10 - occupational stress reflections on theory and practice

8/9/2019 10 - Occupational Stress Reflections on Theory and Practice

1/15

Kenny D.T., 1999Occupational Stress 16

Occupational stress: Reflections on theory and practice

Dianna T. Kenny

Chapter 20, (pp 375-396), Kenny, D. T., Carlson, J. G., McGuigan, F. J., & Sheppard, J. L. (Eds.) (2000). Stress and health: Research

n c inica app ications pages). mster am, e et er an s: or on reac arwoo ca em c u s ers.

376 8.

NTRODUCTION

W et er ur ene y an overw e m ng urry o

daily commitments or stifled by a sense of social

solation (or, oddly both); whether mired for hours

n a sense o e’s po nt essness or eset or ays

by unresolved anxiety; whether deprived by long

work weeks from quality time with one’s offspring

or rown ng n qua ty t me w t t em – w atever

the source of stress, we at times get the feeling thatmodern life isn’t what we were designed for (Wright,

1995, p.62 .

Occupational stress is currently one of the most

costly occupational health issues (Cooper & Cart-

right, 1994; Cooper, Luikkonen & Cartwright,

1996; Cotton & F s er, 1995; Karase & T eore ,

1990; Kottage, 1992 . T e e eter ous mp cat ons

or n v ua s an organ sat ons are man o , an

can result in serious physical and psychological ill-

ess for individuals, and major resource loss for or-

ganisations. The extent and progression of the prob-lem over the past 20 years have been eloquently

ocumente e sew ere see Lev t s vo ume ; &

Sp e erger, Re e ser, Re e ser, & Vagg t s vo -

ume .

Occupational stress research has concentrated on

aetiology (Hart & Wearing, 1993; Toohey, 1993),

easurement Sp e erger, 1998 , an tert ary nter-

ent ons. T ese ave ocuse on e t er en ancement

of the individual’s coping capacity (Murphy, 1988)

or broader organisational level changes such as in-

creased worker participation in decision making, job enlargement and enrichment, redesign of jobs

an wor ng env ronment, an creat on o a more

support ve wor env ronment t roug a range o

uman resource management ntervent ons Coop-

er et al, 1996; Hart & Wearing, 1995; Levi, 1990).

s effective as some of these strategies are in large

scale restructuring enterprises, many organisations

are deterred from such global changes as a means of

prevent ng an manag ng occupat ona stress. T s

s ue to t e cost an ntrus on o suc strateg es an

he relatively small numbers of employees mani-festing stress conditions that impair occupational

functioning at any one time in any one work place

(Cooper & Payne, 1992). There will always, there-

ore, e a nee to cope w t occupat ona stress on

both the macro (organisational, structural, political)

an m cro n v ua , ya c, tr a c eve s. T s

paper contributes to the enhancement of managing

occupat ona stress at t e m cro eve .

Firstly, a systemic model for understanding occu-

pat ona stress s propose . Some extant t eor es o

occupational stress will then be reviewed, and in-

tervent ons ar s ng rom t ese t eor es are assesse .

Finally, an intervention for the rehabilitation of oc-

cupat ona stress ase on t e propose mo e an

theoretical discussion is outlined.

THE MODEL

In a series of recent studies (Kenny, 1995a, 1995b,

1995c, 1995 , 1995e, 1995 , 1995g, 1996 , Kenny

explored the causes of the failure of occupationalrehabilitation to effect a sustainable return to work

o ow ng wor p ace n ury. S e conc u e t at a

systemic framework provided both the most heu-

r st c exp anat on or suc a ures an a wor a e

model on which to base subsequent rehabilitation

ntervent ons. Accor ng y, t e mo e or ot un-

derstanding occupational stress and to occupational

stress ntervent ons, propose n t s c apter s n-

formed by systemic theories, including cybernetics,

commun cat on t eory, am y t erapy as app e to

the systems (ie workplaces, organisations and work-ers’ compensation system) in which the worker is

ocate , an current t eor es o occupat ona stress

which embrace a systemic epistemology (Bowen,

1987; Cottone, 1991; Hart & Wear ng, 1995; Kara-

sek & Theorell, 1990; Kenny, 1995e).

A systemic theoretical model for tertiary rehabili-

tation of occupational stress (Cottone & Emener,

1990; Kenny, 1995g) is different to other models in

that the focus is on neither the individual, nor the

organ sat on, ut on t e system as a w o e. In t s

model, occupational stress is understood as the sys-tem’s attempt to ma nta n equ r um or to restore

homeostasis (Hart & Wearing, 1995; Hoffman,


2/15

Chapter 20, Stress and Health Occupational Stress 17

1981). Occupational stress is not considered to be

symptomat c o ntra psyc c pat o ogy o t e en-

e c ent, as n t e me ca mo e , or a resu t o

env ronmenta actors, as n t e soc o og ca mo -

e . In t e propose mo e , a c rcu ar ep stemo ogy

(Hoffman, 1981; Keeney, 1987) informs the rehabil-

itation process by conceptualising relationships and

processes within the system as the proper subject of

investigation and intervention, thereby illuminating

a range o ntervent on strateg es at ot t e n -

ua an organ sat ona eve s. Anot er mportant

eature o a systems t eory ramewor t at ers

from current approaches is the temporal location,

hich is focused heuristically upon the present and

future, rather than on a forensic establishment of

fact based upon past actions and processes.

HEORIES OF OCCUPATIONAL STRESS

Psychological theories

e pre om nant para gm or un erstan ng

he causes of occupational injury and illness is the

edical model (Quinlan & Bohle, 1991; Quinlan &

ohnstone, 1993). With its emphasis on individuals

ather than groups, on treatment rather than preven-

ion, and on technological intervention rather than

env ronmenta c ange, t e me ca mo e as een

ery n uent a n contro ng ot t e way n w c

occupat ona n ur es an nesses ave een e- ned and the means by which they are managed.

he major criticism of the medical model has been

its focus on treating sick or injured workers rather

han on producing healthy working environments

(Biggins, 1986). The outcome of this approach was

o perpetuate t e not on t at wor p ace n ur es are

acc ents’ w c were not preventa e an to o-

cate t e ame or t e n ury n t e n v ua wor -

er or in the hazardous nature of the work (Davis &

George, 1993; Ferguson, 1988; James, 1989).

e sc p nes o n ustr a , occupat ona anea t psyc o ogy ave not ve up to t e r ear y

prom se ecause t ey ave a opte a manager a st

orientation akin to the medical model. That is, they

end to focus on the characteristics and behaviours

of individual workers and avoid addressing the role

hat the structure of power and authority in indus-

ry play in occupational well-being (Bohle, 1993).

or examp e, a t oug t e re at ons p etween

onotonous, es e an mac ne-pace wor

an env ronmenta an organ sat ona actors suc

as shiftwork, piece work, excessively high or lowork demands, and poor working conditions on

psychological and physiological stress responses

in workers have been demonstrated (Clegg & Wall,

1990 , t e r mpact s pre om nant y assesse n re-

lation to individual attitudes and behaviour, rather

than in relation to the structure of workplaces and

t e organ sat on o a our Qu n an, 1988 .

Sadly, the history of psychological theories of oc-

cupat ona stress, an n ee occupat ona n urygenerally, has been one of finding victims to blame,

and then to intervene in a linear way to alter the per-

ormance o t e atest scapegoat. Proponents o t ese

models have variously blamed the job, blamed the

equipment, blamed the worker, and blamed manage-

ment Cooper, 1995; Kenny, 1995e; Ha ec , 1993;

Quinlan, 1988; Willis, 1994). Such theories have

spawne an enormous amount o researc searc ng

or t e putat ve actors respons e or occupat ona

stress. Personality and organisational factors have

een ent e as t e ma or cu pr ts.Personality has always been considered a major

me ator o stress react v ty. T at s, a t oug cer-

ta n events are regar e as normat ve y stress u ,

sensitivity to stressors varies between individuals.

T at s, n v ua s w t erent persona t es w

respon s m ar y to p ys ca t reats, ut erent

responses to ego threats are related to personality

erences Eysenc , 1988 . Most t eor es o oc-

cupational functioning agree that personality makes

a significant contribution to performance and well-

e ng, w e ac now e g ng t at t e re at ons p between personality and environmental factors is

dynamic and complex. For example, Work Adjust-

ment T eory Roun s, Daw s, & Lo qu st, 1987 s

founded on the notion that stable cognitive, behav-

ioural and emotional dispositions underpin work

a ustment, ut t at s tuat ona n uences mpact

upon these stable dispositions for adaptation and

change, in both positive and negative ways. Simi-

ar y, Hea ey & Wear ng 1992 oun t at en ur-

ing personality characteristics, such as neuroticism

and extraversion, determine people’s daily workexper ences, use o cop ng strateg es, an eve s o

psychological distress and well-being. Extraversion

has been positively correlated with subjective well-

e ng Costa & McRae, 1980 , w e ntrovers on

and neuroticism are associated with increased stress

Fontana & A ouser e, 1993 , emot ona ex aust on

an epersona sat on P e mont, 1993 .

