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Stress damages people and it damages their organisations. It can be all-pervasive. It can affect people in all occupations and of all ages irrespective of sex, nationality, educational background or role. Work-related stress is estimated to affect at least a third of the workforce in any one year. It costs organisations billions of pounds a year in lost productivity and accounts for over half the working days lost through sickness absence. Stress has been linked to a wide variety of diseases and the European Foundation estimates that lifestyle and stress-related illness accounts for at least half of all premature deaths. Although the 'official' figures for the cost of stress vary widely, they have one common feature - they are all massive. They reflect, however imprecisely, a huge cost to individuals and to organisations. The cost isn't just financial; there is a mental, physical and social cost as well. The evidence for stress-related ill health is all around us. Look within your organisation. If you are typical of other UK businesses, it's likely that 10% of your workforce report very low levels of satisfaction with both their jobs and the organisation. Twenty per cent of your staff will report they have suffered some major life event in the past three months and approximately 3% will reportlevels of mental ill health that are worse than those of psychiatric outpatients receiving clinical treatment for anxiety and depression.
When it comes to something as potentially damaging and disruptive as workplace stress, the human and commercial costs are too vast to be approached from a position of anecdote and intuition. Occupational stress needs to be addressed in a structured and effective manner as part of an overall strategy for improving wellbeing at work.
Managers in most organisations recognise that there is some stress amongst their workforce. They may be able to tell you where they think it comes from and may even be able to articulate how they see the issue affecting their efficiency, productivity and competitive advantage. However, being aware of the existence of the problem is not enough to be able to start the process of managing it. Stress is a complex issue. The interplay of a wide range of factors from home, from work and the interface between home and work makes it difficult to separate cause from effect and, in the vast majority of cases, almost impossible to pinpoint one event or incident that 'caused' the stress problem. The variability of the stress process means that managers and researchers are trying to hit a moving target. For the individual, stress may manifest itself as a headache one day, an upset stomach or a sleepless night the next. For the manager, one of her staff may show they are suffering stress by becoming argumentative and abrasive, another may become withdrawn and timid.
It is this wide variety of symptoms and causes and the complex interrelationship between factors that makes stress at work so difficult to manage. Each of the outcomes of the stress process may have multiple causes, only a few of which may be related to workplace issues. Different people will react to the same event in many different ways with different outcomes, some of which may be beneficial whilst others are extremely damaging. It is not surprising that many organisations shy away from trying to make sense of this complex mixture of misunderstood variables and rely on counselling or stress management training to 'deal with stress'. Unfortunately, as we will discuss in more detail later, treatment on its own isn't enough. Counselling and stress management courses may help some individuals to manage their symptoms but they rarely address the factors that caused their stress and these will continue to damage the individual and the organisation. It's like taking fish out of a polluted pool, cleaning them up, and then throwing them back in. The fish will continue to suffer until the water is cleaned up. However, to ensure that the fish stay healthy, cleaning the water is not enough. The pollution has to be stopped at source. That involves finding the source and taking appropriate action. It's the same with people and their organisations; to achieve lasting benefit you have to find out what's causing workplace stress and stop it at its source. It is vitally important to treat the casualties but this must be done in the context of addressing the factors that caused them to become casualties in the first place.
Sending people for counselling who are ill or running a few stress management workshops is simple and straightforward. It doesn't threaten working practices, doesn't take too much time and doesn't raise issues that many managers would rather ignore. Unfortunately it doesn't provide a lasting solution. The answer is to identify and manage the causes of stress as well as its effects by adopting a systematic, structured approach that recognises the difficulties of addressing the root causes and offers a simple, clear process based on small steps for sustainable change.
The process starts with identifying what we know. It's very difficult, if not impossible, to completely understand all of the issues so we should accept that our knowledge of the process does not have to be perfect in order for us to make a difference. There are parallels with a wide range of physiological and medical interventions. For example, we know that there are many common risk factors - such as: smoking, drinking, diet, exercise, and hereditary factors - that contribute toward coronary heart disease but we can still only explain a small proportion of the variance in the onset of the disease. We recognise that many of the risk factors are interrelated and that each unique combination may have a different impact on the onset of illness. This is also the case with occupational stress. We can identify a variety of issues that are known to influence levels of stress and we know that these occur in different combinations for each individual. We do not know enough to be able to predict that one particular person, when exposed to these pressures, will develop a specific set of illnesses but we can say that a proportion of the people will be affected. We can go on to demonstrate that, if we remove some of these pressures, people will, on the whole, improve. The science may not be precise but it's good enough to make things better. In the real world if we have good evidence of the relationship between the causes and the outcomes and can show that removing a source of pressure leads to an improvement in wellbeing then, we don't necessarily need to know precisely how it works. In the practical, pragmatic management of workplace stress, close can be good enough.
The need to understand
In order to effectively manage the stress process we need to act on facts, not anecdote. We need to collect the evidence that will enable us to identify the key issues. We need to improve our level of understanding and we need a framework in which to operate. This requires a good working model of the stress process that can be empirically tested and used to design interventions that produce sustainable and observable improvement. The first priority for this model is that it helps people to understand that stress can be managed and that this complicated, multifaceted problem can be reduced to simpler, more manageable components.
The first task is therefore to break through the ignorance barrier and help people, both managers and staff, to realise that stress at work can be managed. It doesn't have to be endured. Stress may be endemic but it isn't inevitable.
