Chapter 6 Work Related Stress.docx

Overview of Work-Related Stress and Recovery Work-related stress (and associated recovery) collectively represent the largest area of research within the Occupational Health Psychology (OHP) domain (Bennett et al., 2018; Houdmont et al., 2008; Sonnentag & Frese, 2012). This makes sense, given th...

Overview of Work-Related Stress and Recovery Work-related stress (and associated recovery) collectively represent the largest area of research within the Occupational Health Psychology (OHP) domain (Bennett et al., 2018; Houdmont et al., 2008; Sonnentag & Frese, 2012). This makes sense, given that the theories, models, frameworks, and methods used in work-related stress and recovery research also are used to explain and address most other WHSWB phenomena. Our goal in this orienting chapter is to present an overview of work-related stress and recovery that supports our more focused discussion of specific work-related stressors, demands, and resources in Chapters 7 through 10. Essential Concepts and Terminology Stress is studied in a variety of professional disciplines including engineering, medicine, and psychology. Across these domains, stress is generally considered as a force that operates on an object or, in the OHP domain, a worker or group of workers. Several essential concepts and terms need to be understood to facilitate clear communication about these matters. Most of these key stress and recovery terms and concepts emerged from early thinking about stress as a stimulus and response phenomenon, as outlined in the general OHP framework we introduced in Chapter 2. Stressors, Demands, and Resources Stressors are the stimuli that workers sense, perceive, and appraise, and which ultimately trigger some sort of response. These stimuli are often assumed to be external to the person (e.g., workload, interpersonal conflict, environmental exposures), but they can also be internal (e.g., self-doubt). These various forms of stressors can also be seen as different types of demands, as we discuss in the following chapters. When we are exposed to demands, we experience a state of discrepancy in which our perceived or actual reality does not match our desired homeostatic reality. We respond to address these discrepancies with some form of adaptation or action. By definition, demands are “the requirement of work or of the expenditure of a resource” (Merriam-Webster, n.d.a). This mirrors the way OHP professionals commonly conceptualize work experiences, as requiring constant juggling or balancing of work-related demands and the resources (i.e., a source of supply or support; an ability to meet and handle a situation; Merriam-Webster, n.d.b) needed to meet those demands. Use of these terms also illustrates why efforts to somehow vanquish the “enemy” of work-related stressors are often misguided. Work-related demands are intimately linked to worker motivation (e.g., LePine et al., 2004; Lucas et al., 2004), so a more rational objective is to work toward minimizing workers’ risks of chronic demand overload, and maximizing workers’ access to necessary resources. Nearly any work environment characteristic or experience can impose a demand on a worker if exposure to it (or the absence of it) requires the worker to adaptively respond. Even the absence of normally helpful work-related resources (e.g., support) can function as demands. When focusing on work-related stress, OHP professionals tend to target a variety of defined and measurable (i.e., operationalized) demand constructs. A relatively simple classification of such demands is summarized in Table 6.1; we discuss these forms of demands and associated resources in subsequent chapters. Note that many of the example stressors or demands listed in this table can take a variety of forms (e.g., be both psychological and physical/environmental in form); we have attempted to summarize them here as they are predominantly studied and addressed by OHP professionals. Stress Stress is the general psychological and physiological arousal experienced in response to one or more demands. If the subsequent cognitive, emotional, and behavioral response it triggers successfully addresses, reduces, or removes the demand, then this stress experience decreases in intensity. Although similar, stress and anxiety (discussed more in Chapter 4) are not identical phenomena. Stress is often a response to a particular demand or threat, while anxiety tends to be a more persistent reaction to a stress experience. Both conditions can include rumination (i.e., ongoing cognitive and emotional processing) and chronic stress experiences can make this worse (e.g., Michl et al., 2013). While many OHP professionals are engaged in helping workers with issues of work-related stress experiences, persistent difficulties with anxiety are more commonly addressed by clinically trained psychological and mental health professionals. Stress affects workers physiologically and psychologically, and not always in negative ways. The physiological arousal associated with stress can energize and arouse our senses and ability to process information. Stress can also motivate us at a psychological and behavioral level, functioning a little bit like a natural stimulant. Going a bit deeper, stress experiences trigger the activation of the body’s autonomic nervous system. This includes activating the sympathetic nervous system, which is responsible for arousing our body systems to prepare for action (e.g., increasing heart rate, focusing our attention, increasing blood pressure; Nixon et al., 2011; Sapolsky, 1998). This can be adaptive when facing legitimate physical threats (e.g., if you are in a fight, you want to turn your attention toward the greatest threat), but most work-related stressors do not present clear-cut threats to our survival and the associated response can be more damaging than adaptive. This is especially true for the psychological and social stressors that we need to perceive and appraise before they become an arousing stimulus (e.g., a harsh email, last-minute report request from your manager). When a stress experience is passing, the parasympathetic nervous system typically activates, allowing us to begin the process of calming and recovery (e.g., Tugade & Fredrickson, 2004). Over time, there is evidence that exposure to work-related demands can impair the body’s ability to adaptively respond, as shown by reduced vagal nerve control