to identify
some of the most important personal and organizational concerns
about the issue. In fact, for employees to take such a workshop
seriously, it is important that discussion of both organizational
change strategies and personal stress management be included.
This training can be comfortably done in either a half or full
day session. Prior to the end of the training, you should ask
participants to indicate if they are interested in working further
on the issue of workplace stress.
Most organizations obtain participant evaluations as a routine
part of any training. This practice is a particularly good idea
for an occupational stress workshop. This type of feedback will
help you judge the quality of the training, and how important
a concern stress is to employees. Finally, the feedback may be
extremely useful in demonstrating the need for additional programs
or activities to reduce stress.
An occupational safety and health training agency in Massachusetts
offered a stress reduction workshop to a diverse group of workers.
They expected that the workshop would be of most interest to human
service workers as well as other public sector workers. However,
a number of workers from the manufacturing sector also came to
the workshop and were active participants. One concrete benefit
to emerge from the initial workshop was that both the training
agency and the manufacturing workers realized the extent to which
stress on the job was negatively impacting on the workers' home
lives. This led to additional training on coping skills and family
dynamics. Workers participating in this second round of training
found it to be extremely useful. A serious problem was identified,
and employees were motivated to address it during the initial
occupational stress workshop.
What to do After the Workshop - An Occupational Stress Committee
A reasonable next step might be the formation of an occupational
stress committee. This group could meet on an ongoing basis and
formulate a strategy for improving the work environment in your
organization. This group should have a unique identity and focus.
Group membership should include both labor and management. If
employees are represented by a union or bargaining unit, they
should be included in the committee. Potential conflicts with
the collective bargaining process need to be avoided. If no bargaining
unit exists, then a representative group of employees and administrators
should attend meetings. Since this committee is examining issues
of the work environment, everyone involved in that work environment
should be involved including clerical, support and maintenance
Employees from various departments, divisions, shifts, and
work groups should be included. Management representatives should
include persons with real authority in the organization.
It is also essential that employee representatives be protected
from discrimination for their participation on the committee.
The committee should be provided with adequate resources to make
a serious and sustained effort. These resources might include
access to relevant consultants, training materials, relevant records,
and release time.
An effective committee needs an effective group of rules and
guidelines. What should the committee discuss? What limitations
are there? What topics are off limits because they are part of
the collective bargaining agreement? How confidential should the
Social scientists have written many volumes on what good group
process is, but here are a few, brief common sense guidelines
to start with:
· Every member of the group should
be valued and have a chance to speak.
· There should be no negative consequences to opinions expressed in the meetings.
· The groups should be given a clear mandate and the authority to make specific recommendations. This includes a clear understanding of what issues they may not address because of collective bargaining restraints. (As one example, discussing salary levels and job categories would not be allowed outside of a collective bargaining process).
· Meetings should have a clear starting and ending time. Participants should understand that their time is valuable.
· The chairperson of the committee should be rotated between management and employees.
· The committee needs to be distinguished from other ongoing committees. This is not a training committee, or a productivity committee. This is an occupational stress committee and reducing stress levels and enhancing coping strategies should be its focus.
A public service agency on the East Coast formed a joint labor
management stress committee after a survey of staff found serious
morale problems. The ongoing committee consisted of both top administrators
and union leaders, which gave it credibility with the rest of
the staff. After determining what issues could be addressed by
the committee, it generated a number of effective individual and
structural strategies to improve the working climate of the agency.
Sometimes a committee can best get started by setting up a
personal stress management activity along with an organizational
activity. A personal coping strategy would be targeted towards
the individual staff member while an organizational, or structural,
change strategy is targeted towards the larger work environment.
Of the two, structural strategies are more effective in reducing
long term stress and risk of illness. At first, choosing projects
small enough to succeed but large enough to matter is a good way
of getting some momentum going and gain support for the committee.
What follows are some specific strategies that parallel the broad
organizational goals detailed above.
Increasing Employees' Sense of Control and Participation
in the Workplace
The key point here is to increase real control and participation;
not the illusion of control. Possible workplace strategies:
1) Using staff meetings more effectively to encourage participation
A state law had been passed in California that required more
frequent staff meeting in hospitals. In one hospital, an organizational
psychologist worked with employees and management to measure the
effects of participation in decision-making on job stress, job
satisfaction, absenteeism and turnover. Units where the intervention
was carried out reported greater influence, less role conflict
and ambiguity, less emotional strain, and greater job satisfaction,
at 3-month and 6-month follow-up.
