Handbook Series in

Occupational Health Sciences

Series Editors:
Kevin Daniels · Johannes Siegrist

Paula Brough · Elliroma Gardiner

Kevin Daniels
Editors

Handbook on
Management
and Employment
Practices
Handbook Series in Occupational Health
Sciences

Series Editors
Kevin Daniels, Norwich Business School, University of East Anglia, Norwich, UK
Johannes Siegrist, Centre for Health and Society, Faculty of Medicine, Heinrich-
Heine-Universität Düsseldorf, Düsseldorf, Nordrhein-Westfalen, Germany
The Handbook Series in Occupational Health Sciences offers a unique opportunity
to get acquainted with robust updated evidence on specific topics of key interest in
occupational health research and practice. The series provides a venue for the large
amount of significant recent scientific advances in research on occupational health
due to the overriding importance of work and employment in developed and rapidly
developing countries. The series is interdisciplinary, encompassing insights from:
occupational medicine, epidemiology, ergonomics, economics, occupational health
psychology, health and medical sociology, amongst others. Volumes in the series
will cover topics such as socioeconomic determinants of occupational health; dis-
ability, work and health; management, leadership and occupational health; and
health implications of new technologies at work and of new employment-related
global threats. With a broad scope of chapters dealing with in-depth aspects of the
volume’s themes, this handbook series complements more traditional publication
formats in the field (e.g. textbooks; proceedings), using a new system of online
updating and providing explanatory figures and tables. Written by an international
panel of eminent experts, the volumes will be useful to academics, policy
researchers, advanced students and high-level practitioners (e.g. consultants, gov-
ernment policy advisors).

More information about this series at http://www.springer.com/series/15678

Paula Brough • Elliroma Gardiner •
Kevin Daniels
Editors

Handbook on
Management and
Employment Practices

With 26 Figures and 29 Tables

Editors
Paula Brough Elliroma Gardiner
Centre for Work, Organisation and School of Management
Wellbeing QUT Business School
Griffith University Queensland University of Technology
Brisbane, QLD, Australia Brisbane, QLD, Australia

Kevin Daniels
Norwich Business School
University of East Anglia
Norwich, UK

ISSN 2730-7409 ISSN 2730-7417 (electronic)

ISBN 978-3-030-29009-2 ISBN 978-3-030-29010-8 (eBook)
ISBN 978-3-030-29011-5 (print and electronic bundle)
https://doi.org/10.1007/978-3-030-29010-8
© Springer Nature Switzerland AG 2022
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the
material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
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Series Preface

The Handbook Series in Occupational Health Sciences offers a unique opportunity

to get acquainted with robust updated evidence on specific topics of key interest in
occupational health research and practice. The series provides a venue for the large
amount of significant recent scientific advances in research on occupational health
due to the overriding importance of work and employment in developed and rapidly
developing countries. The series is interdisciplinary, encompassing insights from:
occupational medicine, epidemiology, ergonomics, economics, occupational health
psychology, health and medical sociology, amongst others. Volumes in the series
will cover topics such as socioeconomic determinants of occupational health; dis-
ability, work, and health; management, leadership, and occupational health; and
health implications of new technologies at work and of new employment-related
global threats. With a broad scope of chapters dealing with in-depth aspects of the
volume’s themes, this handbook series complements more traditional publication
formats in the field (e.g., textbooks; proceedings), using a new system of online
updating and providing explanatory figures and tables. Written by an international
panel of eminent experts, the volumes will be useful to academics, policy
researchers, advanced students, and high-level practitioners (e.g., consultants, gov-
ernment policy advisors).

v
Volume Preface

This is the third volume in the Handbook Series in Occupational Health Sciences.
The series presents the latest scientific evidence on relationships between occupa-
tional conditions and health, which are particularly important in our current times of
global changes to employment and work. This volume is focused on the contribution
of management and employment practices to the health and well-being of workers,
emphasizing how these work systems directly impact workers’ health. This book
provides readers with a comprehensive oversight of the latest research and thinking
on these issues, with content provided by leading global researchers in their respec-
tive fields. The topics covered represent an interdisciplinary perspective, integrating
psychology, social sciences, biomedical sciences, economics, employment relations,
and management.
The book is divided into 6 parts containing 41 chapters covering key aspects of
employment practices which directly impact employee health and well-being: lead-
ership, change management, employee well-being, managing disabilities, the work-
life interface, and emerging challenges. The first introductory chapter provides an
overview of the 6 parts and 40 chapters within this volume. The first part of this book
includes six chapters which successfully summarize and distill current discussions of
effective and productive management and leadership practices. This part summarizes
what successful workplace leadership and followship is and how it relates to worker
competencies and their health and safety, the concept of servant leadership, and the
key managerial accommodations which impact optimal work participation and
performance of workers with disabilities. The second part presents evidence of
how workplace change management directly impacts workers’ well-being. The
eight chapters in this part discuss the impact, for example, of recessions, downsizing,
lean transformations, and redundancies, with interesting insights into the role of
corporate boards, psychological contracts, and justice. The third part of this volume
discusses how work systems of human resource management and performance
management, and organizational issues such as work-based learning, employee
voice, ethical cultures, whistleblowing, and worker diversity each influence worker’s
well-being, retention, and performance. The six chapters in the fourth part specifi-
cally focus on the management and rehabilitation of workers with chronic health
conditions, including aging, muscular-skeletal issues, mental health concerns, and
burnout. The fifth part focuses on the work-life interface and includes considerations

vii
viii Volume Preface

about the impact of COVID, flexible work, and work design. The final part examines
some emerging challenges for organizations in their future management of people.
This includes chapters discussing the gig economy, trade unions, retention of cross-
cultural workers, and workplace mistreatments.
Each chapter provides major insights and is a key resource of reference on its
topic. As a whole, this handbook equips researchers, practitioners, and policymakers
to anticipate and respond to these challenges associated with key management and
employment practices and the impact they have upon the health and well-being of
our workers. Importantly, we are very grateful to the authors who, as outstanding
scientists, devoted their valued expertise by contributing chapters to this book. Each
author provides invaluable insights and promising solutions to current issues
impacting the health of our workers. We also thank Divya Nithyanandam and the
team at Springer Nature for their valuable support throughout the production of this
volume. We hope you, the reader, also find the contents of this volume thought
provoking and that it encourages you to provide proactive responses to better
support the health and well-being of our workers.

Brisbane, Australia Paula Brough

Norwich, UK Kevin Daniels
Brisbane, Australia Elliroma Gardiner
February 2022 Editors
Contents

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Paula Brough, Kevin Daniels, and Elliroma Gardiner

Part I Leadership, Management Competencies, and Wellbeing . . . 13

2 Successful Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Amy J. Hawkes and Jason Spedding

3 Servant Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Kathleen Bentein and Alexandra Panaccio

4 Leadership and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Lixin Jiang and Xiaohong Xu

5 Management Competencies for Health and Wellbeing . . . . . . . . . . 91

Jo Yarker, Emma Donaldson-Feilder, and Rachel Lewis

6 Beyond the Leadership/Followership Dichotomy . . . . . . . . . . . . . . 117

Vicki Webster

7 Line Managers and Workplace Accommodations . . . . . . . . . . . . . 133

Ellie Fossey and Justin Newton Scanlan

Part II Management of Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

8 Incremental and Disruptive Change and Wellbeing . . . . . . . . . . . . 159

Christine Ipsen and Kasper Edwards

9 Reorganizing and Downsizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

Töres Theorell

10 Managing OSH Through Recession . . . . . . . . . . . . . . . . . . . . . . . . 189

Hans H. K. Sønderstrup-Andersen

11 Lean Management and Employee Well-Being . . . . . . . . . . . . . . . . 209

Steven Kilroy and Patrick C. Flood
ix
x Contents

12 Corporate Boards and Employee Well-Being . . . . . . . . . . . . . . . . . 229

Ulrica von Thiele Schwarz and Caroline Lornudd

13 Organizational Change and Employee Health and Well-Being . . . 247

Alannah E. Rafferty

14 Psychological Contracts and Employee Health . . . . . . . . . . . . . . . 269

Jacqueline A-M Coyle-Shapiro, Sandra Costa, and Chiachi Chang

15 Fairness at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285

Constanze Eib, Constanze Leineweber, and Claudia Bernhard-Oettel

Part III Human Resource Management Practices and Wellbeing . . . 311

16 Work-Based Learning and Wellbeing . . . . . . . . . . . . . . . . . . . . . . . 313

David Watson and Olga Tregaskis

17 Management of Equity and Diversity . . . . . . . . . . . . . . . . . . . . . . . 331

Katherine J. C. Sang, Jennifer Remnant,
Olugbenga Abraham Babajide, and James Richards

18 Employee Voice as a Route to Wellbeing .................... 351

Sarah Brooks and Adrian Wilkinson

19 HRM Practices, Employee Well-Being, and Organizational

Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Chidiebere Ogbonnaya and Samuel Aryee

20 Developmental HR Practices as Tools to Support Employee

Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393
Adelle J. Bish

21 Ethical Culture and Management . . . . . . . . . . . . . . . . . . . . . . . . . . 417

Mari Huhtala

22 The Effective Management of Whistleblowing . . . . . . . . . . . . . . . . 437

Paula Brough, Sandra A. Lawrence, Eva Tsahuridu, and A. J. Brown

23 Psychosocial Safety Climate (PSC) . . . . . . . . . . . . . . . . . . . . . . . . . 459

Sari Mansour

24 Challenges and Opportunities for LGBTQI+ Inclusion

at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Jordana Moser, Jonathan E. Booth, and T. Alexandra Beauregard

25 Performance Management and Wellbeing at the Workplace . . . . . 503

Monica Franco-Santos, Dan Stull, and Mike Bourne
Contents xi

Part IV Employment Practices for Occupational Health and

Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 525

26 The Aging Workforce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527

Elliroma Gardiner and Mego Kuan-Lun Chen
27 Occupational Health Services and Prevention of Work-Related
Musculoskeletal Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547
Deborah Roy
28 Common Mental Health Problems . . . . . . . . . . . . . . . . . . . . . . . . . 573
Abasiama Etuknwa and Mariya Mathai
29 Burnout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 597
Michael P. Leiter
30 Workplace Fatigue: The Impact of the Drive . . . . . . . . . . . . . . . . . 615
Darren Wishart and Daniell Barrett
31 Disruption in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639
Elizabeth Kendall and Vanette McLennan

Part V Work-Life Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 663

32 Psychological Crossover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 665

Paula Brough, Mina Westman, Shoshi Chen, and
Xi Wen (Carys) Chan
33 Flexible Work Initiatives, Employee Workplace Well-Being, and
Organizational Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 687
Melanie De Ruiter and Pascale Peters
34 Extending Work-Life Balance Initiatives . . . . . . . . . . . . . . . . . . . . 711
Xi Wen (Carys) Chan and Shirley Tay
35 Shifting the Mental Health Conversation: Present and Future
Applications of the “Thrive at Work” Framework . . . . . . . . . . . . 727
Sharon K. Parker, Karina Jorritsma, and Mark A. Griffin
36 Workplace Well-Being Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . 749
Emike Nasamu, Sara Connolly, Mark Bryan, and Andrew Bryce

Part VI Trends and Emerging Challenges for Management ..... 767

37 The Growing “Gig Economy” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 769

Penny Williams, Paula McDonald, and Robyn Mayes
38 Workplace Mistreatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 787
Tara C. Reich and Rashpal K. Dhensa-Kahlon
xii Contents

39 Managing Health, Safety, and Well-Being at Work Within

Changing Legal and Policy Frameworks . . . . . . . . . . . . . . . . . . . . 809
Stavroula Leka and Aditya Jain
40 Psychological Adjustment and Post-arrival Cross-cultural
Training for Better Expatriation . . . . . . . . . . . . . . . . . . . . . . . . . . . 827
Sheetal Gai, Paula Brough, and Elliroma Gardiner
41 The Decline of Trade Unions and Worker Representation . . . . . . . 855
Elsa Underhill

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 873
About the Series Editors

Kevin Daniels is a professor of Organizational Behav-

ior at the University of East Anglia, United Kingdom. He
has a Ph.D. in applied psychology (1992) and is a fellow
of the British Psychological Society, the Academy of
Social Sciences, and the Royal Society of Arts. His
research covers approaches to health, safety, and well-
being, originally with particular focus on the psychology
of job design and more latterly an interest in multi-
disciplinary approaches to well-being. He has authored
or coauthored over 90 peer-reviewed journal articles,
30 book chapters, and 20 books or major reports. From
2015 to 2021, he was lead investigator for an evidence
program on work and well-being, one of the foundational
research programs of the UK’s What Works Centre for
Wellbeing. From 2015 to 2019, he served as editor of the
European Journal of Work and Organizational Psychol-
ogy and also in associate editor positions at the British
Journal of Management, Human Relations, and the
Journal of Occupational and Organizational
Psychology.

Johannes Siegrist is currently Senior Professor of

work stress research at the Heinrich Heine University
Duesseldorf in Germany. He received his Ph.D. in Soci-
ology from the University of Freiburg i. Br. in 1969, and
he held professorships for medical sociology at the
Universities of Marburg and Duesseldorf from 1973 to
2012. He was visiting professor at the Johns Hopkins
University (USA) (1981) and at Utrecht University
(NE) (1994). With his long-standing research on
health-adverse psychosocial work environments and
social inequalities in health, he has published more
than 500 papers and book chapters, and has written or
xiii
xiv About the Series Editors

edited several international books. In addition to his

collaboration in distinct European research networks,
he served as a consultant to the World Health Organiza-
tion, and he chaired several national and international
academic societies. Among other distinctions, he is a
member of Academia Europaea (London) and a
corresponding member of the Heidelberg Academy of
Sciences.
About the Editors

Paula Brough is a professor of Organizational Psy-

chology and director of the Centre for Work, Organisa-
tion and Wellbeing at Griffith University in Brisbane,
Australia. Her primary research and teaching areas are
occupational stress and coping, employee mental health
and well-being, work engagement, work-life balance,
workplace conflict (bullying, harassment, toxic leader-
ship), and the psychosocial work environment. She
assesses how work environments can be improved via
job redesign, supportive leadership practices, and
enhanced equity to improve employee health, work
commitment, and productivity. She has authored over
60 industry reports, over 150 journal articles and book
chapters, and has produced 9 scholarly books based on
her research. Paula is an associate editor of Work &
Stress and is a board member of the Journal of Organi-
zational Behaviour, the International Journal of Stress
Management, and the BPS Work-Life Balance Bulletin.
Paula is a fellow of the European Academy of Occupa-
tional Health Psychology and the Asia Pacific Academy
for Psychosocial Factors at Work.

Elliroma Gardiner is a senior lecturer in the School of

Management, QUT, Australia, and an affiliated profes-
sor with IÉSEG School of Management, France. Prior to
joining QUT, Elli was a fellow in the Department of
Management, London School of Economics and Politi-
cal Science, and a lecturer in the School of Psychology,
Griffith University. She is an endorsed organizational
psychologist, with 15 years of industry experience
working with public and private organizations to
enhance employee engagement and productivity. She
has experience providing advice to firms on key
xv
xvi About the Editors

strategic HR functions such as recruitment and selection

(including the use of psychometric assessments), learn-
ing and development, and performance management.
Her broad research interests are in investigating the
interplay between individual differences and contextual
features in influencing employee, team, and organiza-
tional outcomes. She has published her research findings
in high-quality academic journals such as the Psycho-
logical Bulletin, the Human Resource Management
Journal, and the Journal of Personality.