Hobfoll (1994), reacting to what he perceives to

e t e current over-emp as s on env ronmenta ac-

tors, has urged a re-consideration of the role of per-

sona ty n t e aet o ogy o occupat ona stress. Hestates t at we can Ano onger preten t at t ere s an

objective way to define stress at the level of environ-


3/15


ental conditions without reference to the charac-

er o t e person p 24 . In s m ar ve n, Ros es,

ou s-Guer n, & Fourn er, 1993 conc u e t at

persona ty can cus on as we as aggravate t e

mpact o occupat ona stress” p. 616-7 ; w t neg-

ative personality dispositions transforming stressors

into strains and strains into symptoms. Negative af-

fectivity, for example, has been associated with in-

erpersonal conflict (Spector & O’Connell (1994),

egative emotions (Chen & Spector (1991), psycho-

og ca stress, p ys ca symptoms Watson, Pen-

e a er, & Fo ger, 1986 , an o stra n Dec er &

orgen, 1993 . T e re at ons p etween ro e stress

and role distress has been found to be moderated

by a range of personality characteristics includ-

ing intolerance of ambiguity, dependency, strong

affiliation needs, low risk propensity (Siegall &

Cummings (1995), and high self-focused attention

Frone, Russe , & Cooper, 1991 . On t e pos t ves e, umour an opt m sm can s gn cant y mo -

erate t e re at ons p etween a y ass es, se -es-

eem maintenance, emotional exhaustion and physi-

cal illness (Fry, 1995).

esp te t e ent us asm or t e v ew t at person-

a ty c aracter st cs are un amenta to an un er-

stan ng o occupat ona stress, emp r ca support

or suc mo erat ng e ects as een m xe Frone

& McFarlin, 1989). Moreover, much of the research

as been atheoretical or exploratory, and it is dif-

cult to formulate interventions based on findingshat a small amount of variance in the experience

o occupat ona stress s accounte or y a part cu-

ar persona ty c aracter st c. Researc ers wor ng

t n t s ramewor wou , o course, recom-

en t at ntervent ons e a me at ncreas ng u-

our, optimism and tolerance of ambiguity and de-

creasing negative trait affectivity, neuroticism and

dependency. However, the literature is replete with

evidence that personality characteristics are notori-

ously difficult to modify (McRae & Costa, 1994).

ven t were poss e to c ange persona ty n t ees re rect on, t s not certa n t at wor p ace

cu t es wou mprove w t out s mu taneous y

attending to extrinsic organisational factors that

ay be operating. Moreover, personality traits may

be fixed to some extent, but their place in the sys-

em as antecedents or consequences will depend

on the nature of the interaction between individual

an env ronmenta systems, an to any c anges t at

ay occur w t n t at system. Persona ty may a so

e e ne as a unct on o cop ng sty e Eysenc ,

1988); consistent with a systemic framework, cop-ing behaviours will also be influenced by the sources

of occupational stress (O=Driscoll & Cooper, 1994)

and the resources and external support available for

ea ng w t t em Hart & Wear ng, 1995 .

Research into the role of organisational factors in

the aetiology of occupational stress has followed a

s m ar tra ectory to t e one out ne a ove or per-

sona ty. Ever engt en ng sts o putat ve actors

have been identified. In two reviews of occupationalstress, Cooper (1983; 1985) summarised and cate-

gor se s x groups o organ sat ona var a es, out-

ne e ow, t at may cause stress n t e wor p ace.

These are

1. Factors ntr ns c to t e o eg eat, no se,

c em ca umes, s twor

2. Relationships at work (eg conflict with co-

or ers or superv sors, ac o soc a sup-

port

3. Role in the organisation (eg role ambiguity)

4. Career eve opment eg ac o status, ac o

prospects for promotion, lack of a career path,

job insecurity)

5. Organisational structure and climate (eg lack

of autonomy, lack of opportunity to participate

in decision making, lack of control over the

pace o wor

6. Home and work interface (eg conflict between

domestic and work roles; lack of spousal sup-

port or rema n ng n t e wor orce .

There is, of course, a complex relationship be-tween occupational and organisational factors and

psyc o og ca c aracter st cs. Interpersona con ct

n t e wor p ace, ncreas ng y recogn se as a ma or

contributor to work disability, has a complex aetiol-

ogy. Dissatisfaction with life, daily stress, neuroti-

c sm an ost ty were a oun to e s gn cant

r s actors or nterpersona con cts at wor or

both men and women (Appelberg, Romanov, Hon-

kasalo, & Kosdenvuo, 1991)

Responses ar s ng rom a psyc o og ca rame-

work have focused on tertiary and secondary inter-ventions. Tertiary interventions include individual

counse ng, stress management programs, emp oy-

ee ass stance programs, an wor p ace me at on

for conflict resolution (Appelberg, Romanov, Heik-

kila, Honkasalo, & Kosdenvuo, 1996). Second-

ary ntervent ons nc u e tra n ng an e ucat on

Mac ay & Cooper, 1987; Bo e, 1993 . T s s not

to say that such interventions are never effective in

reducing occupational stress. In a recent study, Rey-

nolds (1997) reported that individual counselling

mprove psyc o og ca we - e ng w e organ sa-tional level interventions (ie increasing employees’

participation and control) did not. However, Bohle


4/15


(1993) argued that, in general,

nterventions of this nature imply that the prob-

lem of stress lies primarily with the individual,

at t e respons ty or c ange consequent y es

primarily with workers, and that organisations are

only responsible for assisting individual workers

o c ange. …s nce no attempt s ma e to re uce oremove environmental stressors, interventions can

best be seen as attempts to increase workers’ tol-

erance o nox ous an stress u organ sat ona , tas

an ro e c aracter st cs” p.111 .

e a vanc ng our un erstan ng to some e-

gree, ot persona ty an organ sat ona actors re-

search has remained wedded to the dominant medi-

cal and psychomedical paradigms outlined above.

t oug t ey g g t mportant putat ve actors

hat may contribute to occupational stress, these

factors, considered separately, do not inform the re-a tat on process. Let us now turn to ot er mo -

els and approaches that may assist in this regard.

ociological theories

he most radical departure from the medical

o e as een t e approac o n ustr a soc o o-

g sts w o ave roug t t e soc a organ sat on o

ork as the primary determinant of occupational

n ury, ness, an stress nto s arp ocus Berger,

1993; James, 1989; W ams & T orpe, 1992 . T e

edical model’s notion of health and illness is re- jected as reductionist, individualistic and interven-

on st, n w c su ects are cons ere as un que

cases, independent of cultural, social, political, and

economic structures and processes. Industrial soci-

o og sts argue t at power structures, t e nst tut on-

alised conflicts of interest between safety and pro-

ductivity, the social division of labour, the labour

process, n ustr a re at ons an po t cs are t e root

causes of occupational illness and stress (McIntyre,

1998; Peterson, 1994).

ecent changes to legislation in occupationalealth and safety and workers’ compensation have

s te t e percept on o occupat ona ea t rom

an individual and marginalised process to a proc-

ess with major economic and political implications

Kenny, 1994a; 1994 ; W s, 1989 . T ese c ang-

es have led to the revised view that occupational ill-

ess is a social process, the dimensions of which are

ot n v ua se , un que or spec c. Furt er, soc -

ologists argue that for every occupational illness or

injury, there are physiological and ergonomic com-

ponents w ose e ects are me ate y t e soc aenv ronment, spec ca y, t e organ sat on o wor

and the sociology of medical knowledge surround-

ing the illness or injury (Figlio, 1982). Negotiation

over the social and political meaning of occupation-

al illnesses and their various economic and social

implications occurs prior to their being awarded the

status of a syndrome (Willis, 1994). The irony of

such a process is that while gaining recognition that

such conditions are public issues, solutions continue

to be sought in the individual. With some notable

exceptions (Levi, 1998), this has been the case for

occupat ona stress.

T e ma or contr ut on o soc o og ca approac es

to occupat ona ness s t at “occupat ona ea t

an sa ety as ncreas ng y ecome an n ustr a

re at ons ssue etween cap ta an a our;… t as

ncreas ng y come to me ate t e soc a re at ons o

pro uct on” W s, 1994, p.138 . In ot er wor s,

t e ocus as s te rom a ata st c acceptance

that there will be casualties of the work process to a

legislated requirement that employers provide a safe

workplace for all employees. The cost of compen-

sation is increasingly shaping occupational health

and safety practices and procedures and hence the

labour process itself (McIntyre, 1998).

Negotiating safety in reference to occupational

stress is, of course, more difficult than negotiating

safety with respect to the physical hazards of the

workplace. Occupational stress currently occupies

a similar nebulous position in the medical nomen-

clature that RSI (Repetitive Strain Injury) occupied

in the last decade. One must demonstrate that the

incidence of illness (presence of symptoms) is con-

nected to the organisation of work, and as stress is a

transactional process involving interactions between

physiological, psychological, behavioural and or-

ganisational variables, demonstrating the causal

nexus is not an easy matter. Moreover, the legislated

requ rements may n act ave wor e aga nst t e

reso ut on o ssues re ate to occupat ona stress,

requ r ng as t ey o t e cert cat on o a spec c

ness on t e Wor ers’ Compensat on cert cate.

Leg t mat ng t e exper ence o occupat ona stressme ca y may m tate aga nst an organ sat ona or

transact ona so ut on to t e pro em, s nce cert -

cat on, a process ac eve t roug po t ca act on,

as n v ua se t e pro em an returne u c r-

c e to t e v ct m am ng approac o t e me ca

mo e .

