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Three people performing a yoga pose while standing

Yoga poses, such as the warrior seen here, involve precise alignment of the arms, legs and torso. The balance of poses and breathing help achieve stress management and relaxation.

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Stress management offers a range of ways to help you better deal with stress and difficulty, also called adversity, in your life. Managing stress can help you lead a more balanced, healthier life.

Stress is an automatic physical, mental and emotional response to a difficult event. It's a common part of everyone's life. When used positively, stress can lead to growth, action and change. But negative, long-term stress can lessen your quality of life.

Stress management approaches include:

  • Learning skills such as problem-solving, focusing on important tasks first and managing your time.
  • Improving your ability to cope with difficult events that happen in life. For example, you may learn how to improve your emotional awareness and reactions. You also may learn how to increase your sense of control. And you may find greater meaning and purpose in life and have more gratitude and optimism.
  • Practicing relaxation techniques such as deep breathing, yoga, meditation, tai chi, exercise and prayer.
  • Improving your personal relationships.

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  • 11 healthy ways to handle life's stressors. American Psychological Association. https:// www.apa.org/topics/stress/tips. Accessed March 13, 2023.
  • I'm so stressed out! Fact sheet. National Institute of Mental Health. https:// www.nimh.nih.gov/health/publications/so-stressed-out-fact-sheet. Accessed March 13, 2023.
  • Relaxation techniques for health. National Center for Complementary and Integrative Health. https:// www.nccih.nih.gov/health/relaxation-techniques-what-you-need-to-know. Accessed March 13, 2023.
  • Rakel D, et al., eds. Relaxation techniques. In: Integrative Medicine. 5th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed March 15, 2023.
  • Bystritsky A. Complementary and alternative treatments for anxiety symptoms and disorders: Physical, cognitive, and spiritual interventions. https://www.uptodate.com/index.html. Accessed March 15, 2023.
  • Pizzorono JE, et al., eds. Stress management. In: Textbook of Natural Medicine. 5th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed March 15, 2023.
  • Libby P, et al., eds. Integrative approaches to the management of patients with heart disease. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed March 15, 2023.
  • Bauer BA (expert opinion). Mayo Clinic. March 23, 2023.
  • Massage therapy: What you need to know. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/massage-therapy-what-you-need-to-know. Accessed March 20, 2023.
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Problem-Solving to Manage Stress

Topic contents, related information.

what are the series steps in problem solving under the stress management

Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use.

Think about your behaviour, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify:

  • Behaviours, such as the need to look for another job, earn money for your family, and make other adjustments in your life.
  • Negative thoughts, such as "I'll never get another job."
  • Negative feelings, such as anger and depression.
  • How your body responds, such as fatigue or trouble sleeping.

You can then find coping strategies, such as talking with a counsellor about your feelings of anger or depression.

  • Think of as many solutions as you can, even if they seem very hard to achieve.
  • Don't criticize any solution.
  • Combine solutions.

When rating your solutions, take into account the:

  • Likelihood of being able to carry it out and succeed.
  • Cost in time and energy.
  • Effect of the solution on other people.

Figure out the steps you need to take, and then act.

  • Dealing With Negative Thoughts
  • Stress Management

Current as of: October 20, 2022

Author: Healthwise Staff Medical Review: Kathleen Romito MD - Family Medicine Adam Husney MD - Family Medicine Christine R. Maldonado PhD - Behavioral Health

Author: Healthwise Staff

Medical Review: Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Christine R. Maldonado PhD - Behavioral Health

Click here to learn about Healthwise

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Stress Management and Building Resilience

When dealing with stressful situations and change, it is important to monitor how you’re feeling and take active steps to care for yourself. Many times, there are things going on in life that are distressing and outside our control. Negative feelings associated with these stressors can make it hard to concentrate, be patient with loved ones, or have the energy to do the things you need and want to do. In turn, missing out on enjoyable activities, leaving important things undone, and reacting impatiently with others can then lead to even more feelings of stress, anxiety, loneliness, and anger.

The strategies in this section are designed to manage negative feelings associated with stress and to increase the positive day-to-day experiences in your and your family’s life. These strategies do not fix the problems, changes, or sources of stress in your life. Instead they are designed to build your emotional awareness, strength, presence of mind, and energy to handle daily tasks.

  • The first section describes techniques for calming your mind and body when you begin to feel overwhelmed by stress.
  • The second section includes activities designed to build your energy, sense of accomplishment, social connections, and general well-being.
  • The third section helps you and your family focus on the activities and parts of life that you value most and prioritize what is important to you.

After you have learned about these strategies you can make your own resiliency plan with the activities that fit best for you and your family.

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Stress Leads to Bad Decisions. Here’s How to Avoid Them

  • Ron Carucci

Step back and look for more options.

Our brains are wired to be more reactionary under stress. This can mean that in tough moments we reflexively narrow and simplify our options to all-or-nothing extremes. If we have to deliver bad news, we are either too harsh or too indirect. If we’re overloaded with work, we either overdelegate or try to do everything ourselves. If we have to make a high-stakes decision, we either go with our first instinct or we suffer from analysis paralysis. But there are no complex challenges in the world for which there are only  two  possible solutions. The minute you find yourself torn between two extremes, assume that both are limited, step back, and build a broader menu of options. That’s where you’re likely to find your optimal choice.

A senior sales executive I’ll call Daniela was frustrated. She’d been working on delegating more to her team. To her dismay, many were struggling to take on the levels of freedom she’d offered — even though they’d asked for more responsibility. Exasperated, she vented to me, “I thought delegating was supposed to free me up to do more of my own job. But every time they drop a ball I hand off, it takes me twice as long to clean up the mess as it would have taken for me to just do it myself.” Exhausted from failing at one extreme, her natural impulse was to revert back to the other.

what are the series steps in problem solving under the stress management

  • Ron Carucci is co-founder and managing partner at  Navalent , working with CEOs and executives pursuing transformational change. He is the bestselling author of eight books, including To Be Honest and Rising to Power . Connect with him on Linked In at  RonCarucci , and download his free “How Honest is My Team?” assessment.

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Problem-Solving to Manage Stress

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Top of the page

what are the series steps in problem solving under the stress management

Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use.

Think about your behavior, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify:

  • Behaviors, such as the need to look for another job, earn money for your family, and make other adjustments in your life.
  • Negative thoughts, such as "I'll never get another job."
  • Negative feelings, such as anger and depression.
  • How your body responds, such as fatigue or trouble sleeping.

You can then find coping strategies, such as talking with a counselor about your feelings of anger or depression.

  • Think of as many solutions as you can, even if they seem very hard to achieve.
  • Don't criticize any solution.
  • Combine solutions.

When rating your solutions, take into account the:

  • Likelihood of being able to carry it out and succeed.
  • Cost in time and energy.
  • Effect of the solution on other people.

Figure out the steps you need to take, and then act.

  • Related Information
  • Dealing With Negative Thoughts
  • Stress Management

Current as of: June 24, 2023

Author: Healthwise Staff Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Author: Healthwise Staff

Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Topic Contents

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . Learn how we develop our content .

Click here to learn about Healthwise

To learn more about Healthwise, visit Healthwise.org .

© 1995-2024 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

26 Best Stress-Relief Techniques According to Psychology

Stress relief techniques

All are nasty sources of stress that vary in how long they last and how much they affect your day-to-day life.

None of us can avoid stress completely, and we wouldn’t want to. Stress in small amounts can be helpful. But because stress disrupts the natural functioning of our bodily systems, chronic stress becomes an increasingly heavy burden to bear.

Few of us make time for stress relief in our daily routines, which allows stress to bubble away and build up.

If you’re currently helping a client get a handle on stress, you can use the information in this article, as we explore a range of simple and effective stress-relieving techniques your clients can use to stop stress from getting out of control.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises for free . These science-based exercises will equip you and those you work with tools to better manage stress and find a healthier balance in your life.

This Article Contains:

Why is relieving stress important, 6 evidence-based stress-relief techniques, 3 relaxing breathing techniques, relieving stress with yoga and sports, simple japanese stress-relief method, 6 popular strategies for stressed students, 8 techniques for a stress-free workplace, helpful resources from positivepsychology.com, a take-home message.

It’s no secret that stress is bad for us.

Stress is a destabilizer and a catalyst for other health problems because it messes with the optimal state of balance in our bodies, also known as homeostasis (Schneiderman, Ironson, & Siegel, 2005).

Stress can be intense for a short period, or it can simmer away over weeks, months, or even years. The most crucial reason to prioritize stress relief is to stop it from building up.

Stress and the body

Our sympathetic (‘fight, flight, or freeze’) nervous system gets fired up to respond to stressors, which triggers a range of physiological changes, such as the release of stress hormones and an increase of blood pressure. When this happens, nonessential activities like digestion are put on standby (Schneiderman et al., 2005).

In the short term, these changes can help us cope with a stressor, but repeated or chronic activation of our body’s stress response can be a serious threat to our mental and physical wellbeing (Schneiderman et al., 2005).

Over time, stress hormones like epinephrine and cortisol stop helping us and start being destructive to our bodies. Being in a constant state of stress increases strain on our hearts, suppresses our immune system, and increases inflammation (Juster, McEwen, & Lupien, 2010; Schneiderman et al., 2005).

Some people are also more vulnerable to the ill effects of stress. Age, genetics, life experiences, social support , and coping mechanisms can all contribute to how well we’re able to respond to stress (Schneiderman et al., 2005; Thoits, 2010).

Stress is, of course, a normal part of life, and we can’t always control what happens to us. What is under our control is making time for stress relief to recover, recharge, and rebalance our bodies.

Stress Relief

Taking time out to relax and unwind can be an important part of our everyday routines.

Sleep and sleep hygiene

Sleep and stress are notoriously bad bedfellows. When we’re stressed, we often sleep less, and when we sleep less, we’re stressed. It’s exhausting just thinking about it.

When you’ve survived a stressful day, getting enough good-quality sleep (particularly rapid-eye-movement sleep) can be an important recovery strategy (Suchecki, Tiba, & Machado, 2012). Chronic sleep deprivation can disrupt our stress response system and reduce our ability to deal with stressors (Suchecki et al., 2012).

To combat the negative sleep–stress cycle, improving sleep hygiene habits is a good start.

  • Get a sleeping and waking schedule in place so your body knows when it’s time to rest.
  • Wind down before bed in whatever way works for you. Take a warm bath, read a stress relief book , or try one of the relaxation exercises in this article.
  • Make your bedroom a haven for sleep. Try to remove anything that’s not conducive to sleep, such as clutter, pesky sources of light, exercise equipment, or work-related items (National Health Service, 2019).

Progressive muscle relaxation

Progressive muscle relaxation involves tensing and relaxing different muscle groups (e.g., legs, stomach, back) in a sequence to help you better understand the differences between these sensations. Among many benefits, progressive muscle relaxation has been found to reduce salivary cortisol levels, anxiety, heart rate, and blood pressure (Varvogli & Darviri, 2011).

Mindfulness

Mindfulness-based stress reduction programs have consistently shown to be an effective stress-relieving intervention (Baer, Carmody, & Hunsinger, 2012). Mindfulness involves bringing your awareness to the present moment with a nonjudgmental and accepting attitude, which can help you deal with stressors more effectively when they arise (Baer et al., 2012).

Guided imagery

Guided imagery interventions have been shown to reduce stress and help treat depression (Varvogli & Darviri, 2011).

Guided imagery practices activate the senses and conjure memories or images of serene locations. This positive mental imagery induces a peaceful state of mind.

Deep breathing

Deep breathing can reduce anxiety and help people cope with stressful tasks (Varvogli & Darviri, 2011). Diaphragmatic breathing (or “belly breathing”) involves actively breathing into your diaphragm or abdomen, as opposed to the chest.

Deep-breathing techniques help calm the physiological systems in the body, reducing heart rate and blood pressure, increasing activation of the parasympathetic nervous system (Varvogli & Darviri, 2011), and reducing cortisol levels (Perciavalle et al., 2017).

Laughing and humor

All joking aside, laughing is a simple route to relieve stress.

One study found that “mirthful” laughter reduced levels of cortisol and epinephrine in the body, which could knock down the negative hormonal effects of a stress response (Berk et al., 1989).

Other researchers have found that students who are more humor oriented in their approach to work stress felt more able to cope and reported greater job satisfaction (Booth-Butterfield, Booth-Butterfield, & Wanzer, 2007).

what are the series steps in problem solving under the stress management

Download 3 Free Stress & Burnout Prevention Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to manage stress better and find a healthier balance in their life.

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Taking a moment out of your day just to breathe is an effective way to stop momentary stress in its tracks.

If you’re working with a client to combat stress, try some of these simple breathing exercises at the beginning or end of a session.

Diaphragmatic breathing

Get comfortable in a seated position or lying down, placing one hand on your chest and the other on your stomach. Breathe deeply through your nose, actively expanding your stomach upward, pushing upward on your hand while keeping your chest still. Exhale with slightly puckered lips, expelling all the air from your stomach. Take it slow, and repeat up to 10 times (University of Michigan Health, 2020).

Box breathing

Box breathing can help you regulate your breath. Begin by exhaling completely for four seconds. Then, keep your lungs empty (don’t breathe) for another four seconds. Next, inhale for four seconds at a similar speed. Finally, hold your breath in your lungs for another four seconds before breathing out and starting again (Scott, 2020).

Lion’s breath

You can roar and relax with this yogic breathing exercise. Sit down comfortably on a chair or cross-legged. Place your hands on your knees or on the floor, lean your body forward, and spread your fingers as wide as you can.

Breathe in through your nose. Then, with your mouth wide open, stretch out your tongue toward your chin. Next, breathe out with force from your abdomen, making a sound with your breath (the roar). Breathe normally for a little while before repeating up to seven times (Cronkleton, 2020).

Relieving Stress with Sport

Yoga and stress relief

Yoga has been shown to reduce stress or symptoms of stress in a range of studies (Chong, Tsunaka, & Chan, 2011).

Originating in India, yoga is an age-old practice that can increase flexibility, strength, and wellbeing. Breathing techniques are typically a core element of yogic practice.

How exactly yoga contributes to stress relief is not entirely clear, but it’s believed to exert positive effects through both psychological and biological pathways (Riley & Park, 2015).

Yoga may help take the sting out of stress by (Riley & Park, 2015):

  • Encouraging mindfulness
  • Enhancing self-compassion and positive emotions
  • Decreasing the sympathetic stress response
  • Lessening the stimulation of the vagus nerve, which can subsequently activate the parasympathetic nervous system
  • Reducing inflammation

Exercise and stress relief

Exercise is a type of stress, and over-exercising or doing very intense or long workouts can actually increase stress levels (Hackney, 2006). That being said, regular physical activity in the right amount for you may help you sleep better (Dolezal, Neufeld, Boland, Martin, & Cooper, 2017) and boost your resilience to stress (Childs & de Wit, 2014).

Exercise may also help you respond to stress better in the longer term (American Psychological Association, 2020). This is because exercise acts as a sort of dress rehearsal for the body’s mechanisms that come into play when dealing with stress. When our activity levels are very low, our bodies don’t get as much practice dealing with stress (American Psychological Association, 2020).

what are the series steps in problem solving under the stress management

World’s Largest Positive Psychology Resource

The Positive Psychology Toolkit© is a groundbreaking practitioner resource containing over 500 science-based exercises , activities, interventions, questionnaires, and assessments created by experts using the latest positive psychology research.

Updated monthly. 100% Science-based.

“The best positive psychology resource out there!” — Emiliya Zhivotovskaya , Flourishing Center CEO

Originating in Japan, Jin Shin Jyutsu is an ancient practice that aims to open up the flow of energy throughout the body and encourage healing (Nyar, 2018). The fundamental assumption of Jin Shin Jyutsu is that free-flowing energy contributes to better health and wellbeing and that certain life and lifestyle stresses can block or disrupt this flow (Nyar, 2018).

The hands are thought to be one pathway to relieving different tensions or blockages of energy. Each part of the hand is linked to different emotions, functions, and organs. For example, the ring finger is believed to be linked to depression, sadness, and decision making and associated with the lungs and colon, whereas the palm is connected to overall happiness (Weber Smit, 2017).

Here’s how to practice the Jin Shin Jyutsu method (Weber Smit, 2017):

  • Grab your finger (or thumb) with the opposite hand, as if you were holding a handle.
  • Hold each finger (or thumb) for one or two minutes. You may feel a pulsating sensation.
  • For the palm, use the thumb of your opposite hand to put pressure on the middle of the palm for around one minute.

Student stress relief strategies

If you support students to manage their stress , these strategies may be a good place to start.

  • Reflect and problem-solve: It can be helpful to break down what is causing the stress. Is it a particular project, money worries, or are you missing home? Establishing the root of the stress can help you problem-solve how to relieve the strain and seek support (National Health Service, 2020).
  • Look after yourself: The stereotypical student lifestyle is not always conducive to optimal wellbeing. Getting enough sleep, eating nutritious foods, staying active, and making space for relaxation techniques and things you enjoy can go a long way (National Health Service, 2020).
  • Abstain: Stay away from alcohol, drugs, and caffeine. These can make stress worse and contribute to poorer emotional wellbeing (National Health Service, 2020).
  • Speak up: Talking to someone about what you’re going through and accessing the support available can be a crucial stress buffer. We all need to lean on others sometimes, and having a solid support system can help us cope (National Health Service, 2020).
  • Break it down: Big deadlines and projects can sometimes feel like a mountain to climb. It can be helpful to create a plan and break things down into less overwhelming and more realistic goals (National Health Service, 2020).
  • Be mindful: Many students worry about their future or dwell on poor grades or mistakes they’ve made, which adds to their stress. Mindfulness can help students step away from rumination or catastrophizing thoughts . Many students get mindfulness or meditation apps on their smartphones to help make mindfulness more of a habit (Smith, 2021).

Even if you love your job, the workplace can still be a source of stress. You may be working too many hours, your workload may be unmanageable, or you might not be getting enough support.

Here are a few techniques to help avoid or turn the volume down on workplace stress (Mind, n.d.).

