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Article contents

Work, stress, coping, and stress management.

• Sharon Glazer Sharon Glazer University of Baltimore
•  and  Cong Liu Cong Liu Hofstra University
• https://doi.org/10.1093/acrefore/9780190236557.013.30
• Published online: 26 April 2017

Work stress refers to the process of job stressors, or stimuli in the workplace, leading to strains, or negative responses or reactions. Organizational development refers to a process in which problems or opportunities in the work environment are identified, plans are made to remediate or capitalize on the stimuli, action is taken, and subsequently the results of the plans and actions are evaluated. When organizational development strategies are used to assess work stress in the workplace, the actions employed are various stress management interventions. Two key factors tying work stress and organizational development are the role of the person and the role of the environment. In order to cope with work-related stressors and manage strains, organizations must be able to identify and differentiate between factors in the environment that are potential sources of stressors and how individuals perceive those factors. Primary stress management interventions focus on preventing stressors from even presenting, such as by clearly articulating workers’ roles and providing necessary resources for employees to perform their job. Secondary stress management interventions focus on a person’s appraisal of job stressors as a threat or challenge, and the person’s ability to cope with the stressors (presuming sufficient internal resources, such as a sense of meaningfulness in life, or external resources, such as social support from a supervisor). When coping is not successful, strains may develop. Tertiary stress management interventions attempt to remediate strains, by addressing the consequence itself (e.g., diabetes management) and/or the source of the strain (e.g., reducing workload). The person and/or the organization may be the targets of the intervention. The ultimate goal of stress management interventions is to minimize problems in the work environment, intensify aspects of the work environment that create a sense of a quality work context, enable people to cope with stressors that might arise, and provide tools for employees and organizations to manage strains that might develop despite all best efforts to create a healthy workplace.

• stress management
• organization development
• organizational interventions
• stress theories and frameworks

Introduction

Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived. Common terms often used interchangeably with work stress are occupational stress, job stress, and work-related stress. Terms used interchangeably with job stressors include work stressors, and as the specificity of the type of stressor might include psychosocial stressor (referring to the psychological experience of work demands that have a social component, e.g., conflict between two people; Hauke, Flintrop, Brun, & Rugulies, 2011 ), hindrance stressor (i.e., a stressor that prevents goal attainment; Cavanaugh, Boswell, Roehling, & Boudreau, 2000 ), and challenge stressor (i.e., a stressor that is difficult, but attainable and possibly rewarding to attain; Cavanaugh et al., 2000 ).

Stress in the workplace continues to be a highly pervasive problem, having both direct negative effects on individuals experiencing it and companies paying for it, and indirect costs vis à vis lost productivity (Dopkeen & DuBois, 2014 ). For example, U.K. public civil servants’ work-related stress rose from 10.8% in 2006 to 22.4% in 2013 and about one-third of the workforce has taken more than 20 days of leave due to stress-related ill-health, while well over 50% are present at work when ill (French, 2015 ). These findings are consistent with a report by the International Labor Organization (ILO, 2012 ), whereby 50% to 60% of all workdays are lost due to absence attributed to factors associated with work stress.

The prevalence of work-related stress is not diminishing despite improvements in technology and employment rates. The sources of stress, such as workload, seem to exacerbate with improvements in technology (Coovert & Thompson, 2003 ). Moreover, accessibility through mobile technology and virtual computer terminals is linking people to their work more than ever before (ILO, 2012 ; Tarafdar, Tu, Ragu-Nathan, & Ragu-Nathan, 2007 ). Evidence of this kind of mobility and flexibility is further reinforced in a June 2007 survey of 4,025 email users (over 13 years of age); AOL reported that four in ten survey respondents reported planning their vacations around email accessibility and 83% checked their emails at least once a day while away (McMahon, 2007 ). Ironically, despite these mounting work-related stressors and clear financial and performance outcomes, some individuals are reporting they are less “stressed,” but only because “stress has become the new normal” (Jayson, 2012 , para. 4).

This new normal is likely the source of psychological and physiological illness. Siegrist ( 2010 ) contends that conditions in the workplace, particularly psychosocial stressors that are perceived as unfavorable relationships with others and self, and an increasingly sedentary lifestyle (reinforced with desk jobs) are increasingly contributing to cardiovascular disease. These factors together justify a need to continue on the path of helping individuals recognize and cope with deleterious stressors in the work environment and, equally important, to find ways to help organizations prevent harmful stressors over which they have control, as well as implement policies or mechanisms to help employees deal with these stressors and subsequent strains. Along with a greater focus on mitigating environmental constraints are interventions that can be used to prevent anxiety, poor attitudes toward the workplace conditions and arrangements, and subsequent cardiovascular illness, absenteeism, and poor job performance (Siegrist, 2010 ).

Even the ILO has presented guidance on how the workplace can help prevent harmful job stressors (aka hindrance stressors) or at least help workers cope with them. Consistent with the view that well-being is not the absence of stressors or strains and with the view that positive psychology offers a lens for proactively preventing stressors, the ILO promotes increasing preventative risk assessments, interventions to prevent and control stressors, transparent organizational communication, worker involvement in decision-making, networks and mechanisms for workplace social support, awareness of how working and living conditions interact, safety, health, and well-being in the organization (ILO, n.d. ). The field of industrial and organizational (IO) psychology supports the ILO’s recommendations.

IO psychology views work stress as the process of a person’s interaction with multiple aspects of the work environment, job design, and work conditions in the organization. Interventions to manage work stress, therefore, focus on the psychosocial factors of the person and his or her relationships with others and the socio-technical factors related to the work environment and work processes. Viewing work stress from the lens of the person and the environment stems from Kurt Lewin’s ( 1936 ) work that stipulates a person’s state of mental health and behaviors are a function of the person within a specific environment or situation. Aspects of the work environment that affect individuals’ mental states and behaviors include organizational hierarchy, organizational climate (including processes, policies, practices, and reward structures), resources to support a person’s ability to fulfill job duties, and management structure (including leadership). Job design refers to each contributor’s tasks and responsibilities for fulfilling goals associated with the work role. Finally, working conditions refers not only to the physical environment, but also the interpersonal relationships with other contributors.

Each of the conditions that are identified in the work environment may be perceived as potentially harmful or a threat to the person or as an opportunity. When a stressor is perceived as a threat to attaining desired goals or outcomes, the stressor may be labeled as a hindrance stressor (e.g., LePine, Podsakoff, & Lepine, 2005 ). When the stressor is perceived as an opportunity to attain a desired goal or end state, it may be labeled as a challenge stressor. According to LePine and colleagues’ ( 2005 ), both challenge (e.g., time urgency, workload) and hindrance (e.g., hassles, role ambiguity, role conflict) stressors could lead to strains (as measured by “anxiety, depersonalization, depression, emotional exhaustion, frustration, health complaints, hostility, illness, physical symptoms, and tension” [p. 767]). However, challenge stressors positively relate with motivation and performance, whereas hindrance stressors negatively relate with motivation and performance. Moreover, motivation and strains partially mediate the relationship between hindrance and challenge stressors with performance.

Figure 1. Organizational development frameworks to guide identification of work stress and interventions.

In order to (1) minimize any potential negative effects from stressors, (2) increase coping skills to deal with stressors, or (3) manage strains, organizational practitioners or consultants will devise organizational interventions geared toward prevention, coping, and/or stress management. Ultimately, toxic factors in the work environment can have deleterious effects on a person’s physical and psychological well-being, as well as on an organization’s total health. It behooves management to take stock of the organization’s health, which includes the health and well-being of its employees, if the organization wishes to thrive and be profitable. According to Page and Vella-Brodrick’s ( 2009 ) model of employee well-being, employee well-being results from subjective well-being (i.e., life satisfaction and general positive or negative affect), workplace well-being (composed of job satisfaction and work-specific positive or negative affect), and psychological well-being (e.g., self-acceptance, positive social relations, mastery, purpose in life). Job stressors that become unbearable are likely to negatively affect workplace well-being and thus overall employee well-being. Because work stress is a major organizational pain point and organizations often employ organizational consultants to help identify and remediate pain points, the focus here is on organizational development (OD) frameworks; several work stress frameworks are presented that together signal areas where organizations might focus efforts for change in employee behaviors, attitudes, and performance, as well as the organization’s performance and climate. Work stress, interventions, and several OD and stress frameworks are depicted in Figure 1 .

The goals are: (1) to conceptually define and clarify terms associated with stress and stress management, particularly focusing on organizational factors that contribute to stress and stress management, and (2) to present research that informs current knowledge and practices on workplace stress management strategies. Stressors and strains will be defined, leading OD and work stress frameworks that are used to organize and help organizations make sense of the work environment and the organization’s responsibility in stress management will be explored, and stress management will be explained as an overarching thematic label; an area of study and practice that focuses on prevention (primary) interventions, coping (secondary) interventions, and managing strains (tertiary) interventions; as well as the label typically used to denote tertiary interventions. Suggestions for future research and implications toward becoming a healthy organization are presented.

Defining Stressors and Strains

Work-related stressors or job stressors can lead to different kinds of strains individuals and organizations might experience. Various types of stress management interventions, guided by OD and work stress frameworks, may be employed to prevent or cope with job stressors and manage strains that develop(ed).

A job stressor is a stimulus external to an employee and a result of an employee’s work conditions. Example job stressors include organizational constraints, workplace mistreatments (such as abusive supervision, workplace ostracism, incivility, bullying), role stressors, workload, work-family conflicts, errors or mistakes, examinations and evaluations, and lack of structure (Jex & Beehr, 1991 ; Liu, Spector, & Shi, 2007 ; Narayanan, Menon, & Spector, 1999 ). Although stressors may be categorized as hindrances and challenges, there is not yet sufficient information to be able to propose which stress management interventions would better serve to reduce those hindrance stressors or to reduce strain-producing challenge stressors while reinforcing engagement-producing challenge stressors.

Organizational Constraints

Organizational constraints may be hindrance stressors as they prevent employees from translating their motivation and ability into high-level job performance (Peters & O’Connor, 1980 ). Peters and O’Connor ( 1988 ) defined 11 categories of organizational constraints: (1) job-related information, (2) budgetary support, (3) required support, (4) materials and supplies, (5) required services and help from others, (6) task preparation, (7) time availability, (8) the work environment, (9) scheduling of activities, (10) transportation, and (11) job-relevant authority. The inhibiting effect of organizational constraints may be due to the lack of, inadequacy of, or poor quality of these categories.

Workplace Mistreatment

Workplace mistreatment presents a cluster of interpersonal variables, such as interpersonal conflict, bullying, incivility, and workplace ostracism (Hershcovis, 2011 ; Tepper & Henle, 2011 ). Typical workplace mistreatment behaviors include gossiping, rude comments, showing favoritism, yelling, lying, and ignoring other people at work (Tepper & Henle, 2011 ). These variables relate to employees’ psychological well-being, physical well-being, work attitudes (e.g., job satisfaction and organizational commitment), and turnover intention (e.g., Hershcovis, 2011 ; Spector & Jex, 1998 ). Some researchers differentiated the source of mistreatment, such as mistreatment from one’s supervisor versus mistreatment from one’s coworker (e.g., Bruk-Lee & Spector, 2006 ; Frone, 2000 ; Liu, Liu, Spector, & Shi, 2011 ).

Role Stressors

Role stressors are demands, constraints, or opportunities a person perceives to be associated, and thus expected, with his or her work role(s) across various situations. Three commonly studied role stressors are role ambiguity, role conflict, and role overload (Glazer & Beehr, 2005 ; Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ). Role ambiguity in the workplace occurs when an employee lacks clarity regarding what performance-related behaviors are expected of him or her. Role conflict refers to situations wherein an employee receives incompatible role requests from the same or different supervisors or the employee is asked to engage in work that impedes his or her performance in other work or nonwork roles or clashes with his or her values. Role overload refers to excessive demands and insufficient time (quantitative) or knowledge (qualitative) to complete the work. The construct is often used interchangeably with workload, though role overload focuses more on perceived expectations from others about one’s workload. These role stressors significantly relate to low job satisfaction, low organizational commitment, low job performance, high tension or anxiety, and high turnover intention (Abramis, 1994 ; Glazer & Beehr, 2005 ; Jackson & Schuler, 1985 ).

Excessive workload is one of the most salient stressors at work (e.g., Liu et al., 2007 ). There are two types of workload: quantitative and qualitative workload (LaRocco, Tetrick, & Meder, 1989 ; Parasuraman & Purohit, 2000 ). Quantitative workload refers to the excessive amount of work one has. In a summary of a Chartered Institute of Personnel & Development Report from 2006 , Dewe and Kompier ( 2008 ) noted that quantitative workload was one of the top three stressors workers experienced at work. Qualitative workload refers to the difficulty of work. Workload also differs by the type of the load. There are mental workload and physical workload (Dwyer & Ganster, 1991 ). Excessive physical workload may result in physical discomfort or illness. Excessive mental workload will cause psychological distress such as anxiety or frustration (Bowling & Kirkendall, 2012 ). Another factor affecting quantitative workload is interruptions (during the workday). Lin, Kain, and Fritz ( 2013 ) found that interruptions delay completion of job tasks, thus adding to the perception of workload.

Work-Family Conflict

Work-family conflict is a form of inter-role conflict in which demands from one’s work domain and one’s family domain are incompatible to some extent (Greenhaus & Beutell, 1985 ). Work can interfere with family (WIF) and/or family can interfere with work (FIW) due to time-related commitments to participating in one domain or another, incompatible behavioral expectations, or when strains in one domain carry over to the other (Greenhaus & Beutell, 1985 ). Work-family conflict significantly relates to work-related outcomes (e.g., job satisfaction, organizational commitment, turnover intention, burnout, absenteeism, job performance, job strains, career satisfaction, and organizational citizenship behaviors), family-related outcomes (e.g., marital satisfaction, family satisfaction, family-related performance, family-related strains), and domain-unspecific outcomes (e.g., life satisfaction, psychological strain, somatic or physical symptoms, depression, substance use or abuse, and anxiety; Amstad, Meier, Fasel, Elfering, & Semmer, 2011 ).

Individuals and organizations can experience work-related strains. Sometimes organizations will experience strains through the employee’s negative attitudes or strains, such as that a worker’s absence might yield lower production rates, which would roll up into an organizational metric of organizational performance. In the industrial and organizational (IO) psychology literature, organizational strains are mostly observed as macro-level indicators, such as health insurance costs, accident-free days, and pervasive problems with company morale. In contrast, individual strains, usually referred to as job strains, are internal to an employee. They are responses to work conditions and relate to health and well-being of employees. In other words, “job strains are adverse reactions employees have to job stressors” (Spector, Chen, & O’Connell, 2000 , p. 211). Job strains tend to fall into three categories: behavioral, physical, and psychological (Jex & Beehr, 1991 ).

Behavioral strains consist of actions that employees take in response to job stressors. Examples of behavioral strains include employees drinking alcohol in the workplace or intentionally calling in sick when they are not ill (Spector et al., 2000 ). Physical strains consist of health symptoms that are physiological in nature that employees contract in response to job stressors. Headaches and ulcers are examples of physical strains. Lastly, psychological strains are emotional reactions and attitudes that employees have in response to job stressors. Examples of psychological strains are job dissatisfaction, anxiety, and frustration (Spector et al., 2000 ). Interestingly, research studies that utilize self-report measures find that most job strains experienced by employees tend to be psychological strains (Spector et al., 2000 ).

Leading Frameworks

Organizations that are keen on identifying organizational pain points and remedying them through organizational campaigns or initiatives often discover the pain points are rooted in work-related stressors and strains and the initiatives have to focus on reducing workers’ stress and increasing a company’s profitability. Through organizational climate surveys, for example, companies discover that aspects of the organization’s environment, including its policies, practices, reward structures, procedures, and processes, as well as employees at all levels of the company, are contributing to the individual and organizational stress. Recent studies have even begun to examine team climates for eustress and distress assessed in terms of team members’ homogenous psychological experience of vigor, efficacy, dedication, and cynicism (e.g., Kożusznik, Rodriguez, & Peiro, 2015 ).

Each of the frameworks presented advances different aspects that need to be identified in order to understand the source and potential remedy for stressors and strains. In some models, the focus is on resources, in others on the interaction of the person and environment, and in still others on the role of the person in the workplace. Few frameworks directly examine the role of the organization, but the organization could use these frameworks to plan interventions that would minimize stressors, cope with existing stressors, and prevent and/or manage strains. One of the leading frameworks in work stress research that is used to guide organizational interventions is the person and environment (P-E) fit (French & Caplan, 1972 ). Its precursor is the University of Michigan Institute for Social Research’s (ISR) role stress model (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ) and Lewin’s Field Theory. Several other theories have since evolved from the P-E fit framework, including Karasek and Theorell’s ( 1990 ), Karasek ( 1979 ) Job Demands-Control Model (JD-C), the transactional framework (Lazarus & Folkman, 1984 ), Conservation of Resources (COR) theory (Hobfoll, 1989 ), and Siegrist’s ( 1996 ) Effort-Reward Imbalance (ERI) Model.

Field Theory

The premise of Kahn et al.’s ( 1964 ) role stress theory is Lewin’s ( 1997 ) Field Theory. Lewin purported that behavior and mental events are a dynamic function of the whole person, including a person’s beliefs, values, abilities, needs, thoughts, and feelings, within a given situation (field or environment), as well as the way a person represents his or her understanding of the field and behaves in that space. Lewin explains that work-related strains are a result of individuals’ subjective perceptions of objective factors, such as work roles, relationships with others in the workplace, as well as personality indicators, and can be used to predict people’s reactions, including illness. Thus, to make changes to an organizational system, it is necessary to understand a field and try to move that field from the current state to the desired state. Making this move necessitates identifying mechanisms influencing individuals.

Role Stress Theory

Role stress theory mostly isolates the perspective a person has about his or her work-related responsibilities and expectations to determine how those perceptions relate with a person’s work-related strains. However, those relationships have been met with somewhat varied results, which Glazer and Beehr ( 2005 ) concluded might be a function of differences in culture, an environmental factor often neglected in research. Kahn et al.’s ( 1964 ) role stress theory, coupled with Lewin’s ( 1936 ) Field Theory, serves as the foundation for the P-E fit theory. Lewin ( 1936 ) wrote, “Every psychological event depends upon the state of the person and at the same time on the environment” (p. 12). Researchers of IO psychology have narrowed the environment to the organization or work team. This narrowed view of the organizational environment is evident in French and Caplan’s ( 1972 ) P-E fit framework.

Person-Environment Fit Theory

The P-E fit framework focuses on the extent to which there is congruence between the person and a given environment, such as the organization (Caplan, 1987 ; Edwards, 2008 ). For example, does the person have the necessary skills and abilities to fulfill an organization’s demands, or does the environment support a person’s desire for autonomy (i.e., do the values align?) or fulfill a person’s needs (i.e., a person’s needs are rewarded). Theoretically and empirically, the greater the person-organization fit, the greater a person’s job satisfaction and organizational commitment, the less a person’s turnover intention and work-related stress (see meta-analyses by Assouline & Meir, 1987 ; Kristof-Brown, Zimmerman, & Johnson, 2005 ; Verquer, Beehr, & Wagner, 2003 ).

Job Demands-Control/Support (JD-C/S) and Job Demands-Resources (JD-R) Model

Focusing more closely on concrete aspects of work demands and the extent to which a person perceives he or she has control or decision latitude over those demands, Karasek ( 1979 ) developed the JD-C model. Karasek and Theorell ( 1990 ) posited that high job demands under conditions of little decision latitude or control yield high strains, which have varied implications on the health of an organization (e.g., in terms of high turnover, employee ill-health, poor organizational performance). This theory was modified slightly to address not only control, but also other resources that could protect a person from unruly job demands, including support (aka JD-C/S, Johnson & Hall, 1988 ; and JD-R, Bakker, van Veldhoven, & Xanthopoulou, 2010 ). Whether focusing on control or resources, both they and job demands are said to reflect workplace characteristics, while control and resources also represent coping strategies or tools (Siegrist, 2010 ).