Systemic t eories

In advocating a systemic/transactional approach

to occupational stress, it needs to be stated that there

are circumstances in which either personality is sodamaged or environmental conditions are so ad-

verse, that the relational context of one to the other


5/15


is irrelevant. These special cases must be dealt with

on a case- y-case as s requ r ng un que so ut ons,

anging from the individual to the political.

Severa t eor es o occupat ona stress t at ut se

social systems theory have been developed (Bach-

arac , 1991; E war s, 1992; Furn am & Sc ae er,

1984; Frone & McFurlin, 1989; Hart & Wearing(1995); Hobfoll, 1989; Karasek, 1979; Karasek &

eore , 1990; Lazarus & Fo man, 1984; Mc-

Grath 1976). Space permits only a brief summary of

e re evant mo e s ere, an t e ntereste rea er

is referred to the many excellent reviews available

for a comprehensive coverage.

Person-Environment Fit T eories

erson-Env ronment P-E F t t eor es Cap an &

arrison, 1993; Furnham & Schaeffer, 1984) were

early precursors to the dynamic systemic theoriesescr e n t e next sect on. Cap an 1987 use

-E fit theory as a method for understanding the

process of adjustment between employees and their

or env ronment. Accor ng to t s ramewor ,

occupational stress is defined in terms of work char-

acter st cs t at create stress or t e n v ua ue

o a lack of fit between the individual=s abilities and

attributes and the demands of the workplace. Caplan

1987 suggeste t at reco ect ons o past, present,

and anticipated P-E fit might influence well being as

e as per ormance.nterventions are directed at measuring fit prior

o vocat ona p acement, or measur ng screpancy

in fit in the identification of occupational stress ae-

iology. Interactions between person (eg personal-

ty tra ts, vocat ona or entat on, an exper ence

and environment variables have been found to be

etter pre ctors o stra n t an e t er person or en-

ironmental variables considered separately (An-

onovsky, 1987a; Caplan, Cobb, & French, 1975).

owever, c aracter st cs o o s an c aracter st cs

of workers may influence each other in dynamic re-ciprocal ways. Most P-E fit theories are static and

a e to a ress t e ongo ng, rec proca n uenc-

es of environment and person (Kulik, Oldham, &

ac man, 1987 .

Demand-Control theories

A eve opment an expans on o o stra n mo -

els, the demand-control model (Karasek, 1979)

concerns t e o nt e ects o o eman s an o

control on worker well being. Demand is subdivid-

ed into workload, work hazards, physical and emo-ona eman s an ro e con ct. Contro re ates

o substantive complexity of work, administrative

control, control of outcomes, skill discretion, super-

vision, decision authority and ideological control

Muntaner & Sc oen ac , 1994; So er e t, So er-

e t, Munstnaer, O’Campo, Warg & O son, 1996 .

Base on t e mens ons o eman an contro ,

o s ave een c ass e nto our categor es. T ese

are high strain jobs (high demand/low control); low

strain jobs (low demands/high control); active jobs

(high demands/high control); and passive jobs (low

demands/low control) (Landsbergis, Schnall, Dietz,

Friedman, & Pickering, 1992). In general, psycho-

logical distress is predicted by high demand/low

contro com nat ons Karase , 1990 . Converse y,

an ncrease n contro s pos t ve y corre ate w t

o sat s act on Murp y 1988 . Contro as a so

een mp cate n occupat ona stress ar s ng rom

organisational change processes, where control is

conceptualised as a stress antidote (Sutton & Kahn,

1986). The perception of control can also be linkedto personality factors, such as locus of control and

private self-consciousness (Frone & McFarlin,

1989; Kivimaki & Lindstrom, 1995).

Jo nson an Ha 1988 ave expan e t e mo -

e to nc u e a support component ncorporat ng

coworker and supervisor social support. Social sup-

port has positive effects on well-being and buffers

the impact of occupational stressors on psychologi-

cal distress (Karasek, Triantis, & Chaudry, 1982).

Low social support has been associated with greater

symptomatology, and a significant interaction witheman an contro as een o serve or o s-

sat s act on Lan s erg s, Sc na , D etz, Fr e man,

& P c er ng, 1992 .

Communication t eory

Karasek and Theorell (1990) view occupation-

a stress as a strateg c commun cat on o stress.

Too ey, 1993, 1995 as expan e t s concept nto

a mo e o unct ona commun cat on. In t s mo e ,

ssat s act on at t e wor p ace may e expresse

through illness behaviour (ie occupational stress),which is assessed as “a safe and acceptable manner

in which to communicate distress” (Toohey, 1995,

p 57). It is certainly debatable as to how expressing

one’s distress in this way is either safe or acceptable

in a workplace context, especially given the social

st gma attac e to ot menta ness, an to wor -

ers’ compensat on c a ms genera y. However, t ese

met o s are o v ous y more accepta e t an out-

ursts o anger, p ys ca v o ence or cr m na acts

such as theft or destruction of property. This model

is just a step away from the systemic analysis of thefunction of the symptom in the system in which it

occurs (Hoffman, 1981; Palazzoli et al., 1986), to


6/15


hich we will shortly turn our attention.

Dynamic equilibrium theory

A recent innovative approach to understanding oc-

cupational stress has been proposed by Hart, Wear-

ing, & Heady, 1993c; Hart & Wearing, 1995; Head-

ey & Wearing, 1992). They challenge the prevailing

Cannon (1929) Selye (1975) view of stress which is

ase on an eng neer ng mo e w ere stress s un-

erstoo as t e orce exerte on a structure, w c

ay t en s ow s gns o stra n n response to t at

orce. T e m ss ng part o t s ormu at on are t ose

characteristics which create susceptibility to strain,

either through innate personality traits, behaviours,

esources, or organisational factors. According to

he dynamic equilibrium theory, stress is not defined

as a demand, a response or a process, but as a state

of disequilibrium that arises when a change occurs

at a ects t e n v ua ’s norma eve s o psy-c o og ca stress an we - e ng. To un erstan

e cause o t s c ange, t s necessary to separate y

assess t e mpact o persona ty, organ sat on, cop-

ng processes an ot pos t ve an negat ve wor

experiences. People may respond with both positive

and negative affect to the same environment (Di-

ener & Emmons, 1985), and psychological well-be-

ing is therefore determined by the balance between

separate positive (eg extraversion, salutogenic life

events) and negative (eg neuroticism, adverse life

events actors Bra urn, 1969 , eac one o w cas ts own un que set o causes an consequences

Hart, 1994 . Hart an Wear ng 1995 argue t at

ot sta e persona ty c aracter st cs an t e y-

amic interplay between coping and daily work ex-

periences together account for changes in levels of

psychological distress and well-being.

A t oug o ten use nterc angea y n t e occu-

pat ona stress terature, Hart an Wear ng 1995

ave emonstrate t at psyc o og ca stress an

ora e operate as separate mens ons an ma e

independent contributions to the quality of worklife. That is, positive work experiences impact upon

orale, and negative work experiences impact upon

psychological distress. This suggests that morale

ay be improved by increasing positive work ex-

periences and that psychological distress can be re-

uce y ecreas ng negat ve wor exper ences. In

a t on, researc w t teac ers an po ce o cers

as n cate t at t ese pro ess ona groups are not

stresse so muc y t e nature o t e r wor , ut y

he organisational context in which the work occurs

(Headey & Wearing, 1992). The implication of thisnding is that intervention should focus on develop-

ing a supportive organisational climate that enables

workers to cope more adaptively with operational

work demands, rather than to direct change efforts

at the nature of the work per se. A core set of organi-

sational factors, among them staff relationships and

leadership quality, is related to both psychological

distress and morale. Other factors, such as excessive

work demands, are negative and relate only to psy-

chological distress, while factors such as opportuni-

ties for advancement, are positive and relate only to

mora e Hart, Conn, Carter, & Wear ng, 1993 . T at

s, stra n occurs w en excess e ements eg eman s

may t reaten one nee an e c t e ements eg ac

o commun cat on or support may t reaten anot er.

Care u ana ys s o ot pos t ve an negat ve or-

gan sat ona c aracter st cs s t ere ore nee e e-

ore nterven ng to ame orate ent e pro ems.

Cybernetics and Systems Theory

Cybernetics and General Systems Theory weredeveloped concurrently and are based on similar

theoretical principles. Social systems theory empha-

sises wholeness, the interaction of component parts,

and organisation as unifying principles (Goldenberg

& Goldenberg, 1985, p28); incorporates non-linear

theories of causation (Cottone 1991); and is based

upon a circular epistemology (Hoffman, 1981).

Cy ernet cs as een e ne as a sc ence o

commun cat on an contro n man an mac ne

E war s 1992; Frone & McFar n, 1989; We ner,

1948 ; an ep stemo og ca oun at on or personaan soc a c ange Bateson 1972 , w c ocuses on

menta process Keeney, 1983 , w ere y n v u-

a s mon tor t e r psyc o og ca an p ys o og ca

react ons to var ous stressors Frone & McFar n,

1989, p876 . In cy ernet c t eory, t e concept o

ee ac s t e p vota process. Fee ac escr es

a process w ere y t e system n t ates omeostat-

c mec an sms ase upon n ormat on rece ve .

