The Stress Management Paradigm

Stress Management has provided the default solution to psychological health problems within UK organisations since the mid-1970s.  This position was elevated following Walker v Northumberland County Council (1995), the first case in legal history where an employee was awarded damages for 'psychiatric injury' suffered as a direct result of work related stress.

Over the last four decades, as stress management has become the accepted “mental health” solution within organisations, a myriad of different stress models have emerged to describe the problems between people, their working environment, job characteristics, behaviours, demands verses coping abilities and the balance between effort and reward.

Although often lacking empirical evidence, what all of these approaches to stress management have in common, is that they contrast the demands of work with our perceived ability to cope and be recognised for our efforts.  

The different approaches to stress management have gradually expanded to cover almost every conceivable definition of stress and a wide range of generic approaches to its detection, prevention and management.

Not surprisingly then, the term “stress” itself has become a ubiquitous and often confused term, used to label everything from interpersonal conflict to underlying psychological health problems.  

There is comprehensive agreement on the importance of work related stress, but little consensus on what it actually means in practice.  Stress has become a problem of epidemic proportion and conspicuous ambiguity.  

Figures from the HSE for 2014/15 show that 35% of all work-related illness and 43% of all absence was linked to stress or other psychological problems.

Whilst all good HR and Occupational Health professionals will have a sound theoretical grounding in the different models of stress, our view is that this remedial focus on stress can encourage a risk limited approach and an emphasis on weakness and vulnerability in the organisations culture.  This in turn can undermine high performance values and perpetuate the stigmatisation of “Stress” for those experiencing psychological coping problems at work.

Whilst we advocate the continued implementation of a well-structured risk assurance process for the identification and management of potential stressors, we also believe that this should be just one part of a wider resilience and wellbeing strategy.


So how does employee resilience and Wellbeing Relate to Organisational Performance?

Whilst there is a growing body of research on the relationship between emotional health and good performance, the Yerkes-Dodson model still provides a credible and intuitive basis for conveying the links between work demands, employee performance and stress.  

Yerkes Dodson

What this model shows, is that demand or positive stress creates a focused improvement in performance up to a certain point.  Once we cross the red line, each additional increment of pressure delivers a reduction in overall performance.  Where this continues, employees eventually reach burn-out or break-down.  This is the point at which we recognise the deleterious effects of stress.

According to the HSE figures over 9.9 million days were lost to stress related problems in the UK in 2014/15.  This does not include the cost to productivity of employee absence and presenteeism.  In 2010, a report for the Work Foundation estimated the costs of presenteeism to be approximately 1.5 times the cost of employee absence.


So What is the Answer?

The key challenge is to encourage employees to reach the optimal point on their curve without crossing the red line.  This means we need to have an informed approach for creating a working environment that is conducive to high performance, withoutt the limiting effects of perceived threat or failure.  This involves shifting the focus from stress prevention to improved emotional resilience.


Actually It’s True, You Can Teach People How to Think!

Drawing on extensive research conducted in the field of Cognitive Behavioural Therapy, we advocate a focus on cognitive change to support improved resilience. The research clearly demonstrates that changing the way we think can profoundly influence the way we interpret and respond to different situations.  In other words, our emotional and behavioural reactions can be significantly influenced by altering the way we think.

A good example of this, is how we view the idea of “failure” in organisations.   Of course, we all buy into the idea of learning over failing; don’t we?

The benefits of encouraging employees to learn from mistakes rather than fearing failure are well documented.  In spite of this, we know that the most significant underlying factor for stress is a perceived failure to cope with the demands of work.  This fundamental paradox sits at the root of work related stress.

Our approach to stress management is therefore focused on identifying and strengthening cognitive resilience, as a primary basis for reducing vulnerability to the effects of stress and other psychological problems.

This involves encouraging a cognitive shift from failure to fallibility, from blame to responsibility and perfectionism to mastery of disappointment.  This is not a new concept, the idea of aiming high and accepting the possibility of disappointment has been expounded over decades and forms the basis for numerous leadership, coaching and high performance models.  It runs like a stick of rock theme through   high performing organisations who encourage performance, innovation and learning over management by results.


How Does it Work?

Building individual resilience involves a process known as cognitive restructuring, in which the individual’s perceived ability to cope, appraisal of potential threats and willingness to learn and bounce back are the primary focus of change.

These cognitive changes are then underpinned by systematic behavioural changes, in which the individual is encouraged to identify, rehearse and test out ways of acting that are consistent with increased resilience.  Individuals are encouraged to work through, define, practice and test out new behavioural strategies that strengthen resilience beliefs and undermine perceived weaknesses and vulnerabilities.  These changes are normally supported through a structured coaching process, either taylored to the individual’s needs or delivered as an adjunct to other development activities.  We also believe that the idea of resilience should be supported through the Organisation’s values and underpinned by the employee wellbeing agenda.


What About Employees Already Experiencing Problems?

It’s crucial that employees already experiencing the effects of unhealthy stress or the consequential effects of anxiety or depressive problems should be provided with access to good CBT based psychological interventions to identify and resolve the problem.

CBT is the recommended treatment of choice for anxiety and mood related problems.  There is a compelling level of research data that clearly demonstrates that CBT consistently outperforms medications and other forms of therapy and counselling for stress, anxiety and depression.

Important factors in the transfer of CBT from the clinic to the workplace, have been it's clear focus on SMART goals, use of practical problem solving techniques, transfer of learning to the client, orientation to change and collaborative style.

CBT provides an active problem solving approach to work related stress that teaches employees how to manage the problem rather than passively focusing on the meaning of symptoms.


The Occupational Stress, Anxiety & Depression Inventory

Employees can take a free online psychological assessment to determine stress, anxiety and depression levels at work.  This has been developed by drawing on established clinical assessment tools and could provide the first step towards identifying and understanding a potential psychological problem at work.

The assessment can be taken anonymously for self-assessment purposes or by providing email details where a confidential copy of the report and additional advice is required.

The assessment can be accessed by visiting

Think CBT provide stress and resilience management programmes delivered on an individual, team or group basis.  We also provide consultancy support to allied HR and Occupational Health professionals looking to develop their employee resilience strategy. To find out more about stress and resilience, contact us at or visit our website at

William Phillips is the Principal Psychotherapist at Think CBT Ltd.  He is an accredited Cognitive Behavioural Psychotherapist and a Chartered Fellow of the CIPD.