2) Develop autonomous work groups
Blue-Collar employees in a British confectionary company reported
low scores on three job characteristics (autonomy, task identity
and feedback), low work motivation, low job satisfaction and high
levels of emotional distress. Increases in group autonomy were
attempted by shifting responsibility and control to work teams
and away from the supervisor. Teams had control over the work
pace, organization of rest breaks, and allocation of overtime
and assignments. Six months and 18-month follow up revealed reduced
emotional distress and lasting increases in autonomy.
Increasing the Skill Levels of Employees
Healthy work is skillful work. It allows for the ongoing development
of new skills and the opportunity to use them. There has been
a great deal of discussion at the national level concerning the
importance of high skill, high wage work in increasing the productivity
of U.S. companies. Unfortunately, many of the jobs being added
to the economy are extremely low skill ones. Possible workplace
strategies to counter this deskilling effect:
1) Increased skill based training.
A public sector child welfare agency initiated a competency
based training program that targeted core practice skills. The
trainings were designed to improve the professional skills of
the staff in handling difficult client situations. Participants
in the training showed a significant decrease in psychological
strain symptoms compared with a control group.
Skill development from this perspective should benefit the
employee as well as the organization.
2) Use of career ladders to reward skill development.
3) Use of job rotation to expand skills.
4) Use of job redesign to increase range of skill needed.
5) Healthy use of computers for skill development.
An intervention designed to improve the case practice skills
of child protective workers utilized interactive, multimedia computer-based
training to both provide information, and to encourage further
development of computer skills. This project also had extensive
input from the staff regarding the design and implementation of
software utilized by the agency.
Increasing Levels of Social Support
Key components to social support in the workplace are supervisory
support and coworker support. Possible workplace strategies:
1) Training in proactive supervision.
This supervisory approach emphasizes positive feedback, employee
growth and development, open lines of communication, and strong
levels of support.
2) Training in conflict resolution and team building.
3) Appropriate use of staff retreats.
Changes that Improve Physical Working Conditions
There is extensive evidence that poor physical working conditions
contribute not only to physical hazards, but stress levels as
well. Possible workplace strategies:
1) Improving indoor air quality.
2) Reducing levels of physical hazards such as noise, toxins, chemicals, etc.
3) Job redesign to reduce incidence of repetitive strain injuries (that is, reducing repetitive work, awkward work postures and/or heavy lifting.
Healthy Use of Technology
1) Healthy use of computers
More and more of our working time is spent in front of computers. While they can be a tremendous help in our work, they can also increase stress levels if the computer work is poorly designed. Cumulative trauma disorders can be a particular physical hazard of increased computer use.
Good ergonomics is a key to healthy computer use. State health
departments usually have someone who is an expert in this area.
They can help you with proper equipment, lighting and pace of
work issues. They can also help you reduce the risk of repetitive
strain injuries among your staff.
2) Staff involvement in choosing new equipment:
This is a common sense strategy that is often overlooked. Allowing
the end users to be able to make informed choices about the type
of equipment to be purchased. This can have payoffs for both job
satisfaction and productivity.
A large state human service agency was planning to buy new
computer work stations for its 3000 employees. This represented
a tremendous expenditure for the agency. Instead of making a unilateral
decision, they put three different work stations in one office
and left them there for two months. At the end of that time, they
asked the staff which work station they preferred, and the overwhelming
favorite turned out to be the least expensive, and was purchased
Maintaining Job Demands at Healthy Levels
Human beings can become sick if they work too long at a high
sustained pace. They are at their most productive and healthy
if they can work at a manageable level. Possible workplace strategies:
1) Reduced use of overtime
2) Caseload restrictions
3) Brake mechanism - an administrative group designed to reduce the amount of change the organization initiates.
4) Formation of "What don't we need to do?" committee - an internal group charged with finding low priority or unnecessary tasks. Job reduction is not a goal of this approach.
Changes that Provide for Job Security and Career Development
Frequently, workplace changes occur in a climate of job insecurity
or downsizing. From the perspective of occupational stress, changes
that are intended to eliminate jobs are usually incompatible with
efforts to improve the quality of the working environment. Employees
are particularly resentful of participating in changes that may
well lead to their own job loss such as time and motion studies.
More positive approaches attempt to use the skills of existing
employees in a more effective manner. Possible workplace strategies:
1) Extension of career ladders.