of the heart, which has been linked to increased risk of disease and general poor health (e.g., Jarczok et al., 2013). A couple of widely researched theories help to illustrate common scenarios in which workers are likely to experience stress. We review a few of those theories here and explore additional theories that more clearly incorporate the role of resources later. First, the effort-reward imbalance theory is often used to help explain work-related scenarios in which workers are likely to experience a stress reaction due to a perceived imbalance or discrepancy between the level of effort they are putting into their work and the level, form, and/or value of the reward they are getting in return (e.g., Siegrist, 2002). In a work context, perceived effort is linked to imposed work-related demands, while perceived reward (or lack thereof) can be seen as an indication of how meeting that demand will result in resource gain (or loss). Second, it can also be helpful to conceptualize work-related stress as arising when workers perceive a mismatch or poor “fit” between who they are and what they can do, and what a particular work situation requires. This can happen when workers are not properly screened, developed, or supported so they can actually meet their work-related demands. This concept of person-environment fit (in a variety of forms) has a long history of study in the fields of industrial and organizational psychology and OHP (Edwards, 2008; Hoffman & Woehr, 2006; Kristof-Brown et al., 2005). Poor person-environment fit at work imposes major demands on workers because every time they are in that environment, it feels wrong and difficult, no matter what resources they may leverage. In contrast, when workers fit their environments well, there is a real opportunity for work to be resource replenishing instead of only resource depleting. Strain When our response to stress experiences is ineffective or depletes us of resources, we may experience strain. Strain can take many forms (e.g., cognitive, emotional, physical, behavioral) and can range in severity from not so bad (e.g., headache, light fatigue) to very serious (e.g., burnout, depression). As noted earlier, stress-related arousal can be adaptive, but it also is associated with a variety of other less-positive consequences. At a cognitive level, stress tends to focus us on the source of the stressors (even if we do not really know the exact source). Such stress-induced attentional narrowing may limit worker ability to think broadly (Prinet & Sarter, 2016; Wichary et al., 2016). This can be beneficial in certain types of high-vigilance work situations (e.g., air traffic controllers, emergency dispatchers), but detrimental to performance in occupations that require creativity and innovation, holistic thinking, and open-mindedness. Emotionally, workers dealing with stress are less likely to regulate and respond well emotionally (Raio et al., 2013). In addition, severe strain consequences such as burnout have been significantly linked with reduced empathy for others (Wilkinson et al., 2017). Behaviorally, work-related stress is linked to basically all the “bad” and problematic behaviors that are generally not good for work or WHSWB (e.g., withdrawal, presenteeism, absenteeism, poor nutritional choices, chronic pain, and drug use). Work-related stress is not the only cause of these behaviors, but this linkage is important not to ignore because all of these types of behaviors tend to lead to additional demands and reduced resources, potentially exacerbating or perpetuating workers’ stress experiences (e.g., Allen & Armstrong, 2006; Clark et al., 2011; Clarke, 2012). Behavioral reactions to stress are especially problematic because they tend to build on each other (e.g., regularly going out for drinks after a hard day of work can turn into a socially supported addiction). We discussed earlier that stress triggers physiological and biological responses that can be adaptive to some extent, but harmful when over-activated (e.g., Sapolsky, 1998). Some of these nuances are further explained in the allostatic load model (Juster et al., 2010; McEwen, 1998), which describes how our stress responses can impose a damaging load on our body’s systems. Our immediate or primary responses to stressors (e.g., elevated heart rate, cortisol release) can result in lasting secondary responses or health effects (e.g., high blood pressure) and tertiary responses or disease endpoints if stress experiences occur too frequently or for extended periods of time. Research demonstrates linkages between work-related stressors or demands and these types of stress responses (Ganster & Rosen, 2013), including health complaints like headaches, gastrointestinal problems, and sleep disturbances (Nixon et al., 2011). There is also evidence of rather immediate connections between daily stressors and emotional and physiological responses (Ilies et al., 2016), as well as strong evidence that the effects of chronic stressors on health seem to accumulate over time (Ford et al., 2014). Chronic stress experiences is also linked to changes in our brains (Lucas et al., 2004; McEwen, 2000) and even cells, predisposing our bodies to react more quickly and more strongly to future stressors (e.g., McVicar et al., 2014). Understanding even the basic physiology and biology associated with stress is essential to appreciating the close connection between work-related stress and recovery. As you are hopefully seeing by now, responding to strains reactively is potentially more difficult than trying to proactively optimize workers’ demand and resource situation to minimize chronic stress reactions. Extending the Stress Process to Include Recovery From an OHP perspective, recovery is the process by which we can prevent strain by replenishing resources that we deplete when responding to demands. In this way, recovery can offset effects of work-related stress experiences and help workers to stay engaged, be proactive, and generally perform better at work (Sonnentag, 2003). Work-related stress and recovery are fascinating phenomena in and of themselves, but there is greater power and utility for OHP professionals when we recognize that both phenomena can be seen as components to a single, ongoing cycle (represented in Figure 6.1; e.g., van Hooff et al., 2011). This perspective helps us understand workers’ continual challenge of managing work-related demands and resources, and