Despite the glut of research testing the JD-C and JD-R, results are somewhat mixed. Testing the interaction between job demands and control, Beehr, Glaser, Canali, and Wallwey ( 2001 ) did not find empirical support for the JD-C theory. However, Dawson, O’Brien, and Beehr ( 2016 ) found that high control and high support buffered against the independent deleterious effects of interpersonal conflict, role conflict, and organizational politics (demands that were categorized as hindrance stressors) on anxiety, as well as the effects of interpersonal conflict and organizational politics on physiological symptoms, but control and support did not moderate the effects between challenge stressors and strains. Coupled with Bakker, Demerouti, and Sanz-Vergel’s ( 2014 ) note that excessive job demands are a source of strain, but increased job resources are a source of engagement, Dawson et al.’s results suggest that when an organization identifies that demands are hindrances, it can create strategies for primary (preventative) stress management interventions and attempt to remove or reduce such work demands. If the demands are challenging, though manageable, but latitude to control the challenging stressors and support are insufficient, the organization could modify practices and train employees on adopting better strategies for meeting or coping (secondary stress management intervention) with the demands. Finally, if the organization can neither afford to modify the demands or the level of control and support, it will be necessary for the organization to develop stress management (tertiary) interventions to deal with the inevitable strains.

Conservation of Resources Theory

The idea that job resources reinforce engagement in work has been propagated in Hobfoll’s ( 1989 ) Conservation of Resources (COR) theory. COR theory also draws on the foundational premise that people’s mental health is a function of the person and the environment, forwarding that how people interpret their environment (including the societal context) affects their stress levels. Hobfoll focuses on resources such as objects, personal characteristics, conditions, or energies as particularly instrumental to minimizing strains. He asserts that people do whatever they can to protect their valued resources. Thus, strains develop when resources are threatened to be taken away, actually taken away, or when additional resources are not attainable after investing in the possibility of gaining more resources (Hobfoll, 2001 ). By extension, organizations can invest in activities that would minimize resource loss and create opportunities for resource gains and thus have direct implications for devising primary and secondary stress management interventions.

Transactional Framework

Lazarus and Folkman ( 1984 ) developed the widely studied transactional framework of stress. This framework holds as a key component the cognitive appraisal process. When individuals perceive factors in the work environment as a threat (i.e., primary appraisal), they will scan the available resources (external or internal to himself or herself) to cope with the stressors (i.e., secondary appraisal). If the coping resources provide minimal relief, strains develop. Until recently, little attention has been given to the cognitive appraisal associated with different work stressors (Dewe & Kompier, 2008 ; Liu & Li, 2017 ). In a study of Polish and Spanish social care service providers, stressors appraised as a threat related positively to burnout and less engagement, but stressors perceived as challenges yielded greater engagement and less burnout (Kożusznik, Rodriguez, & Peiro, 2012 ). Similarly, Dawson et al. ( 2016 ) found that even with support and control resources, hindrance demands were more strain-producing than challenge demands, suggesting that appraisal of the stressor is important. In fact, “many people respond well to challenging work” (Beehr et al., 2001 , p. 126). Kożusznik et al. ( 2012 ) recommend training employees to change the way they view work demands in order to increase engagement, considering that part of the problem may be about how the person appraises his or her environment and, thus, copes with the stressors.

Effort-Reward Imbalance

Siegrist’s ( 1996 ) Model of Effort-Reward Imbalance (ERI) focuses on the notion of social reciprocity, such that a person fulfills required work tasks in exchange for desired rewards (Siegrist, 2010 ). ERI sheds light on how an imbalance in a person’s expectations of an organization’s rewards (e.g., pay, bonus, sense of advancement and development, job security) in exchange for a person’s efforts, that is a break in one’s work contract, leads to negative responses, including long-term ill-health (Siegrist, 2010 ; Siegrist et al., 2014 ). In fact, prolonged perception of a work contract imbalance leads to adverse health, including immunological problems and inflammation, which contribute to cardiovascular disease (Siegrist, 2010 ). The model resembles the relational and interactional psychological contract theory in that it describes an employee’s perception of the terms of the relationship between the person and the workplace, including expectations of performance, job security, training and development opportunities, career progression, salary, and bonuses (Thomas, Au, & Ravlin, 2003 ). The psychological contract, like the ERI model, focuses on social exchange. Furthermore, the psychological contract, like stress theories, are influenced by cultural factors that shape how people interpret their environments (Glazer, 2008 ; Thomas et al., 2003 ). Violations of the psychological contract will negatively affect a person’s attitudes toward the workplace and subsequent health and well-being (Siegrist, 2010 ). To remediate strain, Siegrist ( 2010 ) focuses on both the person and the environment, recognizing that the organization is particularly responsible for changing unfavorable work conditions and the person is responsible for modifying his or her reactions to such conditions.

Stress Management Interventions: Primary, Secondary, and Tertiary

Remediation of work stress and organizational development interventions are about realigning the employee’s experiences in the workplace with factors in the environment, as well as closing the gap between the current environment and the desired environment. Work stress develops when an employee perceives the work demands to exceed the person’s resources to cope and thus threatens employee well-being (Dewe & Kompier, 2008 ). Likewise, an organization’s need to change arises when forces in the environment are creating a need to change in order to survive (see Figure 1 ). Lewin’s ( 1951 ) Force Field Analysis, the foundations of which are in Field Theory, is one of the first organizational development intervention tools presented in the social science literature. The concept behind Force Field Analysis is that in order to survive, organizations must adapt to environmental forces driving a need for organizational change and remove restraining forces that create obstacles to organizational change. In order to do this, management needs to delineate the current field in which the organization is functioning, understand the driving forces for change, identify and dampen or eliminate the restraining forces against change. Several models for analyses may be applied, but most approaches are variations of organizational climate surveys.

Through organizational surveys, workers provide management with a snapshot view of how they perceive aspects of their work environment. Thus, the view of the health of an organization is a function of several factors, chief among them employees’ views (i.e., the climate) about the workplace (Lewin, 1951 ). Indeed, French and Kahn ( 1962 ) posited that well-being depends on the extent to which properties of the person and properties of the environment align in terms of what a person requires and the resources available in a given environment. Therefore, only when properties of the person and properties of the environment are sufficiently understood can plans for change be developed and implemented targeting the environment (e.g., change reporting structures to relieve, and thus prevent future, communication stressors) and/or the person (e.g., providing more autonomy, vacation days, training on new technology). In short, climate survey findings can guide consultants about the emphasis for organizational interventions: before a problem arises aka stress prevention, e.g., carefully crafting job roles), when a problem is present, but steps are taken to mitigate their consequences (aka coping, e.g., providing social support groups), and/or once strains develop (aka. stress management, e.g., healthcare management policies).

For each of the primary (prevention), secondary (coping), and tertiary (stress management) techniques the target for intervention can be the entire workforce, a subset of the workforce, or a specific person. Interventions that target the entire workforce may be considered organizational interventions, as they have direct implications on the health of all individuals and consequently the health of the organization. Several interventions categorized as primary and secondary interventions may also be implemented after strains have developed and after it has been discerned that a person or the organization did not do enough to mitigate stressors or strains (see Figure 1 ). The designation of many of the interventions as belonging to one category or another may be viewed as merely a suggestion.

Primary Interventions (Preventative Stress Management)

Before individuals begin to perceive work-related stressors, organizations engage in stress prevention strategies, such as providing people with resources (e.g., computers, printers, desk space, information about the job role, organizational reporting structures) to do their jobs. However, sometimes the institutional structures and resources are insufficient or ambiguous. Scholars and practitioners have identified several preventative stress management strategies that may be implemented.

Planning and Time Management

When employees feel quantitatively overloaded, sometimes the remedy is improving the employees’ abilities to plan and manage their time (Quick, Quick, Nelson, & Hurrell, 2003 ). Planning is a future-oriented activity that focuses on conceptual and comprehensive work goals. Time management is a behavior that focuses on organizing, prioritizing, and scheduling work activities to achieve short-term goals. Given the purpose of time management, it is considered a primary intervention, as engaging in time management helps to prevent work tasks from mounting and becoming unmanageable, which would subsequently lead to adverse outcomes. Time management comprises three fundamental components: (1) establishing goals, (2) identifying and prioritizing tasks to fulfill the goals, and (3) scheduling and monitoring progress toward goal achievement (Peeters & Rutte, 2005 ). Workers who employ time management have less role ambiguity (Macan, Shahani, Dipboye, & Philips, 1990 ), psychological stress or strain (Adams & Jex, 1999 ; Jex & Elaqua, 1999 ; Macan et al., 1990 ), and greater job satisfaction (Macan, 1994 ). However, Macan ( 1994 ) did not find a relationship between time management and performance. Still, Claessens, van Eerde, Rutte, and Roe ( 2004 ) found that perceived control of time partially mediated the relationships between planning behavior (an indicator of time management), job autonomy, and workload on one hand, and job strains, job satisfaction, and job performance on the other hand. Moreover, Peeters and Rutte ( 2005 ) observed that teachers with high work demands and low autonomy experienced more burnout when they had poor time management skills.

Person-Organization Fit

Just as it is important for organizations to find the right person for the job and organization, so is it the responsibility of a person to choose to work at the right organization—an organization that fulfills the person’s needs and upholds the values important to the individual, as much as the person fulfills the organization’s needs and adapts to its values. When people fit their employing organizations they are setting themselves up for experiencing less strain-producing stressors (Kristof-Brown et al., 2005 ). In a meta-analysis of 62 person-job fit studies and 110 person-organization fit studies, Kristof-Brown et al. ( 2005 ) found that person-job fit had a negative correlation with indicators of job strain. In fact, a primary intervention of career counseling can help to reduce stress levels (Firth-Cozens, 2003 ).

Job Redesign

The Job Demands-Control/Support (JD-C/S), Job Demands-Resources (JD-R), and transactional models all suggest that factors in the work context require modifications in order to reduce potential ill-health and poor organizational performance. Drawing on Hackman and Oldham’s ( 1980 ) Job Characteristics Model, it is possible to assess with the Job Diagnostics Survey (JDS) the current state of work characteristics related to skill variety, task identity, task significance, autonomy, and feedback. Modifying those aspects would help create a sense of meaningfulness, sense of responsibility, and feeling of knowing how one is performing, which subsequently affects a person’s well-being as identified in assessments of motivation, satisfaction, improved performance, and reduced withdrawal intentions and behaviors. Extending this argument to the stress models, it can be deduced that reducing uncertainty or perceived unfairness that may be associated with a person’s perception of these work characteristics, as well as making changes to physical characteristics of the environment (e.g., lighting, seating, desk, air quality), nature of work (e.g., job responsibilities, roles, decision-making latitude), and organizational arrangements (e.g., reporting structure and feedback mechanisms), can help mitigate against numerous ill-health consequences and reduced organizational performance. In fact, Fried et al. ( 2013 ) showed that healthy patients of a medical clinic whose jobs were excessively low (i.e., monotonous) or excessively high (i.e., overstimulating) on job enrichment (as measured by the JDS) had greater abdominal obesity than those whose jobs were optimally enriched. By taking stock of employees’ perceptions of the current work situation, managers might think about ways to enhance employees’ coping toolkit, such as training on how to deal with difficult clients or creating stimulating opportunities when jobs have low levels of enrichment.

Participatory Action Research Interventions

Participatory action research (PAR) is an intervention wherein, through group discussions, employees help to identify and define problems in organizational structure, processes, policies, practices, and reward structures, as well as help to design, implement, and evaluate success of solutions. PAR is in itself an intervention, but its goal is to design interventions to eliminate or reduce work-related factors that are impeding performance and causing people to be unwell. An example of a successful primary intervention, utilizing principles of PAR and driven by the JD-C and JD-C/S stress frameworks is Health Circles (HCs; Aust & Ducki, 2004 ).

HCs, developed in Germany in the 1980s, were popular practices in industries, such as metal, steel, and chemical, and service. Similar to other problem-solving practices, such as quality circles, HCs were based on the assumptions that employees are the experts of their jobs. For this reason, to promote employee well-being, management and administrators solicited suggestions and ideas from the employees to improve occupational health, thereby increasing employees’ job control. HCs also promoted communication between managers and employees, which had a potential to increase social support. With more control and support, employees would experience less strains and better occupational well-being.

Employing the three-steps of (1) problem analysis (i.e., diagnosis or discovery through data generated from organizational records of absenteeism length, frequency, rate, and reason and employee survey), (2) HC meetings (6 to 10 meetings held over several months to brainstorm ideas to improve occupational safety and health concerns identified in the discovery phase), and (3) HC evaluation (to determine if desired changes were accomplished and if employees’ reports of stressors and strains changed after the course of 15 months), improvements were to be expected (Aust & Ducki, 2004 ). Aust and Ducki ( 2004 ) reviewed 11 studies presenting 81 health circles in 30 different organizations. Overall study participants had high satisfaction with the HCs practices. Most companies acted upon employees’ suggestions (e.g., improving driver’s seat and cab, reducing ticket sale during drive, team restructuring and job rotation to facilitate communication, hiring more employees during summer time, and supervisor training program to improve leadership and communication skills) to improve work conditions. Thus, HCs represent a successful theory-grounded intervention to routinely improve employees’ occupational health.

Physical Setting

The physical environment or physical workspace has an enormous impact on individuals’ well-being, attitudes, and interactions with others, as well as on the implications on innovation and well-being (Oksanen & Ståhle, 2013 ; Vischer, 2007 ). In a study of 74 new product development teams (total of 437 study respondents) in Western Europe, Chong, van Eerde, Rutte, and Chai ( 2012 ) found that when teams were faced with challenge time pressures, meaning the teams had a strong interest and desire in tackling complex, but engaging tasks, when they were working proximally close with one another, team communication improved. Chong et al. assert that their finding aligns with prior studies that have shown that physical proximity promotes increased awareness of other team members, greater tendency to initiate conversations, and greater team identification. However, they also found that when faced with hindrance time pressures, physical proximity related to low levels of team communication, but when hindrance time pressure was low, team proximity had an increasingly greater positive relationship with team communication.

In addition to considering the type of work demand teams must address, other physical workspace considerations include whether people need to work collaboratively and synchronously or independently and remotely (or a combination thereof). Consideration needs to be given to how company contributors would satisfy client needs through various modes of communication, such as email vs. telephone, and whether individuals who work by a window might need shading to block bright sunlight from glaring on their computer screens. Finally, people who have to use the telephone for extensive periods of time would benefit from earphones to prevent neck strains. Most physical stressors are rather simple to rectify. However, companies are often not aware of a problem until after a problem arises, such as when a person’s back is strained from trying to move heavy equipment. Companies then implement strategies to remediate the environmental stressor. With the help of human factors, and organizational and office design consultants, many of the physical barriers to optimal performance can be prevented (Rousseau & Aubé, 2010 ). In a study of 215 French-speaking Canadian healthcare employees, Rousseau and Aubé ( 2010 ) found that although supervisor instrumental support positively related with affective commitment to the organization, the relationship was even stronger for those who reported satisfaction with the ambient environment (i.e., temperature, lighting, sound, ventilation, and cleanliness).

Secondary Interventions (Coping)

Secondary interventions, also referred to as coping, focus on resources people can use to mitigate the risk of work-related illness or workplace injury. Resources may include properties related to social resources, behaviors, and cognitive structures. Each of these resource domains may be employed to cope with stressors. Monat and Lazarus ( 1991 ) summarize the definition of coping as “an individual’s efforts to master demands (or conditions of harm, threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources” (p. 5). To master demands requires use of the aforementioned resources. Secondary interventions help employees become aware of the psychological, physical, and behavioral responses that may occur from the stressors presented in their working environment. Secondary interventions help a person detect and attend to stressors and identify resources for and ways of mitigating job strains. Often, coping strategies are learned skills that have a cognitive foundation and serve important functions in improving people’s management of stressors (Lazarus & Folkman, 1991 ). Coping is effortful, but with practice it becomes easier to employ. This idea is the foundation for understanding the role of resilience in coping with stressors. However, “not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in relating to the environment” (Lazarus & Folkman, 1991 , p. 198). Furthermore, sometimes to cope with a stressor, a person may call upon social support sources to help with tangible materials or emotional comfort. People call upon support resources because they help to restructure how a person approaches or thinks about the stressor.

Most secondary interventions are aimed at helping the individual, though companies, as a policy, might require all employees to partake in training aimed at increasing employees’ awareness of and skills aimed at handling difficult situations vis à vis company channels (e.g., reporting on sexual harassment or discrimination). Furthermore, organizations might institute mentoring programs or work groups to address various work-related matters. These programs employ awareness-raising activities, stress-education, or skills training (cf., Bhagat, Segovis, & Nelson, 2012 ), which include development of skills in problem-solving, understanding emotion-focused coping, identifying and using social support, and enhancing capacity for resilience. The aim of these programs, therefore, is to help employees proactively review their perceptions of psychological, physical, and behavioral job-related strains, thereby extending their resilience, enabling them to form a personal plan to control stressors and practice coping skills (Cooper, Dewe, & O’Driscoll, 2011 ).

Often these stress management programs are instituted after an organization has observed excessive absenteeism and work-related performance problems and, therefore, are sometimes categorized as a tertiary stress management intervention or even a primary (prevention) intervention. However, the skills developed for coping with stressors also place the programs in secondary stress management interventions. Example programs that are categorized as tertiary or primary stress management interventions may also be secondary stress management interventions (see Figure 1 ), and these include lifestyle advice and planning, stress inoculation training, simple relaxation techniques, meditation, basic trainings in time management, anger management, problem-solving skills, and cognitive-behavioral therapy. Corporate wellness programs also fall under this category. In other words, some programs could be categorized as primary, secondary, or tertiary interventions depending upon when the employee (or organization) identifies the need to implement the program. For example, time management practices could be implemented as a means of preventing some stressors, as a way to cope with mounting stressors, or as a strategy to mitigate symptoms of excessive of stressors. Furthermore, these programs can be administered at the individual level or group level. As related to secondary interventions, these programs provide participants with opportunities to develop and practice skills to cognitively reappraise the stressor(s); to modify their perspectives about stressors; to take time out to breathe, stretch, meditate, relax, and/or exercise in an attempt to support better decision-making; to articulate concerns and call upon support resources; and to know how to say “no” to onslaughts of requests to complete tasks. Participants also learn how to proactively identify coping resources and solve problems.

According to Cooper, Dewe, and O’Driscoll ( 2001 ), secondary interventions are successful in helping employees modify or strengthen their ability to cope with the experience of stressors with the goal of mitigating the potential harm the job stressors may create. Secondary interventions focus on individuals’ transactions with the work environment and emphasize the fit between a person and his or her environment. However, researchers have pointed out that the underlying assumption of secondary interventions is that the responsibility for coping with the stressors of the environment lies within individuals (Quillian-Wolever & Wolever, 2003 ). If companies cannot prevent the stressors in the first place, then they are, in part, responsible for helping individuals develop coping strategies and informing employees about programs that would help them better cope with job stressors so that they are able to fulfill work assignments.

Stress management interventions that help people learn to cope with stressors focus mainly on the goals of enabling problem-resolution or expressing one’s emotions in a healthy manner. These goals are referred to as problem-focused coping and emotion-focused coping (Folkman & Lazarus, 1980 ; Pearlin & Schooler, 1978 ), and the person experiencing the stressors as potential threat is the agent for change and the recipient of the benefits of successful coping (Hobfoll, 1998 ). In addition to problem-focused and emotion-focused coping approaches, social support and resilience may be coping resources. There are many other sources for coping than there is room to present here (see e.g., Cartwright & Cooper, 2005 ); however, the current literature has primarily focused on these resources.

Problem-Focused Coping

Problem-focused or direct coping helps employees remove or reduce stressors in order to reduce their strain experiences (Bhagat et al., 2012 ). In problem-focused coping employees are responsible for working out a strategic plan in order to remove job stressors, such as setting up a set of goals and engaging in behaviors to meet these goals. Problem-focused coping is viewed as an adaptive response, though it can also be maladaptive if it creates more problems down the road, such as procrastinating getting work done or feigning illness to take time off from work. Adaptive problem-focused coping negatively relates to long-term job strains (Higgins & Endler, 1995 ). Discussion on problem-solving coping is framed from an adaptive perspective.

Problem-focused coping is featured as an extension of control, because engaging in problem-focused coping strategies requires a series of acts to keep job stressors under control (Bhagat et al., 2012 ). In the stress literature, there are generally two ways to categorize control: internal versus external locus of control, and primary versus secondary control. Locus of control refers to the extent to which people believe they have control over their own life (Rotter, 1966 ). People high in internal locus of control believe that they can control their own fate whereas people high in external locus of control believe that outside factors determine their life experience (Rotter, 1966 ). Generally, those with an external locus of control are less inclined to engage in problem-focused coping (Strentz & Auerbach, 1988 ). Primary control is the belief that people can directly influence their environment (Alloy & Abramson, 1979 ), and thus they are more likely to engage in problem-focused coping. However, when it is not feasible to exercise primary control, people search for secondary control, with which people try to adapt themselves into the objective environment (Rothbaum, Weisz, & Snyder, 1982 ).

