Combating Workplace Stress Using Cognitive Behavioral Therpay Essay

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…OccupationalStressandScientificMonitoringLiteratureReview2.1IntroductionThedefinitionofthetermoccupationalstressisderivedfromthedefinitionofitstwoconstituentwords.Inthiscontext,occupationalreferstoanythingthatisrelatedtotheworkplacewhilestressisdefinedasanaturalbodyreactionfromphysical,mentaloremotionalstraininanindividual.Thus,occupationalstresscanbedefinedasanymechanismbywhichthebodyattemptstoadapttotheworkplaceenvironment.Theseincludenormalmechanismsfordealingwithworkplacestress,commonlyknownasthefightorflightresponseaswellasanyexpectedorunexpectedreactionsinresponsetotheworkplace.Theseincludeeyestrainbecauseofstaringatcomputerscreensfortoolong,emotionalandphysicalstress,depression,anxiety,aggression,cognitiveimpairmentsuchasdegradedmemoryorreducedconcentrationspan,etc.Allofthesereactionscanleadtopoorworkoutput,increasedemployeeturnover,higherabsenteeism,cardiovasculardisease,injuryorevendeath(Pattersonetal.,2005).Occupationalstresscanalsobedefinedasahazardundertherelevantoccupationalsafetyandhealthlegislationthatcancauseanyharmtoemployeehealthandtowhichemployershaveadutyofcaretoassess,identifyandcontrolasmuchaspossible.Itcanalsobedefinedinotherwordsastheconsequenceofanindividualbeingunabletocopewithpressuresintheworkplace(Rees,1997).Theseundesirableoutcomescomeabouteitherbecauseofpoorfitbetweenthepersonsabilitiesandtherequirementofhisorherpositionorbecauseofworkplaceconditionsbeingotherwiseunfavorable.Becausethewell-beingofemployeesisinextricablyassociatedwithorganizationalperformanceandproductivity,occupationalstressdemandstimelyinvestigationtoidentifywaystomitigatetheseeffects(OsibanjoandSalau,2016).AlthoughunemploymentlevelsintheUnitedStateshavesteadilydeclinedinrecentyears,therehasbeenacorrespondingincreaseintheamountofoccupationalstresslevelsbeingreportedbyAmericanworkers.AsurveysponsoredbyEverestCollegeandconductedbyHarrisInteractivefoundthatfully83%ofallemployedworkersintheUnitedStatesreportbeingstressedbyatleastonejob-relatedfactor(anincreasefrom73%forthepreviousyear),withinadequatepayandinordinatelyexcessiveworkloadsbeingamongthetopfactorsreportedbyU.S.workers(Workstressontherise,2013).Basedonthefindingsthatemergedfromthissurvey,JohnSwartz,theregionaldirectorofcareerservicesatEverestCollege,concludedthat,Morecompaniesarehiring,butworkersarestillwearyandstressedoutfromyearsofatroubledeconomythathasbroughtaboutlongerhours,layoffsandbudgetcuts(ascitedinWorkstressontherise,2013,p.3).Althoughagrowingbodyofresearchconfirmsthatpaylevelsarenolongeramongthemostmotivationalfactorsforworkers,compensationlevelsremainatornearthetopofjob-relatedstressorstoday.Inthisregard,theHarrisInteractivesurveyfoundthatinordinatelyheavyworkloadstiedwithinadequatecompensationlevelsasbeingthetopjobstressorsatpresent,andbothofthesevariablesshowedsignificantincreasesoverthepreviousyear(Workstressontherise,2013).Otherjob-relatedfactorsthatwerefoundtoexacerbateoccupationalstresslevelsincludedpoorrelationshipswithcoworkers,theamountoftimerequiredtocommutetoandfromwork,beingcompelledtoworkinacareerfieldthatisnotalignedwiththeirpersonalinterests,poorwork-lifebalancesandapaucityofcareeradvancementopportunities(Workstressontherise,2013).Itisalsonoteworthythatthereweresomesignificantgender-relateddifferencesintheoccupationalstresslevelsreportedbyAmericanworkers,withnearlytwiceasmanyfemaleworkersasmaleworkers(18%vs.10%)reportinginadequatepaylevelsastheirprimaryjobstressor(Workstressontherise,2013).Inaddition,youngerworkersweremorelikelythantheiroldercounterparts(i.e.,BabyBoomers)toreportbeingstressedasaresultoftheiremployment(Workstressontherise,2013).Insum,youngerAmericanwomen(aged18to29years)arethemoststressedatworkbutothercategoriesofworkersremainathighriskofoccupationalstressaswell(Workstressontherise,2013).Althougheveryoneexperiencesthenegativeandpositiveeffectsofoccupationalstressuniquely,therearesomecommontypesofstressthataretypicalresponsestounmitigatedworkplacestressasdiscussedbelow.2.2TypesofstressStressisthehumanresponsetoanytypesofdemand,andsuchresponsescanbeeitherpositiveornegative(Sharma,2015).Fromabiophysicalperspective,stresscanberegardedasbeingamental,physical,oremotionalresponsethatresultsinmentalorphysicaltension(Sharma,2015).Occupationalstresscanalsobedefinedastheadversepsychologicalandphysicalreactionsthatoccurinanindividualasaresultoftheirbeingunabletocopewiththedemandsbeingmadeonthem(Omolara,2008).Stressthathappensduetoaperson\'semploymentistermedoccupationalstress.Thetermsworkplacestress,jobstressandoccupationalstressareusedinterchangeably(Dollard,2003).Regardlessofwhatitiscalled,occupationalstresslevelsarenotoriouslydifficulttoquantifyandmeasure,makingtheevaluationofstress-managementinterventionsespeciallyproblematic.Inresponse,researchershavedevelopedanumberofdifferentcategoriesofjobstressorstofacilitatetheprocessasdiscussedbelow.Jobstressorshavebeenclassifiedintovariouscategoriesbydifferentinvestigatorsovertheyears.Forexample,El-KotandBurkenotethatresearchersduringthesecondhalfofthe20thccenturyidentifiedfivediscretecategoriesofjobstressorsasfollows:(1)stressorsintrinsictothejob,(2)fromone\'sroleintheorganization,(3)careerdevelopment,(4)relationshipswithothers,and(5)organizationalstructureandculture.Otherresearchershaveidentifiedfourmaincategoriesofjobstressors:(1)fromtaskdemands,(2)roledemands,(3)physicaldemands(fromelementsinone\'sphysicalsettingorenvironment),and(4)interpersonaldemands;inadditionandmorerecently,work-familydemandshavealsobeenincludedinthecategoriesofjobstressorsbysomeorganizationalbehavioralresearchers(El-KotandBurke,2011).Moresuccinctly,aspositedbyNordstrometal.(2001),therearetwomajortypesofstressthatcanoccurinaperson.Thesearephysicalandmentalstress.Physicalstressreferstoanyphysicalreactionofthebodytowardvarioustriggers.Physicalstressisamajorcauseofemotionalstresssincethetwomanifestsineachother.Mentalstress,ontheotherhand,referstomentalexhaustion.AccordingtoKeegeletal.(2009),mentalstressreferstomentalstrainasaresultofaharmfulagentthatcanleadtoillness.Itisreasonabletopositthatsustainedmentalstrainduetooccupationalstresscanhavesuchseriouseffects.Thetwodifferenttypesofstresshavedifferentsignsandsymptoms,someofwhicharemorereadilydiscerniblethanothers.Forexample,physicalstresscanbeseenwhenthepersonsheartratebecomeshighandtheybegintobreathfaster.Incertainsituations,thepersoncanalsostarttosweatprofuselyorevenhavecoldfeet,handsorskin.Anothercommonsignisthatthemouthoftheindividualdriesupandtheymayalso;feeltiredandfatiguedmorefrequently.Theremayalsobemusclespasms,shortnessofbreath,tighteningofmusclesandtensionofthebody(Iavicolietal.,2001).Othercommonsignsofphysicalstressincludethepersoneatingmoreorlessthannormalconstantlyfeelingnervous.Thisisoftendetectedinsignssuchastwitchingofmuscles,fiddling,talkingrapidlyortoomuch,grindingteeth,nailbiting,pacingupanddownrestlessly,orotheruncommonrepetitivehabits.Inotherextremesituations,thepersonmaydevelopdiseasesorconditionssuchasmigraines,asthma,stomachandskinproblems,achesandpains,flu,etc.Thesesignscomeaboutasaresultofthephysicalwell-beingofthepersonbeingoffbalance(CrouterandManke,1994).Asnotedabove,youngerAmericanwomencurrentlysufferthehighestlevelsofoccupationalstressinthecountry,andtheseindividualsarealsoathigherriskofexperiencingadverseeffectsfromjob-relatedphysicalstressaswellasthedeleteriouseffectsthatcanresultfromoccupationalmentalstress(Chitnis,2014).Inthisregard,mentalstressisoftenseenwhenthepersonhassleepingdisordersthatmakethemeithersleeplessormorethanusual,constantfeelingofworry,anxietyorconfusion,frequentmoodchangessuchasfrustration,depression,anger,defensiveness,irritability,irrationality,impatient,restlessnessoroverreaction.Othercommonsignsofoccupationalstressincludedependenceonharmfulsubstancessuchasdrugs,alcoholorcigarettes(Okechukwuetal.,2010).Incertainsituations,thepersonmayalsodevelopapoormemoryortheinabilitytomakedecisions.Inextremesituations,apersonmayevendevelopirrationalfearsofnormalsituationssuchasseeingsunlight,washingunderrunningwater,venturingoutdoors,etc.Allthesesignscomeaboutbecauseofthementalsituationofthepersonbeingadverselyaffectedbyjob-relatedstressors.2.3SignsofoccupationalstressOccupationlstressusuallystartsoutasacutestressthatoccursfromtheincreasingdemandandpressureoftheworksituation.Itcanleadapersontoemotionaldistressthatisseeninanger,anxiety,depression,orirritability.Itcanalsoleadapersontophysicalproblemssuchasmuscletension,achesandpains,frequentheadaches,jawandbackpain.Thesenormallycomefromthepersonbeingexposedtoalotofmanualworkintheworkplacesuchaswalkingorstandingforlongperiods.Suchactivitiesmayalsoleadtoelevationofbloodpressurelevels,sweatypalms,rapidheartbeat,dizziness,coldfeetandhands,chestorbackpain,migrainesorshortnessofbreath.Occupationalstresscanalsobeseenwhenapersondevelopsstomachorbowelproblemsincludingheartburn,diarrhea,constipation,flatulenceorirritablebowelsyndrome.Thesemaybeasaresultofphysicalormentalstressintheworkplace(EldonandShani,1991).Occupationalstressmayalsohaveothersignssuchaslonelinessorisolationofanindividual,agitationorthepersonbeingunabletorelax,pessimism,lossofconcentration,constantworrying,procrastinationorneglectingpersonalresponsibilityorothernervoushabitssuchaspacing,grindingteethandnailbiting.2.4Effects/ConsequencesofjobstressAsputbyHulshofetal.(1999),occupationalstressisquitenormal.However,whenitbecomesexcessive,therearecertainadverseeffectsthatitmaycause.Theseeffectscanbedividedintothreedistinctcategories.Theseareeffectsontheindividual,tofamilyandtotheorganization.Atallthesethreelevels,occupationalstressproducesawiderangeofexpensive,debilitatingandundesirableconsequences(Ross,2005)asdiscussedfurtherbelow.2.5ConsequencestotheindividualWorkplacestresscanleadtovariouseffectsontheindividual.Thesemaybemildorseveredependingontheextentofthestress.Theycanbedividedintotwomajorgroups,whicharephysicalandpsychologicaleffects.Inthisregard,El-KotandBurke(2011,p.11)reportthat,Individualsreportinghigherlevelsofjobstressorsgenerallyindicatelowerlevelsofjobsatisfaction,moreabsenteeism,lowerjobperformance,greaterintenttoquit,andlowerlevelsofpsychologicalandphysicalhealth.Themajorphysicaleffectsareunwantedfeelingsandbehaviors,whichincludefatigue,stomachupset,headache,muscularachesandpains,disturbanceofsleeporsleepingdisorders,eatingdisordersandotherchronicormildillnesses.Othersincludelowmotivation,lowwork-lifebalance,lowoverallqualityofworklife,absenteeism,lowmorale,lowproductivity,unsounddecisions,intentiontogetabetterjob,occupationalburnout,alienation,increasedsubstanceabuse,sabotageorsolitude.Psychologicalproblemsincludeanxiety,irritabilityorshorttemper,psychologicaldistress,passive-aggressivebehaviors,lossofself-confidence,lossofself-esteem,feelingsoffatigueandfutility,impulsivebehavior,lossofcontactwithreality,jobandlifedissatisfaction,andemotionalfatigue(Spector,2002).Moretroublingstill,theconsequencesofunmitigatednegativeoccupationalstressontheindividualextendtoalltypesofsectorsandindustriesamongbothwhite-andblue-collarworkers(Chaudry,2012).Whenoccupationalstressisnotkeptincheck,itmaybecomechronicandleadtosignssuchastraumaorevendepression.Apersonmayalsochangetheirbeliefsorviewsregardingaparticularaspectoflifebecauseoftheiractiveself-examinationoftenwithoutprofessionalhelps.Otheradverseeffectsincludeheartattack,cancer,violence,suicideorevenparalysis(ManonMireilleandBarling,2004).InastudythatwasconductedintheUS(Smithetal.,1992),itwasfoundthatelectronicmonitoringofemployeesintheworkplaceledtoincreaseworkplacestressandthusmanyeitherexperiencedhighboredomlevels,anxiety,depression,healthcomplaints,psychologicaltension,anger,andfatigue.Theresearchersalsofoundthatthesecompanieshadhighemployeeturnoverbecauseofthismonitoring(Smithetal.,1992).2.6ConsequencestofamilyTheindividualsfamilyalsoexperiencesundesirableconsequencesbecauseofoccupationalstress.Consequently,ofoccupationalstress,theindividualmayalsocarrysomeofthestresstotheirhomethuscausingstresstotheotherfamilymembers.Thepersonmayalsofailtoprovideforthefamilybecauseoflosingtheirjoborspendingtoomuchmoneyonsubstanceabuseortreatment.Therearealsootheradverseeffectstothefamily.Theseincludedealingwithsicknessorevendeathoftheindividual(WindleandDumenci,1997).Incertainsituations,occupationalstressmayalsobreakmarriagesandfamiliesbecauseofthefamilynotbeingabletocopewiththeindividualsdysfunctionalresponses.Thecouplemayalsobeadverselyaffectedintheirsexlifebecauseofstress.Occupationalstressalsoincreasesdomesticpressuressuchasfinancialworriesandchildcareresponsibilitiesthusaffectingthequalityoflifeoutsidetheirwork(Suraj-Narayan,2005).Othereffectsincludetakingworkhome,whichreducestheamountoftimespentwithfamilymembers,jobrelocationsthatmaysplitfamiliesandalackofleisureactivities(Suraj-Narayan,2005).2.7ConsequencestotheorganizationAttheorganizationallevel,therearealsoconsequencesofoccupationalstressthatarefelt.Thesearemajorlydividedintotwosubgroups,whichareorganizationalsymptomsandcosts.Organizationalsymptomsincludediscontentandlowmoralethatmayalsospreadtoothermembersoftheworkforce,lowproductivity,poorqualityofservicetocustomersorclientsthatmayleadtolossofcustomers,badpublicityespeciallywhenanindividualsufferschroniceffectsofworkplacestress,highaccidentratesthatleadtohugeinsurancecompensations,prematureretirement,highstaffturnover,poorinternalcommunication,increasedinternalconflict,diminishedcooperationofstaffmembersoradysfunctionalworkplaceclimate(HuffmanandCohen,2004).Indeed,theresearchtodatesuggeststhatasmuchas50percentofallworkplaceabsencesattributableinsomefashiontooccupationalstress(Akpochafe,2012).Organizationalcostsincludereducedperformanceorproductivityofworkersthatleadstodecreasedaddedvaluetotheproductorservicethusdiminishingclientsatisfaction,highcostsasaresultofincreasedemployeeturnover,increasedstaffretrainingandtrainingcosts,increasedinsurancepremiumsasaresultoffrequentinsuranceclaimsandpayouts,increasedhealth-carecostsandsickpaytoemployees,increaseddisabilitypaymentsasaresultofworkplaceaccidents,increasedcostofrepairingdamagedequipment,andbadpublicitywhichalsodiminishesrevenuesgreatly(BjeanandSultan-Taeb,2005).Becauseoccupationalstresshavebeenswhontohaveadirectimpactonemployeeperformance,itisnotsurprisingthatthereisalsoacorrespondingdeclineintheoverallproductivitylevelofaffectedorganizations.Suchdeclinesinoverallproductivityhaveaconcomitanteffectoncompaniesprofitabilityandcanevenresultinanincreasinglynegativeperceptionofacompany(Sharma,2015).Consequently,theadverseeffectsofoccupationalstressultimatelycombinetoadverselyaffectemployeerelationsaswellasorganizationalperformanceandprofitability(Sharma,2015).AccordingtoastudyconductedbyDaniels(2004),occupationalstresshasbeenfoundtocosttheUKeconomyandestimated$4billioneveryyear(BrunandMilczarek,2007).Thesecostsaremajorlyfrominsuranceclaimsrelatedtooccupationalstress.Withsuchhugepayouts,theresearchersfoundthatthereisreasontoconcentrateonthesocioculturalvariationintheirfindings.Theyalsofoundthatthishugesumwasalsocomingfromlossofcustomers,highemployeeturnoverandnegativepublicitybecauseofoccupationalstress.IntheEuropeanUnionasawhole,itisestimatedthatroughly20millionEurosislosteachyearasaresultofwork-relatedstress(EuropeanCommission,2002,Milczareketal.,2009).2.8PositiveeffectsofworkplacestressThoughoccupationalstressisoftenassociatedwithnegativeeffects,therearecertainpositiveeffectsthatcomefromworkplacestress.However,expertsputacaveatonpositivityofstressstatingthatitonlyhappenswhenstressisbalancedandmoderated.Thisiswhattheycommonlyrefertoasgoodstress(Shigemietal.,2000).Forexample,SauderandMurphy(2016)reportthattherearesomemisperceptionsconcerningstressanditseffectsofhumansthatindicatethatallsuchstressisharmful.Agrowingbodyofevidence,however,confirmsthatsomelevelofstressisanessentialpartofthehumanconditionandpeopletendtorespondfavorablytosometypesofstress.AccordingtoSauderandMurphy(2016,p.6),Challengeenergizesuspsychologicallyandphysically,anditmotivatesustolearnnewskillsandmasterourjobs.Notwithstandingthepotentialdeleteriouseffectsofunmitigatedandrelentlessworkplacestress,itisclearthatwithoutsomelevelsofstress,employeeswouldbecomecomplacentwithcorrespondingdeclinesintheirjobsatisfactionandmoralelevelsjustastoomuchworkplacestresscancausetheseunwantedoutcomes.Insum,SauderandMurphy(2016,p.7)concludethat,Theimportanceofchallengeinourworklivesisprobablywhatpeoplearereferringowhentheysayalittlebitofstressisgoodforyou.Oneofthemostsignificantoutcomesofgoodstressisincreasedcreativity.Consequently,ofanindividualexperiencingworkplacestressleadingtolonelinessorsolitude,thepersonmayhaveachancetobroadentheirmindandembracenewideasthusleadingthemtoincreasetheircreativityconsiderably.Tosomeindividuals,stressisalsoamotivatingfactor.Whentheseindividualsarestressedout,theyfindagoodwaytohandleitbychannelingtheiremotionalandphysicalresponsestowardsworkingharderorrectifyinganywrongstheyhaddoneforexampleprocrastination(Smith,2003).Stressisalsorecognizedasacognitiveenhancer.Workplacestressimprovessomeaspectsofintelligencebygivingthemindaboostassociatedwithincreasedfocusing.Whenapersonisstressed,theymaybeabletorecallormemorizethingsbetterandtheirconcentrationlevelsmayalso;increase.Italsoenhancesthephysicalperformanceandenduranceofanindividual.Whenthepersonisabletochanneltheirstresstowardsphysicalactivities,itleadstoreleaseofadrenaline.Thiscausestheheartbeatandmetabolismtoincrease.However,thesereturntonormallevelsafewminutesaftertheactivity.Therefore,thepersonwillhaveincreasedreflexesandreactionsthatbuildendurance,preventandfightfatigueandtiredness.Researchershavealsoshownthatstresshelpstoimproveimmuneresponses.InastudyreportpresentedbyStrikeretal.(1999),itwasfoundthatstresshelpstoincreaseproductionofthestresshormone,cortisol,whichincreasesthebodysimmunity.Thisalsohassomenegativeaspectsincecortisoloverloadingmayleadtoabdominalobesity,whichincreasestheriskofcardiovascularandcerebrovasculardiseaseanddiabetes.Stressmayalsohelpanindividualtosolvetheirproblems.Consequently,ofstress,theindividualmaybeabletolookatsomethingdifferentlywhichallowsthemtosolveissuesbetweenthem.Moderateanxietyhasbeenshowntohelppeopleindecisionmakingbyspurringthemtotherightdirection.2.9CausesofworkplacestressGivenitsenormousimpactonorganizationalperformanceandproductivity,itisnotsurprisingthatagrowingbodyofscholarshiphasbeendevotedtothecausesofworkplacestressinrecentyears.StudiesbytheAmericanPsychologicalAssociationhaveidentifiedthemaincausesofstressintheUnitedStatesasshowninTable1below.Table1CurrentleadingcausesofstressintheUnitedStatesCauseFactors1JobPressureCo-WorkerTension,Bosses,WorkOverload2MoneyLossofJob,ReducedRetirement,MedicalExpenses3HealthHealthCrisis,TerminalorChronicIllness4RelationshipsDivorce,DeathofSpouse,ArgumentswithFriends,Loneliness5PoorNutritionInadequateNutrition,Caffeine,ProcessedFoods,RefinedSugars6MediaOverloadTelevision,Radio,Internet,E-Mail,SocialNetworking7SleepDeprivationInabilitytoreleaseadrenalineandotherstresshormonesSource:AmericanInstituteofStress(2018),2014StressStatisticsathttps://www.stress.org/AscanbeseenfromthebreakdownoftheleadingcausesofstressintheUnitedStatestodayshowninTable1above,job-relatedstressorssuchaspoorrelationshipswithcoworkersandsuperiorsaswellasinordinatelyheavyworkloadsformtheprimarycauseofstresstoday.Likewise,thesecond-leadingcauseofstressintheUnitedStatesisalsojobrelated,withthelossofemploymentorbenefitsrepresentingthesecond-leadingcauseofstressinthecountry.Moreover,thenumbersofAmericansthatareexperiencedthesetypesofjob-relatedstressorsisstaggeringasshowninTable2below.Table2U.S.stressstatisticsCategoryDataPercentofpeoplewhoregularlyexperiencephysicalsymptomscausedbystress77%Regularlyexperiencepsychologicalsymptomscausedbystress73%Feeltheyarelivingwithextremestress33%Feeltheirstresshasincreasedoverthepastfiveyears48%Citedmoneyandworkastheleadingcauseoftheirstress76%Reportedlyingawakeatnightduetostress48%Source:AmericanInstituteofStress(2018),2014StressStatisticsathttps://www.stress.org/AscanbeseenfromthedatapresentedinTable2above,morethanthree-quarters(77%)ofAmericanworkersreportexperiencingstress-relatedphysicalsymptomsandnearlyasmany(73%)reportregularlyexperiencingjob-relatedpsychologicalsymptoms.Inaddition,one-thirdofAmericanworkersreportfeelingasiftheyarelivingwithextremestressandnearlyhalf(48%)reportfeelingasiftheirlevelofstresshasintensifiedoverthepast5years.Giventhesedisturbingtrends,itisnotsurprisingthatmanyAmericanworkersalsoreportsufferingfromvariousjob-relatedstressorsassetforthinTable3below.Table3StressimpactstatisticsCategoryDataPercentwhosaystresshasanegativeimpactontheirpersonalandprofessionallife48%Employedadultswhosaytheyhavedifficultymanagingworkandfamilyresponsibilities.31%Percentwhocitedjobsinterferingwiththeirfamilyorpersonaltimeasasignificantsourceofstress.35%Percentwhosaidstresshascausedthemtofightwithpeopleclosetothem54%Reportedbeingalienatedfromafriendorfamilymemberbecauseofstress26%Annualcoststoemployersinstressrelatedhealthcareandmissedwork.$300billionPercentwhosaytheyarealwaysoroftenunderstressatwork30%Source:AmericanInstituteofStress(2018),2014StressStatisticsathttps://www.stress.org/Whilesometypesofjob-relatedstressmaybeconducivetohigherlevelsofcreativityandserveasamotivationalfactor,thedatapresentedinTable3abovemakesitclearthatmanyAmericanworkerssufferfromoccupationalstress.Infact,nearlyhalf(48%)reportthatstresshashadanegativeeffectontheirpersonalandprofessionallives,andmorethanhalf(54%)reportthatstressthatcausedthemproblemswiththeirinterpersonalrelationships.Inaddition,almostone-third(30%)reportfeelingthattheyarefrequentlyoralwaysunderstressattheirjobs,andmorethanone-third(35%)reportthattheirjobshaveinterferedwiththeirfamilyorpersonalaffairsresultinginelevatedstresslevels.Beyondthehumantollexactedbyjob-relatedstress,theeconomicimpactisalsoenormous,standingatabout$300billionayearinhealthcarecostsandmissedwork.ResearchbytheAmericanPsychologicalAssociationhasalsoidentifiedanumberofphysicalsymptomsthatarecausedbyoccupationalstressthatarecongruentwiththemostfrequentlycitedsymptomsintherelevantliteratureassetforthinTable4below.Table4PercentageofAmericanworkerscitingjob-relatedstress:physicalsymptomsCategoryDataFatigue51%Headache44%Upsetstomach34%Muscletension30%Changeinappetite23%Teethgrinding17%Changeinsexdrive15%Feelingdizzy13%Source:AmericanInstituteofStress(2018),2014StressStatisticsathttps://www.stress.org/AscanbeseenfromthedatapresentedinTable4above,morethanhalf(51%)ofAmericanworkersreportexperiencingfatigueasaresultofjob-relatedstress,andnearlyasmany(44%)reportsufferingfromheadaches.Morethanone-thirdofAmericanworkers(34%)alsoreportexperiencingupsetstomachs,muscletension(30%)andalmostone-quarter(23%)reportchangesintheirappetitesduetojob-relatedstress.SmallerpercentagesofAmericanworkersalsoreportedsufferingfrombruxism(e.g.,teethgrinding),changesintheirlibidos,orfeelingdizzy.Inaddition,manyAmericanworkersalsoreportexperiencingawidearrayofpsychologicalsymptomsduetojob-relatedstressassetforthinTable5below.Table5Americanworkerscitingjob-relatedstress:psychologicalsymptomsCategoryDataIrritabilityoranger50%Feelingnervous45%Lackofenergy45%Feelingasthoughyoucouldcry35%Source:AmericanInstituteofStress(2018),2014StressStatisticsathttps://www.stress.org/AscanbeseenfromthedatapresentedinTable5above,fullyhalfofAmericanworkersreportsufferingfromirritabilityorangerduetojob-relatedstressand45%eachreportfeelingnervousorexperiencingalackofenergy.Inaddition,morethanone-third(35%)reportingfeelingastheycouldcryatanytimeduetojob-relatedstress.Theserecentstatisticsunderscorethefactthatgettingupandgoingtoworkeachdaycanbeadeath-defyingexperienceformanyifnotmostAmericanstoday.Althoughthereisageneralconsensusamongresearchersthattheoverarchingcausesofworkplacestressincludevariousworkplaceconditionsandthemannerinwhichworkersinteractwiththeseconditions(SauterandMurphy,2016).Thereremainssomedebateamongresearchers,however,concerningthepreciseroleplayedbyindividualfactorssuchaspersonality,copingskillsandresilienceontheeffectsofworkplacestress(SauterandMurphy,2016).EmployeeresiliencetoworkplacestressisdefinedbyNilakantandWalker(2014,p.80),asbeingthemaintenanceofpositiveadjustmentunderchallengingconditionssuchthattheorganizationemergesfromthoseconditionsstrengthenedandmoreresourceful.Whileadditionalresearchisneededconcerningtheseindividualfactorsandtheirroleinemployeeresponsestoworkplacestress,itisreasonabletopositthatcertaintypesofworkingconditionsarethesourceofstressformostindividuals(SauterandMurphy,2016).ThisassertioniscongruentwiththeguidanceproviddbytheU.S.NationalInstituteforOccupationalSafetyandHealthwhichhasrecognizedthatwhileviewsdifferontheimportanceofworkercharacteristicsversusworkingconditionsastheprimarycauseofjobstress,theoverarchingthemethatemergesfromtheresearchtodateconcerningoccupationalstressisthatcertainworkingconditions,suchasexcessiveworkloadsandconflictingexpectations,arestressfulandnegativelyaffectmostpeople(ascitedinSewell,2009p.37).Whatisknownforcertainatpresentisthattherearemanycausesofstressrangingfromworkdemand,supervisorystyle,organizationalcultureandsupport,workhazards,generalworkenvironment,roleconflict,workplacechanges,individualfactors,jobinvolvement,workflexibility,workplaceincidents,etc.SixmajorcausesofworkplacestresshavebeenidentifiedbytheHealthandSafetyExecutiveoftheUK(HealthandSafetyExecutive,2013)asfollows:2.9.1Unreasonabledemands:Thiscauseincludesissuessuchasworkload,workpatternsandtheworkenvironment;2.9.2Excessivecontrol:Howmuchsaythepersonhasinthewaytheydotheirwork;2.9.3Lackofsupport:Thisincludestheencouragement,sponsorshipandresourcesprovidedbytheorganization,linemanagementandcolleagues;2.9.4Lackofproperworkplacerelationships:Thisincludespromotingpositiveworkingtoavoidconflictanddealingwithunacceptablebehavior;2.9.5.Lackofunderstandingofroleofjobexpectation:Whetherpeopleunderstandtheirrolewithintheorganizationandwhethertheorganizationensuresthattheydonothaveconflictingroles;and,2.9.6Unmanagedworkplacechanges:Howorganizationalchange(largeorsmall)ismanagedandcommunicatedintheorganization(Workplacestressmanagementstandards,2017,p.2).ThesecausesofworkplacestressarealsosimilartothoseidentifiedbytheOccupationalSafetyandHealthAdministrationintheUS(OccupationalSafety&HealthAdministration,1995)andarediscussedfurtherbelow.2.10UnreasonabledemandsWorkplacedemandsincludeissuesrelatingtoworkload,workenvironmentandpatterns.Occupationalstressmayoccurwhentheemployeesareunabletocopewiththeirworkplacedemands.Consequently,ofthis,thepersonmayfeelthattheyareunabletomatchtheskillsandabilities.Thereforetheemployeesdevelopstressasawayofcompensatingfortheirinabilitytomeettheworkplacedemands(Tarafdaretal.,2007).ThiscauseofworkplacestressisconsistentwiththedefinitionprovidedbySharma(2015)whichstatesthatoccupationalstresscanbedefinedastheadversepsychologicalandphysicalreactionsthatoccurinanindividualasaresultoftheirbeingunabletocopewiththedemandsbeingmadeonthem(p.53).2.11ExcessivecontrolControlappliedbyemployersandsupervisorsisalsoacontributingfactortoworkplacestress.Whenemployeesareexcessivelymonitoredintheworkplace,theydevelopboredom,dislike,lowmotivationandlowmorale,whichleadtoworkplacestress.Consequently,ofthisexcessivecontrol,theemployeesareunabletousetheirskills,creativityandinitiativetowardsthesuccessoftheorganization.Theemployeesalsobecomediscouragedtodevelopnewskillssincetheyaredemotivatedandunwillingtotakenewchallengesintheworkplace.AstudybyKirk-BrownandWallace(2009)foundthattheextenttowhichemployeesfeeltheylackpersonalday-to-daycontrolovertheirjobresponsibilitieswilllikelybetheextenttowhichtheseemployeesareatgreaterriskofdevelopingoccupationalstress.Forinstance,Kirk-BrownandWallace(2009,p.30)advisethat,Perceptionsofpersonalcontrolalleviatethenegativeimpactofjobdemands.Controlreferstotheworker\'sabilitytoreframeeventsorsituationsaslessthreatening.2.12LackofsupportWhenemployeeslackencouragement,resourcesandsponsorshipfromtheorganization,supervisorsandcolleagues,theydevelopstress.Thisisbecausetheyareunabletoachievetheperformancemeasuresattachedtotheirjobsandtheyexperiencechallengesandotherissuesthattheyareunabletoresolve.Thereforetheemployeesarediscouragedtoputtheirbesteffortstowardsthesuccessofthecompanyororganization(Verbeeketal.,2004).2.13LackofproperworkplacerelationshipsWorkplacerelationshipscreateconflictthatemployeesareunabletoresolve.Theseincludebullying,harassmentandotherundesirablebehaviors.Whentheorganizationlackspoliciesandprocedurestopreventorresolvesuchunacceptablebehavior,theyseemoutofcontrolandemployeesdevelopstressbecauseofthis.2.14LackofunderstandingofroleofjobexpectationWhenemployeesdonotunderstandtheirrolewithinanorganizationorwhentheyarenotappreciatedorvaluedwithinanorganization,theydevelopinternalconflictssincetheydonotunderstandtheirimportanceandjobexpectations.Employeesthusdonotmakeeffortstoensuretheirworkisdonetothebestoftheirabilityandtheybecomedemoralizedanddemotivatedtowork.2.15UnmanagedworkplacechangesResistancetochangeisoneofthemajorcausesofworkplacestress.Thisisespeciallysowhenthechangeinvolveslargeaspectsoftheorganizationsuchasanoverhaulofmanagementorstandardoperatingprocedures.Suchchangesmaybeoverwhelmingfortheemployeesandwhenchangemanagementisnotdone,theemployeeswillnotbeawareofthereasonforthechangeandthuswillresistitleadingtoworkplacestressastheyfeeluncomfortablewiththenewstatusquo(Vahteraetal.,1999).2.16FactorsthataffectjobperformancefromstressAnunfortunateconcomitantofvirtuallyanytypeofemploymentissomelevelofstress.Insomecases,thestressthatemployeesroutinelyexperienceismotivationalandcontributestogreaterlevelsofcreativity,butinfartoomanycasesjob-relatedstressislikeasilentkiller.Infact,leftunabated,job-relatedstresscanhaveaprofoundlyadverseeffectonjobperformance.Inthisregard,Lynott(2011,p.26)emphasizesthat,Stressisaconstantpresenceintheworkplace,andnevermoresothanindifficulteconomictimessuchasthese.Occasionallyiteruptsintoheadline-makinginstancesofdeadlyviolence.Moreoften,however,stresssimmersjustbeneaththesurface,silentlyeatingawayatmorale[and]productivity.Insum,itisapparentthattotheextentthatworkersarestressedoutduetojob-relatedfactorswilllikelybetheextenttowhichtheirjobperformanceisaffected,andtherehasalsobeenagrowingbodyofscholarshipdevotedtotheseissuesinrecentyears.Forinstance,inastudyconductedbyAbuAl-Rub(2004),itwasshownthatthereisaU-shapedorcurvilinearrelationshipbetweenworkplacestressandjobperformance.Thestudyshowedthatworkerswhohadmoderatelevelsofoccupationalstressperformedworseintheirjobscomparedtothosewhohaveextremelyloworhighlevelsofworkplacestress.Inadifferentbutsimilarstudy,itwasshownthattheremightbefourdifferentrelationshipsbetweenworkplacestressandjobperformance.ThesearecurvilinearorU-shaped,negativelinear,positivelinearandnorelationship(Jamal,1984).Thesetwostudiescitedaboveidentifiedvariousfactorsthatemanatefromstressanddirectlyaffecttheemployeesjobperformance.Oneofthemajorfactorswaslackofresources.Whentheemployeelacksthenecessitiestoconducttheirjob,theyareunabletoperformintheirroles.Thesecondfactorwasworkoverload,whichmadetheworkerstobeoverwhelmedandlackdirectionwiththeirwork.Thirdwaslackofcommunicationbetweentheemployeesandsupervisors.Thismeantthattheemployeeslackeddirectionandwereunabletoconducttheirday-to-dayactivities.Italsocreatedadisconnectinpassingofdutiesthusmakingsupervisorstoberecognizedascommandersratherthanco-workers.Anotherstudyfoundthatemployeeswhowereunderstresswere50%morelikelytoerrintheirworkwhileanotherstudyshowedthatthiscouldbeashighas70%dependingonthelevelofstress.DatafromtheBureauofLaborStatisticsalsoshowsthatforeverydaythataworkerundergoesstresstheymayendupbeingoutoftheworkplaceforroughly20days.Toemployers,thisrepresentsahugereductioninjobperformance.Otherstudiesconductedintheearly50s(Lazarusetal.,1952)andlate60s(Wilkinson,1969)showthatoccupationalstressaffectstracking,verbalreasoning,signaldetectionandsentenceformationofemployees.Thismayalsoadverselyaffecttheclient-employeerelationsthusreducingthequalityofserviceorproductgiventotheemployer.Moreresearch(Cohen,1980,GlassandSinger,1972)hassupportedthesestatementsbyaddingthatstresscreatesperpetualdistractionsthatpreventtolerance,increasefrustration,decreaseclericalaccuracyandincreaseworkloadeitherperpetuallyoreventuallythroughprocrastination.Allthesefactorsleadtopoorjobperformance.AccordingtoMichie(2002),individualsdifferintheirstressriskandvulnerabilitytoadverseeffectsofstress.Individuals,theymaytendtoreactemotionallytosituations,whichresultsinthemdisconnectingwiththeworkplacethusreducingtheirjobperformance.Othersmayexperiencefatigueortirednessthatpreventsthemfromperformingtheirtasks.InanotherstudybyMichailidisandAsimenos(2002),itwasfoundthatoccupationalstressnegativelyimpactsthedegreeofsatisfationoftheemployeewiththeirownachievement.Thisalsonegativelyaffectspersonalgrowth,skillutilizationandparticipationindecision-makingthusreducingjobperformance.2.17ManagementofstressStressmanagementhasbeenthesubjectofmanyworkplacechangesinordertocontrolthelevelsofstresstoimproveworkperformance.Itisinthebestinterestsoforganizationsofallsizesandtypestomanageworkplacestresstothemaximumextentpossibleduetothedocumentedadverseimpactthatunmitigatedstresscanhaveonemployeejobsatisfactionandphysicalwell-being(RandallandBuys,2013).Likewise,themanagementofworkplacestressisalsoimportantduetotheincreasedworkerscompensationclaimsthatareassociatedwithelevatedlevelsofstress(RandallandBuys,2013).Severaltechniqueshavebeenappliedtoimprovethegeneralwell-beingofemployeeswithvaryinglevelsofeffectiveness.Inaddition,fewofthesemethodshavereceivedattentionfromresearchersthereforetheamountandqualityofevidenceonthevarioustechniquesvariesgreatly.Managementofstressbuildsonthemodelsofstress,especiallythedemand-control-supportmodelthatstatesthatforstresstobemanagedeffectively,itisimportantfortheretobearewardandeffortstopromotebalance.Inadditiontothis,theorganizationmusthavesufficientsystemstoensureorganizationaljusticebyensuringmanagementofstressandanyprogramsadoptedareundertakenbyallemployeesincludingtheseniormanagement(JohnsonandHall,1990,KarasekandTheorell,1990).Researchersagreethattherearetwomajormodelsofworkplacestressmanagement.Thesearethetransactionalmodelandhealthrealizationorinnatehealthmodel.2.18TransactionalmodelThetransactionalmodelsuggeststhatstressresultsfromanimbalancebetweenthedemandsofanindividualandtheresourcesavailableorwhenpressureexceedstheabilityoftheindividualtocope.ItwasdevelopedbyLazarusandFolkman(1984)whopositedthatstressmanagementisbestwhentheindividualacceptsthatstressisasaresultoftheinabilityofthepersontocope.Therefore,stressmanagementispremisedonmediatingthestressresponsetoallowtheindividualtocontrolstresslevelsandincreasetheircopingability.Accordingtothetransactionalmodel,thepersonmustalsoidentifythefactorsthataffecttheirabilitytocontrolthestressinordertoidentifytherightinterventionmethodsthateffectivelytargettheidentifiedfactors.Theauthorsofthismodelarguethatstressisatransactionbetweentheindividualandtheirenvironmentthusbyidentifyingandcontrollingthemitigatingfactors,stresscanbemanagedeffectively.Thetransactionalmodelproposestheindividualtobetaughthowtomanagetheirstressorhowtheycanadequatelydevelopcopingskillstoimprovetheirlivesandbeabletohandleallmannerofstressors.2.19HealthrealizationorinnatehealthmodelThismodelwasputforthbySedgeman(2005)andMills(1995).Theauthorsarguethatstressisnotfoundedonthepresenceofanactualstressor.Themodeldoesnotfocusontheindividualsappraisalofthestressorratherontheirthoughtprocess,whichdeterminestheirresponsetothesituation.Theauthorsofthemodelarguethatstressismanagedbyself-appraisal,whichfiltersallfactorsofinsecurityofnegativityandcreatesafeelingofwell-beingbyputtingagriponnegativeorinsecurethinking.Theindividualwillthusbeabletodisengagefromthestressorandintroducenaturalpositivefeelingsthatultimatelyreducestress.2.20OrganizationallevelmanagementMichie(2002)positsthatfortheeffectivemanagementofworkplacestress,theremustbeorganizationallevelinterventions.Theneedfororganizationlevelstressmanagementisbecausetheworkplaceitselfisthestressor.Therefore,theorganizationmustintroduceinterventionsatthestructurallevelincludinghiringmorestaff,reducingorincreasingworkschedulesappropriately,orcreatingaconduciveenvironmentoratthepsychologicallevelincludingsocialsupport,effectivesupervisionratherthaninvasivesupervisionandincreasingemployeeparticipationindecision-making.Likewise,CooperandCartwright(1999)reportthat,Physicalcharacteristicsofthejob[such]asexcessiveheatandnoisemayproducestrainamongworkersandincreasetheprobabilityofaccidents.Shiftschedule,astructuralaspectofwork,canengendersignificantlevelofphysicalandmentaldiscomfortifnotorderedcorrectly.Theemphasishereisontheorganizationbeingthesourceofstressmanagementpracticesratherthantheindividualandithasbeenshowntobeeffective(GardellandGustavsen,1980,Williamsetal.,1998).2.21DefinitionofsupervisionSupervisionisdefinedastheregulationorcontrolofbehaviorthroughlaidoutrulesorrestrictions.Accordingtovariousauthors,therearedifferentaspectsofsupervisionthatneedtobelookedatindefiningit.Theseincludetakingupofideasandpracticesthatprovidetherightenvironmenttofollowthelaidoutrulesandrestrictions,overseeingthatemployeesareprovidedwiththerighttoolsandresourcestosucceedintheirtasks,providingadviceandsupport,organizingworktasksinagreatordertomakedecisions.2.22CategoriesofsupervisorymodelsSupervisionmodelscanbecategorizedintothreecategoriesbasedontheirdefiningcharacteristics.Thesecategoriesarethepsychotherapy-basedsupervisionmodels,developmentalmodels,andintegrativemodels(SmithandWitt,1993).2.23Psychotherapy-basedsupervisionmodelsThesemodelsdwellonthenaturalextensionofthetherapyitselfandinformtheobservationandselectionofdataforsupervisors(HollowayandWolleat,1994).Oneexampleofthesemodelsisthepsychodynamicapproachtosupervisionwhichstatesthatpsychodynamicsupervisioncanbedividedintothreecategorieswhicharesupervisor-centered,employee-centeredandsupervisory-matrix-centered(Loganbilletal.,1982).Employee-centeredsupervisioncamefromSigmundFreud,whichstatesthatsupervisionfocusesontheemployeebehaviors.Inthiscase,theroleofthesupervisordependsontheemployeesbehavior.Supervisor-centeredfocusesonthesupervisorscontentandprocesstoassistemployeesinmanagementofresistance,resolvinganxietiesandotherproblems.Thesupervisory-matrix-centeredapproachmeansthatthesupervisorsroleisnotthatofanuninvolvedexpertrathertheyshouldparticipateandreflectuponemployeedutiesandbehaviors(Haynesetal.,2003).Anotherexampleofthesemodelsisthecognitive-behavioralsupervisionmodelwhichstatesthatthesupervisorsmajortaskistoteachtheemployeethetheoreticalaspectsoftheirwork(LieseandBeck,1997).Anothermodelistheperson-centeredsupervisionmodel,whichstatesthatthesupervisorshouldensurethattheemployeeshavetherighttools,skillsandresourcestoperformtheirtasks.Thereforethesupervisorisacollaboratorinthesuccessoftheindividualbyprovidinganenvironmenttoengagetheemployeetowardssuccess(Lambers,2000).2.24DevelopmentalmodelsDevelopmentalmodelsdefineprogressivestagesofdevelopmentoftheemployeefromanovicetoanexpertwitheachstageconsistingofdiscreteskillsandcharacteristics.Accordingtothesemodels,thesupervisortakesadevelopmentalapproachtosupervisionbyaccuratelyidentifyingthecurrentstageoftheemployeeandfacilitatingtheirprogressiontothenextstage(ZimmermanandSchunk,2003).OneofthemostpopulardevelopmentalmodelsistheintegrateddevelopmentmodeldevelopedbyStoltenberg(1981)andStoltenbergandDelworth(1987).Themodeldescribesthreelevelsofemployeedevelopment.Thefirstisentry-levelwheretheyarefullofanxietyandfearofevaluation.Themid-leveliswheretheemployeesexperiencefluctuatinglevelsofconfidenceandmotivationwhilethethirdlevelisthatofsecurityandstablelevelsofmotivation.AnothermodelisRonnestadandSkovholtsmodelwhichstatesthatemployeesdevelopinsixphases(RonnestadandSkovholt,2003).Thefirstthreearebasedontheintegrateddevelopmentmodelwhiletheotherthreearethenoviceprofessional,experiencedprofessionalandseniorprofessionalphases,whichdefinetherelativeexperiencegainedbyemployeeintheircareer.2.25IntegrativemodelsIntegrativesupervisionmodelsrelyonseveraltheoriesandtechniques(Haynesetal.,2003).AgoodexampleofthesemodelsisBernardsdiscriminationmodeldevelopedbyBernard(1979)andrevisedbyBernardandGoodyear(2009).Thismodelstatesthattherearesixfociofsupervision.Thefirstthreearefoci,whichareintervention,conceptualizationandpersonalizationwhilethelastthreeareroles,whichareteacher,counselorandconsultant.Accordingtothemodel,thesupervisorrespondsusingoneoftheninewaysresultingfromthethreerolesxthethreefoci.Anothermodelisthesystemsapproachmodel(Holloway,1995)whicharguesthatthesupervisorandemployeehaveamutuallyinvolvingrelationshipwithsevendimensions.Thesearesupervisionfunctions,supervisiontasks,employee,trainee,supervisor,andtheinstitution(MimuraandGriffiths,2003).2.26SupervisorytasksAsupervisoryhasdifferenttaskstoconductdependingontheexactworkplacesetting.However,ingeneral,theybeginbyfmiliarizingthemselveswiththecurrentjobdescriptionsoftheemployees.Asupervisorcannotbeabletoconductanytaskwithoutbeingabletounderstandtherequirementsofeachoftheemployeespositions.Minoetal.(1999)arguesthattherearefourmajorsupervisorytasks.Thesearecoaching,mentoring,advocatingfortheorganizationandadvocatingfortheemployee.2.27CoachingAsacoach,thesupervisorisinvolvedinworkingwiththeemployeestoestablishgoals,plansandtimelinesforaccomplishmentoftasks.Thesupervisorthusprovidesongoingsupportandguidancefortheemployeestocompletetheirtaskswithease.Thesupervisorhelpstodemystifyjobtasks,whichmaymakeanemployee,feelthattheyareunabletomeetthegoalsofthepositiontheyarein.Ascoaches,supervisorsalsotakeintoconsiderationotheraspectsofemployeelifesuchastraining,utilizationofpersonalstrengthsandweaknesses.Themainthingisforthesupervisortoprovideeffectivesupervisionthatenablesemployeesmakebetterdecisionsandperformtheirtasksbetter.2.28MentoringAsamentor,asupervisorunderstandsthatanemployeeneedstohaveagoodwork-lifebalanceandtriestoupholdthat.Thesupervisorthusuniquelyprovidesadvicetoemployeesinvariousaspectsrelatingtotheirjobandlifeingeneral.Thesupervisormakestheemployeelookathimorherasamodelforpersonaldevelopmentanddirection.Thisaffirmstheage-oldphraseofleadingbyexample.2.29AdvocatingfortheorganizationAsupervisoristheorganizationschiefadvocatetotheemployees.Thesupervisorensuresthatemployeesconducttheirtaskswithutmostzealtoensurethattheymeettheirjobperformancestandardsandgoals.Thesupervisoralsoensurescompliancewithorganizationalpoliciesandprogramsthatcomefromthemanagement.Thoughemployeesmaybeconfusedorfrustratedbyactionsbyasupervisor,thereisneedtocheckemployeestoensuretheymeettheirexpectations.Thesupervisormustthusbestrictbuttactful.2.30AdvocatingforemployeesSupervisorsactasintermediariesbetweentheorganizationandtheemployees.Thusastheyadvocatefortheorganization,theyalsoneedtoadvocateforemployees.Employeerequeststothemanagementneedtobetakenintoconsideration.Thesupervisoralsoensuresfairnessandjusticeintheworkplaceinaspectssuchaspromotion.Thesupervisoralsoexplainssituationsfacingemployeestothemanagementtoensurethattheyarenotbeingtreatedunfairlyoragainsttheirwill(Manningetal.,1996).2.31OtherrolesApartfromthesefourmajorroles,supervisorsalsoplayotherrolesintheorganization.Oneisthattheyresolveemployeeconflictsandcomplaints.Here,thesupervisorhelpsemployeestoaddressandresolveanyworkplaceconcernstheymayhave.Thisincludesmediatingbetweenemployeesorbetweentheemployeeandthemanagement.Anotherroleistoapproverecordsandrequestsbystaffmembers.Supervisorsapproveallworkrelatedaspectsforemployeessuchasattendanceortimeoffrequests.2.32FrequencyofsupervisionForsupervisiontobeeffective,itneedstobeasregularaspossiblewithoutinvadingtheprivacyofemployees.Invasionofprivacyinvolvestoomuchclosesupervisionorregularmonitoringofemployeeemails,textsorotheraspects.Thefrequencyofsupervisionvariesfromoneorganizationtoanotherwithmostdeemingthatitdependsmajorlyontheemployeesexperience.Newemployeesneedtobesupervisedmoreoftencomparedtomoreexperiencedones.Inaddition,juniorlevelemployeesneedtobesupervisedmoreoftenthanmanagersorotherseniorlevelemployees(Leighetal.,1999).2.33ConfidentialityandsupervisionConfidentialityisakeyissueinemployeesupervision.Supervisorsandemployeesneedtodefineaclearandmutualunderstandingoftheboundariesofconfidentialityinrespecttosupervisorytasks.Thiswillenableasafeandeffectiveworkingrelationshiptobedevelopedbetweenthesupervisorandtheemployee.Confidentialityinvolvesthesupervisorshowingtheemployeethattheymeanwhattheyaresayingandthattheyarewillingtofollowthroughonanyagreementstheymakewiththeemployee.Thesupervisormustalsodemonstratethattheyarenon-judgmentalandthatnothingcanmakethembreaktheconfidentialityagreement.Ontheotherhand,theemployeegainsthesupervisorstrustbybeingashonestandopenaspossibletothesupervisorinwork-relatedtasks.Insodoing,apositiveworkingrelationshipwillbebuiltfoundedontrustandthiswillfosteranewthinkingprocessanddevelopmentoflearning(Grzywaczetal.,2002).Intheday-to-dayrunningofsupervisorytasks,thesupervisormayneedtoinvolveotherindividuals.Whenthisisrequired,thesupervisorneedstoprotectandhonortheconfidentialityagreementwiththeemployee.Thisisdonebyrequestingtheemployeetoallowthemtoincludeanotherindividualandexplainingtotheemployeewhyitmaybenecessarytoinvolveanotherindividual.Whenconsentisgivenbytheemployeetoinvolveothers,thesupervisorshouldonlydivulgetheminimuminformationrequiredbytheotherindividualthatallowsthemtoprovidetheirsupportinthedevelopingsituation.2.34AdvantagesofsupervisorysupportManyorganizationsemphasizetheimportantofsupervisorysupportforemployeesbecauseofitsadvantages.Amongthelargestadvantagesisitspositiveeffectonworkermoraleandjobsatisfaction.Supportivesupervisionhelpstoreduceoccupationalstress,whichhelpsemployeestohandletheiropportunitiesthusreducingtheinfluenceofotherfactorsthataffectjobperformanceorleadtolessthansatisfactoryproductsorservicestoclientsorcustomers.AccordingtoKadushin(1992),thesupportivesupervisionhelpstopreventpotentiallystressfulsituationsthusremovesemployeesfromstressandreducesstressontheworker.Thishelpsemployeestoadjusttotheworkenvironmentandincreasesmoraleandjobsatisfaction.Supportivesupervisionalsoenhancescommunicationintheworkplaceandcreatesasenseofcohesiveness.Thisisbecausetheemployeesfeelthesupervisoristheretohelpratherthandiscourageorcriticize.Therefore,workerswillbeabletotakeresponsibilityfortheirownactionsandbewillingtojustifythem.Thisgreatlyimprovesorganizationalcommunication.Anotheradvantageofsupportivesupervisionisthatitallowsforsharingofideasandresourcesintheworkplace.Sincetheemployeesseethesupervisorasmoreofacollaboratorthanfoe,theyareencouragedtogivetheirideastowardsthesuccessofthecompanyororganization.Supportivesupervisionalsohelpstoensurethatthecompanystickswithintheoutlinedpoliciesandprocedures.Consequently,offosteringcommunicationbetweenmembersofstaffandsupervisors,theemployeeswillbemorelikelytofollowcompanypoliciesandproceduressincetheyareabletorelatecloselytothem.Supportivesupervisionalsohasotheradvantagessuchasfosteringprofessionalandpersonaldevelopmentthatcomesfrommotivationofemployees,reducedoccupationalburnoutbecauseofemployeeshavingflexibleworkschedules,qualityserviceandproductstoclientsandconsumers,aswellasimprovingorganizationalculturesincestafffeeltheyaresupported.Supportivesupervisioncontributedmajorlytoensuringorganizationsprovideshighqualityservicesandproductsaswellasensuringconsistentoutcomesbyemployees.2.35EffectivesupervisionEffectivesupervisionisacriticalaspectforanyorganizationlookingforwardtodeveloppositiveoutcomesforitsemployees.Asaresult,organizationsthereforeneedtomakeapositiveandunambiguouscommitmenttowardshavingastrongsupervisionculturefortheiremployees.Thiscanbeachievedthroughdevelopingaclearpolicyonsupervisionaswellasencouragingpracticethatsupportsthispolicy.Anotherwayofachievingthisistohaveeffectivetrainingforitssupervisorsandhavingstrongleadsthroughtheseniormanagementteam.Anotherimportantwayofachievingeffectivesupervisionistoensurerealisticperformanceobjectivesaresetwhicharemonitoredregularlytocheckcompliance.Effectivesupervisionhelpsgreatlytoreduceworkplacestress.Thisisbecauseamongitsmajoradvantagesisthatithelpsineffectiveworkloadmanagement.Byhavingclearandrealisticperformanceobjectives,theorganizationisabletoknowwhatisexpectedfromeachemployeeandthusplanfortheachievementoftheseobjectivesthrougheffectivemanagementofeachemployeesworkload.Further,effectivesupervisioncontributestothewell-beingofemployeesbyreducingworkplacestresslevelswhicharepositivelycorrelatedwithincreasedemployeeproductivityandnegativelycorrelatedwithunplannedemployeeturnover,reducedproductivityandemployeewell-being(ReubenandChiba,2017).Inadditiontotheforegoing,effectivesupervisionalsohelpstoensuresufficientplanningofemployeetasksaswellasotherimportantconsiderationsfortheorganization.Byembeddingeffectivesupervisiontoorganizationalculture,theorganizationisabletoensureitcompetentlymonitorsemployeeperformanceandthusplansaheadbasedonthis.2.36TherelationshipbetweenstressandsupervisionOccupationalstressisoftenassociatedwithemployeesnotbeingabletocopewithcertainsituationsintheirworkplace(Gnilkaetal.,212).Thesemayincludestrictsupervision.Whenanemployeeisnotabletocopewiththesupervisionlevelintheorganization,theexperiencestress,whichmayleadtothenegativeaspects,mentionedearlier.Bordin(1979)alsostatedthatwhensupervisorsareunabletomotivatetheiremployees,thestrengthoftheworkingallianceisgreatlycompromisedmakingitharderforemployeestodischargetheirduties.Bordin(1983)alsoaddsthatthesupervisorsattitudecreatespersonaldevelopmentinthesuperviseewhichhelpsthemtocopewiththeworkplaceandthusreducesoccupationalstress.Italsohelpsthemtoappraisetheirworkdemandsandwhethertheyhavethenecessaryresourcesandabilitytocope.Thusithelpsthemtoexerciseemotional,socialandphysicalcontrolwhicheffectivelypreventsthenegativepsychologicaloutcomesthatareassociatedwithstress(Finneyetal.,2013).2.37TheimpactofleadershiponstressOvertheyears,organizationshavemovedfromcharismaticleadershiptointroducesharedordistributedleadershipwithmoreethicalvaluessuchasauthenticity,fairleadershipandethicsbeingemphasized.Thisisbecausetheorganizationshaveunderstoodthenegativeeffectsofpoorleadership,whichincludeabusivesupervision,highemployeeturnover,poorjobperformance,andpassive-avoidanceleadership.Itisestimatedthatorganizationsallovertheworldspendatotalor36to60billionUSdollarseveryyearonleadershipdevelopmentactivities(Leighetal.,1999).Thisindicatesthattheyarebeginningtounderstandthatleadershipisacriticalcomponentinorganizationalsuccessandinreducingoccupationalstress.Effectiveleadershiphelpstobuildtherightpsychosocialworkenvironmentthatfostersemployeestoutilizetheirabilitytowardsthesuccessoftheorganization.Poorleadershipontheotherhandcreatespoorsupervisionwhichcreatesoccupationalstressontheemployees(BlixandLee,1991).2.38QualitiesofeffectiveleadershipVirtuallyanyonewhohasworkedinanytypeofcapacity(whichistosaymostpeople)canreadilytestifyconcerningtheimportanceofthequalityofleadershipintheworkplace.Effectiveleaderscanmakethedifferencebetweenorganizationalsuccessandfailurebyvirtueoftheireffectsoftheirleadershipontheiremployeesandtheincidenceofoccupationalstressthatresults.AstudybyReubenandChiba(2017)foundthatthereisaninextricablerelationshipbetweeneffectiveleadershipandemployeewell-being.Basedonthesefindings,ReubenandChina(2017,p.37)concludethat,Effectiveleadershipstylesarethereforerequiredtodevelophigh-qualityworkenvironmentsthatareconducivetoworkers\'well-beingandwhichultimatelycontributetoachievingorganizationalgoals.Effectiveleadershipischaracterizedbyvariousqualities.Firstisself-confidencewheretheleaderisabletotakeonanynewprojectsorroles,whichmaybeoutsidetheirnormalareaofcomfortandbelievethattheyareabletoworkreallywell.Thesecondqualityisgoodmorals.Effectiveleadersleadbyexamplemeaningthattheydefendtheirownbeliefsandideals,whicharebasedontheorganizationspoliciesandprocedures.Thirdisdecisiveness,whichmeansthattheleaderisabletoweighalltheavailableoptionstomakeacleardecision.Fourthisflexibility,whichmeansthattheleaderisabletochangetheirscheduleasprioritiesoftaskschangeorasnewtaskscomein.Anotherimportantqualityisdependability,whichmeansthattheemployeesareabletodependontheleaderorsupervisortotakecareofanyproblemsorconflictsthatarise.Patientisalsoanimportantqualitysincetheleaderneedstobeabletolistencarefullytoallthings.Patienceshouldbecoupledwithfairnessorjusticemeaningthattheleadershouldlistentobothsidesofanystoryorissuebeforegivingtheirjudgmentordecision.Aneffectiveleadershouldalsobearisk-takermeaningtheyshouldbeabletochallengetheprocessorsystembyfindinginnovativewaysfortheorganizationtochange,improveandgrowandimprove.2.39RoleofasupervisorintheworkplaceSupervisorshavevariousrolesandresponsibilitiestoplayintheworkplace.Oneisdiscipline.Supervisorsareexpectedtoensurethatstaffmemberssticktocompanypoliciesandproceduresatalltimes.Thisensuresthatemployeesarekeptfocusedonproductiveactivitiesandmaintainsalevelfieldforallemployees.Thesupervisoralsohasaroleinemployeedevelopmentwheretheyareexpectedtohelpemployeesbuildskillsinareaswheretheyarelacking.Thishelpstodevelopandimprovetheperformanceofwork.Supervisorsarealsoexpectedtobepeacemakers.Amongtheirkeyrolesistoresolveworkplaceconflictsinanamicableandfairmanner.Theyneedtolistentobothsidesofthestorytodeterminewhoisrightandfindanamicablewaytoresolvetheconflict.Theconflictshouldberesolvedinaway,whichtheinvolvedpartiesunderstand.Thesupervisoralsoplaysaroleinensuringthattheorganizationsemployeesareproductivebyensuringtheyhavetherightskillsandresourcestoperformtheirduties.Theyalsoidentifyareasfortrainingofemployeesandincertainsituationsconductthetrainingbythemselves.2.40TheadverseeffectsofworkplaceambiguityItisdifficulttoquantifytheadverseeffectsofambiguityintheworkplaceincreatingstress,butitisclearthatemployeeswantandneedtimelyandaccurateguidanceconcerningwhatisexpectedofthemaswellastheiroverallroleincontributingtoachievinglargerorganizationalgoals.Whentheseissuesareunclear,employeescanexperienceelevatedstresslevels(Kirk-BrownandWallace,2009).Indeed,Osibanjo,andSalau(2016)emphasizethatroleambiguitycanexacerbateworkplacestresslevels,andthisprocessisfurtherintensifiedwhenworkloadsareespeciallyheavy.Certainly,mostpeoplehavebeencompelledtoworkharderthannormalfromtimetotimedependingontheexigenciesoftheirorganizationalneeds,butworkingharderthannormalandworkingharderthannormalwithoutdirectionareentirelydifferentissues.Asaresult,itisreasonabletosuggestthattheextenttowhichroleambiguityisallowedtopersistwillbetheextenttowhichoccupationalstresslevelsarecorrespondinglyincreased.Jobstressorssuchasroleambiguityhavebeenstudiedinawidearrayofculturalsettingsandthefollowingvariableshavebeenmostfrequentlyidentifiedasbeingpositivelycorrelatedwithroleambiguity:(1)tensionandfatigue,(2)absenteeism,(3)leavingthejobandanxiety,and(4)bothpsychologicalandphysicalstrain(El-KotandBurke,2011).Inaddition,roleambiguityhasalsobeenpositivelycorrelatedwith:(1)roleconflict:task/skillvariety,(2)locusofcontrol,(3)education,and(4)propensitytoleavetheorganization(El-KotandBurke,2011).Thevariablesthathavebeenidentifiedasbeingmostfrequentlynegativelycorrelatedwithroleambiguityinclude:(1)jobsatisfaction,(b)physicalwithdrawal,(3)supervisorysatisfaction,(4)jobperformance,(5)jobinvolvement,(6)decisionmaking,(7)jobinvolvement/engagement,(8)organizationalcommitment,(9)toleranceforconflictandgroupcohesion,and(10)reportedinfluence(El-KotandBurke,2011).Takentogether,itisapparentthatambiguityintheworkplacecanhaveprofoundimplicationsforoccupationalstresslevels,butthereareothervariablesinvolvedthatmakedeterminingwhichfactorsaremostoperativeintheprocessespeciallycomplex.Forexample,otherresearchershaveidentifiedsignificantnegativecorrelationsbetweenroleambiguityandthefollowingvariables:(1)participation,(2)taskidentity,(3)feedback,(4)jobsatisfactionacrosssub-levels,and(5)commitmentandinvolvement.Finally,studieshavealsoshownthatroleconflictandroleambiguityareconsistentlycorrelatedEl-KotandBurke,2011).Finally,theantecedentsofroleambiguityincludethefollowing:(1)workinginorganizationalboundaryroles,(2)beingaserviceemployee,(3)objectiverolerequirementsoftheemployee,(4)limitedparticipationindecisionmaking,(5)limiteduseofgoalsettingbysupervisors,(6)numberofsubordinates,and(7)levelofformalizationintheorganization(El-KotandBurke,2011).Therefore,identifyingthemostsalientvariablesthatcreateheightenedworkplaceambiguitylevelsandimplementinginterventionsthatarespecificallydesignedtoamelioratethemtothemaximumextentpossiblehelpstocreateabalancebetweentheemployeesbehavioralstrainsandproductivebehaviors.Thisisbecauseithelpstopreventcounterproductiveworkplacebehavior,whichmaybedirectedbythesupervisor.Italsohelpstoremovepsychologicalstrainswhichmayleadtoissuessuchasanger,anxiety,frustration,depression,intentiontoquit,jobdissatisfaction,cynicism,exhaustionandreductioninprofessionalefficacy.Theseworkplaceambiguityvariablesincluderoleambiguity,avoidanceofuncertainty,ortheauthoritarianleadershipstyle.Theyaffecttheperceivedjobcontrolthushelpingtomoderatelypreventworkplacestress.Thebesthumanresourcesstrategyforaddressingroleambiguityintheworkplaceistoensurethatemployeesjobdescriptionsactuallyreflecttheworktheydoratherthansomeabstractversionofwhatanorganizationbelievestheyshouldbedoing.AsBamber(2011,p.59)pointsut,Oneofthemainwaysinwhichanemployeesrolesandresponsibilitiesaremadeclearatworkisthroughtheirjobdescription.Insomecases,developingatimelyandaccuratejobdescriptionmayrequireadeskaudittoensurethatalltasksandresponsibilitiesthatarebeinghandledbyworkersareincludedintheirjobdescriptions(Bamber,2011).2.41Supervisor-TheimportanceoffeedbackTheresearchtodateconcerningtheimportanceofsupervisoryfeedbackconfirmsthatthisprocessisessentialformitigatingroleambiguityintheworkplaceandreducingoccupationalstresslevels.Asnotedabove,however,therearenumerousvariablesthatcanexacerbateroleambiguity,butsupervisoryfeedbackcanserveasausefulwaytoaddressmanyofthemeithersimultaneouslyorbasedonpriorityoftheseverityofthestressorlevels(ClarkeandCooper,2004).Fromoneperspective,supervisoryfeedbackrepresentsatypeofsocialsupportintheworkplacethathasbeenfoundtobeanessentialcomponentofjobsatisfactionandloweroccupationalstresslevels(ClarkeandCooper,2004).Inthisregard,ClarkeandCooper(2004,p.24)reportthat,Inanorganizationalsetting,socialsupportisoftenprovidedbyimmediatecolleaguesandfirst-linesupervisors;supervisorysupportisdefinedasthedegreeofconsiderationexpressedbytheimmediatesupervisorforthesubordinatesandco-workersupportasthedegreeofconsiderationexpressedbyco-workers.ResearchbyClarkeandCooper(2004,p.24)identifiedfourdifferenttypesofsocialsupportinanorganizationcontextasfollows:(1)instrumentalsupport(i.e.,givingdirecthelp,oftenofapracticalnature);(2)emotionalsupport(i.e.,showinginterestin,understandingof,caringforandsympathywithapersonsdifficulties);(3)informationalsupport(i.e.,givingthepersoninformationthatmayhelphimorherdealwithproblems);and(4)appraisalsupport(i.e.,providingfeedbackaboutthepersonsfunctioningthatmayenhancehisorherself-esteem).Therefore,ongoingandmeaningfulfeedbackfromsupervisorsandfromcoworkersisimportantbecauseitfosterscommunicationwithintheorganizationandservesasaformofsocialsupport.Inaddition,timelysupervisoryfeedbackhelpstocreateworkingrelationshipsbetweenthesupervisorsandemployeessincethelatterfeelthattheyareinvolvedinthedecision-makingprocessandtheirviewsarevalued.Absentsuchfeedback,employeesareleftwonderingiftheyaresatisfyingand/orexceedingtheirperformanceobjectivesandachievingorganizationalgoals.Theseoutcomesalsodirectlycontributetoworkplaceambiguitywhichhasbeenshowntobeanantecedentofoccupationalstresstimeandagain.Thefeedbackchannelisanimportantwayofincreasingproductivityandperformanceofemployeesintheworkplace.Italsoactsasamotivatingfactorforemployeessinceitisinclusiveratherthanalienatingfortheemployees.Basedontheiranalysisofthevariousantecedentsofoccupationalstress,MijakoskiandKaradzinska-Bislimovska(2015,p.180)concludethat,Thepresenceofproperfeedback,adequatesupervisorandcoworkersupport,aswellasappropriateteamwork,leadstohighjobengagementandlowlevelofdepersonalization,whiletheirabsenceincreasesthelevelofcynicalattitudetowardswork.Moreover,timelyandhonestsupervisoryfeedbackisalsoacrucialaspectofperformancemanagementsinceitmaintainsanopenandhonestrelationshipbetweenthesupervisorandemployeethusthetwo-waydialoguewillenableperformanceappraisalstobeconductedhonestlyandthusimprovetheabilityoftheemployeestomeettheexpectationsofthecompanyororganization.2.42PreventionandfightingwithstressatworkGivenitsdocumentedexorbitanteconomiccostsandtheenormoushumantollthatisexactedbythecondition,thepreventionofworkplacestressisanimportantconsiderationforallorganizations.AsOsibanjoandSalau(2016,p.261)pointout,Highlevelsofworkplacestresscanbecomeharmfulforindividualemployeesandtheorganizationasawhole.Hence,toenhancecorporateimageandachievecompetitiveadvantage,stressmanagementandcopingstrategiesbecomeimperative.Occupationalstresscanbepreventedorminimizedbyintroducingeducationandtrainingprogramsforemployeestounderstandandrelatetooccupationalstress.Itcanalsobepreventedoramelioratedbychangingtheorganizationspoliciesandprocedurestoensurethatallrisksofoccupationalstressaremitigatedandsourcesofstresseliminated.Anotherwayofpreventingoccupationalstressistoestablishemployeeassistanceprogramstosupportemployeesundergoingoccupationalstress(RandallandBuys,2013).Anin-depthstudyofoccupationalstressandefficaciousinterventionsbyRichardsonandRothstein(2008,p.69)definedjobstressasasituationwhereinjob-relatedfactorsinteractwiththeworkertochangehisorherpsychologicaland/orphysiologicalconditionsuchthatthepersonisforcedtodeviatefromnormalfunctioning.Thereisaninherentnotioncontainedinthisdefinitionthatwork-relatedstressorsrepresenttheoverarchingsourceofstressandthatindividualresponsestoelevatedwork-relatedstresscanmanifestinpsychological,physiological,oracombinationoftheseoutcomes(RichardsonandRothstein,2008).Measuringtheefficacyofstressmanagementinterventionsisaccomplishedindifferentwaysdependingonthefocusoftheintervention.Insomecases,researchershaveevaluatedtheeffectivenessofstressmanagementinterventionsbasedontheireffectonquantifiableoutcomessuchasemployeeproductivitylevels,absenteeismrates,bloodpressurelevelsandweightgainorloss(RichardsonandRothstein,2008).Inothercases,researchershaveevaluatedtheeffectivenessofstressmanagementinterventionsusingmoresubjectivecriteriasuchasemployeeengagement,moraleorjobsatisfactionlevels.Regardlessoftheevaluationstrategythatisused,thereremainsasignificantamountofcontroversyconcerningwhichstressmanagementinterventionsaremosteffectiveinvarioussituationsandwhy(RichardsonandRothstein,2008).Varioustypesofstressmanagementinterventionseitherseektomodifywork-relatedstressorfactors,provideemployeeswithassistanceandsupportinmitigatingtheadverseeffectsofsuchstressors,oracombinationofthesestrategies(RichardsonandRothestein,2008).Basedonaconceptualframeworkdevelopedforthedesign,implementation,andevaluationofstressmanagementinterventions,interventionscanbedesignedtoaddressthreemainpointsinthestresscycle:(1)theintensityofstressorsintheworkplace,(2)theemployeesappraisalofstressfulsituations,or(3)theemployeesabilitytocopewiththeoutcomes(RichardsonandRothstein,2008p.70).Theconstituentelementsofstressmanagementprogramsdifferbuttheygenerallyincludeinterventionsthatcanbecategorizedasprimary,secondaryortertiaryinitiativesasdescribedbelow:2.42.1Primaryinterventions:Thesetypesofstressmanagementinterventionsseektochangethemainsourcesofjob-relatedstress.Inthisregard,RichardsonandRothstein(2011,p.70)reportthat,Examplesofprimarypreventionprogramsincluderedesigningjobstomodifyworkplacestressors,increasingworkersdecision-makingauthorityorprovidingcoworkersupportgroups.Inotherwords,primaryinterventionsarethoseintendedtoseekoutthesourceofjob-relatedstressandniptheminthebudbeforetheycanexactastress-relatedtollonworkers.Forinstance,accordingtoBamber(2011,p.42),.Primarylevelinterventionsareaimedatchangingtheworkenvironmentitselftoreduceoreliminatethecauseofthestressatitssource.Insomecases,though,changingtheworkenvironmentinsubstantivewaysisnotfeasibleduetothetypesofoccupationsthatareinvolved(e.g.,acute-carenurses,combatinfantrytroops,firefighters,amongothers)orduetotheexpensethatmaybeinvolved(Bamber,2011).Inthesetypesofcases,researchersbelievethatsecondaryinterventionsaremoreappropriateandeffectiveataddressingjob-relatedstressasdiscussedfurtherbelow.2.42.2Secondaryinterventions:Thesetypesofstressmanagementinterventionsaredesignedtominimizetheseverityofstresssymptomsbeforetheycancausemoreserioushealthissueswithworkers(RichardsonandRothstein,2011,p.70).Secondarylevelinterventionsarealsodesignedtoeducateworkersconcerningvarioustypesofcopingstrategiesorskillsthatcanserveasbuffersagainststressfulworkplaceenvironmentsandprovidethemwiththetoolstheyneedtodeveloptheresiliencetheyneedtorespondinhealthierwaystojob-relatedstressors(Bamber,2011).AccordingtoSidle(2008,p.111),Cognitive-behavioralapproachesaresecondaryinterventionsthathelpemployeesrethinktheirbeliefsaboutchallengingsituations.Specifically,individualslearntorecognizehowtheirpessimisticandoftendistortedthoughtsofgloomanddoomleadtostress.Next,theylearntoreplacetheiroverlypessimisticthinkingwithmorerealisticormoreoptimisticthinking.2.42.3Tertiaryinterventions:Thesetypesofstressmanagementinterventionssuchastheaforementionedemployeeassistanceprogramsareintendedtotreatworkersstress-relatedhealhproblemswithappropriatementalhealthcarepractitioners(RichardsonandRothstein,2008p.70).AccordingtoBamber(2011,p.42),Tertiarylevelinterventionsareappropriatewhensecondarylevelinterventionsareineffectiveandtheindividualisexperiencingstresssyndromeswhichareimpactingontheircapacitytobeproductiveintheworksetting,oreventoremainatwork.Althoughprimaryandtertiaryinterventionsmaybemostappropriateincertaincircumstances,secondaryinterventionsarethemostcommonlyusedworkplacestressmanagementprogramsusedatpresent,andthesetypesofinterventionsaretypicallytargetedathelpingindividualemployeesdevelopimprovedmethodsformanagingandcopingwithjob-relatedstressors.Someofthemostpopularsecondaryinterventionsformanagingandcopingwithoccupationalstressincludevariouscognitive-behavioralskillstrainingthateducateworkersconcerningtheeffectsoftheirthinkingontheirstresslevels,deep-breathingexercises,meditation,relaxation,physicalfitnessexercises,timemanagementskills,maintainingadailyjournalandsettinggoals,or,hereagain,acombinationofthesestrategies(RichardsonandRothstein,2008).AccordingtoRichardsonandRothstein,cognitive-behavioralskillstrainingcanbeanespeciallyefficaciousandcost-effectiveinterventionforjob-relatedstress.Forexample,theseresearchersreportthat,Meditation,relaxation,anddeep-breathinginterventionsaredesignedtoenableemployeestoreduceadversereactionstostressesbybringingaboutaphysicaland/ormentalstatethatisthephysiologicaloppositeofstress(RichardsonandRothstein,2008p.70).Althoughtheresearchtodateindicatesthatprimaryandsecondarylevelstressmanagementinterventionscanbeeffectiveinresolvingmildtomoderatelevelsofstress,thesestrategiesmaybelessefficaciousintreatingmoresevereanddebilitatingstresslevelsthatarelinkedwithoccupationalstress(Bamber,2011).Moreover,themoresevereanddebilitatinglevelsofstressassociatedwithoccupationalstresscanaffectworkersabilitytoperformtheirjobsoreventocontinuetheiremployment.Inthesetypesofcases,evidence-basedtertiarylevelinterventionsareneededtoassistworkersinmanagingtheirstresslevels(Bamber,2011).Whileformaltertiaryinterventionsareusuallyprovidedbyprimarycareandmentalhealthpractitioners,thereareseveralself-helpmethodsavailablethatcanbeusedinconjunctionwiththeseinterventions.Forexample,beyondtheforegoing,therearesomeother,relativelysimplestepsthatemployeescantaketomitigatetheeffectsofjob-relatedstress.Inmanycases,thesestepscanbeappliedintheworkplaceasneeded.Inthisregard,Frandsen(2010,p.61)suggeststhatpeoplewhoareexperiencingoccupationalstressshouldemployvariousself-caremeasures,includingthefollowing:Starteachdaywitharelaxingritualsuchas15minutesformeditating,journaling,stretching,orreadingsomethinginspirational;Adopthealthyeating,exercising,andsleepinghabits;Establishboundariestoavoidoverextending;Takeadailybreakandsetasidetimetocompletelydisconnect;Nourishself-creativitybychoosingfunactivitiesthathavenothingtodowithwork;and,Learntomanagestress.Althoughthesestraightforwardstressmanagementinterventionsallprovidesomedegreeofbenefits,theresearchtodateindicatesthatcognitive-behavioralbasedinterventionsprovideconsistentlygreatereffectscomparedtoothertypesofinterventions.Interestingly,though,totheextentthatadditionaltreatmentelementsareaddedtothecognitive-behavioralinterventionswastheextenttowhichtheefficacyoftheseinterventionswasreduced(RichardsonandRothstein,2008).Thesefindingssuggestthatthereisnoone-size-fits-allstressmanagementinterventionstrategythatworksequallywellinallcircumstancesbutratherreinforcestheneedforindividualizedtreatmentstrategiesthatarebasedontheuniqueneedsofthetargetedemployees.Inaddition,anumberofevidence-basedinterventionshavebeendevelopedthatarespecificallydesignedtohelppreventtheonsetofoccupationalstressandbettermanagetheconditionifitdoesariseamonghelpingprofessionalswheretheworkplaceenvironmentcannotbeeasilychangedsuchasacutecarenursesassetforthinTable6below.Table6Descriptionofevidence-basedinterventionsforworkplacestressSourceDescriptionofinterventionCohen-Katzetal.(2005)Thisinterventionconsistedofan8-weekmindfulness-basedstressreductionprogramthatwasgearedtowardsimprovingrelaxation,self-care,workandfamilyrelationshipsaswellasidentifyingbetterwaysofdealingwithdifficultemotionsintheworkplace.Hayesetal.(2005)Interventionsincludedamentoringprogramdesignedtosupportminoritynursesenteringoncology;oncologynursinggrandrounds,spiritrounds,andreflectivepracticerounds;narrativesforindividualreflectiononpractice;ambulatorynursingretreatsforreflectionandrenewal;andindividualmeetingswithapsychiatricclinicalnursespecialistfornewgraduates.Adams&Putrino(2010)Anexpressivewritingworkshopencouragedself-carebypresentingparticipantswithinformationonwaystogroundexpressivewritingandparticipateinexpressivewritingexercises.Bauer-Wu(2005)Retreatswereheldoutsidetheworksettingwithparticipantschoiceoffourexperientialbreak-outsessions:KeepingtheHope,whichusedart,imagery,andstorytorestorehopefulnessasaself-carepractice;ComingHometoYourBody,whichusedtherapeuticmovement;BeingPeace,whichusedmindfulnessmeditationtofosterpeaceandbalanceineverydaylife;andWhatMattersMost,whichfosteredself-reflectionandexpressionthroughcollageandwriting.Retreatsalsoincludedfreeafternoontimewiththeopportunityforallparticipantstoreceiveamassage;aneveningofliveentertainmentwithsinging,dancing,andlaughing;andamorningYogaclassortheoptiontotakeawalkorsleepin.Lambert&Steward(2007)Theovernightretreatbeganwithdinnerandaneveningoffunandlaughterusingroomandtableassignmentstopairstaffthatnormallydonotinteract.Thiswasfollowedbyafulldayofteambuildingfacilitatedbyanexpert.Topicsincludedunderstandingteamdynamics,personalbehaviorstyles,communicationwithothers,andcreatingsafeenvironmentsthatfostercandidcommunication.LeBlancetal.(2007)Theinterventionincludedastart-upprogramthatwasfollowedby3-hourprogramsdeliveredonamonthlybasisforaperiodof6monthswithanintroductionandquestionnaireonworksituations,communication,andfeedback.Inaddition,programtopicsincludedbuildingsocialsupport,balancingjob-relatedinvestmentsandoutcomes,solvingproblemsthroughteamactionplanning,andidentifyingpotentialproblemsandsolutionsfordealingwithchange.Programcounselorsmetwithparticipantspriortotheprogramtogatherinformationontheorganizationsstructuresandpoliciesaswellasmanagementsperceptionofthemainsourceofjobstress.Medlandetal.