  • Take breaks: Put them in your calendar if you need to. We are not designed to work nonstop. Go outside and take a breath of fresh air whenever possible, and make the most of lunch breaks and coffee breaks.
  • Cultivate your non-working life: We need to save energy and time for our lives outside the workplace. Draw a sharp line on your working day, and prioritize fostering your relationships, hobbies, and interests too.
  • Create an after-work routine: To really cement the boundary between work and non-work, establish a routine to end your day. You could go for a walk, write a list for the next day, or call a loved one.
  • Make time for informal interactions: Building relationships with colleagues can create a greater sense of support at work. Make time for connecting where you can, maybe over lunch or a morning coffee break.
  • Set realistic goals: If your standards or expectations for yourself are too high, you may be sabotaging your ability to get things done. Create contingency time for yourself, and don’t take on more work than you can handle.
  • Acknowledge your achievements: It’s easy to focus on what you have left to do rather than what you’ve done that day. Remember to pat yourself on the back, and reward yourself for your achievements.
  • Ask for help: If you’re struggling, don’t suffer in silence. Reach out and speak to someone to see how you can reduce your workload or resolve issues.
  • Focus on one thing: If you’re juggling multiple tasks, it may be putting the brakes on productivity. Keep things simple where you can, and focus on one task at a time. You may find it helpful to track your time to see how long each task takes.

what are the series steps in problem solving under the stress management

17 Exercises To Reduce Stress & Burnout

Help your clients prevent burnout, handle stressors, and achieve a healthy, sustainable work-life balance with these 17 Stress & Burnout Prevention Exercises [PDF].

Created by Experts. 100% Science-based.

Stress can come from many sources, and as a helping professional, it can be hard to know where to start. To get the ball rolling, we’ve collated some helpful tools and exercises below that you can use in your sessions with clients.

  • Coping With Stress This two-part exercise invites clients to list experienced physiological and emotional symptoms of stress and brainstorm strategies to reduce, cope with, or eliminate these sources of stress.
  • Coping: Stressors and Resources This worksheet helps clients identify past, present, and future stressors and link them with coping resources they can use to overcome them.
  • Identifying Your Stress Resources This worksheet helps clients identify external resources they can connect with and draw strength from during stressful times.
  • One Hour Stress Plan This worksheet provides a 60-minute action plan for dealing with intense demands, helping clients work systematically through a list of tasks that require their most urgent attention.

17 Stress & Burnout Prevention Exercises If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, this collection contains 17 validated stress management tools for practitioners . Use them to help others identify signs of burnout and create more balance in their lives.

Stress relief is not something we can afford to put on the back burner. If we de-prioritize rest and relaxation while continuing to pile on the stress at home or work, sooner or later, we are likely to face dire consequences.

When working with clients on managing stress , it may be difficult for them to begin prioritizing stress relief. But as we’ve outlined in this article, there are many quick and simple ways to seek relaxation day to day.

All too often, we look to stress-relief techniques when we’re burned out or exhausted, but by then, stress has already gotten out of control. Nipping stress in the bud regularly builds positive stress-buffering habits, which can ultimately help us avoid reaching the point where it takes a toll on our physical and mental wellbeing.

We hope you enjoyed this article; don’t forget to download our three Stress & Burnout Prevention Exercises for free .

  • American Psychological Association. (2020, March 4). Working out boosts brain health . Retrieved August 2, 2021, from https://www.apa.org/topics/exercise-fitness/stress
  • Baer, R. A., Carmody, J., & Hunsinger, M. (2012). Weekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program. Journal of Clinical Psychology , 68 (7), 755–765.
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Self-Affirmation Improves Problem-Solving under Stress

J. david creswell.

1 Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, United States of America

Janine M. Dutcher

2 Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America

William M. P. Klein

3 Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland, United States of America

Peter R. Harris

4 Department of Psychology, University of Sheffield, Sheffield, United Kingdom

John M. Levine

5 Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America

Conceived and designed the experiments: JDC JMD WMPK PRH JML. Performed the experiments: JMD. Analyzed the data: JDC JMD. Contributed reagents/materials/analysis tools: JDC. Wrote the paper: JDC JMD WMPK PRH JML.

Associated Data

High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings.

Introduction

Acute and chronic stress have been shown to disrupt problem-solving and creativity [1] . For example, acutely stressful contexts, such as completing problem-solving tasks under negative social evaluation, have been shown to impair performance on a variety of tasks, such as anagrams and remote associate problems [2] , [3] . Feeling chronically stressed produces similar performance impairments. For example, Liston and colleagues found that participants who reported high levels of stress over the previous month demonstrated impaired attention-shifting performance compared to participants who reported low levels of stress [4] , [5] . Moreover, these stress-induced performance impairments were reversed when the high-stress participants completed the tasks after a one-month low stress period [4] . Although this body of research provides supportive evidence indicating that acute and chronic stressors can impair problem solving, little is currently known about stress management approaches for mitigating the effects of stress on problem solving.

An emerging body of research suggests that self-affirmation may be one such effective stress management approach. Self-affirmation theory posits that the goal of the self is to protect one’s self-image when threatened and that one way to do this is through affirmation of valued sources of self-worth [6] , [7] . In order to manipulate self-affirmation, experimental studies commonly have participants rank-order personal values (e.g., politics, relations with friends/family), and then participants in the self-affirmation condition are asked to respond to questions or complete a short essay on why their #1 ranked value is important (control participants complete a similar activity about why a lower ranked value might be important to someone else) [8] . As a result, participants in the self-affirmation condition have an opportunity to affirm a valued self-domain or characteristic [6] , [8] . Studies using this experimental approach have found that self-affirmation can buffer threats to the self in variety of domains [6] , with several recent studies showing that self-affirmation can buffer stress responses to laboratory stressors [9] , [10] and naturalistic academic stressors [11] . Collectively, this work suggests that if self-affirmation can reduce stress, it may also promote problem-solving performance under high stress conditions, although no previous studies have tested the effects of self-affirmation manipulations on actual problem-solving performance [12] – [16] .

In the present study, we test whether a brief self-affirmation can buffer the negative impacts of chronic stress on problem-solving. Specifically, we used a well-known measure of problem-solving and creativity (the Remote Associates Task (RAT)) [17] – [20] to test three hypotheses. First, we tested whether chronic stress is related to poorer problem-solving performance. Second, we tested whether self-affirmation improves problem-solving. Third, we tested whether these two main effects are qualified by a chronic stress × self-affirmation interaction, such that self-affirmation will improve problem-solving in chronically stressed participants, whom are likely to have impaired problem-solving, compared to participants who are low in chronic stress.

Ethics Statement

This research was approved by the Carnegie Mellon University Institutional Review Board.

Participants

Eighty students from two urban universities in Pittsburgh participated for course credit or $20. We excluded seven participants who did not follow instructions (N = 5) or who did not rate academic performance as important to them (N = 2). The sample thus consisted of 73 students (34 females; 39 males) who ranged in age from 18 to 34, with an average age of 21 (SD = 2.4). Given this broad age range and the marginally significantly association between age and overall RAT performance ( r  = −.21, p  = .07), we controlled for age in all analyses. The ethnic composition of the sample was predominantly Caucasian (55%), followed by Asian-American (16.5%), Other (12%), African-American (9.5%), mixed-race (5.5%), and Latino/Hispanic (1.5%). The sample had similar levels of chronic stress ( M =  16.6, SD  = 7.1, Range = 1–34) to normed US samples of individuals under 25 years of age (M = 16.8) [21] . Ethnicity (Caucasian vs. all others) and gender (male vs. female) did not moderate any of the primary study results (see Tables 1 and ​ and2 2 ).

AnalysisBeta Coefficientt-valuep-value
Main Effect  = −.199 (72) = −1.273  = .208
Ethnicity × Affirmation  = .216 (72) = 1.101  = .275
Ethnicity × PSS  = .234 (72) = 0.975  = .333
Ethnicity × Affirmation× PSS  = −.386 (72) = −1.713  = .092
AnalysisBeta Coefficientt-valuep-value
Main Effect  = −.012 (72) = −.077  = .939
Gender × Affirmation  = −.132 (72) = −.667  = .507
Gender × PSS  = −.130 (72) = −.499  = .620
Gender × Affirmation× PSS  = .046 (72) = .161  = .873

Participants provided written informed consent and then completed an experiment ostensibly about intelligence and performance. Participants were informed that a trained evaluator would administer the performance task. Prior to completing the RAT and while the evaluator was ostensibly preparing to administer the test, participants were asked if they would be willing to complete a questionnaire and writing activity that was being piloted for an unrelated experiment on personal values (all agreed). Participants were randomly assigned either to the self-affirmation or control condition. In both cases, they rated 11 values (i.e., art, business, friends/family) in order of personal importance. Next, they wrote about their first ranked value and why it was important to them (self-affirmation condition) or their ninth ranked value and why it might be important to others (control condition) [12] . Following the self-affirmation writing task, as a manipulation check, participants were asked to respond to two items assessing how important the value they wrote about was, using a 6-point response scale (1 = Strongly Disagree to 6 = Strongly Agree). Items were, “This value has influenced my life” and “This value is an important part of who I am” (study α = .96). Participants then completed a state mood adjective checklist assessing state positive mood (5 items: proud, content, joyful, love, and grateful; study α = .84) and state negative mood (3 items: sad, angry, scared; study α = .65) (PANAS-X; [22] , [23] ).

Participants’ heart rate and mean arterial pressure were measured at 2-minute intervals using an automatic sphygmomanometer and inflatable cuff on their left arm (Dinamap Carescape V100, General Electric Company, Finland) during three different periods: an eight-minute baseline period, followed by the RAT (about 9 minutes), and a five-minute recovery period. All readings in each period were averaged. Heart rate was included because it is a useful indirect marker for task engagement [24] , [25] , which may be affected by our self-affirmation manipulation. Mean arterial blood pressure was collected to measure cardiovascular reactivity to the laboratory challenge task.

The experimenter was blind to participant condition, and a separate RAT evaluator (also blind to condition) administered the 30-item RAT performance task. 144 RAT items have been normed for difficulty [17] , and pilot testing indicated that our undergraduate sample population can solve all easy RAT items. We thus selected 30 challenging RAT items ranging in difficulty from moderately to extremely difficult (the items are available in Table S1 ). For each RAT item, participants saw three words on a computer screen (e.g., flake, mobile, cone) and were asked to generate a fourth word (e.g., snow) that when combined with each of the three stimulus words results in a common word pair used in everyday English language (e.g., snowflake, snow mobile, snow cone). They were given 12 seconds to provide an answer verbally. The evaluator provided veridical verbal performance feedback (incorrect, correct) after each response and recorded each response. In order to create performance pressure, the evaluator provided evaluative feedback three times during the 30 RAT trials (“I need you to try harder”).

After completing the performance task, the evaluator left the room and the experimenter re-entered and indicated that the participant was to rest quietly (5 minute recovery period). Participants then completed individual difference measures, including the 10-item Perceived Stress Scale [26] to assess perceived stress over the last month (all items were summed to form a composite index of chronic stress, study α = .87). To reduce potential confounding effects, we administered these measures at the end of the experimental session because previous studies indicate that completing individual difference measures at the beginning of an experimental session may act as an affirmation manipulation (i.e., they have carry-over effects) [27] . We had no reason to expect that the experimental task would bias participants’ responses when self-reporting their chronic stress levels over the past month, and a one-way ANCOVA indicated that the self-affirmation manipulation did not affect perceived stress over the last month ( F (1, 72) = .95, p  = .22, η 2  = .01). After completing individual difference measures, participants were debriefed, compensated, and excused.

Data Analysis

All descriptive statistics, ANCOVA, and multiple regression analyses were conducted using SPSS 19.0 (IBM, Armonk, New York). All predictor variables were mean-centered prior to being entered in multiple regression equations. Our experimental manipulation of self-affirmation was dummy coded (self-affirmation = 1, control = 0). Correct responses on the RAT were summed across the 30 trials to form an overall composite RAT problem-solving performance score. As described above, age was included as a covariate in all analyses (except the preliminary chi-square analyses described below).

Preliminary Analyses

It is possible that there may have been significant differences in how participants ranked their #1 value across study conditions, which could indicate a failure of randomization. To test whether there were differences in the selected #1 ranked value between study conditions, chi-square analyses were conducted to test for condition differences (self-affirmation vs. control, low vs. high chronic stress) on which value participants’ ranked #1 ( Table 3 provides frequencies of #1 ranked values across conditions). Consistent with previous studies [28] , approximately 50% of participants selected “Relations with Friends and Family” as their #1 ranked value. Importantly, there was no main effect for either self-affirmation condition (χ 2 (8) = 6.36, p =  .61) or chronic stress level (χ 2 (8) = 6.50, p  = .59) on the #1 ranked value. Moreover, the self-affirmation × chronic stress interaction for the #1 ranked value was not significant (χ 2 (8) = 3.03, p  = .93). In sum, there was no evidence that self-affirmation condition or chronic stress level affected participants’ selection of their top-ranked value.

Group
Value ChosenControl Condition,Low StressControl Condition,High StressAffirmation Condition,Low StressAffirmation Condition,High Stress
Artistic Skills0100
Athletics0000
Business/Money2011
Creativity1031
Independence2223
Music0011
Politics0000
Relations with Friends and Family91288
Religious Values3121
Sense of Humor1112
Spontaneity2212

As expected, self-affirmation and control participants wrote about different values during the writing activity (χ 2 (10) = 33.7, p<.001; see Table 4 ), such that participants in the control condition wrote about a ninth-ranked value that was different from the first-ranked value in the self-affirmation condition. As shown in Table 4 and noted above, approximately half the self-affirmation condition participants wrote about relations with friends and family, whereas control condition participants wrote about a heterogeneous set of values. We had no reason to believe that chronic stress would influence choice of value. Consistent with this expectation, there was not a main effect for either chronic stress level (χ 2 (10) = 11.08, p  = .35) nor a self-affirmation condition × stress level interaction (χ 2 (10) = 10.6, p =  .39).

Group
Value Written AboutControl Condition,Low StressControl Condition,High StressAffirmation Condition,Low StressAffirmation Condition,High Stress
2200
2100
3311
0031
3223
3111
0600
0188
2121
1112
4112

As a manipulation check, we compared the ratings that participants in different conditions made about their value writing activity immediately after completing the writing activity. A one-way ANCOVA confirmed that the self-affirmation group ( M  = 22.97, SD  = 1.38) rated the value as significantly more important than did the control group ( M =  15.13, SD  = 3.69), F (1, 71) = 142.6, p <.001, η 2  = .671, indicating success of the value-affirmation manipulation.

We also conducted an ANCOVA comparing the total number of words written in the affirmation and control essays to determine if self-affirmation participants were more engaged in the writing task and thus wrote longer essays. Although self-affirmation condition participants wrote somewhat longer essays on average ( M  = 68.79 words, SD  = 25.9) than did control condition participants ( M  = 60.34, SD  = 26.9), this difference was not statistically significant ( F (1,72) = 1.63, p  = .21). Moreover, chronic stress level was not associated with the number of words written in the self-affirmation essays ( F (1, 72) = 1.13, p  = .35). There was also no interaction between self-affirmation condition and chronic stress level on number of words written ( F (1,72) = 1.30, p  = .26). It is also worth noting that word count was not correlated with RAT problem-solving performance ( r  = .14, p  = .23), and including word count as a covariate did not appreciably change our primary problem-solving results (word count was not further pursued as a variable of interest).

Self-Affirmation, Stress, and Problem-Solving Performance

To test our primary hypotheses, we conducted a multiple regression analysis with condition (self-affirmation vs. control), perceived stress over the last month, and their interaction predicting RAT score. Consistent with hypotheses, we observed a significant main effect of chronic stress on RAT performance ( β  = −.45, t (72) = −2.75, p  = .008), such that participants with higher stress in the last month had lower problem-solving performance. Moreover, we observed a significant main effect for self-affirmation condition, ( β  = .31, t (72) = 2.88, p  = .005), such that affirmed participants performed significantly better on the RAT task than control participants ( Figure 1 ). Consistent with our self-affirmation stress buffering hypothesis, these main effects were qualified by a significant chronic stress × self-affirmation interaction on RAT problem-solving performance ( β  = .35, t (72) = 2.09, p  = .041). As shown in Figure 1 , self-affirmation (compared to the control condition) improved the RAT problem solving performance of underperforming high chronic stress individuals, but had a minimal impact on the performance of participants low in chronic stress. Moreover, as depicted in Figure 1 , this stress buffering effect of self-affirmation improved the problem-solving performance of high stress individuals to a level comparable to individuals low in stress.

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Object name is pone.0062593.g001.jpg

Low and high stress groups (as measured by the Perceived Stress Scale) were determined by median split for visual presentation. Error bars reflect standard errors of the mean.

Testing the Positive Affect and Task Engagement Accounts of Problem-Solving

Previous studies indicate that positive affect boosts problem-solving performance [29] , [30] , so we tested the possibility that the self-affirmation activity was a positive affect induction, and that positive affect engendered by self-affirmation explained the problem-solving effects. Consistent with other reports [28] , we found that the self-affirmation group had higher state positive affect compared to the control group (as determined by multiple regression controlling for age: β = . 51, t (69) = 4.79, p <.001.) We also tested negative affect using the same approach, but there was not a significant main effect for self-affirmation condition ( β  = −.12, t (71) = −1.06, p  = .29) or a stress × self-affirmation interaction ( β  = −.02, t (71) = −.90, p  = .37) on state negative affect. However, there was not a self-affirmation × chronic stress interaction on positive affect ( β  = .19, t (69) = 1.19, p  = .24). Given that self-affirmation increased state positive affect, we conducted mediation analyses (following procedure described in [31] ) testing whether state positive affect mediated the impact of self-affirmation on problem-solving. In the first step of the mediation analysis, self-affirmation increased positive affect (as described above). The second step in testing mediation consists of evaluating whether the mediating variable (positive affect) predicts the outcome variable (problem-solving performance) when entered simultaneously with the predictor variable (self-affirmation condition). This second analysis revealed that positive affect was not a significant predictor of RAT performance when it was entered as a simultaneous predictor variable with the self-affirmation condition variable ( β  = −.07, t (71) = −.54, p  = .59). Thus we did not find supporting evidence for positive affect as a mediator for the self-affirmation main effect or the chronic stress × self-affirmation interaction on problem-solving performance.

