work & stress, 2000, vol. 14, no. 3, 213–225

An appraisal of key factors in the implementation of occupational stress interventions KJELL NYTRØ*, PER ØYSTEIN SAKSVIK Department of Psychology, Norwegian University of Science and Technology, Ha/ kon Magnussons gt. 1b, N-7491 Trondheim, Norway

ASLAUG MIKKELSEN Rogaland Research, N-4004 Stavanger, Norway

PHILIP BOHLE and MICHAEL QUINLAN School of Industrial Relations and Organisational Behaviour, The University of New South Wales, Sydney 2052, Australia Keywords: Socio-cognitive process factors ; Stress interventions ; Organizational change. Empirical research on stress intervention in organizations, and experience from organizational change programmes in general, indicates that obtaining intended change is often more di‰ cult than it had been conceived to be at the outset. In order to facilitate the accomplishment of stress prevention and eŠ ective organizational change, this paper examines the importance of the social and cognitive processes in‚ uencing the implementation of any intervention. It states that if change is to be managed skilfully, it is important (1) to create a social climate of learning from failure, (2) to provide opportunities for multi-level participation and negotiation in the design of interventions, (3) to be aware of tacit behaviours that possibly undermine the objectives of interventions, and (4) to de ne roles and responsibilities before and during the intervention period.

1. Introduction Researchers who evaluate interventions designed to improve work organization and reduce occupational stress face many challenges. Surprisingly few studies to date have reported positive results (Burke, 1993; Karasek, 1992; Landsbergis, and Vivona-Vaughan, 1995; Parkes, and Sparkes, 1998; Reynolds, and Briner, 1994). Hunter, and Schmidt (1996) point out that within social policy research there are many studies arguing for diametrically opposed conclusions due to sampling error and over-reliance on signi cance testing. In fact, there is reason to believe that many interventions are unsuccessful and are therefore never reported in journals (Briner, and Reynolds, 1999). Unfortunately, the research that has been published has frequently suŠ ered from methodological limitations. These have included weaknesses in research design (particularly the scarcity of longitudinal studies), unclear links to theoretical models, excessive emphasis on intervention at the level of the individual

* Author for correspondence. e-mail : kjell.nytro!svt.ntnu.no Work & Stress ISSN 0267-8373 print}ISSN 1464-5335 online ’ 2000 Taylor & Francis Ltd http: }} www.tandf.co.uk}journals DOI : 10.1080 }02678370010024749

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employee, inappropriate data analysis strategies, inattention to the eŠ ects of diŠ erences in intervention processes and insu‰ cient recognition of contextual diŠ erences (Briner, and Reynolds, 1999; Burke, 1993; Handy, 1988; Reynolds, and Shapiro, 1991). DiŠ erences in ideological standpoints, theoretical frameworks, levels of analysis and methodologies between the disciplines that have contributed to the  eld have also hampered research collaboration and the development of knowledge (Burke, 1993; Handy, 1988). In this paper the authors examine the role and signi cance of process in the implementation of occupational stress interventions. By ‘ process’ we mean individual, collective or management perceptions and actions in implementing any intervention and their in‚uence on the overall result of the intervention. The main point of departure is that the process can be as important as the contents of the occupational stress intervention itself (Gri‰ ths, 1999; Hurrell, and Murphy, 1996; Murphy, 1988). The evidence produced from a number of comparative studies of psychotherapeutic interventions indicates that the positive outcomes may have less to do with the speci c content of the intervention than simply the fact that some form of intervention has been initiated (Reynolds, and Briner, 1994; Sallis, Trevorrow, Johnson, Hovell, and Kaplan, 1987). Asay, and Lambert (1999) point out that only 15 % of therapeutic change can be attributed to speci c techniques and that the main factors behind change are the quality of the social relations, initial motivation and placebo eŠ ects. In the same vein, organizational researchers point out that trust and motivation are central ingredients in any successful change eŠ ort (Porter, Lawler, and Hackman, 1975). One interpretation, at least, of this evidence could be that general process factors generate arousal among the participants that in turn makes them think and behave diŠ erently in relation to the work group and the organization. It is, however, important to identify key factors behind this process in order to make it a positive contribution to the stress intervention. There are strongly con‚ icting perspectives on the signi cance of process in research on interventions undertaken in organizations. At one extreme is the view that it is a source of bias in  eld research that should be controlled in order to isolate the eŠ ects of the intervention itself (Eriksen, Stene, and Ursin, 1996). At the other extreme is the view that it is the process that gives an intervention its meaning (Gergen, 1992). These diŠ erences re‚ ect wider, and intractable, epistemological con‚ icts between established scienti c paradigms. However, irrespective of whether the objective is ultimately to control or manipulate the process, it is important to de ne its key dimensions and to develop a better understanding of the ways in which it in‚ uences the outcomes of interventions. In this paper we attempt to take some steps in this direction. It is not always easy to tell precisely what the content of an intervention is or, consequently, to identify the precise nature of the implementation process. Even complex organizational interventions may rely upon implementation processes that are very poorly de ned. For the purpose of clari cation we shall focus our discussion on important process issues of an organizational, collective and individual nature identi ed in the literature. These issues include learning from organizational failure, the role of involvement and participation, cultural maturity, and vital aspects of the informal socio-cognitive processes between employees and the organization, that may hinder or promote change. Some, of course, argue that participatory strategies and action research are the only fruitful ways to make interventions (Greenwood, and Levin, 1998). This may well be where our analysis leads us but, for the moment, our intention is to describe and analyse the processes reported in intervention studies to date. In any case, as we shall show later, di‰ cult process problems are likely to arise even when action research is used (Handy, 1988; Landsbergis, and Vivona-Vaughan, 1995).

