This chapter discusses how organisations can use the information gained from the stress audit and risk evaluation stages of the risk management approach, including an overview of past stress interventions. The final stage involves the implementation and monitoring of stress prevention and reduction measures. There is substantial evidence to suggest that many stress reduction programmes, such as employee assistance programmes (EAPs), are very effective in mitigating the symptoms of stress (Cooper and Sadri 1991; Berridge et al. 1997; Highley-Marchington and Cooper 1998). However, much of the evidence is focused on tertiary measures, which are aimed at individuals who display stress-related symptoms, such as stress counselling. Cox et al. (2000) recommend that an intervention package could include tertiary action, but that measures should also be implemented at primary and secondary levels (i.e., should involve preventative action). A description of the levels of stress intervention is presented in Box 9.1.
However, reviews of stress intervention programmes (Burke 1993; Cooper and Payne 1988; Cox 1993; International Labour Organisation 1992; Kahn and Byosiere 1992; Karasek 1992) suggest that such programmes frequently fail to emphasise prevention at the source.
Due to the structure of health care costs, there has been a strong financial incentive for US employers to introduce stress prevention programmes. The focus of the programmes is the prevention of individual ill-health, thus they tend to emphasise the health-related behaviour of workers in relation to specific health problems. There is little impetus for US companies to introduce programmes that include worker participation or changes to the work environment. There are differences in Europe, where preventative action is more