Emotion-Focused Coping

Emotion-focused coping, sometimes referred to as palliative coping, helps employees reduce strains without the removal of job stressors. It involves cognitive or emotional efforts, such as talking about the stressor or distracting oneself from the stressor, in order to lessen emotional distress resulting from job stressors (Bhagat et al., 2012 ). Emotion-focused coping aims to reappraise and modify the perceptions of a situation or seek emotional support from friends or family. These methods do not include efforts to change the work situation or to remove the job stressors (Lazarus & Folkman, 1991 ). People tend to adopt emotion-focused coping strategies when they believe that little or nothing can be done to remove the threatening, harmful, and challenging stressors (Bhagat et al., 2012 ), such as when they are the only individuals to have the skills to get a project done or they are given increased responsibilities because of the unexpected departure of a colleague. Emotion-focused coping strategies include (1) reappraisal of the stressful situation, (2) talking to friends and receiving reassurance from them, (3) focusing on one’s strength rather than weakness, (4) optimistic comparison—comparing one’s situation to others’ or one’s past situation, (5) selective ignoring—paying less attention to the unpleasant aspects of one’s job and being more focused on the positive aspects of the job, (6) restrictive expectations—restricting one’s expectations on job satisfaction but paying more attention to monetary rewards, (7) avoidance coping—not thinking about the problem, leaving the situation, distracting oneself, or using alcohol or drugs (e.g., Billings & Moos, 1981 ).

Some emotion-focused coping strategies are maladaptive. For example, avoidance coping may lead to increased level of job strains in the long run (e.g., Parasuraman & Cleek, 1984 ). Furthermore, a person’s ability to cope with the imbalance of performing work to meet organizational expectations can take a toll on the person’s health, leading to physiological consequences such as cardiovascular disease, sleep disorders, gastrointestinal disorders, and diabetes (Fried et al., 2013 ; Siegrist, 2010 ; Toker, Shirom, Melamed, & Armon, 2012 ; Willert, Thulstrup, Hertz, & Bonde, 2010 ).

Comparing Coping Strategies across Cultures

Most coping research is conducted in individualistic, Western cultures wherein emotional control is emphasized and both problem-solving focused coping and primary control are preferred (Bhagat et al., 2010 ). However, in collectivistic cultures, emotion-focused coping and use of secondary control may be preferred and may not necessarily carry a negative evaluation (Bhagat et al., 2010 ). For example, African Americans are more likely to use emotion-focused coping than non–African Americans (Knight, Silverstein, McCallum, & Fox, 2000 ), and among women who experienced sexual harassment, Anglo American women were less likely to employ emotion focused coping (i.e., avoidance coping) than Turkish women and Hispanic American women, while Hispanic women used more denial than the other two groups (Wasti & Cortina, 2002 ).

Thus, whereas problem-focused coping is venerated in Western societies, emotion-focused coping may be more effective in reducing strains in collectivistic cultures, such as China, Japan, and India (Bhagat et al., 2010 ; Narayanan, Menon, & Spector, 1999 ; Selmer, 2002 ). Indeed, Swedish participants reported more problem-focused coping than did Chinese participants (Xiao, Ottosson, & Carlsson, 2013 ), American college students engaged in more problem-focused coping behaviors than did their Japanese counterparts (Ogawa, 2009 ), and Indian (vs. Canadian) students reported more emotion-focused coping, such as seeking social support and positive reappraisal (Sinha, Willson, & Watson, 2000 ). Moreover, Glazer, Stetz, and Izso ( 2004 ) found that internal locus of control was more predominant in individualistic cultures (United Kingdom and United States), whereas external locus of control was more predominant in communal cultures (Italy and Hungary). Also, internal locus of control was associated with less job stress, but more so for nurses in the United Kingdom and United States than Italy and Hungary. Taken together, adoption of coping strategies and their effectiveness differ significantly across cultures. The extent to which a coping strategy is perceived favorably and thus selected or not selected is not only a function of culture, but also a person’s sociocultural beliefs toward the coping strategy (Morimoto, Shimada, & Ozaki, 2013 ).

Social Support

Social support refers to the aid an entity gives to a person. The source of the support can be a single person, such as a supervisor, coworker, subordinate, family member, friend, or stranger, or an organization as represented by upper-level management representing organizational practices. The type of support can be instrumental or emotional. Instrumental support, including informational support, refers to that which is tangible, such as data to help someone make a decision or colleagues’ sick days so one does not lose vital pay while recovering from illness. Emotional support, including esteem support, refers to the psychological boost given to a person who needs to express emotions and feel empathy from others or to have his or her perspective validated. Beehr and Glazer ( 2001 ) present an overview of the role of social support on the stressor-strain relationship and arguments regarding the role of culture in shaping the utility of different sources and types of support.

Meaningfulness and Resilience

Meaningfulness reflects the extent to which people believe their lives are significant, purposeful, goal-directed, and fulfilling (Glazer, Kożusznik, Meyers, & Ganai, 2014 ). When faced with stressors, people who have a strong sense of meaning in life will also try to make sense of the stressors. Maintaining a positive outlook on life stressors helps to manage emotions, which is helpful in reducing strains, particularly when some stressors cannot be problem-solved (Lazarus & Folkman, 1991 ). Lazarus and Folkman ( 1991 ) emphasize that being able to reframe threatening situations can be just as important in an adaptation as efforts to control the stressors. Having a sense of meaningfulness motivates people to behave in ways that help them overcome stressors. Thus, meaningfulness is often used in the same breath as resilience, because people who are resilient are often protecting that which is meaningful.

Resilience is a personality state that can be fortified and enhanced through varied experiences. People who perceive their lives are meaningful are more likely to find ways to face adversity and are therefore more prone to intensifying their resiliency. When people demonstrate resilience to cope with noxious stressors, their ability to be resilient against other stressors strengthens because through the experience, they develop more competencies (Glazer et al., 2014 ). Thus, fitting with Hobfoll’s ( 1989 , 2001 ) COR theory, meaningfulness and resilience are psychological resources people attempt to conserve and protect, and employ when necessary for making sense of or coping with stressors.

Tertiary Interventions (Stress Management)

Stress management refers to interventions employed to treat and repair harmful repercussions of stressors that were not coped with sufficiently. As Lazarus and Folkman ( 1991 ) noted, not all stressors “are amenable to mastery” (p. 205). Stressors that are unmanageable and lead to strains require interventions to reverse or slow down those effects. Workplace interventions might focus on the person, the organization, or both. Unfortunately, instead of looking at the whole system to include the person and the workplace, most companies focus on the person. Such a focus should not be a surprise given the results of van der Klink, Blonk, Schene, and van Dijk’s ( 2001 ) meta-analysis of 48 experimental studies conducted between 1977 and 1996 . They found that of four types of tertiary interventions, the effect size for cognitive-behavioral interventions and multimodal programs (e.g., the combination of assertive training and time management) was moderate and the effect size for relaxation techniques was small in reducing psychological complaints, but not turnover intention related to work stress. However, the effects of (the five studies that used) organization-focused interventions were not significant. Similarly, Richardson and Rothstein’s ( 2008 ) meta-analytic study, including 36 experimental studies with 55 interventions, showed a larger effect size for cognitive-behavioral interventions than relaxation, organizational, multimodal, or alternative. However, like with van der Klink et al. ( 2001 ), Richardson and Rothstein ( 2008 ) cautioned that there were few organizational intervention studies included and the impact of interventions were determined on the basis of psychological outcomes and not physiological or organizational outcomes. Van der Klink et al. ( 2001 ) further expressed concern that organizational interventions target the workplace and that changes in the individual may take longer to observe than individual interventions aimed directly at the individual.

The long-term benefits of individual focused interventions are not yet clear either. Per Giga, Cooper, and Faragher ( 2003 ), the benefits of person-directed stress management programs will be short-lived if organizational factors to reduce stressors are not addressed too. Indeed, LaMontagne, Keegel, Louie, Ostry, and Landsbergis ( 2007 ), in their meta-analysis of 90 studies on stress management interventions published between 1990 and 2005 , revealed that in relation to interventions targeting organizations only, and interventions targeting individuals only, interventions targeting both organizations and individuals (i.e. the systems approach) had the most favorable positive effects on both the organizations and the individuals. Furthermore, the organization-level interventions were effective at both the individual and organization levels, but the individual-level interventions were effective only at the individual level.

Individual-Focused Stress Management

Individual-focused interventions concentrate on improving conditions for the individual, though counseling programs emphasize that the worker is in charge of reducing “stress,” whereas role-focused interventions emphasize activities that organizations can guide to actually reduce unnecessary noxious environmental factors.

Individual-Focused Stress Management: Employee Assistance Programs

When stress become sufficiently problematic (which is individually gauged or attended to by supportive others) in a worker’s life, employees may utilize the short-term counseling services or referral services Employee Assistance Programs (EAPs) provide. People who utilize the counseling services may engage in cognitive behavioral therapy aimed at changing the way people think about the stressors (e.g., as challenge opportunity over threat) and manage strains. Example topics that may be covered in these therapy sessions include time management and goal setting (prioritization), career planning and development, cognitive restructuring and mindfulness, relaxation, and anger management. In a study of healthcare workers and teachers who participated in a 2-day to 2.5-day comprehensive stress management training program (including 26 topics on identifying, coping with, and managing stressors and strains), Siu, Cooper, and Phillips ( 2013 ) found psychological and physical improvements were self-reported among the healthcare workers (for which there was no control group). However, comparing an intervention group of teachers to a control group of teachers, the extent of change was not as visible, though teachers in the intervention group engaged in more mastery recovery experiences (i.e., they purposefully chose to engage in challenging activities after work).

Individual-Focused Stress Management: Mindfulness

A popular therapy today is to train people to be more mindful, which involves helping people live in the present, reduce negative judgement of current and past experiences, and practicing patience (Birnie, Speca, & Carlson, 2010 ). Mindfulness programs usually include training on relaxation exercises, gentle yoga, and awareness of the body’s senses. In one study offered through the continuing education program at a Canadian university, 104 study participants took part in an 8-week, 90 minute per group (15–20 participants per) session mindfulness program (Birnie et al., 2010 ). In addition to body scanning, they also listened to lectures on incorporating mindfulness into one’s daily life and received a take-home booklet and compact discs that guided participants through the exercises studied in person. Two weeks after completing the program, participants’ mindfulness attendance and general positive moods increased, while physical, psychological, and behavioral strains decreased. In another study on a sample of U.K. government employees, study participants receiving three sessions of 2.5 to 3 hours each training on mindfulness, with the first two sessions occurring in consecutive weeks and the third occurring about three months later, Flaxman and Bond ( 2010 ) found that compared to the control group, the intervention group showed a decrease in distress levels from Time 1 (baseline) to Time 2 (three months after first two training sessions) and Time 1 to Time 3 (after final training session). Moreover, of the mindfulness intervention study participants who were clinically distressed, 69% experienced clinical improvement in their psychological health.

Individual-Focused Stress Management: Biofeedback/Imagery/Meditation/Deep Breathing

Biofeedback uses electronic equipment to inform users about how their body is responding to tension. With guidance from a therapist, individuals then learn to change their physiological responses so that their pulse normalizes and muscles relax (Norris, Fahrion, & Oikawa, 2007 ). The therapist’s guidance might include reminders for imagery, meditation, body scan relaxation, and deep breathing. Saunders, Driskell, Johnston, and Salas’s ( 1996 ) meta-analysis of 37 studies found that imagery helped reduce state and performance anxiety. Once people have been trained to relax, reminder triggers may be sent through smartphone push notifications (Villani et al., 2013 ).

Smartphone technology can also be used to support weight loss programs, smoking cessation programs, and medication or disease (e.g., diabetes) management compliance (Heron & Smyth, 2010 ; Kannampallil, Waicekauskas, Morrow, Kopren, & Fu, 2013 ). For example, smartphones could remind a person to take medications or test blood sugar levels or send messages about healthy behaviors and positive affirmations.

Individual-Focused Stress Management: Sleep/Rest/Respite

Workers today sleep less per night than adults did nearly 30 years ago (Luckhaupt, Tak, & Calvert, 2010 ; National Sleep Foundation, 2005 , 2013 ). In order to combat problems, such as increased anxiety and cardiovascular artery disease, associated with sleep deprivation and insufficient rest, it is imperative that people disconnect from their work at least one day per week or preferably for several weeks so that they are able to restore psychological health (Etzion, Eden, & Lapidot, 1998 ; Ragsdale, Beehr, Grebner, & Han, 2011 ). When college students engaged in relaxation-type activities, such as reading or watching television, over the weekend, they experienced less emotional exhaustion and greater general well-being than students who engaged in resources-consuming activities, such as house cleaning (Ragsdale et al., 2011 ). Additional research and future directions for research are reviewed and identified in the work of Sonnentag ( 2012 ). For example, she asks whether lack of ability to detach from work is problematic for people who find their work meaningful. In other words, are negative health consequences only among those who do not take pleasure in their work? Sonnetag also asks how teleworkers detach from their work when engaging in work from the home. Ironically, one of the ways that companies are trying to help with the challenges of high workload or increased need to be available to colleagues, clients, or vendors around the globe is by offering flexible work arrangements, whereby employees who can work from home are given the opportunity to do so. Companies that require global interactions 24-hours per day often employ this strategy, but is the solution also a source of strain (Glazer, Kożusznik, & Shargo, 2012 )?

Individual-Focused Stress Management: Role Analysis

Role analysis or role clarification aims to redefine, expressly identify, and align employees’ roles and responsibilities with their work goals. Through role negotiation, involved parties begin to develop a new formal or informal contract about expectations and define resources needed to fulfill those expectations. Glazer has used this approach in organizational consulting and, with one memorable client engagement, found that not only were the individuals whose roles required deeper re-evaluation happier at work (six months later), but so were their subordinates. Subordinates who once characterized the two partners as hostile and akin to a couple going through a bad divorce, later referred to them as a blissful pair. Schaubroeck, Ganster, Sime, and Ditman ( 1993 ) also found in a three-wave study over a two-year period that university employees’ reports of role clarity and greater satisfaction with their supervisor increased after a role clarification exercise of top managers’ roles and subordinates’ roles. However, the intervention did not have any impact on reported physical symptoms, absenteeism, or psychological well-being. Role analysis is categorized under individual-focused stress management intervention because it is usually implemented after individuals or teams begin to demonstrate poor performance and because the intervention typically focuses on a few individuals rather than an entire organization or group. In other words, the intervention treats the person’s symptoms by redefining the role so as to eliminate the stimulant causing the problem.

Organization-Focused Stress Management

At the organizational level, companies that face major declines in productivity and profitability or increased costs related to healthcare and disability might be motivated to reassess organizational factors that might be impinging on employees’ health and well-being. After all, without healthy workers, it is not possible to have a healthy organization. Companies may choose to implement practices and policies that are expected to help not only the employees, but also the organization with reduced costs associated with employee ill-health, such as medical insurance, disability payments, and unused office space. Example practices and policies that may be implemented include flexible work arrangements to ensure that employees are not on the streets in the middle of the night for work that can be done from anywhere (such as the home), diversity programs to reduce stress-induced animosity and prejudice toward others, providing only healthy food choices in cafeterias, mandating that all employees have physicals in order to receive reduced prices for insurance, company-wide closures or mandatory paid time off, and changes in organizational visioning.

Organization-Focused Stress Management: Organizational-Level Occupational Health Interventions

As with job design interventions that are implemented to remediate work characteristics that were a source of unnecessary or excessive stressors, so are organizational-level occupational health (OLOH) interventions. As with many of the interventions, its placement as a primary or tertiary stress management intervention may seem arbitrary, but when considering the goal and target of change, it is clear that the intervention is implemented in response to some ailing organizational issues that need to be reversed or stopped, and because it brings in the entire organization’s workforce to address the problems, it has been placed in this category. There are several more case studies than empirical studies on the topic of whole system organizational change efforts (see example case studies presented by the United Kingdom’s Health and Safety Executive). It is possible that lack of published empirical work is not so much due to lack of attempting to gather and evaluate the data for publication, but rather because the OLOH interventions themselves never made it to the intervention stage, the interventions failed (Biron, Gatrell, & Cooper, 2010 ), or the level of evaluation was not rigorous enough to get into empirical peer-review journals. Fortunately, case studies provide some indication of the opportunities and problems associated with OLOH interventions.

One case study regarding Cardiff and Value University Health Board revealed that through focus group meetings with members of a steering group (including high-level managers and supported by top management) and facilitated by a neutral, non-judgemental organizational health consultant, ideas for change were posted on newsprint, discussed, and areas in the organization needing change were identified. The intervention for giving voice to people who initially had little already had a positive effect on the organization, as absence decreased by 2.09% and 6.9% merely 12 and 18 months, respectively, after the intervention. Translated in financial terms, the 6.9% change was equivalent to a quarterly savings of £80,000 (Health & Safety Executive, n.d. ). Thus, focusing on the context of change and how people will be involved in the change process probably helped the organization realize improvements (Biron et al., 2010 ). In a recent and rare empirical study, employing both qualitative and quantitative data collection methods, Sørensen and Holman ( 2014 ) utilized PAR in order to plan and implement an OLOH intervention over the course of 14 months. Their study aimed to examine the effectiveness of the PAR process in reducing workers’ work-related and social or interpersonal-related stressors that derive from the workplace and improving psychological, behavioral, and physiological well-being across six Danish organizations. Based on group dialogue, 30 proposals for change were proposed, all of which could be categorized as either interventions to focus on relational factors (e.g., management feedback improvement, engagement) or work processes (e.g., reduced interruptions, workload, reinforcing creativity). Of the interventions that were implemented, results showed improvements on manager relationship quality and reduced burnout, but no changes with respect to work processes (i.e., workload and work pace) perhaps because the employees already had sufficient task control and variety. These findings support Dewe and Kompier’s ( 2008 ) position that occupational health can be reinforced through organizational policies that reinforce quality jobs and work experiences.

Organization-Focused Stress Management: Flexible Work Arrangements

Dewe and Kompier ( 2008 ), citing the work of Isles ( 2005 ), noted that concern over losing one’s job is a reason for why 40% of survey respondents indicated they work more hours than formally required. In an attempt to create balance and perceived fairness in one’s compensation for putting in extra work hours, employees will sometimes be legitimately or illegitimately absent. As companies become increasingly global, many people with desk jobs are finding themselves communicating with colleagues who are halfway around the globe and at all hours of the day or night (Glazer et al., 2012 ). To help minimize the strains associated with these stressors, companies might devise flexible work arrangements (FWA), though the type of FWA needs to be tailored to the cultural environment (Masuda et al., 2012 ). FWAs give employees some leverage to decide what would be the optimal work arrangement for them (e.g., part-time, flexible work hours, compressed work week, telecommuting). In other words, FWA provides employees with the choice of when to work, where to work (on-site or off-site), and how many hours to work in a day, week, or pay period (Kossek, Thompson, & Lautsch, 2015 ). However, not all employees of an organization have equal access to or equitable use of FWAs; workers in low-wage, hourly jobs are often beholden to being physically present during specific hours (Swanberg McKechnie, Ojha, & James, 2011 ). In a study of over 1,300 full-time hourly retail employees in the United States, Swanberg et al. ( 2011 ) showed that employees who have control over their work schedules and over their work hours were satisfied with their work schedules, perceived support from the supervisor, and work engagement.

Unfortunately, not all FWAs yield successful results for the individual or the organization. Being able to work from home or part-time can have problems too, as a person finds himself or herself working more hours from home than required. Sometimes telecommuting creates work-family conflict too as a person struggles to balance work and family obligations while working from home. Other drawbacks include reduced face-to-face contact between work colleagues and stakeholders, challenges shaping one’s career growth due to limited contact, perceived inequity if some have more flexibility than others, and ambiguity about work role processes for interacting with employees utilizing the FWA (Kossek et al., 2015 ). Organizations that institute FWAs must carefully weigh the benefits and drawbacks the flexibility may have on the employees using it or the employees affected by others using it, as well as the implications on the organization, including the vendors who are serving and clients served by the organization.

Organization-Focused Stress Management: Diversity Programs

Employees in the workplace might experience strain due to feelings of discrimination or prejudice. Organizational climates that do not promote diversity (in terms of age, religion, physical abilities, ethnicity, nationality, sex, and other characteristics) are breeding grounds for undesirable attitudes toward the workplace, lower performance, and greater turnover intention (Bergman, Palmieri, Drasgow, & Ormerod, 2012 ; Velez, Moradi, & Brewster, 2013 ). Management is thus advised to implement programs that reinforce the value and importance of diversity, as well as manage diversity to reduce conflict and feelings of prejudice. In fact, managers who attended a leadership training program reported higher multicultural competence in dealing with stressful situations (Chrobot-Mason & Leslie, 2012 ), and managers who persevered through challenges were more dedicated to coping with difficult diversity issues (Cilliers, 2011 ). Thus, diversity programs can help to reduce strains by directly reducing stressors associated with conflict linked to diversity in the workplace and by building managers’ resilience.

