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ContentsAcknowledgementsHow to use the ToolkitTool matrixIntroductionFurther resources and bibliographyviiiixxixiixviiiCONTENTSSection 1: Understanding stressTool 1: Understanding stress 1Tool 2: Calculating the cost of sickness absence and turnover 11Tool 3: Understanding the legal case for managing stress 17Tool 4: Stress awareness quiz 23Tool 5: Recognising stress in others 31Tool 6: Identifying ‘at-risk’ groups 37Section 2: The business caseTool 7: Preparing the business case 51Section 3: Strategy and policy developmentTool 8: Developing a stress policy 57Tool 9: Marketing and branding 67Section 4: The auditing approachTool 10: Five steps to stress risk assessment 75Tool 11: Effective focus groups 83Tool 12: Action planning 89Section 5: Stress reduction interventions and solutionsTool 13: Stress reduction intervention design 93Tool 14: Guidelines for resilience training and development 99Tool 15: Guidelines for developing stress management training for line managers 103Tool 16: Line manager’s toolkit – a checklist 109Tool 17: The first conversation 113Section 6: Evaluating the effectiveness of stress interventionsTool 18: Evaluating the effectiveness of stress interventions 125viiA free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

INTRODUCTIONIntroduction‘Prevalence estimates indicate that around half a million individuals in Britainbelieved in 2006/07 that they were experiencing work-related stress at a levelthat was making them ill.’ (HSE 2007b)‘Self-reported work-related stress, depression or anxiety accounts for anestimated 13.8 million reported lost working days per year in Britain. Thisrepresents an estimated average of 30.2 working days lost per year peraffected case.’ (HSE 2007b)‘Stress, depression or anxiety is one of the largest contributors to the overallestimated annual days lost from work-related ill-health.’ (HSE 2007b)‘In 2005/06 higher rates of work-related stress, depression or anxietyprevalence and incidence were identified in the industry sections: publicadministration and defence, education, health and social work and financialintermediation.’ (HSE 2006b)These powerful statistics illustrate that stress is a serious problem in today’s workplaces.They also show that it is by no means just an individual health issue – workplace stressalso has important consequences for organisations and the wider UK economy alike.The good news is that stress doesn’t have to be a fact of working life. Through proactivestress management, individuals and organisations can together tackle stress and realisethe benefits, both in terms of individual health and on the bottom line.This Toolkit can be used to help to change your organisation, and to train and tosupport your managers. It contains sample stress management policies that youcan adapt for your own use, advice and a full PowerPoint presentation for makingthe business case for stress management, activities to use when training managersin preventing and dealing with stress (whether in bite-sized sessions or full trainingdays) and practical checklists and handouts that you can disseminate throughout yourorganisation.xiiA free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

What is proactive workplace stress management?Proactive stress management is essentially about the ongoing measurement andmonitoring of stress within organisations, with a view to identifying and then targetingresources at problem areas.Steps to proactive organisational stress managementINTRODUCTIONOrganisational stress management can be thought of as a series of steps:Step 1 is about understanding what stress is, specifically in the context of your organisationor industry, and why your organisation needs to prevent or reduce it (Tools2–6).Step 2 is about developing a business case for stress management within your organisationto secure buy-in and commitment from all key stakeholders who are going to beinvolved in the process (Tool 7).Step 3 is about developing and implementing a comprehensive stress policy, alongwith related procedures and guidelines that will underpin your approach to stressmanagement, and also the importance of creating the right brand with the work thatyou do in this area (Tools 8–9).Step 4 is about establishing an approach to risk assessment and identifying specificareas of the organisation that are likely to be affected by stress and what the particularissues perceived by these groups are (Tools 10–12).Step 5 is about implementing appropriate stress prevention and reduction interventionsand solutions, including training – targeted where they are most needed (Tools13–17).Step 6 is about measuring and evaluating the effectiveness of the interventions put inplace (Tool 18).Step 1: Understanding stressBefore implementing any stress management approach, it is important that thoseresponsible for the area understand the basics. This includes gaining an understandingof what work-related stress actually is, recognising where it can come from, how it canxiiiA free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

