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By Sarah Ford, InPsych feature writer

Work stress is a hot topic. More workers are making psychological stress-related compensation claims than ever before, with the national cost of such claims estimated to be $105.5 million in 2000-2001. Employers and the government are grappling with how to address the problem. Adelaide-based organisational psychologist Associate Professor Maureen Dollard has been researching and consulting on occupational stress for over a decade. "I have never seen such a national reaction to it as now", she says. Psychosocial risk factors in work environments are firmly on the National Occupational Health and Safety Commission agenda and the State-based workers' compensation bodies are running programs for stress prevention, intervention and management.

Part of this recent action comes from the growing recognition of the human cost of stress, but it is the financial expense that has forced a response. Recent figures show how the nature of stress claims makes them particularly costly. Although the number of such claims account for a minority of claims overall, stressed workers tend to stop working for longer periods, resulting in a higher relative cost to employers. In 2001-2002 stress accounted for over half of all long term (12 or more weeks) compensation claims that did not involve an injury. Stress is considered to include work pressure, harassment at work, exposure to traumatic events, lack of autonomy and support, and exposure to workplace and occupational violence.

There are a myriad of reasons for the escalation of occupational stress. Maureen, who is also the Director of the Work and Stress Research Group at the University of South Australia, says that workers are facing more demands from various sources. For example, changing government policies, such as outsourcing, downsizing, casualising and de-institutionalisation without appropriate resources, have boosted the workload on the human services industry and government agencies, including community services, corrections and police. This, in turn, creates an environment ripe for interpersonal conflict. "Workers are having to work harder and faster, and meet new management objectives and performance criteria", Maureen says. "So there is a lot of distress from emotional demands and the intensification of work."

Stressors vary with job type and location

Research on work stress has focussed on occupations that implicitly involve high levels of stress, such as emergency service work. Dr Paula Brough, a lecturer in organisational psychology at Griffith University in Brisbane, recently studied occupational stress in fire, police and ambulance services. Her aim was to differentiate the impact of trauma, which is unique to this work, from the daily hassles encountered by all workers. Paula found that daily hassles contribute more to job satisfaction levels, while trauma contributes more to psychological health, especially in the long term. But the picture is complex, with daily hassles exerting a greater effect in the short term, she explains. "Not all trauma affects officers in a negative way all the time because they have training and counselling to deal with it", Paula says. "But, the daily hassles are often not addressed (and) they build up over time."

Policing has been heavily researched given the comparatively high levels of divorce, suicide, and alcoholism associated with the occupation. Factors that contribute to the pressure of policing include the occupation's negative public image, the frustration of dealing with the legal system, and exposure to violence. However, some of these stressors are being addressed by the increasing diversity of the police workforce, particularly the presence of more female officers. Paula says that typically females deal with public incidences differently to males. "They tend to talk with people and calm them down, compared to men who are more likely to use aggression." These benefits have lead to fire services investigating how to recruit and retain more women.

Despite these gains, female police officers continue to face difficulties working in a male-dominated policing culture. However, the incidence of sexual harassment, for example, is declining. Some police services have set up mentoring schemes for female officers to encourage them to stay in the service, and to show them how to achieve promotion. Paula says there is evidence that this improves retention rates, opportunities for promotion, and overall acceptance of these officers.

As well as the stress associated with particular jobs, there are occupational stressors that are unique to job locations. Maureen at the University of South Australia has been researching strains faced by rural workers. She has found that isolation presents particular difficulties for professionals in rural areas, including a lack of access to professional training, development and support. Further, these workers regularly encounter dual relationship problems, in which their role as a professional conflicts with that of being a community member in small towns. Farmers also face unique work pressures. Uncontrollable variables, such as the weather, market prices, and globalisation can make farming anxiety-provoking work; little research has been conducted on the strains experienced in owner-operated type businesses such as farming.

Individual factors in occupational stress

Individual differences also affect how people cope with work stress. Two people doing the same job can react in opposite ways to a shared occupational stressor. Dr Peter Cotton, a specialist in workplace mental health with Comcare, the Commonwealth workers' compensation authority, says individual personality factors impact on psychological injuries (a preferred term for stress claims). He says that psychologists working in the area are increasingly assessing the role of personality, an issue that has been neglected in the past. Of the five recognised personality factors - openness, agreeableness, extraversion, conscientiousness and neuroticism (aka emotionality) - the latter two play a significant role in compensation claims.

Peter says that people who are high on conscientiousness are over represented in musculoskeletal and occupational injuries. They are inclined to exhibit somatic symptoms and, because they experience increased peripheral muscle tension, they are prone to more wear and tear from repetitive movements, Peter says. "That's often why, for example, you can have ten people doing the same job, but only one will get the overuse syndrome." These individuals are likely to submit claims when the damage is done, so interventions include trying to identify them before reaching this point, and increasing their awareness of potential risks.

