Is stress management worth doing?

Stress Management? Does it work?

This was an article written in 2000

Much of what passes for stress management techniques at work is hardly worth doing according to a report by Rob Brimer published in Employee Health Bulletin.
Brimer asserts that there is a lack of hard evidence for a causal link between work stress and ill health, saying stress management “has become habitual, uncritical, knee jerk reaction and is not as helpful as it should be”. Very little of existing research evidence is valid or reliable and research based on self-reported is so discredited that a number of professional journals now refuse to publish it.

There is no consistency in defining what work stress actually is or how it can be measured. Many stress management initiatives are doomed to failure because they do not set out with clear objectives.

The implementation of current stress management policies is based on two questionable assumptions, Briner says. The first is that there is sound evidence for the effects of stress on employees’ health and behaviour and the second is that stress management policies actually work.
It is taken for granted that “stress” has a clear and single meaning, but the term has come to be interpreted very broadly indeed to mean a huge range of work conditions, illnesses and behaviours. According to Briner, this relaxed approach to the definition of stress has had drastic consequences.
It seems easier to define what stress is not. It isn’t a particular physical or physiological state. No particular feelings or emotions are necessarily stress, no combination of psychological symptoms define stress and no set of behaviours are stress. The word “stress” therefore many not be a particularly helpful one to use.
The association between stress and illness has never been particularly strong because other more significant factors play a role in causing illness. Neither have the effects of stress on performance or absence been shown to be particularly profound.
This confusion over what stress is and how it can be countered means that sometimes it seems as if any organisational initiative – from providing healthy food in staff restaurants, advice on smoking to on-site massage – can be repackaged as a stress management initiative.
Briner points out that the most sensible way of defining stress management interventions is that they are activities which intervene in the job inputs or outputs or the job processes themselves. Simply doing something that makes employees feel better is not in itself a stress management intervention.
Briner considered seven widely used approaches to stress management to evaluate their effectiveness. Stress management training, involving teaching personal stress management techniques and skills plus healthy lifestyle advice, he concluded, was probably not worth using in its current form.
Employee Assistance Programmes based on counselling and other kinds of support is not really a stress management intervention as such. They may have benefits to employees’ well being but these may be unrelated to work. Similarly, help with and encouragement to exercise, stop smoking, change diet or drug use are not stress management and more evidence is needed before it can be said they have a positive impact on stress at work.
Job redesign – changing job conditions which are assumed to be harmful – like high workload and low autonomy – should in principle be the most useful approach to tackling stress and it is unclear why they have not been more effective.
Stress audits, usually in the form of a questionnaire survey may not be very effective as they do not normally examine cause and effect and they use self-reporting measures of limited validity and reliability.
Risk management, which follows the model developed for physical risks and applies it to psychological hazards shows some promise but more field testing and refinement of techniques is needed.
Management standards based around job design, selection and training and supervision and management does, at least, spell out what needs to be in place to manage stress. But at the moment there is limited evidence to say what should go into the standards. One of the important ideas underlying this approach is that good stress management is simply “good management”.
Schemes like Investors in People adopt this philosophy. The Health and Safety Commission’s proposed management standards will seek to define those things an organisation should achieve or have in place to manage stress problems. They are limited however by stating what should be achieved but not saying how.
Briner calls for a systematic approach to stress management based on evidence. We should have a healthy scepticism about stress and look for specific problems and issues rather than use “stress” as a blanket term. There should be specific and focussed evidence-based solutions which ask what is likely to work, and work here, and what is the evidence? And there should be evaluation and feedback.
Briner warns, “unless we step back and take a long hard and critical look at what we are doing or failing to do, stress management interventions will remain very limited at best and simply ineffective at worst”.