Managing Stress in the Workplace Systemically

According to 2022 American Psychology Association (APA) statistics, 76% of adults had experienced health impacts from stress in the past month, such as headaches, fatigue, feeling nervous or anxious, and/or feeling depressed and sad. In addition, 34% of adults reported stress to be “completely overwhelming” most days. The APA adds that stress has been linked to relational conflict, loss of productivity, absenteeism from work, depression, aggression - even to causes of death, including cancer and heart disease.[1] 

The question for business leaders and HR professionals is: How to best tackle stress within our organization? 

A 2015 meta-analysis of studies identified parameters of most effective stress management programs:

  1. A systemic approach, integrating both organizational and individual levels intervention lead to better results than approaches focusing on either individual or organizational level [2].
  2. A preventive approach, also called primary, is preferrable and more likely to be systemic. Alternatively, a secondary approach that focuses on removing the risk factors is generally more effective than a tertiary approach that would focus on individuals experiencing distress [3].
  3. Cognitive-behavioral interventions were found to be more effective than relaxation interventions or multimodal interventions [4].

While several approaches have become popular in the last few years, including mindfulness and yoga [5][6][7], the most significant successes have been recorded by interventions that start with a risk clarification/assessment, then set up a program to target the specific risk factors identified, ie. job redesign [9], workload evaluation/reduction [11][12], training/education [9], etc. The Danish Maritime Authority/DMA (Søfartsstyrelsen) has for several years used the described approach: Systemic, preventive, initially cognitive-behavioral, targeted, and involving relevant stakeholders in co-creating steps customized to each situation. Our approach has been developed as a dynamic co-creation together with DMA. Over the years it has shown its value and usefulness, now strongly confirmed by heavy research (see below) as a top efficient approach to dealing with stress in the Workplace.

Danish Maritime Authority/Søfartsstyrelsen - Policy for prevention of stress

‘At the Danish Maritime Authority, we work systematically with stress. That is, we consider all cases of stress as an organizational challenge that requires organizational action. If an employee gets stressed, it means that there is something we have not succeeded in as an organization. It is therefore not the stressed person or their boss who are the sole cause of the problem. As an organization, we must work with well-being in everyday life, and we must care for each other. If there are signs of stress, early intervention must be carried out with a systemic interview process.’

How is it applied? When a stress situation is noticed, the employee and the manager/next level manager decide to start the process, which is initiated as a series of 3 dialogues: 

1) the employee and facilitator, 

2) direct manager and facilitator, 

3) and then all three together – employee, direct manager, and facilitator.

As part of the process, it is considered how to involve others in the organization and what other activities is needed.


  2. Tetrick, L. E., & Winslow, C. J. (2015). Workplace stress management interventions and health promotion. Annu. Rev. Organ. Psychol. Organ. Behav., 2(1), 583–603.
  3. Lamontagne, A. D., Keegel, T., Louie, A. M., Ostry, A., & Landsbergis, P. A. (2007). A systematic review of the job-stress intervention evaluation literature, 1990–2005. International journal of occupational and environmental health, 13(3), 268–280.
  4. Richardson, K. M., & Rothstein, H. R. (2008). Effects of occupational stress management intervention programs: a meta-analysis. Journal of occupational health psychology, 13(1), 69.
  5. Michel, A., Bosch, C., & Rexroth, M. (2014). Mindfulness as a cognitive–emotional segmentation strategy: An intervention promoting work–life balance. Journal of occupational and organizational psychology, 87(4), 733–754.
  6. Wolever, R. Q., Bobinet, K. J., McCabe, K., Mackenzie, E. R., Fekete, E., Kusnick, C. A., & Baime, M. (2012). Effective and viable mind-body stress reduction in the workplace: a randomized controlled trial. Journal of occupational health psychology, 17(2), 246.
  7. Querstret, D., Morison, L., Dickinson, S., Cropley, M., & John, M. (2020). Mindfulness-based stress reduction and mindfulness-based cognitive therapy for psychological health and well-being in nonclinical samples: A systematic review and meta-analysis. International Journal of Stress Management, 27(4), 394.
  8. Bourbonnais, R., Brisson, C., & Vézina, M. (2011). Long-term effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting. Occupational and Environmental Medicine, 68(7), 479–486.
  9. Cifre, E., Salanova, M., & Rodríguez‐Sánchez, A. M. (2011). Dancing between theory and practice: Enhancing work engagement through work stress intervention. Human Factors and Ergonomics in Manufacturing & Service Industries, 21(3), 269–286.
  10. Hartung, D., & Hahlweg, K. (2011). Stress reduction at the work-family interface: Positive parenting and self-efficacy as mechanisms of change in Workplace Triple P. Behavior modification, 35(1), 54–77.
  11. West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016). Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The lancet, 388(10057), 2272–2281.
  12. De Simone, S., Vargas, M., & Servillo, G. (2021). Organizational strategies to reduce physician burnout: a systematic review and meta-analysis. Aging clinical and experimental research, 33, 883–894.