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Predicting stress and strategies for reducing it

At a glance:
Even for employees in potentially violent or distressing environments, relationships with managers and co-workers seem to have the greatest influence on stress. Conflict is a key cause of stress and the response of managers and colleagues to a person's stress affects the success of efforts to manage the problem. Stress leave is associated with significant stigma, meaning that taking stress leave can itself be a source of stress.

Chronic stress seems to lead to more work absence than exposure to a single traumatic incident.
Perspectives:
Employee
Employees who are struggling with stress are often hesitant to seek assistance, or make a claim. Employees usually try to avoid the additional stress of the associated stigma. This can mean that stress-related problems are not addressed until the person concerned has suffered for some time and developed significant symptoms.

If you are struggling with stress, do what you can to address the problem as soon as possible. This might mean talking to your GP and asking about strategies for managing stress. If there's someone in management with whom you have a good relationship, speak to them about the problems you are encountering. They might be able to give you some solutions or useful advice. Some companies provide the services of a psychologist or counsellor. These services can be helpful; if they're available, give them a go.

Dealing with stress early can help prevent the problem getting worse.
Employer
Employees who take stress leave or make stress-related compensation claims often:
Indicate that workplace conflict is a significant cause of their stress
Take a lot of time off work in the six months prior to their compensation claim
Avoid lodging a claim until their stress levels are very high.
Employers can minimise stress claims by encouraging early reporting, resolution of workplace conflict, and providing support to employees who are stressed.

Without good training it may be difficult for supervisors and line managers to pick up early warning signs and prevent or manage workplace stress. Remember that these employees are also subject to stress, and need to be supported.

Employers can introduce mechanisms for early reporting of stress problems. This approach is most likely to be successful if managers trained to receive feedback and deal with these issues. Some companies also have a second reporting mechanism, such as a confidential phone number or hotline, which allows employees to report sensitive problems that might otherwise go unnoticed.
Treater
This study examined people who lodged stress claims within the welfare sector. The majority indicated that workplace conflict caused or significantly contributed to their claim.

Strategies that help stressed employees to manage their stress are likely to help them return to work. Meditation, exercise and access to counselling services all have the potential to improve outcomes.
Insurer
Employees typically avoid lodging stress claims, and report a high level of concern about the reaction of co-workers and management. Usually a stress claim is preceded by a history of stress and workplace absence.

If a stress claim is lodged, employers should be encouraged to listen carefully to the employee making the claim. The incident that precipitates the claim may actually be an issue of lesser importance to the employee – usually a stress claim is based on a long term problem that builds over time. It could be important to look behind the issue presented to see if there is a more important underlying problem that needs to be addressed.
Original Article, Authors & Publication Details:
M. F. Dollard1, H. R. Winefield1 and A. H. Winefield2 (1999)

Predicting work stress compensation claims and return to work in welfare workers. Journal of Occupational Health Psychology 4(3): 279-87.

1School of Psychology, University of South Australia, Whyalla, SA, Australia
2Department of Psychiatry, University of Adelaide, SA, Australia
Background, Study Objectives, How It Was Done:
Occupational stress is common, especially in the human services sector. Employees in this area often work with clients who are distressed, dependant or experiencing difficulties. Occupational stress is costly in terms of the psychological
psychological
Refers to a person's perceptions, thought processes, emotions, personality and behaviour. Psychologists can treat mental health problems.
 suffering of the affected workers, and also in terms of medical and compensation costs for their employer.

Claims for psychological damages are hard to measure objectively. People claiming compensation for chronic
chronic
continuing a long time or recurring frequently
 stress feel anxious that decision-makers, friends and colleagues will not believe their claim is genuine.

The experiences of people who make stress-related compensation claims are less well-documented than the experiences of people with physical injuries. It is known, however, that those who make stress-related claims are:
More likely to be female
Have usually taken more sick leave than the average worker
As with physical injuries, the longer an employee is off work due to stress, the less likely they return.

This study aimed to:
  • Investigate the common characteristics of workers who claim stress-related leave and compensation
  • Explore the ways in which stress leads to psychological injuries
  • Describe the factors that helped or hindered the return to work in these cases
The study was carried out in South Australia, in a large welfare agency of approximately 1200 employees. The agency provides services including child protection, residential care for adolescents, financial assistance and counselling. Some of the employees did shift work, and a growing proportion were employed on short-term contracts. In the 10 years prior to the study, 219 employees made stress-related compensation claims, at a cost to the organisation of approximately $5 million.