Kevin Daniels is a professor of Organizational Behav-

ior at the University of East Anglia, United Kingdom.
He has a Ph.D. in applied psychology (1992) and is a
fellow of the British Psychological Society, the Acad-
emy of Social Sciences, and the Royal Society of Arts.
His research covers approaches to health, safety, and
well-being, originally with particular focus on the psy-
chology of job design and more latterly an interest in
multidisciplinary approaches to well-being. He has
authored or coauthored over 90 peer-reviewed journal
articles, 30 book chapters, and 20 books or major
reports. From 2015 to 2021, he was lead investigator
for an evidence program on work and well-being, one of
the foundational research programs of the UK’s What
Works Centre for Wellbeing. From 2015 to 2019, he
served as editor of the European Journal of Work and
Organizational Psychology and also in associate editor
positions at the British Journal of Management, Human
Relations, and the Journal of Occupational and Orga-
nizational Psychology.
Contributors

Samuel Aryee Surrey Business School, University of Surrey, Guildford, UK

Olugbenga Abraham Babajide The Centre for Research on Employment, Work
and the Professions, Edinburgh Business School, Heriot Watt University, Edinburgh,
Scotland, UK
Daniell Barrett Griffith University, Mt Gravatt Campus, Mount Gravatt, QLD,
Australia
T. Alexandra Beauregard Department of Organizational Psychology, Birkbeck,
University of London, London, UK
Kathleen Bentein School of Business Administration (ESG), University of Quebec
at Montreal (UQAM), Montreal, QC, Canada
Claudia Bernhard-Oettel Department of Psychology, Stockholm University,
Stockholm, Sweden
Adelle J. Bish Willie Deese College of Business and Economics, North Carolina
Agricultural and Technical State University, Greensboro, NC, USA
Jonathan E. Booth Department of Management, London School of Economics
and Political Science, London, UK
Mike Bourne Cranfield School of Management, Bedford, UK
Sarah Brooks Sheffield University Management School, Sheffield, UK
Paula Brough Centre for Work, Organisation and Wellbeing, Griffith University,
Brisbane, QLD, Australia
A. J. Brown Centre for Governance and Public Policy, Griffith University,
Brisbane, QLD, Australia
Mark Bryan Department of Economics, University of Sheffield, Sheffield, UK
Andrew Bryce Department of Economics, University of Sheffield, Sheffield, UK
Xi Wen (Carys) Chan Centre for Work, Organisation and Wellbeing (WOW),
Griffith University, Brisbane, QLD, Australia
xvii
xviii Contributors

School of Applied Psychology, Griffith Health, Griffith University, Mt Gravatt,

QLD, Australia
Chiachi Chang International Business School Suzhou (IBSS), Xi’an Jiaotong
Liverpool University (XJTLU), Suzhou, China
Mego Kuan-Lun Chen School of Management, QUT Business School, Brisbane,
QLD, Australia
Shoshi Chen Coller School of Management, Tel Aviv University, Tel Aviv, Israel
Sara Connolly Norwich Business School, University of East Anglia, Norwich, UK
Sandra Costa ISCTE – Instituto Universitário de Lisboa, Business Research Unit
(BRU-IUL), Lisbon, Portugal
Jacqueline A-M Coyle-Shapiro Department of Management, London School of
Economics, London, UK
Jack H. Brown College of Business and Public Administration, California State
University San Bernardino, San Bernardino, CA, USA
Kevin Daniels Norwich Business School, University of East Anglia, Norwich, UK
Rashpal K. Dhensa-Kahlon Birkbeck, University of London, London, UK
Emma Donaldson-Feilder Affinity Health at Work and Affinity Coaching and
Supervision, London, UK
Kasper Edwards DTU Management, Technical University of Denmark, Kgs.
Lyngby, Denmark
Constanze Eib Department of Psychology, Uppsala University, Uppsala, Sweden
Division of Epidemiology Stress Research Institute, Stockholm University, Stock-
holm, Sweden
Abasiama Etuknwa Allied Professions, Sport and Exercise, University of Hud-
dersfield, Huddersfield, UK
Patrick C. Flood DCU Business School, Dublin City University, Dublin, Ireland
Ellie Fossey Department of Occupational Therapy, School of Primary and Allied
Health Care, Monash University – Peninsula Campus, Frankston, VIC, Australia
Living with Disability Research Centre, School of Allied Health, La Trobe Univer-
sity, Melbourne, VIC, Australia
Monica Franco-Santos Cranfield School of Management, Bedford, UK
Sheetal Gai Centre for Work, Organisation and Wellbeing and School of Applied
Psychology, Griffith University, Brisbane, QLD, Australia
Elliroma Gardiner School of Management, QUT Business School, Queensland
University of Technology, Brisbane, QLD, Australia
Contributors xix

Mark A. Griffin Future of Work Institute, Curtin University, Bentley, WA,

Australia
Amy J. Hawkes School of Applied Psychology, Griffith University, Brisbane,
QLD, Australia
Mari Huhtala Department of Psychology, University of Jyväskylä, Jyväskylä,
Finland
Christine Ipsen DTU Management, Technical University of Denmark, Kgs.
Lyngby, Denmark
Aditya Jain Nottingham University Business School, University of Nottingham,
Nottingham, UK
Lixin Jiang School of Psychology, University of Auckland, Auckland,
New Zealand
Karina Jorritsma Future of Work Institute, Curtin University, Bentley, WA,
Australia
Elizabeth Kendall The Hopkins Centre Menzies Health Institute Qld, Griffith
University, Brisbane, QLD, Australia
Steven Kilroy Tilburg University, Tilburg, The Netherlands
Sandra A. Lawrence Griffith Business School, Griffith University, Brisbane,
QLD, Australia
Constanze Leineweber Stress Research Institute, Stockholm University,
Stockholm, Sweden
Michael P. Leiter Deakin University, Geelong, Australia
Acadia University, Wolfville, NS, Canada
Stavroula Leka Cork University Business School, University College Cork, Cork,
Ireland
Rachel Lewis Affinity Health at Work and Birkbeck, University of London,
London, UK
Caroline Lornudd Procome, Medical Management Centre, LIME, Karolinska
Institutet, Stockholm, Sweden
Sari Mansour School of Business Administration, University TÉLUQ, Montreal,
QC, Canada
Mariya Mathai Norwich Business School, Norwich Research Park, University of
East Anglia, Norwich, UK
Robyn Mayes School of Management, QUT Business School, Brisbane, QLD,
Australia
xx Contributors

Paula McDonald School of Management, QUT Business School, Brisbane, QLD,

Australia
Vanette McLennan The Hopkins Centre Menzies Health Institute Qld, Griffith
University, Brisbane, QLD, Australia
Jordana Moser Ipsos MORI, London, UK
Emike Nasamu Social and Political Science University, University of Chester,
Chester, UK
Chidiebere Ogbonnaya University of Sussex Business School, University of
Sussex, Brighton, UK
Alexandra Panaccio John Molson School of Business, Concordia University,
Montreal, QC, Canada
Sharon K. Parker Future of Work Institute, Curtin University, Bentley, WA,
Australia
Pascale Peters Center for Strategy, Organization and Leadership, Nyenrode Busi-
ness Universiteit, Breukelen, The Netherlands
Alannah E. Rafferty Griffith Business School, Griffith University, Brisbane, QLD,
Australia
Tara C. Reich Kings Business School, Kings College London, London, UK
Jennifer Remnant Chancellor’s Fellow, Scottish Centre for Employment
Research, Strathclyde Business School, Glasgow, Scotland, UK
James Richards The Centre for Research on Employment, Work and the
Professions, Edinburgh Business School, Heriot Watt University, Edinburgh,
Scotland, UK
Deborah Roy School of Psychology, University of Bath, Bath, UK
Melanie De Ruiter Center for Strategy, Organization and Leadership, Nyenrode
Business Universiteit, Breukelen, The Netherlands
Katherine J. C. Sang The Centre for Research on Employment, Work and the
Professions, Edinburgh Business School, Heriot Watt University, Edinburgh,
Scotland, UK
Justin Newton Scanlan Discipline of Occupational Therapy, Sydney School of
Health Sciences, Faculty of Medicine and Health, The University of Sydney,
Sydney, NSW, Australia
Hans H. K. Sønderstrup-Andersen Department of People and Technology,
Roskilde University, Roskilde, Denmark
Jason Spedding School of Applied Psychology, Griffith University, Brisbane,
QLD, Australia
Contributors xxi

Dan Stull Cranfield School of Management, Bedford, UK

Shirley Tay School of Management, College of Business and Law, RMIT Univer-
sity, Melbourne, VIC, Australia
Töres Theorell Karolinska Institutet and Stockholm University, Stockholm,
Sweden
Olga Tregaskis Norwich Business School, University of East Anglia, Norwich,
UK
Eva Tsahuridu Melbourne, VIC, Australia
Elsa Underhill Department of Management, Deakin University, Melbourne, VIC,
Australia
Ulrica von Thiele Schwarz School of Health, Care and Social Welfare, Mälardalen
University, Västerås, Sweden
Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm,
Sweden
David Watson Norwich Business School, University of East Anglia, Norwich, UK
Vicki Webster Griffith University, Brisbane, QLD, Australia
Mina Westman Coller School of Management, Tel Aviv University, Tel Aviv,
Israel
Adrian Wilkinson Sheffield University Management School, Sheffield, UK
Business School, Griffith University, Nathan, QLD, Australia
Penny Williams School of Management, QUT Business School, Brisbane, QLD,
Australia
Darren Wishart Griffith University, Mt Gravatt Campus, Mount Gravatt, QLD,
Australia
Xiaohong Xu University of Texas, San Antonio, TX, USA
Jo Yarker Affinity Health at Work and Birkbeck, University of London, London,
UK
Introduction
1
Paula Brough, Kevin Daniels, and Elliroma Gardiner

Contents
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Management and Employment Practices During Changing Contexts . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Handbook of Management and Employment Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Future Directions for Management and Employment Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Abstract
This introductory chapter provides an overview to the six parts and 40 other
chapters of this book and emphasizes the value of this book for managers; policy
makers focused on industrial strategy, labor markets, and employment relations;
and management researchers. This book provides a coherent discussion of why
management and good employment practices are more relevant than ever, with a
particular focus on recent management developments in the six key areas of
leadership, change management, employee well-being, managing disabilities,
work-life interfaces, and emerging challenges.

P. Brough (*)
Centre for Work, Organisation and Wellbeing, Griffith University, Brisbane, QLD, Australia
e-mail: p.brough@griffith.edu.au
K. Daniels
Norwich Business School, University of East Anglia, Norwich, UK
e-mail: [email protected]
E. Gardiner
School of Management, QUT Business School, Queensland University of Technology, Brisbane,
QLD, Australia
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 1

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_1
2 P. Brough et al.

Keywords
Management · Leadership · Well-being · Work-life interfaces · Disabilities at
work · Management challenges · Change management

Overview

As is evidenced by the 40 other chapters in this book, management and employment

practices are directly connected to workers’ health and so cannot be considered a
separate topic or area of practice independent on the management of occupational
health. There are two major reasons why management and employment practices are
important for employee health. First, the workplace can be a cause of ill health,
through exposure to hazards. Although this is typically thought to be relevant to
exposure to psychosocial hazards and risks to mental health (e.g., Cox and Cox
1993), management decisions to use certain technologies and processes, perhaps for
reasons of cost, can influence workers’ exposure to physical hazards (e.g., noxious
chemicals). Second, irrespective of the workplace as a potential cause of ill health,
workers may have health problems not caused by work but with symptoms that are
work-relevant (Kendall et al. 2015). That is to say, symptoms that have a bearing on
behavior at work, including those psychological symptoms relevant to performance
such as absenteeism and presenteeism. Absence management and return-to-work
processes are clear examples of where occupational health professional and human
resources professionals do/should work closely together in order to maximize
employee health and their work performance. Moreover, given the critical role of
line managers (Etuknwa et al. 2019), the relevance of management practices for
employee health clearly goes beyond those with only functional expertise in human
resources.
A further reason for the relevance of management and employment practices to
occupational health pertains to links between worker health and productivity. A
worker on long-term sickness absence clearly cannot be productive. However,
even if the worker can be replaced temporarily with, for example, agency staff,
that worker’s tacit knowledge gained through on-the-job experience cannot easily
be replicated by someone else – especially in highly skilled/knowledge-intensive
work. The prospective of “mutual gains” adds further weight to the argument.
“Mutual gains” occur when workers benefit from management practices that
promote health and well-being and thus reciprocate the organization’s investment
in workers with enhanced commitment and productivity (see, e.g., Ogbonnaya
et al. 2017). Some have identified the fragility of mutual gains (Dobbins and
Dundon 2017), indicating management needs to be vigilant and active in their
pursuit (Butler et al. 2011).
For worker health and well-being, industry standards (ISO 2018), exemplary
organizational practice (Johnson et al. 2018), and the evidence base (LaMontagne
et al. 2014) all indicate that active management addresses issues of prevention and
1 Introduction 3

rehabilitation. The standard differentiation is employment practices focused on

prevention of ill health (Burgess et al. 2020; Richardson and Rothstein 2008) and
the promotion of well-being through good management that minimizes exposure to
risk (primary prevention focused on work); practices focused on promoting healthy
lifestyles among workers (primary prevention focused on health behaviors, e.g.,
workplace health promotion focused on exercise and nutrition); providing training
and development for workers to self-regulate their own health and well-being if
exposed to risk (secondary prevention, e.g., mindfulness training); and practices
focused on effective rehabilitation and absence management (tertiary interventions,
e.g., return to work programs, access to physiotherapy, access to talking therapies for
mental health programs). The management of specific practices and integrated pro-
grams covering a wide range of practices also involves many management chal-
lenges (see Daniels et al. 2021, for a review).

Management and Employment Practices During Changing

Contexts

The work context for many workers has rapidly changed during the current COVID-
19 pandemic. One outcome of the societal lockdowns has been a seismic forced shift
in how and where many workers conduct their work. Intertwining both work and
non-work responsibilities (work-life balance) has, however, also been a distinct
challenge for many workers (Brough et al. 2021; Field and Chan 2018). For
example, many employees have juggled working full time while also home-
schooling children during school closures. This has profound implications for
employees’ work-life balance, well-being, and work productivity. Reports also
indicate an increased spread of working hours throughout the day, resulting in up
to 48% more working time in comparison with standard workdays (DeFilippis et al.
2020). A pertinent point of concern here is the long-term sustainability and employer
monitoring of this increased work time and its impact on workers’ well-being, which
has not yet been systematically addressed.
The permanence of these changed work situations post-COVID-19 remains
debatable. However, due to the continual threat of subsequent outbreaks of
COVID-19, predictions are for substantial disruptions to working practice across
most industry sectors (Middleton et al. 2020). This work context change will be
accompanied by a clear division of workers able/not able to work from home, based
primarily on their type of work (Bonacini et al. 2021; Carroll and Conboy 2020),
raising questions about the equity of those workers in less-privileged, low-paid, and
precarious work having differential exposure to risks. The fragility of employment
and the fragility of mutual gains for employers and employees are especially salient
during crises (Cook et al. 2016). There is, therefore, a clear need to consider and to
update, our best practices for managing workers. It is clearly apparent that further
thought is required to identify how organizations can best protect and sustain the
long-term performance and well-being of their workers.
4 P. Brough et al.

Handbook of Management and Employment Practices

This Handbook of Management and Employment Practices is therefore extremely

timely. The chapters, written by experienced researchers from around the world,
describe 40 distinct aspects of how we can best manage our workplaces and our
workers. The handbook is divided into six parts, each discussing a pertinent current
management issue.
The first part focuses on leadership. While the leadership literature is
voluminous, the six chapters here successfully “Leadership, Management Com-
petencies, and Wellbeing,” summarize and distil current discussions of effective
and productive management and leadership practices. ▶ Chapter 2, “Successful
Leadership,” provides a pertinent summary of the key leadership approaches and
focus on identifying the somewhat elusive characteristics of successful leadership
(Hawkes and Spedding). ▶ Chapter 3, “Servant Leadership,” discusses the unique
issue of servant leadership and its direct relationship with employees’ well-being
(Bentein and Panaccio). ▶ Chapter 4, “Leadership and Safety,” discusses the strong
associations between leadership and safety-related outcomes, including a perti-
nent review of the “dark side” of safety leadership styles and its impact on workplace
safety (Jiang and Xu). ▶ Chapter 5, “Management Competencies for Health and
Wellbeing,” provides a valuable review of how management competencies impact
employee health and well-being and describes validated competency frameworks
to guide managers’ behaviors (Yarker, Donaldson-Feilder, and Lewis). Yarker et al.
make the pertinent argument that managing health and well-being is not a separate
activity on top of managing performance but rather is an integral part of management
practices. ▶ Chapter 6, “Beyond the Leadership/Followership Dichotomy,” dis-
cusses the specific issue of followership within the leadership process, including
its evolvement from being initially considered as merely a passive recipient of
leadership to how followership is actively involved in shaping shared leadership
practices (Webster). This chapter also provides a pertinent commentary of common
followership reactions to both constructive and destructive leadership. The final
chapter (▶ Chap. 7, “Line Managers and Workplace Accommodations,”) in this
leadership part focuses on managers and workplace accommodations. Fossey and
Scanlan review the evidence and describe a guide for managers demonstrating how
key workplace accommodations can support optimal work participation and perfor-
mance of workers with disabilities.
The second part of this handbook contains eight chapters focusing on the
management of change. Change is often considered harmful to well-being, and a
major theme through this part is how change in different circumstances can be best
managed to least mitigate negative effects of change on health and well-being.
However, some changes are intended to benefit workers’ health and well-being.
The first chapter in this part (▶ Chap. 8, “Incremental and Disruptive Change and
Wellbeing,” Ipsen and Edwards) investigates both sides of change – change that may
harm well-being and change intended to benefit well-being – and considers the
distinction between more and less disruptive forms of change. In ▶ Chap. 9,
“Reorganizing and Downsizing, Theorell reviews evidence on aspects of change
that are most harmful to employee health and well-being – downsizing – and the
1 Introduction 5

impacts of those made redundant, the “survivors” of reorganizing and downsizing,

and some of the ways in which the worst aspects of these change processes
can be avoided. Relatedly, in ▶ Chap. 10, “Managing OSH Through
Recession,” Sønderstrup-Andersen considers the effects of recessions on health
and the particular public health concerns that surface. In ▶ Chap. 11, “Lean Man-
agement and Employee Well-Being” Kilroy and Flood consider a specific but
prevalent form of change, which is the implementation of lean management prac-
tices, and delineate factors associated with lean transformation that can both
improve well-being (e.g., autonomy/participation) and harm well-being (e.g., mon-
itoring). Von Thiele Schwarz and Lornudd (▶ Chap. 12, “Corporate Boards and
Employee Well-Being”) focus on the role corporate boards can play in enhancing
employee well-being through effective governance of organizations. They define
key steps to encourage boards to think more strategically about employee health and
well-being. The final three chapters in this part focus on psychological factors that
impact how workers respond to changes. In ▶ Chap. 13, “Organizational Change
and Employee Health and Well-Being,” Rafferty makes the distinction between
objective exposure to change and the subjective experience of changes and reviews
research in both areas of the impact of change on health. Coyle-Shapiro, Costa, and
Chang (▶ Chap. 14, “Psychological Contracts and Employee Health”) examine how
psychological contract breaches can influence employee health, presenting a model
of how contract breach can affect health through acute stress reactions. Finally, in
▶ Chap. 15, “Fairness at Work,” Eib, Leineweber, and Bernhard-Oettell focus on
fairness and justice perceptions, which can be important to address when making
organizational changes that may adversely affect employees.
The third part of this handbook focuses specifically on employee well-being and
particularly how human resource management (HRM) is able to support employee
well-being through the application of policies concerned with learning, equity,
diversity and inclusion, performance, and justice and safety. The first chapter in
this part (▶ Chap. 16, “Work-Based Learning and Wellbeing”), by Watson and
Tregaskis, examines the extent to which employee well-being is influenced by
work-based learning processes and its associated outcomes. In ▶ Chap. 17, “Man-
agement of Equity and Diversity,” focusing on disability, Sang, Remnant, Babajide,
and Richards present historical and contemporary explanations of disability at work
and provide management recommendations to promote inclusion. In ▶ Chap. 18,
“Employee Voice as a Route to Wellbeing,” Brooks and Wilkinson discuss the link
between employee voice and well-being to understand how speaking out can
enhance both individual and collective well-being in the workplace. The focus of
▶ Chap. 19, “HRM Practices, Employee Well-Being, and Organizational
Performance,” written by Ogbonnaya and Aryee, is on evaluating the accumulating
evidence on what constitutes HRM systems, as well as how, why, and when they
influence employee well-being and organizational performance. Bish contributes
▶ Chap. 20, “Developmental HR Practices as Tools to Support Employee
Well-Being,” providing a detailed guide to the research investigating the use of
developmental HR practices as tools to support and enhance employee well-
being. In ▶ Chap. 21, “Ethical Culture and Management,” Huhtala discusses what
constitutes and drives an ethical culture and provides specific management
6 P. Brough et al.

strategies to maintain and minimize potential threats to ethical culture.

