Theresa Dent-Gater, Croydon Council: Developing stress management strategies that work – and measuring the outcomes

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I am thinking about the stress management strategies that have worked for us at Croydon Council as I am currently preparing for the presentation that I will give at the Workplace Wellbeing and Stress conference in November.

Pressure is part of everyday life. It is when that pressure is constant and becomes more than we can cope with that it becomes stress. The tipping point varies from person to person, depending on their personal resilience. It is important to recognise that some individuals can cause their own stress, and some can be the root cause of stress in others.

Stress is not a medical condition, although it is one of the biggest causes of long-term sickness absence. Change, uncertainty, heavy workloads and poor management practices can all lead to stress at work, which, in turn, can lead to depression, anxiety and other mental and physical conditions. Stress has many adverse effects on the body. It can also lead to self-medication in the form of substance misuse or other forms of self-harm, such as binge eating. However, it is perceived to be more acceptable to admit to stress, rather than depression or anxiety.

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Taking sickness leave for stress will not resolve the problem in the long term.  Either the workload will grow in the employee’s absence or other team members will have to take up the slack, which, in turn, will increase their stress and lead to resentment. It is important, therefore, that managers and staff are aware of what support is available to them and to develop some self-help coping strategies.

The first step should be to look at the HSE Management Standards, which cover six key areas of work design that, if not properly managed, are associated with poor health and well-being, lower productivity and increased sickness absence. In other words, the six management standards cover the primary sources of stress at work. These are:

  • Demands – this includes issues such as workload, work patterns and the work environment.
  • Control – how much say the person has in the way they do their work.
  • Support – this includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues.
  • Relationships – this includes promoting positive working to avoid conflict and dealing with unacceptable behaviour.
  • Role – whether people understand their role within the organisation and whether the organisation ensures that they do not have conflicting roles.
  • Change – how organisational change (large or small) is managed and communicated in the organisation.

There is evidence that the empowerment of staff via participation, delegation, constructive feedback and coaching has a positive impact on stress in the workplace. Lack of control and lack of influence at work are independent risk factors for stress. Recent research has shown that, for jobs where demands are high but control is low, there is a 23% higher risk of employees suffering a heart attack. Empowerment cannot be achieved without setting realistic deadlines.

Role modelling is the most powerful way that managers can communicate their learning and understanding about stress in the workplace and how to reduce it. Senior managers may need support to develop a culture across their teams and the organisation in which stress is not seen as a weakness, and is talked about more openly.

Managers can design a risk assessment for stress based on the HSE management standards. The risk assessment should be reviewed on a regular basis, at times of organisational change, changes in personnel, restructures, etc, and staff should be involved in the process throughout.

A range of tried and tested resources is available, many of which are at zero cost to your organisation.

  • Stress management risk assessments based on HSE Management Standards http://www.hse.gov.uk/stress/standards/
  • Stress management competency tool http://www.hse.gov.uk/stress/mcit.pdf
  • Stress management presentations, workshops and training.
  • The Stress website http://www.the-stress-site.net/index.html
  • Employee Assistance Programme (around £5 per employee, per annum).
  • Mental Health First Aid training www.mhfaengland.org
  • MHFA support for line managers.
  • Review trigger points for sickness absence.
  • Automatic referral to OH for stress, anxiety or depression regardless of trigger points.
  •  “Stress Box” – an anonymous method of determining the main causes of workplace stress.
  • Health and well-being days.
  • Low cost massage and reflexology – negotiate with local therapists. Staff are prepared to pay around £15 for 30 minutes.

Online cognitive behavioural therapy (CBT) as can be found at:

www.moodgym.anu.edu.au – an interactive site that teaches people to use positive ways of thinking.

www.livinglifetotheful.co.uk – a self-help format and also the CBT model which has a proven effectiveness in helping people develop life skills and help them tackle feelings of low mood, stress and distress.

www.getselfhelp.co.uk – offers free CBT self-help information, resources and includes therapy worksheets.

Alongside organisation-level obligations to deal with stress in the workplace, comes the personal role of individuals to take responsibility for being aware of their own stress.  As with any initiative, it is important to measure the outcomes. Regular staff well-being surveys can give a temperature check on the organisation.

Robust sickness management monitoring to ensure data is accurate and differentiate between work-related and personal stress. Identify and monitor “hot spots” to target interventions.

Theresa Dent-Gater, Health and Wellbeing Co-ordinator, Public Health, Croydon Council

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