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2. Processes at the organizational level When occupational stress interventions are introduced, precautions should be taken to ensure that they can become integrated into the organization. Landsbergis, and VivonaVaughan (1995) identi ed several possible explanations for the mixed results obtained in their own intervention study. Based on their experiences, they concluded that the following issues should be considered when introducing organizational interventions: (1) formal involvement of unions; (2) integration of the intervention with ongoing organizational development projects and reorganizations; (3) establishment of structures for good communication between local participants; (4) development of implementation plans that involve the entire organization; (5) promotion of the view that the intervention is an ongoing activity of the organization and not a time-limited project; and (6) completion of a cost-bene t analysis. With the exception of the last point, most of these recommendations may seem to be straightforward and easy to follow when you are aware of their importance, but what do they imply and where are the hidden traps ? Likewise, these issues represent appropriate practical and behavioural recommendations, but several prerequisites should be in place before they can be implemented in practice. We have labelled these prerequisites learning from organizational failure, involvement and negotiation, and cultural maturity.

2.1. Learning from organizational failure Much of the literature on organizational change, in both management consulting and human resources management, gives the impression that the changing of organizational structures and behaviour is a relatively unproblematicendeavourso long as the organization keeps to certain rules for implementing change and some principles for evaluating progress. There is an abundance of recipes for changing culture (Peters, and Waterman, 1982), implementing total quality (Ciampa, 1991), improving commitment (Beer, Spector, Lawrence, Mills, and Walton, 1984; Meyer, and Allen, 1997) or building learning organizations (Mongeon, and Edmondson, 1996; Senge, 1990). However, there are more prescriptions about how to change organizations than there are reliable empirical demonstrations of their success or failure. In fact, there is a widespread lack of analysis of the reasons for the failure of many apparently well-designed organizational change eŠ orts to achieve their intended results. One convincing explanation for not taking failure into consideration is that the types of intervention that are commonly promoted in the management consulting literature are doomed to failure because they misunderstand organizational problems, are manipulative and designed to assert managerial control or intensify work (Reynolds, and Briner, 1994; Reynolds, and Shapiro, 1991). It could also be argued that interventions of this type provide management consultants with ongoing business precisely because they rarely work or are principally designed to secure short-term gains for some interest groups rather than the organization as a whole. If we look at downsizing, a recent longitudinal study by Parker, Chmiel, and Wall (1997) argued that detrimental eŠ ects on worker well-being could be oŠ set if the downsizing process also entailed increases in individual control, clarity and participation. While this well-executed study made a valuable contribution, conceptually