can facilitate the development of helpful strategies and interventions to make this more possible. As already noted, because many effects of stress are cumulative (e.g., Godin et al., 2005) and do not dissolve or disappear quickly, workers’ abilities to respond adaptively and effectively to today’s demands are influenced by how (un)successful they were at responding to preceding demands. A practical implication is that understanding workers’ perceived demands and resource levels can improve our ability to better direct and management worker effort, while also protecting WHSWB. It is so important to understand recovery as much as we understand stress because workers typically have more control over themselves, their lifestyle choices, their routines, etc. than they do over their work-related demands. Given this reality, workers are almost guaranteed to experience stress at work and ultimate strain, unless they are regularly engaging in recovery. The dominant theories supporting stress and recovery research and practice all implicitly recognize that recovery takes time (Fritz & Ellis, 2015) and needs to happen, else the effects of stress build to unsustainable levels and longer-term consequences. These theories also emphasize that resources as essential to workers’ abilities to function. For example, the effort-recovery model (Meijman & Mulder, 1998) emphasizes a need to disconnect from or otherwise stop exerting effort in response to work-related demands to replenish spent resources when a period of resource expenditure has ended. Within this model, the main sources of demands are linked to work assignments and environmental factors, including one’s social relationships. A related perspective is emphasized in the stressor-detachment model (Sonnentag, Kuttler, et al., 2010), which highlights how workers’ reactions to stress (i.e., “strain reactions”) often persist even after a worker’s exposure to a demand is minimized. Because of this, these strain reactions can persist and even build on each other over time, impacting worker physical and psychological health unless there is physical and psychological detachment from work (Sonnentag & Fritz, 2015). The goal for most interventions in this area becomes teaching workers how to recover as well as possible. This seems like a simple thing to do, but it is not because workers differ in terms of their demands and corresponding resource needs. Much remains to be learned about how workers can optimally recover depleted resources. A general principle is that not all recovery activities are equally valuable. For example, active forms of recovery (i.e., requiring some level of resource investment) may do a better job of replenishing resources than passive forms of recovery (Rook & Zijlstra, 2006; Sonnentag & Jelden, 2009). A more commonly applied perspective on recovery suggests that there are four general elements to activities that contribute to resource replenishment (Sonnentag & Fritz, 2007). Psychological detachment involves distancing oneself and disconnecting from work-related demands (Sonnentag, Binnewies, et al., 2010; Sonnentag & Fritz, 2015). In-line with the Stressor-Detachment model, psychological detachment may help workers recover from negative effects of high work-related demands and generally be good for worker well-being (Sonnentag & Bayer, 2005; Sonnentag, Binnewies, et al., 2010). Lack of detachment (or inability to detach) also seems to be particularly detrimental to overall well-being (Sonnentag & Fritz, 2007). Mastery experiences are a second element to recovery that can facilitate detachment from work, as these experiences are generally linked with activities that require intensive focus, challenge, and learning (e.g., engaging in competitive sport, learning a new language, accomplishing a personal nonwork goal; Sonnentag & Fritz, 2007). Mastery experiences facilitate development of new competencies, self-efficacy, and other resources (Bandura, 1997; Hobfoll & Lilly, 1993; Sonnentag & Fritz, 2007). Both mastery and detachment experiences do not happen on their own; workers typically have to invest some resources to make these experiences possible – this is a main reason for a major paradox associated with recovery: Those who need recovery most often are least able to optimally achieve it. Control is a third main element to recovery of resources and involves workers having the ability to exercise some degree of choice over what they do and when they do it (Sonnentag & Fritz, 2007). The positive psychological effects of control are well-understood in general (Skinner, 1996) and within work environments (e.g., Melamed et al., 1991; Schat & Kelloway, 2000). Finally, the fourth main element to recovery is relaxation, which is generally seen as an experience made possible by engaging in a recovery activity that the individual controls to some degree and in which there are minimal demands of any kind imposed upon them (Sonnentag & Fritz, 2007; Tinsley & Eldredge, 1995). Relaxation is important to recovery, because it seems to boost positive affect and reduce the effects of negative emotions that may be tied to work-related stress experiences (Fredrickson et al., 2000). In terms of the effort-recovery model noted earlier, relaxation is essential to facilitating workers’ return to their pre-stress homeostasis state. As our knowledge about work-related stress and recovery continues to develop, it is also important to challenge and expand the way we think about resource replenishing (i.e., recovery) experiences. To illustrate, consider the essential recovery element of detachment. Although we typically think of detachment as the result of a decision to separate from work, it can also be facilitated by purposeful and strategic exposure to restorative environments or stimuli. In particular, exposure to nature has been shown to be impactful (Bowler et al., 2010; Gritzka et al., 2020). Attention restoration theory (Berto, 2014; Kaplan, 1995) helps explain how and why this is true, expanding on early ideas from James (1892) regarding the concept of involuntary attention, which occurs when we experience moments of fascination or awe (e.g., surrounded by nature, standing in a cathedral). In these moments, no matter how resource-depleted we may be, we automatically find ourselves focusing on where and how we are. This form of attention does not require the expenditure of additional attentional resources and could