As noted earlier, previous research suggests that heart rate is a useful indirect marker for task engagement [24] , [25] . To test whether there was differential task engagement in the self-affirmation and control conditions using this physiological measure, we conducted a repeated measures ANCOVA to assess change in heart rate over time between conditions (In order to run a parallel ANCOVA analyses as our primary analysis, the heart rate and mean arterial pressure analyses were run with the chronic stress variable entered as a two-level between subjects variable (low vs. high stress), as determined by median split). Although participants showed an overall significant heart rate increase from baseline ( M  = 68.50, SE  = 1.03) to the RAT problem solving period ( M  = 76.44, SE  = 1.31) ( paired-samples t (69) = −9.26, p  = <.001), there were no significant main effect or interactive effects of conditions on heart rate change. Specifically, we did not observe a significant main effect for self-affirmation condition ( F (1, 67) = .36 p  = .55, η 2  = .01) or chronic stress ( F (1,66) = .09, p  = .77, η 2  = .001). Notably, we also did not observe a significant self-affirmation condition × time interaction ( F (2, 67) = .43 p  = .65, η 2  = .01) or a condition × time × chronic stress interaction ( F (2, 67) = 1.15 p  = .32, η 2  = .03) ( Figure 2 ), indicating that there were no differential effects of self-affirmation (or the self-affirmation × chronic stress interaction) on heart rate. Collectively, these findings do not provide support for a differential task engagement explanation of our performance findings. Instead, our data indicate that participants across conditions were similarly engaged in the problem-solving task.

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Object name is pone.0062593.g002.jpg

Panel A depicts the results for participants low in chronic stress, and Panel B depicts the results for participants high in chronic stress, as determined by median split. Error bars reflect standard errors of the mean.

We also assessed the impact of our self-affirmation manipulation on mean arterial blood pressure responses during the RAT problem-solving period. Like heart rate, participants showed an overall significant mean arterial pressure increase from baseline ( M  = 79.71, SE  = .86) to the RAT problem solving period ( M  = 89.05, SE  = 1.08) ( paired-samples t (69) = −12.12, p <.001), but we did not observe significant main effects of self-affirmation ( F (1,67) = 2.21, p  = .14, η 2  = .03) or chronic stress ( F (1,66) = .32, p  = .57, η 2  = .01). Similarly, the self-affirmation condition × time ( F (2, 64) = .13, p  = .88, η 2  = .004) and condition × time × chronic stress ( F (2, 64) = 1.53 p  = .23, η 2  = .05) interactions were not significant ( Figure 3 ). These heart rate and mean arterial blood pressure results are in accord with our previous work showing that self-affirmation does not appreciably alter heart rate or blood pressure responses to acute stress-challenge tasks [9] . Importantly, the changes in heart rate and blood pressure reaffirm that the RAT task was stressful for participants.

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The present study provides the first evidence that self-affirmation can protect against the deleterious effects of stress on problem-solving performance. Specifically, we show that chronically stressed individuals have impaired problem-solving performance and that self-affirmation can boost problem-solving performance under pressure. Notably, these effects were qualified by a significant chronic stress by self-affirmation interaction, such that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. These findings have important implications for self-affirmation research and educational interventions. First, although we have shown in several studies that self-affirmation can reduce acute stress experiences [9] – [11] , previous research has not tested whether self-affirmation can be protective in the context of chronic (or ongoing) stressors. Moreover, until now it has been unclear whether the stress buffering benefits of self-affirmation translate into improved performance outcomes on actual problem solving tasks. Our present study suggests that a brief self-affirmation activity is sufficient to buffer the negative effects of chronic stress on task performance and can improve the ability to problem solve in a flexible manner during high stress periods [3] , [32] . It is important to note that the task used in the present study (RAT) is a common measure of creativity performance and insight [18] , [33] , and hence our study suggests that self-affirmation may increase creativity and insight in stressed individuals [16] , [34] .

Second, our study suggests that self-affirmation may be effective at boosting performance in academic tasks requiring associative processing and creativity, particularly for students who experience stress on such tasks [34] . Thus, our findings identify a potential mechanism by which a self-affirmation intervention at the beginning of a school term can improve at-risk students’ academic achievement, reducing achievement disparities between African Americans and European Americans and between women and men in science [12] – [15] .

Finally, two limitations of our study should be mentioned. It is possible that the stress buffering effects of self-affirmation on problem-solving performance that we obtained are specific to evaluative performance settings, since all of our participants completed difficult RAT items under time pressure in front of a critical evaluator. (We note that the problem-solving task we used produced significant cardiovascular stress reactivity (see Figures 2 & 3 ), comparable to other well-known psychosocial stress-challenge tasks [35] .) Future studies should therefore experimentally test whether social evaluation is a necessary condition for self-affirmation problem-solving effects. Another limitation of our study is that we measured chronic stress using a self-report measure, and this measure was collected at the end of our study session (although there were no experimental (self-affirmation manipulation) effects on chronic stress scores). We elected to use this procedure given that completing individual difference measures may have carry-over effects if completed immediately prior to self-affirmation activities [27] . Future studies using other measures for assessing chronic stress (e.g., selecting chronically stressed vs. matched control groups) [4] would therefore be useful.

The present research contributes to a broader effort at understanding how stress management approaches can facilitate problem-solving performance under stress. Despite many studies showing that acute and chronic stressors can impair problem-solving [1] , [2] , [4] , we know little about stress management and coping approaches for buffering stress during problem-solving [36] . Our work suggests that self-affirmation may be a relatively easy-to-use strategy for mitigating stress and improving problem-solving performance in evaluative settings. It will be important for future studies to consider the mechanisms linking self-affirmation with improved problem solving. We show here that our self-affirmation effects are unlikely to be explained by changes in positive affect or task engagement. The fact that we did not see any differential effects of self-affirmation on a physiological measure of task engagement (heart rate) also suggests that these effects are not driven by changes in persistence or motivation [32] . A more likely possibility, to be tested by future research, is that self-affirmation facilitates a more open and flexible attentional stance (e.g., [16] ), which increases working memory availability [37] , [38] for problem-solving in evaluative contexts.

Conclusions

The present study builds on previous research showing that self-affirmation has stress protective effects in performance settings [9] , [12] , [13] , [15] , providing an initial indication that self-affirmation can buffer the effects of chronic stress on actual problem-solving in performance settings.

Supporting Information

Remote Associate items used in the present study.

Acknowledgments

This dataset is available upon request ( ude.umc@llewserc ).

Funding Statement

This research was supported by the National Science Foundation under Grant #924387 and the Pittsburgh Life Sciences Greenhouse Opportunity Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Problem-solving to manage stress.

what are the series steps in problem solving under the stress management

Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use.

Think about your behavior, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify:

  • Behaviors, such as the need to look for another job, earn money for your family, and make other adjustments in your life.
  • Negative thoughts, such as "I'll never get another job."
  • Negative feelings, such as anger and depression.
  • How your body responds, such as fatigue or trouble sleeping.

You can then find coping strategies, such as talking with a counselor about your feelings of anger or depression.

  • Think of as many solutions as you can, even if they seem very hard to achieve.
  • Don't criticize any solution.
  • Combine solutions.

When rating your solutions, take into account the:

  • Likelihood of being able to carry it out and succeed.
  • Cost in time and energy.
  • Effect of the solution on other people.

Figure out the steps you need to take, and then act.

Current as of: June 24, 2023

Author: Ignite Healthwise, LLC Staff

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Article contents

Work, stress, coping, and stress management.

  • Sharon Glazer Sharon Glazer University of Baltimore
  •  and  Cong Liu Cong Liu Hofstra University
  • https://doi.org/10.1093/acrefore/9780190236557.013.30
  • Published online: 26 April 2017

Work stress refers to the process of job stressors, or stimuli in the workplace, leading to strains, or negative responses or reactions. Organizational development refers to a process in which problems or opportunities in the work environment are identified, plans are made to remediate or capitalize on the stimuli, action is taken, and subsequently the results of the plans and actions are evaluated. When organizational development strategies are used to assess work stress in the workplace, the actions employed are various stress management interventions. Two key factors tying work stress and organizational development are the role of the person and the role of the environment. In order to cope with work-related stressors and manage strains, organizations must be able to identify and differentiate between factors in the environment that are potential sources of stressors and how individuals perceive those factors. Primary stress management interventions focus on preventing stressors from even presenting, such as by clearly articulating workers’ roles and providing necessary resources for employees to perform their job. Secondary stress management interventions focus on a person’s appraisal of job stressors as a threat or challenge, and the person’s ability to cope with the stressors (presuming sufficient internal resources, such as a sense of meaningfulness in life, or external resources, such as social support from a supervisor). When coping is not successful, strains may develop. Tertiary stress management interventions attempt to remediate strains, by addressing the consequence itself (e.g., diabetes management) and/or the source of the strain (e.g., reducing workload). The person and/or the organization may be the targets of the intervention. The ultimate goal of stress management interventions is to minimize problems in the work environment, intensify aspects of the work environment that create a sense of a quality work context, enable people to cope with stressors that might arise, and provide tools for employees and organizations to manage strains that might develop despite all best efforts to create a healthy workplace.

  • stress management
  • organization development
  • organizational interventions
  • stress theories and frameworks

Introduction

Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived. Common terms often used interchangeably with work stress are occupational stress, job stress, and work-related stress. Terms used interchangeably with job stressors include work stressors, and as the specificity of the type of stressor might include psychosocial stressor (referring to the psychological experience of work demands that have a social component, e.g., conflict between two people; Hauke, Flintrop, Brun, & Rugulies, 2011 ), hindrance stressor (i.e., a stressor that prevents goal attainment; Cavanaugh, Boswell, Roehling, & Boudreau, 2000 ), and challenge stressor (i.e., a stressor that is difficult, but attainable and possibly rewarding to attain; Cavanaugh et al., 2000 ).

Stress in the workplace continues to be a highly pervasive problem, having both direct negative effects on individuals experiencing it and companies paying for it, and indirect costs vis à vis lost productivity (Dopkeen & DuBois, 2014 ). For example, U.K. public civil servants’ work-related stress rose from 10.8% in 2006 to 22.4% in 2013 and about one-third of the workforce has taken more than 20 days of leave due to stress-related ill-health, while well over 50% are present at work when ill (French, 2015 ). These findings are consistent with a report by the International Labor Organization (ILO, 2012 ), whereby 50% to 60% of all workdays are lost due to absence attributed to factors associated with work stress.

The prevalence of work-related stress is not diminishing despite improvements in technology and employment rates. The sources of stress, such as workload, seem to exacerbate with improvements in technology (Coovert & Thompson, 2003 ). Moreover, accessibility through mobile technology and virtual computer terminals is linking people to their work more than ever before (ILO, 2012 ; Tarafdar, Tu, Ragu-Nathan, & Ragu-Nathan, 2007 ). Evidence of this kind of mobility and flexibility is further reinforced in a June 2007 survey of 4,025 email users (over 13 years of age); AOL reported that four in ten survey respondents reported planning their vacations around email accessibility and 83% checked their emails at least once a day while away (McMahon, 2007 ). Ironically, despite these mounting work-related stressors and clear financial and performance outcomes, some individuals are reporting they are less “stressed,” but only because “stress has become the new normal” (Jayson, 2012 , para. 4).

This new normal is likely the source of psychological and physiological illness. Siegrist ( 2010 ) contends that conditions in the workplace, particularly psychosocial stressors that are perceived as unfavorable relationships with others and self, and an increasingly sedentary lifestyle (reinforced with desk jobs) are increasingly contributing to cardiovascular disease. These factors together justify a need to continue on the path of helping individuals recognize and cope with deleterious stressors in the work environment and, equally important, to find ways to help organizations prevent harmful stressors over which they have control, as well as implement policies or mechanisms to help employees deal with these stressors and subsequent strains. Along with a greater focus on mitigating environmental constraints are interventions that can be used to prevent anxiety, poor attitudes toward the workplace conditions and arrangements, and subsequent cardiovascular illness, absenteeism, and poor job performance (Siegrist, 2010 ).

Even the ILO has presented guidance on how the workplace can help prevent harmful job stressors (aka hindrance stressors) or at least help workers cope with them. Consistent with the view that well-being is not the absence of stressors or strains and with the view that positive psychology offers a lens for proactively preventing stressors, the ILO promotes increasing preventative risk assessments, interventions to prevent and control stressors, transparent organizational communication, worker involvement in decision-making, networks and mechanisms for workplace social support, awareness of how working and living conditions interact, safety, health, and well-being in the organization (ILO, n.d. ). The field of industrial and organizational (IO) psychology supports the ILO’s recommendations.

IO psychology views work stress as the process of a person’s interaction with multiple aspects of the work environment, job design, and work conditions in the organization. Interventions to manage work stress, therefore, focus on the psychosocial factors of the person and his or her relationships with others and the socio-technical factors related to the work environment and work processes. Viewing work stress from the lens of the person and the environment stems from Kurt Lewin’s ( 1936 ) work that stipulates a person’s state of mental health and behaviors are a function of the person within a specific environment or situation. Aspects of the work environment that affect individuals’ mental states and behaviors include organizational hierarchy, organizational climate (including processes, policies, practices, and reward structures), resources to support a person’s ability to fulfill job duties, and management structure (including leadership). Job design refers to each contributor’s tasks and responsibilities for fulfilling goals associated with the work role. Finally, working conditions refers not only to the physical environment, but also the interpersonal relationships with other contributors.

Each of the conditions that are identified in the work environment may be perceived as potentially harmful or a threat to the person or as an opportunity. When a stressor is perceived as a threat to attaining desired goals or outcomes, the stressor may be labeled as a hindrance stressor (e.g., LePine, Podsakoff, & Lepine, 2005 ). When the stressor is perceived as an opportunity to attain a desired goal or end state, it may be labeled as a challenge stressor. According to LePine and colleagues’ ( 2005 ), both challenge (e.g., time urgency, workload) and hindrance (e.g., hassles, role ambiguity, role conflict) stressors could lead to strains (as measured by “anxiety, depersonalization, depression, emotional exhaustion, frustration, health complaints, hostility, illness, physical symptoms, and tension” [p. 767]). However, challenge stressors positively relate with motivation and performance, whereas hindrance stressors negatively relate with motivation and performance. Moreover, motivation and strains partially mediate the relationship between hindrance and challenge stressors with performance.

Figure 1. Organizational development frameworks to guide identification of work stress and interventions.

In order to (1) minimize any potential negative effects from stressors, (2) increase coping skills to deal with stressors, or (3) manage strains, organizational practitioners or consultants will devise organizational interventions geared toward prevention, coping, and/or stress management. Ultimately, toxic factors in the work environment can have deleterious effects on a person’s physical and psychological well-being, as well as on an organization’s total health. It behooves management to take stock of the organization’s health, which includes the health and well-being of its employees, if the organization wishes to thrive and be profitable. According to Page and Vella-Brodrick’s ( 2009 ) model of employee well-being, employee well-being results from subjective well-being (i.e., life satisfaction and general positive or negative affect), workplace well-being (composed of job satisfaction and work-specific positive or negative affect), and psychological well-being (e.g., self-acceptance, positive social relations, mastery, purpose in life). Job stressors that become unbearable are likely to negatively affect workplace well-being and thus overall employee well-being. Because work stress is a major organizational pain point and organizations often employ organizational consultants to help identify and remediate pain points, the focus here is on organizational development (OD) frameworks; several work stress frameworks are presented that together signal areas where organizations might focus efforts for change in employee behaviors, attitudes, and performance, as well as the organization’s performance and climate. Work stress, interventions, and several OD and stress frameworks are depicted in Figure 1 .

The goals are: (1) to conceptually define and clarify terms associated with stress and stress management, particularly focusing on organizational factors that contribute to stress and stress management, and (2) to present research that informs current knowledge and practices on workplace stress management strategies. Stressors and strains will be defined, leading OD and work stress frameworks that are used to organize and help organizations make sense of the work environment and the organization’s responsibility in stress management will be explored, and stress management will be explained as an overarching thematic label; an area of study and practice that focuses on prevention (primary) interventions, coping (secondary) interventions, and managing strains (tertiary) interventions; as well as the label typically used to denote tertiary interventions. Suggestions for future research and implications toward becoming a healthy organization are presented.

Defining Stressors and Strains

Work-related stressors or job stressors can lead to different kinds of strains individuals and organizations might experience. Various types of stress management interventions, guided by OD and work stress frameworks, may be employed to prevent or cope with job stressors and manage strains that develop(ed).

A job stressor is a stimulus external to an employee and a result of an employee’s work conditions. Example job stressors include organizational constraints, workplace mistreatments (such as abusive supervision, workplace ostracism, incivility, bullying), role stressors, workload, work-family conflicts, errors or mistakes, examinations and evaluations, and lack of structure (Jex & Beehr, 1991 ; Liu, Spector, & Shi, 2007 ; Narayanan, Menon, & Spector, 1999 ). Although stressors may be categorized as hindrances and challenges, there is not yet sufficient information to be able to propose which stress management interventions would better serve to reduce those hindrance stressors or to reduce strain-producing challenge stressors while reinforcing engagement-producing challenge stressors.

Organizational Constraints

Organizational constraints may be hindrance stressors as they prevent employees from translating their motivation and ability into high-level job performance (Peters & O’Connor, 1980 ). Peters and O’Connor ( 1988 ) defined 11 categories of organizational constraints: (1) job-related information, (2) budgetary support, (3) required support, (4) materials and supplies, (5) required services and help from others, (6) task preparation, (7) time availability, (8) the work environment, (9) scheduling of activities, (10) transportation, and (11) job-relevant authority. The inhibiting effect of organizational constraints may be due to the lack of, inadequacy of, or poor quality of these categories.

Workplace Mistreatment

Workplace mistreatment presents a cluster of interpersonal variables, such as interpersonal conflict, bullying, incivility, and workplace ostracism (Hershcovis, 2011 ; Tepper & Henle, 2011 ). Typical workplace mistreatment behaviors include gossiping, rude comments, showing favoritism, yelling, lying, and ignoring other people at work (Tepper & Henle, 2011 ). These variables relate to employees’ psychological well-being, physical well-being, work attitudes (e.g., job satisfaction and organizational commitment), and turnover intention (e.g., Hershcovis, 2011 ; Spector & Jex, 1998 ). Some researchers differentiated the source of mistreatment, such as mistreatment from one’s supervisor versus mistreatment from one’s coworker (e.g., Bruk-Lee & Spector, 2006 ; Frone, 2000 ; Liu, Liu, Spector, & Shi, 2011 ).