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and methodologically, to the  eld, it may present an atypical picture of downsizing and the objectives of management in implementing it. Rather than increasing individual control, clarity and participation, downsizing typically entails precisely the opposite tendencies: intensifying work, creating uncertainty, reducing worker involvement and ultimately increasing occupational stress (Dunford, Bramble, and Littler, 1998; Iwi, Watson, Barber, Kimber, and Sharman, 1998; Quinlan, 1999; Reissman, Orris, Lacey, and Hartman, 1999). Insecurity generated by downsizing}restructuring can distract workers and managers from their job tasks, subtly re-orientate organizational priorities, and lead to a de-emphasis on activities such as participation in committees (Quinlan, 1999). At best, the proŠ ered solutions (such as counselling}support and communication) address some symptoms while studiously ignoring that the very process of downsizing is a stark re-assertion of where power really resides in the organization. This is often accompanied by none-too-subtle messages to workers about the limits to individual control, job security and participation in critical decision-making. Fullan, Miles, and Taylor (1981), among others, have pointed out that the probability of failure for any organizational change eŠ ort is about 50 %. If the idea of experiential learning is taken seriously (Kolb, and Fry, 1975), it is imperative for organizations that survive failed change eŠ orts to analyse and document the reasons for failure so that future change projects can pro t from past experience. Ursin (1990) has elaborated on the frequent observation that failure is common in organizations, which show a reluctance to learn from these failures. These organizations are more likely to repeat past mistakes without knowing why, and develop less potential for survival and growth, than organizations that are capable of explicating, disseminating and retaining lessons learnt from prior change eŠ orts. Argyris (1990) claims that organizational turmoil is more likely to result in cynicism and scapegoating than to produce fresh insights into organizational dynamics or improved problem solving abilities. In eŠ orts to develop new ways of behaving and communicating in organizations, it is advisable to withhold sanctions for making errors—both at the individual and at the organizational level. Paradoxically, while writers on organizational change frequently encourage organizations to explicate lessons learnt from planned change eŠ orts, few publications have made a detailed analysis of organizational failures. It is understandable that success stories are better received by consultants, managers and journal editors than sober depictions of organizations that do not cope with change. This is not to say that failure is never reported. Evaluations originally aimed at uncovering problems and bad decisions are of course published. It is when unintended failure occurs or when the results are inconclusive that the urge to publish diminishes. Sitkin (1996) has put a strong case for organizations to be more open to the possibilities for renewal oŠ ered by learning through failure. Few would argue against the bene ts of learning through success, but many would perhaps be less ready to appreciate that success brings its own liabilities in the form of complacency, restricted modes of innovation and diminishing organizational heterogeneity. There are probably as many opportunities to learn from organizational failure as from organizational success, but there appear to be strong cultural, social and psychological prohibitions against harvesting wisdom from failure.

2.2. Involvement and negotiation The importance of taking into account the in‚ uence exerted by powerful coalitions, informal group processes and the bargaining positions adopted by various stakeholders has

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often been reported in the literature (Cyert, and March, 1963; Newton, Handy, & Fineman, 1995, Quinlan, 1993). An eŠ ort to change work behaviour and attitudes, and organizational climate or structure, involves negotiations and informal dialogue about the adequacy of the prevailing organizational contingencies (Argyris, and Scho$ n, 1996). In practical terms, this may mean that even interventions as apparently simple and uncontentious as the introduction of exercise, dietary or stress management programmes during working hours may produce con‚ ict over the value of the intervention in the existing organizational context. Employees might, for example, question why they should have to strengthen their capacity to cope with the stress created by their work when they see that little is being done to redesign jobs or that organizational strategies, such as downsizing, are being used to deliberately intensify work. Alternatively, managers may consider training during working hours to be too time-consuming and wasteful when resources are limited. One reason why it has been di‰ cult to  nd successful organizationallevel interventions to improve health in organizations is that they are so complex and require co-operation and commitment from union leaders, management and employees (Karasek, 1992). Briner, and Reynolds (1999, p. 661) possibly had complications of this nature in mind when they observed that ‘ Organizational interventions are not simple solutions to the complex problems of undesirable employee states and behaviors’. In practice, many health promotion activities in organizations appear to be more concerned with cutting costs, limiting genuine participation in problem solving, and shifting attention away from organizational and environmental factors toward individual attitudes and behaviour (Bohle, and Quinlan, 2000). Nichols (1998) provides a good illustration of the impact of these processes at DuPont, noting that it suŠ ered a major blip in its safety record in 1986—1987 when the familiar combination of downsizing (40,000 employees were made redundant) and increased emphasis on cost eŠ ectiveness led some managers to take short cuts. When, as is often the case, the subject of work organization is excluded from collective bargaining, explanations for health problems at work are dominated by a management perspective that focuses heavily on the individual employee’s behaviour and capacity to cope (Steele, 1995). Managers generally have a preference for supporting individual-level interventions, such as employee assistance programmes and stress management training, and are much less likely to support organizational changes aimed at reducing the organizational sources of stress (Murphy, 1989; Reynolds, and Briner, 1994). They avoid issues concerning power, autonomy and work organization that are critical factors in understanding the development of occupational illness (Bohle, and Quinlan, 2000).