be as simple as looking at images of something beautiful or taking a walk in a park. These moments can inspire and help us to detach, find calm, and restore depleted resources. Imagine what could happen if we all experienced more daily moments of fascination? Understanding Demands and Resources in the Work Environment Many theoretical perspectives guide OHP research and practice pertaining to work-related stress and recovery. These perspectives generally emphasize the importance of alignment between the demands imposed upon workers and the resources that are available to meet these demands. Various contextual and personal factors are also considered in many of the most dominant stress and recovery theories, which we summarize in this section. Regulating Demand and Resource Alignment Responding to demands requires workers to leverage their available resources. This makes understanding the concept of a balanced demand-resource relationship essential to protecting and improving WHSWB. As workers deplete their available resources, they become less able to respond effectively to future demands and they develop a need for recovery (e.g., Sonnentag, Kuttler, et al., 2010). When such needs are not met, there can be negative effects on worker behavior and well-being (Sonnentag, 2001; Sonnentag & Fritz, 2015). It is easy to feel daunted by the complex and person-specific nature of stress and recovery. We often find it helpful in our own research and practice efforts to approach stress and recovery challenges from a resource alignment perspective (represented in Figure 6.2). Focusing on specific work demands makes it possible to help workers and organizations identify and obtain specific and corresponding resources that are needed to meet those demands. Work-related resources can take a variety of forms. One resource framework that corresponds well with most dominant theories in this domain, positions resources in terms of their source (personal or contextual) and longevity (short-term or long-lasting; Hobfoll, 2002; Ten Brummelhuis & Bakker, 2012). Personal resources (e.g., cognitive abilities, energy, traits) emanate from and are maintained within the person, while contextual resources (e.g., financial stability, social support, adequate shelter) are influenced by external factors. In terms of longevity, short-term or volatile resources (e.g., time, energy, attention) are easily and quickly used up or depleted and cannot be directly replenished. In contrast, longer-lasting or structural resources (e.g., shelter, social connections, technology) are more stable and can be replenished and used again (Ten Brummelhuis & Bakker, 2012). There is likely no single optimal blend of specific resources or even types of resources that ensure resilience for all workers. Instead, workers need access to a broad foundational set of psychological, social, and material resources to respond effectively to day-to-day work and nonwork demands. This assertion is clarified and developed further by several major theories in this domain, which we discuss in the following subsections. Job Demands and Control A simple, yet powerful perspective on demands and resources comes from Karasek’s (1979) job demands and control (D-C) model (see also Wall et al., 1996). In our own work, the core concepts of this model have repeatedly provided a framework and structure that makes sense even to individuals who have no background or interest in applied psychology. The main D-C model focuses attention on the relatively easy-to-understand factors of how workers perceive and experience (a) work-related demands and (b) control or latitude to decide how they will address those demands. According to this model, workers are better able to handle demands when they have at least some degree of control over how they can meet those demands. In contrast, workers struggle in situations characterized by high work demands and low control. Research involving this D-C model has identified factors that condition or moderate the relationship between work demands and the resource of control. The two most notable conditioning factors are presence of needed social support (e.g., Brough et al., 2018; Van Yperen & Hagedoorn, 2003) and the extent to which workers believe they are capable of doing what is necessary to meet demands (e.g., self-efficacy; Salanova et al., 2002; Schaubroeck & Merritt, 1997). These and potentially other conditioning factors can help to explain why more control and fewer demands is not always the optimal blend for all workers in all work contexts. Setting the stage for the next two theories we discuss, workers who are generally more resource rich may be able to maintain a stronger sense of control even in high demand situations than workers who are resource poor. Conservation of Resources Theory The conservation of resources (COR) theory (Hobfoll, 1989) provides a broadly applicable set of tenets and corollaries that help us understand how people experience stress as a function of real or impending resource loss, as well as how recovery occurs through replenishing depleted resources. Within this theory, resources can take many forms, including objects, personal characteristics, conditions, and energies (Hobfoll, 1989). The underlying logic of COR is closely aligned with Lazarus and Folkman’s (1984) definition of stress as a psychological and physiological reaction to the overtaxing of one’s available resources and with many other resource-related models that have been posited and tested over the years (see Hobfoll, 2002 for a summary). The utility of COR theory is not limited to work environments, making it very popular with OHP professionals working to understand and address domain spanning WHSWB issues involving stress and recovery. COR can also help to explain individual differences in resource availability and resource-related resilience, through the concept of resource caravans (i.e., the notion that resources build on and exist with each other). An implication here is that those who have more will generally continue to have more, while those who have less, will continue to have less (Hobfoll, 2002, 2011). As an example, when we secure a good job that provides sufficient income, this often also engenders a sense of confidence and positive emotions. In contrast, losing employment tends to trigger multiple negative consequences (i.e., loss spirals in COR) linked to your inability to meet financial