(2004)Day-longretreatsheldawayfromtheclinicalareasincludedinteractiveandinformalpresentationsonwellness,bereavement,developingstressmanagementskillssuchasrelaxation,journaling,cultivatingteameffectiveness,andart-makingactivities.Participantsalsoviewedavideotapeonpositivemanagementphilosophyanddiscussedaframeworkforincorporatingstressmanagementandself-careintopractice.Practicechangestodecreaseburnoutandincreaseongoingfocusonstaffsupportatthefacilitywereimplementedbasedonideasgenerated.Source:SummarizedandadaptedfromHenry(2014,p.212)Whilesomeoccupationsareinherentlymorestressful,otherauthoritieshavealsoevaluatedtheefficacyofstressmanagementinterventionstoidentifythosethatworkbestunderdifferentcircumstanceswithotheroccupationsaswell.ArecapitulationandsummaryofthesestudiesareprovidedinTable7below.Table7RecapitulationandsummaryoftheefficacyofvariousstressmanagementinterventionsSourceMethodResultsKim,JH(2007)Meta-analysisof46experimentalstudies.Thestudieswereclassifiedaccordingtothesamplecharacteristics,thetypesandmethodsoftheinterventions,andthetypesofoutcomevariables.Sixinterventiontypesweredistinguished:(1)cognitive-behavioralintervention(CBT),(2)relaxationtechniques(RT),(3)exercise(EX),(4)multimodalprograms1and2(MT1,2),and(5)organizationfocusedinterventions(OTs).Effectsizeswerecalculatedfortheoutcomecategoriesacrossinterventiontypes:psychosocialoutcome,behavioral-personalresources,physiologic,andorganizationaloutcome.Theresultsofthisstudyshowedthatindividualworker-focusedinterventions(ITs)weremoreeffectivethanOTs.Asmallbutsignificantoveralleffectwasfound.AmoderateeffectwasfoundforRT,andsmalleffectswerefoundforotherITs.TheeffectsizeforOTswasthesmallest.TheinterventionsinvolvingCBTandRTappearedtobethepreferredmeansofreducingworker\'spsycho-socialandorganizationaloutcomes.Withregardtophysiologicoutcomes,RTappearedtobemosteffective.CBTappearedtobemosteffectivinreducingpsycho-socialoutcomes.TheeffectsofOTwerenon-significant,exceptforthepsycho-socialoutcomes.Basedonthesefindings,theauthorconcludedthatallofthesestressmanagementinterventionsareeffective,butthatinterventionsinvolvingRTandcognitive-behavioraltherapyaremoreeffectivethanothertypes.Sidle(2008)Systematicliteraturereviewofcurrentbestpracticesinstressmanagementinterventions.Eventhoughtheyaremoreeffectivethanotherstressmanagementinterventions,managersmayconsiderthecognitive-behavioraltechniquesmorechallengingthanotherapproachestoimplement.Typically,cognitive-behavioralinterventionsrequirethehiringofaprofessionaltoleadagroupsession.Consequently,managersmaygravitatetowardinterventionsthatareeasiertoimplementandrequireasmallerinvestmentofresources(e.g.,relaxationtraining);however,relaxationtraininginterventionsareoneofthemostpopularapproachestostressmanagement.Indeed,relaxationtechniquesareperceivedasoneoftheeasiestandleastexpensiveapproachestoimplement,primarilybecausetheycanbeself-taughtwithDVDsortheinternet.RichardsonandRothstein(2008)Meta-analysisof36experimentalstudiesrepresenting55differentstressmanagementinterventions.Thetotalsamplesizeofthemeta-analysiswas2,847;oftheparticipants,59%werefemale,meanagewas35.4,andaveragelengthofinterventionwas7.4weeks.Interventionswerecodedascognitive-behavioral,relaxation,organizational,multimodal,oralternative.Analysesbasedonthesesubgroupssuggestedthatinterventiontypeplayedamoderatingrole.Cognitive-behavioralprogramsconsistentlyproducedlargereffectsthanothertypesofinterventions,butifadditionaltreatmentcomponentswereaddedtheeffectwasreduced.Withinthesampleofstudies,relaxationinterventionsweremostfrequentlyused,andorganizationalinterventionscontinuedtobescarce.Effectswerebasedmainlyonpsychologicaloutcomevariables,asopposedtophysiologicalororganizationalmeasures.KowalskiandHarmon(2009)Mixed-methodactionresearchwasusedtoevaluatetheeffectivenessofamulti-yearcognitive-behavioralstressmanagementinterventioncalledtheWorkplaceStressandAggressionProjectwith3,000employeesat11pilotsitesinDepartmentofVeteransAffairstertiaryhealthcarefacilities.Thecognitive-behavioralstressmanagementinterventionsthatwereimplementedpursuanttothisinitiativewerefoundsuperiortotheothertypesofstressmanagementinterventionsthathadbeenusedbytheDepartmentofVeteransAffairsandtheresearchersconcludethatcognitive-behavioralinterventionsrepresentthebestapproachformitigatingandtreatingstressmanagementintheworkplace.Stoughetal.(2014)Citingtheenormouscostsandadverseeffectsofoccupationalstress,theseresearchersemphasizetheneedfortime-andcost-effectiveinterventionsthathaveprovenefficacyinmitigatingstresslevels.Tothisend,Stoughandhisassociatesreportthatnutritionalinterventions,especiallyusingBgroupvitamins,hasbecomeincreasinglyrecognizedasaviablestressmanagementintervention.Thestudywasarandomized,double-blind,placebo-controlled,parallel-groupsclinicaltrialinvolving200subjectsrandomizedtoacontrolgrouporreceiveBlackmoresExecutiveBStressFormulaorplacebodailyforaperiodof6months.ThisstudyexaminedtheeffectsofBgroupvitaminsonworkplacestressandmoodvariableswithasampleoffull-timeemployedolderadultswhosubjectivelyreportfeelingstressed.ThefindingsthatemergedfromthisstudyconfirmedthatefficaciousinterventionstargetedatreducingoccupationalstresslevelsusingdietarysupplementationwithBgroupvitaminsisaneconomicallyviableandsustainableintervention.CooperandCartwright(1999)Emphasizingtheurgencyoftheneed,theseresearchersuseacontentanalysisofrelevantstudiestoidentifyinterventionsthathavebeenproveneffectiveinreducingworkplacestresslevels.Basedontheiranalysisofthestressmanagementinterventionsdevelopedtodate,theseresearchersconcludethatalthoughindividualcounselingandstressmanagementtrainingcanserveasusefulcomponents,organization-wideinitiativesareneededtoensurethatworkplacestressorsareaddressedfromastructuralpointofview.ReidandRomans(2014)NotingapaucityoftimelyandrelevantstudiesconcerningoccupationalstresslevelsamongAfricanAmericansingeneralandAfricanAmericanmalesinparticular,theseresearchersevaluatedthedegreetowhichacculturationstrategy(traditionalistbeliefs,traditionalistbehavior,assimilationistbeliefsandassimilationistbehaviors)measuredbytheMeasurementofAcculturationStrategiesforPeopleofAfricanDescent(whichhasknownvalidityandreliability)affectsperceivedjobstressasmeasuredbytheJobStressSurveyinasampleof87employedAfricanAmericanprofessionals.Thefindingsthatresultedfromthisstudyfailedtoidentifyarelationshipbetweentraditionalacculturationstrategiesandoccupationalstresslevelssuggestingthatthesubjectswhousetraditionaliststrategiesmayeitherexperiencelessstressandmoresupport.Thisfindingreinforcestheimportanceoftraditionalacculturativecopingstrategyasaprotectiveresourceagainstperceivedstress.Individualswithtraditionalacculturativecopingstrategiesmaybemoreawareofandunderstandingofthreatstoself-concept,whichisalsoprotective.Basedonthesefindings,theresearchersalsoemphasizetheneedforadditionalstudiesusingrace-relatedvariables.Ekman(2015)Usingacasestudyapproach,thisresearchercitesthelackofrelevantresearchintooccupationalstresslevelsamonglawenforcementauthoritiesincludingthosetaskedwithjuvenilejustice.Thequalitativethree-phasecasestudyfocusedona16-hourmindfulnessmeditationstrategycalledCultivatingEmotionalBalancepilotstressmanagementinterventionfor50juvenilejusticeofficersintwosettingsinSanMateoCounty,California.Theresultsofthisstudyshowedthatempathytrainingusingvignettes,themindfulnessskillsincludingbreathingexercises,andthemotivationexerciseswereespeciallyeffectiveinreducingoccupationalstresslevelsamongthispopulationofjuvenilejusticeofficers.Theresultsofthisstudyindicatethatstrengtheningempathylevelsandprovidingjuvenilejusticeofficerswithtoolssuchasrelaxationandmeditationareespeciallyvaluableadditionstostressmanagementinterventions.RandallandBuys(2013)Usingasystematicreviewoftherelevantliterature,theseresearchersprovideacomprehensivebackgroundconcerningtheseverityofoccupationalstressandthetollitexactsonindividualsandorganizations.LiketheEkman(2015studyreviewedabove,thisstudyalsofocusedonmitigatingoccupationalstresslevelsamonglawenforcementofficers.Theseresearchersfoundthatstressmanagementthataredesignedtoaddressindividualfactorsbyprovidingemployeeswithtrainingandtoolssuchasteachingthemtocontrolstressresponsesusingbehavioralself-control,biofeedback,meditationandabdominalbreathing,progressivevisualizationandcognitiveprocessingareregardedaseffectiveevidence-basedtreatmentstrategies.Thesetypesofinterventionsaredesignedtominimizestressresponsesbycontrollingthought,physiologicalandbehavioralresponsestojob-relatedstressors.Likewise,interventionssuchascognitivebehavioraltherapyalsohavedemonstratedefficacy.McCratyetal.(2003)Thepurposeofthisrandomizedexperimentalstudywastoexaminetheeffectsofaworkplace-basedstressmanagementprogramonbloodpressure,emotionalhealth,andworkplace-relatedmeasuresin38hypertensiveemployeesofaglobalinformationtechnologycompany.Thesubjectswererandomlyassignedtoacontrolgroupwhichreceivednointerventionoragroupthatreceivedthestress-reductionintervention.Thetreatmentgroupparticipatedina16-hourprogram,whichincludedinstructioninpositiveemotionrefocusingandemotionalrestructuringtechniquesintendedtoreducesympatheticnervoussystemarousal,stress,andnegativeaffect,increasepositiveaffect,andimproveperformance.Learningandpracticeofthetechniqueswasenhancedbyheartratevariabilityfeedback,whichhelpedparticipantslearntoself-generatephysiologicalcoherence,abeneficialphysiologicmodethatareassociatedwithincreasedheartrhythmcoherence,physiologicentrainment,parasympatheticactivity,andvascularresonance.Bloodpressure,emotionalhealth,andworkplace-relatedmeasureswerealsoevaluatedassessedbeforeand3monthsaftertheprogram.Thisstudyfoundthatthetreatmentgroupexhibitedameanadjustedreductionof10.6mmHginsystolicbloodpressureandof6.3mmHgindiastolicbloodpressure.3-monthspost-intervention.Thereductioninsystolicbloodpressurewasregardedassignificantinrelationtothecontrolgroup.Thetreatmentgroupalsodemonstratedimprovementsinemotionalhealth,includingsignificantreductionsinstresssymptoms,depression,andglobalpsychologicaldistressandsignificantincreasesinpeacefulnessandpositiveoutlook.Reucedsystolicbloodpressurewascorrelatedwithreducedstresssymptoms.Inaddition,thetrainedemployeesdemonstratedsignificantincreasesinthework-relatedscalesofworkplacesatisfactionandvalueofcontribution.Theseresultsindicatethatabriefworkplacestressmanagementinterventioncanproduceclinicallysignificantreductionsinbloodpressureandimproveemotionalhealthamonghypertensiveemployees.Theimplicationsofthesefindingsarethatsuchinterventionsmayproduceahealthierandmoreproductiveworkforce,enhancingperformanceandreducinglossestotheorganizationresultingfromcognitivedecline,illness,andprematuremortality.KinmanandJones(2005)Thisstudyinvestigatedlayrepresentationsofworkstressusingsemi-structuredinterviewswith45individualsfromarangeofoccupations.Themeaningofoccupationalstress,itsantecedentsandoutcomes,andwaysbywhichitmaybemanagedwereexamined.Dominantfactorswereestablishedthroughtheuseofthematiccontentanalysis.Similaritiesanddifferenceswerefoundbetweenlayandprofessionaldiscoursesonworkstress.Theresultsthatemergedfromthisstudyindicatethatlayrepresentationsofoccupationalstressaremulti-faceted.Thereremainsalackofconsensus,however,concerninghowparticipantsinterpretedtheconcept:adiverserangeofpersonal,environmental,andsocietalfactorswashighlighted.Adifferent(andarguablymorecomplex)rangeofdefinitionsofjobstressandthemannerinwhichitimpactsonindividualswasrevealedthanhasbeenreportedinpreviousstudies.Thecausesofstressatworkwereperceivedasbeingpredominantlyorganizational,buttheimpactofstressontheemployeewasmoresalientthanorganizationaloutcomes.Secondaryandtertiarystressmanagementtechniqueswerethoughttobemoreeffectivethaninterventionsdesignedtopreventstressatwork.Intervieweeswithlinemanagementresponsibilityweremorelikelytoemphasizeindividualresponsibilityformanagingstress,mostothersmaintainedthattheindividualandtheorganizationareequallyresponsible.Saksviketal.