2.3. Cultural maturity Schein (1980) argued that in order to realize the full potential of an intervention an organization must be highly competent in managing the change process. If an organization is immature in this respect, it may be appropriate to pursue greater empowerment of employees (Callan, 1993). Employees should be assisted in adopting the role of change agents and provided with the authority and resources to take action to remove the sources of excessive stress. Of course, the organization must  rst be aware of the need to assist its employees in this respect. It must also have the skills and willingness to do so. Union involvement provides an important means of achieving empowerment, and has been recognized as an important source of genuine and enduring change (Landsbergis, Schnall, Schwartz, Warren, and Pickering, 1995), but managers ultimately control organizational renewal projects (Hammer, Ingebrigtsen, and Karlsen, 1994). A manager’s leadership style,

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way of communicating with subordinates and attitude towards change may therefore be a key factor in understanding how organizational processes in‚ uence the success of occupational stress interventions. In a recent study it was found that the same organizational intervention was implemented in quite diŠ erent ways in two post o‰ ces (Mikkelsen, and Saksvik, 1998). The reason for its ineŠ ectiveness in one post o‰ ce was found in the prevailing organizational culture where it was seen to be part of the job of the manager to solve the problems and the employees felt that it was their proper role to sit in judgement and complain about the lack of eŠ ort. Thus, little involvement in developing action plans was found from either the manager or the employees in this post o‰ ce, while in the other the ‘ local theory ’ (Elden, 1983) was based on co-operation, common interests and continuous improvement. Despite evidence of the positive role that unions can play, it has long been noted that stress interventions are individualized or rely on very circumscribed forms of collective activity (Lerner, 1982; Reynolds, and Shapiro, 1991). In part, this can be seen to re‚ ect an arti cial and historically contingent separation (both at the level of state regulation and in terms of workplace practice) between industrial relations and health, environment and safety in industrialized countries that must be interpreted in ideological terms (Carson, and Henenberg, 1988; Quinlan, 1993). Handy (1988) points to the relationship between social conditions and subjective experience and therefore to the in‚ uence of organizational structures and power relations on stress interventions. Both manifest and latent structures within organizations lead to disparities in power and contribute to con‚ icts of interest between employers and employees. This provides a cogent explanation for the individualized and managerialist focus of most occupational stress interventions and has strong implications for the nature and management of participatory processes if they are to counteract power imbalances. A fundamental step in many intervention programmes may therefore be to educate managers and employers about the complex mechanisms behind the development of stress and illness at work and to convince them of the importance of sharing power and conducting preventive intervention at the organizational level. Thus, preliminary investigations of the ‘ maturity ’ and preparedness of the organizations participating in intervention studies may have saved unnecessary eŠ ort and expenditure of time and research funds by providing vital information on the types of processes likely to be acceptable, and eŠ ective, in the organizational context under investigation. When considering the wider application of  ndings from intervention studies it is also important to recognize that the success of a particular intervention may be limited if it is not generally understood that time should be spent on providing insights into the culture within the organization before change initiatives are introduced (Schein, 1985). 3. Informal socio-cognitive processes We will now focus on the informal socio-cognitive processes within and among employees and managers that are often disregarded in eŠ orts to produce change. Intervention processes at this level concern participation, communication, readiness for change, roles and responsibilities in the intervention and ways of coping with anxiety, passive sabotage and unintended subversion. 3.1. Participation or collective employee voice in the change process Project managers, interventionists, and health professionals often pay insu‰ cient attention to the informal norms (Homans, 1950) or basic assumptions (Schein, 1985) of organizations