Ho man 1981 escr es ee ac oops as e t er

ev at on amp y ng or ev at on counteract ng,

w ere y a system e t er sta ses, mov ng to a stateo equ r um, or esta ses, mov ng to a state o

sequ r um. Accor ng to a cy ernet c ana ys s,

systems or organ sat ons may un ergo rst or sec-

on or er c ange. In rst or er c ange, negat ve

ee ac s t e process w ere y systems ma nta n

t e r organ sat on t roug ev at on-counteract ng

mec an sms suc as omeostas s, morp ostas s,

an se -correct on S uz , 1985 . In secon or er

c ange, pos t ve ee ac oops amp y ev at on

e create c ange rat er t an ma nta n stas s .

Feedback loops are initiated when an individualidentifies a discrepancy between a perceived current

state that creates imbalance and discomfort, and an-


7/15


other desired psychological and/or physiological

state (Frone & McFarlin, 1989). The individual then

assigns significance (importance) to the discrepan-

cy Carver & Sc e er, 1981; Cumm ngs & Cooper,

1979; E war s, 1992 . T e mportance or mean-

ng accor e t s screpancy eterm nes w et er

a ee ac mec an sm s n t ate E war s 1992 .

n an nterest ng var at on o t s t eme, Buun an

Y ema 1997 ave propose t at exper enc ng oc-

cupat ona stress, or any orm o uncerta nty, nst -

gates a es re or soc a compar son n ormat on,

at s, a nee to scover ow ot er peop e ee

a out t e s tuat on. Contact w t s m ar ot ers may

lead the individual to adapt his/her stress response

o those of other group members. Such a process

ay account, in part, for particular patterns of oc-

currence of occupational stress or illness that have

been identified (Willis, 1994).

Consistent with circular causality and the muta-

bility of causal direction in relation to key variables,

cop ng s e ne as screpancy re uct on e av-

our Frone & McFar n, 1989 ; an outcome o t e

stress process E war s, 1992 , as a component o

e ntrapersona var a es w c ma e up persona -

ty, w c n uence ot t e n t a suscept ty to

perce ve stressors var a es suc as ego strengt ,

ar ness etc an t e a ty to respon to t e t reat

o omeostas s n system c terms or t e screpan-

cy occurr ng etween perce ve an es re states

n cy ernet c t eory . T e app cat on o a c rcu arepistemology resolves current disagreement over the

function and consequences of coping as either a me-

diator of the stress-strain relationship or as a mod-

erator (stress buffer) of the relationship (O’Driscoll

& Cooper, 1994). Edwards (1992) describes stress

explicitly as a discrepancy between perceptions and

desires, rather than a conflict between demands and

abilities, as in Selye’s model (Selye, 1975), which

dwards views as predictors of coping efficacy,

ather than stress per se (p 246).

A t oug t e para e s rare y rawn, t ere s astrong p osop ca re at ons p etween t e con-

cept o ‘ screpancy’ n systems t eory, ‘a enat on’

n Marx’s t eory o t e pat o ogy o soc a c ange

Marx, 1982 , an Dur e m’s 1952 ‘anom e.’ Su-

san Sontag 1978 conce ve o ‘ ness as metap or’

ithin sociological theorising at about the same

ime that psychologists and family therapists were

embracing the notion of the symptom in the iden-

ified patient as a metaphor of family dysfunction

(Bowen, 1978; Haley, 1964; Minuchin, 1974; Pal-

azzoli, 1986). Similar analogies have been offeredsubsequently, for example, Willis’s (1994) analysis

of RSI as a metaphor for alienation. Applying these

concepts to occupational stress, one could argue

that occupational stress arises when, through either

n v ua or organ sat ona c ange processes, a s-

crepancy occurs etween t e persona va ues o t e

wor er an t e va ues o t e organ sat on to w c

s e e ongs. Because managers an superv sors

are ey representat ves o organ sat ona cu ture, t

s most o ten w t n t e re at ons p etween t e n-

dividual and the supervisor that the individual will

experience alienation (McIntyre, 1998).

The experience of occupational stress and its

concrete manifestation ie the lodging of a workers’

compensat on c a m, s t e unct ona commun ca-

t on o stress roug t a out y a enat on Kara-

se & T eore , 1990 . In E war ’s 1992 t eory,

a enat on may e un erstoo n terms o t warte

es res, w c pro uce negat ve emot ons suc as

anger, s us onment, or t e es re or retr ut on

or revenge. Decreased worker morale, in dynamic

equilibrium theory (Hart & Wearing, 1995), may be

conceptualised as a precursor to alienation if steps

are not taken to remedy the morale problem early in

the cycle. Similarly, Kenny (1995c; 1995d) argued

that the failure of some injured workers to return to

work following workplace injury was due, at least

in part, to a failure of management to either believe

t at t e n ury was genu ne or to s ow care, concern

an respect to t e n ure wor er. T ese a ures set

up a negat ve ee ac oop n w c wor ers ex-

per ence a narc ss st c n ury t at resu te n anger,ost ty, an a es re or revenge aga nst manage-

ment, w c o course, ea s to a enat on etween

worker and management.

REHABILITATION OF

OCCUPATIONAL STRESS

Occupational rehabilitation theories have followed

the dominant paradigms of occupational stress and

can be summarised using four broad categories.

These are a) expert technical approaches that fo-cus on the physical environment of work and work

practices; b) work psychology, which attributes ill-

ness to wor er e av oura c aracter st cs as we

as to some mme ate organ sat on e av ours suc

as pay systems, superv s ng env ronments, etc.; c

pseu o-psyc o ogy, a v ct m- am ng approac

w c ocuses on n v ua wor er e av our suc

as ma nger ng an acc ent proneness, an ea s

to relatively inexpensive employer corrective ac-

tivities such as pre-employment health assessments,

worker education, and drug tests; and d) sociologi-cal approaches which focus on broader social issues

such as power structures, profit/production impera-


8/15


ives and gender, ethnic and class divisions as well

as organ sat ona e av our Jo nstone & Qu n an,

1993).

e expert tec n ca approac as mprove t e

ergonomic environment of workers, but on its own,

cannot account for all problems related to occupa-

ona n ury or occupat ona stress. W s 1994 ,for example, questioned why some workers devel-

oped RSI after years of using the same equipment,

or cont nue to eve op RSI a ter ergonom c urn -

ure, pause strategies and exercises, and work rede-

sign had been introduced into the workplace. The

or psyc o ogy an pseu o-psyc o ogy mo e s

are still generally based upon a medical model of

near causa ty, w c as t erto prov e t e

om nant para gm n tert ary re a tat on Cot-

one & Emener, 1990; Kenny, 1995c). Its basic re-

qu rement s t e attac ment o a me ca or psyc o-og ca agnost c a e to t e c a mant. In so o ng,

he intervention becomes focused upon only one

component o a comp ex system Too ey 1993 ,

amely the putative psychopathology of the indi-

idual. This approach militates against a successful

e a tat on outcome, ea ng as t oes, to v ct m

blaming (Davis & George, 1993; Kenny, 1995e).

Conversely, the political/advocacy approach, based

on a soc o og ca ana ys s, attempts to reso ve t e

environmental issues to the exclusion of intra-psy-

chic problems.

he ecological view of humans as living systems

dependent upon a healthy relationship with the envi-

onment s one o some currency n po t ca , pu c

ealth and philosophical realms. The development

of this perspective into a model for explicating the

antece ent processes o occupat ona stress ase

on cybernetics and systems theory has been fore-

shadowed, but not yet realised (Cottone & Emener

1990; Cox, 1987; E war s 1992; Hart & Wear ng

1995; Kenny 1995e; Tate, 1992). The ecological

iew of occupational stress is succinctly summa-se , as o ows:

ork related psychosocial stressors originate in

soc a structures an processes, a ect t e uman or-

ganism through psychological processes, and influ-

ence health through four types of closely interrelat-

e mec an sms – emot ona , cogn t ve, e av oura

and physiological. Situational (eg social support)

and individual factors (eg personality, coping rep-

erto re mo y t e ea t outcome. T e wor -env -

onment-stress-health system is a dynamic one with

any ee ac oops…t e approac to nterven-on s ou e systems-or ente , nter sc p nary,

problem-solving oriented, health (not disease) ori-

ented, and participative (Levi, 1990, p1142).

Extant theories of occupational stress focusing on

cybernetics go some way towards operationalising

t e concepts an exp or ng aspects o t e mo e , ut

not in relation to the design of interventions from

either a preventive or management perspective (Ed-

war s, 1992; Frone & McFar n, 1989 .The processes involved in occupational rehabili-

tat on can e conceptua se cy ernet ca y, n terms

similar to those of systemic family therapy. Bowen

(1966, 1978) was a systemic family therapist who

postu ate t e mportance o t e ro e p aye y tr -

angles in family interaction. This process, called tri-

angulation, occurs in all social groups, as twosomes

orm to t e exc us on o , or aga nst a t r party. Bo-

wen proposed that a two-person system may form a

three-person system under stress. For instance, ten-

s on m g t ar se etween t e two an t e one w ofeels most uncomfortable or vulnerable may ‘trian-

g e n’ a t r party, to re eve tens on an to restore

t e power a ance. T e t r party, once rawn n,

may form his/her own set of alliances, thus creating

s t ng power a ances. T e act on may not rema n

oca se w t n t e or g na tr ang e, as more an

more stakeholders become involved in the ongoing

strugg e. Bowen assoc ates pat o ogy w t r g ty

and suggests that, although all systems create triadic

patterns, these patterns will become more rigid dur-

ng per o s o cr s s or stress. T e r g ty o t e re-sponse patterns set up by injury/occupational stress

and the central players’ initial response to the claim

o ow a m te an pre cta e pat an set up a

highly restricted set of choices for the stakeholders

involved.