Emotionality is the other personality factor that is over represented in individuals seeking psychological injury compensation, especially for long-term claims. Individuals with high levels of trait emotionality tend to experience negative emotions in response to life events, and think more negatively about themselves and the world, Peter says. "In response to the same sort of stressors, people with higher trait emotionality are likely to become more distressed, more anxious or more depressed". Individuals with this trait are also more likely to carry personal stressors into the workplace and vice versa.

Peter says occupational psychologists are also increasingly focusing on individual levels of morale, a term used for resilience in the workplace. "What we are finding is that people with low trait morale tend to be most vulnerable to developing distress responses that may eventually lead to a psychological injury." He says there is growing evidence that a supportive leadership style, and a positive and engaging work team climate, are key to boosting morale and reducing claims. "People will submit a claim stating they had a traumatic event, but often when you scratch the surface it isn't so much the incident, it's more the feeling that their leader didn't support them. Perceptions of support are a critical driver in the workplace." Prevention work is about trying to build supportive leadership and improve the quality of the work team climate as a way of boosting morale, Peter says. "When people have higher morale they cope much more effectively... and there is less negative impact on them."

Interventions for occupational stress

Interventions for work stress range from organisational to individual-based approaches. At the organisational level, there is a trend towards risk management aimed at preventing stress. In its simplest form, this involves identifying potential hazards in the workplace, and the harms associated with these. Efforts are made to control the hazards, and these initiatives are then evaluated. Maureen says effective risk management takes a bottom-up approach, involving active participation from workers and supervisors, who try to develop new ideas for interventions. Issues can also be raised at a higher level in the organisation, such as at an occupational health and safety committee meeting. Ideally, it should involve top management support, participation at all levels, and the development of communication strategies so people can identify problems and be involved in solving them.

At the other end of the scale, individual-focused approaches include distressed workers visiting professionals to seek medication or therapy. In the middle are interventions that combine individual and organisational approaches. For example, employee assistance programs, provided by employers, offer staff a limited number of confidential counselling sessions by independent consultants. Staff receive individual help for problems, and counsellors can provide feedback on work-related issues to the organisation to improve its work environment.

In the emergency services, interventions have developed from the growing recognition of the impact of traumatic experiences on individuals. Some efforts have been made to improve training, such as police recruits shadowing seasoned officers to learn how to handle stressful events. But the focus has been on debriefing and counselling programs, which have been increased significantly in recent years. Paula Brough at Griffith University says this has involved the establishment of peer debriefing systems and access to psychological support.

It's difficult to evaluate work stress interventions because there are so many other processes going on that threaten the validity of the results. Maureen says obtaining workers' feedback on strategies that have been implemented is one way to continually improve processes. Support has been found for job enrichment programs, which aim to increase both workers' involvement in decision making processes and their variety of job tasks, so jobs are more diverse and stimulating. These programs have been shown to increase workers' autonomy, such that they report more positive attitudes to the work environment and more positive mental health. "A lot of research suggests it's not so much the demands you are faced with, but your level of autonomy and support to actually manage them that is the key issue," she says.

Future directions

Turning to the future, Maureen is planning research to examine how external factors, such as government policies, influence work stress. For example, how the allocation of resources to organisations affect their capacity to cope with increasing demands from the community. "Much of psychology focuses on psychological perceptions, coping and reactions and misses important upstream issues which in turn affect organisational processes," she says.

Capturing a clear picture on how work stress is being addressed in Australian workplaces is another priority. "Australians haven't developed a systematic approach to the problem, or learnt lessons from each other about what might really work," Maureen says. A recent literature review of interventions in Australian workplaces found that most were individual-level focussed, and many were not critically evaluated or published in academic literature. Conducting a national omnibus survey of work stress across organisations would be a step towards creating a benchmark from which to make improvements. "Our current research is also teasing out the link between the experience of stress at work and putting in a workers compensation claim. Longitudinal data just to hand is showing that the link may be moderated by (a lack of) resources on the job," she says.

But even when equipped with this information, the rapidly changing nature of work creates a challenge for organisational psychologists and others working in the area, Maureen says. "It's great that there's finally been an agreement among various stakeholders that occupational stress is an issue that's not going to go away," she says. "But even if we understand what the current key stressors are, they are going to change because jobs are changing so rapidly that we will have to continuously develop new mechanisms for picking up new issues and reacting to them."

References

Brough, P. (2004). Comparing the influence of traumatic and organisational stressors on the psychological health of police, fire and ambulance officers. 'International Journal of Stress Management', 11, 227-244.

Caulfield, N., Chang, D., Dollard, M. F., & Elshaug, C. (2004). A review of occupational stress interventions in Australia. 'International Journal of Stress Management', 11, 149-166.

National Occupational Health and Safety Commission. (2003). 'Compendium of workers' compensation statistics', Australia, 2000-2001. Canberra, Australia.

Workplace Relations Ministers' Council (2003). Comparative Performance Monitoring, Fifth Report, 'Australian and New Zealand Occupational Health and Safety and Workers' Compensation Schemes'. Canberra, Australia.