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before conveying information to employees concerning incipient interventions. Argyris (1990, p. 6) claims that one of the most common organizational paradoxes emerges when ‘ actions intended to increase understanding and trust often produce misunderstanding and mistrust’. This dynamic can appear when those responsible for initiating projects have doubts as to whether the project really is advisable but try to hide their uncertainties or misgivings. It can also appear when changes are initiated with high expectations even though project managers are aware that similar projects have failed in the past (and try to hide this fact). Many recently employed middle managers encounter project fatigue among employees when starting a career in a company that has been plagued by former managers who have embarked upon projects that have not been completed. This may be due to in‚ ated expectations of success while ignoring the needs for communication and participation, and at the same time violating the unique organizational history and the tacit norms of the co-workers that determine the proper onset of interventions and the pacing of implementation (Doyle, Buchanan, and Claydon, 1997). Well-designed dissemination of information is a necessary but not su‰ cient prerequisite for successful change projects. Opportunities for exchanging opinions and enquiring into the intentions behind the project are important for establishing understanding,commitment and participation. Putnam (1994) has observed that many initiatives taken in organizations lack a guiding vision and clear-cut objectives, and subsequently, the ill-informed managers and workers start inventing their own idiosyncratic justi cations for change from their own locally bound perspectives. These assumptions are seldom stated openly and can act as eŠ ective barriers to accepting the initial arguments behind the change eŠ orts, hindering the progress of change. It has been claimed that there is a language barrier between interventionists and other stakeholders in the organization that hinders change. Argyris (1990) claims that supervisors request information that is general, prospective, and ‘ objective’ in order to make future decisions that are in alignment with strategic goals and in the interest of the company owners. On the other hand, many subordinates require information that is concrete and emotional and deals with the situation here and now. It is often not possible for high-level managers or interventionists to deal with the varieties of work group cultures, but the eŠ ectiveness of the information provided is often a function of whether there is an adequate understanding of local norms, values and use of language. In launching organizational change projects, Smith (1994) considers that the  rst major phase consists of  ve small indispensable overlapping steps : telling, selling, testing, consulting and co-creating. These steps require employee involvement, and in the cocreating phase there is an inherent risk that project content and goals will be altered by the participants, requiring modi cation of the initial plans that were perhaps established by top management or researchers. If, at the outset, project managers seek to gain unilateral control over the change project and at the same time espouse participation and involvement, a likely reaction will be polite silence and passive resistance. This again can foster advanced cover-ups to give impressions that measures are taken when in practice they are not.

3.2. Unresolved anxieties, passive sabotage and non-intended subversion Morgan (1986) argues that organizational life can be observed and acted upon in the light of diŠ erent organizational perspectives or metaphors. One of his intriguing metaphors is that of organizations as psychic prisons, which play a critical role in de ning the identity of their members. Many organizational processes and practices, such as legends and rituals,