When a worker is injured/stressed, the matter is

initially dealt with in the injured worker-employer

ya . I t e wor er an emp oyer ea w t t e mat-

ter to their mutual satisfaction, no other parties need

become involved, other than in a service provision

capac ty. T at s t e emp oyer w not y t e n-surer, who will organise payment, and the injured

worker may contact a health professional for treat-

ment. However, t e emp oyer s ssat s e w t

the injured worker’s response to his injury (eg by

taking too much time off work, or by remaining on

s ortene ours o wor , e may ca n t e nsurer,

not as a service provider, but as an ally against the

injured worker. The insurer will respond by disput-

ng t e c a m or wor ers’ compensat on, or er ng

expert medical opinion and instructing the worker

to atten a octor appo nte y t e nsurance com- pany. T e n ure wor er may respon y atten ng

his own doctor, no longer only as a service provider,


9/15


but also as an ally who will assist the injured worker

o restore the power balance by organising medi-

cal specialist opinion which is frequently contrary

o t e nsurance octor’s op n on. T e part es may

en ecome po ar se n an apparent y unreso v-

a e emma. One o t e reasons or t s s t at t e

ssue o ow est to manage t e n ury s rep ace

t t e ssue o sta e o er ntegr ty, part cu ar y

at o t e n ure wor er. T e genu neness o t e

n ury ecomes t e ocus o sta e o er nvo ve-

ent, rat er t an searc ng or t e est ‘soc a t’

or t e wor er an s er emp oyer. T e more par-

es w o ecome nvo ve , t e poorer t e commu-

ication between them and the greater the suspicion

and hostility. Recourse to the legal profession with

protracted legal proceedings is often the next step in

his process of triangulation.

Systemic concepts such as Bowen’s notion of

riangulation (Bowen, 1966, 1978), and Karasek’s

otion of stress as a form of strategic or functional

commun cat on Karase & T eore , 1990 , ave

e capac ty to prov e a rm un erp nn ng to t e

o e o tert ary re a tat on escr e n t s

c apter.

he proposed systemic model is particularly rel-

evant to the analysis and case management of oc-

cupational stress. It suggests that the intervention of

he rehabilitation case manager should be directed

at identifying the dyadic and triadic relationships

and at providing clients with a functional means

of communicating their distress. It is vital that this

process allows the real sources of stress to be identi-

ed. In an interesting and provocative paper, Maho-

y (1996), building on Goffman’s (1971) distinction

between ‘front stage’ and ‘back stage’ explana-

ions of behaviour, argues that certain occupational

groups present ‘front stage’ explanations only for

e causes o t e r occupat ona stress. Front stage

e ers to t ose exp anat ons t at are most e y to

ave currency w t preva ng soc a norms, man-

agement, an n t e case o c a ms or occupat onastress, t e Wor ers’ Compensat on aut or t es. S e

s g ts t e examp e o pr son o cers, w ose ront

stage exp anat ons or occupat ona stress nc u e

a y exposure to persona r s , resu t ng n sa ety

ears, nc u ng ears o n ury an eat at t e

ands of violent criminals. The back stage reality,

hat were the underlying causes of absenteeism, sick

leave and occupational stress was the inherent bore-

dom of the job (eg standing in a tower on guard for

eight hours) and stigmatisation by outsiders. These

putative back stage factors would receive much lesssupport from management or Workers’ Compensa-

ion authorities. Therefore, workers may collude in

propagating the front stage reality to the detriment

o eve op ng appropr ate ntervent ons or c ange.

Careful analysis is required to avoid intervening on

the basis of front stage interpretations of the prob-

em. T s may ea to mpasses, sta emates, anger,

hostility, and industrial action.

Prov s on o t e opportun ty to ea w t otfront stage and back stage issues, that may include,

among others, medical or treatment issues, industri-

a an ega ssues, c ange management pro ems,

family problems, life cycle issues, underlying or

consequent psychological or psychiatric conditions,

an competence an tra n ng cu t es, s a neces-

sary component in the rehabilitation process. If suc-

cess u , t s commun cat on w ree ot t e c ent

an s gn cant sta e o ers rom t e aggregat on o

issues (eg searching for truth or blame and appoint-

ng scapegoats t at as resu te n tr angu at on processes see Kenny, 1995 , 1995e t at were ot

precursors to the claim and impediments to success-

u return to wor . T s ana ys s a so serves to c ar-

ify expected outcomes of the rehabilitation process,

as distinct from other (eg industrial/legal) processes

w c may ave a ear ng on t e reso ut on o t e

problems (Nowland, 1997).

Due to t e comp ex nature o t e re a tat on

process and the large number of stakeholders in-

volved, the role of the case manager is central and

p vota Kenny, 1995c; We & Kar s, 1985 . T eadoption by the rehabilitation professional of an ad-

vocacy or adversarial role, either on behalf of the

wor er, or on e a o one o t e ot er sta e o ers

(usually the employer) may create a major barrier

to successful rehabilitation (Kenny, 1995a, 1995f;

S rey, 1993 . A system ca y ase ntervent on

will resolve these errors by clarifying the role of

the case manager within this system as an advocate

or t e re a tat on process, rat er t an or any o

the stakeholders. A systems framework emphasises

the importance of professional neutrality, providingc ear ro es an unct ons ase upon t e pro ess on-

al’s relationship to the system as a whole, rather than

to any one component (Furlong & Young, 1996).

T s approac a so serves to c ar y expecte out-

comes of the rehabilitation process, as distinct from

ot er eg n ustr a ega processes t at may ave a

ear ng on t e reso ut on o t e pro ems.

The focus of the systemic intervention is the re-

at ons p etween t e n ure wor er an t e sys-

tem rather than an exploration of the individual’s

tra ts, s s an capac t es n so at on. It s aseon t e cy ernet c mo e out ne a ove w c as

in turn been informed by the theories and processes


10/15


described in the preceding sections. In this model,

developed by Nowland (1997), and enlarged upon

ere, the case manager should

1 Map t e sta e o ers an t e r nter-re-

at ons ps. Bot t e c ent an t e case manager

ee to un erstan w o s nvo ve , e t er overt y

or covert y. A e map s t en constructe o t e

overa system o sta e o ers an t e r re at on-

s ps to one anot er n t e system. F gure 1 presents

a prototyp ca examp e o a e map. T s map n-

c u es a most sta e o ers w o may ecome n-

o ve once a c a m or wor ers’ compensat on s

a e. Not a c ents w come nto contact w t a

part es out ne n F gure 1. However, t e sc emat c

epresentat on o t e e r ngs nto s arp ocus a

e poss e ya c an tr a c re at ons ps t at can

occur n t e post- n ury per o .

2) Identify sub-systems. Sub-systems areidentified by the commonality of their purpose and

ules. Different stakeholders may belong to more

han one sub-system, and through a process of iden-

ifying sub-system membership, conflicts of interest

and alliances and coalitions may be clarified (ie Bo-

en’s triangulation processes). The client is inevi-

ably a member of a large number of sub-systems

simultaneously (ie workplace, medical and rehabili-

ation systems, family systems and social systems).

t is important to determine the relative strength and

influence of each of these systems. The more inten-sive, committed, and socially integrated a setting,

he greater is its potential impact on the outcome

(Moos, 1987). In addition, the relationship of the

worker to his/her work in terms of demand/control/

social support may further illuminate the putative

sources of stress currently experienced. It may also

be possible to identify the dominant source of stress

within one of the identified sub-systems.

3 I ent y t e ru es govern ng t e operat on

o t e su -systems. T e ru es govern ng t e e av-

our o t e su -systems may not e cons stent w t

t e purpose o t e overa system, nor to e n t e

est nterest o success u re a tat on. T e case

manager nee s to ent y any omeostat c mec a-

n sms t at wou operate to t reaten c ange, an to

ma e t ese ru es an mec an sms exp c t.

4) Identify the issues for the client. This step

assists the client to understand the systemic causal

relationship between his/her stress response and in-

dividual and systems variables. This process willhighlight the initial factors as well as to identify

potential barriers to resolution of the problem. A

number of structured exercises can facilitate this

process (Brassard & Ritter, 1994). During this

stage, it is important that the case manager obtain

a clear understanding of the ‘back stage’ issues for

the client, and to allow ample opportunity for the

functional communication of distress that may con-

stitute one of the underlying impediments to the res-

olution of the issues. Clarifying and separating both

positive and negative work experiences may assistthe client to gain some conceptual clarification of

the causes of their psychological distress, as distinct

Legend

or over ut or ty

Rehabilitation Provider

mp oyer

nsurer

n u re or er

reat ng octor

nsurance octor

n nsurance nvest gator

upport roups

o c t or

Rehabilitation Coordinator

n

Fig.1 A mo e o t e proxima an ista sta e o ers in t e post-injury perio an communication pat ways


11/15


from vocational dissatisfaction or morale. This step

can then lead into stage 5 of the process.