obligations, a loss of personal confidence, and difficulty maintaining positive emotions. Job Demands and Resources Theory The job demands and resources (JD-R) theory (Bakker & Demerouti, 2007) has many elements that are similar to COR, but its specific focus is the work domain. The JD-R theory highlights, very importantly, that worker ability to manage demands comes from resources that are not just person-specific, but also job-specific (e.g., support, time, technology, materials, healthy environment). Both JD-R and COR illustrate how such resources can neither come only from within the worker, nor solely from the organization. The JD-R model has been effectively leveraged to help explain how and when workers experience positive states, like motivation and engagement, and negative outcomes, such as worker burnout (Bakker, 2015; Bakker & Demerouti, 2017; Bakker et al., 2014; Lesener et al., 2018). JD-R theory also has relevance to work-related stress and recovery (e.g., Sonnentag et al., 2012; Tadić et al., 2015). COR and JD-R theory clearly emphasize that protecting WHSWB requires ensuring workers have the resources they need to meet their work-related demands. The Importance of Appraisals and Context If you have completed an introductory psychology course, you probably learned that most stimuli only take on meaning when they are perceived and cognitively appraised or evaluated. This is a dominant psychological perspective on how the work stress process operates (Harris & Daniels, 2007; Kinman & Jones, 2007). One of the earliest and most widely cited general stress-related theories along these lines is the transactional theory of Lazarus and colleagues (Folkman et al., 1986; Lazarus & Folkman, 1984). This theory outlines a process by which exposure to stimuli may lead to a stress response through a two-step appraisal process, through which we perceive a stressor and first evaluate the extent to which we are threatened (i.e., primary appraisal), and then second evaluate and determine what we can do in response (i.e., secondary appraisal). Applying this framework, a work demand is stressful when we see it as threatening our resources and when we do not feel we have sufficient resources to adequately respond. Over time, this concept of appraisal has been revisited and expanded to include the appraisal of stressors in both positive and negative ways (Gerich, 2017; Podsakoff et al., 2007; Tuckey et al., 2015). It is intriguing to consider the possibility that some stressors may be less bad, maybe even positively perceived at times. However, it is important to recognize that our body’s response to stress is nonspecific and relatively uniform; physiologically speaking, there is no healthy form of stress (French et al., 2019; Mazzola & Disselhorst, 2019; Rosen et al., 2020). How we perceive and appraise work-related demands, and how we ultimately respond to them is also linked to social norms around stress in our work environments. There is increasing recognition of the role that social environments, norms, and shared social identities play in determining the stressors we perceive and appraise, and the stress experiences we ultimately have (Haslam & Reicher, 2006; Haslam & van Dick, 2011). Related to all of this is the normalization of stress and even the elevation of stress into something to be prized or treated as a status symbol. We have both observed (and researched) this tendency among some workers to try to frame work-related stress as a sort of badge of honor (Black & Britt, 2018). It is also true that some workers may acknowledge a need for recovery, but believe that they do not have the opportunity or ability to respond to this need. The weight of their work-related stress may even make some workers feel guilty for taking time to attempt to recover (i.e., relaxation remorse), further negatively impacting their health (Black & Britt, 2018). This is an important area for more research and practice, given the power of social norms over how we perceive and respond to work demands. An Integrated Stress and Recovery Framework Summarizing the information presented up to this point, the work-related stress and recovery process can be seen as an expanded stimulus-response process similar to what we outlined in Chapter 2. Figure 6.3 provides a high-level conceptual representation of a broad OHP perspective on work-related stress and recovery as a single, cyclical process. Workers are exposed to stressors or demands (stimuli). Some stressors have a direct influence, while others are processed cognitively and emotionally before triggering our psychological and physiological stress response. This figure also highlights ways in which work demands can impact our personal and contextual resources, and also our perceptions and responses to further work demands. This type of broad conceptual model can help to connect many of the seemingly disparate elements of the vast OHP literature pertaining to stress and recovery. We believe this type of model can also support practical thinking about ways to address workers’ stress and recovery needs. Why Work-Related Stress and Recovery Matter There are so many reasons why work-related stress and recovery need to be understood and managed well by workers and within organizations. In the following subsections, we discuss a couple of the most compelling general reasons. Additional reasons pertaining to specific forms of demands and resources are explored in subsequent chapters. Self-Care is Essential Understanding the work-related stress and recovery cycle enables OHP professionals to help workers protect and replenish the resources needed to meet work-related demands. This is accomplished through self-care or recovery practices. For most adults, working and work environments constitute the main, controllable source of demands, as well as a major source of opportunities to build and replenish essential resources. Surveys of populations of working adults routinely indicate now that most workers are regularly experiencing stress associated with their work (American Psychological Association, 2020). Even more troubling, is that one in five working adults may never engage in activities to manage this stress (American Psychological Association, 2015). Absent or insufficient self-care can have implications that extend far beyond any individual worker. In many occupations, the consequences of not performing at optimal levels can be critical. In