2) Expansion of responsibilities and tasks.
A private company in Sweden provided mechanisms for their clerical
employees to increase their skill levels, job responsibilities
and depth of specialization. Nearly half of the secretaries were
eventually promoted to higher job classifications, opening up
new career opportunities for them. This process also generated
a number of proposals for improved productivity at the company.
Changes that Provide Healthy Work Schedules
Work schedules can have positive or negative health consequences.
A number of studies have associated poorer physical and psychological
functioning with rotating shifts. On the other hand, more flexible
work schedules have the potential of improving employee satisfaction
and reducing stress. Possible workplace strategies:
1) Reduced use of forced overtime
2) Rotating shifts in a forward (day to night) schedule.
3) Use of flextime and other alternative work week schedules.
A public sector agency responsible for environmental protection
implemented an Alternative Workweek Program for some of its employees.
After the program had been in place for approximately 8 months,
participants, non-participants and managers were surveyed regarding
their satisfaction with the plan. Strong majorities in all three
groups expressed satisfaction with the program. Virtually all
participants reported that the program improved the quality of
their working life, gave them increased flexibility and control
over their schedules, improved their productivity, reduced their
stress levels, and allowed them to more easily balance work and
family responsibilities. Participants in the program also had
a significant drop in sick day use compared with non-participants.
Strategies to Improve Personal Coping Mechanisms
Individual strategies are easier to initiate but should never
be seen as an equivalent substitute for organizational change.
These strategies can, however, be very useful companions to structural
One good distinction for person change strategies is the difference
between functional and dysfunctional coping mechanisms. All human
beings have coping mechanisms. Unfortunately, these mechanisms
are not always the most effective or functional. The goal is to
replace dysfunctional coping mechanisms with functional ones.
Some healthy choices:
1) Improving the diet of employees:
Possible work place strategies: bring in a nutritionist for
a day of training, encourage employees to keep diet diaries for
a week, offer nutritional foods at the worksite, form a healthy
2) Encouraging the employees to exercise.
Possible work place strategies: start a walking club at lunch
time, look for group discounts at nearby health clubs, bring in
a fitness trainer for an in-service day, provide exercise equipment
One intervention study found that combining a health risk assessment
with behavioral counseling was effective in reducing some cardiovascular
risk factors. This program gave workers a health assessment, education
on the risk factors of cardiovascular disease and provided them
some behavioral counseling. Among other suggestions, the counseling
sessions encouraged workers to stop smoking, improve their diet
and increase their exercise level.
3) Training in deep muscle relaxation techniques.
Psychologists have known for some time that anxiety and deep
muscle relaxation are mutually exclusive. That is, you can't be
anxious and relaxed at the same time. This finding has been used
to successfully treat many phobias, but it can also be a useful
strategy for dealing with stress. The goal is to train your employees
to be able to become relaxed on demand, thereby cutting the stress
cycle short. One widely used relaxation technique was developed
by Edmund Jacobsen. It is an effective method for training individuals
how to relax their major muscle groups. There are other useful
techniques available for employees working on computers.
Possible workplace strategies: Many stress management consultants
are able to train your employees in these techniques. A good use
of an in-service training day would be to bring in a consultant
and either have them train all your employees, or intensively
train a small group who would then become your in-house trainers.
You want to be sure that you learn some "quick" relaxation
techniques. These can be performed in just a few minutes on the
4) Training in effective cognitive strategies.
There are several potentially useful techniques here. Remember
that something is not stressful unless it is perceived or appraised
as stressful. Cognitive psychologists have developed techniques
that replace negative cognitions (that is Ñ negative thoughts
like "I will never be able to figure this out", with
more positive, empowering thoughts like, "I can get this
done if I just take it one step at a time"). Another useful
strategy is called thought stopping. Since we know that negative
thoughts can increase anxiety and therefore stress symptoms, psychologists
have learned to train individuals to literally "stop"
these thoughts before they become too repetitive. These techniques
have been found to be extremely useful for people who have serious
problems with anxiety or depression. However, they can also be
effective tools in the workplace.
Some possible workplace strategies: Realistically, these techniques
require a trained professional. You should find a competent cognitive
psychologist in your area and ask him/her to come in for an in-service
day or work through an Employee Assistance Program.
5) Training in Substance Abuse Awareness.