5 Apport on respons ty or management o

e actors. D erent ssues may nee to e re erre

o erent personne , e t er w t n or outs e t e

organ sat on. Poss e sources o a t ona support

include union representative or other employee ad-ocate, individual counsellor, or line manager. The

ehabilitation case manager co-ordinates and moni-

ors these referrals and acts as a conduit and liaison

between the client and other stakeholders.

6) Plan and implement the rehabilitation in-

ervention. Once the aggregation of issues has been

ea t w t , t e case manager can t en prepare t e

c ent or return to wor . Dur ng t s p ase, t e case

anager gra ua y re nqu s es respons ty to t e

c ent an ot er ey sta e o ers n t e wor p ace.

reliminary investigation indicates that systemicinterventions have not previously been operational-

ised in this way and diverge in significant ways from

current practice. Predictions from the application of

his model include role clarification for all stake-

olders, case manager neutrality, task assignment,

increased ability to manage the multivariate factors

involved in a claim for occupational stress, chal-

lenging homeostatic mechanisms, and illuminating

a greater range of intervention strategies through the

systemic analysis of the precipitating and maintain-

ing factors.

IRECTIONS FOR FUTURE RESEARCH

his model for rehabilitation of occupational

stress s yet to e teste emp r ca y. Mo e spec -

cat on an mp ementat on wou e en ance y

e o ow ng:

i) improving identification, nomenclature and

classification of occupational stress claims and sep-

arating them from related factors such as morale,

ocational satisfaction and attitudes towards work(Hart & Wearing, 1995).

ii) development of strategies to avoid the medi-

ca sat on, an ot erw se na equate c n ca man-

agement, o occupat ona stress c a ms. Current

pro ems are ue to omver-me ca sat on o oc-

cupat ona stress Qu n an, 1988 , poor agnost c

s s n genera pract t oners Kenny, 1996 , poor

c n ca assessment pract ces, pass ve c n ca man-

agement rom re a tat on prov ers an over-re-

ance on c a mant se -report as t e pr nc pa source

o ata Cotton, 1996 .iii) an assessment of pre-program (eg availability

of Employee Assistance Programs, grievance pro-

cedures, mediation services) and program (eg type

o ntervent on, y w om, sta e o ers nvo ve ,

nature and frequency of contact) variables, which

can be linked to successful outcomes in the man-

agement o occupat ona stress c a ms. A t oug

t ere as een some recent attent on to t e eve -

opment of stricter procedures, protocols, and role

spec cat on o t e var ous sta e o ers nvo ve n

t e management o stress c a ms, t e ntervent on

processes that occur at the different stages of the

life of the claim, and which contribute to success-

u unsuccess u outcome ave not, to ate, een

sufficiently elucidated

REFERENCES

Appe erg, K., Romanov, K., Hon asa o, M. L., & Ko-

skenvuo, M. (1991). Interpersonal conflicts at work

an psyc osoc a c aracter st cs o emp oyees. Socia

Science and Medicine 32 (9), 1051-1056.

Appelberg, K., Romanov, K., Heikkila, K., Honkasalo,

M. L., & Kos envuo, M. 1996 . Interpersona con ct

as a predictor of work disability: A follow-up study of

15,348 F nn s emp oyees. Journa o Psyc osomatic

Research, 40 (2), 157-167.

Bac arac , S. B., Bam erger, P., & Con ey, S. 1991 .

Work-home conflict among nurses and engineers: Me-

at ng t e mpact o ro e o stress on urnout an sat-

isfaction at work. Journal of Organisation Behavior

12 1 , 39-53.

Berger, Y. 1993 . T e Hoec st spute: A para gm s t

in occupational health and safety. In M. Quinlan (Ed.).

Work and health: The origins, management and regula-

tion of occupational illness. (pp. 126-139). Melbourne:

MacMillan Education.

Biggins, D. (1986). Focus on occupational health: What

can e one? New Doctor 47, 6-10.

Bo e, P. 1993 . Wor psyc o ogy an t e management

of occupational health and safety: An historical over-

view. In M. Quinlan (Ed.). Work and health: The ori-

gins, management and regulation of occupational ill-

ness. (pp. 92-115). Melbourne: MacMillan Education.

Bowen, M. (1966). The use of family theory in a clinical

pract ce. C inica Psyc iatry 7, 345-374.

Bowen, M. 1978 . Fami y t erapy in c inica practice.

New York: Aronson.

Bra urn, N. M. 1969 . T e structure o psyc o ogica

well-being . Chicago: Aldine.

Brassard, M., & Ritter, D. (1994). The memory jogger .

MA: Met uen, Goa QPC.

Buunk, B. P., & Ybema, J. F. (1997). Social comparisons

an occupat ona stress: T e ent cat on-contrast

model. In B. P. Buunk, & F. X. Gibbons (Eds.). Health,coping, an we - eing: Perspectives rom socia com-

parison theory (pp. 359-388). Mahwah, NJ: Lawrence


12/15


Erlbaum Associates.

Cannon, W. B. (1929). Organisation for physiological

homeostasis. Physiological Reviews 9, 399-431.

Cap an, R. D. 1987 . Person-env ronment t t eory an

organizations: Commensurate dimensions, time per-

spect ves, an mec an sms. Journa o Vocationa Be-

aviour 31, 248-267.

Caplan, R. D., & Harrison, R. V. (1993). Person-envi-

ronment t t eory: Some story, recent eve opments,

and future directions. Journal of Social Issues 49 (4),

253-275.

Caplan, R. D., & Jones, K. W. (1975). Effects of work

oad, role ambiguity, and Type A personality on anxi-

ety, epress on, an eart rate. Journa o App ie Psy-

hology 60 (6), 713-719.

Carver, C. S., & Sc e er, M. F. 1981 . Attention an

se -regu ation: A contro t eory approac to uman

ehavior. New York: Springer-Verlag.

C egg, C., & Wa , T. 1990 . T e re at ons p etweensimplified jobs and mental health: A replication study.

Journa o Occupationa Psyc o ogy 63, 289-296.

Cooper, C. L. (1983). Identifying stressors at work: Re-

cent research developments. Journal of Psychosomatic

Researc 27 5 , 369-376.

Cooper, C. L. (1985). The stress of work: An overview.

Aviation, Space an Environmenta Me icine 56 7 ,

627-632.

Cooper, C. L. 1995 . T e ma or types o psyc o og ca

ys unct on n wor p ace sett ngs. In P. Cotton E . ,

Psychological Health in the Workplace (pp. 87-102).

V ctor a: T e Austra an Psyc o og ca Soc ety.

Cooper, C.L. & Cartwright,S. (1994). Healthy mind,

healthy organisation. Human relations 47 (4), 455-

71.

Cooper, C.L., Liukkonen, P. & Cartwright,S. (1996).

Stress prevention in t e wor p ace. Du n, Ire an :

European Foundation for the Improvement of Living

and Working Conditions.

Cooper, C. L., & Payne, R. L. (1992). International per-

spectives on research into work, well-being, and stress

management. In J. C. Qu c , L. R. Murp y, & J. J. Hur-

re E s. . tress & we - eing at wor : Assessmentsnd interventions for occupational mental health (pp.

348-368 . Was ngton, DC, US: Amer can Psyc o og -

ca Assoc at on.

Costa, P. T., & McCrae, R. R. 1980 . In uence o ex-

trovers on an neurot c sm on su ect ve we - e ng.

Journal of Personality and Social Psychology 38,

668-678.

Cotton, P. (1995). Psychological health in the workplace.

Victoria: Australian Psychological Society.

Cotton, P. & Fisher, B.(1995). Current issues and direc-

tions for the management of workplace psychological

ea t ssues. In P. Cotton E . . 1995 . Psyc o ogicaea t in t e wor p ace. V ctor a: Austra an Psyc o-

ogical Society.

Cottone, R. (1986). Toward a systemic theoretical frame-

wor or vocat ona re a tat on. Journa o App ie

Re a i itation Counse ing , 17 4 , 4-7.

Cottone, R. (1991). Counselor roles according to two

counse ng wor v ews. Journa o Counse ing an

Deve opment 69, 398-401.

Cottone, R. & Emener, W. (1990). The psychomedical

para gm o vocat ona re a tat on. Re a i itationCounse ing Bu etin 34 2 , 91-102.

Cummings, T. G., & Cooper, C. L. (1979). A cybernetic

ramewor or stu y ng occupat ona stress. Human

Re ations 72, 395-418.

Davis, A., & George, J. (1993). States of health: Health

an i ness in Austra ia 2n E t on . Sy ney: Harper

& Row.

Decker, P.J. & Borgen, F. H. (1993). Dimensions of work

appra sa : Stress, stra n, cop ng, o sat s act on, an

negat ve a ect v ty. Journa o Counse ing Psyc o -

ogy 40 (4), 470- 478.

D ener, E., & Emmons, R. A. 1985 . T e n epen ence

o pos t ve an negat ve a ect. Journa o Persona ity

and Social Psychology 47, 1105-1117.

Do ar , M. F. & W ne e , A.H. 1995 . Tra t anx ety,

wor eman , soc a support an psyc o og ca s-

tress in correctional officers. Anxiety, Stress & Coping:

an International Journal 8 (1), 25-35.