Organization-Focused Stress Management: Healthcare Management Policies

Over the past few years, organizations have adopted insurance plans that implement wellness programs for the sake of managing the increasing cost of healthcare that is believed to be a result of individuals’ not managing their own health, with regular check-ups and treatment. The wellness programs require all insured employees to visit a primary care provider, complete a health risk assessment, and engage in disease management activities as specified by a physician (e.g., see frequently asked questions regarding the State of Maryland’s Wellness Program). Companies believe that requiring compliance will reduce health problems, although there is no proof that such programs save money or that people would comply. One study that does, however, boast success, was a 12-week workplace health promotion program aimed at reducing Houston airport workers’ weight (Ebunlomo, Hare-Everline, Weber, & Rich, 2015 ). The program, which included 235 volunteer participants, was deemed a success, as there was a total weight loss of 345 pounds (or 1.5 lbs per person). Given such results in Houston, it is clear why some people are also skeptical over the likely success of wellness programs, particularly as there is no clear method for evaluating their efficacy (Sinnott & Vatz, 2015 ).

Moreover, for some, such a program is too paternalistic and intrusive, as well as punishes anyone who chooses not to actively participate in disease management programs (Sinnott & Vatz, 2015 ). The programs put the onus of change on the person, though it is a response to the high costs of ill-health. The programs neglect to consider the role of the organization in reducing the barriers to healthy lifestyle, such as cloaking exempt employment as simply needing to get the work done, when it usually means working significantly more hours than a standard workweek. In fact, workplace health promotion programs did not reduce presenteeism (i.e., people going to work while unwell thereby reducing their job performance) among those who suffered from physical pain (Cancelliere, Cassidy, Ammendolia, & Côte, 2011 ). However, supervisor education, worksite exercise, lifestyle intervention through email, midday respite from repetitive work, a global stress management program, changes in lighting, and telephone interventions helped to reduce presenteeism. Thus, emphasis needs to be placed on psychosocial aspects of the organization’s structure, including managers and overall organizational climate for on-site presence, that reinforces such behavior (Cancelliere et al., 2011 ). Moreover, wellness programs are only as good as the interventions to reduce work-related stressors and improve organizational resources to enable workers to improve their overall psychological and physical health.

Concluding Remarks

Future research.

One of the areas requiring more theoretical and practical attention is that of the utility of stress frameworks to guide organizational development change interventions. Although it has been proposed that the foundation for work stress management interventions is in organizational development, and even though scholars and practitioners of organization development were also founders of research programs that focused on employee health and well-being or work stress, there are few studies or other theoretical works that link the two bodies of literature.

A second area that requires additional attention is the efficacy of stress management interventions across cultures. In examining secondary stress management interventions (i.e., coping), some cross-cultural differences in findings were described; however, there is still a dearth of literature from different countries on the utility of different prevention, coping, and stress management strategies.

A third area that has been blossoming since the start of the 21st century is the topic of hindrance and challenge stressors and the implications of both on workers’ well-being and performance. More research is needed on this topic in several areas. First, there is little consistency by which researchers label a stressor as a hindrance or a challenge. Researchers sometimes take liberties with labels, but it is not the researchers who should label a stressor but the study participants themselves who should indicate if a stressor is a source of strain. Rodríguez, Kozusznik, and Peiró ( 2013 ) developed a measure in which respondents indicate whether a stressor is a challenge or a hindrance. Just as some people may perceive demands to be challenges that they savor and that result in a psychological state of eustress (Nelson & Simmons, 2003 ), others find them to be constraints that impede goal fulfillment and thus might experience distress. Likewise, some people might perceive ambiguity as a challenge that can be overcome and others as a constraint over which he or she has little control and few or no resources with which to cope. More research on validating the measurement of challenge vs. hindrance stressors, as well as eustress vs. distress, and savoring vs. coping, is warranted. Second, at what point are challenge stressors harmful? Just because people experiencing challenge stressors continue to perform well, it does not necessarily mean that they are healthy people. A great deal of stressors are intellectually stimulating, but excessive stimulation can also take a toll on one’s physiological well-being, as evident by the droves of professionals experiencing different kinds of diseases not experienced as much a few decades ago, such as obesity (Fried et al., 2013 ). Third, which stress management interventions would better serve to reduce hindrance stressors or to reduce strain that may result from challenge stressors while reinforcing engagement-producing challenge stressors?

A fourth area that requires additional attention is that of the flexible work arrangements (FWAs). One of the reasons companies have been willing to permit employees to work from home is not so much out of concern for the employee, but out of the company’s need for the focal person to be able to communicate with a colleague working from a geographic region when it is night or early morning for the focal person. Glazer, Kożusznik, and Shargo ( 2012 ) presented several areas for future research on this topic, noting that by participating on global virtual teams, workers face additional stressors, even while given flexibility of workplace and work time. As noted earlier, more research needs to be done on the extent to which people who take advantage of FWAs are advantaged in terms of detachment from work. Can people working from home detach? Are those who find their work invigorating also likely to experience ill-health by not detaching from work?

A fifth area worthy of further research attention is workplace wellness programing. According to Page and Vella-Brodrick ( 2009 ), “subjective and psychological well-being [are] key criteria for employee mental health” (p. 442), whereby mental health focuses on wellness, rather than the absence of illness. They assert that by fostering employee mental health, organizations are supporting performance and retention. Employee well-being can be supported by ensuring that jobs are interesting and meaningful, goals are achievable, employees have control over their work, and skills are used to support organizational and individual goals (Dewe & Kompier, 2008 ). However, just as mental health is not the absence of illness, work stress is not indicative of an absence of psychological well-being. Given the perspective that employee well-being is a state of mind (Page & Vella-Brodrick, 2009 ), we suggest that employee well-being can be negatively affected by noxious job stressors that cannot be remediated, but when job stressors are preventable, employee well-being can serve to protect an employee who faces job stressors. Thus, wellness programs ought to focus on providing positive experiences by enhancing and promoting health, as well as building individual resources. These programs are termed “green cape” interventions (Pawelski, 2016 ). For example, with the growing interests in positive psychology, researchers and practitioners have suggested employing several positive psychology interventions, such as expressing gratitude, savoring experiences, and identifying one’s strengths (Tetrick & Winslow, 2015 ). Another stream of positive psychology is psychological capital, which includes four malleable functions of self-efficacy, optimism, hope, and resilience (Luthans, Youssef, & Avolio, 2007 ). Workplace interventions should include both “red cape” interventions (i.e., interventions to reduce negative experiences) and “green cape” interventions (i.e., workplace wellness programs; Polly, 2014 ).

A Healthy Organization’s Pledge

A healthy workplace requires healthy workers. Period. Among all organizations’ missions should be the focus on a healthy workforce. To maintain a healthy workforce, the company must routinely examine its own contributions in terms of how it structures itself; reinforces communications among employees, vendors, and clients; how it rewards and cares for its people (e.g., ensuring they get sufficient rest and can detach from work); and the extent to which people at the upper levels are truly connected with the people at the lower levels. As a matter of practice, management must recognize when employees are overworked, unwell, and poorly engaged. Management must also take stock of when it is doing well and right by its contributors’ and maintain and reinforce the good practices, norms, and procedures. People in the workplace make the rules; people in the workplace can change the rules. How management sees its employees and values their contribution will have a huge role in how a company takes stock of its own pain points. Providing employees with tools to manage their own reactions to work-related stressors and consequent strains is fine, but wouldn’t it be grand if organizations took better notice about what they could do to mitigate the strain-producing stressors in the first place and take ownership over how employees are treated?

