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AU: Murphy-LR
TI: Stress management at work: secondary prevention of stress
SO: The handbook of work and health psychology. New York: John Wiley & Sons, Ltd., 2003 Jan; :533-548
LT:
NN: 20022228 
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AB:The nature and complexity of occupational stress have been addressed in numerous research articles and books. This literature indicates that stress is a common problem in work settings. and can lead to physical and psychological ill health; that stress is often determined by personal appraisals of work environment situations (one person's meat is another person's poison); and that stress is costing companies substantial amounts of money in the terms of health care costs. productivity losses, and worker compensation claims. Increasingly. more and more companies are exploring ways to deal with occupational stress. There are three distinct approaches to the problem of occupational stress, each addressing different aspects of the problem. The most common approach is to provide treatment services to troubled workers. usually in the form of employee assistance programs. This is a reactive approach, in as much as the health problems already exist, and the main efforts are focused on treatment of the health outcomes. This approach typically does not involve efforts to identify and reduce job/organizational factors that create stress. In medical terminology, this is tertiary prevention. In contrast. primary prevention seeks to identify and reduce the sources of stress, which can be work or non-work factors. This approach can be reactive (that is, dealing with an existing stress problem) or proactive (preventing stressful work conditions from becoming a problem), but deals directly with the source(s) of stress at work. not just the outcomes of exposure to stressors. Evaluations of !.his type of intervention are relatively rare in the published literature (see Murphy, 1988; Ivancevich et al., 1990). However. a recent review of such interventions in health care settings identified a critical mass of studies that provide guidance on how to design successful interventions (Murphy, 1999). Intermediate between primary and tertiary approaches is secondary prevention. which aims to reduce the severity of stress symptoms before they lead to more serious health consequences. Commonly called stress management, these programs are individual-oriented, and usually seek to educate workers about the nature of stress. and to teach workers specific techniques for reducing physiological and psychological symptoms of stress. and fostering a state of relaxation. The most common types of stress management strategies are progressive muscle relaxation, biofeedback. meditation. and cognitive-behavioral skills training. This chapter focuses primarily on stress management methods as narrowly defined above, and does not review job and organizational interventions for preventing or reducing stress, nor does it review interventions involving individual counseling, physical fitness, or conflict intervention. As noted earlier. however. there is a section that attempts to assimilate research on stress management with research on job- and organizational-level interventions.
KW:Job-stress; Worker-health; Mental-stress; Psychological-stress; Psychological-responses

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