Do ar , M.F. & W ne e , A.H. 1996 . Manag ng oc-

cupational stress: A national and international perspec-

tive. International Journal of Stress Management 3

2 , 69-83.

Durkheim, E. (1952). Suicide: A study in sociology. Lon-don: Routledge & Gegan Paul.

Edwards, J.R. (1992). A cybernetic theory of stress, cop-

ing, and well being in organizations. Academy of Man-

agement Review 17 (2), 238-274.

Eysenck, H. J. (1988). Personality, stress and cancer:

Prediction and prophylaxis. British Journal of Medical

Psychology 61, 57-75.

Ferguson, S. (1988). Occupational medicine in Australia:

The past, the present and the future. Journal of Occu-

pational Health and Safety – Australia and New Zea-

an 4, 481-488.

Figlio, K. (1982). How does illness mediate social re-

at ons? Wor men’s compensat on an me co- e-

ga pract ces, 1890-1940. In P. Wr g t & A. Treac er

(Eds.). The problem of medical knowledge, examining

the social construction of medicine. Edinburgh: Edin-

burgh University Press.

French, J. R. P., Caplan, R. D., & Harrison, R. V. (1982).

The mechanisms of job stress and strain. London: Wi-

ley.

Frone, M.R. & McFarlin, D.B. (1989). Chronic occupa-

tional stressors, self-focused attention, and well-being:

Test ng a cy ernet c mo e o stress. Journa o Ap- p ie Psyc o ogy 74 6 , 876-883.

Frone, M.R., Russell, M. & Cooper, M.L. (1991). Rela-


13/15


tionship of work and family stressors to psychologi-

ca stress: t e n epen ent mo erat ng n uence o

social support, mastery, active coping and self focused

attent on. Journal of Social Behaviour and Personal-

ty 6 7 , 227-250.

Fry, P.S. 1995 . Per ect on sm, umour an opt m sm

as moderators of health outcomes and determinants

of coping styles of women executives. Genetic, Socialn Genera Psyc o ogy Monograp s 121 2 , 211-

245.

Fur ong, M., & Young, J. 1996 . Ta ng a out ame.

Australian & New Zealand Journal of Family Therapy.

17 4 , 191-200.

Furnham, A. & Schaeffer, R. (1984). Person-environ-

ment t, o sat s act on an menta ea t . Journa o

Occupational Psychology 57, 295-307.

Go man, E. 1971 . e presentation o se in every ay

ife. Harmondsworth: Penguin.

Goldenberg, I. & Goldenberg, H. (1985). Family thera- y: An overview Brooks/Cole: Monterey,CA.

Habeck, R. (1993). Achieving quality and value in serv-

ce to the workplace. Bulletin of the Australian Society

Re a i itation Counse ors, 4, 15-20.

Ha ey, J. 1964 . Strategies o Psyc ot erapy New Yor :

Grune an Stratton.

Hart, P. M. 1994 . Teac er qua ty o wor e: Integrat-

ng work experiences, psychological distress and mo-

rale. Journal of Occupational and Organization Psy-

o ogy 67, 109-132.

Hart, P. M., Conn, M., Carter, N. L., & Wear ng, A. J.

1993 . Deve opment o t e Sc oo Organisationa

Health Questionnaire: A measure for assessing teacher

ora e an sc oo organisationa c imate Paper pre-

sented at the Annual Conference of the Australian As-

sociation for Research in Education, Fremantle, West-

ern Austra a, Novem er.

Hart, P.M. & Wear ng, A.J. 1993 . Pro ems o insta-

ility and change in quality of life research: Implica-

ions for a longitudinal model of personality, health

n we - eing . Paper presente to t e F rst Con er-

ence of the Australian Association for Social Research,

Launceston, Tasman a, January.

Hart, P.M. & Wearing, A.J. (1995). Occupational stress

an we e ng: A system c approac to researc , po -

cy and practice. In P. Cotton (Ed) (1995). Psychologi-

al health in the workplace. Victoria: Australian Psy-

c o og ca Soc ety.

Hart, P.M., Wear ng, A.J. & Hea ey, B. 1993 . Assess ng

po ce wor exper ences: Deve opment o t e Po ce

Daily Hassles and Uplifts Scales. Journal of Criminal

Justice 21, 553-572.

Hart, P.M., Wearing, A.J. & Headey, B. (1995). Police

stress an we - e ng: Integrat ng persona ty, cop ng

and daily work experiences. Journal of OccupationalOrganisationa Psyc o ogy, 68 2 , 133-156.

Headey, B., & Wearing, A. J. (1992). Understanding hap-

piness: A theory of subjective well-being . Melbourne:

Longman Cheshire.

Ho o , S. E. 1989 . Conservat on o resources: A new

attempt at conceptualising stress. The American Psy-

chologist 44, 513-524.

Ho o 1994 .

Ho man, L. 1981 . Foun ations o ami y t erapy.

USA: Basic Books

Holmes, T.H. & Rahe, R.H. (1967). The social readjust-

ment rat ng sca e. Psyc osomatic Me icine 11, 213-

218.

James, C. R. (1989). Social sequelae of occupational in-

jury an i ness. Unpu s e P D t es s, Gr t Un -

versity, Australia.

Johnstone, R., & Quinlan, M. (1993). The origins, man-

agement an regu at on o occupat ona ness: An

overview. In M. Quinlan (Ed.). Work and health: The

origins, management and regulation of occupational

ness. pp. 3-32 . Me ourne: MacM an E ucat on.

Kahn, R.L., Wolfe D. M.,Quinn, R.P., Snoek, J.D. &

Rosenthal,R.A.(1964). Organizational stress: Studies

n ro e con ict an am iguity. New Yor : W ey.

Karasek, R. A. (1979). Job demands, job decision lati-

tude, and mental strain: Implications for job redesign.

A ministrative Science Quarter y 24, 285-308.

Karasek, R. & Theorell, T. (1990). Healthy work: Stress,

productivity and the reconstruction of working life.

New Yor : Bas c Boo s.

Karase , R. A., Tr ant s, K. P., & C au ry, S. S. 1982 .

Coworker and supervisor support as moderators ofassoc at ons etween tas c aracter st cs an menta

strain. Journal of Occupational and Behavior 3, 181-

200.

Keeney, B.P. 1983 . Aest etics o c ange. New Yo :

Guilford.

Keeney, B. P. (1987). The construction of therapeutic

rea t es. Spec a Issue: Psyc ot erapy w t am es.

Psychotherapy 24 (3S) 469-476.

Kenny, D. T. (1994a). Determinants of time lost from

wor p ace n ury: T e mpact o t e n ury, t e n ure ,

the industry, the intervention and the insurer. Interna-

tiona Journa o Re a i itation Researc , 17 4 333-

342.

Kenny, D. T. (1994b). The relationship between work-

ers’ compensat on an occupat ona re a tat on: An

historical perspective. Journal of Occupational Health

and Safety 10 (2), 157-164.

Kenny, D. T. 1995a . Barr ers to occupat ona re a ta-

t on: An exp oratory stu y o ong-term n ure wor -

ers. Journal of Occupational Health and Safety- Aus-

tra ia an New Zea an 11 3 249-256.

Kenny, D. T. 1995 . Common t emes, erent per-

spectives: A systemic analysis of employer-employeeexper ences o occupat ona re a tat on. Re a i ita-

tion Counseling Bulletin 39 (1) 53-77


14/15


Kenny, D. T. (1995c). Failures in occupational rehabilita-

t on: A case stu y ana ys s. Austra ian Journa o Re-

abilitation Counselling 1(1) 33-45.

Kenny, D. T. 1995 . Case management n occupat on-

a re a tat on: Wou t e rea case manager p ease

stand up? Australian Journal of Rehabilitation Coun-

se ing 1 2 104-117.

Kenny, D. T. (1995e). Stressed organisations and organi-sat ona stressors: A system c ana ys s o wor p ace

n ury. Internationa Journa o Stress Management 2,

207-220.

Kenny, D. T. 1995 . Occupationa re a i itation in New

South Wales. Sydney: The University of Sydney.

Kenny, D. T. 1995g . Barriers to return to wor in New

South Wales: Research findings and theoretical con-

siderations. Proceedings of the National Occupational

Hea t Con erence: Br s ane, Queens an pp.75-78 .

Kenny, D. T. (1996). The roles, functions, and effective-

ness o treat ng Doctors n t e management o occupat ona n ury: Percept ons o ey sta e o ers. T e

Australian Journal of Rehabilitation Counselling 2

2 , 86-98.

Kivimaki, M. & Lindstrom, K. (1995). Effects of private

self-consciousness and control on the occupational

stress-stra n re at ons p. Stress Me icine 11 1 , 7-

16.

K v ma , M., E ova n o, M. & Nor , J. 1996 . E ects

of components of personal need for structure on occu-

pational strain. Journal of Social Psychology, 136 (6),

69-777.

Kobak, R.& Shaver,P. (1987). Strategies for maintaininge t security: A t eoretica ana ysis o continuity an

ange in sty es o socia a aptation. Paper presente

at a conference in honor of John Bowlby’s 80th birth-

ay, Bayswater, Lon on.

