There has been a rapid increase in compensation claims for work-related stress in recent years. A Court of Appeal ruling (Sutherland v. Hatton) made it clear that;
'...employees who feel under stress at work should inform their employers and give them a chance to do something about it.'
Any employer who offers a confidential counselling service with access to treatment may have some protection from prosecution. In the face of a possible explosion in the provision of such services we need to ask — do they actually work?
In 2001 the British Association for Counselling and Psychotherapy (BACP) commissioned and published a report, Counselling in the Workplace: The Facts which described itself as
‘...the most comprehensive possible review of all English language studies of counselling in the workplace’.
The results appeared clear and unequivocal.
After counselling, work-related symptoms returned to normal in more than half of all clients and sickness absence was reduced by over 25%.
The report has received much publicity in the general medical press. But just how reliable is the evidence?
Workplace counselling may be defined as ‘the provision of brief psychological therapy for employees of an organisation, which is paid for by the employer’.
A typical and very generic ‘external’ service, such as an Employee Assistance Programme (EAP), typically comprises face-to-face counselling, a telephone helpline, legal advice and critical-incident debriefing.
In an ‘in-house’ service however, counsellors may be directly employed or retained via contract by the organisation. It is instantly a more powerful client - therapist relationship.
Workplace counselling offers employees a facility that is confidential, easily accessed (initial appointment normally within a week), provides a properly qualified and supervised practitioner, does not raise the threat of a diagnosis of psychiatric disorder, and directly attempts to alleviate distress within a reasonably short period of time (most services allow the provision of only 6-8 sessions per person in any one year).
Workplace counselling offers the employer a service that is valued by employees, has the potential for savings by reducing staff sickness absence, takes pressure off managers through the availability of a constructive means of dealing with ‘difficult’ staff or situations, and contributes to its reputation as a caring employer.
Workplace counselling is often viewed by employers as an insurance policy against the threat of compensation claims made by employees exposed to work-related stress. It is often regarded as a safety net.
The provision of workplace counselling has steadily expanded over the past 20 years, with more than 75% of medium and large organisations in Britain and North America making counselling available to their staff.
What about the smaller operations that would find it possibly uneconomical to employ a full time therapist / counselling service within their company? The answer is simple - Retain a contracted workplace counsellor to operate on or off site. The result? Minimal outlay for maximum service.
One review of research into the outcomes of workplace counselling identified 34 studies, including controlled studies, naturalistic studies (in which reliable pre- and post-counselling data were collected), and case studies. Employees presented to counselling with high levels of psychological symptoms. Those who received counselling were highly satisfied, and attested that it had helped them resolve their problem.
Clinically significant improvement in levels of anxiety and depression was reported in 60-75% of clients.
Counselling was associated with reduction in sickness absence and improvement in other organisational outcomes such as more positive work attitudes, fewer accidents and enhanced work performance.
However, it is important to recognise the limitations of the existing research base for workplace counselling.
There is a great deal of sensitivity around confidentiality; the fear that ‘management’ may learn that a person has received counselling has made many clients and counsellors reluctant to complete research questionnaires.
The provision of a highly structured counselling process is absolutely imperative.
Despite these methodological weaknesses, the general picture that emerges is that workplace counselling is appreciated by its users, and appears to have a positive impact on objective measures of distress (e.g. sickness absence) and on self-reported measures of symptom experience.
Probably, several factors have contributed to the growth and popularity of workplace counselling. At one level, workplace counselling can be viewed merely as an application of methods of brief, relationship-focused psychological intervention that have been shown to be effective in other settings. A distinctive strength of workplace counselling is that the client is seen by a therapist who is sensitised to the combination of personal and work pressures that the person may present.
Workplace counselling is a systemic, as well as individual, intervention. The introduction of a counselling service may begin to change the way that managers and other staff think and talk about emotional difficulties and personal problems.
The costs to employers of psychological disability should never be underestimated.