▶ Chapter 22, “The Effective Management of Whistleblowing,” by Brough, Law-
rence, Tsahuridu, and Brown, integrates multidisciplinary perspectives of
whistleblowing and proposes a multilevel model to inform and encourage research
focused on the effective management of whistleblowing. Mansour presents the
theory of psychosocial safety climate in ▶ Chap. 23, “Psychosocial Safety Climate
(PSC)” and describes how psychosocial safety climate is measured and researched as
well as applied in practice. In ▶ Chap. 24, “Challenges and Opportunities for
LGBTQI+ Inclusion at Work,” Moser, Booth, and Beauregard examine inclusion in
the context of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+)
employees and provide an overview of the current state of play and key opportunities
for employers to facilitate the full and free participation of these workers. The final
chapter in this part (▶ Chap. 25, “Performance Management and Wellbeing at the
Workplace”), by Franco-Santos and Stull, and Bourne, investigates the relationship
between performance management practices and employee well-being and formu-
lates a conceptual framework elucidating the conditions under which different well-
being results are likely to occur.
The fourth part of the book contains six chapters specifically focused on the
management of workers with health conditions or with factors associated with an
elevated risk for chronic, health conditions (entitled “Employment Practices for
Occupational Health and Disability”). Many of the issues examined in this part are
characterized by societal importance but a generally unclear etiology and progno-
sis of different treatment outcomes; thus the management of these issues is
complex. In ▶ Chap. 26, “The Aging Workforce,” Gardiner and Chen examine
how the aging process affects the health and performance of workers and what
organizations can do to mitigate some adverse effects of aging and support
workforce participation of aging workers. Roy (▶ Chap. 27, “Occupational Health
Services and Prevention of Work-Related Musculoskeletal Problems”), Etuknwa
and Mathai (▶ Chap. 28, “Common Mental Health Problems”), and Leiter
(▶ Chap. 29, “Burnout”) in turn examine specific and prevalent employee chronic
health conditions, namely, muscular-skeletal problems, common mental health
problems, and burnout. ▶ Chapter 30, “Workplace Fatigue: The Impact of the
Drive,” by Wishart and Barrett, discusses the serious issues of how to mitigate
fatigue for those who drive as an occupation. Finally, in ▶ Chap. 31, “Disruption in
the Workplace,” Kendall and McLennan examine vocational rehabilitation pro-
cesses for those returning to work after major illness or injury, examining recent
trends and highlighting future opportunities with the emergence of new
technologies.
Part 5 of this handbook is entitled Work-Life Interface contains five chapters
discussing five current issues about the work-life interface. The management of
work, family, and other roles is a constant juggling act for the majority of employees
and directly influences employee well-being and productivity, as well as the recruit-
ment and retention of employees. ▶ Chapter 32, “Psychological Crossover” dis-
cusses the interesting issue of how stress, resources, and emotions can be transferred
via a cognitive crossover process between work and home via spouses and
1 Introduction 7

transferred within workplaces between colleagues and leaders (Brough, Westman,

Chen, and Chan). ▶ Chapter 33, “Flexible Work Initiatives, Employee Workplace
Well-Being, and Organizational Performance” provides a pertinent review of flexi-
ble work initiatives which have successfully demonstrated causality between
employee workplace well-being and organizational performance (Ruiter and Peters).
This chapter reviews flexible work practice intervention studies focusing on where
and when employees perform their work and how these contexts impact their well-
being and performance. ▶ Chapter 34, “Extending Work-Life Balance Initiatives,”
discusses how work-life balance initiatives can be extended to address the often
substantial gap between the provision and promise of work-life balance initiatives
and their actual uptake and outcomes (Chan and Tay). This chapter also discusses the
impact of the COVID-19 pandemic on employee’s work-life balance and how
employment practices can reduce this impact. In a discussion of work design and
information technology, ▶ Chap. 35, “Shifting the Mental Health Conversation:
Present and Future Applications of the “Thrive at Work” Framework,” describes the
specific Thrive at Work framework that synthesizes organizational approaches to
mental health and the work-life interface (Parker, Jorritsma, and Griffin). This
framework emphasizes how employment practices can proactively address
employee well-being via enhancing the intrinsic quality of work. The final chapter
in this part, ▶ Chap. 36, “Workplace Well-Being Initiatives,” discusses the cost
benefits of work-life balance initiatives. Nasamu, Connolly, Bryan, and Bryce
describe a pertinent well-being cost-effectiveness analysis and illustrate its practical
use with four case studies. There is a clear value to organizations to provide effective
work-life balance initiatives.
The final part of this handbook, part “Trends and Emerging Challenges for
Management,” focuses on the key trends and emerging challenges that organizations
are likely to face in the future management of people. The first chapter in this part,
▶ Chap. 37, “The Growing “Gig Economy””, by Williams, McDonald, and Mayes,
focuses on the growing “gig economy” and evaluates the benefits and associated
risks of digital platform work, as well as the implications of this work on the health
and safety of digital platform workers. In ▶ Chap. 38, “Workplace Mistreatment”,
Reich and Dhensa-Kahlon review the extant workplace mistreatment literature,
highlighting some key predictors of both experienced and enacted mistreatment and
the potential role of third parties to help address mistreatment. Leka and Jain present
key policy approaches to managing health, safety, and well-being at the macro-,
meso-, and micro-level in ▶ Chap. 39, “Managing Health, Safety, and Well-Being
at Work Within Changing Legal and Policy Frameworks.” ▶ Chapter 40, “Psycho-
logical Adjustment and Post-arrival Cross-cultural Training for Better Expatriation,”
by Gai, Brough, and Gardiner, details the outcome of a systematic review on the
association between cross-cultural training and expatriate adjustment. In the
final chapter, in this part ▶ Chap. 41, “The Decline of Trade Unions and Worker
Representation,” Underhill considers the implications of changes to trade unions
and independent worker representation and reviews the processes which
strengthen the impact of work, health, and safety representatives on worker health
and well-being.
8 P. Brough et al.

Future Directions for Management and Employment Practices

The contents of this handbook will equip researchers, practitioners, and policy
makers to better anticipate and respond to the future challenges associated with
management and employment practices. Recent technological, social, and legal
advances have removed many barriers to doing business. It has never been easier
to access information, communicate with individuals on the other side of the world,
or enter new markets. It is undeniable that the world of work is changing. While there
might be some debate as to whether these changes create opportunities or barriers for
workers (Kaine and Josserand 2019), the impact of global, social, technological, and
legal changes on how we each experience and view work is pervasive. Indeed, the
combined result of these social, technological, and legal changes is a move away
from standard forms of one-to-one employment relationships to several new forms
of employment, including, but not limited to, employee sharing, job sharing, plat-
form work, portfolio work, collaborative employment, and casual work arrange-
ments (Eurofound 2020).
One major driver of change is the introduction and uptake of information and
communication technologies (ICT). The growing success of work-based platforms
such as Zoom, MS Teams, Slack, and Dropbox, as well as social media applications
such as Facebook and Twitter, not only facilitate productivity but also highlight the
importance that many of us place on staying connected as humans. Globally, surveys
seem to indicate that most workers desire a “hybrid” work pattern moving forward,
where they have the flexibility to work on-site as well as remotely from time to time
(Cisco 2020). While it is anticipated that most companies will retain some physical
offices, demand for “hybrid” work, as well as a realization by organizations of the
financial savings which result from reduced office space, makes it likely that the
impact of ICT on how we manage and perform our work will be strengthened.
However, despite the many benefits which ICT can offer, it remains vitally important
that we see a concerted effort to support workers to also disconnect from their work,
to avoid fatigue and burnout.
The momentum of social movements such as #metoo and #blm also has pro-
foundly heightened societal expectations that businesses will not only comment on
but adopt a stance and become involved in social issues. The rise in popularity of
social sharing platforms has allowed debate of societal and political issues, which
were previously reserved for private discussions with family and close friends, to
cross-over to the work and public spheres. Organizations are more cognizant of and
driven to meet employee expectations around closing the gender pay gap and
creating workplaces that are inclusive and engaging and aspire to operate at a higher
ethical standard. Indeed, opinion polls indicate that employees want organizations to
take a stance on societal issues and, importantly, are willing to leave their organiza-
tion if there is a cultural or value mismatch (Gartner 2021). However, while we are
seeing a growing segment of empowered and vocal employees who demand and
receive better conditions and standards, we also see a sizable group of workers and
communities who have not benefitted from globalization and technology. Research
by OECD continues to demonstrate severe inequalities in access to secure work and
1 Introduction 9

digital technology due to age, gender, and socioeconomic status, resulting in mem-
bers of these groups feeling marginalized and anxious about the future (OECD
2019). With such fast-moving and pervasive social change, it is challenging but
still crucially important that organizations, governments, researchers, and policy
makers refocus their efforts on ensuring that those who feel left behind and vulner-
able are supported holistically, though opportunities to obtain stable work, stronger
social protections, and increased access to public services and universal social
benefits.
The rapidly changing employment landscape has also shed some doubt over
what, if any, legal protections are afforded to workers in new forms of employment.
Legislation, which is often out of date and difficult to amend, has been shown to be a
poor instrument for regulating labor. While case law has been integral to resolving
important labor issues as they arise, such as dealing with classifying who is and who
is not an independent contractor, there is still much confusion when comparing case
law across jurisdictions (Koutsimpogiorgos et al. 2020). We see the knock-on effect
of these worker classification issues, with respect to the legal obligations of organi-
zations to ensure the health and safety of their workers (Weber et al. 2020). With the
mass move to work from home, prevention of physical and mental illness and
disease has become an important concern for HRM practitioners, organizations,
and governments alike. The use of soft law, such as corporate social responsibility,
is emerging as an important tool for organizations to meet their social and environ-
mental obligations. The growing number of organizations who voluntarily undertake
third-party assessment, such as via the Global Reporting Initiative, provides some
evidence that more organizations recognize the value placed by shareholders, cus-
tomers, and society, more generally, to be accountable, transparent, and good
corporate citizens (García-Sánchez et al. 2019). With health and safety firmly part
of CSR, we hope to see organizations rise to evolving employment challenges,
proactively responding with solutions to better support the health and well-being
of their workers.
Certainly, while the impact of COVID-19 on the health and well-being of workers
is likely to be felt for some time, looking beyond COVID-19, it should be clear that
many of the pressures we are now experiencing are the result of ongoing social,
technological, and legal shifts over time. The discussions in this handbook, there-
fore, provide an invaluable analysis of how we have arrived at the current state of
events, as well as a wealth of evidence-based insights and practical recommenda-
tions for how we can capitalize on the many different possibilities presented by the
new and ever-changing future of work.

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 Part I
Leadership, Management Competencies, and
Wellbeing
Successful Leadership
2
Amy J. Hawkes and Jason Spedding

Contents
Theoretical Approaches to Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Trait Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Behavioral Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Contingency Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Relational Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Charismatic and Transformational Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Modern Positive Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
An Integrative Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Outcomes of Successful Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Individual Outcomes of Successful Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Team Outcomes of Successful Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Organizational Outcomes of Successful Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Moderating Effects on Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Task Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Power Distance, Autonomy, and Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Future Leadership Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Causal Modelling of Leadership Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Exploring Leadership Through an Economic Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Abstract
This chapter discusses the concept of successful leadership by presenting the
historical and theoretical perspectives from the field. Following this, a summary
model is provided to enable the reader a comprehensive view of the leadership
process. In this model, individual traits, characteristics, and experiences of
leaders, followers, and teams are represented at the start of the leadership process.

A. J. Hawkes (*) · J. Spedding

School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
e-mail: a.hawkes@griffith.edu.au; jason.spedding@griffithuni.edu.au

© Springer Nature Switzerland AG 2022 15

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_2
16 A. J. Hawkes and J. Spedding

The behaviors, interactions, and relationships form the second stage. These
interactions produce outcomes for the individual (leader and follower), the
team, and the organization. A feedback loop represents the reciprocal nature of
leadership, such that outcomes are achieved (or fail to be achieved), which
influences future behavior. Lastly, the context and external moderating factors
may influence each stage of the leadership process. This summary draws together
core tenets from established leadership theories. Following this, how successful
leaders can influence outcomes at the individual (engagement, performance,
creativity, wellbeing, burnout, and psychological capacities), team (shared mental
models, team learning, psychological safety climate, team cohesion, and team
potency), and organizational (psychosocial safety climate, organizational change
readiness, and ethical organizational culture) levels are discussed. Finally, mod-
erators of the leadership process and challenges for future research are discussed.

Keywords
Leader · Leadership · Leadership review · Team leadership · Organizational
leadership · Leadership framework · Theoretical

Leadership is a core component of a successful organization; an effective leader

provides guidance, encouragement, knowledge, and influences people to come
together to achieve a shared goal. The key outcomes of effective leadership include
performance improvements, health and wellbeing, empowerment, team cohesion,
and culture change. It is for this reason that leadership development interventions
(such as training and coaching) are seen as essential investments. In 2019, $370
billion was spent on leadership development by global organizations
(TrainingIndustry.com 2020). Unfortunately, many leadership development initia-
tives are criticized for failing to produce improvements in leadership. In order to
fully understand successful leadership, both the factors that contribute to leadership
and the outcomes of leadership need to be examined. This chapter will provide an
overview of leadership theories, including an integrative summary of central tenets
from these theories. Additionally, the evidence supporting the role of leadership
influencing individual, team, and organizational outcomes will be discussed includ-
ing the constraining or moderating factors, and directions for future research in the
leadership field.
There is an abundance of definitions in the academic and general literature for
leadership. A pioneer in the leadership space, Ralph Stogdill famously commented
that “there are as many definitions of leadership as there are researchers in the field”
(House and Podsokoff 1994, p. 45). Despite decades of research this statement is as
true now as it was then. Bryman defined leadership as “a process of social influence
whereby a leader steers members of a group towards a goal” (Bryman, 1992 p. 2).
Kotter defined leadership as “the process of moving a group (or groups) in some
direction through mostly noncoercive means” (1988, p. 5). Shamir and Howell
(1999) defined charismatic leadership as an “interaction between leaders and
2 Successful Leadership 17

followers that results in (1) making the followers' self-esteem contingent on the
vision and mission articulated by the leader, (2) strong internalization of the leader's
values and goals by the followers, (3) strong personal or moral (as opposed to
calculative) commitment to these values and goals, and (4) a willingness on the
part of followers to transcend their self-interests for the sake of the collective (team
or organization)” (p. 259). Many early definitions focused on the hierarchical
position of the leader, the group context, or the influence exhibited towards goal
achievement (Vroom and Jago 2007). Compared to more recent theories that have
conceptualized leadership as a process. As discussed by Day and Halpin (2004), we
should accept the dynamic context-specific nature of leadership, and refrain from
seeking a single all-encompassing definition. Despite the difficulty in reaching a
consensus on defining leadership there has been substantial progress in uncovering
contributors to the leadership process and there remains little doubt about its impact
and importance for organizations.
Later in this chapter we will present a framework of successful leadership,
summarizing ideas across the leadership literature. We contend that to understand
leadership we must take an eclectic approach, integrating ideas from a variety of
models and adopting a multi-level perspective. Understanding the history of leader-
ship theories is useful when adopting an eclectic approach to leadership initiatives or
interventions. Overtime, leadership theory has progressed through distinct stages
including: (1) trait theories (2) behavioral theories, (3) socio-cognitive and contin-
gency theories, (4) charismatic and transformational theories, (5) social exchange/
leader-member exchange theories, (6) authentic and ethical theories, and (7) modern
perspectives (followership, distributed, and shared leadership). A brief overview of
this literature will be provided, for a more detail review see Avolio et al. (2009), Day
et al. (2014), and Lord et al. (2017).