• Abramis, D. J. (1994). Work role ambiguity, job satisfaction, and job performance: Meta-analyses and review. Psychological Report, 75 , 1411–1433.
• Adams, G. A. , & Jex, S. M. (1999). Relationships between time management, control, work–family conflict, and strain. Journal of Occupational Health Psychology, 1 , 72–77.
• Alloy, L. B. , & Abramson, L. Y. (1979). Judgment of contingency in depressed and nondepressed students: Sadder but wiser? Journal of Experimental Psychology: General, 108 , 441–483.
• Amstad, F. T. , Meier, L. L. , Fasel, U. , Elfering, A. , & Semmer, N. K. (2011). A meta-analysis of work-family conflict and various outcomes with a special emphasis on cross-domain versus matching-domain relations. Journal of Occupational Health Psychology, 16 , 151–169.
• Assouline, M. , & Meir, E. I. (1987). Meta-analysis of the relationship between congruence and well-being measures. Journal of Vocational Behavior, 31 , 319–332.
• Aust, B. , & Ducki, A. (2004). Comprehensive health promotion interventions at the workplace: Experiences with health circles in Germany. Journal of Occupational Health Psychology, 9 , 258–270.
• Bakker, A. B. Demerouti, E. , Sanz-Vergel, A. I. (2014). Burnout and work engagement: The JD-R approach. Annual Review of Organizational Behavior, 1 , 389–411.
• Bakker, A. B. , van Veldhoven, M. J. P. M. , & Xanthopoulou, D. (2010). Beyond the demand-control model: Thriving on high job demands and resources. Journal of Personnel Psychology, 9 , 3–16.
• Beehr, T. A. , Glaser, K. M. , Canali, K. G. , & Wallwey, D. A. (2001). Back to basics: Re-examination of demand control theory of occupational stress. Work & Stress, 15 , 115–130.
• Beehr, T. A. , & Glazer, S. (2001). A cultural perspective of social support in relation to occupational stress. In P. Perrewé , D. C. Ganster , & J. Moran (Eds.), Research in occupational stress and well-being (pp. 97–142). Amsterdam: JAI Press.
• Bergman, M. E. , Palmieri, P. A. , Drasgow, F. , & Ormerod, A. J. (2012). Racial/ethnic harassment and discrimination, its antecedents, and its effect on job-related outcomes. Journal of Occupational Health Psychology, 17 , 65–78.
• Bhagat, R. S. , Krishnan, B. , Nelson, T. A. , Leonard, K. M. , Ford, D. J. , & Billing, T. K. (2010). Organizational stress, psychological strain, and work outcomes in six national contexts: A closer look at the moderating influences of coping styles and decision latitude . Cross Cultural Management, 17 , 10–29.
• Bhagat, R. S. , O’Driscoll, M. P. , Babakus, E. , Frey, L. , Chokkar, J. , Ninokumar, B. H , et al. (1994). Organizational stress and coping in seven national contexts: A cross-cultural investigation . In G. P. Keita & J. J. Hurrell (Eds.), Job stress in a changing workforce: Investigating gender, diversity, and family issues (pp. 93–105). Washington, DC: American Psychological Association.
• Bhagat, R. S. , Segovis, J. C. , & Nelson, T. A. (2012). Work stress and coping in the era of globalization . New York: Routledge.
• Billings, A. G. , & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4 , 139–157.
• Birnie, K. , Speca, M. , & Carlson, L. E. (2010). Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR). Stress & Health, 26 , 359–371.
• Biron, C. , Gatrell, C. , & Cooper, C. L. (2010). Autopsy of a failure: Evaluating process and contextual issues in an organizational-level work stress intervention. International Journal of Stress Management, 17 , 135–158.
• Bowling, N. A. , & Kirkendall, C. (2012). Workload: A review of causes, consequences, and potential interventions. In J. Houdmont , S. Leka , & R. Sinclair (Eds.), Contemporary occupational health psychology (Vol. 2) (pp. 221–238). Chichester, U.K.: Wiley.
• Breaugh, J. A. , & Colihan, J. P. (1994). Measuring facets of job ambiguity: Construct validity evidence. Journal of Applied Psychology, 79 , 191–202.
• Bruk-Lee, V. , & Spector, P. E. (2006). The social stressors-counterproductive work behaviors link: Are conflicts with supervisors and coworkers the same? . Journal of Occupational Health Psychology, 11 , 145–156.
• Cancelliere, C. , Cassidy, J. D. , Ammendolia, C. , & Côte, P. (2011). Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature. BMC Public Health, 11 , 395–406.
• Caplan, R. D. (1987). Person–environment fit in organizations: Theories, facts, and values. In A. W. Riley & S. J. Zaccaro (Eds.), Occupational stress and organizational effectiveness (pp. 103–140). New York: Praeger.
• Cartwright, S. , & Cooper, C. L. (2005). Individually targeted interventions. In J. Barling , E. K. Kelloway , & M. R. Frone (Eds.), Handbook of work stress (pp. 607–622). Thousand Oaks, CA: SAGE.
• Cavanaugh, M. A. , Boswell, W. R. , Roehling, M. V. , & Boudreau, J. W. (2000). An empirical examination of self-reported work stress among U.S. managers . Journal of Applied Psychology, 85 , 65–74.
• Chong, D. S. F. , van Eerde, W. , Rutte, C. G. , & Chai, K. H. (2012). Bringing employees closer: The effect of proximity on communication when teams function under time pressure. Journal of Product Innovation Management, 29 , 205–215.
• Chrobot-Mason, D. , & Leslie, J. B. (2012). The role of multicultural competence and emotional intelligence in managing diversity. Psychologist-Manager Journal, 15 , 219–236.
• Cilliers, F. (2011). Individual diversity management and salutogenic functioning. International Review of Psychiatry, 23 , 501–507.
• Claessens, B. C. , Van Eerde, W. , Rutte, C. G. , & Roe, R. A. (2004). Planning behavior and perceived control of time at work . Journal of Organizational Behavior, 25 , 937–950.
• Cooper, C. L. , Dewe, P. D. , & O’Driscoll, M. P. (2011). Employee assistance programs: Strengths, challenges, and future roles. In J. C. Quick , L. E. Tetrick , J. C. Quick , L. E. Tetrick (Eds.), Handbook of occupational health psychology (2d ed.) (pp. 337–356). Washington, DC: American Psychological Association.
• Cooper, C. L. , Dewe, P. J. , & O’Driscoll, M. P. (2001). Organizational stress: A review and critique of theory, research, and applications . Thousand Oaks, CA: SAGE.
• Coovert, M. D. & Thompson, L. F. (2003). Technology and workplace health. In J. C. Quick & L. E. Tetrick (Eds.), Handbook of occupational health psychology (pp. 221–241). Washington, DC: American Psychological Association.
• Dawson, K. M. , O’Brien, K. E. , & Beehr, T. A. (2016). The role of hindrance stressors in the job demand-control-support model of occupational stress: A proposed theory revision . Journal of Organizational Behavior, 37 (3), 397–415.
• Dewe, P. , & Kompier, M. (2008). Foresight mental capital and wellbeing project: Wellbeing and work: Future challenges . London: The Government Office for Science.
• Dopkeen, J. C. , & DuBois, R. (2014). Stress in the workplace: A policy synthesis on its dimensions and prevalence . White paper. University of Illinois Chicago, Center for Employee Health Studies, School of Public Health.
• Dwyer, D. J. , & Ganster, D. C. (1991). The effects of job demands and control on employee attendance and satisfaction. Journal of Organizational Behavior, 12 , 595–608.
• Ebunlomo, E. O. , Hare-Everline, N. , Weber, A. , & Rich, J. (2015). Development of a comprehensive 12-week health promotion program for Houston Airport System. Texas Public Health Journal, 67 (1), 11–13.
• Edwards, J. R. (2008). Person-environment fit in organizations: An assessment of theoretical progress. The Academy of Management Annals, 2 , 167–230.
• Etzion, D. , Eden, D. , & Lapidot, Y. (1998). Relief from job stressors and burnout: Reserve service as a respite. Journal of Applied Psychology, 83 , 577–585.
• Firth-Cozens, J. (2003). Doctors, their wellbeing, and their stress: It’s time to be proactive about stress—and prevent it. British Medical Journal, 326 , 670–671.
• Flaxman, P. E. , & Bond, F. W. (2010). Worksite stress management training: Moderated effects and clinical significance. Journal of Occupational Health Psychology, 15 , 347–358.
• Folkman, S. , & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample . Journal of Health and Social Behavior, 21 , 219–239.
• French, J. R. P., Jr. , & Caplan, R. D. (1972). Organizational stress and individual strain. In A. Marrow (Ed.), The failure of success . New York: AMACOM.
• French, J. R. P., Jr. , & Kahn, R. L. (1962). A programmatic approach to studying the industrial environment and mental health. Journal of Social Issues, 18 , 1–48.
• French, S. (2015, May 27). PCS workload and work-life balance survey 2013 . London: Public and Commercial Services Union.
• Fried, Y. , Laurence, G. A. , Shirom, A. , Melamed, S. , Toker, S. , Berliner, S. , & Shapira, I. (2013). The relationship between job enrichment and abdominal obesity: A longitudinal field study of apparently healthy individuals. Journal of Occupational Health Psychology, 18 , 458–468.
• Frone, M. R. (2000). Interpersonal conflict at work and psychological outcomes: Testing a model among young workers. Journal of Occupational Health Psychology, 5 , 246–255.
• Giga, S. I. , Cooper, C. L. , & Faragher, B. (2003). The development of a framework for a comprehensive approach to stress management interventions at work. International Journal of Stress Management, 10 , 280–296.
• Glazer, S. (2008). Cross-cultural issues in stress and burnout. In J. R. B. Halbesleben (Ed.), Handbook of Stress and Burnout in Health Care (pp. 79–93). Huntington, NY: Nova Science Publishers.
• Glazer, S. , & Beehr, T. A. (2005). Consistency of the implications of three role stressors across four countries. Journal of Organizational Behavior , 26 , 467–487.
• Glazer, S. , Kożusznik, M. W. , Meyers, J. H. , & Ganai, O. (2014). Cultural implications of meaningfulness as a resource to mitigate work stress. In S. Leka & R. Sinclair (Eds.), Contemporary occupational health psychology: Global perspectives on research and practice (Vol. 3) (pp. 114–130). Hoboken, NJ: Wiley.
• Glazer, S. , Kożusznik, M. W. , & Shargo, I. A. (2012). Global virtual teams: A cure for- or a cause of- stress. In P. L. Perrewé , J. Halbesleben , & C. Rosen (Eds.), Research in occupational stress and well being: The role of the economic context on occupational stress and well being (Vol. 10, pp. 213–266). Bingley, U.K.: Emerald.
• Glazer, S. , Stetz, T. A. , & Izso, L. (2004). Effects of personality on subjective job stress: A cultural analysis. Personality and Individual Differences, 37 , 645–658.
• Greenhaus, J. H. , & Beutell, N. J. (1985). Sources of conflict between work and family roles. Academy of Management Review, 10 , 76–88.
• Hackman, J. R. , & Oldham, G. R. (1980). Work Redesign . Reading, MA: Addison-Wesley.
• Hauke, A. , Flintrop, J. , Brun, E. , & Rugulies, R. (2011). The impact of work-related psychosocial stressors on the onset of musculoskeletal disorders in specific body regions: A review and meta-analysis of 54 longitudinal studies . Work & Stress, 25 , 243–256.
• Health & Safety Executive (n.d.). Cardiff and Value University Health Board—A stress case study .
• Heron, K. E. , & Smyth, J. M. (2010). Ecological momentary interventions: Incorporating mobile technology into psychosocial and health behaviour treatments. British Journal of Health Psychology, 15 , 1–39.
• Hershcovis, M. (2011). “Incivility, social undermining, bullying … oh my!”: A call to reconcile constructs within workplace aggression research . Journal of Organizational Behavior, 32 , 499–519.
• Higgins, J. E. , & Endler, N. S. (1995). Coping, life stress, and psychological and somatic distress . European Journal of Personality, 9 , 253–270.
• Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44 , 513–524.
• Hobfoll, S. E. (1998). Stress, culture, and community: The psychology and philosophy of stress . New York: Plenum Press.
• Hobfoll, S. E. (2001). The influence of culture, community, and the nested-self in the stress process: Advancing Conservation of Resources Theory. Applied Psychology: An International Review, 50 , 337–421.
• International Labor Organization (2012, July 5). Why stress at work matters . International Labor Organization.
• International Labor Organization (n.d.). Psychosocial risks and work-related stress . International Labor Organization.
• Jackson, S. E. , & Schuler, R. S. (1985). A meta-analysis and conceptual critique of research on role ambiguity and role conflict in work settings. Organizational Behavior and Human Decision Processes, 36 , 16–78.
• Jayson, S. (2012, January 11). Yeah, we’re stressed but dealing with it; Americans report a decrease in stress for the first time in five years, maybe because it’s just the new normal . USA Today .
• Jex, S. M. , & Beehr, T. A. (1991). Emerging theoretical and methodological issues in the study of work-related stress. Research in Personnel and Human Resources Management, 9 , 311–365.
• Jex, S. M. , & Elaqua, T. C. (1999). Time management as a moderator of relations between stressors and employee strain. Work & Stress, 13 , 182–191.
• Johnson, J. V. , & Hall, E. M. (1988). Job strain, workplace social support, and cardiovascular disease: A cross-sectional study of a random sample of the Swedish working population. American Journal of Public Health, 78 , 1336–1342.
• Kahn, R. L. , Wolfe, D. M. , Quinn, R. P. , Snoek, J. D. , & Rosenthal, R. A. (1964). Organizational stress: Studies in role conflict and ambiguity . New York: Wiley.
• Kannampallil, T. G. , Waicekauskas, K. , Morrow, D. G. , Kopren, K. M. , & Fu, W. (2013). External tools for collaborative medication scheduling. Cognition, Technology & Work, 15 , 121–131.
• Karasek, R. A. (1979). Job demands, job decision latitude, and mental strain: Implications for job redesign. Administrative Science Quarterly , 24 , 285–308.
• Karasek, R. A. , & Theorell, T. (1990). Healthy work: Stress, productivity, and the reconstruction of working life . New York: Basic Books.
• van der Klink, J. J. L. , Blonk, R. W. B. , Schene, A. H. , & van Dijk, F. J. H. (2001). The benefits of interventions for work-related stress. American Journal of Public Health, 91 , 270–276.
• Knight, B. G. , Silverstein, M. , McCallum, T. J. , & Fox, L. S. (2000). A sociocultural stress and coping model for mental health outcomes among African American caregivers in southern California . The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 55B , 142–150.
• Kossek, E. E. , Thompson, R. J. , Lautsch, B. A. (2015). Balanced workplace flexibility: Avoiding the traps. California Management Review, 57 , 5–25.
• Kożusznik, M. , Rodriguez, I. , & Peiró, J. M. (2012). Cross-national outcomes of stress appraisal. Cross Cultural Management, 19 , 507–525.
• Kożusznik, M. , Rodriguez, I. , & Peiró, J. M. (2015). Eustress and distress climates in teams: Patterns and outcomes. International Journal of Stress Management, 22 , 1–23.
• Kristof-Brown, A. L. , Zimmerman, R. D. , & Johnson, E. C. (2005). Consequences of individuals’ fit at work: A meta-analysis of person-job, person-organization, person-group, and person-supervisor fit. Personnel Psychology, 58 , 281–342.
• LaMontagne, A. D. , Keegel, T. , Louie, A. M. , Ostry, A. , & Landsbergis, P. A. (2007). A systematic review of the job-stress intervention evaluation literature, 1990–2005. International Journal of Occupational and Environmental Health, 13 , 268–280.
• LaRocco, J. M. , Tetrick, L. E. , & Meder, D. (1989). Differences in perceptions of work environment conditions, job attitudes, and health beliefs among military physicians, dentists, and nurses. Military Psychology, 1 , 135–151.
• Lazarus, R. S. , & Folkman, S. (1984). Stress, appraisal, and coping . New York: Springer.
• Lazarus, R. S. , & Folkman, S. (1991). The concept of coping. In A. Monat & R. S. Lazarus (Eds.), Stress and coping: An anthology (3d ed.) (pp. 189–206). New York: Columbia University Press.
• LePine, J. A. , Podsakoff, N. P. , & LePine, M. A. (2005). A meta-analytic test of the challenge stressor-hindrance stressor framework: An explanation for inconsistent relationships among stressors and performance. Academy of Management Journal, 48 , 764–775.
• Lewin, K. (1936). Principles of topological psychology . New York: McGraw-Hill.
• Lewin K. (1951). Field theory in social science . New York: Harper and Row.
• Lewin, K. (1997). Resolving social conflicts & Field theory in social science . Washington, DC: American Psychological Association. Previously published in 1948 and 1951.
• Lin, B. C. , Kain, J. M. , & Fritz, C. (2013). Don’t interrupt me! An examination of the relationship between intrusions at work and employee strain. International Journal of Stress Management, 20 , 77–94.
• Liu, C. , & Li, H. (2017) Stressor and stressor appraisals: The moderating effect of task efficacy . Journal of Business and Psychology , 1–14.
• Liu, C. , Liu, Y. , Spector, P. E. , Shi, L. (2011). The interaction of job autonomy and conflict with supervisor in China and the United States: A qualitative and quantitative comparison. International Journal of Stress Management, 18 , 222–245.
• Liu, C. , Spector, P. E. , & Shi, L. (2007). Cross-national job stress: A quantitative and qualitative study. Journal of Organizational Behavior, 28 , 209–239.
• Luckhaupt, S. E. , Tak, S. , Calvert, G. M. (2010). The prevalence of short sleep duration by industry and occupational in the National Health Interview Survey. Sleep, 33 , 149–159.
• Luthans, F. , Youssef, C. M. , & Avolio, B. J. (2007). Psychological capital: Developing the human competitive edge . New York: Oxford University Press.
• Macan, T. H. (1994). Time management: Test of a process model. Journal of Applied Psychology, 79 , 381–391.
• Macan, T. H. , Shahani, C. , Dipboye, R. L. , & Philips, A. P. (1990). College students’ time management: Correlations with academic performance and stress. Journal of Educational Psychology, 82 , 760–768.
• Masuda, A. D. , Poelmans, S. A. Y. , Allen, T. D. , Spector, P. E. , Lapierre, L. M. , Cooper, C. L. , et al. (2012). Flexible work arrangements availability and their relationship with work-to-family conflict, job satisfaction, and turnover intentions: A comparison of three country clusters. Applied Psychology: An International Review, 61 , 1–29.
• McMahon, M. (2007). Think you might be addicted to email? You’re not alone . AOL.
• Monat, A. , & Lazarus, R. S. (Eds.). (1991). Stress and coping: An anthology (3d ed.). New York: Columbia University Press.
• Morimoto, H. , Shimada, H. , & Ozaki, K. (2013). Does stressor evaluation mediate sociocultural influence on coping selection? An investigation using Japanese employees. International Journal of Stress Management, 20 , 1–19.
• Narayanan, L. , Menon, S. , & Spector, P. E. (1999). A cross-cultural comparison of job stressors and reactions among employees holding comparable jobs in two countries. International Journal of Stress Management, 6 , 197–212.
• National Sleep Foundation (2005). Segment profiles . National Sleep Foundation.
• National Sleep Foundation (2013). How much sleep do adults need? . National Sleep Foundation.
• Nelson, D. L. , & Simmons, B. L. (2003). Health psychology and work stress: A more positive approach. In J. C. Quick & L. E. Tetrick (Eds.), Handbook of Occupational Health Psychology (pp. 97–119). Washington, DC: American Psychological Association.
• Norris, P. A. , Fahrion, S. L. , & Oikawa, L. O. (2007). Autogenic biofeedback training in psychophysiological therapy and stress management. In P. M. Lehrer , R. L. Woolfolk , & W. E. Sime (Eds.), Principles and practices of stress management (3d ed., pp. 175–205). New York: Guilford.
• Ogawa, N. (2009). Stress, coping behavior, and social support in Japan and the United States. Dissertation Abstracts International Section A , 69 , 3802.
• Oksanen, K. , & Ståhle, P. (2013). Physical environment as a source for innovation: Investigating the attributes of innovative space. Journal of Knowledge Management, 17 , 815–827.
• Page, K. M. , & Vella-Brodrick, D. A. (2009). The “what,” “why” and “how” of employee well-being: A new model. Social Indicators Research, 90 , 441–458.
• Parasuraman, S. , & Cleek, M. A. (1984). Coping behaviors and managers’ affective reactions to role stressors . Journal of Vocational Behavior, 24 , 179–193.
• Parasuraman, S. , & Purohit, Y. S. (2000). Distress and boredom among orchestra musicians: The two faces of stress. Journal of Occupational Health Psychology, 5 , 74–83.
• Pawelski, J. O. (2016). Defining the “positive” in positive psychology: Part II. A normative analysis . Journal of Positive Psychology, 11 , 357–365.
• Pearlin, L. I. , & Schooler, C. (1978). The structure of coping . Journal of Health and Social Behavior, 19 , 2–21.
• Peeters, M. A. G. , & Rutte, C. G. (2005). Time management behavior as a moderator for the job demand-control interaction. Journal of Occupational Health Psychology , 1 , 64–75.
• Peters, L. H. , & O’Connor, E. J. (1980). Situational constraints and work outcomes: The influence of a frequently overlooked construct. Academy of Management Review , 5, 391–397.
• Peters, L. H. , & O’Connor, E. J. (1988). Measuring work obstacles: Procedures, issues, and implications. In F. D. Schoorman & B. Schneider (Eds.), Facilitating work effectiveness (pp. 105–123). Lexington, MA: Lexington Books.
• Polly, S. (2014, July 2). Workplace well-being is not an oxymoron . Positive Psychology News Daily .
• Quick, C. J. , Quick, J. D. , Nelson, D. L. , & Hurrell, J. J. (2003). Preventive stress management in organizations . Washington, DC: APA.
• Quillian-Wolever, R. E. , & Wolever, M. E. (2003). Stress management at work . In J. C. Quick & L. E. Tetrick (Eds.), Handbook of occupational health psychology (pp. 355–375). Washington, DC: American Psychological Association.
• Ragsdale, J. M. , Beehr, T. A. , Grebner, S. , & Han, K. (2011). An integrated model of weekday stress and weekend recovery of students. International Journal of Stress Management, 18 , 153–180.
• Richardson, K. M. , & Rothstein, H. R. (2008). Effects of occupational stress management intervention programs: A meta-analysis. Journal of Occupational Health Psychology, 13 , 69–93.
• Rodríguez, I. , Kozusznik, M. W. , & Peiró, J. M. (2013). Development and validation of the Valencia Eustress-Distress Appraisal Scale. International Journal of Stress Management, 20 , 279–308.
• Rothbaum, F. , Weisz, J. R. , & Snyder, S. S. (1982). Changing the world and changing the self: A two-process model of perceived control. Journal of Personality and Social Psychology, 42 , 5–37.
• Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs, 80 , 609.
• Rousseau, V. , & Aubé, C. (2010). Social support at work and affective commitment to the organization: The moderating effect of job resource adequacy and ambient conditions. Journal of Social Psychology, 150 , 321–340.
• Saunders, T. , Driskell, J. E. , Johnston, J. , & Salas, E. (1996). The effect of stress inoculation training on anxiety and performance. Journal of Occupational Health Psychology, 1 , 170–186.
• Schaubroeck, J. , Ganster, D. C. , Sime, W. E. , & Ditman, D. (1993). A field experiment testing supervisory role clarification. Personnel Psychology, 46 , 1–25.
• Selmer, J. (2002). Coping strategies applied by Western vs overseas Chinese business expatriates in China. International Journal of Human Resource Management, 13 , 19–34.
• Siegrist, J. (1996). Adverse health effects of high effort/low reward conditions. Journal of Occupational Health Psychology, 1 , 27–41.
• Siegrist, J. (2010). Effort-reward imbalance at work and cardiovascular diseases. International Journal of Occupational Medicine and Environmental Health, 23 , 279–285.
• Siegrist, J. , Dragano, N. , Nyberg, S. T. , Lunau, T. , Alfredsson, L. , Erbel, R. , et al. (2014). Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: The IPD-Work consortium. International Archives of Occupational and Environmental Health, 87 , 249–256.
• Sinha, B. K. , Willson, L. R. , & Watson, D. C. (2000). Stress and coping among students in India and Canada . Canadian Journal of Behavioural Science/Revue Canadienne Des Sciences Du Comportement , 32 (4), 218–225.
• Sinnott, J. , & Vatz, R. E. (2015, March 13). Maryland doesn’t trust state employees to manage their health . Baltimore Sun .
• Siu, O. L. , Cooper, C. L. , & Phillips, D. R. (2013, July 1). Intervention studies on enhancing work well-being, reducing burnout, and improving recovery experiences among Hong Kong health care workers and teachers . International Journal of Stress Management, 21 , 69–84.
• Sonnentag, S. (2012). Psychological detachment from work during leisure time: The benefits of mentally disengaging from work. Current Directions in Psychological Science, 21 , 114–118.
• Sørensen, O. H. , & Holman, D. (2014). A participative intervention to improve employee well-being in knowledge work jobs: A mixed-methods evaluation study. Work & Stress, 28 , 67–86.
• Spector, P. E. , Chen, P. Y. , & O’Connell, B. J. (2000). A longitudinal study of relations between job stressors and job strains while controlling for prior negative affectivity and strains. Journal of Applied Psychology, 85 , 211–218.
• Spector, P. E. , & Jex, S. M. (1998). Development of four self-report measures of job stressors and strains: Interpersonal Conflict at Work Scale, Organizational Constraints Scale, Quantitative Workload Inventory, and Physical Symptoms Inventory. Journal of Occupational Health Psychology, 3 , 356–367.
• State of Maryland . (n.d.). Wellness program frequently asked questions . Maryland.gov.
• Strentz, T. , & Auerbach, S. M. (1988). Adjustment to the stress of simulated captivity: Effects of emotion-focused versus problem-focused preparation on hostages differing in locus of control . Journal of Personality and Social Psychology, 55 , 652–660.
• Swanberg, J. E. , McKechnie, S. P. , Ojha, M. U. , & James, J. B. (2011). Schedule control, supervisor support and work engagement: A winning combination for workers in hourly jobs? Journal of Vocational Behavior, 79 , 613–624.
• Tarafdar, M. , Tu, Q. , Ragu-Nathan, B. S. , & Ragu-Nathan, T. , (2007). The impact of technostress on role stress and productivity. Journal of Management Information Systems, 24 , 301–328.
• Tepper, B. J. , & Henle, C. A. (2011). A case for recognizing distinctions among constructs that capture interpersonal mistreatment in work organizations . Journal of Organizational Behavior, 32 , 487–498.
• Tetrick, L. E. , & Winslow, C. J. (2015). Workplace stress management interventions and health promotion. Annual Review of Organizational Psychology and Organizational Behavior, 2 , 583–603.
• Thomas, D. C. , Au, K. , & Ravlin, E. C. (2003). Cultural variation and the psychological contract. Journal of Organizational Behavior, 24 , 451–471.
• Toker, S. , Shirom, A. , Melamed, S. , & Armon, G. (2012). Work characteristics as predictors of diabetes incidence among apparently healthy employees. Journal of Occupational Health Psychology, 17 , 259–267.
• Velez, B. L. , Moradi, B. , & Brewster, M. E. (2013). Testing the tenets of minority stres theory in workplace contexts. Journal of Counseling Psychology, 60 , 532–542.
• Verquer, M. L. , Beehr, T. A. , & Wagner, S. H. (2003). A meta-analysis of relations between person–organization fit and work attitudes. Journal of Vocational Behavior, 63 , 473–489.
• Villani, D. , Grassi, A. , Cognetta, C. , Toniolo, D. , Cipresso, P. , & Riva, G. (2013). Self-help stress management training through mobile phones: An experience with oncology nurses. Psychological Services , 10 , 315–322.
• Vischer, J. C. (2007). The effects of the physical environment on job performance: Towards a theoretical model of workspace stress. Stress & Health, 23 , 175–184.
• Wasti, S. A. , & Cortina, L. M. (2002). Coping in context: Sociocultural determinants of responses to sexual harassment . Journal of Personality and Social Psychology , 83, 394–405.
• Willert, M. V. , Thulstrup, A. M. , Hertz, J. , & Bonde, J. P. (2010). Sleep and cognitive failures improved by a three-month stress management intervention . International Journal of Stress Management, 17 , 193–213.
• Xiao Q. , Ottosson I. , & Carlsson I. (2013). Stressors and coping strategies in Chinese and Swedish students at a Swedish university. Chinese Journal of Clinical Psychology, 21 , 309–312.

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How to Recover from Work Stress, According to Science

• Alyson Meister,
• Bonnie Hayden Cheng,
• Franciska Krings

Five research-backed strategies that actually work.

To combat stress and burnout, employers are increasingly offering benefits like virtual mental health support, spontaneous days or even weeks off, meeting-free days, and flexible work scheduling. Despite these efforts and the increasing number of employees buying into the importance of wellness, the effort is lost if you don’t actually recover. So, if you feel like you’re burning out, what works when it comes to recovering from stress? The authors discuss the “recovery paradox” — that when our bodies and minds need to recover and reset the most, we’re the least likely and able to do something about it — and present five research-backed strategies for recovering from stress at work.

The workforce is tired. While sustainable job performance requires us to thrive at work, only 32% of employees across the globe say they’re thriving. With 43% reporting high levels of daily stress, it’s no surprise that a wealth of employees feel like they’re on the edge of burnout, with some reports suggesting that up to 61% of U.S. professionals feel like they’re burning out at any moment in time.  Those who feel tense or stressed out during the workday are more than three times as likely to seek employment elsewhere.

• Alyson Meister is a professor of leadership and organizational behavior at IMD Business School in Lausanne, Switzerland. Specializing in the development of globally oriented, adaptive, and inclusive organizations, she has worked with thousands of executives, teams, and organizations from professional services to industrial goods and technology. Her research has been widely published, and in 2021, she was recognized as a Thinkers50 Radar thought leader.  
• Bonnie Hayden Cheng is an associate professor of management and strategy and the MBA program director at HKU Business School, University of Hong Kong. She is the chief resilience officer of Human at Work and serves as a scientific advisor of OneMind at Work. She works with senior executives of companies ranging from startups to Fortune 500, transforming corporate cultures by incorporating wellness into their business strategy. Follow her on Twitter: @drbcheng.
• ND Nele Dael is a senior behavioral scientist studying emotion, personality, and social skills in organizational contexts. She is leading research projects on workplace well-being at IMD Lausanne, focusing on stress and recovery. Nele is particularly tuned into new technologies for the benefit of research and application in human interaction, and her work has been published in several leading journals.
• FK Franciska Krings is professor of organizational behavior at HEC Lausanne, University of Lausanne. Her research interests include workforce diversity and discrimination, work-family balance, impression management, and (non)ethical behaviors. Her work has been published regularly in leading journals in the field.

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Learn how to manage your workplace stress

Workers at every level are experiencing increased tension and uncertainty, and are updating their resumes.

• Healthy Workplaces

In today’s economic upheavals, downsizing, layoffs, mergers, and bankruptcies have cost hundreds of thousands of workers their jobs. Millions more have been shifted to unfamiliar tasks within their companies and wonder how much longer they will be employed.

Adding to the pressures that workers face are new bosses, computer surveillance of production, fewer health and retirement benefits, and the feeling they have to work longer and harder just to maintain their current economic status. Workers at every level are experiencing increased tension and uncertainty, and are updating their resumes.

The loss of a job can be devastating, putting unemployed workers at risk for physical illness, marital strain, anxiety, depression, and even suicide. Loss of a job affects every part of life, from what time you get up in the morning, to whom you see, and what you can afford to do. Until the transition is made to a new position, stress is chronic.

A sense of powerlessness

A feeling of powerlessness is a universal cause of job stress. When you feel powerless, you’re prey to depression’s traveling companions, helplessness and hopelessness. You don’t alter or avoid the situation because you feel nothing can be done.

Secretaries, waitresses, middle managers, police officers, editors, and medical interns are among those with the most highly stressed occupations marked by the need to respond to others’ demands and timetables, with little control over events. Common to this job situation are complaints of too much responsibility and too little authority, unfair labor practices, and inadequate job descriptions.

Employees can counteract these pressures through workers’ unions or other organizations, grievance or personnel offices, or, more commonly, by direct negotiations with their immediate supervisors.

Your job description

Every employee should have a specific, written job description. Simply negotiating one does more to dispel a sense of powerlessness than anything else we know. It is a contract that you help write. You can object to what don’t want and insist on what you do want. If there is a compromise, it’s because you agreed to it. With a clear job description, your expectations are spelled out, as are your boss’s.

A good job description is time limited. Set a specific date for a review and revision based on your mutual experience with this initial job description. If you and your boss can’t agree on what your job description should be, look for another job, either within the same company or outside. Even in these tough economic times, it is important that your job be a source of satisfaction and respect.

When you’re a square peg and your job is a round hole

Remember the old saying, “Find a job you love and you’ll never work another day in your life.” Most people spend about 25% of their adult lives working. If you enjoy what you do, you’re lucky. But if you’re the proverbial square peg and your job is a round hole, job stress hurts your productivity and takes a serious toll on your mind and body.