INTRODUCTIONmanifest itself in individuals and what the associated impact and costs are likely to be. Asan aid to developing this understanding a full set of presentation slides with explanatorynotes is included at the end of this Introduction to the Toolkit (Tool 1). This can be usedto run a short stress awareness session in your organisation.Step 2: The business caseThe second important milestone in organisational stress management is securingstakeholder buy-in. The success of any stress management approach relies heavily onthe commitment of all those involved, particularly senior management. It is importantthat they are engaged as early as possible since their commitment to the process andto acting on the results of any stress survey or audit will be critical. Unfortunately, itwill not always be an easy task to persuade key decision-makers and budget-holders toinvest the necessary resource required to deal with stress issues – demonstrating thepotential value of the investment will be important here. One critical part of convincingthe key stakeholders is to use the growing body of research evidence, showing thatinvestments in the health and psychological well-being of staff do result in bottom-linebenefits. Tool 7 provides help in producing such a business case.Step 3: Strategy and policy developmentOnce commitment has been secured to investing in and addressing work-related stress,the next step is to develop a stress policy, along with related procedures and guidelines,to bring it to life in the organisation. It is important to do this within a context that willfit with the organisation’s strategy. The stress policy should clearly set out the way theorganisation will deal with stress. Stress policies come in all shapes and sizes and someorganisations find that incorporating their approach to tackling stress into other policiesworks well for them. The policy should not be excessively long, two to three pages isenough to be both succinct and explicit. The most important thing of all is to ensurethat the policy is widely distributed and communicated to all staff, and to ensure thatmanagers, in particular, have a full understanding of their role and their obligations inexecuting the policy. Without this, it will just remain a piece of paper that is referredto from time to time, without any real meaning in the organisation. Tool 8 provides astep-by-step guide for developing a stress policy.In developing the policy position for the organisation on stress, there is also an opportunityto create a strong internal brand for the work that is envisaged in the area. Thishas many benefits and it is clear that organisations that successfully control and managestress in the long term create strong positive brand identities for the work they do. ToolxivA free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

9 provides clear guidance on creating a strong brand and marketing the work doneinternally in this area.Step 4: The auditing approachOnce the senior team is on board and a stress policy has been produced, the nextstep is to audit stress levels across the organisation. Auditing is an essential part ofmanaging workplace stress, and is a core element of risk assessment. To target effortand resources where they are most needed, it is crucial to identify who is likely to beaffected by stress within the organisation and what the specific risks are. The best wayto achieve this is to ask individuals about their perceptions using a validated and reliablestress surveying tool. Tool 10 sets out the auditing approach within the context of thefive steps to risk assessment advocated by the Health and Safety Executive (HSE) intheir Management Standards. Tool 11 is a suggested focus group approach that fits withthe HSE process. Tool 12 is an aid to action planning.INTRODUCTIONStep 5: Stress reduction interventions and solutionsWhen your organisation has an understanding of what the main stress-related issuesare, it is then time to take action and target interventions where they are needed.There are three levels of intervention when it comes to dealing with workplace stressand the best organisations work at all three levels: Primary interventions: aimed at eliminating or modifying environmental stressorsto reduce their negative impact on individuals, for example job redesign, culturechange, flexible working, work–life balance initiatives. Secondary interventions: focus on increasing the awareness, resilience and copingskills of the individual, for example, stress management training, health promotionactivities and skills training more generally (without trying to eliminate or modify thestressors). Tertiary interventions: concerned with the treatment and rehabilitation of distressedindividuals, for example counselling, employee assistance programmes (EAPs) andreturn-to-work policies.Primary interventionsPrimary-level intervention can be an ambitious task. Interventions take a long time toorganise and can be expensive both in terms of resource requirements and people’sxvA free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