Theoretical Approaches to Leadership

Trait Approaches

Many of the earliest approaches to leadership sought to understand what differed

between “great leaders” and “ordinary men.” These approaches explored how
personality traits were correlated with leadership emergence and ratings of leader-
ship effectiveness. Unfortunately this early work failed to identify consistent traits
predicting leadership effectiveness (Judge et al. 2002; Stogdill 1948). Despite early
failures, the study of leader traits and individual differences still has explanatory
value in understanding successful leadership. Through improvements in psychomet-
rics, increased computing power, and new analytics, the evaluation of leadership
traits has seen a resurgence. The modern approach to leadership research in this area
has been to widen the focus from personality traits to include, values, skills, motives,
strengths, and cognitive ability (Zaccaro 2007). Characteristics that have been
identified among effective leaders include emotional intelligence (Riggio and Lee
2007), extraversion (Bono and Judge 2004), and leader self-efficacy (Anderson et al.
18 A. J. Hawkes and J. Spedding

2008). A comprehensive meta-analysis found an association between traits and

components of transformational and transactional leadership, however these associ-
ations were weak (Judge et al. 2002). Individual characteristics that allow a leader to
be aware of their context and adjust their behavior have also been linked to effective
outcomes, such as openness, tolerance for ambiguity, cognitive flexibility, and
emotional intelligence (Ployhart and Bliese 2006; Zaccaro 2002, 2007). A small
but significant relationship between emotional intelligence and transformational
leadership was also found in a meta-analysis of 62 samples (Harms and Credé 2010).
Despite some success identifying individual traits related to leader effectiveness,
there is consensus in the literature that there is not a single trait, or set of traits, that all
leaders must possess to be effective (House and Podsokoff 1994). Further, traits may
exhibit a curvilinear relationship with effectiveness, such that at a very weak or a
very strong trait may be detrimental to performance, while a moderate level may be
more beneficial (Zaccaro 2007). Finally, the interaction with the context needs to be
considered. Successful leadership may only be apparent when traits necessary or
relevant to the context are combined at appropriate levels. Overall, personality,
values, morals, people skills, problem solving skills, and emotional intelligence all
have a role to play in successful leadership (Riggio and Lee 2007). As leadership
theories matured, we see that both leader behavior and organizational contexts
should be considered in conjunction with individual characteristics.

Behavioral Approaches

During the 1950s the behavioral movement was gaining traction, trait approaches to
leadership (which displayed only marginal success) were being discarded in favor of
more behaviorist perspectives. These early behavioral approaches (the classic Ohio
and Michigan studies) concluded that balance was needed between task and rela-
tionship focused behaviors for effective leadership (Stogdill and Coons 1957). Task-
focused behaviors (also called initiating structure or production-oriented) are those
focused on task completion and individual performance; while relationship focused
behaviors (also referred to as consideration or employee-oriented) are those related
to the social functioning of the team (Stogdill and Coons 1957). This balance is
needed between both task and relational leadership behaviors to achieve effective
outcomes. This distinction in task- and people-focused leadership behavior is still
referred to in modern leadership training and consulting. Eventually, it was apparent
that these leadership behaviors did not explain enough variance in leadership out-
comes, and the environment/context in which leaders worked was explored (Kerr
et al. 1974).

Contingency Approaches

While contextual factors were discussed in early leadership literature these factors
were rarely the focus of the success or failure of leaders to be effective. As scholars
2 Successful Leadership 19

recognized the wide variability in the effectiveness of leader behaviors, attention

turned to matching behaviors to situations (i.e., effective behaviors are contingent
upon the situation; Kerr et al. 1974). The most well-known contingency theories are
Fielder’s Contingency Theory (1967), Hersey and Blanchard’s Situational Leadership
Theory (1969), and House’s Path Goal Theory (1971). Fielder’s (1967) contingency
theory considers individual leaders to have a set preference for behavior that is either
task or relationship focused, and that this preference must be matched to the situation
according to three contingency factors (task structure, positional power, and leader–
member relationships). Hersey and Blanchard (1969) proposed four leadership styles,
based on combinations of high/low task and relationship behaviors. Hersey and
Blanchard’s approach differed from Fielders’ by allowing the leader to adapt their
behaviors to suit the situation. The contingency factors in this model focus on
employee characteristics, namely competence and commitment. For instance, when
employees are low on both competence and commitment the leader will need to adopt
a more directive style (high task, low relationship) to be effective. Finally, House’s
(1971) Path Goal Theory proposes that leaders can adopt four leadership styles (again
drawing on combination of low-high task and relationship behaviors), to guide
followers to reach a goal. This theory recognizes both environmental and employee
contingency factors that can affect the path to goal achievement. Unfortunately
contingency theories have faced heavy criticisms and failed to replicate a convincing
patterns of results (Wofford and Liska 1993). As discussed by Vroom and Jago (2007)
situations shape the way leaders behave and also the consequences of the leaders
behavior. While modern approaches have moved away from contingency approaches,
the consideration of situational moderators on the effectiveness of leadership on
outcomes is an important and lasting contribution of this literature (Howell et al.
1986; Paustian-Underdahl et al. 2014; Podsakoff et al. 1995).

Relational Approaches

Leader-member exchange (LMX; originally named vertical dyad linkage) takes a

social exchange perspective to understand the unique relationship between a leader
and each individual follower (Bauer and Erdogan 2015; Dansereau et al. 1975). The
concept of LMX was inspired by differences observed among followers when rating
the same leader’s behavior (Graen et al. 1972 as cited by Liden et al. 2015). LMX
specifies that leaders have a relationship with each follower that is either of high
quality (in-group members) or poor quality (out-group members). High quality
exchanges are characterized by mutual respect, trust, positive emotions, high per-
formance, and satisfaction. In a meta-analysis of 79 studies, LMX was correlated
with satisfaction, role clarity, commitment, performance, and turnover intentions
(Gerstner and Day 1997). LMX has also been linked to task performance, organi-
zational citizenship behaviors, and reduced counterproductive behavior (Martin
et al. 2016). An ongoing issue in this literature is the small correlation between
leader and member ratings of LMX (Gerstner and Day 1997); this suggests an
employee’s perception of in-group membership may remain a good predictor of
20 A. J. Hawkes and J. Spedding

outcomes regardless of the leader’s view. The important contribution of LMX to the
leadership literature is that the unique dual relationship between leaders and indi-
vidual followers can shape outcomes for employees, leaders, and organizations.

Charismatic and Transformational Approaches

Criticisms of the contingency and behavioral approaches include their failure to

capture the inspiring and motivating components of leadership (Avolio et al. 2009).
Charismatic leaders are those who are able to energize and build commitment to a
vision. Transformational leadership, originally proposed by Burns (1978) and fur-
ther developed by Bass and Avolio (1990), is one of the most widely researched
theories of leadership (Avolio et al. 2009). The full range leadership model includes
a spectrum of leadership, from laissez-faire to transactional (management by excep-
tion passive, management by exception active, contingent reward) and transforma-
tional (idealized influence, inspirational motivation, intellectual stimulation, and
individualized consideration; Bass 1999). Another widely used model of transfor-
mational leadership was described by Podsakoff et al. (1990). Transactional leader-
ship is focused on the management and reward tasks of general supervision (Bass
and Avolio 1990). While transformational leaders inspire and motivate their fol-
lowers to go above and beyond organizational requirements, they challenge their
employees to be creative, and show genuine care for their employees personal and
professional development (Dvir et al. 2002). This approach does not present trans-
formational leadership as the optimal or preferred approach, rather transformational
leadership augments the transactional leadership behaviors (Bass and Avolio 1990).
Although, recent meta-analysis has indicated the potential benefits of contingent
reward beyond transformational leadership for individual task performance (see
Wang et al. 2011).
Multiple meta-analyses have demonstrated the positive benefits of transforma-
tional leadership for individuals, teams, and organizations (DeGroot et al. 2000;
Lowe et al. 1996; Wang et al. 2011). Transformational leadership has been applied to
many contexts, including military (Dvir et al. 2002), healthcare (Avolio et al. 2004;
Jordan et al. 2015), and specific target behaviors, such as safety behavior (Clarke
2013). While transformational leadership may be one of the strongest approaches to
leadership, there is a need for further exploration into the developmental outcomes of
transformational leaders and interventions to build transformational leadership (Dvir
et al. 2002; Siangchokyoo et al. 2020).

Modern Positive Approaches

A set of leadership theories, in line with the positive psychology movement, grew
largely out of repeated mismanagement and unethical business dealings causing
corporate scandals (see for example, the chapter discussing whistleblowing in this
handbook; ▶ Chap. 22, “The Effective Management of Whistleblowing”). These
2 Successful Leadership 21

theories focus on authenticity, interpersonal relationships, trust, humility, and ethical

decision making as the building blocks of effective leadership (Lord et al. 2017).
Ethical leadership occurs when personal actions and interpersonal relationships are
driven by appropriate standards of conduct, and that appropriate behavior is encour-
aged in others. Authentic leadership investigates the processes and outcomes of
leaders with high moral character, positive values, an awareness of self and others,
inclusive and transparent decision making, and the honest sharing of information
(Luthans and Avolio 2003). Servant leadership positions the leader as someone to
guide or support employees through empowerment and personal development while
working toward a shared vision (Smith et al. 2004). Servant leadership is character-
ized by empathy and a willingness to serve, such that caring for staff will lead to
organizational goals being achieved (Avolio et al. 2009; Langhof and Güldenberg
2020; van Dierendonck 2011). See also the servant leadership chapter in this
handbook; ▶ Chap. 3, “Servant Leadership.”
In a meta-analysis comparing ethical, servant, and authentic leadership to trans-
formational leadership, Hoch et al. (2018) concluded that servant leadership was a
promising theory as it explained variance beyond transformational leadership. In
comparison, ethical and authentic leadership were highly correlated with transfor-
mational leadership but failed to account for any unique variance beyond transfor-
mational leadership. In another exploration of the discriminant validity of authentic
leadership, a recent meta-analytic review reported large overlap with transforma-
tional leadership, such that neither leadership measure added incremental predictive
validity beyond the other (Banks et al. 2016). Some scholars have argued these
processes represent a single underlying leadership style (i.e., transformational-
servant leadership; Peregrym and Wollf 2013), while others have sought to differ-
entiate these based on their focus: organizational-focused compared to follower-
focused, respectively (Hoch et al. 2018).
Other theories proposed to understand leadership include: substitutes for leadership
(Kerr and Jermier 1978), empowering leadership (Park et al. 2017), abusive/destruc-
tive leadership (Brender-Ilan and Sheaffer 2019; Einarsen et al. 2007), the dark side of
leadership (use of influence for self-interest at the expense of others; Conger 1990).
Additionally, there has been a push to understand followers in the leadership process,
to move away from a leader centric view, culminating in a field focused on follower-
ship as the other half of the leadership process (see Uhl-Bien et al. 2014 for a detailed
review). See also the followership chapter in this handbook; ▶ Chap. 6, “Beyond the
Leadership/Followership Dichotomy.” Others have explored the concept of shared or
distributed leadership, whereby leadership responsibilities are shared among fol-
lowers, such processes have been linked to both increased performance, cooperation,
and satisfaction (Wang et al. 2014). Leaders can also play an important role as mentors
(Godshalk and Sosik 2000) and coaches (Ladyshewsky 2010) for employees. In a
review of the leadership development literature, Day et al. (2014) advocated for
research that presented leaders as individuals distinct from leadership as a process.
This is an important distinction because it allows the process of leadership to be more
fluid and move beyond traditional power structures (i.e., management) while also
recognizing the role of the individual, their traits and experiences.
22 A. J. Hawkes and J. Spedding

An Integrative Model

It is apparent that leadership is a complex phenomenon that is created via many

factors, including the leader, their followers, team dynamics, and the work context.
Previous theoretical approaches to leadership provide a useful foundation; however,
they fail to fully capture the leadership process. The key ideas underlying these
theories have been summarized and presented in Fig. 1. Drawing on trait theories,
the leader brings his or her own characteristics, traits, goals, past experiences, and
skills to the leadership interaction. The foundational work behind authentic leader-
ship also recognized the importance of a leaders past experiences in shaping future
behavior (Luthans and Avolio 2003). The leader will draw on these individual
differences and skills to perceive their environment which, drawing on behavioral
and style theories, will lead to behaviors of acting and interacting with their
employees/team. The followers also bring their own individual characteristics,
goals, experiences, and skills to the interaction. Similar to leaders, followers perceive
the situation and behave in order to interact with others in the workplace including
their leader. The team as the broader collective group also contributes to the
leadership process through team dynamics such as cohesion, potency, and team
efficacy. The inclusion of teams in the leadership process is often overlooked in the
leadership literature.
This interaction between the leader and followers captures the interactional/
relational process, drawing on relational dyadic theories (LMX and shared leader-
ship). As noted by Deluga (1992), transformational leaders foster warm committed
relationships with followers and through social exchange processes followers recip-
rocate with positive encouragement for the leader. This reciprocal process is the
point where influence is occurring and will lead to successful or unsuccessful out-
comes/results. Outcomes refer to the attitudinal, cognitive, or behavioral outputs
(either positive or negative) exhibited by an individual (leaders and/or followers), a
team, or an organization.
In leadership research, relationships are often hypothesized to occur in one
direction when in fact they could be bidirectional. For instance, Nielsen and Munir
(2009) found that the relationship between transformational leadership and
employee self-efficacy could be reciprocal, such that while self-efficacy remains
an outcome of transformational leadership, confident staff may encourage leaders to
exhibit more transformational behaviors or they may be more receptive to transfor-
mational leader behavior. Hence, it is important to include a feedback loop in Fig. 1
to represent the continuous process that occurs between leader, follower, team, and
outcomes. The outcomes, successful or otherwise, will be perceived by both leaders
and followers and add to their history of past experiences that shape their future
perceptions and actions.
Lastly, drawing on contingency theories and evidence for external moderators,
the process outlined in Fig. 1 occurs within the context of the organization and the
external environment. This external environment can influence every stage of this
process, such that the context influences the leader and follower’s experiences,
perceptions, behaviors, interactions, and success of leadership behaviors on
 2
Successful Leadership

Fig. 1 The holistic leadership model, drawing on central ideas from historical and current leadership theories to represent ongoing leadership processes
23
24 A. J. Hawkes and J. Spedding

outcomes, the context also contributes to the feedback received by leaders and
followers.
Derue et al. (2011) summarized leadership theories to capture the leadership
process, through combining trait and behavioral approaches. Our theoretical model
shares some similarities with Derue et al. (2011), including levels of analysis
(individual, team/group, and organization), leader traits/characteristics, and leader
behaviors. Our model advances their ideas by including the follower (traits/charac-
teristics, perceptions, and behaviors) and the team characteristics/dynamics within
the process. The feedback loop in Fig. 1 also represents the ongoing interactional
process that characterizes leadership as a continuous relationship. Due to the com-
plex nature of leadership, particularly within constantly changing and unique con-
texts, it is unlikely that there will ever be a single definition or theory that completely
captures all the elements of successful leadership. However, this model presents a
summary of the most relevant theoretical approaches that are useful for understand-
ing leadership and for exploring the leadership process. The next section discusses
the individual, team, and organizational outcomes of successful leadership.

Outcomes of Successful Leadership

Effective leadership has been linked to many outcomes for organizations, ranging
from employee behaviors through to corporate social responsibility and culture. The
following sections will summarize the evidence for outcomes of successful leader-
ship. This section is not meant to be an exhaustive account of all leadership out-
comes, rather it provides a summary of key leadership outcomes at the individual,
team, and organizational level of analysis.

Individual Outcomes of Successful Leadership

Employee Engagement
Engagement refers to a positive affective emotional state of work-related motivation
characterized by exhibiting vigor, dedication, and absorption in one’s work (Bakker
et al. 2008). Meta-analysis investigating the effects of employee engagement have
found engagement results in increased job satisfaction, more organizational com-
mitment, more frequent organizational citizenship behaviors, and reduced intentions
to quit (Borst et al. 2020). Others focusing on performance outcomes found that
levels of employee engagement explained 60% of the differences observed in
performance (Anitha 2014). Research has demonstrated the ability of particular
leadership styles to effect greater engagement in employees. For example, Li et al.
(2020) found a significant relationship between empowering, ethical, and charis-
matic leadership styles and increased engagement, while Hawkes et al. (2017)
reported similar effects for transformational leader behaviors. Additionally, Knight
et al. (2017) explored the benefits of leadership interventions on engagement and
2 Successful Leadership 25

found a marginal relationship, such that offering leadership training resulted in an

increase in reported employee engagement.

Wellbeing and Burnout

The costs of stress and burnout in the Australian economy are well known to
organizational researchers, once proximal stress outcomes such as absenteeism,
presenteeism, sickness, and workplace injuries are included, estimate swell to
roughly AU$3.08 billion annually (Safe Work Australia 2015). As with other
performance and motivational outcomes, successful leaders must consider the phys-
ical and mental wellbeing of their followers. Arnold (2017) synthesized research
exploring the benefits of transformational leadership on employee wellbeing, finding
the relationship was mediated through a range of processes such as occupational
self-efficacy, trust, role clarity, and social support. In a longitudinal study, self-
efficacy significantly mediated the relationship between transformational leadership
and employee wellbeing (Nielsen and Munir 2009). Transformational behaviors also
benefit the leader’s personal wellbeing producing genuine positive emotions (Arnold
et al. 2015). Employing biological measures of wellbeing (i.e., employee cortisol
levels), Diebig et al. (2016) found leadership behaviors which increased ambiguity
resulted in increased employee cortisol, while behaviors which reduced ambiguity
(i.e., communicating vision) reduced these stress outcomes. Similar results are
reported for shared leadership processes, when these result in reduced role ambigu-
ity, team ratings of occupational stress are attenuated (Wood and Fields 2007).

