Occupational Stress Prevention

Success in Combating Stress

Here we feature our case study of an occupational stress prevention project where we cut stress claims by 74%.

The project was a state wide program of occupational stress prevention training and counselling intervention. The project ran over a period of twelve months from 2003-2004, with just over 100 participants. At the end of 12 months, The sponsoring insurance company reported back to MKA Risk Mitigation, that there had been a 74% decrease in the number of stress claims.

Training was conducted in metropolitan and rural locations. The project was sponsored by a Workers Compensation Insurer and the Insured Organisation. The Insured Organisation was a church, and the target occupational group were religious ministers.

There was a clear recognition that occupational stress was a significant problem within the insured organisation. Stress claims were described by claims officers as a common occurrence. Further when claims did occur, claimants were extremely severely incapacitated and were often off work for substantial period of time. A number of claimants were unable to sustain any form of return to work. They were eventually described as totally and permanently incapacitated.

Emerging areas of concern were:
• How to introduce change into the workplace.
• How to manage time and prioritise effectively.
• Assertiveness and basic communication skills.
• Anger management.
• How to resolve conflict.
• Team building and how to delegate work.
• Work – life/ balance and social support.
• Occupational stress prevention.
• Managing depression and anxiety.
• Managing suicidalindividuals.
• Effective self talk and motivational strategies.
• Defusing guilt.
• Maintaining professional boundaries.

A draft of the training program was developed and presented to the Church executive, who requested various additional materials. Their suggestions were incorporated.

The other very important part of the process was the involvement of an adult education specialist. As an organisational researcher and executive coach, I would write training modules that would “clunk” rather than “communicate”. So I turned my material over to the adult education specialist, and say to her, "keep the information and the learning objectives, but make it fun and alive". To my eternal gratitude, the adult education specialist did exactly that.

  Conducting the Training Program

It became apparent right from the first training program, that we were still presenting the materials in a fashion that was “too secular.” We were receiving wonderful evaluations, but it was felt by both the adult education specialist and myself that the material was not being absorbed as completely as we would like. So I took an additional step in customising the material and presented it to a theologian. I requested that the theologian provide me with an explanation of relevant biblical arguments about the materials we were presenting. The result was that interaction in the training courses suddenly moved up a notch from being “appreciated and regarded as informative” to a real point of engagement and valuable debate. Suddenly the trainees were as passionate as the adult education specialist and myself in considering these matters of occupational stress.

This process of enculturation continued throughout the entire time that we were running these programs. I would frequently go to my hotel room in some remote rural location, ring up my theologian friend and say “they threw this at me as a challenge, what does this actually mean?” We would then work together on how this information could be better conveyed within the trainees’ frame of reference. Sufficient to say the adult education specialist and I learned a great deal from this process.

  Counselling Interventions

MKA Risk Mitigation had incorporated a basic measure of clinical stress conditions, which we had asked people to complete before the start of the training program. This provided us with a baseline measure of where trainees were at with respect to depression, anxiety and stress. I began following up participants for the first counselling session at approximately one to four months after training interventions. The purpose of the first set of counselling sessions was to track whether people were actually implementing the training; and to commit them to putting the training into practice. The session went through objectives from each training module and I would interview people about how they were implementing material from each module.

We resent the stress measures out to people to complete, and eventually obtained a 77% return rate. The second set of stress measures were taken six months after we had done the training intervention.

23% of ministers obtained an initial stress score which placed them as suffering from mild to extremely severe stress levels. Ministers with elevated stress scores reported that they would be upset by trivial matters, over-reacting to situations, finding difficult to relax, using lots of emotional energy, feeling impatient if delayed in any way, irritable, finding it hard to calm down after being upset, finding it difficult to tolerate interruptions and being agitated. These ministers were unable to balance work and family obligations.

Stress scores taken six months after training revealed that there were no cases in the extremely severe stress range, severe cases had declined by 3%, moderate cases by 1%, and mild cases had declined by 5%. This represents a total decline of 10% of total cases in the clinical ranges, (or roughly halving of clinical score range cases). Comparison on a score against score basis (as opposed to shifts across clinical bands) revealed that 70% of trainees were reporting a reduction in stress scores. In the second follow-up interview trainees were questioned about which modules they were implementing. Training participants indicated that they were most likely to implement Time Management Training (38.37%) and occupational stress prevention (39.53%). Training Participants reported increased use of lists, daily planning, prioritisation and reducing the number of tasks attempted per day. Close to half of these ministers reported that they had applied the administrative training in the Paperwork Management Module (15%). In terms of occupational stress management strategies, Ministers and their wives reported that they were now attempting to reduce the number of working hours, had adopted some form of regular exercise, were establishing more regular communication with their peers, and had begun to implement strategies for managing insomnia. This ties in with 12.26% of participants choosing to spend more time with their families.

Team Building was next most common module that was being put into practice (29%). The implementation of this module was quite varied. Some ministers had taken their elders and church support structure through the team building module. Other ministers had informally considered the match between their interpersonal style and those they had to work with. Ministers had then used material from the team building module to better accommodate different interpersonal styles; and reported an increased understanding of colleagues who had a different interpersonal approach.

A significant number of ministers reported an increase in assertiveness as modelled in the course, (19.76%), indicating that they were more likely to firmly manage boundaries to protect time management structures and days off. A sizeable percentage of Ministers (19.76%) reported implementing the conflict resolution module outlined in the course and application of strategies such as defusing and assertive delay in reducing conflicts. Ministers also reported application of the conflict resolution module when mediating between parishioners. It seemed that a positive result in the conflict resolution area was enhanced through improved listening skills and negotiation (10.4%).

We were in a very fortunate position to also have monetary measures of the project’s effectiveness with the 74% decrease in the number of stress claims. The next steps arsing from this project were to develop plans for permanent structures to reduce occupational stress. To summarise the key strategies for preventing occupational stress in this group were:

• Reducing the number of hours ministers were working.
• Helping ministers to clarify job role boundaries and priorities.
• Encouraging them to spend time with their families and colleagues.
• Teaching ministers how to delegate.
• Encouraging ministers to exercise.
• Promoting effective conflict resolution strategies.