Role Stressors

Role stressors are demands, constraints, or opportunities a person perceives to be associated, and thus expected, with his or her work role(s) across various situations. Three commonly studied role stressors are role ambiguity, role conflict, and role overload (Glazer & Beehr, 2005 ; Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ). Role ambiguity in the workplace occurs when an employee lacks clarity regarding what performance-related behaviors are expected of him or her. Role conflict refers to situations wherein an employee receives incompatible role requests from the same or different supervisors or the employee is asked to engage in work that impedes his or her performance in other work or nonwork roles or clashes with his or her values. Role overload refers to excessive demands and insufficient time (quantitative) or knowledge (qualitative) to complete the work. The construct is often used interchangeably with workload, though role overload focuses more on perceived expectations from others about one’s workload. These role stressors significantly relate to low job satisfaction, low organizational commitment, low job performance, high tension or anxiety, and high turnover intention (Abramis, 1994 ; Glazer & Beehr, 2005 ; Jackson & Schuler, 1985 ).

Excessive workload is one of the most salient stressors at work (e.g., Liu et al., 2007 ). There are two types of workload: quantitative and qualitative workload (LaRocco, Tetrick, & Meder, 1989 ; Parasuraman & Purohit, 2000 ). Quantitative workload refers to the excessive amount of work one has. In a summary of a Chartered Institute of Personnel & Development Report from 2006 , Dewe and Kompier ( 2008 ) noted that quantitative workload was one of the top three stressors workers experienced at work. Qualitative workload refers to the difficulty of work. Workload also differs by the type of the load. There are mental workload and physical workload (Dwyer & Ganster, 1991 ). Excessive physical workload may result in physical discomfort or illness. Excessive mental workload will cause psychological distress such as anxiety or frustration (Bowling & Kirkendall, 2012 ). Another factor affecting quantitative workload is interruptions (during the workday). Lin, Kain, and Fritz ( 2013 ) found that interruptions delay completion of job tasks, thus adding to the perception of workload.

Work-Family Conflict

Work-family conflict is a form of inter-role conflict in which demands from one’s work domain and one’s family domain are incompatible to some extent (Greenhaus & Beutell, 1985 ). Work can interfere with family (WIF) and/or family can interfere with work (FIW) due to time-related commitments to participating in one domain or another, incompatible behavioral expectations, or when strains in one domain carry over to the other (Greenhaus & Beutell, 1985 ). Work-family conflict significantly relates to work-related outcomes (e.g., job satisfaction, organizational commitment, turnover intention, burnout, absenteeism, job performance, job strains, career satisfaction, and organizational citizenship behaviors), family-related outcomes (e.g., marital satisfaction, family satisfaction, family-related performance, family-related strains), and domain-unspecific outcomes (e.g., life satisfaction, psychological strain, somatic or physical symptoms, depression, substance use or abuse, and anxiety; Amstad, Meier, Fasel, Elfering, & Semmer, 2011 ).

Individuals and organizations can experience work-related strains. Sometimes organizations will experience strains through the employee’s negative attitudes or strains, such as that a worker’s absence might yield lower production rates, which would roll up into an organizational metric of organizational performance. In the industrial and organizational (IO) psychology literature, organizational strains are mostly observed as macro-level indicators, such as health insurance costs, accident-free days, and pervasive problems with company morale. In contrast, individual strains, usually referred to as job strains, are internal to an employee. They are responses to work conditions and relate to health and well-being of employees. In other words, “job strains are adverse reactions employees have to job stressors” (Spector, Chen, & O’Connell, 2000 , p. 211). Job strains tend to fall into three categories: behavioral, physical, and psychological (Jex & Beehr, 1991 ).

Behavioral strains consist of actions that employees take in response to job stressors. Examples of behavioral strains include employees drinking alcohol in the workplace or intentionally calling in sick when they are not ill (Spector et al., 2000 ). Physical strains consist of health symptoms that are physiological in nature that employees contract in response to job stressors. Headaches and ulcers are examples of physical strains. Lastly, psychological strains are emotional reactions and attitudes that employees have in response to job stressors. Examples of psychological strains are job dissatisfaction, anxiety, and frustration (Spector et al., 2000 ). Interestingly, research studies that utilize self-report measures find that most job strains experienced by employees tend to be psychological strains (Spector et al., 2000 ).

Leading Frameworks

Organizations that are keen on identifying organizational pain points and remedying them through organizational campaigns or initiatives often discover the pain points are rooted in work-related stressors and strains and the initiatives have to focus on reducing workers’ stress and increasing a company’s profitability. Through organizational climate surveys, for example, companies discover that aspects of the organization’s environment, including its policies, practices, reward structures, procedures, and processes, as well as employees at all levels of the company, are contributing to the individual and organizational stress. Recent studies have even begun to examine team climates for eustress and distress assessed in terms of team members’ homogenous psychological experience of vigor, efficacy, dedication, and cynicism (e.g., Kożusznik, Rodriguez, & Peiro, 2015 ).

Each of the frameworks presented advances different aspects that need to be identified in order to understand the source and potential remedy for stressors and strains. In some models, the focus is on resources, in others on the interaction of the person and environment, and in still others on the role of the person in the workplace. Few frameworks directly examine the role of the organization, but the organization could use these frameworks to plan interventions that would minimize stressors, cope with existing stressors, and prevent and/or manage strains. One of the leading frameworks in work stress research that is used to guide organizational interventions is the person and environment (P-E) fit (French & Caplan, 1972 ). Its precursor is the University of Michigan Institute for Social Research’s (ISR) role stress model (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964 ) and Lewin’s Field Theory. Several other theories have since evolved from the P-E fit framework, including Karasek and Theorell’s ( 1990 ), Karasek ( 1979 ) Job Demands-Control Model (JD-C), the transactional framework (Lazarus & Folkman, 1984 ), Conservation of Resources (COR) theory (Hobfoll, 1989 ), and Siegrist’s ( 1996 ) Effort-Reward Imbalance (ERI) Model.

Field Theory

The premise of Kahn et al.’s ( 1964 ) role stress theory is Lewin’s ( 1997 ) Field Theory. Lewin purported that behavior and mental events are a dynamic function of the whole person, including a person’s beliefs, values, abilities, needs, thoughts, and feelings, within a given situation (field or environment), as well as the way a person represents his or her understanding of the field and behaves in that space. Lewin explains that work-related strains are a result of individuals’ subjective perceptions of objective factors, such as work roles, relationships with others in the workplace, as well as personality indicators, and can be used to predict people’s reactions, including illness. Thus, to make changes to an organizational system, it is necessary to understand a field and try to move that field from the current state to the desired state. Making this move necessitates identifying mechanisms influencing individuals.

Role Stress Theory

Role stress theory mostly isolates the perspective a person has about his or her work-related responsibilities and expectations to determine how those perceptions relate with a person’s work-related strains. However, those relationships have been met with somewhat varied results, which Glazer and Beehr ( 2005 ) concluded might be a function of differences in culture, an environmental factor often neglected in research. Kahn et al.’s ( 1964 ) role stress theory, coupled with Lewin’s ( 1936 ) Field Theory, serves as the foundation for the P-E fit theory. Lewin ( 1936 ) wrote, “Every psychological event depends upon the state of the person and at the same time on the environment” (p. 12). Researchers of IO psychology have narrowed the environment to the organization or work team. This narrowed view of the organizational environment is evident in French and Caplan’s ( 1972 ) P-E fit framework.

Person-Environment Fit Theory

The P-E fit framework focuses on the extent to which there is congruence between the person and a given environment, such as the organization (Caplan, 1987 ; Edwards, 2008 ). For example, does the person have the necessary skills and abilities to fulfill an organization’s demands, or does the environment support a person’s desire for autonomy (i.e., do the values align?) or fulfill a person’s needs (i.e., a person’s needs are rewarded). Theoretically and empirically, the greater the person-organization fit, the greater a person’s job satisfaction and organizational commitment, the less a person’s turnover intention and work-related stress (see meta-analyses by Assouline & Meir, 1987 ; Kristof-Brown, Zimmerman, & Johnson, 2005 ; Verquer, Beehr, & Wagner, 2003 ).

Job Demands-Control/Support (JD-C/S) and Job Demands-Resources (JD-R) Model

Focusing more closely on concrete aspects of work demands and the extent to which a person perceives he or she has control or decision latitude over those demands, Karasek ( 1979 ) developed the JD-C model. Karasek and Theorell ( 1990 ) posited that high job demands under conditions of little decision latitude or control yield high strains, which have varied implications on the health of an organization (e.g., in terms of high turnover, employee ill-health, poor organizational performance). This theory was modified slightly to address not only control, but also other resources that could protect a person from unruly job demands, including support (aka JD-C/S, Johnson & Hall, 1988 ; and JD-R, Bakker, van Veldhoven, & Xanthopoulou, 2010 ). Whether focusing on control or resources, both they and job demands are said to reflect workplace characteristics, while control and resources also represent coping strategies or tools (Siegrist, 2010 ).

Despite the glut of research testing the JD-C and JD-R, results are somewhat mixed. Testing the interaction between job demands and control, Beehr, Glaser, Canali, and Wallwey ( 2001 ) did not find empirical support for the JD-C theory. However, Dawson, O’Brien, and Beehr ( 2016 ) found that high control and high support buffered against the independent deleterious effects of interpersonal conflict, role conflict, and organizational politics (demands that were categorized as hindrance stressors) on anxiety, as well as the effects of interpersonal conflict and organizational politics on physiological symptoms, but control and support did not moderate the effects between challenge stressors and strains. Coupled with Bakker, Demerouti, and Sanz-Vergel’s ( 2014 ) note that excessive job demands are a source of strain, but increased job resources are a source of engagement, Dawson et al.’s results suggest that when an organization identifies that demands are hindrances, it can create strategies for primary (preventative) stress management interventions and attempt to remove or reduce such work demands. If the demands are challenging, though manageable, but latitude to control the challenging stressors and support are insufficient, the organization could modify practices and train employees on adopting better strategies for meeting or coping (secondary stress management intervention) with the demands. Finally, if the organization can neither afford to modify the demands or the level of control and support, it will be necessary for the organization to develop stress management (tertiary) interventions to deal with the inevitable strains.

Conservation of Resources Theory

The idea that job resources reinforce engagement in work has been propagated in Hobfoll’s ( 1989 ) Conservation of Resources (COR) theory. COR theory also draws on the foundational premise that people’s mental health is a function of the person and the environment, forwarding that how people interpret their environment (including the societal context) affects their stress levels. Hobfoll focuses on resources such as objects, personal characteristics, conditions, or energies as particularly instrumental to minimizing strains. He asserts that people do whatever they can to protect their valued resources. Thus, strains develop when resources are threatened to be taken away, actually taken away, or when additional resources are not attainable after investing in the possibility of gaining more resources (Hobfoll, 2001 ). By extension, organizations can invest in activities that would minimize resource loss and create opportunities for resource gains and thus have direct implications for devising primary and secondary stress management interventions.

Transactional Framework

Lazarus and Folkman ( 1984 ) developed the widely studied transactional framework of stress. This framework holds as a key component the cognitive appraisal process. When individuals perceive factors in the work environment as a threat (i.e., primary appraisal), they will scan the available resources (external or internal to himself or herself) to cope with the stressors (i.e., secondary appraisal). If the coping resources provide minimal relief, strains develop. Until recently, little attention has been given to the cognitive appraisal associated with different work stressors (Dewe & Kompier, 2008 ; Liu & Li, 2017 ). In a study of Polish and Spanish social care service providers, stressors appraised as a threat related positively to burnout and less engagement, but stressors perceived as challenges yielded greater engagement and less burnout (Kożusznik, Rodriguez, & Peiro, 2012 ). Similarly, Dawson et al. ( 2016 ) found that even with support and control resources, hindrance demands were more strain-producing than challenge demands, suggesting that appraisal of the stressor is important. In fact, “many people respond well to challenging work” (Beehr et al., 2001 , p. 126). Kożusznik et al. ( 2012 ) recommend training employees to change the way they view work demands in order to increase engagement, considering that part of the problem may be about how the person appraises his or her environment and, thus, copes with the stressors.

Effort-Reward Imbalance

Siegrist’s ( 1996 ) Model of Effort-Reward Imbalance (ERI) focuses on the notion of social reciprocity, such that a person fulfills required work tasks in exchange for desired rewards (Siegrist, 2010 ). ERI sheds light on how an imbalance in a person’s expectations of an organization’s rewards (e.g., pay, bonus, sense of advancement and development, job security) in exchange for a person’s efforts, that is a break in one’s work contract, leads to negative responses, including long-term ill-health (Siegrist, 2010 ; Siegrist et al., 2014 ). In fact, prolonged perception of a work contract imbalance leads to adverse health, including immunological problems and inflammation, which contribute to cardiovascular disease (Siegrist, 2010 ). The model resembles the relational and interactional psychological contract theory in that it describes an employee’s perception of the terms of the relationship between the person and the workplace, including expectations of performance, job security, training and development opportunities, career progression, salary, and bonuses (Thomas, Au, & Ravlin, 2003 ). The psychological contract, like the ERI model, focuses on social exchange. Furthermore, the psychological contract, like stress theories, are influenced by cultural factors that shape how people interpret their environments (Glazer, 2008 ; Thomas et al., 2003 ). Violations of the psychological contract will negatively affect a person’s attitudes toward the workplace and subsequent health and well-being (Siegrist, 2010 ). To remediate strain, Siegrist ( 2010 ) focuses on both the person and the environment, recognizing that the organization is particularly responsible for changing unfavorable work conditions and the person is responsible for modifying his or her reactions to such conditions.

Stress Management Interventions: Primary, Secondary, and Tertiary

Remediation of work stress and organizational development interventions are about realigning the employee’s experiences in the workplace with factors in the environment, as well as closing the gap between the current environment and the desired environment. Work stress develops when an employee perceives the work demands to exceed the person’s resources to cope and thus threatens employee well-being (Dewe & Kompier, 2008 ). Likewise, an organization’s need to change arises when forces in the environment are creating a need to change in order to survive (see Figure 1 ). Lewin’s ( 1951 ) Force Field Analysis, the foundations of which are in Field Theory, is one of the first organizational development intervention tools presented in the social science literature. The concept behind Force Field Analysis is that in order to survive, organizations must adapt to environmental forces driving a need for organizational change and remove restraining forces that create obstacles to organizational change. In order to do this, management needs to delineate the current field in which the organization is functioning, understand the driving forces for change, identify and dampen or eliminate the restraining forces against change. Several models for analyses may be applied, but most approaches are variations of organizational climate surveys.

Through organizational surveys, workers provide management with a snapshot view of how they perceive aspects of their work environment. Thus, the view of the health of an organization is a function of several factors, chief among them employees’ views (i.e., the climate) about the workplace (Lewin, 1951 ). Indeed, French and Kahn ( 1962 ) posited that well-being depends on the extent to which properties of the person and properties of the environment align in terms of what a person requires and the resources available in a given environment. Therefore, only when properties of the person and properties of the environment are sufficiently understood can plans for change be developed and implemented targeting the environment (e.g., change reporting structures to relieve, and thus prevent future, communication stressors) and/or the person (e.g., providing more autonomy, vacation days, training on new technology). In short, climate survey findings can guide consultants about the emphasis for organizational interventions: before a problem arises aka stress prevention, e.g., carefully crafting job roles), when a problem is present, but steps are taken to mitigate their consequences (aka coping, e.g., providing social support groups), and/or once strains develop (aka. stress management, e.g., healthcare management policies).

For each of the primary (prevention), secondary (coping), and tertiary (stress management) techniques the target for intervention can be the entire workforce, a subset of the workforce, or a specific person. Interventions that target the entire workforce may be considered organizational interventions, as they have direct implications on the health of all individuals and consequently the health of the organization. Several interventions categorized as primary and secondary interventions may also be implemented after strains have developed and after it has been discerned that a person or the organization did not do enough to mitigate stressors or strains (see Figure 1 ). The designation of many of the interventions as belonging to one category or another may be viewed as merely a suggestion.

Primary Interventions (Preventative Stress Management)

Before individuals begin to perceive work-related stressors, organizations engage in stress prevention strategies, such as providing people with resources (e.g., computers, printers, desk space, information about the job role, organizational reporting structures) to do their jobs. However, sometimes the institutional structures and resources are insufficient or ambiguous. Scholars and practitioners have identified several preventative stress management strategies that may be implemented.

Planning and Time Management

When employees feel quantitatively overloaded, sometimes the remedy is improving the employees’ abilities to plan and manage their time (Quick, Quick, Nelson, & Hurrell, 2003 ). Planning is a future-oriented activity that focuses on conceptual and comprehensive work goals. Time management is a behavior that focuses on organizing, prioritizing, and scheduling work activities to achieve short-term goals. Given the purpose of time management, it is considered a primary intervention, as engaging in time management helps to prevent work tasks from mounting and becoming unmanageable, which would subsequently lead to adverse outcomes. Time management comprises three fundamental components: (1) establishing goals, (2) identifying and prioritizing tasks to fulfill the goals, and (3) scheduling and monitoring progress toward goal achievement (Peeters & Rutte, 2005 ). Workers who employ time management have less role ambiguity (Macan, Shahani, Dipboye, & Philips, 1990 ), psychological stress or strain (Adams & Jex, 1999 ; Jex & Elaqua, 1999 ; Macan et al., 1990 ), and greater job satisfaction (Macan, 1994 ). However, Macan ( 1994 ) did not find a relationship between time management and performance. Still, Claessens, van Eerde, Rutte, and Roe ( 2004 ) found that perceived control of time partially mediated the relationships between planning behavior (an indicator of time management), job autonomy, and workload on one hand, and job strains, job satisfaction, and job performance on the other hand. Moreover, Peeters and Rutte ( 2005 ) observed that teachers with high work demands and low autonomy experienced more burnout when they had poor time management skills.

