Work Related StressWork Related Stress
Theory and Clinical CaseworkTheory and Clinical Casework
• Work-related Stress
• Theory and Clinical Casework
• Counselling Psychology MSc
• School of Psychology and Therapeutic Studies, Whitelands College
Some problems that may present in Some problems that may present in a work context:a work context:
• Personal pathology triggered by work situation e.g. anxiety, depression, work phobia
• Where nobody appears to care at home• May be interpersonal – affairs in the
workplace, displaced power or skills situations
• May be existential: boredom, apathy, meaninglessness, life stage.
““Stress” is now a user friendly word Stress” is now a user friendly word so may hide may issues so may hide may issues
• Usually characterised by someone not knowing if they can keep up with their usual functions
• Some act this out e.g. behaviour towards colleagues
• Some push it inside as withdrawal and defeat
Some preliminary observations…Some preliminary observations…
• Stress is an umbrella term and may well hide anxiety, depression, socio-pathological behaviour as well as the results of organisational issues as they impact on the individual
• Think of ways in which an individual can cease to function well, largely because of the way that an organisation is structured
Definitions of StressDefinitions of Stress
• Hans Selye (1946) Three Stages• 1. Alarm reaction during which defence
mechanisms become active• Resistance – stage of maximum adaptation• Exhaustion when adaptive mechanisms collapse• This definition ignores psychological aspects of
stress• (Selye H (1946) The General Adaptation Syndrome and the Diseases of
Adaptation Journal of Clinical Endocrinology 6 (1946), 117
Lazarus (1970s)Lazarus (1970s)
• Individual’s stress reaction depends on how a person interprets or responds to a harmful, challenging or threatening event
• Cf. approaches that look mainly to the environment
• (Lazarus R.S. (1976) Patterns of Adjustment, New York: McGraw-Hill)
Cox et alCox et al
• “Part of a complex and dynamic system of transaction between a person and his environment”
• (Cox T (1978) Stress, London: Macmillan
Cummings and CooperCummings and Cooper
• Individuals tend to keep thoughts and emotions in a steady state
• Each factor in an individual has a “range of stability”. If the range is overreached the individual must restore a feeling of comfort
• An individual’s behaviour is aimed at maintaining a steady state
• Cummings T and Cooper C A Cybernetic Framework for the Study of Occupational Stress, Human Relations vol.32 (1979) 395-419
So definitions…So definitions…
• A physical state
• A maladjustment to a change in circumstances
• A maladaptive position between self and environment
• A kind of dissonance that requires adjustment
• A search to regain comfort
Maybe best seen as a range of Maybe best seen as a range of symptomssymptoms
• Panic attacks
• Raised blood pressure
• Excessive angry outbursts
• Over-eating
• Low mood
• Decreased concentration
• Inability to make decisions etc. etc.
Now look at your Stress ProfileNow look at your Stress Profile
• This comes from Cooper C, Cooper R, Eaker L (1988) Harmondsworth: Penguin
• Type A Behaviour - originated in 1960s Friedman and Rosenman susceptibility to heart disease. Type A 3 X more likely to die of heart disease
• So some of these issues appear to relate to temperament, and some to behaviour.
• What did you score, and which of the behaviours could you change?
Locus of Control (J B Rotter (1966)Locus of Control (J B Rotter (1966)
• About feeling a victim on the one hand, or responsible for everything on the other hand
• What would psychodynamic or other models of counselling call these two “positions?”
• What can be done about it if someone is locked into one or another of these positions?
Life Events (Life Events (T.H. HolmesR. H. Rehé))
• May seem to be beyond control but may be worth exploring
• This inventory misses several important stressors. What can you see that matters to may people?
• How many concatenations of events in your own life would you want to take some personal responsibility for?
• How do you respond to the person with the “Job” experience?
Social SupportSocial Support
• Can you see the link here between counselling and the social work approach to care?
• What kind of maintaining circle in CBT terms would you perhaps draw for a person who was stressed and whose social support broke down?
• What effect does your course have on your social support?
The resources approachThe resources approach
• In stressed situation people often forget their resources, or neglect them
• Asking them if they have ever met this kind of situation before/ felt like this before may help
• Asking them which forces inside of themselves and outside of themselves may help. Try Force-Field Analysis
Life skillsLife skills
• These can usually be taught. If you are aware of which key adaptive skills are missing, a great deal can be done using say Egan’s three stage model of problem solving
• Notice that work and home may ask for different skills according to Cooper et al
Some questions to ask yourselfSome questions to ask yourself
• When you meet a person with work related stress how do you know that it is work related?
• When do I refer this person to an agency where they get specialised help with a more serious problem e.g. clinical depression
Uncomfortable questionsUncomfortable questions
• The stress may relate to bullying, poor physical conditions, or to impossible workloads. What is your position if you are “part of the firm?”
• Where can the counsellor give good feedback to the organisation and how can confidentiality be protected?
Beware!Beware!
• Beware of pathologising the client in order to save the face of the organisation
• Beware of making the organisation the “bad object” – can easily happen in supervision as well as in the counselling encounter because everyone has bad experiences of organisations!
• Get the balance right between emphasising individual responsibility and organisational responsibility
With “martyrs”With “martyrs”
• Help them to decide what is their “bottom line”
• Gently help them to work out the cost and the benefits of questioning the system
• Help them to respond to “whole objects” i.e. a situation in which they are probably not wholly bad or wholly good/ where the organisation is not wholly bad or wholly good
So what about dealing with stressSo what about dealing with stress
• A small intervention may do a lot of good putting the client back in touch with their resources
• It may act as a potent place of referral so assessment is very important
• It uses some fairly low-level skills, and sometimes some very sophisticated strategies so should be respected
• Peter Martin 2003