Performance
A central concern for all organizations is performance and productivity. Transfor-
mational leadership, contingent reward, and positive LMX have been linked to
increased follower performance (Howell and Hall-Merenda 1999; Saeed et al.
2019). In a meta-analysis of 113 studies, transformational leadership was positively
related to individual, team, and organizational performance (Wang et al. 2005).
Organizational citizenship behaviors are extra discretionary behaviors that support
the functioning of the organization. Effective leadership has been consistently
related to higher employee organizational citizenship behavior, including transfor-
mational leadership (Bottomley et al. 2016; Cho and Dansereau 2010), ethical
leadership (Mostafa 2018), servant leadership (Ahmad Bodla et al. 2019), authentic
leadership (Valsania et al. 2012), and empowering leadership (Little et al. 2016). For
example, high quality LMX mediated the relationships between transformational
leadership and performance, task and organizational citizenship behaviors (Wang
et al. 2005). Leaders demonstrating authentic behaviors are also more likely to have
high performing employees (Leroy et al. 2012). At the other end of the leadership
spectrum, abusive leadership has been linked to increased deviant and counterpro-
ductive behavior at work (Webster et al. 2016).

Employee Creativity
With the observed growth in the knowledge economy, workers frequently face
problems which require unique solutions, hence employee creativity and capacity
26 A. J. Hawkes and J. Spedding

to innovate have become increasingly valued assets (Anderson et al. 2004). Leaders
are able to improve employee creativity through maintaining transformational and
empowering leadership styles (Hughes et al. 2018). Interestingly, many studies adopt
a unidimensional view of these transformational leadership processes, when indi-
vidual subscales (i.e., intellectual stimulation) have been argued to be more predic-
tive of employee innovation (Hughes et al. 2018). Additionally, contingent reward
behaviors are particularly effective at enhancing creativity when rewards are tied to
creative outputs and provided in addition to positive task-focused feedback and
creative autonomy, while completion-contingent rewards exhibit a negative effect on
innovation (Byron and Khazanchi 2012). Others have found similar benefits for
moral leadership styles (Gu et al. 2015), authentic leadership (Rego et al. 2012), and
ethical leadership (Tu and Lu 2013) to effect employee innovation. Transformational
leadership has also been associated with increased innovation climate, which in turn
was related to increased employee creativity (Jaiswal and Dhar 2015; Wang et al.
2013).

Psychological Capacities (PsyCap, Trust, Empowerment)

Many of the performance benefits outlined above can be explained by improved
psychological capacity of employees including empowerment, engagement, trust, or
psychological capital. Psychological capital (PsyCap) is a higher order construct
consisting of self-efficacy, resilience, optimism, and hope. PsyCap has been corre-
lated with a range of individual outcomes including: performance, satisfaction,
commitment, wellbeing, and reduced turnover intentions (Avey et al. 2011a, b).
PsyCap is important for motivation and achievement of goals, which is also a central
tenet of successful leadership. Hence, it is not surprising that there is increasing
evidence for the relationship between leadership and PsyCap, including transforma-
tional leadership (Gooty et al. 2009; Lei et al. 2020). In another study, authentic and
ethical leadership also explained variance in PsyCap after accounting for individual
differences, demographics, and job characteristics (Avey 2014). Interestingly, the
way a leader conveys their own PsyCap may influence their team’s energy and also
ratings of leadership effectiveness (Rego et al. 2019). Interventions to improve
leader PsyCap has demonstrated small increases in follower PsyCap as well (Avey
et al. 2011a, b).
Two other relevant psychological capacities are empowerment and trust. Empow-
erment, a sense of completing meaningful work, has been linked to leadership, often
as a mediator between leadership and organizational outcomes. In a longitudinal
survey of nurses, authentic leadership was linked to empowerment, which in turn
was linked to performance and satisfaction (Wong and Laschinger 2013). Trust is
built over time via consistent patterns of behavior aligned with intentions and
promises. In an experimental study where leadership was manipulated, performance
was higher amongst those that worked for a transformational leader, with these
effects mediated by trust and increased value congruence (Jung and Avolio 2000).
Trust is central in transformational, ethical, authentic, and servant leadership theories
(for a review on leadership and trust we recommend Bligh 2017).
2 Successful Leadership 27

Team Outcomes of Successful Leadership

Successful leadership can elicit a range of positive cognitive, affective, and behav-
ioral outcomes for followers. However, when managing teams of individuals, leaders
must also consider the complex web of team interactions through which work is
completed. Rather than a collection of individuals, occupational teams enable
synergistic effects, such that collective outputs can exceed the sum of individual
contributions (Katz and Kahn 1978). These gains however, come at the cost of
increased complexity in coordinating individual contributions to achieve team out-
comes. Evidence from meta-analyses shows improving coordination by a single
standard deviation results in a one-third standard deviation increase in team perfor-
mance, and half a standard deviation increase in team satisfaction (LePine et al.
2008). Through these ongoing interactions teams develop a stable sense of identity.
Leaders can affect these team characteristics through a range of mechanisms which
are discussed below.

Shared Mental Models

Shared mental models refer to the team’s level of collective familiarity with the
processes employed by team members and the ability to utilize this knowledge to
anticipate future team states (Converse et al. 1993). Teams with highly developed
(and accurate) shared mental models can predict the actions and needs of other team
members, allowing members to better coordinate their individual inputs to maximize
team outcomes. Leaders can affect the development of shared mental models via
communication and sharing participation in leadership processes (Gurtner et al.
2007; Kozlowski et al. 2009). In simulated combat scenarios, Marks et al. (2000)
found leaders who delivered effective pre-mission team briefings increased both the
similarity and accuracy of team shared mental models. Similarly, Gurtner et al.
(2007) found leaders who used task-adaptive communications (opposed to more
general team instructions) resulted in greater team performance, mediated via shared
mental models. Self-managed teams who actively shared leadership responsibilities
also exhibited more similar and accurate shared mental models resulting in increased
performance outcomes (McIntyre and Foti 2013).

Team Learning
With the changing nature of modern workplaces, organizations are becoming reliant
on teams to solve difficult organizational issues, such solutions require agile adap-
tation and innovative work practices. Team learning processes enable the identifica-
tion of new insights, solutions, or adaptation of previous processes to achieve team
outcomes. Team learning can explain up to 18% of the variance observed in
supervisor ratings of team performance (Van Der Vegt and Bunderson 2005).
However, team learning behaviors are not automatic, instead research indicates
leaders can leverage team learning to achieve team and organizational outcomes.
Use of an empowering leadership style has been shown to increase team learning,
with meta-analysis suggesting that these actions explained 30% of the variance
28 A. J. Hawkes and J. Spedding

observed in team learning outcomes (Burke et al. 2006), furthermore these effects
were buffered by perceptions of intra-team trust (Wibowo and Hayati 2019).

Psychological Safety Climate

Psychological safety climate refers to the perceived consequences of interpersonal
risk-taking by staff within a team environment (Edmondson 1999). Improving
psychological safety allows staff to “feel secure and capable of changing”
(Edmondson 1999, p. 354). Such teams will encourage greater contributions from
members, as individuals feel less socially threatened for admitting an error, seeking
help, or asking for feedback (Edmondson 2003; Newman et al. 2017). Formal
leaders can enhance team psychological safety; for example, leader characteristics
such as inclusiveness (Bienefeld and Grote 2014; Hirak et al. 2012), trustworthiness
(Madjar and Ortiz-Walters 2009), and supportiveness (May et al. 2004) have been
linked to psychological safety. Others have explored the effects of specific leadership
styles, finding that transformational leadership (Detert and Burris 2007; Nemanich
and Vera 2009), servant leadership (Schaubroeck et al. 2011), ethical leadership
(Walumbwa and Schaubroeck 2009), and shared leadership processes (Liu et al.
2014) all correlated with increased levels of psychological safety. Previous system-
atic literature reviews highlight that collectively, leaders can enhance psychological
safety through maintaining supportive environments (i.e., providing supportive
leadership, encouraging supportive relationships, and developing supportive orga-
nizational practices; Newman et al. 2017).

Team Cohesion
Team cohesion defined as “the tendency for a group to stick together and remain
united in the pursuit of its instrumental objections” (Tekleab et al. 2009, p. 174) is
among the most widely studied and cited constructs in team research (Greer
2012; Kozlowski and Chao 2012). Team cohesion is associated with a range of
team benefits including: increased team learning (Tekleab et al. 2016), more team
satisfaction (Tekleab et al. 2009), and explains up to 12% of the variance in team
performance (DeChurch and Mesmer-Magnus 2010). Leaders can enhance orga-
nizational outcomes through assisting the development of team cohesiveness,
especially in occupational environments that necessitate high levels of work
interdependence. Chiniare and Bentein (Chiniara and Bentein 2018) found that
managers who utilize servant leadership practices increase the consistency of
intra-team relational dynamics, resulting in more cohesive work-units. Similarly,
Mathieu et al. (2015) reported that increased cohesion and performance cycles
were a by-product of leaders who encouraged more shared leadership behaviors.
Others have highlighted the social identity aspects of cohesion, arguing that
leaders can enhance cohesion through communication of socially salient aspects
of group identity, through encouraging early team socialization, or creating
shared experiences between team members (Kozlowski and Chao 2012; Marks
et al. 2001).
2 Successful Leadership 29

Team Potency
Team potency refers to perceptions regarding a team’s capability to perform suc-
cessfully across a range of tasks and contexts (Guzzo et al. 1993). Team potency has
been linked to subsequent team outcomes such as group satisfaction (Lee et al. 2002;
Lester et al. 2002), team learning (Widmann and Mulder 2018), organizational
citizenship behaviors (Collins and Parker 2010; Hu and Liden 2011), performance
(Gully et al. 2002), and the development of reciprocal potency-performance feed-
back cycles (Lester et al. 2002). Hu and Liden (2011) argued servant leadership led
to an increased sense of team potency, specifically through enhancing the benefits of
maintaining clarity regarding team goals and team processes. Charismatic leadership
has also been related to increased team potency at follow-up (Le Blanc et al. 2020;
Lester et al. 2002), with this effect being increased under highly interdependent work
conditions (Le Blanc et al. 2020). Additionally, transformational leadership pro-
cesses have been shown to enhance team members’ potency beliefs, with these
effects being particularly pronounced under conditions of high-power distance or
highly collective team environments (Schaubroeck et al. 2007), or mediated via team
cohesion and identity (Garcia-Guiu et al. 2016).

Team Viability
Team viability refers to a team members’ overall satisfaction with their team and
willingness to continue working together into the future (Hackman 1990). Increased
team viability has been linked to various team benefits such as reduced turnover and
increased performance (Hu and Liden 2015), reduced team conflict (Balkundi et al.
2009), and team engagement (Costa et al. 2015). Transformational behaviors are
linked to a 14% increase in reported team viability (Tu and Liu 2017), while Foo
et al. (2006) found teams which maintained more open communications and
increased social integration between members also reported heightened perceptions
of team viability. Other research has produced significant moderation effects, such
that team viability was more strongly predictive of team performance when tasks
were more interdependent (Hu and Liden 2015). Using a social network design,
research has shown teams with formal leaders who freely provide advice and
expertise to subordinates are seen as more viable, additionally leaders can also
encourage advice networks between individual team members to further enhance
perceptions of team viability (Balkundi et al. 2009).

Organizational Outcomes of Successful Leadership

In addition to influencing positive individual and team outcomes, successful leaders

are also able to affect beneficial outcomes at the wider organizational level. Although
it seems cogent for upper management to use their power to determine organizational
outcomes through formal policy and practices (Zhu et al. 2005), non-executive
leadership also contributes to internal (and public) perceptions of the organization.
Adopting a systems perspective, successful leaders serve as an interface between
30 A. J. Hawkes and J. Spedding

followers and the wider organizational ecosystem. As explained by Hui and col-
leagues, an employee’s relationship with their leader “may be the single most
powerful connection an employee can build in an organization” (Hui et al. 2004,
p. 233). The following section expands on this and demonstrates the several mech-
anisms through which leaders can affect positive organizational outcomes.

Psychosocial Safety Climate

Psychosocial safety climate refers to the shared perceptions regarding the policies,
practices, and procedures within an organization designed to protect the psycholog-
ical health and wellbeing of staff (Dollard et al. 2017). Psychosocial safety climate
has been linked to a reduction in workplace injuries (both directly and mediated via
reduced emotional exhaustion; (Zadow et al. 2017), fewer instances of workplace
bullying (Dollard et al. 2017), and increased employee engagement (Lee and Idris
2017). Although the development and maintenance of organizational climates and
cultures remain the remit of senior leadership (Dollard et al. 2017), front-line leaders
can enhance (or hinder) the development of psychosocial safety climates. Dollard
et al. (2017) posited that these climates may be dependent on the quality of leader-
member-exchange patterns; while others highlighted that leader role modelling will
implicitly signal “what is valued” to both followers and also to the wider organiza-
tion (Brown et al. 2005; Stouten et al. 2013). Biggs et al. (2014) utilized leadership
interventions to enhance organizational climates, the authors found that interven-
tions targeting transformational leader behaviors (in addition to effective leader
communication and strategic leadership) were able to enhance perceptions of orga-
nizational psychosocial support, which in turn increased employee work engage-
ment and job satisfaction. Qualitative research investigating the antecedents of
psychosocial safety procedures found that paradoxically an absence of senior man-
agement support for psychosocial safety drove front-line leaders to “adopt the
burden” of engaging in more psychosocial risk prevention (Baillien et al. 2020).
Such findings are a reminder that leaders are rarely passive actors within organiza-
tional systems, but rather through their own agency can affect positive individual,
team, and organizational outcomes.

Organizational Change Readiness

Given the ever-changing nature of modern workplaces, organizational change pro-
cesses remain an important aspect of organizational success. Despite this, scholars
and practitioners have found little success in understanding organizational change
processes; famously, previous evaluations of organizational change programs
reported a failure rate of roughly 70% (Beer and Nohria 2000; Hughes 2011). Li
et al. (2016) found empowering leadership was related to employee change behav-
iors, with these effects enhanced when staff were granted more autonomy and greater
agency to enact changes. Jordan et al. (2015) found that transformational leadership
was related to positive organizational change, while others found transformational
leadership processes reduced both employee cynicism to change and overall climates
of cynicism, resulting in greater commitment to change processes (Bommer et al.
2005; DeCelles et al. 2013). Transformational leaders can also communicate a vision
for the organization’s future aligned with these change outcomes, leading to more
2 Successful Leadership 31

employee engagement and change championing behaviors (Faupel and Süß 2019).
During change processes the leader’s ability to manage positive and negative affect
via communication and staff participation is critical to change success, as
highlighted by Smith “While excitement and enthusiasm for change can be conta-
gious, so too can fear, anger and resentment. Generating enthusiasm, rather than
anxiety, about change is thus critical and creating and communicating a vision of the
future” (Smith 2005, p. 410).

Ethical Organizational Culture

Scandals, corruption, and accounts of unethical business practices seem to be ever
present in the contemporary organizational landscape, such actions have increased
scholarly research into the causes and outcomes of unethical organizational behav-
iors. Maintaining an ethical organizational culture has been linked to reduced
burnout and increased engagement (Huhtala et al. 2015), reduced management
turnover (Kangas et al. 2018), and greater intentions to report wrong-doing (Zhang
et al. 2009). Leaders and managers must remain vigilant to the potential erosion of
these shared normative ethical beliefs (Brown et al. 2005). As outlined by Trevino
and Nelson “Managers need to be careful because an organization may easily be
lulled into thinking that its ethical house is soundly constructed, only to find that the
roof has been leaking and it’s about to cave in” (Trevino and Nelson 2016, p. 155).
Adopting an ethical leadership style, managers are able to influence employee
perceptions of ethical organizational cultures (Brown et al. 2005; Mayer et al.
2010), resulting in positive outcomes such as job satisfaction (Neubert et al. 2009)
and reduced deviance (Mayer et al. 2010).

Moderating Effects on Leadership

Although much empirical research has explored the direct effects of successful
leadership on individual, team, and organizational outcomes, less is known about
the specific boundary conditions which enhance or hinder these effects. For example,
the benefits of transformational leader behaviors on team adaptivity and innovation
have been shown to be strongest in teams with increased organizational identity
(Wang et al. 2017), or in teams with positive collective wellbeing (Miao and Cao
2019). Moderators that should be considered when applying various leadership
theories in research and in practice are discussed.