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take on special signi cance in times of change and turmoil. Members may cling to those that ful l security needs, such as illusions of eternity, predictability, and paternalism : ‘ Just as a child may rely on the presence of his or her doll or teddy bear as a means of rea‰ rming who and where they are, managers and workers may rely on equivalent phenomena for de ning their sense of identity ’ (Morgan, 1986, p. 221). Consequently, organizational and social change will not occur unless organizational members are prepared to relinquish what they have clung to in order to make life predictable and controllable. The interventionist should be able to assess the degree of organizational malleability and be ready to cope with job incumbents’ temporary feelings of loss and withdrawal. It is sometimes possible to convince organizational members to embark upon change programmes that promise immediate improvement, but organizational ‘ quick  xes’ seldom work, because they do not  t the identity and integrity of the organization that have been shaped and developed through years by its founding members. It is crucial to identify and make visible needs and incentives for change and learning (Fiol, and Lyles, 1985) and provide time for members to re‚ ect on positive and possible negative outcomes if change is to be long lasting. The inclination to revert to old ways of doing things and to seek organizational inertia is always tempting and must be dealt with in times of stress (Laughlin, 1991). These tendencies are particularly apparent if employees feel that job security is threatened by undeclared lay-oŠ s or downsizing being planned by management. If the change programme is introduced too rapidly and in con‚ ict with the organization’s culture, employees can construct un-testable attributions so that the o‰ cial justi cations for change will be perceived to be pretences for the extension of management control. Porter et al. (1975) make a strong case for developing trust within organizations in order to obtain autonomous developmental processes that in the long term will bene t organizational survival and growth. Of course, it can be a challenging task to focus on in the organizational microsphere, while in the worst case the general business and labour market is being marked by increased fracturing, uncertainty and volatility due to outsourcing, downsizing and de-regulation. Trust is, however, di‰ cult to de ne in speci c terms, but it is clearly related to personal integrity and whether superiors and subordinates can rely on each other. For the employees, it is vital that the organization ‘ promises ’ not to exploit its employees beyond written agreements and the psychological contract (Schein, 1980). Lack of trust can create con‚ icts, aggression and anxiety, thereby undermining wellintended developmental eŠ orts. If employees are accustomed to untrustworthy behaviours, and learn to expect them from management, it is unlikely that fresh initiatives to develop healthy modes of organizationalfunctioning will be met with enthusiasm and commitment. Experimental research in social psychology has found signi cant diŠ erences in group members’ goal-directed behaviour, contingent upon whether or not they were instructed to expect trustworthiness from individual group leaders (Zand, 1972). Although the concept of trust is vague in scienti c terms, it is important to point out that interventions aimed at preventing occupational stress are likely to be better received if those managing implementation processes have an adequate understanding of the level and meaning of trust among employees.

3.3. De ning roles and responsibilities In the literature on change management and health promotion in the workplace, it is often recommended that enterprises provide social support, build cohesive teams, re-design work and focus incessantly on organizational renewal (Cooper, and Cartwright, 1994). This

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advice is helpful in directing attention to general areas for development in any enterprise, but it does not tell us how such things should be achieved or who should be responsible for them. The need to de ne roles and responsibilities prior to commencing organizational change seems self-evident, but experience indicates that choosing competent persons with outspoken faith in the change project is advantageous, if not crucial, for intended change to take place. Grossman, and Scala (1993) have observed that health promotion and planned change in organizations involve a wide range of activities. They suggest that these activities require four main roles to be  lled by employee representatives, middle-managers or consultants: (1) The expert: This person should be experienced in organizational development and possess special skills in assessing working conditions (and health status) and also in providing advice concerning methods for both process and outcome evaluation. This role is particularly required at the commencement and termination of projects. (2) The advocate: This role must be  lled by a person who can raise consciousness, convince, and motivate participants and help them to fully understand agreed project activities, and who can also be responsible for ensuring that these activities do not evaporate after the initial project optimism begins to dissipate. (3) The enabler: This role must be  lled by a person who is capable of tracking the details of the change and recording progress and setbacks. It is a role suitable for persons who can work out various steps of the change programme and who are persistent in adhering to the minutiae of the procedures. (4) The change facilitator : This role overlaps to a certain degree with that of the enabler, but requires social skills and leadership abilities that can be utilized in developing autonomous work groups and building alliances across the functional divisions of departments. DiŠ erent change projects require diŠ erent roles and diŠ erent roles require diŠ erent skills. The need for diŠ erentiation of roles in change projects is seldom discussed in the literature. Too often we have seen ad hoc groups responsible for organizational change that have not raised the issue of individual roles and responsibilities in facilitating that change. Covin, and Kilmann (1990) found that unclear allocation of responsibilities was an issue frequently reported to have a negative impact on the facilitation of large-scale change. The same authors showed that a sample of 240 managers and business consultants regarded ‘ visible management support and commitment’, ‘ preparing for successful change’ and ‘ encouraging employee participation’ as the three most important factors in promoting organizational change in general.