They should be clearly understood. The acceptability of workplace counselling is certainly linked to shifts in the quality of work rate.
In a recent qualitative study, police officers and support staff who had received counselling for work-related difficulties were interviewed. Most of the participants reported that counselling had helped them to overcome the problem that had led to them seek help.
More striking, though, was the finding that all of these informants described themselves as learning something new and useful about themselves as a result of counselling.
For example, an experienced detective stated that ‘I am 100% better now at listening to a person’.
Although further controlled studies of the effectiveness of workplace counselling on psychiatric symptoms are undoubtedly necessary, it is also essential to acknowledge the relevance of a wider research agenda in which the role of workplace counselling can be examined in relation to a range of issues such as health, organisational culture and work effectiveness.
Employment practices in the UK are changing, with more people on short-term contracts, working part-time and with less job security. An added burden for employees, employers and the economy as a whole is the large number of employees absent from work, sick or retired because of ill health.
Although under-recognised, frank psychological conditions - (most notably anxiety and depression) but also 'somatoform' disorders and substance misuse - account for a growing proportion of these absences.
A new diagnosis has recently emerged which is ubiquitous, not viewed pejoratively, widely used on sickness certificates and has formed the basis of legal claims against employers;
Workplace Stress
It does not seem to have an objective definition and thus any overlap with the psychiatric diagnoses already noted is unclear.
Fortunately, workplace stress is seemingly quite treatable; in fact, it is highly responsive to treatment. The name of this well-tolerated and efficacious treatment is;
Workplace Counselling
Work and workplaces are rapidly evolving and 21st-century occupational medicine will have to manage a different set of problems from its early-20th-century predecessor. However, where previously a link between exposure and illness was clear and such exposure could have occurred only in the workplace, now many complaints have more vague, non-specific symptoms and signs.
The concept of workplace stress implies that work is the causative factor but despite an individual being unhappy at work and using a work-based outlet to complain, symptoms may be explained in several other ways.
There may be a perception that appropriate help is difficult to access via more traditional routes. The problems may stem from the employees personal life, or from their past. The causative factors could be almost limitless – yet they all manifest in the form of workplace stress.
Treatment for such a generalized group of problems with a single therapeutic modality would seem almost impossible, yet workplace counselling seems to be a fairly successful first-step therapy.
All treatments that work have the potential for adverse effects and this holds true for psychotherapeutic as well as pharmacological interventions. Although the available studies are limited by small sample sizes, short follow-up periods and wide variation in the form and content of the therapy given, there is evidence to suggest that they are of benefit to both employer and employee alike.
It has to be said though, to date, long term empirical evidence is not available for efficacy of workplace counselling.
The ‘medicalisation’ or ‘psychologisation’ of normal human distress is a real and unwelcomed possibility. So too is the possibility of failing to manage the other factors involved; work may indeed be a part of the jigsaw but in all probability only a part — most stressors are external to work.
So does workplace counselling work? Well, that depends on what you want it to do.
Many studies highlight the significant client satisfaction associated with workplace counselling.
If that is its aim, then it succeeds.
Many employees feel that their employers are caring and supportive by offering this kind of service.
If that is the aim, then it succeeds.
Employees are far more productive if they are happy and secure in their working environment.
If that is the aim, then it succeeds.
Many companies have and will save thousands of pounds in lost time, upset and wasted work hours dealing with staff grievances that stem from none work related causes. The retention of an external workplace counsellor could prevent a significant proportion of these cases.
If that is the aim, then it succeeds.
The cynic might suggest that if employers want a tool that their employees appreciate and that, in view of the recent Court of Appeal ruling (Sutherland v. Hatton ), protects them from litigation, then workplace counselling does indeed work. The objective scientific observer looking purely at ‘clinical outcomes’ may conclude that there is no reliable evidence that workplace counselling is of benefit – but then again, they are not sharing a workplace environment with an individual suffering with stress.
Contact us to find out more about our workplace counselling packages to suit your company.
http://www.mewshypnotherapy.com/