Kottage, B.E. (1992). Stress in the workplace. Profes-

sional Safety 37(August), 24-26.

Kulik, C. T., Oldman, G. R., & Hackman, J. R. (1987).

ork design as an approach to person-environment fit.

Journa o Vocationa Be aviour , 31, 278-296.

Landsbergis, P. A., Schnall, P. L., Deitz, D., Friedman,

R., & P c er ng, T. 1992 . T e pattern ng o psyc o-

og ca attr utes an stress y “Jo Stra n” an so-

cial support in a sample of working men. Journal of

Be aviora Me icine 15 4 , 379-405.

Lazarus, R. S. (1987) Individual susceptibility and resist-

ance to psyc o og ca stress. In Ka mo, R., E -Bataw ,

M. A., & Cooper, C.L. E s. Psyc osocia Factors at

Work . World Health Organization, Geneva, 127-133.

Lazarus, R.S. 1995 . Psyc o og ca stress n t e wor -

place. In R. Crandall & P.L.Perrewe (Eds.) Occupa-

ional Stress: A handbook . Taylor and Francis, Phila-

e p a, US. pp 3-14.

Lazarus, R.S. & Folkman, S. (1984). Stress, appraisal,n coping . New Yor : Spr nger.

Levi, L.(1997). A biopsychosocial approach to etiology

and pathogenesis. Acta Physiologica Scandinavica

161 640 , 103-105.

Levi, L. (1990). Occupational stress. Spice of life or kiss

of death? American Psychologist 45 (10), 1142-1145.

Mac ay, C. J., & Cooper, C. L. 1987 . Occupat ona

stress and health: Some current issues. In C. L. Cooper

& I. T. Robertson (Eds.). International review of in-

ustria an organisationa psyc o ogy 1987 pp. 167-199 . C c ester, UK: Jo n W ey an Sons.

Mahony, K. (1996). An argument for using qualitative

met o s to revea t e mu t causa ty o occupat ona

stressors n t e wor o Tr p e 0 party wor ers, n D.

Kenny (Ed.). Proceedings (Edited Abstracts), Interna-

tional Congress on Stress and Health The University

o Sy ney, p29.

Marx, K. (1982). Capital, Volume 1 Middlesex: Pen-

guin.

McRae, R.R. & Costa, P.T. 1994 . T e sta ty o per-

sonality: Observations and evaluations. Current Direc-

tions in Psychological Science, 3 (6), 173-175.

McGrat , J. E. 1976 . Stress an e av or n organ za-

tions. In M. D. Dunnette (Ed.). Handbook of industrial

and organization psychology. Chicago, IL: Rand Mc-

Na y.

McIntyre, D. (1998). The politics and experience of oc-

cupational stressors. Unpublished PhD Dissertation.

Newcast e Un vers ty.

Minuchin, S. (1978). Families and family therapy. Lon-

don, Great Britain: Tavistock Publications Ltd.

Matheny, K.B., Aycock, D.W., Pugh, J.L., Curlette, W.L.,

& Silva Canella, K.A. (1986). Stress coping:A quali-tative and quantitative synthesis with implication for

treatment. Counse ing Psyc o ogist 14, 499-549.

Moos, R. H. (1987). Person-environment congruence in

work, school, and health care settings. Journal of Voca-

tiona Be avior , 31, 231-247.

Murphy, L.R. (1988). Workplace interventions for stress

reduction and prevention. In C.L. Cooper & R. Payne

E s. , Causes, coping an consequences o stress at

work . London, Wiley , (pp 310-309).

Now an , L. 1997 . App cat on o a systems approac

to t e re a tat on assessment o c ents w t an occu-

pational stress-related injury. The Australian Journal

of Rehabilitation Counselling 3 (1), 9-20.

O’Dr sco , M. P., & Cooper, C. L. 1994 . Cop ng w t

work-related stress: A critique of existing measures

and proposal for an alternative methodology. Journal

of Occupational & Organizational Psychology 67 (4),

343-354.

Palazzoli, M., Boscolo, L., Cecchin, G., & Prata, G.

(1986). Paradox and counter paradox Palo Alto, Cali-

orn a: Jason Aronson

Parkes, K.R. (1994). Personality and coping as modera-

tors o wor stress processes: Mo e s, met o s anmeasures. Wor an Stress 8 2 , 110-129.

Peterson, C. L. (1994). Work factors and stress: A criti-


15/15


cal review. International Journal of Health Services

24 3 , 495-519.

Quick, J.C., Joplin, J. R., Nelson, D.L., & Quick, J. D.

1992 . Be av oura responses to anx ety: Se re -

ance, counterdependence, and over dependence. Anxi-

ety, Stress an Coping: an Internationa Journa , 5 1 ,

1-54.

Qu n an, M. 1988 . Psyc o og ca an soc o og ca approaches to the study of occupational illness: A critical

rev ew. T e Austra ian an New Zea an Journa o

Sociology 24 (2), 189-207.

Qu n an, M., & Bo e, P. 1991 . anaging occupationa

ealth and safety in Australia. Melbourne: Macmillan

Austra a.

Reynolds, S. (1997). Psychological well-being at work:

Is prevent on etter t an cure? Journa o Psyc oso-

atic Research, 43 (1), 93-102.

Roun s, J. B., Daw s, R. V., & Lo qu st, L. H. 1987 .

Measurement of person-environment fit and predictiono sat s act on n t e t eory o wor a ustment. Jour-

a o Vocationa Be avior 31, 297-318.

Sc e er, M.F. & Carver, C.S. 1985 . Opt m sm, cop ng

and health: assessment and implications of generalized

outcome expectancies. Health Psychology 4, 219-

247.

Se ye, H. 1975 . T e stress o i e Rev. E . . New Yor :

McGraw H .

S rey, D. 1993 . Wor p ace- ase isa i ity manage-

ent: Challenges and opportunities for joint employer

ehabilitation professional initiatives. Proceedings of

t e Secon Nat ona Re a tat on Con erence pp.27-36). Sydney, Australia: Commonwealth Rehabilita-

t on Serv ce.

Siegall, M. & Cummings, L.L. (1995). Stress and organi-

at ona ro e con ct. Genetic, Socia an Genera Psy-

hology Monographs 121 (1), 65-95.

S uz , C.E. 1985 . A minima map o cy ernetics. Net-

worker, May-June p 26.

Sp e erger, C. D., Re e se, E. C., Re e ser, J. E., &

Vagg, P. R. (1998). Measuring stress in the workplace:

t e Jo Stress. Survey In D. T. Kenny, J. C. Car son,

F. J. McGuigan, & J. L. Sheppard (Eds). Stress andealth: Research and clinical applications. Ry e: Gor-

on Breac Harwoo Aca em c Pu s ers

Sp e erger, C.D. 1997 . Pro essiona manua or t e

Job Stress Survey (JSS). Odessa, FL., Psychological

Assesment Resources, Inc.

Sp e erger, C.D. & Re e ser, E.C. 1994 . T e Jo Stress

Survey: measuring gender differences in occupational

stress. Journal of Social Behaviour and Personality 9

2 , 199-218.

Spector, P.E. & O’Connell, B.J. (1994). The contribu-

tion of personality traits, negative affectivity, locus of

control and Type A to the subsequent reports of jobstressors an o stra ns. Journa o Occupationa an

Organizationa Psyc o ogy, 67 1 , 1-12.

Sutton, R.I. & Kahn, R.L. (1986). Prediction, understand-

ng an contro as ant otes to organ zat ona stress. In

J.W. Lorsc E . , Han oo o organisationa e-

haviour (pp272-285), Englewood Cliffs NJ: Prentice

Hall.

Tate, D. G. 1992 . Factors n uenc ng n ure emp oy-

ees return to wor .. Journa o App ie Re a i itation

Counselling 23 (2), 17-20.

Too ey, J. 1993 . Qua ity o wor ing i e project: A stu y

o occupationa stress in Commonwea t Government

Agencies. Canberra, Australia: Comcare

Too ey, J. 1995 . Manag ng t e stress p enomenon at

wor . In P. Cotton E 1995 Psyc o ogica ea t in

the workplace (pp 51-71). Victoria: Australian Psycho-

logical Society.

Turner, J. & Sp e erger, C. 1991 . Jo stress n man-

agers, pro ess ona s an c er ca wor ers. Wor an

Stress. 5 (3) 165-176

Watson, D., Penne a er, J.W. & Fo ger, R. 1986 . Be-

yon negat ve a ect v ty: measur ng stress an sat s-

faction in the workplace. Journal of Organizational Behaviour Management 8 (2), 141-157.

We , M., & Kar s, J. M. 1985 . Case management in u-

man service practice. California: Jossey-Bass.

We ner, N. 1948 . Cybernetics or control and commu-

nication in t e anima an t e mac ines. New Yor :

Wiley.

Williams, C., & Thorpe, B. (1992). Beyond industrial so-

cio ogy: T e wor o men an women. Sy ney: A en

an Unw n.

Willis, E. (1989). Commentary: RSI as a social process.

Community Hea t Stu ies X 2 , 210-219.

Willis, E. (1994). Illness and Social Relations. Sydney:

Allen & Unwin.

Wr g t, R. 1995 . T e eva uation o espair. T me, 11

September, 62-68.

10 - occupational stress reflections on theory and practice

Documents