The role of the line managerThe line manager’s role is pivotal in organisational stress management. The line managerhas a responsibility to spot the signs and symptoms of stress, to intervene and take thenecessary preventative action before the individual becomes absent from work – andto manage in a way that reduces the likelihood of stress occurring in the first place. Tool15 provides guidelines for training line managers in this area. There is also a need toensure that line managers can access the information they need to manage effectivelyin this area in a user-friendly manner; this is covered by Tool 16.INTRODUCTIONStep 6: Evaluating the effectiveness of stress interventionsThe best way to measure the effectiveness of the interventions that you have implementedis to re-audit and examine any hard data you collect as an organisation, forexample absence data, performance figures. If commitment levels were sustainedthroughout the process and appropriate interventions were genuinely put in place,you can expect to see an improvement in your audit results from the first audit. It isimportant to leave enough time between the two audits for the interventions to takeeffect.Whether a re-audit is feasible or not, stress interventions should be evaluated in nearlyall cases. Tool 18 provides comprehensive guidance on evaluating stress interventions.This Toolkit is primarily aimed at SME businesses but is also likely to be useful forlarger organisations. Smaller businesses and organisations will not need to develop oradopt processes and practices that realistically can only be successfully implementedin larger organisations. However, they should use the Toolkit as an aid to ensuringthey do as much as they can to develop a successful proactive stress managementapproach, within their resource constraints.xviiA free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

UNDERSTANDING STRESSThe term ‘stress’ can actually be quite unhelpful as there are so many interpretationsof it – what lies at the heart of this is the negative reaction that individuals experiencewhen the pressure they are under exceeds their coping abilities.Slide 4 – What is pressure?It is critically important to distinguish stress from pressure. The two terms are relatedand often used interchangeably, but are very different concepts.Pressure is: faced with a difficult or challenging situation, we experience some tension orarousal us the motivation and drive that we need to perform, to overcome challengingsituations and achieve objectives. For example, athletes often report thatthey do better when they are competing because they are under pressure toperform pressure can lead to stress if it exceeds coping capacity and this will invariably impacton performance and cause a variety of short- and long-term illnesses with damagingeffects on psychological and physical well-being.Slide 5 – Pressure and performanceThis inverted ‘U’-shaped diagram (based on the Yerkes-Dodson curve) shows therelationship between pressure and performance. It also further reinforces the differencebetween pressure and stress.The diagram indicates that:1 there is a certain amount of pressure that is motivating but has not reached a levelthat threatens coping capacity and are not likely to feel motivated to perform or be inclined to strive towards ourgoals. This is referred to as being in the ‘rust-out’ zone2A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

which there is enough pressure to focus our attention, but not so much that we’reoverstretched and it disrupts our performance, can be called the ‘well-being’ zone cope, we experience stress and ‘burn-out’.A one-off experience of stress is unlikely to cause major problems for us and we willprobably recover perfectly well from it – it’s when the stress is prolonged and severethat the impact on our health and well-being is likely to be felt. This is when stressbecomes a problem at all levels.FACILITATOR’S NOTESSlide 6 – Recognising the signs of stressStress can manifest itself in a number of different reactions and symptoms. These canbe categorised into the following four main areas: These reactions, or symptoms, will not appear all in one go and will vary extensivelyfrom person to person. Usually it will be the behavioural and the emotional symptomsthat will be the first signs to show. Symptoms may occur directly as a result of exposureto a specific stressful event, such as an argument with a colleague, or may be due to anaccumulation of pressures over time. Sometimes the stress response may be evident ina very obvious and dramatic reaction or it might be in the form of more subtle behaviouralchanges over time. The important signs to look out for in others are changes inbehaviour and emotions that are uncharacteristic for that individual.Slide 7 – Effects of stressOn the individualThere has been much research conducted into the effects of stress on individual health.Some of the findings remain open to ongoing academic debate, but the range of illnessesfor which stress has been identified as a contributory factor range from the minor (forexample colds and headaches) through to the life-threatening (coronary heart disease31A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

UNDERSTANDING STRESSand cancer). In the latter category the strongest evidence relates to coronary heartdisease (CHD) (Tennant 1999; Rosengren et al 2006).Stress can also impact detrimentally on the progression of a disease and can impair ourdecision-making in terms of how we respond to illnesses and the treatment we seek.On the organisationResearch has also found that stress can result in adverse corporate outcomes, such as: In addition to the direct costs of stress on the organisation, there is also a risk ofdamaging the image and reputation of the organisation. If news of litigation andturnover problems gets into the public arena, this may well deter potential employeesfrom applying for jobs with the organisation.Slide 8 – Causes of stressOutside of workStress clearly does not confine itself just to the workplace. The stress caused by majorevents outside of work – such as bereavement, divorce, changes in financial status –can often have an adverse impact on work performance. It’s unrealistic to think thatindividuals can keep their home problems away from the workplace and vice versa – ifan individual is stressed by non-work-related issues, but this affects their behaviour andperformance at work, then it very quickly becomes an issue for the organisation.In the workplaceStress can stem from a variety of sources in the workplace. Two frameworks whichcapture the different sources of workplace stress are the ASSET model (Cartwrightand Cooper 2002) and the Management Standards for Work-related Stress (HSE2004); both are based on widely accepted models of stress.14A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