Task Characteristics

The characteristics of the specific task being completed will naturally effect the types
of behaviors which lead to success, with more complex work exhibiting a stronger
positive relationship between transformative leadership styles and task motivation
(Mahmood et al. 2019). Complex and highly interdependent tasks result in more
team member interaction and coordination (LePine et al. 2008). Le Blanc et al.
(2020) found that task interdependence moderated the effects of charismatic
32 A. J. Hawkes and J. Spedding

leadership on team potency, such that no effects were found in teams characterized
by low task interdependence while highly interdependent teams benefited greatly
from charismatic leadership. Transformational leadership has also been linked to
high quality leader–member relationships in geographically dispersed teams with
highly interdependent tasks and a reliance on collaborative software (Wong and
Berntzen 2019), while empowering leadership resulted in more perceived occupa-
tional fit (Erkutlu and Chafra 2015), and creativity (Byun et al. 2016) when team
tasks were more interdependent. Broadly, empowering leadership styles are more
effective when creative and non-routine actions are required (Lee et al. 2018).
Meanwhile, Burke et al. (2006) demonstrated leadership style enhanced team effec-
tiveness outcomes in highly interdependent teams, with person-focused leadership
explaining 12% and task-focused leadership explaining 11% of the variance in team
effectiveness (compared to 1% and 5%, respectively, in low interdependent teams).

Power Distance, Autonomy, and Culture

Social and cultural characteristics can also enhance the benefits of specific organi-
zational leadership styles. Lee et al. (2018) meta-analysis of empowering leader
behaviors unexpectedly found that empowering leadership was only significantly
related to task performance in vertical-collectivistic cultures (characterized by
greater respect for authority and greater power distance). The authors suggested a
ceiling effect in the data, with employees sampled from individualistic cultures
already maintaining strong norms regarding workplace empowerment, thus organi-
zations nested in collectivistic cultures benefitted more from utilizing an empowered
leadership style (compared to individualistic organizations; Lee et al. 2018). Similar
results have been reported, with empowering leaders having greater effects on team
empowerment and employee voice outcomes when perceived power distances were
larger (Jeung and Yoon 2018). Additionally, employee autonomy has been shown to
moderate the effect of empowering leadership on employee engagement and orga-
nizational citizenship behaviors (Li et al. 2016); such that micro-managed teams will
not receive the benefits associated with heightened team empowerment.

Future Leadership Research

Despite an expansive empirical literature to draw upon, there still remains much that
organizational scholars do not know about the behaviors and processes which
underlie successful leadership. The following section discusses key future areas of
research.

Causal Modelling of Leadership Effects

When modelling relationships between organizational constructs researchers are

normally interested in the specific effects (direction and effect size) of the
2 Successful Leadership 33

independent variable(s) on the dependent variable. However, as leadership processes

can affect (and are affected by) many different sources, reducing the noise in such
models can become an especially difficult task. The problem of endogeneity can
occur when external variables which effect these results are omitted, causing biases
to occur within model estimates (Antonakis et al. 2010; Sajons 2020). For example,
follower levels of extraversion have been shown to correlate with field ratings of
transformational leadership (Bono et al. 2012) and ratings of job satisfaction (Judge
et al. 2002); omitting extraversion in a regression analysis will bias estimates and
(in this case) inflate estimated effects of transformational leadership on job satisfac-
tion (additionally this will cause regression error terms to become correlated;
Antonakis et al. 2010). To attenuate this specific example, researchers might adopt
more robust and conservative estimation metrics. However, given the multitude of
potential omitted variables and their combined effects on transformational leadership
and job satisfaction, it is often impossible to know the direction or magnitude of
these biases (as these may collectively cause under-estimation or over-estimation
effects; Wooldridge 2012). Unfortunately, experimental methods used to ameliorate
these biases (i.e., random assignment) are often impractical or simply not available
within organizational research. The application of advanced econometric techniques,
including the use of instrument variables (Sajons 2020), difference-in-differences
models (Bennedsen et al. 2007), and regression discontinuity designs (Arvate et al.
2018; Grönqvist and Lindqvist 2016) are being advocated in leadership sciences,
and represent a valuable avenue for leadership scholars (for an in-depth review see
Sieweke and Santoni 2020). Future research is encouraged to adopt these methods
when exploring the causal effects of leadership on organizational outcomes.

Exploring Leadership Through an Economic Lens

In addition to the utility of econometric analysis to explore the true relationship

between leadership and organizational outcomes, it has been posited that scholars
should apply an economic lens to leadership processes (Garretsen et al. 2020;
Zehnder et al. 2017). Garretsen et al. (2020) argued for greater alignment between
economic and psychological perspectives, highlighting the potential gains generated
through cross-disciplinary collaboration. Zehnder et al. (2017) observed a diver-
gence between these fields, with economic theorists adopting a transactional per-
spective of leadership focusing on exchange relationships, the use of incentives, and
contractual obligations (i.e., contingent reward processes); while organizational
scholars have focused on the socio-affective components, such as transformational
and charismatic leadership influence. For example, economic research has explored
the role of CEO pay on employee outcomes (Steffens et al. 2018), finding that
increased CEO remuneration was related to a decrease in personal identification with
organizational leaders, which subsequently lowered ratings of charisma and the
development of collective organizational identity. Bennedsen et al. (2007) investi-
gated hereditary CEO appointments, finding that CEO selection based on familial
ties resulted in decreased organizational performance, particularly in large organi-
zations, or those based in knowledge industries. More cross-disciplinary research
34 A. J. Hawkes and J. Spedding

including both economic and psychological perspectives will enhance our knowl-
edge and understanding of these allusive organizational processes.

Conclusion

Overall, this chapter has provided an overview of the key leadership research
evidence. These leadership theories all have mixed results predicting outcomes for
individuals, teams, and organizations. It is unlikely that a unified theory of leadership
will ever fit the unique and changing context of workplaces and teams. However,
there is value in taking an eclectic approach to understanding leadership through
summarizing central tenets from many approaches. We provided a theoretical model
to summarize the contributions of leadership theories. Future leadership researchers
should try to broaden their focus to include multiple components of the leadership
process. Following the discussion of leadership theories, evidence for the outcomes
of successful leadership was reviewed.
Successful leadership has a clear relationship with individual performance vari-
ables (e.g., organizational citizenship, deviance, task performance, creativity, inno-
vation), attitudinal and psychological variables (e.g., satisfaction, commitment, trust,
PsyCap, empowerment), and occupational health variables (e.g., wellbeing, burn-
out). Leadership is also related to team processes and outcomes, such as shared
mental models, team learning, psychological safety climate, team cohesion, and
team potency. Finally, we outlined organizational outcomes of successful leadership
including psychosocial safety climate, organizational change readiness, and ethical
organizational culture. These individual, team, and organizational outcomes are also
related to broader effective functioning of a workplace. These positive outcomes of
leadership are often used to support investment in leadership development initia-
tives. While there is evidence for the relationship between effective leadership and
these outcomes much of the evidence is correlational in nature or fails to account for
external factors/moderators. This gap in knowledge presents an issue for investment
into leadership development programs. Hence there is a need for more research on
leadership broadly, but also on leadership development utilizing good experimental
designs and assessing outcomes over time. The moderators of successful leadership
were discussed and the opportunities for future research, adopting a causal model-
ling of leadership effects and exploring leadership through an economic lens were
discussed as the challenges and opportunities for future research. Leadership can
have a profound impact on the health and wellbeing of individuals, teams, and
organizations and we look forward to further advancements in this field.

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Servant Leadership
Influence on Well-Being
3
Kathleen Bentein and Alexandra Panaccio

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Servant Leadership and Well-Being: An Overview of the Empirical Literature . . . . . . . . . . . . . . . . 47
Servant Leadership and Hedonic Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Servant Leadership and Eudaimonic Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Servant Leadership and Ill-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Servant Leadership and Well-Being: Theoretical Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Servant Leadership and Well-Being: What to Do Next? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Abstract
Servant leadership theory puts a strong emphasis on leading by serving followers
that is unique among leadership approaches and explicitly posits that organiza-
tional performance is a by-product of employees’ well-being. However, the
empirical literature has only begun to explore the link between servant leadership
and well-being, and our understanding of this relationship remains underdevel-
oped. The current chapter seeks to provide an overview of theory and empirical
evidence on servant leadership and well-being, addressing the two following
questions: (a) what do we know about the relationship(s) between servant lead-
ership and well-being and (b) what theoretical mechanisms are used by
researchers to explain these relationships? Based on a qualitative state of the

K. Bentein (*)
School of Business Administration (ESG), University of Quebec at Montreal (UQAM), Montreal,
QC, Canada
e-mail: [email protected]
A. Panaccio
John Molson School of Business, Concordia University, Montreal, QC, Canada

© Springer Nature Switzerland AG 2022 43

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_43
44 K. Bentein and A. Panaccio

science review addressing these two questions, challenges and opportunities for
future research are discussed.

Keywords
Servant leadership · Well-being · Job demands-resources model · Conservation of
resources theory · Broaden-and-build theory · Resource allocation theories · Self-
determination theory

Introduction

Over the past decades, the concept of servant leadership has garnered increasing
attention from both practitioners and academics (e.g., Eva et al. 2019). This might be
explained by a current demand for more ethical, pro-social, and people-centered
management leadership and for organizations to show greater concern for the
community in which they are embedded (van Dierendonck 2011). Servant leadership
has its roots in the seminal work of Greenleaf (1977, 1991), in which servant
leadership is described not as a management technique but as a way of life, which
starts with a “natural feeling that one wants to serve, to serve first” (Greenleaf 1977,
p. 14). Eva et al. (2019) defined servant leadership as “an (1) other-oriented approach
to leadership (2) manifested through one-on-one prioritizing of follower individual
needs and interests, (3) and outward reorienting of their concern for self towards
concern for others within the organization and the larger community” (p. 114). This
definition emphasizes three key elements. First, the motive of servant leadership is
serving others. Second, the mode of servant leadership is based upon the recognition
that each follower is unique and has different needs and interests and that the servant
leader promotes the self-growth and well-being of each ones. Finally, the mindset of
servant leadership reflects that the focus on follower development occurs within an
overarching concern for the larger community.
While servant leadership shares conceptual similarities with other leadership
styles, it is often distinguished from other approaches by its prioritization of fol-
lowers’ needs above those of the organization and of the leaders themselves (Eva
et al. 2019; van Dierendonck 2011). However, servant leadership further differs from
other leadership styles in that the servant leader is sensitive to the needs of all
stakeholders, including the community in which the organization is embedded and
society as a whole (Graham 1991). In sum, servant leadership’s focus on multiple
stakeholders is what distinguishes it most clearly from other approaches (e.g.,
Lemoine et al. 2019). Servant leadership has also been distinguished empirically
from other leadership approaches. Indeed, three recent meta-analyses (Banks et al.
2018; Hoch et al. 2018; Lee et al. 2020) provided empirical evidence that servant
leadership predicted additional variance in various follower outcomes above and
beyond other leadership styles, such as transformational leadership (Hoch et al.
2018) or authentic and ethical leaderships (Lee et al. 2020). Comparative studies
(e.g., Neubert et al. 2008; van Dierendonck et al. 2014) also demonstrated how
3 Servant Leadership 45

servant leadership influences outcomes through distinctive mediating mechanisms.

Van Dierendonck et al. (2014) specifically addressed the potential overlap between
servant leadership and transformational leadership and found that servant leadership
worked primarily through follower’s need satisfaction, whereas transformational
leadership worked mainly through perceived leadership effectiveness. All these
empirical results support the idea that servant leadership is unique and distinct
from other leadership styles.
While for many years servant leadership did not attract much scholarly attention,
the past few years have seen a sharp increase in the number of academic publications
on the topic. Unfortunately, few studies have clearly articulated the theoretical
mechanisms through which servant leadership was proposed to affect the selected
outcomes. Recent reviews of the servant leadership literature reveal that, among the
few studies that did propose a theoretical explanation for the proposed relationships,
social exchange theory and social learning theory were the two theoretical frame-
works most often used (Eva et al. 2019; Lemoine et al. 2019; Madison and Eva
2019).
Social exchange theory (Blau 1964) guided by the norm of reciprocity (Gouldner
1960) has been used to suggest that servant leaders develop a strong exchange
relationship with their followers, by providing them with valued resources. That
is, by focusing on the growth and development of each of their followers, the servant
leader creates a sense of obligation within their follower, where they feel compelled
to reciprocate and to return the positive behaviors the servant leader exhibits toward
them. The other theory which has been used, social learning theory (Bandura 1977),
suggests that followers observe their servant leaders’ behaviors because they are
attractive role models and learn from them the servant leadership attitudes and
behaviors through modeling. Servant leaders are seen as credible role models
because they lead by putting their employees first, above their own needs, and act
altruistically. This theory resonates with Greenleaf’s (1991) assertion that servant
leaders are likely to transform their followers into servant leaders themselves.
While social exchange theory focuses on the dyadic relationship and exchanges
between the leader and the follower, social learning theory may better explain how
other stakeholders might benefit from the servant leader’s actions (Bao et al. 2018).
These two theoretical frameworks are promising to better understand the workings
of servant leadership, but much work remains to be done to truly uncover the
mechanisms involved. Indeed, even in studies where a theoretical framework is
presented, it is often unclear how this framework guided the choice of variables or
explains the nature of their relationships with servant leadership. Moreover, these
mechanisms are not specific to servant leadership but commonly used to explain the
effects of all forms of “moral” – ethical, authentic, and servant – leadership
(Lemoine et al. 2019).
Servant leadership explicitly posits that organizational performance is a
by-product of employees’ well-being (Frick 2004; Greenleaf 1977). Thus, the
questions of (a) whether/how servant leadership relates to well-being and (b) what
theoretical mechanisms may explain this relationship are of paramount importance
to better understand the contribution of servant leadership as a worthwhile leadership
46 K. Bentein and A. Panaccio

approach. It is thus not surprising that, with the rise in the number of academic
publications on servant leadership, studies on the relationships between servant
leadership and well-being – be it employee or, more rarely, team, organizational,
or community well-being – have also been proliferating. The state of the literature is
thus quite different from what it was just a few years ago, when scholars reflecting on
the servant leadership-well-being relationship noted the glaring lack of empirical
evidence on the topic (e.g., Panaccio et al. 2015). However, this body of work lacks
integration and, possibly due to the absence of a clear theoretical framework, has a
number of blind spots.
This chapter seeks to provide an overview of theory and empirical evidence on
servant leadership and well-being, addressing the questions of (a) what we know
about servant leadership and well-being and (b) what theoretical mechanisms may
explain these relationships, in order to then propose avenues for future research. We
thus started by reviewing the literature on servant leadership and well-being. While
this review does not claim to be exhaustive, we sought to produce an overview of the
state of academic knowledge by including all peer-reviewed journals and adopting a
broad conceptualization of the term “well-being.” We extracted the key findings
from this body of work which, combined with a reflection on underlying theoretical
mechanisms, would allow us to propose meaningful directions for future research on
servant leadership and well-being. Drawing on our research questions, we have
structured this chapter into four main sections. First, we describe the methodology
used to conduct our literature review, including the way we conceptualized well-
being for this purpose. We then present the results of this review, focusing in
empirical articles and seeking to answer the first question: what do we know about
servant leadership and well-being? In the following section, we explore the theoret-
ical mechanisms that may explain these relationships, drawing on the results from
our review of the servant leadership literature. In the fourth section, we conclude by
proposing directions for future research.

Methodology

Before describing the methodology we used to search the literature on servant

leadership and well-being, it is useful to briefly present how we conceptualized
and consequently captured the notion of well-being. Because there is much diversity
across concepts of well-being and a considerable body of literature has developed
over the past 50 years, we adopted an integrative perspective in the current paper.
Consistent with the proposition of Ryan et al. (2008), we see well-being as an
umbrella term that includes two broad categories of more specific constructs:
hedonic well-being constructs and eudaimonic well-being constructs. Hedonic
well-being constructs are concerned with the subjective experience of pleasure.
Some constructs refer to this subjective experience of pleasure as an affective or
emotional reaction to events, such as experiencing positive affects like happiness or
joy and not experiencing negative affects like sadness, anger, and stress. Other
constructs refer to this subjective experience of pleasure as a cognitive evaluation,
3 Servant Leadership 47

such as thoughts about the quality or goodness of the life in general (life satisfaction)
or the work situation in particular (job satisfaction). Often seen as complementary to
the hedonic perspective (e.g., Keyes 2005), eudaimonic well-being constructs are
concerned with the subjective experience of personal fulfillment and the realization
of human potential, such as self-actualization, the meaning and purpose of one’s
work, or thriving. The concept of flourishing has sometimes been used to encompass
both hedonic and eudaimonic well-being (e.g., Keyes 2005). Note that despite the
great differences between these constructs, most “well-being” researchers believe
that this phenomenon is multifaceted and includes a combination, or even all, of
these aspects (e.g., Diener 2009; Sirgy 2012). This broad conceptualization of well-
being guided the choice of the search terms used in our review of the literature, as
described below.
To address our research questions, in order to get a picture of the state of
knowledge on servant leadership and well-being, we conducted a review of scholarly
articles and book chapters on the topic. We searched the ABI/Inform Collection,
PsycINFO, and Web of Science databases and, for the year 2020, Google Scholar
using servant leader/leadership with a series of keywords which, according the broad
conceptualization which we adopted, pertained to well-being or its opposite,
ill-being. For instance, on the positive side, we included keywords such as affect,
eudaimonia, flourishing, health, happiness, hedonia, satisfaction, self-actualization,
thriving, welfare, and well-being. To capture the negative side of well-being, we
included keywords such as burnout, distress, exhaustion, ill-being, and stress. We
included all countries and years of publications but restricted the search to English-
language publications. We then examined the results based on relevance, for
instance, eliminating articles that were neither empirical nor conceptual. Among
empirical articles, we retained studies where servant leadership was included as a
substantive or control variable in the model.