Person-Organization Fit

Just as it is important for organizations to find the right person for the job and organization, so is it the responsibility of a person to choose to work at the right organization—an organization that fulfills the person’s needs and upholds the values important to the individual, as much as the person fulfills the organization’s needs and adapts to its values. When people fit their employing organizations they are setting themselves up for experiencing less strain-producing stressors (Kristof-Brown et al., 2005 ). In a meta-analysis of 62 person-job fit studies and 110 person-organization fit studies, Kristof-Brown et al. ( 2005 ) found that person-job fit had a negative correlation with indicators of job strain. In fact, a primary intervention of career counseling can help to reduce stress levels (Firth-Cozens, 2003 ).

Job Redesign

The Job Demands-Control/Support (JD-C/S), Job Demands-Resources (JD-R), and transactional models all suggest that factors in the work context require modifications in order to reduce potential ill-health and poor organizational performance. Drawing on Hackman and Oldham’s ( 1980 ) Job Characteristics Model, it is possible to assess with the Job Diagnostics Survey (JDS) the current state of work characteristics related to skill variety, task identity, task significance, autonomy, and feedback. Modifying those aspects would help create a sense of meaningfulness, sense of responsibility, and feeling of knowing how one is performing, which subsequently affects a person’s well-being as identified in assessments of motivation, satisfaction, improved performance, and reduced withdrawal intentions and behaviors. Extending this argument to the stress models, it can be deduced that reducing uncertainty or perceived unfairness that may be associated with a person’s perception of these work characteristics, as well as making changes to physical characteristics of the environment (e.g., lighting, seating, desk, air quality), nature of work (e.g., job responsibilities, roles, decision-making latitude), and organizational arrangements (e.g., reporting structure and feedback mechanisms), can help mitigate against numerous ill-health consequences and reduced organizational performance. In fact, Fried et al. ( 2013 ) showed that healthy patients of a medical clinic whose jobs were excessively low (i.e., monotonous) or excessively high (i.e., overstimulating) on job enrichment (as measured by the JDS) had greater abdominal obesity than those whose jobs were optimally enriched. By taking stock of employees’ perceptions of the current work situation, managers might think about ways to enhance employees’ coping toolkit, such as training on how to deal with difficult clients or creating stimulating opportunities when jobs have low levels of enrichment.

Participatory Action Research Interventions

Participatory action research (PAR) is an intervention wherein, through group discussions, employees help to identify and define problems in organizational structure, processes, policies, practices, and reward structures, as well as help to design, implement, and evaluate success of solutions. PAR is in itself an intervention, but its goal is to design interventions to eliminate or reduce work-related factors that are impeding performance and causing people to be unwell. An example of a successful primary intervention, utilizing principles of PAR and driven by the JD-C and JD-C/S stress frameworks is Health Circles (HCs; Aust & Ducki, 2004 ).

HCs, developed in Germany in the 1980s, were popular practices in industries, such as metal, steel, and chemical, and service. Similar to other problem-solving practices, such as quality circles, HCs were based on the assumptions that employees are the experts of their jobs. For this reason, to promote employee well-being, management and administrators solicited suggestions and ideas from the employees to improve occupational health, thereby increasing employees’ job control. HCs also promoted communication between managers and employees, which had a potential to increase social support. With more control and support, employees would experience less strains and better occupational well-being.

Employing the three-steps of (1) problem analysis (i.e., diagnosis or discovery through data generated from organizational records of absenteeism length, frequency, rate, and reason and employee survey), (2) HC meetings (6 to 10 meetings held over several months to brainstorm ideas to improve occupational safety and health concerns identified in the discovery phase), and (3) HC evaluation (to determine if desired changes were accomplished and if employees’ reports of stressors and strains changed after the course of 15 months), improvements were to be expected (Aust & Ducki, 2004 ). Aust and Ducki ( 2004 ) reviewed 11 studies presenting 81 health circles in 30 different organizations. Overall study participants had high satisfaction with the HCs practices. Most companies acted upon employees’ suggestions (e.g., improving driver’s seat and cab, reducing ticket sale during drive, team restructuring and job rotation to facilitate communication, hiring more employees during summer time, and supervisor training program to improve leadership and communication skills) to improve work conditions. Thus, HCs represent a successful theory-grounded intervention to routinely improve employees’ occupational health.

Physical Setting

The physical environment or physical workspace has an enormous impact on individuals’ well-being, attitudes, and interactions with others, as well as on the implications on innovation and well-being (Oksanen & Ståhle, 2013 ; Vischer, 2007 ). In a study of 74 new product development teams (total of 437 study respondents) in Western Europe, Chong, van Eerde, Rutte, and Chai ( 2012 ) found that when teams were faced with challenge time pressures, meaning the teams had a strong interest and desire in tackling complex, but engaging tasks, when they were working proximally close with one another, team communication improved. Chong et al. assert that their finding aligns with prior studies that have shown that physical proximity promotes increased awareness of other team members, greater tendency to initiate conversations, and greater team identification. However, they also found that when faced with hindrance time pressures, physical proximity related to low levels of team communication, but when hindrance time pressure was low, team proximity had an increasingly greater positive relationship with team communication.

In addition to considering the type of work demand teams must address, other physical workspace considerations include whether people need to work collaboratively and synchronously or independently and remotely (or a combination thereof). Consideration needs to be given to how company contributors would satisfy client needs through various modes of communication, such as email vs. telephone, and whether individuals who work by a window might need shading to block bright sunlight from glaring on their computer screens. Finally, people who have to use the telephone for extensive periods of time would benefit from earphones to prevent neck strains. Most physical stressors are rather simple to rectify. However, companies are often not aware of a problem until after a problem arises, such as when a person’s back is strained from trying to move heavy equipment. Companies then implement strategies to remediate the environmental stressor. With the help of human factors, and organizational and office design consultants, many of the physical barriers to optimal performance can be prevented (Rousseau & Aubé, 2010 ). In a study of 215 French-speaking Canadian healthcare employees, Rousseau and Aubé ( 2010 ) found that although supervisor instrumental support positively related with affective commitment to the organization, the relationship was even stronger for those who reported satisfaction with the ambient environment (i.e., temperature, lighting, sound, ventilation, and cleanliness).

Secondary Interventions (Coping)

Secondary interventions, also referred to as coping, focus on resources people can use to mitigate the risk of work-related illness or workplace injury. Resources may include properties related to social resources, behaviors, and cognitive structures. Each of these resource domains may be employed to cope with stressors. Monat and Lazarus ( 1991 ) summarize the definition of coping as “an individual’s efforts to master demands (or conditions of harm, threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources” (p. 5). To master demands requires use of the aforementioned resources. Secondary interventions help employees become aware of the psychological, physical, and behavioral responses that may occur from the stressors presented in their working environment. Secondary interventions help a person detect and attend to stressors and identify resources for and ways of mitigating job strains. Often, coping strategies are learned skills that have a cognitive foundation and serve important functions in improving people’s management of stressors (Lazarus & Folkman, 1991 ). Coping is effortful, but with practice it becomes easier to employ. This idea is the foundation for understanding the role of resilience in coping with stressors. However, “not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in relating to the environment” (Lazarus & Folkman, 1991 , p. 198). Furthermore, sometimes to cope with a stressor, a person may call upon social support sources to help with tangible materials or emotional comfort. People call upon support resources because they help to restructure how a person approaches or thinks about the stressor.

Most secondary interventions are aimed at helping the individual, though companies, as a policy, might require all employees to partake in training aimed at increasing employees’ awareness of and skills aimed at handling difficult situations vis à vis company channels (e.g., reporting on sexual harassment or discrimination). Furthermore, organizations might institute mentoring programs or work groups to address various work-related matters. These programs employ awareness-raising activities, stress-education, or skills training (cf., Bhagat, Segovis, & Nelson, 2012 ), which include development of skills in problem-solving, understanding emotion-focused coping, identifying and using social support, and enhancing capacity for resilience. The aim of these programs, therefore, is to help employees proactively review their perceptions of psychological, physical, and behavioral job-related strains, thereby extending their resilience, enabling them to form a personal plan to control stressors and practice coping skills (Cooper, Dewe, & O’Driscoll, 2011 ).

Often these stress management programs are instituted after an organization has observed excessive absenteeism and work-related performance problems and, therefore, are sometimes categorized as a tertiary stress management intervention or even a primary (prevention) intervention. However, the skills developed for coping with stressors also place the programs in secondary stress management interventions. Example programs that are categorized as tertiary or primary stress management interventions may also be secondary stress management interventions (see Figure 1 ), and these include lifestyle advice and planning, stress inoculation training, simple relaxation techniques, meditation, basic trainings in time management, anger management, problem-solving skills, and cognitive-behavioral therapy. Corporate wellness programs also fall under this category. In other words, some programs could be categorized as primary, secondary, or tertiary interventions depending upon when the employee (or organization) identifies the need to implement the program. For example, time management practices could be implemented as a means of preventing some stressors, as a way to cope with mounting stressors, or as a strategy to mitigate symptoms of excessive of stressors. Furthermore, these programs can be administered at the individual level or group level. As related to secondary interventions, these programs provide participants with opportunities to develop and practice skills to cognitively reappraise the stressor(s); to modify their perspectives about stressors; to take time out to breathe, stretch, meditate, relax, and/or exercise in an attempt to support better decision-making; to articulate concerns and call upon support resources; and to know how to say “no” to onslaughts of requests to complete tasks. Participants also learn how to proactively identify coping resources and solve problems.

According to Cooper, Dewe, and O’Driscoll ( 2001 ), secondary interventions are successful in helping employees modify or strengthen their ability to cope with the experience of stressors with the goal of mitigating the potential harm the job stressors may create. Secondary interventions focus on individuals’ transactions with the work environment and emphasize the fit between a person and his or her environment. However, researchers have pointed out that the underlying assumption of secondary interventions is that the responsibility for coping with the stressors of the environment lies within individuals (Quillian-Wolever & Wolever, 2003 ). If companies cannot prevent the stressors in the first place, then they are, in part, responsible for helping individuals develop coping strategies and informing employees about programs that would help them better cope with job stressors so that they are able to fulfill work assignments.

Stress management interventions that help people learn to cope with stressors focus mainly on the goals of enabling problem-resolution or expressing one’s emotions in a healthy manner. These goals are referred to as problem-focused coping and emotion-focused coping (Folkman & Lazarus, 1980 ; Pearlin & Schooler, 1978 ), and the person experiencing the stressors as potential threat is the agent for change and the recipient of the benefits of successful coping (Hobfoll, 1998 ). In addition to problem-focused and emotion-focused coping approaches, social support and resilience may be coping resources. There are many other sources for coping than there is room to present here (see e.g., Cartwright & Cooper, 2005 ); however, the current literature has primarily focused on these resources.

Problem-Focused Coping

Problem-focused or direct coping helps employees remove or reduce stressors in order to reduce their strain experiences (Bhagat et al., 2012 ). In problem-focused coping employees are responsible for working out a strategic plan in order to remove job stressors, such as setting up a set of goals and engaging in behaviors to meet these goals. Problem-focused coping is viewed as an adaptive response, though it can also be maladaptive if it creates more problems down the road, such as procrastinating getting work done or feigning illness to take time off from work. Adaptive problem-focused coping negatively relates to long-term job strains (Higgins & Endler, 1995 ). Discussion on problem-solving coping is framed from an adaptive perspective.

Problem-focused coping is featured as an extension of control, because engaging in problem-focused coping strategies requires a series of acts to keep job stressors under control (Bhagat et al., 2012 ). In the stress literature, there are generally two ways to categorize control: internal versus external locus of control, and primary versus secondary control. Locus of control refers to the extent to which people believe they have control over their own life (Rotter, 1966 ). People high in internal locus of control believe that they can control their own fate whereas people high in external locus of control believe that outside factors determine their life experience (Rotter, 1966 ). Generally, those with an external locus of control are less inclined to engage in problem-focused coping (Strentz & Auerbach, 1988 ). Primary control is the belief that people can directly influence their environment (Alloy & Abramson, 1979 ), and thus they are more likely to engage in problem-focused coping. However, when it is not feasible to exercise primary control, people search for secondary control, with which people try to adapt themselves into the objective environment (Rothbaum, Weisz, & Snyder, 1982 ).

Emotion-Focused Coping

Emotion-focused coping, sometimes referred to as palliative coping, helps employees reduce strains without the removal of job stressors. It involves cognitive or emotional efforts, such as talking about the stressor or distracting oneself from the stressor, in order to lessen emotional distress resulting from job stressors (Bhagat et al., 2012 ). Emotion-focused coping aims to reappraise and modify the perceptions of a situation or seek emotional support from friends or family. These methods do not include efforts to change the work situation or to remove the job stressors (Lazarus & Folkman, 1991 ). People tend to adopt emotion-focused coping strategies when they believe that little or nothing can be done to remove the threatening, harmful, and challenging stressors (Bhagat et al., 2012 ), such as when they are the only individuals to have the skills to get a project done or they are given increased responsibilities because of the unexpected departure of a colleague. Emotion-focused coping strategies include (1) reappraisal of the stressful situation, (2) talking to friends and receiving reassurance from them, (3) focusing on one’s strength rather than weakness, (4) optimistic comparison—comparing one’s situation to others’ or one’s past situation, (5) selective ignoring—paying less attention to the unpleasant aspects of one’s job and being more focused on the positive aspects of the job, (6) restrictive expectations—restricting one’s expectations on job satisfaction but paying more attention to monetary rewards, (7) avoidance coping—not thinking about the problem, leaving the situation, distracting oneself, or using alcohol or drugs (e.g., Billings & Moos, 1981 ).

Some emotion-focused coping strategies are maladaptive. For example, avoidance coping may lead to increased level of job strains in the long run (e.g., Parasuraman & Cleek, 1984 ). Furthermore, a person’s ability to cope with the imbalance of performing work to meet organizational expectations can take a toll on the person’s health, leading to physiological consequences such as cardiovascular disease, sleep disorders, gastrointestinal disorders, and diabetes (Fried et al., 2013 ; Siegrist, 2010 ; Toker, Shirom, Melamed, & Armon, 2012 ; Willert, Thulstrup, Hertz, & Bonde, 2010 ).

Comparing Coping Strategies across Cultures

Most coping research is conducted in individualistic, Western cultures wherein emotional control is emphasized and both problem-solving focused coping and primary control are preferred (Bhagat et al., 2010 ). However, in collectivistic cultures, emotion-focused coping and use of secondary control may be preferred and may not necessarily carry a negative evaluation (Bhagat et al., 2010 ). For example, African Americans are more likely to use emotion-focused coping than non–African Americans (Knight, Silverstein, McCallum, & Fox, 2000 ), and among women who experienced sexual harassment, Anglo American women were less likely to employ emotion focused coping (i.e., avoidance coping) than Turkish women and Hispanic American women, while Hispanic women used more denial than the other two groups (Wasti & Cortina, 2002 ).

Thus, whereas problem-focused coping is venerated in Western societies, emotion-focused coping may be more effective in reducing strains in collectivistic cultures, such as China, Japan, and India (Bhagat et al., 2010 ; Narayanan, Menon, & Spector, 1999 ; Selmer, 2002 ). Indeed, Swedish participants reported more problem-focused coping than did Chinese participants (Xiao, Ottosson, & Carlsson, 2013 ), American college students engaged in more problem-focused coping behaviors than did their Japanese counterparts (Ogawa, 2009 ), and Indian (vs. Canadian) students reported more emotion-focused coping, such as seeking social support and positive reappraisal (Sinha, Willson, & Watson, 2000 ). Moreover, Glazer, Stetz, and Izso ( 2004 ) found that internal locus of control was more predominant in individualistic cultures (United Kingdom and United States), whereas external locus of control was more predominant in communal cultures (Italy and Hungary). Also, internal locus of control was associated with less job stress, but more so for nurses in the United Kingdom and United States than Italy and Hungary. Taken together, adoption of coping strategies and their effectiveness differ significantly across cultures. The extent to which a coping strategy is perceived favorably and thus selected or not selected is not only a function of culture, but also a person’s sociocultural beliefs toward the coping strategy (Morimoto, Shimada, & Ozaki, 2013 ).

Social Support

Social support refers to the aid an entity gives to a person. The source of the support can be a single person, such as a supervisor, coworker, subordinate, family member, friend, or stranger, or an organization as represented by upper-level management representing organizational practices. The type of support can be instrumental or emotional. Instrumental support, including informational support, refers to that which is tangible, such as data to help someone make a decision or colleagues’ sick days so one does not lose vital pay while recovering from illness. Emotional support, including esteem support, refers to the psychological boost given to a person who needs to express emotions and feel empathy from others or to have his or her perspective validated. Beehr and Glazer ( 2001 ) present an overview of the role of social support on the stressor-strain relationship and arguments regarding the role of culture in shaping the utility of different sources and types of support.

Meaningfulness and Resilience

Meaningfulness reflects the extent to which people believe their lives are significant, purposeful, goal-directed, and fulfilling (Glazer, Kożusznik, Meyers, & Ganai, 2014 ). When faced with stressors, people who have a strong sense of meaning in life will also try to make sense of the stressors. Maintaining a positive outlook on life stressors helps to manage emotions, which is helpful in reducing strains, particularly when some stressors cannot be problem-solved (Lazarus & Folkman, 1991 ). Lazarus and Folkman ( 1991 ) emphasize that being able to reframe threatening situations can be just as important in an adaptation as efforts to control the stressors. Having a sense of meaningfulness motivates people to behave in ways that help them overcome stressors. Thus, meaningfulness is often used in the same breath as resilience, because people who are resilient are often protecting that which is meaningful.

Resilience is a personality state that can be fortified and enhanced through varied experiences. People who perceive their lives are meaningful are more likely to find ways to face adversity and are therefore more prone to intensifying their resiliency. When people demonstrate resilience to cope with noxious stressors, their ability to be resilient against other stressors strengthens because through the experience, they develop more competencies (Glazer et al., 2014 ). Thus, fitting with Hobfoll’s ( 1989 , 2001 ) COR theory, meaningfulness and resilience are psychological resources people attempt to conserve and protect, and employ when necessary for making sense of or coping with stressors.

