(1974: 2) states that employers have a duty ‘to ensure as far as is reasonably practicable,
the health, safety and welfare at work of all employees’. Since the 1990s this has been
interpreted to include work demands, organization and work relationships (HSE,
1995). UK employers are now also required to assess the risk of stress-related ill health
arising from work and to take steps to control such risks. This approach is now
formalized within the Management Standards approach to work stress advocated by
the UK Health and Safety Executive (see Table 4.1). For each of the standards listed
there is the additional standard that ‘systems are in place locally to respond to any
individual concerns’ (HSE, 2007). These standards are not legally enforced, rather they
are recommendations to help employers meet legal obligations.
Interventions aimed at changing the workplace and thereby reducing or removing
causes of stress are perhaps the most challenging type of stress management both to
conduct and to evaluate rigorously and thus there is less research evidence in this area
(Randall, Griffiths and Cox, 2005). For example, a meta-analysis (see Research
methods 8.1) by van der Klink et al. (2001) considered 48 experimental evaluations
of stress reduction interventions to be of sufficient rigour to be included (see also the
discussion of intervention evaluation in Chapter 9). However, only five of these were
organizational interventions aimed at reducing stressors (the rest being interventions
targeting the individual). These researchers found no overall significant effect across
the five studies. However, a more recent review (Bambra et al., 2007) looked at 19
studies of interventions to restructure tasks and found that interventions which
increased demand and reduced control (i.e. the opposite of the recommendations of
the JDC), resulted in poorer health, as the JDC predicts. There were also health benefits
where interventions increased control and reduced demands but these were less
marked. A study by Bond and Bunce (2001) found that increases in job control were
related not only to improved well-being but also to better self-rated performance and
reduced sickness absenteeism. It is likely that the extent to which organisational
interventions are of benefit to health will vary from person to person and researchers
have started to consider the effects of individual differences. For example, those with
greater psychological flexibility have been found to benefit more from an intervention
to increase job control (Bond, Flaxman and Bunce, 2008)
Overall, organisational interventions face numerous challenges. For example,
uncontrolled variables, such as changes in market conditions causing job insecurity,
may undermine positive influences. Furthermore, organizational change may itself be
stressful. Murphy (2003) suggests that simultaneous individual interventions may be
needed to help people adjust to planned organizational change. Nevertheless, while
evidence concerning such interventions is as yet limited, the pressure to reduce the
causes of stress in the workplace remains high.
In recent years, the call for greater work–life balance has led to new organizational
interventions aimed at helping people to manage the interface between home and
work, for example the introduction of policies enabling employees to work more
flexibly both in terms of working hours and work location. Such interventions might
be expected to enhance employees’ control and thereby reduce stress. While there is
little evidence concerning the stress reducing effects of interventions to increase
flexibility, studies indicate that perceptions of work flexibility are linked to improved
well-being and health behaviours (Grzywacz, Casey and Jones, 2007) and improved
perceptions of health (Butler et al., 2009).
82 STRESS AND HEALTH