This article addresses a comprehensive approach to preventing stress at work.

Are stressful working conditions a necessary evil to remain productive and profitable in today’s economy?

Some employers make this assumption. However, research findings challenge this belief. Studies show that stressful working conditions are actually associated with increased absenteeism, tardiness, and intentions by workers to quit their jobs - all of which have a negative effect on the bottom line.

According to a 2001 report by the American Institute of Stress (AIS), job-related stress costs the U.S. industry $300 billion annually, as assessed by absenteeism, diminished productivity, employee turnover, direct medical costs, compensation claims, and legal and insurance fees. AIS estimates that one million workers are absent on an average workday because of stress-related complaints.

Studies of so-called healthy organizations suggest that policies benefiting worker health also benefit the bottom line. A healthy organization is defined as one that has low rates of illness, injury, and disability in its workforce and is also competitive in the marketplace. Research conducted by the National Institute of Occupational Safety and Health (NIOSH) has identified organizational characteristics associated with both healthy, low-stress work, and high levels of productivity.

Examples of these characteristics include the following:

  • Recognition of employees for good work performance.
  • Opportunities for career development.
  • An organizational culture that values the individual worker.
  • Management actions are consistent with organizational values.

Nearly one-half of large companies in the United States provide some type of stress management training for their workforces. Stress management programs teach workers about the nature and sources of stress, the effects of stress on health, and personal skills to reduce stress (such as time management or relaxation exercises). Employee Assistant Programs (EAP) provide individual counseling for employees with both work and personal problems. Stress management training may rapidly reduce stress symptoms such as anxiety and sleep disturbances; it also has the advantage of being inexpensive and easy to implement.

However, stress management programs have two major disadvantages:

  • The beneficial effects on stress symptoms are often short-lived.
  • They often ignore important root causes of stress because they focus on the worker and not the environment.

In contrast to stress management training and EAP programs, identifying the stressful aspects of work (e.g., excessive workload, conflicting expectations, etc.) and designing strategies to reduce or eliminate the identified stressors is the most direct way to reduce stress at work. The advantage of this approach is that it deals directly with the root causes of stress at work. However, managers are sometimes uncomfortable with this approach because it can involve changes in work routines or production schedules, or changes in the organizational structure.

Ways to change the organization to prevent job stress include the following (Sauter et al., 1990):

  • Ensure that the workload is in line with workers’ capabilities and resources.
  • Design jobs to provide meaning, stimulation, and opportunities for workers to use their skills.
  • Clearly define workers’ roles and responsibilities.
  • Give workers opportunities to participate in decisions and actions affecting their jobs.
  • Improve communications to reduce uncertainty about career development and future employment prospects.
  • Provide opportunities for social interaction among workers.
  • Establish work schedules that are compatible with demands and responsibilities outside the job.

Getting started

No standardized approach or simple “how to” manual exists for developing a stress prevention program. Program design and appropriate solutions will be influenced by the size and complexity of the organization, available resources, and especially unique types of stress problems faced by the organization. For example, in one company, the main problem may be work overload; whereas, for another company, employees may be bothered by difficult interactions with the public and/or an inflexible work schedule.

Although it is not possible to give a universal prescription for preventing stress at work, it is possible to offer guidelines on the process of stress prevention in organizations.

In all situations, the process for stress prevention programs involves three distinct steps: 1) problem identification, 2) intervention, and 3) evaluation. For this process to succeed, organizations need to be adequately prepared. At a minimum, preparation for a stress prevention program should include the following:

  • Building general awareness about the causes, costs, and control of job stress.
  • Securing top management commitment and support for the program.
  • Incorporating employee input and involvement in all phases of the program.
  • Establishing the technical capacity to conduct the program (e.g., specialized training for in-house staff or use of consultants).

Steps toward prevention

Low morale, health and job complaints, and employee turnover often provide the first signs of job stress. But sometimes, there are no clues, especially if employees are fearful of losing their jobs. Lack of obvious or widespread signs is not a good reason to dismiss concerns about job stress or minimize the importance of a prevention program.

STEP 1 - Identify the problem

The best method to explore the scope and source of a suspected stress problem in an organization depends partly on the size of the organization and the available resources.

Group discussions among managers, labor representatives, and employees can provide rich sources of information. Such discussions may be all that is needed to track down and remedy stress problems in a small company.

In a larger organization, such discussions can be used to help design formal surveys for gathering input about stressful job conditions from large numbers of employees.

Regardless of the methods used to collect data, information should be obtained about employee perceptions of their job conditions and perceived levels of stress, health, and satisfaction. The list of job conditions that may lead to stress and the warning signs and effects of stress provide good starting points for deciding what information to collect.

STEP 2 - Design and implement interventions

Once the sources of stress at work have been identified and the scope of the problem is understood, an intervention strategy can then be designed and implemented.

In small organizations, the informal discussions that helped identify stress problems may also produce fruitful ideas for prevention.

In large organizations, a more formal process may be needed. Frequently, a team is asked to develop recommendations based on analysis of data from Step 1 and consultation with outside experts. The interventions should target the source of stress for change, be prioritized, communicated to employees, and then implemented.

Certain problems, such as a hostile work environment, may be pervasive in the organization and require company-wide interventions.

Other problems such as excessive workload may exist only in some departments and thus require more narrow solutions such as redesign of the way a job is performed.

Still other problems may be specific to certain employees and resistant to any kind of organizational change, calling instead for stress management or employee assistance interventions. Some interventions might be implemented rapidly (e.g., improved communication, stress management training, etc.), but others may require additional time to put into place (e.g., redesign of a manufacturing process).

STEP 3 - Evaluate interventions

Evaluation is an essential step in the intervention process. Evaluation is necessary to determine whether the intervention is producing desired effects and whether changes in direction are needed.

Time frames for evaluating interventions should be established. Interventions involving organizational scrutiny should receive both short- and long-term scrutiny. Short-term evaluations might be done quarterly to provide an early indication of program effectiveness or possible need for redirection. Many interventions produce initial effects that do not persist. Long-term evaluations are often conducted annually and are necessary to determine whether interventions produce lasting efforts.

Evaluations should focus on the same types of information collected during the problem identification phase of the intervention, including information from employees about working conditions, levels of perceived stress, health problems, and satisfaction.

Employee perceptions are usually the most sensitive measure of stressful working conditions and often provide the first indication of intervention effectiveness. Adding objective measures such as absenteeism and healthcare costs may also be useful. However, the effects of job stress interventions on such measures tend to be less clear-cut and can take a long time to appear.

The jobs stress prevention process does not end with evaluation. Rather, job stress prevention should be seen as a continuous process that uses evaluation data to refine or redirect the intervention strategy.



Sauter, S. M. (1999). STRESS...At Work (Publication No. 99-101). Retrieved January 3, 2013, from National Institute of Occupational Safety and Health (NIOSH):

Segal, J. S. (2012, December). Stress at Work. Retrieved January 3, 2013, from

Workplace Safety and Insurance Board of Ontario. (2006). Basic Certification Training Program: Participant’s Manual