Tertiary Interventions (Stress Management)

Stress management refers to interventions employed to treat and repair harmful repercussions of stressors that were not coped with sufficiently. As Lazarus and Folkman ( 1991 ) noted, not all stressors “are amenable to mastery” (p. 205). Stressors that are unmanageable and lead to strains require interventions to reverse or slow down those effects. Workplace interventions might focus on the person, the organization, or both. Unfortunately, instead of looking at the whole system to include the person and the workplace, most companies focus on the person. Such a focus should not be a surprise given the results of van der Klink, Blonk, Schene, and van Dijk’s ( 2001 ) meta-analysis of 48 experimental studies conducted between 1977 and 1996 . They found that of four types of tertiary interventions, the effect size for cognitive-behavioral interventions and multimodal programs (e.g., the combination of assertive training and time management) was moderate and the effect size for relaxation techniques was small in reducing psychological complaints, but not turnover intention related to work stress. However, the effects of (the five studies that used) organization-focused interventions were not significant. Similarly, Richardson and Rothstein’s ( 2008 ) meta-analytic study, including 36 experimental studies with 55 interventions, showed a larger effect size for cognitive-behavioral interventions than relaxation, organizational, multimodal, or alternative. However, like with van der Klink et al. ( 2001 ), Richardson and Rothstein ( 2008 ) cautioned that there were few organizational intervention studies included and the impact of interventions were determined on the basis of psychological outcomes and not physiological or organizational outcomes. Van der Klink et al. ( 2001 ) further expressed concern that organizational interventions target the workplace and that changes in the individual may take longer to observe than individual interventions aimed directly at the individual.

The long-term benefits of individual focused interventions are not yet clear either. Per Giga, Cooper, and Faragher ( 2003 ), the benefits of person-directed stress management programs will be short-lived if organizational factors to reduce stressors are not addressed too. Indeed, LaMontagne, Keegel, Louie, Ostry, and Landsbergis ( 2007 ), in their meta-analysis of 90 studies on stress management interventions published between 1990 and 2005 , revealed that in relation to interventions targeting organizations only, and interventions targeting individuals only, interventions targeting both organizations and individuals (i.e. the systems approach) had the most favorable positive effects on both the organizations and the individuals. Furthermore, the organization-level interventions were effective at both the individual and organization levels, but the individual-level interventions were effective only at the individual level.

Individual-Focused Stress Management

Individual-focused interventions concentrate on improving conditions for the individual, though counseling programs emphasize that the worker is in charge of reducing “stress,” whereas role-focused interventions emphasize activities that organizations can guide to actually reduce unnecessary noxious environmental factors.

Individual-Focused Stress Management: Employee Assistance Programs

When stress become sufficiently problematic (which is individually gauged or attended to by supportive others) in a worker’s life, employees may utilize the short-term counseling services or referral services Employee Assistance Programs (EAPs) provide. People who utilize the counseling services may engage in cognitive behavioral therapy aimed at changing the way people think about the stressors (e.g., as challenge opportunity over threat) and manage strains. Example topics that may be covered in these therapy sessions include time management and goal setting (prioritization), career planning and development, cognitive restructuring and mindfulness, relaxation, and anger management. In a study of healthcare workers and teachers who participated in a 2-day to 2.5-day comprehensive stress management training program (including 26 topics on identifying, coping with, and managing stressors and strains), Siu, Cooper, and Phillips ( 2013 ) found psychological and physical improvements were self-reported among the healthcare workers (for which there was no control group). However, comparing an intervention group of teachers to a control group of teachers, the extent of change was not as visible, though teachers in the intervention group engaged in more mastery recovery experiences (i.e., they purposefully chose to engage in challenging activities after work).

Individual-Focused Stress Management: Mindfulness

A popular therapy today is to train people to be more mindful, which involves helping people live in the present, reduce negative judgement of current and past experiences, and practicing patience (Birnie, Speca, & Carlson, 2010 ). Mindfulness programs usually include training on relaxation exercises, gentle yoga, and awareness of the body’s senses. In one study offered through the continuing education program at a Canadian university, 104 study participants took part in an 8-week, 90 minute per group (15–20 participants per) session mindfulness program (Birnie et al., 2010 ). In addition to body scanning, they also listened to lectures on incorporating mindfulness into one’s daily life and received a take-home booklet and compact discs that guided participants through the exercises studied in person. Two weeks after completing the program, participants’ mindfulness attendance and general positive moods increased, while physical, psychological, and behavioral strains decreased. In another study on a sample of U.K. government employees, study participants receiving three sessions of 2.5 to 3 hours each training on mindfulness, with the first two sessions occurring in consecutive weeks and the third occurring about three months later, Flaxman and Bond ( 2010 ) found that compared to the control group, the intervention group showed a decrease in distress levels from Time 1 (baseline) to Time 2 (three months after first two training sessions) and Time 1 to Time 3 (after final training session). Moreover, of the mindfulness intervention study participants who were clinically distressed, 69% experienced clinical improvement in their psychological health.

Individual-Focused Stress Management: Biofeedback/Imagery/Meditation/Deep Breathing

Biofeedback uses electronic equipment to inform users about how their body is responding to tension. With guidance from a therapist, individuals then learn to change their physiological responses so that their pulse normalizes and muscles relax (Norris, Fahrion, & Oikawa, 2007 ). The therapist’s guidance might include reminders for imagery, meditation, body scan relaxation, and deep breathing. Saunders, Driskell, Johnston, and Salas’s ( 1996 ) meta-analysis of 37 studies found that imagery helped reduce state and performance anxiety. Once people have been trained to relax, reminder triggers may be sent through smartphone push notifications (Villani et al., 2013 ).

Smartphone technology can also be used to support weight loss programs, smoking cessation programs, and medication or disease (e.g., diabetes) management compliance (Heron & Smyth, 2010 ; Kannampallil, Waicekauskas, Morrow, Kopren, & Fu, 2013 ). For example, smartphones could remind a person to take medications or test blood sugar levels or send messages about healthy behaviors and positive affirmations.

Individual-Focused Stress Management: Sleep/Rest/Respite

Workers today sleep less per night than adults did nearly 30 years ago (Luckhaupt, Tak, & Calvert, 2010 ; National Sleep Foundation, 2005 , 2013 ). In order to combat problems, such as increased anxiety and cardiovascular artery disease, associated with sleep deprivation and insufficient rest, it is imperative that people disconnect from their work at least one day per week or preferably for several weeks so that they are able to restore psychological health (Etzion, Eden, & Lapidot, 1998 ; Ragsdale, Beehr, Grebner, & Han, 2011 ). When college students engaged in relaxation-type activities, such as reading or watching television, over the weekend, they experienced less emotional exhaustion and greater general well-being than students who engaged in resources-consuming activities, such as house cleaning (Ragsdale et al., 2011 ). Additional research and future directions for research are reviewed and identified in the work of Sonnentag ( 2012 ). For example, she asks whether lack of ability to detach from work is problematic for people who find their work meaningful. In other words, are negative health consequences only among those who do not take pleasure in their work? Sonnetag also asks how teleworkers detach from their work when engaging in work from the home. Ironically, one of the ways that companies are trying to help with the challenges of high workload or increased need to be available to colleagues, clients, or vendors around the globe is by offering flexible work arrangements, whereby employees who can work from home are given the opportunity to do so. Companies that require global interactions 24-hours per day often employ this strategy, but is the solution also a source of strain (Glazer, Kożusznik, & Shargo, 2012 )?

Individual-Focused Stress Management: Role Analysis

Role analysis or role clarification aims to redefine, expressly identify, and align employees’ roles and responsibilities with their work goals. Through role negotiation, involved parties begin to develop a new formal or informal contract about expectations and define resources needed to fulfill those expectations. Glazer has used this approach in organizational consulting and, with one memorable client engagement, found that not only were the individuals whose roles required deeper re-evaluation happier at work (six months later), but so were their subordinates. Subordinates who once characterized the two partners as hostile and akin to a couple going through a bad divorce, later referred to them as a blissful pair. Schaubroeck, Ganster, Sime, and Ditman ( 1993 ) also found in a three-wave study over a two-year period that university employees’ reports of role clarity and greater satisfaction with their supervisor increased after a role clarification exercise of top managers’ roles and subordinates’ roles. However, the intervention did not have any impact on reported physical symptoms, absenteeism, or psychological well-being. Role analysis is categorized under individual-focused stress management intervention because it is usually implemented after individuals or teams begin to demonstrate poor performance and because the intervention typically focuses on a few individuals rather than an entire organization or group. In other words, the intervention treats the person’s symptoms by redefining the role so as to eliminate the stimulant causing the problem.

Organization-Focused Stress Management

At the organizational level, companies that face major declines in productivity and profitability or increased costs related to healthcare and disability might be motivated to reassess organizational factors that might be impinging on employees’ health and well-being. After all, without healthy workers, it is not possible to have a healthy organization. Companies may choose to implement practices and policies that are expected to help not only the employees, but also the organization with reduced costs associated with employee ill-health, such as medical insurance, disability payments, and unused office space. Example practices and policies that may be implemented include flexible work arrangements to ensure that employees are not on the streets in the middle of the night for work that can be done from anywhere (such as the home), diversity programs to reduce stress-induced animosity and prejudice toward others, providing only healthy food choices in cafeterias, mandating that all employees have physicals in order to receive reduced prices for insurance, company-wide closures or mandatory paid time off, and changes in organizational visioning.

Organization-Focused Stress Management: Organizational-Level Occupational Health Interventions

As with job design interventions that are implemented to remediate work characteristics that were a source of unnecessary or excessive stressors, so are organizational-level occupational health (OLOH) interventions. As with many of the interventions, its placement as a primary or tertiary stress management intervention may seem arbitrary, but when considering the goal and target of change, it is clear that the intervention is implemented in response to some ailing organizational issues that need to be reversed or stopped, and because it brings in the entire organization’s workforce to address the problems, it has been placed in this category. There are several more case studies than empirical studies on the topic of whole system organizational change efforts (see example case studies presented by the United Kingdom’s Health and Safety Executive). It is possible that lack of published empirical work is not so much due to lack of attempting to gather and evaluate the data for publication, but rather because the OLOH interventions themselves never made it to the intervention stage, the interventions failed (Biron, Gatrell, & Cooper, 2010 ), or the level of evaluation was not rigorous enough to get into empirical peer-review journals. Fortunately, case studies provide some indication of the opportunities and problems associated with OLOH interventions.

One case study regarding Cardiff and Value University Health Board revealed that through focus group meetings with members of a steering group (including high-level managers and supported by top management) and facilitated by a neutral, non-judgemental organizational health consultant, ideas for change were posted on newsprint, discussed, and areas in the organization needing change were identified. The intervention for giving voice to people who initially had little already had a positive effect on the organization, as absence decreased by 2.09% and 6.9% merely 12 and 18 months, respectively, after the intervention. Translated in financial terms, the 6.9% change was equivalent to a quarterly savings of £80,000 (Health & Safety Executive, n.d. ). Thus, focusing on the context of change and how people will be involved in the change process probably helped the organization realize improvements (Biron et al., 2010 ). In a recent and rare empirical study, employing both qualitative and quantitative data collection methods, Sørensen and Holman ( 2014 ) utilized PAR in order to plan and implement an OLOH intervention over the course of 14 months. Their study aimed to examine the effectiveness of the PAR process in reducing workers’ work-related and social or interpersonal-related stressors that derive from the workplace and improving psychological, behavioral, and physiological well-being across six Danish organizations. Based on group dialogue, 30 proposals for change were proposed, all of which could be categorized as either interventions to focus on relational factors (e.g., management feedback improvement, engagement) or work processes (e.g., reduced interruptions, workload, reinforcing creativity). Of the interventions that were implemented, results showed improvements on manager relationship quality and reduced burnout, but no changes with respect to work processes (i.e., workload and work pace) perhaps because the employees already had sufficient task control and variety. These findings support Dewe and Kompier’s ( 2008 ) position that occupational health can be reinforced through organizational policies that reinforce quality jobs and work experiences.

Organization-Focused Stress Management: Flexible Work Arrangements

Dewe and Kompier ( 2008 ), citing the work of Isles ( 2005 ), noted that concern over losing one’s job is a reason for why 40% of survey respondents indicated they work more hours than formally required. In an attempt to create balance and perceived fairness in one’s compensation for putting in extra work hours, employees will sometimes be legitimately or illegitimately absent. As companies become increasingly global, many people with desk jobs are finding themselves communicating with colleagues who are halfway around the globe and at all hours of the day or night (Glazer et al., 2012 ). To help minimize the strains associated with these stressors, companies might devise flexible work arrangements (FWA), though the type of FWA needs to be tailored to the cultural environment (Masuda et al., 2012 ). FWAs give employees some leverage to decide what would be the optimal work arrangement for them (e.g., part-time, flexible work hours, compressed work week, telecommuting). In other words, FWA provides employees with the choice of when to work, where to work (on-site or off-site), and how many hours to work in a day, week, or pay period (Kossek, Thompson, & Lautsch, 2015 ). However, not all employees of an organization have equal access to or equitable use of FWAs; workers in low-wage, hourly jobs are often beholden to being physically present during specific hours (Swanberg McKechnie, Ojha, & James, 2011 ). In a study of over 1,300 full-time hourly retail employees in the United States, Swanberg et al. ( 2011 ) showed that employees who have control over their work schedules and over their work hours were satisfied with their work schedules, perceived support from the supervisor, and work engagement.

Unfortunately, not all FWAs yield successful results for the individual or the organization. Being able to work from home or part-time can have problems too, as a person finds himself or herself working more hours from home than required. Sometimes telecommuting creates work-family conflict too as a person struggles to balance work and family obligations while working from home. Other drawbacks include reduced face-to-face contact between work colleagues and stakeholders, challenges shaping one’s career growth due to limited contact, perceived inequity if some have more flexibility than others, and ambiguity about work role processes for interacting with employees utilizing the FWA (Kossek et al., 2015 ). Organizations that institute FWAs must carefully weigh the benefits and drawbacks the flexibility may have on the employees using it or the employees affected by others using it, as well as the implications on the organization, including the vendors who are serving and clients served by the organization.

Organization-Focused Stress Management: Diversity Programs

Employees in the workplace might experience strain due to feelings of discrimination or prejudice. Organizational climates that do not promote diversity (in terms of age, religion, physical abilities, ethnicity, nationality, sex, and other characteristics) are breeding grounds for undesirable attitudes toward the workplace, lower performance, and greater turnover intention (Bergman, Palmieri, Drasgow, & Ormerod, 2012 ; Velez, Moradi, & Brewster, 2013 ). Management is thus advised to implement programs that reinforce the value and importance of diversity, as well as manage diversity to reduce conflict and feelings of prejudice. In fact, managers who attended a leadership training program reported higher multicultural competence in dealing with stressful situations (Chrobot-Mason & Leslie, 2012 ), and managers who persevered through challenges were more dedicated to coping with difficult diversity issues (Cilliers, 2011 ). Thus, diversity programs can help to reduce strains by directly reducing stressors associated with conflict linked to diversity in the workplace and by building managers’ resilience.

Organization-Focused Stress Management: Healthcare Management Policies

Over the past few years, organizations have adopted insurance plans that implement wellness programs for the sake of managing the increasing cost of healthcare that is believed to be a result of individuals’ not managing their own health, with regular check-ups and treatment. The wellness programs require all insured employees to visit a primary care provider, complete a health risk assessment, and engage in disease management activities as specified by a physician (e.g., see frequently asked questions regarding the State of Maryland’s Wellness Program). Companies believe that requiring compliance will reduce health problems, although there is no proof that such programs save money or that people would comply. One study that does, however, boast success, was a 12-week workplace health promotion program aimed at reducing Houston airport workers’ weight (Ebunlomo, Hare-Everline, Weber, & Rich, 2015 ). The program, which included 235 volunteer participants, was deemed a success, as there was a total weight loss of 345 pounds (or 1.5 lbs per person). Given such results in Houston, it is clear why some people are also skeptical over the likely success of wellness programs, particularly as there is no clear method for evaluating their efficacy (Sinnott & Vatz, 2015 ).

Moreover, for some, such a program is too paternalistic and intrusive, as well as punishes anyone who chooses not to actively participate in disease management programs (Sinnott & Vatz, 2015 ). The programs put the onus of change on the person, though it is a response to the high costs of ill-health. The programs neglect to consider the role of the organization in reducing the barriers to healthy lifestyle, such as cloaking exempt employment as simply needing to get the work done, when it usually means working significantly more hours than a standard workweek. In fact, workplace health promotion programs did not reduce presenteeism (i.e., people going to work while unwell thereby reducing their job performance) among those who suffered from physical pain (Cancelliere, Cassidy, Ammendolia, & Côte, 2011 ). However, supervisor education, worksite exercise, lifestyle intervention through email, midday respite from repetitive work, a global stress management program, changes in lighting, and telephone interventions helped to reduce presenteeism. Thus, emphasis needs to be placed on psychosocial aspects of the organization’s structure, including managers and overall organizational climate for on-site presence, that reinforces such behavior (Cancelliere et al., 2011 ). Moreover, wellness programs are only as good as the interventions to reduce work-related stressors and improve organizational resources to enable workers to improve their overall psychological and physical health.

Concluding Remarks

Future research.

One of the areas requiring more theoretical and practical attention is that of the utility of stress frameworks to guide organizational development change interventions. Although it has been proposed that the foundation for work stress management interventions is in organizational development, and even though scholars and practitioners of organization development were also founders of research programs that focused on employee health and well-being or work stress, there are few studies or other theoretical works that link the two bodies of literature.

A second area that requires additional attention is the efficacy of stress management interventions across cultures. In examining secondary stress management interventions (i.e., coping), some cross-cultural differences in findings were described; however, there is still a dearth of literature from different countries on the utility of different prevention, coping, and stress management strategies.