There are many reasons for staying in a job that doesn’t fit you or that you don’t particularly like. One reason can be the “golden handcuff”—having salary, pension, benefits and “perks” that keep one tied to a job regardless of stress consequences.

Many people are in jobs they don’t like or aren’t good at. The quick answer is to get a job they like or one that better matches their skills, abilities, and interest—easier said than done. Some people have no idea what kind of job they would like or what kind of job would be better. Worse, they don’t have a clue on how to go about finding out this information.

Traumatic events on the job

Some jobs are inherently dangerous and others can suddenly become so. Criminal justice personnel, firefighters, ambulance drivers, military personnel, and disaster teams witness many terrible scenes and are exposed to personal danger routinely. They usually handle such incidents capably.

But occasionally a particularly bad episode will stay with them, appearing in memory flashbacks and nightmares. Sleep disturbance, guilt, fearfulness, and physical complaints may follow.

Even ordinary jobs can become traumatic: a coworker, boss, or client physically threatens an employee; a bus crashes on a field trip; an employee is robbed or taken hostage; a shooting occurs. Such events can create posttraumatic stress disorder (PTSD) and result in workers’ compensation claims if left untreated by a trauma specialist.

Work setting

Sometimes your work setting creates physical stress because of noise, lack of privacy, poor lighting, poor ventilation, poor temperature control, or inadequate sanitary facilities. Settings where there is organizational confusion or an overly authoritarian, laissez-faire or crisis-centered managerial style are all psychologically stressful.

Act through labor or employee organizations to alter stressful working conditions. If that doesn’t work, try the courts, which have become increasingly receptive to complaints of stressful working conditions. Recent rulings created pressure for employers to provide working environments that are as stress free as possible.

The Occupational Safety and Health Administration is the federal agency charged with monitoring the work environment in the interest of work safety and health. If you think your work environment is dangerous to your health and safety from a physical standpoint, give them a call.

If nothing helps and the working environment remains stressful, exercise your avoidance options and get a new job. Job hunting can be stressful, particularly in times of high unemployment, but being ground down day after day by work is far worse.

Adapted from The Stress Solution by Lyle H. Miller, PhD, and Alma Dell Smith, PhD.

Recommended Reading

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• Coping with stress at work
• Managing your distress in the aftermath of a shooting

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Stress at the Workplace and Its Impacts on Productivity: A Systematic Review from Industrial Engineering, Management, and Medical Perspective

2022, Industrial Engineering & Management Systems

In every fast-paced surrounding, stress is present in every life aspect, including at the workplace. It is a deeply personal experience, with various stressors affecting every individual differently. This study assessed the past and present workplace stress-related information and analyzed its impact on productivity. It primarily concentrates on the field's philosophical principles, while providing a collection of directions for future study as well. This study was formed in the statement of PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis). The impact of stress at the workplace on the employee's productivity was observed in the cohort and cross-sectional studies from the perspective of industrial engineering, management, and medicine. Four eligible studies were qualitatively assessed from 2,642 identified literature through four databases (Cochrane, Science Direct, Scielo, and PubMed) using keywords stress, impact, productivity, industrial engineering, management, and medicine. The study was convinced that stress at the workplace contributes to worsening relationships at home, worsening relationships between superiors and subordinates as well as contracting diseases. It has a potential negative impact on productivity. Furthermore, the work environment plays a significant contribution in inducing workplace stress because of human physiologic response. Noxious stress is detrimental to the human body, especially if maintained in the long run. Therefore, stress management is imperative before it is too late.

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Ebenezer Ofosuhene

This review of the literature gives information about work stress, factors in the working environment that cause stressful situations and negative health consequences of the workplace stress. Stressors are pointed out in details that lead to stress at the workplace. Approaches to the stress are explained and most famous models of the stress are assessed critically in this review. This article highlights the work stress and its adverse effects on the physical and mental health of an employee. Finally, recommendations for future research are given and areas are highlighted where there is need of more empirical research.

Scandinavian Journal of Work, Environment & Health

Umesh Maiya

Stress is much in the news at present but it isn't a new problem. Pressure is part and parcel of all work and helps to keep us motivated. But excessive pressure can lead to stress which undermines performance, is costly to employers and can make people ill. Research reveals that many working days are lost to stress, depression and anxiety. Work-related stress costs a huge burden to the society. Stress takes many forms as well as leading to anxiety and depression it can have a significant impact on an employee's physical health. Research links stress to heart disease, back pain, headaches, gastrointestinal disturbances and alcohol and drug dependency. Individuals are more willing to admit that they are suffering from stress if they can expect to be dealt with sympathetically. In some cases good counseling may be all that is needed. This paper aims at studying the stressors that affects an individual at work, to examine the effects of stress and suitable measures which employe...

AAOHN Journal

Bonita Long

Michael Murray

Rex Journal

In today's age of automation, advanced technology & high competition, man has great dreams of a luxurious living & enjoys at the thought of experiencing it. It is a well-accepted fact that every human being is an individual with his own unique characteristics & ways of responding & behaving. These various ways of responding & behaving can be either positive or negative & these can make one's life a happy or a miserable one. These facts are true for every individual in every sphere of life. In today's fast moving world every individual strives hard to achieve their dreams & the best of luxurious living but faces stress in the process of doing so. The present study will bring to light the stress level, sources of stress & stress management strategies.

Littera Scripta

Andrea Bencsik

Erick Onsongo

Over the past few decades the stress had become a growing dilemma in organization and cause unfavorable effects on job performance. Stress is a universal element that affects employees worldwide. There are many barriers that affecting the employees in the workplace. Work stress often affects the employees in the workplace, where each employee will feel it at least once in their workplace. Work stress is a real life problem that not only affects the organization, but the employees mainly become victims of stress. stress become a familiar element in organization and nowadays the workplace become more complicated, which bring more negative impacts to the employees compared to positive impacts. Stress among workers is greater than before which also effect on the whole performance of the employees. Stress which occurred in workplace declared as harmful to physical and emotional responses that happen within a human being when the requirement of the job do not match the employees‟ capacity...

Norliyana Zakaria

The systematic review in this study is looking at the causes of stress in the workplace. The authors will identify the most leading causes of work-related stress, as well as their impacts on employees’ physical well-being, mental health and work performance. In addition, the stress factors arising from work environment or atmosphere, workplace relationships, organizational culture, career growth, role conflict, and work-life balance are highlighted. Finally, the authors discuss on several stress coping approaches, namely getting social support, attending stress coping or stress management programmes, upgrading work environment, and reforming organizational culture.

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What Managers Can Do to Ease Workplace Stress

Employees complain of unrealistic expectations, being asked to do work beyond their skills

Study after study—and survey after survey—tell the same story: Modern workers feel stressed out on the job, and the stress is taking a toll on their sleep, health, relationships, productivity and sense of well-being.

Add to that the stress brought on by the coronavirus—because of furloughs, job losses, worries about getting sick, feeling isolated while working remotely.

Eight in 10 workers say they are stressed by at least one thing at work. About 1 in 2 workers in low-paying jobs say their job has a negative effect on their stress levels, while about 4 in 10 in medium- and high-paying jobs say the same, according to several sources cited by Happify Health, a New York City-based company that helps employees develop skills to reduce stress. Among those sources were the  2016 Work and Well-Being Survey  from the American Psychological Association and a 2016 study by the Harvard T. H. Chan School of Public Health.

And new research suggests that people aged 30 to 59 are experiencing the greatest levels of anxiety over fears that they may catch the coronavirus.

"Since the lockdown measures were brought in two weeks ago, we have seen a change in what most people are worrying about," the study's lead author Dr. Daisy Fancourt said in a statement from University College London, where the study was conducted. "The current highest stress factor appears to be worries about either catching COVID-19 or becoming seriously ill from it."

Unrealistic Expectations

Just recently, Heather Kelly was speaking with a former colleague and reminiscing about their early careers.

"We were working in the office every Saturday and most weeknights until 8, and everyone had the all-nighter war story to share," said Kelly, CEO of SSPR LLC, a public relations agency with offices in Philadelphia, Chicago, San Francisco and Colorado Springs, Colo. "Today, our office is often empty by 4, but folks are back online at 7 or 8. No one comes into the office on Saturday, but everyone checks their email 24/7."

"We live in a culture that values business and stress," she said. "Stress is a powerful currency. The busier and more stressed you are, the more important and valuable you seem. Is the stress level of today's worker really higher than that of a worker … [employed] when there were no labor laws or weekends? It doesn't matter. Culturally, we perceive ourselves as the most-stressed worker-era in history, and our perception is our reality."

According to the  World Health Organization , workplace stress is particularly common in situations when employees are asked to do things that exceed their knowledge, abilities and coping skills, and when they do not have enough support from peers and supervisors to close that gap.

In   research  from Accountemps staffing service, employees also cited unrealistic manager expectations as a top stressor, along with heavy workloads and looming deadlines.

"Increasing workloads can make you feel like there are not enough hours in the day to get everything done," said Mike Steinitz, executive director for Accountemps.

In fact, the top five things that employees say make them feel stressed have to do with workplace conditions that managers could probably do something about, according to   Happify Health. Those top five things are low wages or salaries, lack of opportunity for advancement or growth, too heavy a workload, unrealistic job expectations and long hours.

"It's important for managers to spot the signs of stressed-out employees, such as incomplete work, decreased productivity, lower quality of work and mistakes," Steinitz said. They can also ease up on deadlines and meet with workers and help them prioritize projects.

Even if managers only occasionally place demands on employees during off hours, employees may never really get a mental break from being at work if they know their manager could contact them at any time, said Acacia Parks, chief scientist at Happify Health. "This is not to put all the blame on managers. Employees also do this to themselves, working more in the evenings because of pressure—real or imagined—to do more."

Changes in Career Arcs

There was a time, not too long ago, when employees decided on a career, landed an entry-level position, then steadily worked their way up within the same organization until retirement, said Kyle Kensing, online content editor for CareerCast, a Carlsbad, Calif.-based company that hosts an online job-search portal and publishes career management and HR advice.

"Such career arcs are decreasing, both because of human competition and technological advancements that, while making certain jobs easier, might threaten career options," Kensing said.  

"As technology and best practices evolve, so will the roles we are expected to fill and the skills we will need to fill these roles," Parks said. "The answer isn't to liberate workers from having to learn new things, but for workers to become more resilient so that they are better able to handle this type of challenge. One key piece of resilience … is how you look at a stressful situation. Do you see it as a threat or a challenge? Changing needs of the marketplace when it comes to technology could be seen as a threat, but resilient people see it as a challenge to tackle."

People are living farther from their jobs, and commuting is a relatively new stressor in the workplace. While the advent of telecommuting—especially during the coronavirus—means workers can reduce or eliminate those commutes, remote work can also shake the stability of careers.

"Telecommuting might turn the candidate pool into a regional, national or even international one for jobs that may have been local in the past," Kensing said.

[SHRM members-only toolkit:  Developing and Sustaining Employee Engagement ]

Experts offered other ways managers can help employees handle stress:

• Encourage your team to take advantage of stress-management webinars, wellness tips or programs, and yoga or meditation classes. Set an example by using these resources yourself.
• Make sure workers are taking regular breaks, and be sure to take them yourself.
• Encourage employees to exercise daily, take time for friends or a significant other after work, pursue hobbies, listen to music and take time off.

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16 Causes of Workplace Stress & How to Prevent Its Effects

• Are you falling behind with your work commitments?
• Snappy with loved ones and having trouble sleeping?
• Are you working long hours yet not getting enough done?

If your job demands more than you can deliver, you could be experiencing workplace stress (Schwartz & McCarthy, 2014). According to the American Psychological Association (2018), “everyone who has had a job has, at some point, felt the pressure of work-related stress.”

While seemingly inevitable, we can do much to prevent stress and reduce its effects. This article explores many of the causes and introduces practical measures that help.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free . These science-based exercises will equip you and your clients with tools to better manage stress and find a healthier balance in your life.

This Article Contains:

The psychology of workplace stress, symptoms of workplace stress: 3 examples, 16 possible causes of stress at work, 5 negative effects of workplace stress, how to manage stress according to research, 9 tips to prevent workplace stress, our stress-relief resources & more, a take-home message.

“Stress is one of the major reasons employees cite for their absence from work, and stress-related absence is increasing.”

Neenan, 2018, p. 92

Unfortunately, chronic stress is all too common in the workplace. According to the American Psychological Association’s (2020) annual Stress in America survey , work is consistently cited as one of the top sources of stress in people’s lives.

What is stress?

It is important to begin by understanding what we mean by the term stress.

Definitions of stress typically fall into three categories (Gross, 2020, p. 199):

• “Stress as a stimulus. ”
• “Stress as a response. ”
• “Stress as an interaction between an organism and its environment.”

Each category is a good match for the three models of stress most often used in research (Gross, 2020):

• Engineering model Suggests that external stressors ( stimuli ) produce a stress reaction in the individual. Stress is what happens to the person, not within the person.
• Physiological model Focuses on what happens within the person in response to the stress.
• Transactional model A blend of the other two models concerned with the relationship between the person and the environment.

This article mainly focuses on the transactional model, looking at what causes workplace stress ,  its effects , and how we cope.

Workplace stress

According to former associate director of the Centre for Stress Management and Cognitive-Behavioral Therapist Michael Neenan (2018), stress is the result of pressures exceeding our ability to cope with them.

If we experience too much stress in the workplace, we become psychologically overwhelmed and unable to avoid the tensions found in our jobs (American Psychological Association, 2018).

Resilience and stress

Psychology literature broadly agrees that resilience offers a buffer against stress (Rutter, 1985, 2012).

While the popular view of resilience concerns bouncing back from adversity or stressful situations, Neenan (2018) suggests that building resilience requires us to face adversity, handle it, and ultimately return stronger.

Most importantly, resilience and the capacity to handle stress are for everyone , not just the extraordinary few (Neenan, 2018). Crucially, resilience can be learned and grown using lessons from Cognitive-Behavioral Therapy (CBT).

CBT’s strength in handling stress and difficult situations involves recognizing what can be changed and what cannot (yet), as follows (modified from Neenan, 2018):

• If you can change some, or all, of the situation, then take the required steps to do so.
• If you cannot change any aspect of the situation, then make every effort to change your emotional reaction to it.
• If you can change some or all of the situation, but your degree of emotional distress means you can’t see that as an option, then moderate that distress before taking practical problem-solving steps.

This CBT approach (along with other therapeutic treatments) has proven successful in managing difficult situations while handling and reducing stress.

After all, “you can’t always avoid the tensions that occur on the job. Yet you can take steps to manage work-related stress” (American Psychological Association, 2018).

With more people working remotely and able to work anytime and anywhere, there is even more spillover of workplace stress into our home lives (Stitch, 2020).

“A stressful work environment can contribute to problems such as headache, stomachache, sleep disturbances, short temper, and difficulty concentrating.”

American Psychological Association, 2018

Over time, the symptoms of workplace stress may become chronic, damaging physical and mental health.

Prolonged occupational stress resulting from extended, frequent, or intense stressors leads to distress, occurring in one or more of the following forms (Quick & Henderson, 2016).

Medical distress

The impact of long-term stress on the body is profound and well documented. Research has linked shift work, hazardous working conditions, and social hazards (all factors known to increase stress) with cardiovascular disease.

Other studies indicate that stress is an important factor in “the onset of cancers and having an indirect role in worsening the disease and limiting recovery” (Quick & Henderson, 2016, p. 3).

Surprisingly, an increased risk of physical injuries – the fourth leading cause of death – has also been linked to stress.

Psychological distress

Two of the leading and most severe psychological impacts of stress include the increased likelihood of anxiety and depression (Quick & Henderson, 2016).

Depression is ranked as one of the most significant factors in illness, disease, and loss of productivity in the workplace, affecting around 16% of adults (Quick & Henderson, 2016). Prolonged stress can also lead to anxiety disorders and burnout, with high costs to the individual and the organization.

Behavioral distress

Stress is also a significant factor in behavioral distress, increasing drug use, including reliance on tobacco, alcohol, and prescription and illicit drugs.

Download 3 Free Stress & Burnout Prevention Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to manage stress better and find a healthier balance in their life.

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Stress at work has many causes, often specific to the individual and the workplace. Common workplace stressors include (American Psychological Association, 2018; Neenan, 2018):

• Longer working hours impacting work–life balance
• Job insecurity
• Excessive and tiring commutes
• Increasing work demands
• Unrealistic deadlines
• Limited opportunities for growth, development, or advancement
• Challenging or difficult colleagues
• Too many meetings
• Email overload
• Incompetent or uncaring managers and supervisors
• Meaningless targets
• Constantly changing technology
• Lack of social support
• Insufficient control over job-related decisions
• Conflicting job demands and unclear performance expectations

In most cases, multiple stressors combine to produce our work-related stress, differing in severity through the day and even our career.

World’s Largest Positive Psychology Resource

The Positive Psychology Toolkit© is a groundbreaking practitioner resource containing over 500 science-based exercises , activities, interventions, questionnaires, and assessments created by experts using the latest positive psychology research.

Updated monthly. 100% Science-based.

“The best positive psychology resource out there!” — Emiliya Zhivotovskaya , Flourishing Center CEO

Prolonged and excessive stress can have many and various negative impacts on our mental and physical wellbeing.

While the highest performers can often survive and thrive in stressful environments, stress remains overwhelming and damaging for the rest of us (Kovacs, 2007).

The adverse effects of workplace stress can take many forms, including the following (Contrada & Baum, 2011):

Unhealthy eating

Studies in adolescents and adults have also shown they consume more snacks when stressed (Contrada & Baum, 2011).

Recreational drug use

Stress is associated with a marked increase in recreational drug use – legal (e.g., alcohol, nicotine, and caffeine) and illegal (e.g., heroin and cocaine). While the exact reasons for the association may vary, they may include the belief that drug use can reduce stress. Further complicating matters, physical and psychological reactions to abstaining from previously self-administered drugs can increase stress as a symptom of withdrawal (Contrada & Baum, 2011).

Burnout & workplace stress

Prolonged stress in the workplace often leads to burnout and is particularly likely in suppliers of critical services to the public. During natural disasters or health crises, healthcare and emergency service workers often work long hours over many days and weeks, reporting severe psychological distress (Moss, 2021).

Can workplace stress cause depression?

Workplace stress has a significant impact on the incidence and duration of depression. However, research has found that improving workers’ ability to cope and manage stressful situations through stress management programs (including cognitive-behavioral approaches) reduces absence rates due to sickness and staff turnover, and eases depressive symptoms (Mino, Babazono, Tsuda, & Yasuda, 2006).

Negative effects at the company level

While stress can be harmful to the employee, it also has the potential to damage the company due to increased staff absence due to sickness, poor productivity, high turnover, low morale, poor motivation, and increased employee complaints (Attridge, 2017).

The American Institute of Stress estimates the cost of stress to U.S. industry to be over $300 billion annually.

The cost of workplace stress – and how to reduce it – Rob Cooke

The American Psychological Association (2018) offers several research-based techniques for managing stress, at work and beyond:

• Track your stressors. Keep a journal and track situations that create the most stress over several weeks and how you handle them. What are you thinking? How does it feel? In what environments do the stressors (people, circumstances, physical) appear? You are looking for patterns in what is causing stress and how you react.
• Develop healthy, helpful, and positive responses. We often rely on unhealthy choices to cope with stress: fast food, alcohol, or a cigarette. Look for healthy ways to de-stress, such as exercising (even a fast walk will help), getting into nature, meeting with friends, meditation, or yoga. Good sleeping habits are also essential.
• Establish boundaries. In our always available online world, it is increasingly important to set clear work–life boundaries. Don’t check emails after your evening meal or over the weekend. Agree to only talk (or vent) about work for 30 minutes when at home .
• Recharge and switch off. We need time to reach our pre-stress balance. Walking after work (whether working remotely or in the office) or using the commute to listen to music or an audiobook can encourage the transition between work and home life. Such practices can help by bookending the workday, disconnecting, and focusing on non-work activities.
• Learn how to relax. While it sounds easy, learning to relax may take practice until it becomes a habit. Find ways to experience the present moment, perhaps using breathing exercises, mindfulness techniques, savoring a meal , or listening to music.
• Talk to your supervisor. It is in your boss’s interest for you to be happy, healthy, and in a positive and productive working environment. Talk to your manager to develop a realistic plan for managing or removing stressors. Being given more meaningful tasks may help.
• Seek support. Support is often all around us when we look. Friends, family, and employee support programs can help you manage stress and adopt more healthy coping mechanisms.

Stress doesn’t always need to be bad. By encountering stress and learning how to cope, we can grow and develop greater resilience to make future situations less difficult. Remember, “resilience is about managing emotions, not suppressing them” (Neenan, 2018, p. 9).