Individuals who are under a great deal of stress begin to self-medicate
themselves in order to feel better. They may drink more, take
more prescription medication, or take illegal drugs. Every organization
has individuals who may already have serious problems in this
regard. These individuals probably need professional help. Substance
abuse awareness is best used as a preventative measure.
Possible work place strategies: there are many resources available
in the community for substance abuse awareness training. Many
human service agencies are willing to do this kind of outreach
for free, and many schools are now hiring well qualified counselors
who could be an important resource to your employees, or you can
establish your own employee assistance program.
6) Organize discussion groups on healthy stress reducers.
The idea is to get employees to share effective strategies
with each other.
Possible workplace strategies: this strategy does not need
external resources. You can simply pull together a meeting where
people share the stress reducers that work for them. You may want
to prepare a handout ahead of time that reviews examples of healthy
coping mechanisms. This will help to structure the discussion
and provide an opportunity for some additional training. An added
benefit of this approach is that it also provides a mechanism
for giving social support to employees.
7) Transition time.
Many employees leave their jobs only to return to stressful
conditions at home. They may have families to take care of, meals
to cook, or older parents to visit. Remember that it can take
a good 20 to 30 minutes for the body to return to baseline after
experiencing a stressor. If the employee walks into their door
"stressed out" and then has to deal with a difficult
situation at home, their chances of having long-term health consequences
increase. Obviously the work place isn't responsible for solving
employee's domestic problems. But it is in your interest to have
the healthiest possible workers. Transition time can be a useful
technique in short circuiting the stress response at home. The
basic idea is to train employees to find a way to relax for 20-30
minutes before assuming family responsibilities. This allows the
body's autonomic responses (heart rate, blood pressure, etc.)
to return to baseline.
8) Leaving stress at the front door - training on family dynamics
and parenting skills.
There's been a good deal of research showing that, as stress
increases, so do family problems. It is very easy for angry, frustrated
employees to take stress out on their families. Even healthy,
supportive families can go through some rough times. Parents who
had few problems with their children suddenly have major difficulties
with them in adolescence. Again, the work place is not responsible
for domestic violence. But improving your employees' abilities
to handle pressures at home can have major payoffs for your organization.
Possible workplace strategies: Many human service agencies
can provide your staff with training on family dynamics, dealing
with aging parents and parenting skills. You could also consider
forming a short term discussion group for employees who are interested
in these topics.
Developing Strategies that Do No Harm
It is surprisingly easy to initiate an intervention strategy
that results in a deterioration of the quality of working life.
One common problem is spending considerable effort in identifying
stressors on the job, and then not addressing them in a serious
way. Or designing an intervention of insufficient intensity or
duration. Or making changes that have the net effect of making
employees feel more overwhelmed and confused than before. Or implementing
changes that undermine the existing collective bargaining process.
Change for the sake of change is not a goal of stress reduction
One effective way to avoid these negative outcomes is to design
an assessment mechanism (for example, a survey, or medical record
reviews) that will accurately measure key aspects of the work
environment and stress symptoms before, during and after your
efforts. If these assessments tell you that levels of support
are increasing, that is an excellent indication that your supervisor
training program is having the desired effect. If, on the other
hand, levels of perceived control actually start to decline, you
might want to reevaluate the structure of a work organization
Important Things to Assess
Since this approach focuses on reducing occupational stress
and strain, any assessment of the process should include the following:
· Has social support (both co-workers
and supervisory) increased?
· Have job demands decreased?
· Have employees' sense of autonomy and control increased?
· Has job satisfaction increased?
· Have skill levels and use of skills increased?
· Have physical or psychological stress symptoms decreased?
A positive finding on any of these measures is an encouraging affirmation of healthy organizational change.
Organizational change that improves employee health is hard. While changing individual behavior is tough, changing organizations is even more difficult. However, it is also important to remember that the costs of stress can be extremely high. Initiating change may require a considerable effort, but allowing inertia or the illusion of change to take over may exact an even higher price.
*Adapted from UAW Region EAP program
Health care costs consume a growing part of the costs of doing business. Job stress has been estimated to cost American industry $150 billion per year in:
To get some perspective, these costs are more than 15 times that of all strikes combined. For example:
Stressed workers smoke more, eat less well, have more problems
with alcohol and drugs, have more family problems, are less motivated
on the job, have more trouble with co-workers, and have more physical
Even reducing only the most high strain jobs will translate into a healthier and more productive work force.
A well designed stress reduction program addresses all three levels. But note again, of the three, the organizational level is by far the most important.