A third area that has been blossoming since the start of the 21st century is the topic of hindrance and challenge stressors and the implications of both on workers’ well-being and performance. More research is needed on this topic in several areas. First, there is little consistency by which researchers label a stressor as a hindrance or a challenge. Researchers sometimes take liberties with labels, but it is not the researchers who should label a stressor but the study participants themselves who should indicate if a stressor is a source of strain. Rodríguez, Kozusznik, and Peiró ( 2013 ) developed a measure in which respondents indicate whether a stressor is a challenge or a hindrance. Just as some people may perceive demands to be challenges that they savor and that result in a psychological state of eustress (Nelson & Simmons, 2003 ), others find them to be constraints that impede goal fulfillment and thus might experience distress. Likewise, some people might perceive ambiguity as a challenge that can be overcome and others as a constraint over which he or she has little control and few or no resources with which to cope. More research on validating the measurement of challenge vs. hindrance stressors, as well as eustress vs. distress, and savoring vs. coping, is warranted. Second, at what point are challenge stressors harmful? Just because people experiencing challenge stressors continue to perform well, it does not necessarily mean that they are healthy people. A great deal of stressors are intellectually stimulating, but excessive stimulation can also take a toll on one’s physiological well-being, as evident by the droves of professionals experiencing different kinds of diseases not experienced as much a few decades ago, such as obesity (Fried et al., 2013 ). Third, which stress management interventions would better serve to reduce hindrance stressors or to reduce strain that may result from challenge stressors while reinforcing engagement-producing challenge stressors?

A fourth area that requires additional attention is that of the flexible work arrangements (FWAs). One of the reasons companies have been willing to permit employees to work from home is not so much out of concern for the employee, but out of the company’s need for the focal person to be able to communicate with a colleague working from a geographic region when it is night or early morning for the focal person. Glazer, Kożusznik, and Shargo ( 2012 ) presented several areas for future research on this topic, noting that by participating on global virtual teams, workers face additional stressors, even while given flexibility of workplace and work time. As noted earlier, more research needs to be done on the extent to which people who take advantage of FWAs are advantaged in terms of detachment from work. Can people working from home detach? Are those who find their work invigorating also likely to experience ill-health by not detaching from work?

A fifth area worthy of further research attention is workplace wellness programing. According to Page and Vella-Brodrick ( 2009 ), “subjective and psychological well-being [are] key criteria for employee mental health” (p. 442), whereby mental health focuses on wellness, rather than the absence of illness. They assert that by fostering employee mental health, organizations are supporting performance and retention. Employee well-being can be supported by ensuring that jobs are interesting and meaningful, goals are achievable, employees have control over their work, and skills are used to support organizational and individual goals (Dewe & Kompier, 2008 ). However, just as mental health is not the absence of illness, work stress is not indicative of an absence of psychological well-being. Given the perspective that employee well-being is a state of mind (Page & Vella-Brodrick, 2009 ), we suggest that employee well-being can be negatively affected by noxious job stressors that cannot be remediated, but when job stressors are preventable, employee well-being can serve to protect an employee who faces job stressors. Thus, wellness programs ought to focus on providing positive experiences by enhancing and promoting health, as well as building individual resources. These programs are termed “green cape” interventions (Pawelski, 2016 ). For example, with the growing interests in positive psychology, researchers and practitioners have suggested employing several positive psychology interventions, such as expressing gratitude, savoring experiences, and identifying one’s strengths (Tetrick & Winslow, 2015 ). Another stream of positive psychology is psychological capital, which includes four malleable functions of self-efficacy, optimism, hope, and resilience (Luthans, Youssef, & Avolio, 2007 ). Workplace interventions should include both “red cape” interventions (i.e., interventions to reduce negative experiences) and “green cape” interventions (i.e., workplace wellness programs; Polly, 2014 ).

A Healthy Organization’s Pledge

A healthy workplace requires healthy workers. Period. Among all organizations’ missions should be the focus on a healthy workforce. To maintain a healthy workforce, the company must routinely examine its own contributions in terms of how it structures itself; reinforces communications among employees, vendors, and clients; how it rewards and cares for its people (e.g., ensuring they get sufficient rest and can detach from work); and the extent to which people at the upper levels are truly connected with the people at the lower levels. As a matter of practice, management must recognize when employees are overworked, unwell, and poorly engaged. Management must also take stock of when it is doing well and right by its contributors’ and maintain and reinforce the good practices, norms, and procedures. People in the workplace make the rules; people in the workplace can change the rules. How management sees its employees and values their contribution will have a huge role in how a company takes stock of its own pain points. Providing employees with tools to manage their own reactions to work-related stressors and consequent strains is fine, but wouldn’t it be grand if organizations took better notice about what they could do to mitigate the strain-producing stressors in the first place and take ownership over how employees are treated?

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Research Article

Self-Affirmation Improves Problem-Solving under Stress

* E-mail: [email protected]

Affiliation Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, United States of America

Affiliation Department of Psychology, University of California Los Angeles, Los Angeles, California, United States of America

Affiliation Division of Cancer Control and Population Sciences, NCI, Bethesda, Maryland, United States of America

Affiliation Department of Psychology, University of Sheffield, Sheffield, United Kingdom

Affiliation Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America

  • J. David Creswell, 
  • Janine M. Dutcher, 
  • William M. P. Klein, 
  • Peter R. Harris, 
  • John M. Levine

PLOS

  • Published: May 1, 2013
  • https://doi.org/10.1371/journal.pone.0062593
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Table 1

High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation improves problem-solving performance in chronically stressed participants. Eighty undergraduates indicated their perceived chronic stress over the previous month and were randomly assigned to either a self-affirmation or control condition. They then completed 30 difficult remote associate problem-solving items under time pressure in front of an evaluator. Results showed that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. This research suggests a novel means for boosting problem-solving under stress and may have important implications for understanding how self-affirmation boosts academic achievement in school settings.

Citation: Creswell JD, Dutcher JM, Klein WMP, Harris PR, Levine JM (2013) Self-Affirmation Improves Problem-Solving under Stress. PLoS ONE 8(5): e62593. https://doi.org/10.1371/journal.pone.0062593

Editor: José César Perales, Universidad de Granada, Spain

Received: September 28, 2012; Accepted: March 26, 2013; Published: May 1, 2013

Copyright: © 2013 Creswell et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This research was supported by the National Science Foundation under Grant #924387 and the Pittsburgh Life Sciences Greenhouse Opportunity Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Acute and chronic stress have been shown to disrupt problem-solving and creativity [1] . For example, acutely stressful contexts, such as completing problem-solving tasks under negative social evaluation, have been shown to impair performance on a variety of tasks, such as anagrams and remote associate problems [2] , [3] . Feeling chronically stressed produces similar performance impairments. For example, Liston and colleagues found that participants who reported high levels of stress over the previous month demonstrated impaired attention-shifting performance compared to participants who reported low levels of stress [4] , [5] . Moreover, these stress-induced performance impairments were reversed when the high-stress participants completed the tasks after a one-month low stress period [4] . Although this body of research provides supportive evidence indicating that acute and chronic stressors can impair problem solving, little is currently known about stress management approaches for mitigating the effects of stress on problem solving.

An emerging body of research suggests that self-affirmation may be one such effective stress management approach. Self-affirmation theory posits that the goal of the self is to protect one’s self-image when threatened and that one way to do this is through affirmation of valued sources of self-worth [6] , [7] . In order to manipulate self-affirmation, experimental studies commonly have participants rank-order personal values (e.g., politics, relations with friends/family), and then participants in the self-affirmation condition are asked to respond to questions or complete a short essay on why their #1 ranked value is important (control participants complete a similar activity about why a lower ranked value might be important to someone else) [8] . As a result, participants in the self-affirmation condition have an opportunity to affirm a valued self-domain or characteristic [6] , [8] . Studies using this experimental approach have found that self-affirmation can buffer threats to the self in variety of domains [6] , with several recent studies showing that self-affirmation can buffer stress responses to laboratory stressors [9] , [10] and naturalistic academic stressors [11] . Collectively, this work suggests that if self-affirmation can reduce stress, it may also promote problem-solving performance under high stress conditions, although no previous studies have tested the effects of self-affirmation manipulations on actual problem-solving performance [12] – [16] .

In the present study, we test whether a brief self-affirmation can buffer the negative impacts of chronic stress on problem-solving. Specifically, we used a well-known measure of problem-solving and creativity (the Remote Associates Task (RAT)) [17] – [20] to test three hypotheses. First, we tested whether chronic stress is related to poorer problem-solving performance. Second, we tested whether self-affirmation improves problem-solving. Third, we tested whether these two main effects are qualified by a chronic stress × self-affirmation interaction, such that self-affirmation will improve problem-solving in chronically stressed participants, whom are likely to have impaired problem-solving, compared to participants who are low in chronic stress.

Ethics Statement

This research was approved by the Carnegie Mellon University Institutional Review Board.

Participants

Eighty students from two urban universities in Pittsburgh participated for course credit or $20. We excluded seven participants who did not follow instructions (N = 5) or who did not rate academic performance as important to them (N = 2). The sample thus consisted of 73 students (34 females; 39 males) who ranged in age from 18 to 34, with an average age of 21 (SD = 2.4). Given this broad age range and the marginally significantly association between age and overall RAT performance ( r  = −.21, p  = .07), we controlled for age in all analyses. The ethnic composition of the sample was predominantly Caucasian (55%), followed by Asian-American (16.5%), Other (12%), African-American (9.5%), mixed-race (5.5%), and Latino/Hispanic (1.5%). The sample had similar levels of chronic stress ( M =  16.6, SD  = 7.1, Range = 1–34) to normed US samples of individuals under 25 years of age (M = 16.8) [21] . Ethnicity (Caucasian vs. all others) and gender (male vs. female) did not moderate any of the primary study results (see Tables 1 and 2 ).

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Participants provided written informed consent and then completed an experiment ostensibly about intelligence and performance. Participants were informed that a trained evaluator would administer the performance task. Prior to completing the RAT and while the evaluator was ostensibly preparing to administer the test, participants were asked if they would be willing to complete a questionnaire and writing activity that was being piloted for an unrelated experiment on personal values (all agreed). Participants were randomly assigned either to the self-affirmation or control condition. In both cases, they rated 11 values (i.e., art, business, friends/family) in order of personal importance. Next, they wrote about their first ranked value and why it was important to them (self-affirmation condition) or their ninth ranked value and why it might be important to others (control condition) [12] . Following the self-affirmation writing task, as a manipulation check, participants were asked to respond to two items assessing how important the value they wrote about was, using a 6-point response scale (1 = Strongly Disagree to 6 = Strongly Agree). Items were, “This value has influenced my life” and “This value is an important part of who I am” (study α = .96). Participants then completed a state mood adjective checklist assessing state positive mood (5 items: proud, content, joyful, love, and grateful; study α = .84) and state negative mood (3 items: sad, angry, scared; study α = .65) (PANAS-X; [22] , [23] ).

Participants’ heart rate and mean arterial pressure were measured at 2-minute intervals using an automatic sphygmomanometer and inflatable cuff on their left arm (Dinamap Carescape V100, General Electric Company, Finland) during three different periods: an eight-minute baseline period, followed by the RAT (about 9 minutes), and a five-minute recovery period. All readings in each period were averaged. Heart rate was included because it is a useful indirect marker for task engagement [24] , [25] , which may be affected by our self-affirmation manipulation. Mean arterial blood pressure was collected to measure cardiovascular reactivity to the laboratory challenge task.

The experimenter was blind to participant condition, and a separate RAT evaluator (also blind to condition) administered the 30-item RAT performance task. 144 RAT items have been normed for difficulty [17] , and pilot testing indicated that our undergraduate sample population can solve all easy RAT items. We thus selected 30 challenging RAT items ranging in difficulty from moderately to extremely difficult (the items are available in Table S1 ). For each RAT item, participants saw three words on a computer screen (e.g., flake, mobile, cone) and were asked to generate a fourth word (e.g., snow) that when combined with each of the three stimulus words results in a common word pair used in everyday English language (e.g., snowflake, snow mobile, snow cone). They were given 12 seconds to provide an answer verbally. The evaluator provided veridical verbal performance feedback (incorrect, correct) after each response and recorded each response. In order to create performance pressure, the evaluator provided evaluative feedback three times during the 30 RAT trials (“I need you to try harder”).

After completing the performance task, the evaluator left the room and the experimenter re-entered and indicated that the participant was to rest quietly (5 minute recovery period). Participants then completed individual difference measures, including the 10-item Perceived Stress Scale [26] to assess perceived stress over the last month (all items were summed to form a composite index of chronic stress, study α = .87). To reduce potential confounding effects, we administered these measures at the end of the experimental session because previous studies indicate that completing individual difference measures at the beginning of an experimental session may act as an affirmation manipulation (i.e., they have carry-over effects) [27] . We had no reason to expect that the experimental task would bias participants’ responses when self-reporting their chronic stress levels over the past month, and a one-way ANCOVA indicated that the self-affirmation manipulation did not affect perceived stress over the last month ( F (1, 72) = .95, p  = .22, η 2  = .01). After completing individual difference measures, participants were debriefed, compensated, and excused.

Data Analysis

All descriptive statistics, ANCOVA, and multiple regression analyses were conducted using SPSS 19.0 (IBM, Armonk, New York). All predictor variables were mean-centered prior to being entered in multiple regression equations. Our experimental manipulation of self-affirmation was dummy coded (self-affirmation = 1, control = 0). Correct responses on the RAT were summed across the 30 trials to form an overall composite RAT problem-solving performance score. As described above, age was included as a covariate in all analyses (except the preliminary chi-square analyses described below).

Preliminary Analyses

It is possible that there may have been significant differences in how participants ranked their #1 value across study conditions, which could indicate a failure of randomization. To test whether there were differences in the selected #1 ranked value between study conditions, chi-square analyses were conducted to test for condition differences (self-affirmation vs. control, low vs. high chronic stress) on which value participants’ ranked #1 ( Table 3 provides frequencies of #1 ranked values across conditions). Consistent with previous studies [28] , approximately 50% of participants selected “Relations with Friends and Family” as their #1 ranked value. Importantly, there was no main effect for either self-affirmation condition (χ 2 (8) = 6.36, p =  .61) or chronic stress level (χ 2 (8) = 6.50, p  = .59) on the #1 ranked value. Moreover, the self-affirmation × chronic stress interaction for the #1 ranked value was not significant (χ 2 (8) = 3.03, p  = .93). In sum, there was no evidence that self-affirmation condition or chronic stress level affected participants’ selection of their top-ranked value.

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https://doi.org/10.1371/journal.pone.0062593.t003

As expected, self-affirmation and control participants wrote about different values during the writing activity (χ 2 (10) = 33.7, p<.001; see Table 4 ), such that participants in the control condition wrote about a ninth-ranked value that was different from the first-ranked value in the self-affirmation condition. As shown in Table 4 and noted above, approximately half the self-affirmation condition participants wrote about relations with friends and family, whereas control condition participants wrote about a heterogeneous set of values. We had no reason to believe that chronic stress would influence choice of value. Consistent with this expectation, there was not a main effect for either chronic stress level (χ 2 (10) = 11.08, p  = .35) nor a self-affirmation condition × stress level interaction (χ 2 (10) = 10.6, p =  .39).

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https://doi.org/10.1371/journal.pone.0062593.t004

As a manipulation check, we compared the ratings that participants in different conditions made about their value writing activity immediately after completing the writing activity. A one-way ANCOVA confirmed that the self-affirmation group ( M  = 22.97, SD  = 1.38) rated the value as significantly more important than did the control group ( M =  15.13, SD  = 3.69), F (1, 71) = 142.6, p <.001, η 2  = .671, indicating success of the value-affirmation manipulation.

We also conducted an ANCOVA comparing the total number of words written in the affirmation and control essays to determine if self-affirmation participants were more engaged in the writing task and thus wrote longer essays. Although self-affirmation condition participants wrote somewhat longer essays on average ( M  = 68.79 words, SD  = 25.9) than did control condition participants ( M  = 60.34, SD  = 26.9), this difference was not statistically significant ( F (1,72) = 1.63, p  = .21). Moreover, chronic stress level was not associated with the number of words written in the self-affirmation essays ( F (1, 72) = 1.13, p  = .35). There was also no interaction between self-affirmation condition and chronic stress level on number of words written ( F (1,72) = 1.30, p  = .26). It is also worth noting that word count was not correlated with RAT problem-solving performance ( r  = .14, p  = .23), and including word count as a covariate did not appreciably change our primary problem-solving results (word count was not further pursued as a variable of interest).

Self-Affirmation, Stress, and Problem-Solving Performance

To test our primary hypotheses, we conducted a multiple regression analysis with condition (self-affirmation vs. control), perceived stress over the last month, and their interaction predicting RAT score. Consistent with hypotheses, we observed a significant main effect of chronic stress on RAT performance ( β  = −.45, t (72) = −2.75, p  = .008), such that participants with higher stress in the last month had lower problem-solving performance. Moreover, we observed a significant main effect for self-affirmation condition, ( β  = .31, t (72) = 2.88, p  = .005), such that affirmed participants performed significantly better on the RAT task than control participants ( Figure 1 ). Consistent with our self-affirmation stress buffering hypothesis, these main effects were qualified by a significant chronic stress × self-affirmation interaction on RAT problem-solving performance ( β  = .35, t (72) = 2.09, p  = .041). As shown in Figure 1 , self-affirmation (compared to the control condition) improved the RAT problem solving performance of underperforming high chronic stress individuals, but had a minimal impact on the performance of participants low in chronic stress. Moreover, as depicted in Figure 1 , this stress buffering effect of self-affirmation improved the problem-solving performance of high stress individuals to a level comparable to individuals low in stress.