The following tips help reduce the likelihood of feeling overloaded and overwhelmed (modified from Halvorson, 2014):

• Practice self-compassion , permitting yourself to make mistakes. Rather than dwell on the past, learn from it and improve your performance.
• Picture the overall goal or purpose and reflect on the why behind your behavior. You will be more likely to stop and plan rather than burn too much energy on being busy.
• Use routines whenever possible. Each new task and choice takes time and creates mental tension, so find ways to reduce the number of decisions.
• Interesting activities replenish energy. Being curious and finding something that captivates you will help you recharge.
• Add when and where to every item on your task to avoid the week slipping away without getting everything done on time.
• Consider situations and events that trigger stress. Come up with a set of if–then plans (e.g., “ If X happens, I will do Y .”). Planning for the worst will leave you prepared and less stressed if it happens.
• Striving for perfection can lead to procrastination and even burnout. Focus on being good and on improving, rather than setting standards you can’t meet.
• Reflect on past successes and the progress you have already made. You have come a long way; give yourself the credit you deserve.
• Recognize what motivates you. Life is full of opportunities; find what excites you and apply yourself to the challenge.

17 Exercises To Reduce Stress & Burnout

Help your clients prevent burnout, handle stressors, and achieve a healthy, sustainable work-life balance with these 17 Stress & Burnout Prevention Exercises [PDF].

Created by Experts. 100% Science-based.

Before looking at a sample of the many worksheets and exercises we have available, you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free .

These science-based exercises were sourced from our Positive Psychology Toolkit© , an online collection of over 400 mindfulness-based exercises, interventions, and tests. They will equip you and your clients with tools to better manage stress and find a healthier balance in life.

For some additional free stress-relief tools to help you or your client better manage stress, check out the following:

• Squeeze and Release This group activity helps participants discover the energizing potential of positive stress, known as  eustress , which can help improve motivation, performance, and emotional wellbeing.
• Coping With Stress This two-part exercise invites clients to list experienced physiological and emotional symptoms of stress and brainstorm strategies to reduce, cope with, or eliminate these sources of stress.
• Coping: Stressors and Resources This worksheet helps clients identify past, present, and future stressors and link them with coping resources they can use to overcome them.
• Identifying Your Stress Resources This worksheet helps clients identify external resources they can connect with and draw strength from during stressful times.
• One Hour Stress Plan This worksheet provides a 60-minute action plan for dealing with intense demands, helping clients work systematically through a list of tasks that require their most urgent attention.

17 Stress & Burnout Prevention Exercises If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, check out this collection of 17 validated stress management tools for practitioners . Use them to help others identify signs of burnout and create more balance in their lives.

Stress affects us all. While a certain amount of pressure in the workplace can be invigorating and even exciting, too much for too long can damage our physical and mental wellbeing.

Increased stress potentially leads to cardiovascular disease, cancer, poor sleep, difficulty concentrating, damage to relationships, and more (American Psychological Association, 2018; Quick & Henderson, 2016).

Psychological distress is also a significant factor in burnout and can lead to depression and other mental health issues.

For employers, having a stressed staff results in lost productivity, absenteeism, and the risk of accidents and legal proceedings.

It doesn’t have to be this way. Stress can be managed and even become positive by addressing, reducing, or removing some of the causes; establishing boundaries between work and life outside; and allowing staff to recharge.

Review the theoretical background to stress, understand its causes (for you or your client), and adopt tools and techniques that reduce feelings of being overloaded and overwhelmed. Over time, it is possible to form helpful habits, discard old negative ones, and change our relationship to stress.

We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free .

• American Psychological Association. (2018). Coping with stress at work . http://www.apa.org/topics/healthy-workplaces/work-stress
• American Psychological Association. (2020). Stress in America: A national mental health crisis.  Retrieved August 26, 2021, from https://www.apa.org/news/press/releases/stress/2020/sia-mental-health-crisis.pdf
• Attridge, D. (2017). Effects of work-related stress . University of Cambridge Human Resources. Retrieved August 26, 2021, from https://www.hr.admin.cam.ac.uk/policies-procedures/managing-stress-and-promoting-wellbeing-work-policy/policy-statement/effects
• Contrada, R. J., & Baum, A. (2011). The handbook of stress science: Biology, psychology, and health . Springer.
• Gross, R. D. (2020). Psychology: The science of mind and behaviour . Hodder and Stoughton.
• Halvorson, H. (2014). Nine ways successful people defeat stress. In HBR guide to managing stress at work (pp. 1–11). Harvard Business Review Press.
• Kovacs, M. (2007). Stress and coping in the workplace . The British Psychological Society. Retrieved August 25, 2021, from https://thepsychologist.bps.org.uk/volume-20/edition-9/stress-and-coping-workplace
• Mino, Y., Babazono, A., Tsuda, T., & Yasuda, N. (2006). Can stress management at the workplace prevent depression? A randomized controlled trial. Psychotherapy and Psychosomatics , 75 (3), 177–182.
• Moss, J. (2021). Rethinking burnout. In HBR guide to beating burnout (pp. 1–13). Harvard Business Review Press.
• Neenan, M. (2018). Developing resilience: A cognitive-behavioural approach . Routledge.
• Quick, J., & Henderson, D. (2016). Occupational stress: Preventing suffering, enhancing wellbeing. International Journal of Environmental Research and Public Health , 13 (5), 459.
• Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance in psychiatric disorder. British Journal of Psychiatry , 147 (1), 598–611.
• Rutter, M. (2012). Resilience as a dynamic concept. Development and Psychopathology , 24 (2), 335–344.
• Schwartz, T., & McCarthy, C. (2014). Manage your energy not your time. In HBR guide to managing stress at work (pp. 53–80). Harvard Business Review Press.
• Stitch, J. (2020). A review of workplace stress in the virtual office. Intelligent Buildings International , 12 (3), 208–220.

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Whole Person Health: What It Is and Why It's Important

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Whole person health involves looking at the whole person—not just separate organs or body systems—and considering multiple factors that promote either health or disease. It means helping and empowering individuals, families, communities, and populations to improve their health in multiple interconnected biological, behavioral, social, and environmental areas. Instead of just treating a specific disease, whole person health focuses on restoring health, promoting resilience, and preventing diseases across a lifespan.

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Health and disease are not separate, disconnected states but instead occur on a path that can move in two different directions, either toward health or toward disease.

On this path, many factors, including one’s biological makeup; some unhealthy behaviors, such as poor diet, sedentary lifestyle, chronic stress, and poor sleep; as well as social aspects of life—the conditions in which people are born, grow, live, work, and age—can lead to chronic diseases of more than one organ system. On the other hand, self-care, lifestyle, and behavioral interventions may help with the return to health.

Chronic diseases, such as diabetes, cardiovascular disease, obesity, and degenerative joint disease, can also occur with chronic pain, depression, and opioid misuse—all conditions exacerbated by chronic stress. Some chronic diseases increase the immediate and long-term risks with COVID-19 infection. Understanding the condition in which a person has lived, addressing behaviors at an early stage, and managing stress can not only prevent multiple diseases but also help restore health and stop the progression to disease across a person’s lifespan.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Is whole person health being used now in health care?

Some health care systems and programs are now focusing more on whole person health.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} U.S. Department of Veterans Affairs (VA) Whole Health Approach

The VA’s Whole Health System of Care and Whole Health approach aims to improve the health and well-being of veterans and to address lifestyle and environmental root causes of chronic disease. The approach shifts from a disease-centered focus to a more personalized approach that engages and empowers veterans early in and throughout their lives to prioritize healthy lifestyle changes in areas like nutrition, activity, sleep, relationships, and surroundings. Conventional testing and treatment are combined with complementary and integrative health approaches that may include acupuncture, biofeedback, massage therapy, yoga, and meditation.

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The Total Force Fitness program arose within the U.S. Department of Defense Military Health System in response to the need for a more holistic approach—a focus on the whole person instead of separate parts or only symptoms—to the demands of multiple deployments and the strains on the U.S. Armed Forces and their family members. The focus extends the idea of total fitness to include the health, well-being, and resilience of the whole person, family, community, and U.S. military.

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Established in 2020, the Whole Health Institute’s Whole Health model helps people identify what matters most to them and build a plan for their journey to whole health. The model provides tools to help people take good care of their body, mind, and spirit, and involves working with a health care team as well as tapping into the support of family, friends, and communities.

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The North Carolina Department of Health and Human Services has incorporated a whole person health approach into its health care system by focusing on integrating physical, behavioral, and social health. The state has taken steps to encourage collaborative behavioral health care and help resolve widespread inequities in social conditions, such as housing and nutritious food access.

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The Ornish Program for Reversing Heart Disease is an intensive cardiac rehabilitation program that has been shown to reverse the progression of coronary heart disease through lifestyle changes, without drugs or surgery. The program is covered by Medicare and some health insurance companies. The program’s lifestyle changes include exercise, smoking cessation, stress management, social support, and a whole-foods, plant-based diet low in total fat. The program is offered by a team of health care professionals who provide the support that individuals need to make and maintain lasting changes in lifestyle.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} What does research show about whole person health?

A growing body of research suggests the benefits of healthy behaviors, environments, and policies to maintain health and prevent, treat, and reverse chronic diseases. This research includes several large, long-term epidemiological studies—such as the Framingham Heart Study, Nurses’ Health Study, and Adventist Health Studies—that have evaluated the connections between lifestyle, diet, genetics, health, and disease.

There is a lack, however, of randomized controlled trials and other types of research on multicomponent interventions and whole person health. Challenges come with conducting this type of research and with finding appropriate ways to assess the evidence. But opportunities are emerging to explore new paths toward reliable and rigorous research on whole person health.

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Yes, NCCIH plans to fund research on whole person health . (Details can be found in the NCCIH Strategic Plan FY 2021–2025: Mapping a Pathway to Research on Whole Person Health . )

By deepening the scientific understanding of the connections that exist across the different areas of human health, researchers can better understand how conditions interrelate, identify multicomponent interventions that address these problems, and determine the best ways to support individuals through the full continuum of their health experience, including the return to health.

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Nccih clearinghouse.

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226

Telecommunications relay service (TRS): 7-1-1

Website: https://www.nccih.nih.gov

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Know the Science

NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information.

Explaining How Research Works (NIH)

Know the Science: How To Make Sense of a Scientific Journal Article

Understanding Clinical Studies (NIH)

A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed .

Website: https://pubmed.ncbi.nlm.nih.gov/

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• Aggarwal M, Ornish D, Josephson R, et al. Closing gaps in lifestyle adherence for secondary prevention of coronary heart disease. American Journal of Cardiology. 2021;145:1-11.
• Centers for Medicare & Medicaid Services. Decision Memo for Intensive Cardiac Rehabilitation (ICR) Program—Dr. Ornish’s Program for Reversing Heart Disease (CAG-00419N). Accessed at https://www.cms.gov/ on April 26, 2021.
• Deuster PA, O’Connor FG. Human performance optimization: culture change and paradigm shift. Journal of Strength and Conditioning Research. 2015;29(suppl 11):S52-S56.
• Gaudet T, Kligler B. Whole health in the whole system of the Veterans Administration: how will we know we have reached this future state? Journal of Alternative and Complementary Medicine. 2019;25(S1):S7-S11.
• Malecki HL, Gollie JM, Scholten J. Physical activity, exercise, whole health, and integrative health coaching. Physical Medicine and Rehabilitation Clinics of North America. 2020;31(4):649-663.
• National Center for Complementary and Integrative Health. NCCIH Strategic Plan FY 2021–2025: Mapping a Pathway to Research on Whole Person Health. National Center for Complementary and Integrative Health website. Accessed at https://www.nccih.nih.gov/about/nccih-strategic-plan-2021-2025 on May 14, 2021.
• North Carolina Department of Health and Human Services website. Healthy Opportunities and Medicaid Transformation. Accessed at https://www.ncdhhs.gov/about/department-initiatives/healthy-opportunities/healthy-opportunities-pilots/healthy on April 26, 2021.
• Military Health System website. Total Force Fitness. Accessed at https://health.mil/Military-Health-Topics/Total-Force-Fitness on April 26, 2021.
• Tilson EC, Muse A, Colville K, et al. Investing in whole person health: working toward an integration of physical, behavioral, and social health. North Carolina Medical Journal. 2020;81(3):177-180.
• U.S. Department of Veterans Affairs website. Whole Health. Accessed at https://www.va.gov/wholehealth/ on April 26, 2021.
• U.S. Department of Veterans Affairs website. Whole Health Library. Accessed at  https://www.va.gov/wholehealthlibrary/ on April 26, 2021.
• Vodovotz Y, Barnard N, Hu FB, et al. Prioritized research for the prevention, treatment, and reversal of chronic disease: recommendations from the Lifestyle Medicine Research Summit. Frontiers in Medicine (Lausanne). 2020;7:585744.
• Whitehead AM, Kligler B. Innovations in care: complementary and integrative health in the Veterans Health Administration Whole Health System. Medical Care. 2020;58(9S)(suppl 2):S78-S79.

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• Alborzkouh P, Nabati M, Zainali M, et al. A review of the effectiveness of stress management skills training on academic vitality and psychological well-being of college students. Journal of Medicine and Life. 2015;8(4):39-44.
• Bisht K, Sharma K, Tremblay M-È. Chronic stress as a risk factor for Alzheimer's disease: roles of microglia-mediated synaptic remodeling, inflammation, and oxidative stress. Neurobiology of Stress. 2018;9:9-21.
• Buettner D, Skemp S. Blue Zones: lessons from the world’s longest lived. American Journal of Lifestyle Medicine. 2016;10(5):318-321.
• Chen T-L, Chang S-C, Hsieh H-F, et al. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: a meta-analysis. Journal of Psychosomatic Research. 2020;135:110144.
• Conversano C, Orrù G, Pozza A, et al. Is mindfulness-based stress reduction effective for people with hypertension? A systematic review and meta-analysis of 30 years of evidence. International Journal of Environmental Research and Public Health. 2021;18(6):2882.
• Katz DL, Karlsen MC, Chung M, et al. Hierarchies of evidence applied to lifestyle medicine (HEALM): introduction of a strength-of-evidence approach based on a methodological systematic review. BMC Medical Research Methodology. 2019;19(1):178.
• Kruk J, Aboul-Enein BH, Bernstein J, et al. Psychological stress and cellular aging in cancer: a meta-analysis. Oxidative Medicine and Cellular Longevity. 2019;2019:1270397.
• Levesque C. Therapeutic lifestyle changes for diabetes mellitus. Nursing Clinics of North America. 2017;52(4):679-692.
• Ni Y, Ma L, Li J. Effects of mindfulness-based stress reduction and mindfulness-based cognitive therapy in people with diabetes: a systematic review and meta-analysis. Journal of Nursing Scholarship. 2020;52(4):379-388.
• Ornish Lifestyle Medicine website. The Ornish Reversal Program: Intensive Cardiac Rehabilitation. Accessed at https://www.ornish.com/intensive-cardiac-rehab/ on April 26, 2021.
• Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annual Review of Clinical Psychology. 2005;1:607-628.
• Seal KH, Becker WC, Murphy JL, et al. Whole Health Options and Pain Education (wHOPE): a pragmatic trial comparing whole health team vs primary care group education to promote nonpharmacological strategies to improve pain, functioning, and quality of life in veterans—rationale, methods, and implementation. Pain Medicine. 2020;21(suppl 2):S91-S99.
• Tamashiro KL, Sakai RR, Shively CA, et al. Chronic stress, metabolism, and metabolic syndrome. Stress. 2011;14(5):468-474.
• Whayne TF Jr, Saha SP. Genetic risk, adherence to a healthy lifestyle, and ischemic heart disease. Current Cardiology Reports. 2019;21(1):1.
• Whole Health Institute website. Accessed at https://www.wholehealth.org/ on May 19, 2021.

Acknowledgments

NCCIH thanks Mary Beth Kester, M.S., and Helene M. Langevin, M.D., NCCIH, for their review of this publication.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

Related Topics

NCCIH Strategic Plan FY 2021–⁠2025 Mapping a Pathway to Research on Whole Person Health

Methodological Approaches for Whole Person Research Workshop

Transforming Veterans’ Health: Implementing a Whole Health System of Care

Complementary, Alternative, or Integrative Health: What’s In a Name?

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Realizing the benefits of music in the workplace.

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Justin Grome, Founder & CEO of Clonefluence , helping thousands grow their online presence with networking tactics.

Music is a powerful force that transcends boundaries and connects us on a deep emotional level. Its impact on mental health is profound for many. It can create transformative experiences, and research also suggests that it has therapeutic benefits . Music can be leveraged in your workspace in several ways, including by helping you achieve complete and utter focus, especially if you work in the music industry already. Here are some of its benefits and how to leverage them at work.

Alleviating Stress and Anxiety

Music has a unique ability to soothe the mind and body, and I find that it reduces my stress and anxiety levels. Some research has suggested that music can lower cortisol (stress hormone) levels. Whether it's the gentle strains of classical music or the rhythmic beats of lo-fi hip-hop, music can provide a sanctuary from the chaos of daily life.

You can ask your boss to allow you the time to take breaks, which you can use to listen to music that calms you. This can help you come off of a break ready to get your tasks done throughout the workday. For me, it keeps my mind sharp and extremely focused on what is to come.

Enhancing Cognitive Function

Engaging with music, whether through listening, playing an instrument or even dancing, stimulates various areas of the brain. Research suggests that this can lead to improved cognitive functions, such as memory and processing speeds . I find that music elevates my mood and helps me think properly.

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A great idea for tapping into these benefits would be to choose appropriate music for the corresponding tasks. If your day is looking very clear-cut and simple, there's nothing like some slow R&B for the workplace. Understand that different types of music have different effects on people. There's soothing music to relieve anxiety and stress, Lo-fi music that many say helps them focus, and soul music that can bring people together. Listen to the music in your environment that suits you.

Fostering Social Connections

Music is a social catalyst; it can bring people together and foster a sense of community. Attending concerts, joining a choir or simply sharing your favorite songs with friends can strengthen social bonds and create a supportive network. Moreover, I've found that collaborative music-making can enhance interpersonal skills and boost self-esteem.

In the workplace, music can have a bonding effect, whether you listen to it with colleagues on your lunch break or even during collaborations with your co-workers. Imagine the day without music: You could say it's quite "empty" without it. Music helps some people stimulate the free flow of ideas and improve their focus. At work, consider incorporating music with themed days and shared playlists to focus on team-building exercises and creating easy conversation starters.

The relationship between music and mental health is intricate and deeply personal. For many of us, music serves as a mirror to our emotions, a balm for our wounds, and a bridge connecting us to others. By integrating music into our daily lives and work, we can harness its potential and enhance our mental well-being. Whether you’re an avid listener or a passionate creator, let music guide you.

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Perceptions of work stress causes and effective interventions in employees working in public, private and non-governmental organisations: a qualitative study

Kamaldeep bhui.

1 Barts and The London School of Medicine and Dentistry

Sokratis Dinos

2 BPP University, London

Magdalena Galant-Miecznikowska

Bertine de jongh, stephen stansfeld.

Aims and method

To identify causes of stress at work as well as individual, organisational and personal interventions used by employees to manage stress in public, private and non-governmental organizations (NGOs). Qualitative interviews were conducted with 51 employees from a range of organisations.

Participants reported adverse working conditions and management practices as common causes of work stress. Stress-inducing management practices included unrealistic demands, lack of support, unfair treatment, low decision latitude, lack of appreciation, effort–reward imbalance, conflicting roles, lack of transparency and poor communication. Organisational interventions were perceived as effective if they improved management styles, and included physical exercise, taking breaks and ensuring adequate time for planning work tasks. Personal interventions used outside of work were important to prevent and remedy stress.

Clinical implications

Interventions should improve management practices as well as promoting personal interventions outside of the work setting.

