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