Servant Leadership and Well-Being: An Overview of the Empirical

Literature

Although non-exhaustive, our review of empirical articles published on servant

leadership and well-being reveals some clear trends. First, the topic is increasingly
popular among scholars, as the majority of studies on servant leadership and well-
being topic was published in the last 10 years, with a notable increase in the past
3 years. Second, the vast majority of articles examined servant leadership as a
predictor of well-being. Indeed, only a handful of studies examined servant leader-
ship as a contextual variable which could moderate relationships between other
predictors and well-being variables, and even fewer considered well-being as pre-
dictor of servant leadership behaviors. Third, the outcomes most often studied fall
under the broad umbrella of employee well-being, as fewer studies examined, for
instance, the well-being of other stakeholders such as the leader him-/herself. Fourth,
the breadth of well-being variables studied in relation with servant leadership
remains relatively limited, with one hedonic variable – satisfaction – and one
48 K. Bentein and A. Panaccio

eudaimonic variable, work engagement, receiving the most attention. Finally, very
few studies addressed the team or group level of analysis, the vast majority exam-
ining individual-level variables. Having provided this general overview, we now
present these studies’ findings in more detail.

Servant Leadership and Hedonic Well-Being

One of the first observations that emerges from our review of the literature is that
servant leadership appears to be positively related to employee hedonic positive well-
being. Satisfaction – whether it is with one’s job, career, or life – is the most studied
facet of hedonic well-being in relation to servant leadership, which is not surprising
given the topic’s popularity in the management and organizational behavior literatures.
Consistent with servant leadership theory, an abundance of studies suggests that
employees who are supervised by a servant leader experience greater job satisfaction
(e.g., Barbuto and Wheeler 2006; Donia et al. 2016; Ilkhanizadeh and Karatepe 2018;
Mayer et al. 2008; van Dierendonck and Nuijten 2011; see also meta-analyses by
Zhang et al. 2019b; and Stein et al. 2020). Stein et al.’s (2020) meta-analysis suggested
there are no significant differences in the size of this relationship between Anglo-
Saxon and Chinese employees. Studies also suggest servant leadership is associated
with greater career satisfaction (e.g., Ilkhanizadeh and Karatepe 2018; Kaya and
Karatepe 2020; Latif et al. 2020; Wang et al. 2019b) and greater life satisfaction
(e.g., Hakanen and van Dierendonck 2011; Ilkhanizadeh and Karatepe 2018; Latif
et al. 2020; Li et al. 2018; Upadyaya et al. 2016), and a recent study suggests
employees of servant leaders experience greater satisfaction with their work-family
balance (Meng et al. 2020). In one of the rare studies examining a) the servant
leadership – satisfaction at the group level – and b) the satisfaction of stakeholders
other than employees, Neubert et al. (2016) found unit-level servant leadership to
predict unit-level job satisfaction in a sample of nurses and, via nurse job satisfaction,
patient satisfaction with nursing and pain management.
Scholars have proposed several variables to mediate these relationships. For
instance, Mayer et al. (2008) found employee perceptions of organizational justice
and need satisfaction to mediate the relationship between servant leadership and job
satisfaction, while Chan and Mak (2014) found trust in the leader to mediate this
relationship. According to Wang et al.’s (2019b) study, career skills mediated the
relationship between servant leadership and career satisfaction. Hakanen and van
Dierendonck’s (2011) study suggested servant leadership’s relationship with life
satisfaction is mediated by justice, job control, and (negatively) burnout;
Ilkhanizadeh and Karatepe’s (2018) study suggested these relationships are mediated
by job and career satisfaction and Latif et al.’s (2020) by career satisfaction. In one of
the few studies examining facets of hedonic employee well-being other than satis-
faction, Li et al. (2018) found employee workplace positive affect to mediate the
relationship between servant leadership and life satisfaction. Mindfulness was found
to mediate the relationship between servant leadership and employee satisfaction
with their work-life balance (Meng et al. 2020).
3 Servant Leadership 49

Fewer studies have examined moderators of the relationships between servant

leadership and satisfaction, but some studies suggest the existence of boundary
conditions enhancing or reducing the strength of these relationships. For instance,
Neubert et al. (2016) found that team-level servant leadership was only related to
patient satisfaction via nurse job satisfaction at high levels of organizational structure
or formalized prescriptions for how organizational members related to another and
complete their work. Examining the role of employee motives as boundary condi-
tions of the servant leadership-job satisfaction relationship, Donia et al. (2016) found
that servant leadership was less strongly associated with job satisfaction among
employees with self-serving, impression management motives. Wang et al. (2019b)
found that the relationship between servant leadership and career satisfaction via
career skills was stronger among highly proactive employees. Li et al. (2018) found
that the positive indirect relationship between servant leadership and employee life
satisfaction via workplace positive affect was stronger among employees with a high
collectivistic orientation and those with high self-efficacy. Recently, looking at
servant leadership as a contextual factor moderating the relationship between new-
comers’ proactive behaviors and job satisfaction, Bauer et al. (2019) found that this
relationship was stronger under conditions of low servant leadership. This suggests
servant leaders may provide an environment which reduces the need for proactivity
from followers, while conversely, proactive followers may be able to compensate for
leadership deficiencies. As a whole, these results indicate that followers of servant
leaders tend to experience greater satisfaction with their job, career, and life, but
more research is needed to understand the mechanisms underlying these relation-
ships. There is also a need for more research on relationships between servant
leadership and facets of hedonic well-being other than employee satisfaction.

Servant Leadership and Eudaimonic Well-Being

Looking beyond hedonic well-being, the most studied variable is employee work
engagement, and considerable empirical evidence shows servant leadership to be
positively associated with this outcome (e.g., Bao et al. 2018; Chughtai 2018;
Coetzer et al. 2017; De Clercq et al. 2014; Kaya and Karatepe 2020; Ling et al.
2017; Peng and Chen 2020; Upadyaya et al. 2016; van Dierendonck and Nuijten
2011; van Dierendonck et al. 2014; Yang et al. 2017), including in particularly
challenging contexts such as mergers (de Sousa and van Dierendonck 2014).
Looking at mediating mechanisms, de Sousa and Van Dierendonck et al. (2014)
found servant leadership to be associated with employee work engagement via
organizational identification and psychological empowerment, while van
Dierendonck et al. (2014) found need satisfaction to mediate this relationship.
Yang et al. (2017) found job crafting to be a partial mediator of the positive
relationship between servant leadership and engagement, while Bao et al. (2018)
found leader member exchange (LMX) to mediate this relationship. In a recent study
with public sector employees, Shim et al. (2020) found that servant leaders contrib-
uted to employee engagement via job autonomy, goal specificity, public service
50 K. Bentein and A. Panaccio

motivation, and organizational trust. In two of the rare multilevel studies of servant
leadership, Ling et al. (2017) found that group-level servant leadership was posi-
tively associated with employee-level work engagement via a climate of trust, while
Peng and Chen (2020) found that employee work engagement and concern climate
mediated a positive relationship between branch-level servant leadership and indi-
vidual employee service performance. Taken as a whole, these results suggest that
followers of servant leaders tend to experience more work engagement, but the
mechanisms through which this may occur are only starting to be uncovered.
Finally, servant leadership may also enhance or buffer relationships between
other variables and work engagement: in one of the rare studies examining
servant leadership as a contextual factor moderating the impact of other pre-
dictors on well-being variables, Zhang et al. (2019a) found this leadership style to
moderate the relationship between challenge stressors and work engagement such
that it was positive among employees working with a servant leader and nonsig-
nificant among those working under conditions of low servant leadership. Again,
more research is needed to better understand such moderating effects, but these
findings suggest servant leadership may contribute in different ways to employee
well-being.
While studies on servant leadership and other eudaimonic well-being vari-
ables are relatively scarce, existing evidence suggests this leadership style is
beneficial in this regard. For instance, recent studies have shown servant leader-
ship to be positively related to employee thriving at work (e.g., Iqbal et al. 2020;
Wang et al. 2019a), meaningful work (e.g., Cai et al. 2018), and meaning in life
(e.g., Rodríguez-Carvajal et al. 2019). Chen et al. (2013) found a marginally
significant positive relationship between self-rated servant leadership and
employee self-acceptance, a dimension of eudaimonic well-being. Other studies
have shown positive associations between servant leadership and a global mea-
sure of employee eudaimonic well-being, combining facets such as self-
acceptance, mastery, and positive relations with others (e.g., Clarence et al.
2020; der Kinderen et al. 2020). Clarence et al. (2020) found that this positive
relationship between servant leadership and well-being was mediated by psycho-
logical capital, while der Kinderen et al. (2020), interestingly, found work
engagement to mediate the positive relationship between servant leadership and
other facets of eudaimonic well-being.
In one of the few studies examining servant leadership in relation with team-level
well-being outcomes, Xu and Wang (2019) found servant leadership to be positively
associated with collective thriving via team high-quality member exchange (TMX).
Relatedly, in one of the rare multilevel studies aimed at examining the impact of
servant leadership on various stakeholders conducted to date, Giolito et al. (2020)
found this leadership style to be positively associated with employee flourishing at
the individual level and to contribute to unit-level profit growth via group-level
employee flourishing. Interestingly, power distance orientation moderated these
effects at the individual level, such that the relationship between servant leadership
and flourishing was weaker among employees high on power distance but no such
effects were observed at the group level.
3 Servant Leadership 51

Servant Leadership and Ill-Being

Turning to ill-being, or the negative side of well-being, one of the most frequently
studied outcomes in relation to servant leadership is employee burnout, or its main
component, emotional exhaustion. Studies have consistently found negative rela-
tionships between servant leadership and these outcomes (e.g., Babakus et al. 2010;
Hakanen and van Dierendonck 2011; Tang et al. 2016; Upadyaya et al. 2016). Zhang
et al.’s (2019b) meta-analysis, although conducted on a very small number of
studies, also showed a negative relationship between servant leadership and emo-
tional exhaustion. A study by Rivkin et al. (2014) further suggested that servant
leadership is negatively related to depersonalization, another dimension of burnout,
in addition to emotional exhaustion. A recent study by Obi et al. (2020) in a sample
of religious sisters suggested servant leadership is indirectly (negatively) related to
employee emotional exhaustion via a negative relationship with forcing behavior.
In addition to burnout and its manifestations, empirical evidence suggests servant
leadership is negatively related to employee depressive symptoms (e.g., Upadyaya
et al. 2016) and job stress (e.g., Jaramillo et al. 2009) and, indirectly, to other mental
health diagnoses and workaholism (e.g., Upadyaya et al. 2016). A study by Tang
et al. (2016) suggests servant leadership is indirectly (negatively) related to work-
family conflict via emotional exhaustion. Recently, in one of the rare studies a)
exploring emotions in relation with servant leadership and b) examining servant
leadership behaviors as a dependent variable, Stollberger et al. (in press) found that
leaders’ perception of anger from their own manager was negatively associated with
manifestations of servant leadership behavior via (lower) perceived manager moral
behavior.
Looking beyond the direct relationships between servant leadership and ill-being
variables, a handful of studies have examined servant leadership’s role as a moder-
ating variable, buffering or enhancing relationships between predictors and facets of
ill-being. Upadyaya et al. (2016) found that servant leadership moderated the
association between high workload and burnout and depressive symptoms such
that these relationships were weaker under conditions of high servant leadership.
Similarly, Zhang et al. (2019a) found this leadership style to reduce the strength of
the (positive) relationship between challenge stressors and burnout. Recently, Wu
et al. (2020) also found that servant leadership reduced the strength of the positive
relationship between challenge stressors and burnout but, surprisingly, found that it
enhanced the strength of the positive relationship between hindrance stressors and
emotional exhaustion in a sample of Chinese schoolteachers. In a rare study exam-
ining servant leadership as a moderator of relationships between well-being and
other outcomes, Bande et al. (2015) found that it reduced the strength of the positive
association between emotional exhaustion and turnover intentions in employees
working in sales, such that this relationship became nonsignificant when these
employees worked under the supervision of a servant leader.
Recently, scholars have begun to examine how adopting servant leadership
behaviors may impact the leader’s own well-being (e.g., Zhou et al. 2020; Liao
et al. in press). Interestingly, findings suggest being a servant leader may not always
52 K. Bentein and A. Panaccio

benefit the leader. Indeed, Zhou et al. (2020) found servant leadership to be posi-
tively associated with leader emotional exhaustion, which in turn led to more
perceived work-family conflict. Conscientiousness moderated this relationship,
however, such that the relationship between servant leadership and emotional
exhaustion was nonsignificant among highly conscientious leaders. Interestingly,
in another recent study, Liao et al. (in press) found that engaging in servant
leadership behaviors was associated with feelings of depletion among leaders who
were low on perspective taking but reduced such feelings among leaders who were
high on perspective taking.
This overview of the empirical literature on servant leadership and well-being
leads to the tentative general conclusion that this approach fulfils its promise of
contributing positively to followers’ well-being. Indeed, most studies suggest a
positive impact of servant leadership on employee well-being, either directly, indi-
rectly, or via a moderating role. These results must be balanced against preliminary
evidence suggesting that this may be, in some cases, at the expense of the leader’s
own well-being. However, drawing firm conclusions from this body of work remains
hazardous given the lack of integration between theoretical and empirical work, the
lack of integration between the studies, the methodological limitations often stem-
ming from the use of cross-sectional single-source research designs, and the relative
small number of studies. In the next section, we turn to the theoretical mechanisms
underlying the relationships between servant leadership and well-being, drawing
from the servant leadership literature.

Servant Leadership and Well-Being: Theoretical Mechanisms

As noted earlier, reviewed empirical studies rarely provide a strong theoretical basis
for the mechanisms or processes that explain how and/or why servant leadership is
related to well-being. Some studies do not mention a theoretical framework at all.
Other studies, even if they mention some theoretical framework(s), do not provide
well-developed theoretical justifications for the choice of the studied variables or an
explanation for the mechanisms at play between servant leadership and employee
well-being variables.
As was noted above, among studies that provide a theoretical framework as a
basis for their empirical work, many papers draw on the classical social exchange
theory. These studies investigate the role of relational variables, in particular
followers’ trust (i.e., Chan and Mak 2014; Ilkhanizadeh and Karatepe 2018; Kim
and Kim 2017), leader-member exchange (i.e., Akdol and Arikboga 2017; Amah
2018; Bao et al. 2018), and team-member exchange (i.e., Xu and Wang 2019), in
mediating relationships between servant leadership and well-being-related out-
comes. As social exchange theory is built on the notion of reciprocation by the
employee for positive behaviors from the leader, the use of this theory seems
justified to explain what could be considered “performance-related” well-being
outcomes such as work engagement. However, social exchange theory seems
3 Servant Leadership 53

ill-fitted to explain other employee-centered well-being outcomes such as job or life

satisfaction.
Social learning theory, the second classical framework used to explain the
workings of servant leadership, is rarely used in empirical studies linking servant
leadership and well-being. Even if some studies mention it (i.e., Bao et al. 2018;
Neubert et al. 2016), none of the studies included in our review used social learning
theory as their main theoretical framework to support the specific link between
servant leadership and well-being. This, however, is not particularly surprising as
this theory focuses on how followers learn specific behaviors from leaders through
role modeling and then emulate these behaviors. Like social exchange theory, this
theory thus seems more appropriate to explain how servant leadership might lead to
performance-related attitudes or behaviors, such as public service motivation or
helping behaviors, than to explain its relationship with employee-centered well-
being-related outcomes.
Interestingly, the overwhelming majority of theoretically-grounded empirical
studies linking servant leadership and well-being refer to other theoretical
approaches. The job demands-resources model (JD-R, Bakker and Demerouti
2007, 2014; Demerouti et al. 2001) and conservation of resources theory (COR;
Hobfoll 1989, 2001) are the two most popular theoretical frameworks. Others, such
as the broaden-and-build theory of positive emotions (Fredrickson 1998, 2000;
Fredrickson and Branigan 2005), resource allocation theories of self-control
(Baumeister et al. 1998; Muraven and Baumeister 2000), and self-determination
theory (SDT – Deci and Ryan 2000; Ryan et al. 2008) have also been used, although
less often. In the next paragraphs, we briefly present each of these frameworks and
describe in general terms how each one might explain the relationship between
servant leadership and well-being. We then give examples of studies having used
these frameworks to illustrate how these theories have been utilized in the literature.
The job demands-resources model (JD-R model) is one of the leading models
used by scholars to explain the relationship between servant leadership and well-
being. The JD-R model proposes that high job demands lead – via burnout – to
negative outcomes, which constitute the stress process, whereas job resources lead,
via work engagement, to positive outcomes, which represents the motivational
process (Bakker and Demerouti 2007, 2014; Demerouti et al. 2001). Burnout is
typically described as a reaction to chronic occupational stress characterized by
emotional exhaustion, a distant attitude toward work in general or toward the
recipients of one’s service or care, and reduced personal accomplishment or profes-
sional efficacy (Bakker and Demerouti 2014). Engagement, in contrast, is defined as
“a positive, fulfilling, work-related state of mind that is characterized by vigor,
dedication, and absorption” (Schaufeli et al. 2002, p. 74). Both burnout and engage-
ment constructs thus reflect distinct but related dimensions of employees’ well-
being.
In studies using the JD-R model as the main theoretical framework, some authors
position servant leadership as a “separate variable” that influences job resources
and/or job demands (e.g., Coetzer et al. 2017, p. 7; Shim et al. 2020), without
theorizing its specific nature, whereas other authors precisely define servant
54 K. Bentein and A. Panaccio