(2003)Thestudyevaluatedsevendifferentindividualandorganizationalstressmanagementinterventions.DataforthestudywasobtainedfromasampleusedasapartoftheevaluationofaNorwegiannationalinterventionprogramcalled`HealthatWork.ThestudywasconductedinthreeDifferententerprises(twofromthepublicsector(theNorwegianPostalServiceandamunicipality)andthelocalgovernmentofadistrictthatincludedamid-sizedNorwegiantownandonefromtheprivatesector(ashoppingmall).Interviewswereconductedin22postoffices,12organizationalunits(i.e.,carehomesandlocaladministrativeunits)ofaNorwegianmunicipality,andin10shopsinashoppingmall.Theinterviewstookplacebeforeandaftertheinterventions.Thefollowingkeyprocessfactorswereidentified:(1)theabilitytolearnfromfailureandtomotivateparticipants;(2)multi-levelparticipationandnegotiation,anddifferencesinorganizationalperception;(3)insightintotacitandinformalorganizationalbehavior;(4)clarificationofrolesandresponsibilities,especiallytheroleofmiddlemanagement;and(5)competingprojectsandreorganization.Basedontheresultsthatemergedfromthisambitiousstudy,theseresearchersconcludethatquantitativetechniquesaloneoftenfailtocapturethemagnitudeandthemeaningofaccomplishinginterventionswithinorganizations;however,quantitativeinvestigationsarecrucialindocumentingthesignificanceofimprovingoccupationalhealthinordertoinfluencethosestakeholderswhohavethepowertoinitiatechange.Gyllenstenetal.(2005)Thisqualitativestudyoftwomalesandthreefemalesexaminedtheattitudesoffinanceorganizationstowardsworkplacestressandstressinterventions.Semi-structuredinterviewswereusedandsevenindividuals,eachrepresentingtheirorganization,participatedinthestudy.InterpretativePhenomenologicalAnalysis(IPA)wasusedtoanalyzethedatathatresulted.ThegoalofIPAistoexploretheinsiderviewsoftheparticipants,andthiswastheaimofthecurrentstudy.InIPAitisassumedthatthereisanassociationbetweenwhattheparticipantsaysandwhattheythink.IPAseekstocapturethemeaningsoftheparticipantsaccounts,andthisisdonethroughaprocessofinterpretativeanalysis.AnadditionalbenefitofIPAisthatitfacilitatesthediscoveryofrarethemeswithintheareaofinvestigation.Theoverarchingfindingthatemergedfromthisstudywasthatsubjectsheldstrongviewsthatpeoplewhoseekcounselingforoccupationalstress,irrespectiveoftheseverityoftheirconditions,maybeperceivedashavingsometypeofmentalillness.Thestigmathatisassociatedwiththisperceptionisbelievedtopreventmanyemployeeswhoaremostinneedofefficaciousstressmanagementinterventionsfromseekingassistanceintheworkplace.Thefindingsunderscoretheneedforadditionaleducationofemployeestoensurethattheyrecognizethesignsandsymptomsofjob-relatedstressandfeelcomfortableinseekingassistancefortheseproblems.Bironetal.(2016)Theseresearchersusedanadaptedstudydesigntoevaluatetheeffectivenessofaninterventionexposureandtocreateanartificialcontrolandinterventiongroups.Thisstudyalsoincludedlongitudinaldata(i.e.,twoassessments)withaddedprocessmeasuresattime,twogatheredfromthreecomplexparticipatoryinterventionprojectsinCanadainahospitalandauniversity.Structuralequationmodelingwasusedtoexplorethespecificworkingmechanismsofparticularinterventionsonstressoutcomes.Theresultsofthisstudyshowedthathigherexposuretointerventionsaimingtomodifytasksandworkingconditionsreduceddemandsandimprovedsocialsupport,butnotjobcontrol,whichinturn,reducedpsychologicaldistress.Exposuretointerventionsaimingtoimproverelationshipswasnotrelatedtopsychosocialrisks.Moststudiescannotexplainhowinterventionsproducetheireffectsonoutcomes,especiallywhentherearemultipleconcurrentinterventionsdeliveredinseveralcontexts.Thisstudyadvancesknowledgeonprocessevaluationbyusinganadaptedstudydesigntocapturetheactiveingredientsofmulti-componentinterventionsandsuggestingsomemechanismsbywhichtheinterventionsproducetheireffectsonstressoutcomes.Inaddition,thesefindingsalsoprovideanillustrationofhowtoconductprocessevaluationandrelateexposurelevelstoobservedoutcomes.Pignataetal.(2016)Theseresearchersusedthesocial-exchangetheoreticalframeworktoexaminetheeffectofemployeesawarenessofstressreductioninterventionsontheirlevelsofpsychologicalstrain,jobsatisfaction,organizationalcommitment,perceptionsofseniormanagementtrustworthinessandproceduraljustice.Theresearcherspresentlongitudinalpaneldatafrom869employeeswhocompletedquestionnairesattwotimepointsat13Australianuniversities.Theresultsofthisstudyshowedthatemployeeswhoreportedanawarenessofstress-reductioninterventionsundertakenattheiruniversityscoredloweronpsychologicalstrainandhigheronjobsatisfactionandcommitmentthanthosewhowereunawareoftheinterventions.Theresultsindicatethatsimplytheawarenessofstressinterventionscanbelinkedtopositiveemployeeoutcomes.Thestudyfurtherrevealedthatseniormanagementtrustworthinessandproceduraljusticemediatetherelationshipbetweenawarenessandemployeeoutcomes.Bowenetal.(2014)Thisstudyusedanonlinesurveytocollectopinionsfromarchitects(n=3,025),civilengineers(n=1,842),quantitysurveyors(n=1,449),andprojectandconstructionmanagers(n=3,359)inSouthAfrica.Theresultsofthisstudyshowedthatamajorityoftherespondentsexperiencehighlevelsofstressatwork.Architects(morethanengineers,quantitysurveyors,andprojectandconstructionmanagers)andfemale(morethanmale)professionalsfeelstressed.Psychologicaleffectsofworkplacestressincludethefeelingofnotbeingappreciatedbyothersforajobwell-done,feelingdissatisfiedwithonesownperformanceatwork,andfeelingtenseatwork.Physiologicaleffectsincludedisturbancestousualsleeppatterns,difficultyinrelaxingafterhours,anddifficultyinconcentrating.Sociologicaleffectsincludeastrainonfamilylife,socialactivities,andsocialrelationships.Awiderangeofpositivecopingmechanismsareusedbytherespondents,includingphysicalexercise,spendingtimewithfamilyandfriends,traveling,watchingtelevisionandmovies,surfingandwatersports,jogging,archery,meditationandprayer,yoga,cycling,shooting,fishing,hikingandcamping,golf,gardening,squash,cooking,reading,card-playing,model-building,wininganddining,photography,woodwork,gaming,listeningtomusic,participatinginmartialarts,motorbikeriding,44driving,andtryingtogetmoresleep.LemaireandWallace(2010)TheseresearchersusedamixedmethodsstrategytoexplorefactorsrelatedtophysicianwellnesswithinalargehealthregioninWesternCanada.Thestudyfocusedonthecopingstrategiesthatphysiciansuseinresponsetowork-relatedstress.Thequalitativecomponentexploresphysiciansselfreportedcopingstrategiethroughopenendedinterviewsof42physiciansrepresentingdiversemedicalspecialtiesandsettings(91%responserate).Themajorthemesextractedfromthequalitativeinterviewswereusedtoconstruct12surveyitemsthatwereincludedinthecomprehensivequantitativequestionnaire.Questionnairesweresenttoalleligiblephysiciansinthehealthregionwith1178completedsurveys(40%responserate.)Questionnaireitemswereusedtomeasurehowoftenphysiciansdrawonthevariouscopingstrategies.Feelingsofburnoutwerealsomeasuredinthesurveyby5itemsfromtheEmotionalExhaustionsubscaleoftheRevisedMaslachBurnoutInventory.Themajorthemesthatemergedfromthedataanalysisincludedthecopingstrategiesthatthesubjectsusedintheworkplace(i.e.,workingthroughstress,talkingwithco-workers,takingatimeout,usinghumor)andafterwork(e.g.,exercise,quiettime,spendingtimewithfamily).Analysisofthequestionnairedatashowedthreeoftenusedworkplacecopingstrategieswerepositivelycorrelatedwithfeelingemotionallyexhausted(i.e.,keepingstresstooneself(r=.23),concentratingonwhattodonext(r=.16),andgoingonasifnothinghappened(r=.07)).Somelessoftenusedworkplacecopingstrategies(i.e.,takingatimeout)andallthoseusedafterworkwerenegativelycorrelatedwithfrequencyofemotionalexhaustion.Basedonthesefindings,theseresearchersconcludethatphysiciansselfreportedcopingstrategiesarenotallcreatedequalintermsoffrequencyofuseandcorrelationwithfeelingemotionallyexhaustedfromoneswork.Theresearchersalsoconcludethatthesefindingscanbeintegratedintopracticalphysicianstressreductioninterventions.Harknessetal.(2005)Thisstudyuseddiscourseanalysistoexplorethewayinwhichemployeesunderstandworkstress.Twenty-twofemaleclericalworkersinaCanadiancityparticipatedinfocusgroupmeetingswheretheytalkedaboutandmadesenseoftheirexperiencesofworkstress.Thewomensaccountswereanalyzedusingdiscourseanalysismethods(i.e.,anexaminationofhowtalkisconstructed).Thefindingsthatemergedfromthisstudyshowedthatsimplytalkingaboutbeingstressedprovidesasociallyacceptablewayofexpressingdiscomfortandregainingasenseofimportancethatislostthroughfeelingunder-valuedandunderappreciatedintheorganization.Incontrast,admittingtobeingunabletocopewithstresswasconsideredtobeabnormal.Thestressdiscoursefostersasenseofhelplessnessandambiguitybynotacknowledgingexternalinfluencesonclericalworkersexperiences,suchastheirplacewithinthepowerstructureoftheorganization,andbylimitingtheirsenseofagencyandcontroloverproblemsexperiencedatwork.Theimplicationsofthesefindingsfororganizationalcultureandinterventionsincludetheneedforemployerstobeconsciousofthemessagesbeingsenttoemployeesabouthownegativeemotionsordistressingexperiencesatworkaretobeaddressed(i.e.,howstressistobemanaged).Therecommendationsthatwereprovidedbytheseresearchersincludedtheneedfortheexaminationofalternativediscoursesthataimtoimproveconditionsatwork.Howard(2008)Usingasystematicreviewoftherelevantliteratureandacasestudyofsupervisoryinterventionsforoccupationalstressmanagement,thisresearcherdrewonconceptsfromthefieldofpositivepsychologysuchasworkengagement,senseofcoherence,self-efficacy,flowandresiliencehasbeguntoprovidedetailedunderstandingofworkershappiness,healthandbettermentBasedonthefindingsthatresultedfromthisstudy,Howardconcludedthattherelationshipbetweensupervisorandsuperviseeneedstobeoneinwhichtrustandempathyarebuiltfromtheoutset.Inaddition,itisalsoimportanttoconsiderwhentoapplythesemethods.Therearemanyopportunitiesforthesupervisortodoso.Opportunitiesmayincludecasediscussion,video-oraudio-tapereview,reviewingsuccess,learningneedsassessment,evaluationprocesses,professionalcompetencereviews,andteamworkanalysis.Dedicatedsessionsmaybeseenasimportantfromtimetotime,especiallywhenreviewsofthesupervisionhavebeenplanned.Adedicatedsessioncouldalsobecomeanopportunityforacelebrationofachievement.Gunn(2013)Thestudyusedacasestudyandhistoricprospectivemixed-methoddesign,comprisedofsixhomecareunitsinaNorwegianmunicipality(n=138respondents;responserate=76.2%or17informants.Thestudyincludedquantitativeestimations,registerdataofsickleave,atimelineofsignificanteventsandchanges,andqualitativedescriptionsofemployeeappraisalsoftheirworksituationgatheredthroughsemi-structuredinterviewsandopensurveyresponses.Thefindingsofthestudyshowedthattheworkenvironmentinterventionswereingeneralregardedaspositivebythehomecareworkers;allunits,though,weresimultaneouslysubjectedtosubstantialcontextualinstability,involvingnewworkprograms,newtechnology,restructurings,unitmergers,andmanagementreplacements,perceivedbythehomecareworkerstobemajorsourcesofstress.Thesefindingssuggestthatconcurrentchangesinducedthroughrationalizationresultedinnegativeexposureeffectsthatnegatedpositiveworkenvironmentinterventioneffects,causinganoveralldeterioratedworksituationforthehomecareworkers.Rinaldietal.(2010)Thisrandomized,controlledstudyevaluatedtheeffectivenessintheimprovementofthepsychicandsymptomaticstress-relateddisordersbymeansofradio-electricstimulationonsomeauricularreflexpointswithadevicenamedtheradio-electricasymmetricconveyer(REAC).Thestudywasconductedon124subjectswithpsychologicaldistresssymptomsthatwereassessedbytheSymptomaticCheckList-90pre-andpost-intervention.Afterrandomization,twogroupswerecreated:agrouptreatedwitheffectiveREACandagroupthatunderwentthesametreatmentwithdisarmedREAC(theplacebogroup).ThefindingsthatresultedfromthisstudyshowedthattherewasasignificantreductioninSCL-90scoresinthetreatedgroupcomparedwiththeplacebogroup.Theresultsofthepsychometrictestsshowedthatthesubjectswhounderwenteffectivetherapyshowedastatisticallysignificant(p