One of the first steps in an effective strategy for managing stress is to reach a common understanding of what is meant by the term 'stress'. To cut through the confusion we need a useable working definition and a clear understanding of the words we use to talk about stress. One of the easiest initiatives an organisation can take in starting to manage stress at work is to adopt a common language for talking about it. We have found that something as simple as separating pressure - the demands or challenges facing people - from stress - the unwanted outcome of too much pressure - makes a big difference to the way people approach the problem. Focusing attention on how to reduce or remove specific sources of pressure is much easier than trying to come to grips with something as vague and as emotive as the word 'stress'.
The stress model
Experts talk about stress in a variety of ways: they mention stressors, pressures, demands, and they talk about good and bad stress, eustress (bad stress as opposed to good stress) and distress. As almost every book on stress defines the term in a different way it's not surprising that people find it hard to recognise and manage workplace stress. In order to raise awareness and help people in your organisation to manage stress you need a clear definition and a simple model that makes sense and can act as a framework on which to build appropriate interventions. Our model starts with the dynamics of the stress process and describes it in terms of inputs, outcomes and individual differences. The model is like a simple manufacturing process, say for making pottery.
The process starts with the raw materials, the inputs. In making pottery this is the clay and the water. However, each of the raw materials, the different types of clay that are used to make the pots, are not identical; they have different sizes, different qualities, and will react differently to the process. The differences in the raw materials influence the quality of the end-product. In the case of stress these differences are people's personalities and behaviours, the factors that make each of us a unique individual. The clay is fired in a kiln where the raw material is exposed to high temperatures for a long period; in our analogy, these are the pressures, the demands we place on people. When we take out the finished product we can see the outcome of the process. When we look at the finished pottery, we notice that not all the pots are the same. Although all of the raw material has been through the same process, baked at the same temperature for the same time, some pieces have become strong and kept their shape, others have cracked, distorted, or crumbled. It's like this with people - only more complicated! We put our people under pressure and expect them to react in the same way. They don't! Some thrive, some survive and some break.
To manage stress effectively we need to know why and how this happens. We also need to realise that sometimes we get it completely wrong. We raise the temperature too high, leave the clay in for too long, or miss out an essential ingredient. Then we ruin the entire batch. Sometimes we put our people under just too much pressure or we keep the pressure up for just too long and, in different ways, they all suffer. To understand why this happens and to increase the probability that we get healthy outcomes we need to understand the process and quantify the variables.
Stress therefore is an outcome. It is the end of the process, not the beginning. The start of the process, the raw material, is the people. We are all different; to quote Ralph Waldo Emerson, 'We boil at different degrees.' Life, at work and at home, puts people under pressure. Pressure is felt as the range of problems, demands or challenges that we encounter at work and in the rest of our lives.
The 4-way model of stress
Just as there are many different definitions of stress there are many different models of the stress process. In explaining the factors that need to be measured in analysing stress at work we use a simple, mechanistic model to describe the various elements of the stress process and show how these elements are interrelated. We call this the four-way model of stress (see Figure 1.1).
The model illustrates the dynamics of the stress process. It shows the sources of pressure, and how they are moderated or amplified by personality and behavioural characteristics. It also shows the counterbalancing effect of coping and support. The end box is the effect of the interaction between pressures, individual characteristics and coping in terms of positive and negative health and wellbeing outcomes. The way that the pointer moves up and down depends on the relative strength of those factors for an individual.
The better and more varied our coping mechanisms, the larger the counterbalancing force pushing the pointer toward the positive end of the scale. Good coping generates an additional benefit; as the better we cope, the more we feel in control and the higher our self-esteem. This, in turn, produces a positive feedback loop in which better coping leads to raised self-esteem, which is itself another coping skill - a virtuous circle of effective pressure management.
People experience an increase in self-confidence and self-esteem when they succeed in managing pressure. The more we do, the more we're capable of doing. When someone feels they are doing a good job, that they're valued and appreciated, they become more confident of themselves and better able to cope. Instead of the vicious circle that occurs when people can't cope we have a virtuous circle of positive self-reinforcement.
Stress is a personal response and is the negative outcome of an imbalance between pressure and the person's ability to cope with that pressure. Stress is the way I feel when it's all too much; it's the knot in the stomach, the tension in the shoulders, the inability to sleep, the problems with behaviour, and so forth. These are the physical, mental and social signs that we can no longer cope.
If we separate the factors involved in the stress process in this way then we have a model for understanding that is straightforward and makes sense to most people.
It is the differences between each of us as individuals that make managing stress so challenging. When we understand why similar levels of pressure affect different people in different ways we can start to manage pressure at the individual rather than the group level. We can take steps to make sure we know how our people will react to different pressures, who is likely to thrive and who will fall apart, and we can change the nature or the extent of the pressure for each individual to get the most out of each of them without damage. As this book will make clear, proactive stress management places more emphasis on preventing stress than on treating the symptoms. We recognise that both prevention and treatment are important and we know that treatment on its own is not enough. Pressure must be addressed at source; otherwise the same problems will keep reoccurring, and time, effort and resources will be wasted on a perpetual round of 'patching up' the casualties.
Excerpted from Managing Workplace Stress by Stephen Williams Lesley Cooper Excerpted by permission.
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About the Authors.
What is Stress?
How to Recognise Workplace Stress.
The Cost of Stress.
What Effect Does Stress Have on Performance and Productivity?
Quantifying the Stress Problem.
Gaining a Deeper Understanding - Stress Surveys.
Running a Stress Survey.
Interpreting the Information.
What Do I Do About the Issues?
Levels of Intervention.