healthcare, for example, suboptimal performance could even lead to someone’s death. This reality is what makes self-care an absolute responsibility and necessity as outlined by many professions’ ethics codes, graduate education requirements, and licensing laws. Unfortunately, no such guidance exists for workers and organizations in more general business and manufacturing contexts. This means that it is often up to organizational leaders to emphasize the importance of adequate self-care as a personal and occupational necessity for their workers. Business Implications As noted earlier, the omnipresence of demands at work should not surprise or necessarily concern us – if most workers reported experiencing no demands and no stress at work, we would expect to see numerous other serious problems emerge with worker motivation, engagement, and other important indicators of positive worker and organization alignment. The challenge here is ensuring that workers’ normal state of existence at work is not one of chronic psychological and physiological stress arousal. Workers’ personal demand-resource equation can only balance with personal and organizational efforts to ensure all necessary resources are available when needed. This all becomes a business-level concern due to cost-related ripple effects triggered by consequences of workers’ chronic or acute stress experiences, which are exacerbated by the absence of necessary resources and ineffective or nonexistent recovery. Organizations can experience costs associated with work-related stress that are both indirect and direct in form. Direct costs are typically associated with negative worker attitudes and performance, and increased numbers of accidents and healthcare-related expenditures. Indirect costs often include less tangible effects on workers (e.g., reduced energy, poor communication, negative relationship quality; Hargrove et al., 2011; Macik-Frey et al., 2007). Ensuring workers have the resources needed to address work-related demands is not just about cost-avoidance; it is really a matter of good human resource and talent management. Methodological Considerations and Practical Recommendations Work-related stress and recovery are person-level phenomena that can also impact groups and organizations. When researching or attempting to intervene to address stress and recovery challenges, OHP professionals must make several methodological and measurement decisions. These decisions are influenced by the types of stressors, demands, resources, and outcomes involved in a particular research or intervention scenario. Given this reality, we save our discussion of more specific methodologies and intervention strategies for our discussion of specific demands and resources in the following chapters. Here, however, we present a few general recommendations for working with stress and recovery. Measuring and Monitoring Work-Related Stress and Recovery Work-related stress and recovery are not singular constructs that can be easily measured or monitored with a single scale or measure at a single point in time. With respect to stress, a determination has to be made about whether the measurement target is the stress arousal or experience itself, or rather the extent to which exposure is happening or is perceived as happening. Alternatively, maybe the focus is on how workers are appraising and choosing to respond to specific stressors. When it comes to recovery, direct measurement of the extent to which a person is “recovered” is really difficult and typically indirect. Generally, what is measured is some form of need for recovery (e.g., de Croon et al., 2006) or the extent to which a person perceives that they have sufficiently replenished depleted resources. The personal nature of both of these phenomena is what makes most measurement strategies pertaining to work-related stress and recovery focus on the self-reported perceptions of feelings and energy levels (Giumetti et al., 2013; Zacher et al., 2014), among other related phenomena. Typically such data are gathered using cross-sectional surveys, though if the goal is to more fully capture stress and recovery as part of the cyclical process described in this chapter, a repeated measurement design or longitudinal data measurement and monitoring methodology can be employed (e.g., diary studies, experience sampling; Sonnentag et al., 2013). There may also be opportunities to branch out a bit from strict self-report and engage in some form of more observational data gathering when trying to understand stress and recovery. This is particularly true now that wearable tracking technology is now readily available that can monitor physiological arousal (as we discussed in Chapter 2). A related measurement strategy is to gather physiological and biological indicators of stress as a way of corroborating self-reported experiences and obtaining more objective data regarding stress levels in a group or organization. Such efforts might include measurement and tracking of cortisol, hormones, neurotransmitters, etc. that are known to increase (or decrease) when individuals are experiencing stress or in need of recovery (Carrasco & Van de Kar, 2003; Ganster & Rosen, 2013; Heckenberg et al., 2020). Intervening to Address Work-Related Stress and Recovery Although there is still much to learn about work-related stress and recovery, OHP professionals are not prevented from leveraging the broad theory and knowledge we do have to positively impact WHSWB with evidence-based intervention efforts. In the following subsections, we outline a few generally important points to remember when intervening in this area at the person, group, leader, and organization levels. Strategies for Individuals When intervening at this level, it is important to note that implementing an intervention can itself introduce a new work-related stressor or set of demands. Related to the dual appraisal concept of stress and basic underlying physiological realities of stress discussed earlier in this chapter, Boyatzis and colleagues have put forth the intentional change theory (e.g., Boyatzis & McKee, 2006; Boyatzis & Jack, 2018; Jack et al., 2013). Leveraging this theory, we can minimize the risk of triggering a counterproductive stress reaction among workers by not leading into an intervention with lots of data, a strong problem statement, or heavy educational material that demand workers’ time and energy (resources that are already likely