Slide 9 – Exercise: recognising stress in others (Tool 5)Once individuals have completed their response sheets separately, bring everyonetogether for a group discussion and to share their answers.Slide 10 – Exercise: stress awareness quiz (Tool 4)End the session with the stress awareness quiz to help consolidate the learningacquired.FACILITATOR’S NOTES51A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

UNDERSTANDING STRESSUnderstanding stressThe ToolObjectives organisation 1Definitions of stress2‘The word stress, like success, failure, or happiness, means different thingsto different people and no one has really tried to define it, although it hasbecome part of our daily vocabulary.’ Hans Seyle‘The adverse reaction people have to excessive pressure or other types ofdemand placed on them’Health and Safety Executive (HSE)‘Work-related stress is the response people may have when presented withwork demands and pressures that are not matched to their knowledge andabilities and which challenge their ability to cope’World Health Organisation‘When perceived pressure exceeds your perceived ability to cope’Robertson Cooper Ltd1This document can be downloaded from www.cipd.co.uk/tsm© CIPD. Please use or adapt this document in line with our terms of use www.cipd.co.uk/Bookstore/onlineresources/termsofuse6A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

In the eye of the beholder– The stress reaction of an individual will depend on how they perceive thesignificance of a harmful, threatening or challenging event and whetherthey perceive that they have the resources to cope with it.3TOOL 1What is pressure?4Pressure is:Pressure is:Pressure is:what most people mean when they say they are stressed.positive – often called ‘eustress’, or positive stress, because itgives us the motivation and drive to perform.therefore necessary and desirable up to a certain level. However,extreme and prolonged pressure can lead to stress if it exceedscoping capacity.Pressure and performance5Lack ofengagementWell-beingStressPerformanceRust-outBurn-outPressureThis document can be downloaded from www.cipd.co.uk/tsm© CIPD. Please use or adapt this document in line with our terms of use www.cipd.co.uk/Bookstore/onlineresources/termsofuse71A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

UNDERSTANDING STRESS Physiological:Recognising the signs of stress– the body’s reaction to stress, for example headaches, indigestion, fatigue Emotional:– emotional reactions, for example irritability, impatience, depression,tearfulness6 Mental/thinking:– poor concentration, memory lapses, difficulty making decisions Behavioural:– not behaving characteristically of one’s self, for example, increased smokingor drinking, restlessness, appetite changesScientific evidence7 – for example, physical and psychological illness – for example, high sickness absence, high staff turnover1This document can be downloaded from www.cipd.co.uk/tsm© CIPD. Please use or adapt this document in line with our terms of use www.cipd.co.uk/Bookstore/onlineresources/termsofuse8A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore

Causes of stress8TOOL 1– for example, bereavement,divorce, changes in financialstatus The ASSET ModelWork relationshipsWork-life balanceOverloadJob securityControlResources and communicationAspects of the jobThe Management Standards forWork-related StressRelationshipsDemandsControlRoleSupportChangeExercise: Recognising stress in others9 – Read the case study that you have been given and then answer thequestions posed on the response sheet.Quiz time10This document can be downloaded from www.cipd.co.uk/tsm© CIPD. Please use or adapt this document in line with our terms of use www.cipd.co.uk/Bookstore/onlineresources/termsofuse91A free sample chapter from Stress by Robertson Cooper. Published by the CIPD. © 2008 CIPD.All rights reserved; no part of this excerpt may be reproduced, stored in a retrieval system, or transmitted in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior writtenpermission of the publishers or a licence permitting restricted copying in the United Kingdom issued by theCopyright Licensing Agency.If you would like to purchase this product please go to www.cipd.co.uk/bookstore