The conceptualisation of work stress is of crucial importance when developing interventions for the workplace. Work-related stress is defined as ‘a harmful reaction that people have to undue pressures and demands placed on them at work’. 1 As many as 440 000 people in the UK complain of work-related stress, depression or anxiety that makes them ill; nearly 9.9 million work days were lost as a consequence in 2014/2015. 1 The most recent Health and Safety Executive (HSE) report (2015) gives a prevalence of 1380 and an incidence of 740 per 100 000 workers, and also concludes that work stress is more common in public service institutions. 1 The estimated economic costs to the British economy as a result of stress at work are considerable, with £14.3 billion lost in 2013/2014, 2 and the higher costs in public service amount to £1.2 billion per year. 3

Work stress can lead to physical illness, as well as psychological distress and mental illness. 4 , 5 , 6 The recent increase in work stress has been linked with the global and national recession, 7 - 9 job insecurity and work intensity, all leading to greater workloads and more interpersonal conflicts, 3 and can have an impact on children's mental health through disrupted parenting. 10 Essentially, stress in the workplace may be the result of exposure to a range of work stressors and appears to arise when people attempt to manage their responsibilities, tasks or other forms of pressure related to their jobs, and encounter difficulty, strain, anxiety or worry in this attempt. 11 Work stressors can take different forms depending on the characteristics of the workplace, and may be unique to an organisation or an industry. 12 Theoretical models of stress consider it to be either related to adverse life events and stressful environments or the individual's physiological and psychological responses to stressors, or a ‘transactional’ interaction between the individual and environment. 13 , 14 – 17 Although theoretical models conceptualise stress as a result of an imbalance between perceptions of external demands and internal resources, the consensus between theoretical academic models and lay representations of definitions of stress is far from clear. Definitions of stress in the research literature as well as those reported by lay people vary considerably. For example, Kinman & Jones 18 found that there was a lack of consensus on conceptualisations of stress, and a number of different personal, social, environmental and work-related factors were used to define and interpret the meaning of stress. 11 Brooker & Eakin 19 suggest that concepts such as power or control in relation to gender and class are related to stress, yet models of stress do not explicitly take them into account. For example, Page et al 20 found that participants perceived stress as a feminine trait associated with weakness, thus few people admit to it.

Cahil, 16 Cooper et al 13 and Marine et al 21 describe categories of stress management interventions that target individuals or organisations; these can be further segmented as preventive interventions at primary, secondary or tertiary levels. 22 Primary interventions aim to prevent the causal factors of stress, secondary interventions aim to reduce the severity or duration of symptoms, and tertiary or reactive interventions aim to provide rehabilitation and maximise functioning among those with chronic health conditions. 23 Individual interventions may include stress awareness training and cognitive–behavioural therapy (CBT) for psychological and emotional stress. Organisational interventions affect groups of people at work and may include workplace adjustments or conflict management approaches in a specific organisation. Some interventions target both the individual and the organisation, for example policies to secure a better work–life balance and peer-support groups. Bhui et al 's systematic review 24 found that interventions that target individuals show larger effects compared with organisational interventions on individual outcomes such as levels of depression and anxiety. However, individual interventions did not improve organisational outcomes such as absenteeism, which is the most important indicator of loss of organisational productivity. The evidence gaps identified in this review included studies that compared different types of organisation (e.g. public, private and non-governmental organisation (NGO)), and studies that examine whether they employ and benefit from similar interventions, given that different sectors deploy very different business processes, levels and consistency of resources and profit focus, and public service or charitable objectives. Furthermore, studies tended to be based in work settings, rather than considering all interventions applied outside of work that people found helpful. 25

These evidence gaps continue to exist despite the growing body of research into work stress. Our systematic synthesis of the research evidence on managing work stress showed a wide variety of organisational settings, research methods and outcome measures, such that too many questions were being asked but few answered definitively. 24 We concluded that more empirical research was required, but that surveys were premature until there was a better understanding of:

• What work stress issues do employees and managers face on a day-to-day basis?
• What are organisations and employees already doing about work stress in the workplace and outside of work?
• What are the interventions that employees perceive to be the most effective when managing work-related stress?
• Should the approaches taken by public and private organisations and NGOs be distinct given the very different levels and consistency of resources, focus on profit, and public service or charitable objectives?

The present study used qualitative interviews to address these questions and to identify individual, organisational and personal interventions and their perceived effectiveness in managing work-related stress. Contrasts between different types of organisation were also investigated.

Participants

The sample used in this study was purposive (e.g. type and size of organisation, vocational role) and explored participants' experiences of work stress in the course of their working day. A total of 12 organisations took part in the study, of which 6 were public organisations, 4 were private organisations and 2 were NGOs. Three organisations were based outside London, whereas the remaining 9 were based in London. Organisations were from a variety of sectors, including education, health services, insurance, graphic design and betting agencies. The purposive sampling methods aimed to ensure as broad as possible a representation of organisations, levels of the organisation and types of work within the organisation.

For the organisations that met the inclusion criteria, the senior manager was contacted by telephone and informed about the nature of the study, and agreement was reached for participation in the study. The researchers selected a number of employees in different positions along the hierarchy so there is representation from different roles: 28 of the participants were in managerial roles, and the remaining were in non-management positions. We interviewed approximately 5 participants per organisation. A total sample of 51 employees (17 men and 34 women) took part in the study; 26 participants were aged 30 years or under, 17 were between 31 and 50 years and 8 were over 51 years old.

Procedure and topic guide

The topic guide was piloted on six employees who had experienced work stress. The content of these pilot interviews was used to refine the topic guide and to gain feedback from participants on clarity and appropriateness of the questions. Organisations were approached and invited to participate by e-mails containing information on the nature of the study and the data collection processes. Participation was voluntary; the interviews were conducted face to face and, whenever possible, at the interviewee's place of work. The interviews were semi-structured and lasted up to 45 minutes. The topic guide focused on factors that may cause stress and/or absence, personal experiences of and/or recommendations on managing stress at work and experiences of effective individual and organisational interventions to manage work-related stress (see the appendix for topic guide).

The interviews were transcribed verbatim, excluding any potentially identifying information. The data collected were subject to thematic analysis in order to identify and describe recurring themes. 26 Themes and subthemes were organised using the framework approach that is commonly used in policy-relevant qualitative research. 27 Charts were generated from the themes, the range and nature of the experiences were mapped, and patterns between and within themes were revealed. Typologies were iteratively generated to accommodate the data if existing themes were inadequate or were better grouped within a higher theme. Content analysis was also performed by counting the frequency of themes in order to identify their relative prominence in the data, and also to reveal types of interventions and contexts, and views about effectiveness. These frequencies are presented only to support the strength of the findings in these data rather than to estimate prevalence more generally. With this purpose in mind, the analysis proceeded until saturation was reached, and only themes on which saturation was reached are presented.

Data were organised by three higher themes that captured the aims of the study:

• perceived causes of stress at work
• individual and organisational stress management interventions and their perceived effectiveness
• personal interventions to manage stress at work.

Causes of stress at work

The narrative data on participants' understanding of factors that may cause stress at work suggested working conditions, management practices, nature of job, life events and financial factors ( Table 1 ). The majority of participants ( n = 42/51) referred to working conditions as a main source of stress. Working conditions were mainly related to factors such as workload, the physical environment (e.g. noisy offices, lack of windows, small rooms, and offices in which the temperature was either too low or too high for comfort), long working hours, heavy workloads and understaffing.

NGO, non-governmental organisation.

‘We are short [staffed] so two people cannot go on holiday at the same time, so it's such an inconvenience and … we are trying to cover the days, nights and it's like wrrrr … really stressful place to be … ’ (female, 24, NGO).

Working conditions were the main cause of stress regardless of the sector people worked in; people working in the NGO or the public sector more often referred to the physical environment and workloads as relevant factors. Private sector employees more often referred to long working hours and a lack of structure to the working day.

A similar number of participants ( n = 40) suggested that the nature of the job itself contributed to stress, with participants from private organisations and NGOs more often reporting this as a cause of stress. Participants attributed stress more specifically to a job with high unpredictability in what may be required from day to day, or a job that demands unsociable hours.

‘Shift work … I find that quite stressful because it affects my personal life because I have to work during the weekends and that's when most of my family and friends are off … ’ (female, 26, NGO).

Management practice was proposed as a cause of stress by more than half of the interviewees ( n = 32), but was least often implicated in the public sector organisations. Participants in high managerial positions (e.g. head of unit) tended to refer to management practice as a cause of stress less often than employees in non-managerial positions. However, for all other participants (e.g. middle management positions and employees) no differences were observed. Management practice as a cause of stress related to personal style of leadership, implicating lack of warmth and support with a feeling that staff were unimportant and not respected as people; insufficient praise or confidence-building were also important omissions that caused stress. Limited opportunities for decision-making (often referred to as low decision latitude) and lack of transparency as well as unrealistic demands, poor communication and effort–reward imbalance were all implicated.

‘That's what makes you angry, because there's nobody taking my case. As soon as this phone goes to my boss and they complain about me, nobody asks me what happened. And even if I'm right, they still apologise. Why? I've done nothing wrong. It's them. They've done the wrong thing’ (male, 45, public). ‘ … the message the organisation gives to you is that you don't really matter’ (female, 40, NGO).

Life events were identified as another contributor to the level of stress experienced by employees regardless of the type of organisation they worked for ( n = 21). Life events referred to problems with family or relationships, death and sickness, as well as trying to maintain a balance between work demands and responsibilities in the social and personal or family lives of respondents.

A small number of respondents ( n = 6) reported financial factors as a cause of work stress; financial strain causing work stress was related to working for organisations that lacked a benefits package, or in which the salary did not reflect the amount of effort invested in work. Job insecurity as a cause of work stress reflected fears about losing income and facing further financial strain.

Individual and organisational stress management interventions

Participants were asked about any interventions at their workplace for managing stress. Overall, participants referred less frequently to individual interventions; such interventions were also either secondary or tertiary. In particular, they were either psychological interventions such as face-to-face telephone or internet counselling, or educational interventions or training courses that taught practical skills such as organisational management and assertiveness ( Table 2 ).

NGO, non-governmental organisation; TOIL, time off in lieu.

Some patterns emerged in the use of individual interventions by type of organisation: NGOs were least likely to deliver individual interventions to employees, perhaps owing to cost. In terms of effectiveness, those participants who received one-to-one counselling interventions thought these were effective, mainly because they could be accessed promptly when needed.

‘So [I] went to my [general practitioner] GP and they set it up through my local authority for face-to-face counselling, so I was seeing the occupational therapist, [had] face-to-face counselling and that happened on my day off. So [I] could do some work at home, because I was very tired I didn't have the stress of having to get into work, so just took a bit off. So [it was] kind of a package of things that just assisted me for a while’ (female, 49, public).

Organisational interventions were more often mentioned by workers in public sector employment and in contrast to individual interventions, they were mainly primary or secondary ( Table 2 ). Most of these organisational interventions were related to management practices ( n = 35/51). In particular, participants mentioned efforts to develop a management style that was supportive and improved communication, as well as frequent team meetings and supervision and two-way feedback.

‘[The manager is] one of those people that make you feel appreciated, even if it's a little thing she will praise you for it. A lot goes for being praised, that in itself can take away stress. If someone turns around and says what you are doing is a fantastic job you feel good’ (female, 52, public).

A supportive organisational and team culture, a collective spirit including dialogue in groups and space for discussion, and educational and training courses to improve management skills were frequently reported as effective interventions to manage stress at work ( n = 27/51).

‘ … it's good that we all sit down together and discuss anything that may be causing a problem or tension, or anything we feel needs to be adjusted’ (female, 27, public).

Flexibility in working hours, well-planned shifts and environmental or structural interventions such as a staff room for relaxation were mentioned by almost a third of the participants as effective ways of managing work stress. Participants working in private sector organisations rarely report the existence of any interventions related to work structure (e.g. flexibility in work times), whereas in the public sector there was evidence of trying to introduce more flexibility.

‘ … time off in lieu […] seems to work quite well 'cos it's about that work–life balance’ (female, 54, public).

Almost half of participants ( n = 22) said training and career development opportunities in the workplace were effective for managing work-related stress, as they made them feel adequately informed and valued. Appropriate training and adequate equipment and resources allowed employees to perform their roles effectively. A small number of interviewees ( n = 3) suggested training in stress management was a useful intervention.

‘[My manager] is very good at sending people on training courses. I've just been on one which is positive interactions, which was telling you the right way of dealing with situations’ (female, 52, public).

Finally, a small number of participants ( n = 9/51) reported that there were a number of health promotion interventions (e.g. courses, exercise) at their workplace to help them prevent work stress. Participants thought that being subsidised for gym membership or being encouraged by their organisation to exercise during their working day were very effective interventions. None of the participants working for NGOs mentioned health promotion.

‘ … we're quite actively encouraged to do lots of exercise in this trust, we get lots of emails about walking to work, or running … I think linking exercise and well-being and being healthy at work […] I think that's always good, it would be good to have that in every institution’ (female, 28, public).

Personal interventions to manage work stress

Participants were asked general questions about their personal strategies to manage work stress. We were interested in personal interventions not provided by their employers but ones that were used and considered effective.

Table 3 shows the types of personal interventions used at work. Some interventions helped employees process stressful thoughts and think through difficult situations, akin to what CBT therapists might suggest as cognitive restructuring and tackling cognitive distortions – for example, focusing on positive rather than stressful situations, and using self-reflection to gain a better perspective.

Effective personal interventions to manage stress at work (total number of respondents: 51)

‘Yeah, yeah or if something happens I try and think, erm, so there's another technique I learnt in the last place I worked at was five questions so I ask, the why questions five times, why this? why is it causing stress? … because of this, why is that? Why is that? And I usually get to the root cause and that usually chills me out a bit if I deal with the root cause rather than the thing causing me the stress’ (male, 30, public).

Support from colleagues and friends was the most frequently reported personal intervention for managing stress at work.

‘I actually had to say to a colleague, “I can't see the wood for the trees here, can you help me?” and the colleague was absolutely brilliant and helped me so we got through it. I got some excellent help from a colleague yeah and that was someone I worked with in the team who does the same job as me. My manager was very supportive and helpful as well’ (male, 41, private).

Keeping oneself organised and maintaining a structured schedule at work were thought to be very effective personal interventions. These included planning, reducing overtime, prioritising tasks and keeping a better balance between work and personal life.

‘One of the signals for me is if my desk starts getting a bit messy, it means I'm chasing between too many projects and that's often the time when I personally just take stock, think, right, what do I need to do, look at a priority list, clear the decks again and sort of take a bit of a step back and review. So that's how I manage it and I find that to be helpful for me’ (male, 47, public).

Almost half of the participants ( n = 24) pointed out the importance of a healthy lifestyle when trying to manage stress at work. In particular, exercise was the most frequently reported personal intervention. Participants also acknowledge the importance of healthy eating as a means of maintaining a healthy weight and better health in general, both of which helped people to better manage stress at work.

‘Exercise is the most important thing for me for stress. So yeah, if I'm stressed, as long as I can, I'll often leave work at a decent time and go for a run and come back to work or go take my computer home and go for a swim and then do some more work. As long as I can make sure I can get some exercise in then I'm fine. It kinda works quite good 'cause I can generally take a longer lunch break and go to the gym at lunch and then, you know, work later or whatever it is. That's probably the most important flexibility for me at work is being able to have that’ (female, 32, private).

Finally, having out-of-work interests and leisure activities was reported by more than half of the participants ( n = 31). For example, participants mentioned relaxation during lunch breaks and going on holidays as an effective personal intervention.

‘We do get inspired by going to talks and design galleries and illustration events and all that sort of thing, they're hobbies as much as they are a career but, at the same time, I think that, in a way, [this] helps to alleviate the stress levels at work because what you're doing at work is part of your hobby as well’ (male, 30, private).

A mixture of personal, organisational and individual interventions were reported in our study, but these are not often captured together, with emphasis often being given to workplace changes or separate public health approaches to lifestyle and physical activity. 28 – 30 The majority of individual and organisational interventions reported were secondary and tertiary preventive interventions, with less emphasis on primary prevention.

High-demand and low-control situations and effort–reward imbalance related to working conditions, management style and the type of job were causing distress at work. 12 , 31 , 32 It is also important to address management practices as one of the most significant and consistent work-related stressors. Management practice as a stressor was also more prominent in private and NGO sectors than in the public sector and in middle and low management positions than in higher management ones. Participants identified poor communication with management, unfair treatment and, above all, the feeling of not being appreciated as the biggest sources of stress for them. Furthermore, many participants highlighted working conditions, such as physical environment, unsociable working hours and under-staffing, as causes of their work stress, the harmful effects of which have been identified in previous research. 18 , 33 Financial factors, mainly a lack of financial recognition by the organisation, were also reported as a cause of stress. According to Stranks, 11 when workers experience insufficient rewards in the form of salary or amount of praise received, or are missing recognition, the feeling of devaluation might appear and can contribute to an experience of work stress.

Interventions used by employees to manage stress at work: perceived effectiveness

Participants in the present study tended to report mainly the presence of primary and secondary organisational interventions (as opposed to individual interventions) at their workplace. With regard to individual approaches, these were mainly psychological interventions. Although there is much research that has documented the effectiveness of psychological interventions, these are usually provided at the secondary or tertiary level rather than for primary prevention. 34 – 36

Organisational interventions were discussed by the participants more frequently and were also more often perceived as effective in managing stress at work than individual interventions. One of the main reasons that organisational interventions were identified as an effective way of managing stress was because they were primary interventions with the aim to modify or eliminate environmental stressors. Participants in the present study identified the organisational interventions to manage stress at work as: job redesign, change of organisational culture, encouragement of participative management, introduction of work–life balance policies, flexible working and reconstruction of the organisation as well as improvement of organisational communications. 11 The literature on organisational interventions does not identify management practices as an intervention. The main reason may stem from the fact that management is seen as part of organisational structures rather than as potentially subject to modification to manage stress. Our findings highlighted management practices as an important workplace intervention, especially management characteristics such as open communication, supportiveness, approachability and being appreciative; these ranked the highest in terms of perceived effectiveness. Improving management practices as an intervention and introducing flexibility in working structures were much more apparent in the public sector as opposed to the private sector and the NGOs. Content analysis suggested that there may be a relationship between reported causes of stress and individual and organisational interventions. For example, stress was less often reported in the public sector because there were more management interventions than in other sectors, and these were perceived to be effective by the participants.

Most personal interventions identified by participants were related to health behaviours such as exercise, meditation and healthy eating, as well as leisure activities and social support from family and colleagues. Although personal interventions outside the workplace were not considered by the organisations, it is important to emphasise the power of such interventions and that they should be included in future intervention packages. For example, physical activity programmes have been among the few organisational interventions that show convincing effects on absenteeism in accord with our previous reviews, but physical activity could be encouraged more generally. 24 , 30 By adapting organisational interventions to capitalise on and encourage personal individual interventions outside the workplace, stress management in the workplace may be less necessary or more effective where it is needed.

Strengths and limitations

The results suggest that employees in private organisations and NGOs report more perceived causes of stress and have fewer interventions in place to help employees manage stress compared with public sector organisations, notably National Health Service (NHS) employers. We have listed potential organisational, individual and personal interventions that were used and found to be helpful. These might be tested as correlates of better workforce health and well-being and less work stress.

A limitation of the study was related to the sample characteristics. Although there were variations, especially with regard to type, size and location of the organisations involved, the sample consisted of only 12 organisations in total. A larger number of organisations would have provided us with more variety of occupations and organisation size and location, which would have given a more complete picture concerning the causes of stress and interventions between sectors. Our study is exploratory, and although these are perceived causes, the findings should not be understood in terms of epidemiological causal relationships, but rather as important ways in which workers think about and manage work stress, providing clues as to how interventions might be developed, tested and located in these work settings.

Qualitative studies offer new insights and provide the in-depth and experience-near perspectives of participants, rather than an overtheorised and superficial analysis. The findings will contribute to future in-depth work including more varied samples, as well as survey research to test for interventions that correlate with organisational measures of health and well-being. Future work should also consider how to improve management practices, as these seemed to have the most important influence on reducing work stress. More research is needed to further explore the differences between private, public and NGO sectors and different job types such as education and healthcare to examine whether they respond to the same or different intervention techniques. Finally, research needs to take into account compositional effects including the demographic characteristics of samples, and the cost effectiveness of interventions.

Topic guide

General questions to start the interview

• How do you find your job with regard to demands, pressure, working hours, etc.?
• Are there any elements in your job that you find stressful?
• What are the common organisational factors that can cause stress at work?
• What are the common individual factors that can cause stress at work?

Managing stress at work (both managing yourself and other people)

• If you manage other people, how do you manage stress?
• How do you manage other people's stress at work?
• How do you deal with this?
• What were/are the challenges?
• Can you give any examples?

Managing return to work (managing both yourself and other people)

• How do you manage your return to work after sickness?
• How do/did you manage their return to work after sickness?
• If no experience, how would you manage their return to work?

Policies: managing stress at work and return to work

• How has this policy been put together?
• How effective is it in practice?
• What are the strong and weak points of this policy, if any? Or
• How (in what ways) would you change this policy?
• 12. What would you say are the best (individual and organisational) policies for managing employee stress?
• 13. What would you say are the best (individual and organisational) policies for managing employee return to work after sickness absence?

Declaration of interest None.