seriously depleted). Instead, we can approach workers with a coaching mentality (e.g., McGonagle et al., 2014), initiating an intervention with discussion about what workers value and what their health-related or more general life goals may be. This approach is more likely to trigger positive emotions and help workers remain open to the possibility of making adjustments that can help them move toward better alignment between their work experiences and their personal values and goals. More concretely, self-care and stressor/demand management are two general intervention strategies that can help individual workers better manage their work-related stress experiences and recovery needs. IMPROVING SELF-CARE AND RESOURCE MANAGEMENT Even if all of a worker’s current work-related demands could be resolved, more will arise tomorrow. Because demands will always exist, workers need pragmatic strategies for recognizing and addressing their personal resource recovery needs. Similar to how workers in industrial settings are often taught how to not lift more than they safely can, all workers need to learn their personal resource limits. The problem is that many workers lack self-awareness regarding their personal demand and resource imbalance. This is one reason why mindfulness-based interventions are so common in this area (Howarth et al., 2019; Kabat-Zinn, 2003), for improving workers’ self-awareness pertaining to what our minds and bodies are doing (or not doing). However, it is one thing to improve workers’ awareness of demands and resources, and another thing to develop personally relevant strategies for reducing exposure and enhancing resource replenishment. Mindfulness alone does not address both of these goals. There is also the possibility that trying to combat stress by increasing self-awareness may open workers up to perceiving more demands and also recognizing that they have even fewer resources than originally thought. Thus, mindfulness by itself may not always lead to the results we are seeking with OHP interventions. Instead, such techniques may need to be partnered with more specific strategies for building and actively managing resources. Thankfully, our evidence base pertaining to this is growing rapidly, with some consistent findings about the qualities or elements of recovery and the types of environments that can be particularly restorative. As we also noted earlier in this chapter, recovery does not have to occur only in demand-free contexts or exclusively outside of working time. Responding to demands generally depletes workers’ resources and can lead to strain, but at times it may also provide opportunities to replenish or build new resources (as illustrated in Figure 6.3). This is especially true if our responses to demands lead us to grow or change in a positive way, or to achieve or experience mastery in a particular domain or over a particular task. Thus, there is value in helping workers identify and take advantage of opportunities for recovery that may be present in the workplace, not just during nonwork time (Cranley et al., 2015; Henning et al., 1997; Hunter & Wu, 2016; Trougakos et al., 2013; Zacher et al., 2014). Opportunities for recovery both during and after the workday have the potential to support psychological health (Sonnentag et al., 2017). Research developments continue along these lines that may eventually make it possible to identify and target specific recovery experiences and strategies to replenish specific resources needed to meet specific work demands (e.g., Bennett et al., 2016; Tuckey et al., 2017). STRESSOR/DEMAND MANAGEMENT AND STRESS COPING STRATEGIES A second general form of intervention for workers can involve empowering workers to manage stressors and stress experiences that they can control. To be clear, what we are describing here really is more about stressor management and stress coping strategies, and less about managing our feelings of stress that happen in response to exposure to a stressor. The theory and evidence base in OHP supports a more targeted approach to managing stress than what is typically taught in high-level stress management workshops. Targeted approaches can help workers prepare themselves to handle anticipated and unanticipated stressor exposures. Extending from the transactional model of stress noted earlier (Folkman et al., 1986; Lazarus & Folkman, 1984), personal coping responses to stress can vary. Active or problem-focused coping strategies enable workers to exert at least some control and potentially gain mastery over a particular demand. Sometimes, though, other forms of coping may be needed, even if just to temporarily reduce an emotional response to stress. For example, if directly addressing a stressor requires more resources than a person has available, it may be effective for the individual to temporarily pursue some form of resource recovery. A risk here is that pursuing recovery activities can turn into a form of avoidance coping. Socializing with friends, exercising, going for a walk are all potentially good recovery activities, but their overall value is reduced if doing these things is a way of not dealing with a demand that needs to be addressed. Also, there is the risk that avoidance may turn into withdrawal or more seriously negative and counterproductive psychological states if workers are chronically exposed to demands that exceed their resources (e.g., Podsakoff et al., 2007; Sliter et al., 2012). Workers can be helped by learning how to avoid getting to this point. There is also evidence that workers can learn to build resources and resilience through a process of self-reflection regarding how and why they respond as they do to specific stressors (Crane et al., 2019). Strategies for Groups, Leaders, and Organizat-ions Workers’ stress and recovery experiences are often influenced by social norms pertaining to how work-related demands are perceived, appraised, and responded to within a particular work context. Interventions delivered at the workgroup, leadership, and broader organization level can all help to adjust and reinforce healthy social norms along these lines. In addition, there are many forms of intervention within organizational control that can directly improve workers’ access to resources needed to address work-related demands. We explore three general forms of such interventions in this section. MANAGE DEMANDS RELATIVE TO RESOURCES Organizational leaders can