3.4. Readiness for change Earlier, we commented that employers and managers as well as their subordinates frequently resist organizational change for fear of adverse consequences to them or their colleagues. Many functional sub-systems within organizations, such as marketing,  nance and information technology, are frequently exposed to continuous change stemming from improvements in technology brought forward by external actors. Information and participation is not always necessary or requested when sub-systems that are under pressure to adapt will undergo minor changes. However, when enterprises have decided upon introducing interventions to reorganize in order to promote health, or prevent ill-health,

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it is wise to monitor employee attitudes towards those interventions in order to assess to what degree the interventions are appreciated as appropriate to alleviate the current state. Tacit or overt resistance to organizational renewal exhibited by a handful of informal leaders, can in the worst case lead to active subversion of the intervention by the ‘ underground management’ (Argyris, 1990). Evidence from social and health psychology demonstrates that unhealthy behaviour patterns are not amenable to change unless the persons involved (1) perceive their current behaviours to be unhealthy, (2) are convinced that change is necessary, (3) believe that the intervention will have a positive eŠ ect, and (4) are motivated to follow the advice concerning the intervention (Radley, 1994). Additionally, it is important to  nd out whether organizational members support each other in meeting the requirements of the intervention and whether they in general possess an internal health locus of control (Brickman, 1982). If the employees believe that their health is not controlled by their own behaviour (external health locus of control), interventions designed to promote new individual behaviour patterns may prove to be futile. In addition, positive health behaviour patterns are more likely to be sustained if people place a high value on their health (Wallston, 1992) and if the groups to which they belong experience a high level of collective e‰ cacy in coping with incipient stress (Zellars, Perrewe, Hochwarter, and Wayne, 1999). It appears that many organizational health programmes achieve, at best, modest positive results. The limited success may be attributed to a failure to assess employees ’ perceptions of the need for change, and whether the proposed intervention(s) is regarded as suitable for the identi ed problem (e.g. reducing acute responses) or future challenges (e.g. promoting enhanced well-being). An additional pitfall confronting health interventions at work is the high probability that they will principally appeal to employees outside the target group; that is, the most  t and healthy employees may  nd the initiative to be attractive while those who really need to change their health behaviours may  nd it to be stigmatizing and unattractive (Wallston, 1983). In these circumstances, implementation of measures intended to promote positive change for all can, paradoxically, increase stress among those employees who are most in need of help.

4. Conclusions This paper has identi ed and analysed processes crucial in implementing organizational change and introducing occupational stress interventions. We believe that it is important to consider these processes before stress interventions are introduced. If change is to be managed skilfully, it is important (1) to create a social climate of learning from failure ; (2) to provide opportunities for multi-level participation and negotiation in the design of interventions; (3) to be aware of tacit behaviours that possibly undermine the objectives of interventions; and (4) to de ne roles and responsibilities before and during the intervention period. In the literature on organizational change and workplace health, there is no lack of advice for implementing and monitoring change, but recommendationsare of limited value if the change agents are unable to understand organizational realities such as subversion, resistance

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and the meaning of trust. These psychological social processes are di‰ cult to manage without organizational experience, but we do not agree with some action researchers who claim that transferring change competence between change agents is impossible because the expertise required is based upon distinctly local and tacit knowledge (Fossen, and Skule, 1993). If positive organizational change is to take place, it is critical that the employers and employees involved in the change eŠ orts are willing to continually verbalize, test, and revise their espoused theories and harvest lessons from interventions that do not produce expected results, thereby making the organization more adaptive to future challenges. Such self-critical activities can only  nd a place in organizations with members that seriously contemplate the meaning of communication, culture, unresolved anxieties, readiness for change, responsibilities, participation and negotiation. This includes structures to su‰ ciently acknowledge the organizational barriers that have to be put in place for the collective to provide opportunities for multi-level participation and negotiation in the design of interventions (Pettigrew, and Fenton, 2000). Even when the objective is to control such processes in experimental  eld designs, further knowledge about the importance of social and cognitive processes in interventions is needed (Gri‰ ths, 1999). Our recommendation is therefore both to try to identify the processes we have outlined above in future intervention projects and to publish interventions reporting negative or no eŠ ects: by this strategy, practitioners and change experts can learn to promote more successful change in organizations.

Acknowledgement Preparation of this paper was supported by The Norwegian Research Council.

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