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Low and high stress groups (as measured by the Perceived Stress Scale) were determined by median split for visual presentation. Error bars reflect standard errors of the mean.

https://doi.org/10.1371/journal.pone.0062593.g001

Testing the Positive Affect and Task Engagement Accounts of Problem-Solving

Previous studies indicate that positive affect boosts problem-solving performance [29] , [30] , so we tested the possibility that the self-affirmation activity was a positive affect induction, and that positive affect engendered by self-affirmation explained the problem-solving effects. Consistent with other reports [28] , we found that the self-affirmation group had higher state positive affect compared to the control group (as determined by multiple regression controlling for age: β = . 51, t (69) = 4.79, p <.001.) We also tested negative affect using the same approach, but there was not a significant main effect for self-affirmation condition ( β  = −.12, t (71) = −1.06, p  = .29) or a stress × self-affirmation interaction ( β  = −.02, t (71) = −.90, p  = .37) on state negative affect. However, there was not a self-affirmation × chronic stress interaction on positive affect ( β  = .19, t (69) = 1.19, p  = .24). Given that self-affirmation increased state positive affect, we conducted mediation analyses (following procedure described in [31] ) testing whether state positive affect mediated the impact of self-affirmation on problem-solving. In the first step of the mediation analysis, self-affirmation increased positive affect (as described above). The second step in testing mediation consists of evaluating whether the mediating variable (positive affect) predicts the outcome variable (problem-solving performance) when entered simultaneously with the predictor variable (self-affirmation condition). This second analysis revealed that positive affect was not a significant predictor of RAT performance when it was entered as a simultaneous predictor variable with the self-affirmation condition variable ( β  = −.07, t (71) = −.54, p  = .59). Thus we did not find supporting evidence for positive affect as a mediator for the self-affirmation main effect or the chronic stress × self-affirmation interaction on problem-solving performance.

As noted earlier, previous research suggests that heart rate is a useful indirect marker for task engagement [24] , [25] . To test whether there was differential task engagement in the self-affirmation and control conditions using this physiological measure, we conducted a repeated measures ANCOVA to assess change in heart rate over time between conditions (In order to run a parallel ANCOVA analyses as our primary analysis, the heart rate and mean arterial pressure analyses were run with the chronic stress variable entered as a two-level between subjects variable (low vs. high stress), as determined by median split). Although participants showed an overall significant heart rate increase from baseline ( M  = 68.50, SE  = 1.03) to the RAT problem solving period ( M  = 76.44, SE  = 1.31) ( paired-samples t (69) = −9.26, p  = <.001), there were no significant main effect or interactive effects of conditions on heart rate change. Specifically, we did not observe a significant main effect for self-affirmation condition ( F (1, 67) = .36 p  = .55, η 2  = .01) or chronic stress ( F (1,66) = .09, p  = .77, η 2  = .001). Notably, we also did not observe a significant self-affirmation condition × time interaction ( F (2, 67) = .43 p  = .65, η 2  = .01) or a condition × time × chronic stress interaction ( F (2, 67) = 1.15 p  = .32, η 2  = .03) ( Figure 2 ), indicating that there were no differential effects of self-affirmation (or the self-affirmation × chronic stress interaction) on heart rate. Collectively, these findings do not provide support for a differential task engagement explanation of our performance findings. Instead, our data indicate that participants across conditions were similarly engaged in the problem-solving task.

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Panel A depicts the results for participants low in chronic stress, and Panel B depicts the results for participants high in chronic stress, as determined by median split. Error bars reflect standard errors of the mean.

https://doi.org/10.1371/journal.pone.0062593.g002

We also assessed the impact of our self-affirmation manipulation on mean arterial blood pressure responses during the RAT problem-solving period. Like heart rate, participants showed an overall significant mean arterial pressure increase from baseline ( M  = 79.71, SE  = .86) to the RAT problem solving period ( M  = 89.05, SE  = 1.08) ( paired-samples t (69) = −12.12, p <.001), but we did not observe significant main effects of self-affirmation ( F (1,67) = 2.21, p  = .14, η 2  = .03) or chronic stress ( F (1,66) = .32, p  = .57, η 2  = .01). Similarly, the self-affirmation condition × time ( F (2, 64) = .13, p  = .88, η 2  = .004) and condition × time × chronic stress ( F (2, 64) = 1.53 p  = .23, η 2  = .05) interactions were not significant ( Figure 3 ). These heart rate and mean arterial blood pressure results are in accord with our previous work showing that self-affirmation does not appreciably alter heart rate or blood pressure responses to acute stress-challenge tasks [9] . Importantly, the changes in heart rate and blood pressure reaffirm that the RAT task was stressful for participants.

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https://doi.org/10.1371/journal.pone.0062593.g003

The present study provides the first evidence that self-affirmation can protect against the deleterious effects of stress on problem-solving performance. Specifically, we show that chronically stressed individuals have impaired problem-solving performance and that self-affirmation can boost problem-solving performance under pressure. Notably, these effects were qualified by a significant chronic stress by self-affirmation interaction, such that self-affirmation improved problem-solving performance in underperforming chronically stressed individuals. These findings have important implications for self-affirmation research and educational interventions. First, although we have shown in several studies that self-affirmation can reduce acute stress experiences [9] – [11] , previous research has not tested whether self-affirmation can be protective in the context of chronic (or ongoing) stressors. Moreover, until now it has been unclear whether the stress buffering benefits of self-affirmation translate into improved performance outcomes on actual problem solving tasks. Our present study suggests that a brief self-affirmation activity is sufficient to buffer the negative effects of chronic stress on task performance and can improve the ability to problem solve in a flexible manner during high stress periods [3] , [32] . It is important to note that the task used in the present study (RAT) is a common measure of creativity performance and insight [18] , [33] , and hence our study suggests that self-affirmation may increase creativity and insight in stressed individuals [16] , [34] .

Second, our study suggests that self-affirmation may be effective at boosting performance in academic tasks requiring associative processing and creativity, particularly for students who experience stress on such tasks [34] . Thus, our findings identify a potential mechanism by which a self-affirmation intervention at the beginning of a school term can improve at-risk students’ academic achievement, reducing achievement disparities between African Americans and European Americans and between women and men in science [12] – [15] .

Finally, two limitations of our study should be mentioned. It is possible that the stress buffering effects of self-affirmation on problem-solving performance that we obtained are specific to evaluative performance settings, since all of our participants completed difficult RAT items under time pressure in front of a critical evaluator. (We note that the problem-solving task we used produced significant cardiovascular stress reactivity (see Figures 2 & 3 ), comparable to other well-known psychosocial stress-challenge tasks [35] .) Future studies should therefore experimentally test whether social evaluation is a necessary condition for self-affirmation problem-solving effects. Another limitation of our study is that we measured chronic stress using a self-report measure, and this measure was collected at the end of our study session (although there were no experimental (self-affirmation manipulation) effects on chronic stress scores). We elected to use this procedure given that completing individual difference measures may have carry-over effects if completed immediately prior to self-affirmation activities [27] . Future studies using other measures for assessing chronic stress (e.g., selecting chronically stressed vs. matched control groups) [4] would therefore be useful.

The present research contributes to a broader effort at understanding how stress management approaches can facilitate problem-solving performance under stress. Despite many studies showing that acute and chronic stressors can impair problem-solving [1] , [2] , [4] , we know little about stress management and coping approaches for buffering stress during problem-solving [36] . Our work suggests that self-affirmation may be a relatively easy-to-use strategy for mitigating stress and improving problem-solving performance in evaluative settings. It will be important for future studies to consider the mechanisms linking self-affirmation with improved problem solving. We show here that our self-affirmation effects are unlikely to be explained by changes in positive affect or task engagement. The fact that we did not see any differential effects of self-affirmation on a physiological measure of task engagement (heart rate) also suggests that these effects are not driven by changes in persistence or motivation [32] . A more likely possibility, to be tested by future research, is that self-affirmation facilitates a more open and flexible attentional stance (e.g., [16] ), which increases working memory availability [37] , [38] for problem-solving in evaluative contexts.

Conclusions

The present study builds on previous research showing that self-affirmation has stress protective effects in performance settings [9] , [12] , [13] , [15] , providing an initial indication that self-affirmation can buffer the effects of chronic stress on actual problem-solving in performance settings.

Supporting Information

Remote Associate items used in the present study.

https://doi.org/10.1371/journal.pone.0062593.s001

Acknowledgments

This dataset is available upon request ( [email protected] ).

Author Contributions

Conceived and designed the experiments: JDC JMD WMPK PRH JML. Performed the experiments: JMD. Analyzed the data: JDC JMD. Contributed reagents/materials/analysis tools: JDC. Wrote the paper: JDC JMD WMPK PRH JML.

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Action-Oriented Approaches to Stress Management

what are the series steps in problem solving under the stress management

There are various approaches to effective stress management, or the practice of limiting stress and reducing its effects on the mind and body. One way to approach stress management is an action-oriented approach. This approach is most useful when facing a stressful situation that can be changed by taking action.

When taking action to change a stressful situation, the situation can improve, lowering stress levels. Taking action can also lead to positive feelings of empowerment and control. Here are some examples of action-oriented approaches to stress management:

When many tasks need attention, it is nearly impossible for one person to complete them all, especially when dealing with a chronic illness or chronic pain. Taking on too many responsibilities can lead to stress. Delegating tasks, such as asking a family member to help with the cooking, asking a coworker to help with part of a project, or even hiring a cleaning service to help around the house, can help reduce stress levels.

Setting boundaries

Everyone has limited amounts of time, energy and resources. Setting personal boundaries helps prevent overextension, which can increase stress levels. Once boundaries are set, it is important to say “no” to requests or activities that go beyond those boundaries. Although it can be difficult to say “no,” it is an essential part of stress management.

Relaxing standards

Stress can be self-imposed when personal standards are set too high. Relaxing personal standards can reduce stress. Expecting perfection during any task is an impossible goal. For example, cleaning the entire house well enough to pass a white-glove test is unrealistic. A relaxed standard would involve cleaning the most frequently-used rooms in the house so that they are sanitary and relatively clutter-free to promote a safe and calming environment. This relaxed standard is achievable.

Managing time

Failing to effectively manage time can lead to unfulfilled obligations, sleep deprivation, and lack of self-care, which can all contribute to stress. Effective time management involves prioritizing the most important or time-sensitive tasks and deferring less critical tasks for a less hectic time. Making realistic schedules and to-do lists, including time for adequate sleep, relaxation, self-care, and time with friends and family, is an important component of stress management.

Being assertive

Asserting personal needs, feelings, opinions, and beliefs when interacting with others is important. Being too passive can lead to unfulfilled needs and feeling unvalued. It’s important not to cross the line between being assertive and aggressive.

Certain stressful situations can be avoided. Oftentimes, making a simple change, such as grocery shopping during non-peak hours, staying away from a coworker with a negative attitude, or taking a back road to avoid traffic, can reduce stress.

Problem solving

If it is not clear what action to take in response to a stressful situation, problem-solving steps are helpful. Problem-solving steps include the following:

  • Describing the problem or stressful situation in detail
  • Brainstorming options for improving or solving the problem
  • Making and then executing an action plan

Using an action-oriented approach to stress management may not completely eliminate a stressful situation, but it will likely reduce stress levels. An action-oriented approach can also be combined with other approaches to stress management, such as an emotion-oriented or acceptance-oriented approach to further reduce stress.

Stress Management

what are the series steps in problem solving under the stress management

What Is Stress Management?

what are the series steps in problem solving under the stress management

Supplements for Stress Management

what are the series steps in problem solving under the stress management

Physical Activity for Stress Management

what are the series steps in problem solving under the stress management

Relaxation Techniques for Stress Management

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Foods to Avoid for Stress Management

what are the series steps in problem solving under the stress management

The 4 A’s of Stress Management

what are the series steps in problem solving under the stress management

Foods to Eat for Stress Management

what are the series steps in problem solving under the stress management

Emotion-Oriented Approaches to Stress Management

what are the series steps in problem solving under the stress management

Acceptance-Oriented Approaches to Stress Management

what are the series steps in problem solving under the stress management

Meditation: Managing Stress - Part 1

what are the series steps in problem solving under the stress management

Meditation: Managing Stress - Part 2

what are the series steps in problem solving under the stress management

7 Tips to Manage Stress Levels

what are the series steps in problem solving under the stress management

4 Simple Techniques to Manage Stress

what are the series steps in problem solving under the stress management

Infographic: Stress-Reduction Techniques for Chronic Pain

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The Difference Between Distress and Eustress

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Reduce Stress to Decrease Pain

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The 8 Worst Ways to Cope With Stress

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Stress and Chronic Pain

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The Difference Between Stress and Anxiety

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COMMENTS

  1. Problem-solving techniques for stress management

    Problem-solving is the process of identifying stressors and creating strategies to manage them. It's a powerful tool to add to your stress management toolbox. You can brush up on your problem-solving skills with these simple steps. Like any skill, the more you practice the more effective you'll be. <p>Stress management: Problem-solving is a ...

  2. Problem-Solving to Manage Stress

    Overview. Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use. Identify all aspects of a stressful event. Think about your behavior, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify:

  3. Stress management In-Depth

    Maintaining a healthy lifestyle will help you manage stress. Eat a healthy diet, exercise regularly and get enough sleep. Make a conscious effort to spend less time in front of a screen — television, tablet, computer and phone — and more time relaxing. Avoid using alcohol or drugs to manage stress. Stress won't disappear from your life.

  4. Stress management

    When used positively, stress can lead to growth, action and change. But negative, long-term stress can lessen your quality of life. Stress management approaches include: Learning skills such as problem-solving, focusing on important tasks first and managing your time. Improving your ability to cope with difficult events that happen in life.

  5. Problem-Solving to Manage Stress

    Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use. Identify all aspects of a stressful event. Think about your behaviour, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify: Behaviours, such as the need to look for another job, earn money for ...

  6. Tips to Improve Problem-Solving Skills and Reduce Stress

    Keys to solving a problematic situation and reducing stress, include an ability to step back and more objectively view a situation's varying facets. "Instead of looking at it as a massive boulder, it helps to look at it as stones stuck together," he said. "Then, chip away at the boulder and break it apart stone by stone and step by step

  7. Stress Management and Building Resilience

    These strategies do not fix the problems, changes, or sources of stress in your life. Instead they are designed to build your emotional awareness, strength, presence of mind, and energy to handle daily tasks. The first section describes techniques for calming your mind and body when you begin to feel overwhelmed by stress. The second section ...

  8. Stress Leads to Bad Decisions. Here's How to Avoid Them

    Summary. Our brains are wired to be more reactionary under stress. This can mean that in tough moments we reflexively narrow and simplify our options to all-or-nothing extremes. If we have to ...

  9. How to handle stress at work

    Problem-solving. Problem-solving is an active coping strategy that involves teaching people to take specific steps when approaching a roadblock or challenge. These steps include defining the problem, brainstorming potential solutions, ranking the solutions, developing an action plan, and testing the chosen solution. Mindfulness.

  10. Problem-Solving to Manage Stress Information

    Overview. Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use. Identify all aspects of a stressful event. Think about your behavior, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify: Behaviors, such as the need to look for another job, earn ...

  11. 10 Techniques to Manage Stress & 13 Quick Tips

    Accept - Choose - Take action. Acceptance and Commitment Therapy (ACT) has proven valuable for clients learning to manage anxiety and stress; it encourages (Forsyth & Eifert, 2016): Letting go of the struggles that keep them stuck. Cultivating peace of mind. Accepting what is, and doing what works.

  12. Workplace Stress Management: 11 Best Strategies & Worksheets

    The theory of preventive stress management: A 33-year review and evaluation. Stress and Health: Journal of the International Society for the Investigation of Stress, 27(3), 182-193. Niemiec, R. (2019). Strength-based workbook for stress relief: A character strengths approach to finding calm in the chaos of daily life. New Harbinger.

  13. 26 Best Stress-Relief Techniques According to Psychology

    Breathe in through your nose. Then, with your mouth wide open, stretch out your tongue toward your chin. Next, breathe out with force from your abdomen, making a sound with your breath (the roar). Breathe normally for a little while before repeating up to seven times (Cronkleton, 2020).

  14. Problem-Solving to Manage Stress

    Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use. Identify all aspects of a stressful event. Think about your behaviour, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify: Behaviours, such as the need to look for another job, earn money for ...

  15. Self-Affirmation Improves Problem-Solving under Stress

    Introduction. Acute and chronic stress have been shown to disrupt problem-solving and creativity .For example, acutely stressful contexts, such as completing problem-solving tasks under negative social evaluation, have been shown to impair performance on a variety of tasks, such as anagrams and remote associate problems , .Feeling chronically stressed produces similar performance impairments.

  16. Problem-Solving to Manage Stress

    Problem-solving can help you overcome complex stressful events. Here are the basic steps you can use. Identify all aspects of a stressful event. Think about your behavior, thoughts, and feelings. For example, if you have just been laid off from your job, you need to identify:

  17. Work, Stress, Coping, and Stress Management

    Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived.

  18. The 4 A's of stress relief

    Stress is a part of everyday life. Practicing these four steps can help to provide balance for a healthier, happier lifestyle. Learn more about stress: Get 5 tips to manage stress. Take a mental and emotional health assessment. Find out how to cope if you're overwhelmed by anxiety. Get tips to keep stress from hurting your heart.

  19. 3 simple strategies for stress relief

    Aim to change your perspective, and you can often reduce the number of stressors in your life. Burn off tension. Physical activity can reduce cortisol levels, and help get you on a more even keel. But for many people, sticking to a daily exercise schedule is itself stressful, because they pick activities they don't enjoy.

  20. Self-Affirmation Improves Problem-Solving under Stress

    High levels of acute and chronic stress are known to impair problem-solving and creativity on a broad range of tasks. Despite this evidence, we know little about protective factors for mitigating the deleterious effects of stress on problem-solving. Building on previous research showing that self-affirmation can buffer stress, we tested whether an experimental manipulation of self-affirmation ...

  21. Action-Oriented Approaches to Stress Management

    Problem-solving steps include the following: Describing the problem or stressful situation in detail. Brainstorming options for improving or solving the problem. Making and then executing an action plan. Using an action-oriented approach to stress management may not completely eliminate a stressful situation, but it will likely reduce stress ...

  22. Problem-solving training for effective stress management and prevention

    Discusses stress-management training (SMT), which involves instruction in the application of active coping skills and techniques that enable a client to reduce, minimize, control, tolerate, and/or prevent stress in everyday living. Approaches to SMT include anxiety-management training and stress-inoculation. Three models that involve a problem-solving approach to stress management are detailed ...

  23. Under Pressure: a Stress Management Case Study

    This straightforward case study requires little in the way of facilitation but mingle with the groups and be on hand to answer any questions or prompt discussion. It could be used as part of a stress management workshop or stress awareness campaign. It would work best with groups of up to six participants. Allow just over an hour for completion.