In the 12-month period between 1994 and 1995, 19 employees filed stress claims. The researchers recorded the gender of each employee, and the amount of sick leave they had taken in the year prior to their claim. They also recorded the number of employees that returned to work. 16 of the workers completed a 1-2 hour semi-structured interview in which they described:
  • How their psychological injury came about
  • The personal costs of their stress
  • Their perceptions of the claims process
Study Findings:
Of the 19 employees who had filed claims, 6 were male and 13 female. It should be noted that the organisation employs more females than males (63% compared to 37%).

Employees who filed stress claims had taken an average of about 10 sick days in the previous year, which was more than double the average number taken by other employees.

6 months or more after filing their claim, only 8 of the 16 workers had resolved their issues and returned to work. 6 had returned to work with ongoing problems, and 2 had not returned at all. Of the other 3 employees who were not interviewed, one had committed suicide, and 2 could not be contacted.

The type of stress the employee experienced was important in determining how much leave they took. 3 employees had experienced a single traumatic event, 6 had experienced a traumatic event and long-term work stress, and 7 had experienced chronic stress only. Traumatic events included:

  • The death of a client
  • Being taken hostage
  • Being spat on
  • Verbal threats
  • Physical abuse
Sources of chronic stress included:
  • Large workloads
  • Inadequate training
  • Conflict with co-workers or managers
  • The violent nature of the work environment
  • Job dissatisfaction
  • Lack of opportunities for recognition or promotion
  • Lack of support
  • High management turnover
Conflicts with management or co-workers were more frequently reported as causes of stress than situations involving clients. Workers who experienced chronic stress took significantly more time off work than those who only experienced a single traumatic event.

The employees reported a range of psychological symptoms, including:
  • Grief
  •  
  • Depression
  • depression
    A symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection. Major depression is likely to interfere significantly with everyday activity, with symptoms including insomnia, irritability, weight loss, and a lack of interest in outside events. The disorder may last several months or longer and may recur, but it is generally reversible in the short run.
     
  • Panic
  • Feelings of worthlessness
  • Suicidal thoughts
  • Anger
These symptoms left employees unable to concentrate and thus unable to work.

Employees reported significant stigma associated with stress leave. One worker was told that taking stress leave would destroy her career prospects. This stigma meant that employees generally took other kinds of leave in preference to stress leave. Some used all of their annual leave, sick leave and long service leave rather than take stress leave.

All participants were very satisfied with the official procedure that was followed when a claim was lodged. Policy called for an accident assessment by a Health and Safety Advisor, which involved the worker, their manager, and co-workers. An action plan was also devised to prevent the problem recurring.

Employees were less positive about rehabilitation
rehabilitation
The process of helping a person back to their former abilities and quality of life (or as close as possible) after injury or a medical condition.
 and return to work. 7 were dissatisfied, 4 were neutral and 5 were satisfied. Some believed they had returned to work too quickly, or were unhappy with the tasks they were assigned when they returned.

Interpersonal problems with managers, supervisors and co-workers created the most difficulties during the compensation and return-to-work process. 9 employees rated their managers response to their claim as “bad,' 4 employees rated it as “average' and 3 as “good.' Some positive examples were given of support from supervisors, but these were the exception. Employees appreciated being contacted by their manager or supervisor, but this rarely happened.

Support from co-workers was also important. Many employees were concerned about how their colleagues would react, especially when they were transferred to a new department.

Employees who returned to work were generally grateful for a transfer to a new department. Some had trouble adjusting to their new role, sometimes leading them to go on leave again. Learning a new role and joining a new group of people sometimes added to the stress the person was experiencing.

Few employees consulted the staff counsellor. They didn't believe the counsellor would “go against management", and in some cases management was the source of the workers stress. Some were unaware that the counselling service was available. Some found counselling helpful, but felt it could not resolve the underlying issue.
Conclusions:
This study was conducted within the welfare sector, where client interactions are often a source of stress. Even in this environment, organisational difficulties and conflict with managers and co-workers were the most significant sources of stress.

Stress-related claims were likely to be the result of chronic stress rather than a single traumatic event. Those with chronic stress took much more time off work than those who experienced a single traumatic event.

Compensation claims for chronic stress are more difficult to resolve because it is harder to measure this stress objectively. When stress is caused by a traumatic event, disputes over eligibility for compensation are less likely. Cases in which management is the source of stress are particularly hard to resolve, because most solutions require positive input from management.

The stigma associated with stress leave and the perceived threat it posed to peoples careers meant that a decision to take stress leave was itself a significant source of stress.

Other research has suggested some strategies for reducing work stress, including:
  • Employee education
  • Supervisor training
  • Early intervention
  • Mediation
  • Reviewing claims to identify and reduce work stress risks
  • Reducing the stigma associated with stress
People who make stress-related compensation claims tend to take more sick leave than average before they make their claim. This might provide an opportunity to identify those at risk of significant work stress and intervening before a claim is made.
References:
PubMed Abstract
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