help to ensure workers have access to the resources they need to meet work demands. This is an extension of an idea known as the “match hypothesis” outlined by Cohen and Wills (1985) when discussing the role that social support can play in protecting workers from the negative effects of work stress. The majority of OHP intervention efforts have focused on stress and recovery as person-level phenomena. At a more macro or organizational level, however, controlling demands or otherwise minimizing workers’ exposures can be a direct and effective way of addressing the challenges outlined in this chapter. Sometimes these types of adjustments may involve taking steps that are controversial to different stakeholders at first, but potentially helpful over time (e.g., limiting work hours, restricting demands on workers outside of work, rotating worker exposure to different workloads). FACILITATE JOB CRAFTING There is growing evidence that workers are often better able to respond to work demands when they have some say or control over how their jobs operate and/or how they respond to such demands. This type of design-related worker autonomy is commonly known as job crafting (Wrzesniewski & Dutton, 2001). One reason that job crafting works for individuals and organizations is that it puts into practice what we understand about stress from the D-C model discussed earlier (Karasek, 1979). Specifically, when work demands are high, workers are more likely to handle them well if they at least perceive that they have some control over how they go about meeting those demands. Unfortunately, many managers regularly create imbalanced demand-control situations by forcing employees to do things that they are not prepared to do, that they are not supported to do, and they have no latitude to modify or craft into a form that works for them. A direct way to address these types of situations is to intervene at the leader and workgroup level to enable workers (when possible) to engage in job crafting and allow workers to process alternative ways of getting the work done. There is no single way to go about crafting a job, but key elements are to ensure that workers are supported in identifying their resources, strengths, values, and motivations, and then encouraged to consider these elements as they determine how they will approach meeting work-related demands going forward (e.g., Niessen et al., 2016). Job crafting has been shown to positively impact workers’ ability to manage work demands and sustain positive well-being (e.g., Tims et al., 2013). SUPPORTIVE POLICIES AND PRACTICES Addressing work-related stress and recovery may also require interventions in the form of organization-wide policy and practice changes. Often, we think about this in terms of trying to grant workers more flexibility over their work schedules, encouraging supervisors to provide more support for utilizing such flexibility and taking time to recover. Keep in mind, however, that organizations can also implement policies and practices that are more extreme. Remember that the concept of an eight-hour workday is an organizational invention, from Henry Ford’s well-known efforts to balance production against risk of injury in his assembly line factories in the early 1900s. It is important to keep in mind that limiting work demands, workload, and even work hours and generally supporting WHSWB are all strategies that can be managed through policies and practices. These strategies also can help to provide workers with at least the opportunity to engage in resource recovery. Evaluating Work-Related Stress and Recovery Interventions Methods and strategies for evaluating work-related stress and recovery interventions can take many forms and need to be designed to fit a specific intervention context and focus. We encourage you to revisit Chapter 2 for an overall discussion of generally relevant information along these lines. We also explore these evaluation challenges with respect to specific forms of OHP-related intervention efforts over the next few chapters in which we discuss specific work-related demands. Concluding Thoughts and Reality Check As discussed in this and the following chapters, a major WHSWB concern for OHP researchers and practitioners is how workers manage the complex and continuous balancing of work demands with the personal and work-related resources needed to meet those demands. Stress associated with working has become part of our common language and experience. We can see this so clearly in our everyday interactions, when a question of “How is work going?” is so often met with a response of, “Busy!” or “Stressful.” At some level, all workers experience demands and therefore are likely to experience moments of stress arousal. What is less clear is whether such stress needs to be a chronic or in some cases continuous feature of workers’ realities, or whether it is an unfortunate and at least somewhat preventable consequence of poor work design, poor management, misaligned organizational policies and practices, and poor person-environment fit. Interrupting workers’ stress cycle is difficult. Efforts to improve workers’ stress and recovery experiences must be multi-faceted and multi-level, focused on rebalancing the demands-resources relationship using a combination of person, group, leader, and organization level strategies. These issues cannot be resolved just by increasing workers’ personal awareness and resilience. Also required are modifications and improvements to actual work environments, to ensure workers have access to necessary resources and appropriate levels of demands. The linkage between chronic stress arousal and a wide variety of psychological and physiological consequences elevates these concerns about work-related stress and recovery to the level of a global public health concern. Stress is not a new phenomenon in our modern world, but the types and frequency of our demands are continuously changing and there is increasing competition for our limited attention and time. This is especially true in workenvironments, where technology and social norms combine to keep workers nearly continuously engaged in demanding, resource-depleting activities. There is a tremendous opportunity for OHP research and practice to inform a new way of working and living, in which workers, organizations, and society are strengthened by maintaining a healthier demand and resource balance. Imagine the possibilities.