leadership as a job resource in the workplace (e.g., Bao et al. 2018; Upadyaya et al.
2016). However, it must be noted that this view of leadership as a resource is not
specific to servant leadership and has been considered to be “leader-centric,” not
necessarily accounting for the followers’ state of mind (Perko et al. 2016).
Among the many empirical studies supporting a positive association between
servant leadership and work engagement, a few provide preliminary evidence of the
mediating role of job resources in this process. Indeed, Coetzer et al. (2017) found
that the empowerment and humility dimensions of servant leadership positively
influenced job resources (consisting of organizational support, supervisory support,
and job clarity) and that higher job resources, in turn, predicted work engagement.
More recently, Shim et al. (2020) found that resources such as job autonomy and
goal specificity mediated servant leadership’s relationship with engagement. These
results tend to support the idea that servant leadership fuels the motivational process
proposed in the JD-R model.
In a handful of empirical studies drawing on the JD-R model, servant leadership
was also positioned as a moderator, proposed to weaken the relationship between job
demands and burnout (e.g., Upadyaya et al. 2016; Wu et al. 2020; Zhang et al.
2019a) or to amplify the positive effects of challenging job demands on work
engagement (Zhang et al. 2019a). Results of these studies provide the first empirical
support to the proposition put forward by JD-R theorists that job demands and
resources interact in predicting well-being (Bakker and Demerouti 2014). Based
on Upadyaya et al.’s (2016) and Zhang et al.’s (2019a) findings, employees
supported by a servant leader may have many job resources available to cope better
with their job demands (job resources buffer the impact of job demands on burnout –
first interaction). Moreover, servant leadership becomes more salient and has the
strongest positive impact on work engagement when job demands are high (second
interaction – see Zhang et al. 2019a). However, the surprising enhancing effect
found by Wu et al. (2020) on the relationship between hindrance stressors and
emotional exhaustion suggests more work is needed in this area.
Conservation of resources theory (COR theory, Hobfoll 1989, 2001) is
another leading model used to explain the relationship between servant leadership
and well-being. This theory is complementary to the JD-R model but emphasizes the
role of resources. A key premise of COR theory is that people are fundamentally
motivated to gain resources or “things” (objects, personal characteristics, conditions,
and energies) they value and seek to obtain new resources, protect existing ones,
and restore the old ones (the resource gain premise), because those resources help
them to cope with psychological stress. The theory predicts that stress might
result from the actual loss of resources, threat of resource loss, or failing to gain
resources following an investment of resources (Hobfoll SE 1988). It further claims
that sustained psychological stress emanating from any of these three paths can lead
to burnout.
Some researchers have used COR theory as a framework to explain how
servant leaders may provide personal resources to their employees, such as
psychological capital (e.g., Karatepe and Talebzadeh 2016) or self-efficacy
(e.g., Zhong et al. 2020) and via these resources impact follower well-being
3 Servant Leadership 55

(e.g., work engagement; Karatepe and Talebzadeh 2016) or other outcomes.

Others, in perfect alignment with the proposition of researchers who based their
work on the JD-R model, view servant leadership itself as a resource, directly
influencing well-being outcomes such as work engagement (e.g., Upadyaya and
Salmela-Aro 2020; Upadyaya et al. 2016), burnout (e.g., Babakus et al. 2010;
Upadyaya and Salmela-Aro 2020; Upadyaya et al. 2016), or its main dimension,
emotional exhaustion (e.g., Tang et al. 2016).
Relatedly, some researchers have described servant leadership as a contextual
resource that shapes personal resources for employees (e.g., der Kinderen et al.
2020). Indeed, Hobfoll (2001) included among key personal resources the feeling
that life has meaning or purpose, or a sense of mastery of one’s life, which
correspond to the eudaimonic well-being concept. Results of der Kinderen et al.’s
(2020) study showed that servant leadership is positively related to followers’ well-
being and that as a macro resource, workplace civility climate works as a boundary
condition to enable or restrain the ability of servant leaders to affect well-being. In
terms of COR theory, these results seem to support the proposition that servant
leadership is a contextual resource which impacts personal resources and that a
macro resource may act as a boundary factor which impacts the power of this
relationship. As underlined by the authors (der Kinderen et al. 2020), these results
also support the categorization of different contextual resources according to their
functions suggested by Ten Brummelhuis and Bakker (2012). Taken together, these
empirical results support one of the basic tenets of COR theory, which is that servant
leadership involves resource gains or substitutions that can help employees in coping
with job burnout.
The broaden-and-build theory of positive emotions (Fredrickson 1998, 2000;
Fredrickson and Branigan 2005) states that certain discrete positive emotions (e.g.,
joy, interest, contentment, pride, and love) have the ability to broaden people’s
momentary thought-action repertoires, widening the array of the thoughts and
actions that come to mind (e.g., to play, to explore, to savor and integrate, or to
envision future achievement). This is in direct contrast to negative emotions, which
narrow a person’s momentary thought-action repertoire by calling to mind an urge to
act in a particular way (e.g., to escape, to attack, to expel). These broaden mindsets
have indirect and long-term adaptive benefits, as they build enduring personal
resources, ranging from physical and intellectual resources to social and psycholog-
ical resources, in which people can later draw to manage future threats.
One example of an empirical study which used this theory to explain the
relationship between servant leadership and well-being is Li et al. (2018). These
authors suggested that servant leadership is likely to enhance employees’ positive
affect in the workplace, because they act beyond self-interest and place followers and
their needs at the center of their focus and form good interpersonal connections with
them. By broadening individuals’ thought-action repertoires and facilitating the
accumulation of resources, workplace positive affect will then spill over to the
overall life domain, promoting general life satisfaction among employees. Their
empirical results provided support for the mediation of the relationship between
servant leadership and life satisfaction through workplace positive affect.
56 K. Bentein and A. Panaccio

Another example is Rodríguez-Carvajal et al.’s (2019) daily study which exam-

ined the role of vitality or the conscious positive experience of individuals having
energy available for themselves, as a mediator between servant leadership and goal
attainment. Their study showed that daily servant leadership at work during the day
is positively related to meaning in life at night, which is itself positively related to
daily vitality the following morning. They further found that this enhancement in
vitality level increases goal attainment after work, supporting the broaden-and-build
assertions. Also anchored in the broaden-and-build theory, Clarence et al.’s (2020)
study showed that servant leadership is positively related to followers’ psychological
well-being, through the building of a set of three enduring personal resources: hope,
efficacy, and resilience, which together corresponds to psychological capital.
Resource allocation theories of self-control (Baumeister et al. 1998; Johnson
et al. 2017; Muraven and Baumeister 2000) posit that individuals have a finite pool
of resources available for self-regulation and that exercising self-control drains
individuals’ resources. When these resources are depleted, people tend to show
diminished self-control on subsequent activities until they have had opportunities
for rest or recovery activities (Johnson et al. 2018). These theories have been used to
explain the link between servant leadership behaviors and the leader’s own well-
being (e.g., Liao et al. in press; Zhou et al. 2020). From this perspective, engaging in
servant leadership behaviors consumes self-regulatory resources of the leader, as
leaders must use self-control to overcome the tendency to pursue self-interest and to
take into consideration the interests of a variety of stakeholders in making their
decisions. This will lead them to depletion, and eventually to a diminution of their
efforts in their subsequent action. Zhou et al.’s (2020) results confirmed a positive
daily relationship between servant leadership behaviors and leader emotional
exhaustion and between leader emotional exhaustion and leader work-family con-
flict. Two experience sampling studies conducted by Liao et al. (in press) suggested
that manifesting servant leadership behaviors may not be detrimental to all leaders:
results showed that only managers who were generally low in perspective taking felt
depleted after exhibiting servant behaviors on a given day, which in turn increased
their laissez-faire behaviors the following day. Liao et al.’s (in press) results further
showed not only that daily servant leadership behaviors consume less self-control
resources for high-perspective-taking leaders but also that, for them, servant behav-
iors could be replenishing.
Self-determination theory (SDT – Deci and Ryan 2000; Ryan et al. 2008) is a
general theory of human motivation based on the following four premises: (a) human
beings are proactive organisms that have an inherent tendency to shape and optimize
their own life conditions in order to develop and grow toward their fullest potential;
(b) this natural growth tendency requires specific nutriments, in the form of satis-
faction of three basic psychological needs: the need for autonomy, the need for
competence, and the need for relatedness; (c) satisfaction of the three basic psycho-
logical needs stems from the dialectic between the active organism and its social
context. Social contexts that are supportive, congruent with, and validate an indi-
vidual’s true self are particularly likely to facilitate need fulfillment; and finally,
(d) there is a critical distinction between behaviors that are volitional and
3 Servant Leadership 57

accompanied by the experience of freedom and autonomy – those that emanate from
one’s sense of self-and those that are accompanied by the experience of pressure and
control and are not representative of one’s self. Intrinsically motivated behaviors
represent the prototype of self-determined activity as they are performed out of
interest and satisfy the innate psychological needs. Extrinsically motivated behav-
iors, those that are executed because they are dependent on contingent outcomes that
are separable from the action per se, can vary in the extent to which they represent
self-determination. Internalization and integration are the processes through which
extrinsically motivated behaviors become more self-determined (Deci and Ryan
2000).
Drawing on SDT, Mayer et al. (2008) and van Dierendonck et al. (2014) showed a
positive link between servant leadership and a global construct corresponding to
“overall need satisfaction.” Going a step further, Chiniara and Bentein (2016)
suggested that servant leaders’ distinctive focus on meeting followers needs leads
them to recognize SDT’s three distinct basic psychological needs and contribute to
their fulfillment. Their empirical results supported this assertion as they found a
positive relationship between servant leadership and satisfaction of each of the three
needs: autonomy, competence, and relatedness. Also drawing on SDT, Chen et al.
(2013) suggested that servant leadership, because it emphasizes trust and empower-
ment, provides subordinates with a higher sense of autonomy and meaningfulness,
which improves their intrinsic motivation and increases their eudaimonic well-being.
Their empirical results confirmed that servant leadership is positively related to
subordinate’s eudaimonic well-being via employees’ intrinsic motivation. However,
their study also showed that, in addition to intrinsic motivation, two other forms of
work motivation, one also autonomous (identified regulation) and one controlled
(external regulation), significantly mediated relationships between servant leader-
ship and well-being. These results suggest that servant leadership might have an
effect on both intrinsic and extrinsic motivations.

Servant Leadership and Well-Being: What to Do Next?

In this section, we summarize the key outcomes of our review, and, combining these
with our theoretical reflection, we propose directions for future research. As our
review shows, while scholars now seem to be conducting research on the links
between servant leadership and well-being at an accelerated pace, several areas
remain under-explored. First, empirical studies have largely focused on a few
specific facets of hedonic and eudaimonic well-being (viz., satisfaction and work
engagement on the positive side and burnout on the negative side), neglecting other
well-being constructs. In addition, notably absent from our review were empirical
studies including physical measures of well-being (e.g., physiological indicators of
stress, sleep quality). This is consistent with what Inceoglu et al. (2018) concluded
based on a state of the science review of the processes by which leadership behaviors
in general (without focusing on one style in particular) impact employee well-being.
58 K. Bentein and A. Panaccio

Future research might thus want to explore a larger set of differentiated well-being
forms, hedonic and eudaimonic, and psychological and physical.
Moreover, as servant leadership’s focus on multiple stakeholders’ needs is what
distinguishes it from other leadership approaches, future research might also want to
develop more integrated hypotheses on distinctive forms of well-being among a
broader range of stakeholders. Very recently, scholars have begun examining how
adopting servant leadership behaviors may affect the leader’s own well-being and
have suggested the existence of complex mechanisms underlying these relationships
(e.g., Zhou et al. 2020; Liao et al. in press). However, very few studies have explored
whether servant leadership could be of value in promoting the well-being of other
stakeholders. Theoretical models including servant leadership’ links with the well-
being of clients and community at large are thus needed to test the core tenet of
servant leadership, that is, the emphasis on serving multiple stakeholders’ needs.
Our overview of the literature on servant leadership and well-being also shows
that most empirical studies implicitly assume that servant leadership may operate as
both an individual and a group phenomenon. Individual-level servant leadership
refers to the leadership behaviors experienced and perceived by an individual
employee. That is, each follower develops his/her own perception of servant lead-
ership based on the extent to which his/her leader focuses on his/her individual needs
and the nature and quality of the one-on-one relationship the leader develops with
him/her. In contrast, group-level servant leadership refers to the overall pattern of
leadership behaviors displayed by the leader toward the entire work group; it can be
viewed as a shared perception of a leaders’ servant leadership style among group
members. To date, very few studies on servant leadership and well-being have
addressed the team or group level of analysis (i.e., Ling et al. 2017; Neubert et al.
2016; Peng and Chen 2020) in their theoretical and empirical model. Following the
recommendation to examine the impact of leadership approaches at multiple levels
of analysis (Yammarino et al. 2005), future research might thus want to develop
multilevel models that explain how servant leadership impacts well-being at both the
individual and the group level.
As our literature search reveals, many of the reviewed studies do not explicitly
draw upon an existing theoretical perspective. This may be in part responsible for the
fragmented nature of this body of work, especially when it comes to understanding
the mechanisms underlying servant leadership’s relationships with well-being out-
comes. For instance, a number of variables have been examined as mediators,
without a clear sense of how these could be integrated in an overarching framework.
Similarly, while a few studies suggest there may be boundary conditions to the
effects of servant leadership on well-being, a theoretical framework justifying the
choice of variables and the direction of the expected effects is needed to provide a
finer-grained understanding of the conditions under which servant leadership may or
may not contribute to well-being.
Interestingly, while many empirical studies refer to the classical social exchange
theory to explain the relationship between servant leadership and well-being vari-
ables, the great majority of empirical studies refers to other theoretical approaches.
Two resource-based theories, the job demands resources model (Bakker and
3 Servant Leadership 59

Demerouti 2007, 2014; Demerouti et al. 2001) and conservation of resources theory
(Hobfoll 1989, 2001), were the most popular. The reference to these theories (JD-R
model and COR theory) is pertinent as they include well-being variables as focal
constructs (e.g., work engagement, work burnout, personal resources). Those studies
generally describe servant leadership as a job resource for the followers who benefit
from these servant leadership behaviors.
However, most studies use very limited parts of these theories to select only one
or two variables, without taking into account the interrelationships between demands
and resources, for instance, or between different demands or different resources. This
is a limitation because according to the JD-R model, in addition to the dual pathways
to employee well-being, in which demands cause exhaustion and resources cause
engagement (Bakker and Demerouti 2007), there are buffering and coping mecha-
nisms at play. For instance, if sufficient job resources are readily available, these can
buffer the adverse effects of demands and thereby help secure high levels of work
engagement. Besides, job demands might not be necessarily problematic, as chal-
lenging demands, which can contribute to work engagement, may also amplify the
positive impact of job resources on engagement.
This principle is also described in COR theory in the gain paradox principle,
which states that resource gain increases in salience in the context of resource loss.
Among the empirical studies reviewed here, only two have examined the interaction
between servant leadership (as a job resource) and job demands in predicting well-
being (e.g., Upadyaya et al. 2016; Zhang et al. 2019a). With regard to servant
leadership (as a resource) interacting with other resources, we reviewed only one
study, examining the interaction between servant leadership as a contextual resource
and workplace civility climate described as a macro resource in shaping employees’
personal resources (e.g., der Kinderen et al. 2020). Future research might thus want
to continue exploring how servant leadership interacts with other resources and with
job demands in the prediction of well-being. Indeed, servant leadership is only one
piece of the context that surrounds the employee, and it might become more or less
valuable depending on the circumstances (i.e., challenging job demands).
According to COR theory, there is also an important dynamic corollary linked to
the resource principles, that is, resource gain spirals tend to be weak and take time to
develop, while resource loss cycles gain quickly in momentum and magnitude over
time (Hobfoll et al. 2018). As the overwhelming majority of empirical studies
reviewed here have relied on cross-sectional designs and treated servant leadership
as an average leadership style that differs between individuals, we do not know a)
how the levels of servant leadership and well-being-related variables may change
over time (within individuals) and b) how these changes could be related to one
another, a fortiori in resource gain spirals or in resource loss cycles.
As an exception, three very recent studies demonstrated meaningful day-to-day
variations in managers’ servant leadership behaviors and their effects on employees’
well-being (Rodríguez-Carvajal et al. 2019) or on the leader’s own well-being (Liao
et al. in press; Zhou et al. 2020). Moreover, Liao et al. (in press) even showed that a
leader might demonstrate very antagonist leadership styles, like servant leadership
and laissez-faire leadership, on 2 consecutive days, depending on the state of his/her
60 K. Bentein and A. Panaccio

personal self-regulation resources and perspective-taking experience (Liao et al. in

press). Future research might thus want to continue developing more process-based
studies like these to help uncover the dynamic process underlying the relationships
between servant leadership behaviors and well-being-related variables. For example,
it might be more important for a leader to be consistent over time in manifesting
servant behaviors than to demonstrate high levels of servant behaviors at one point in
time. In this vein, Matta et al. (2017) demonstrated that being treated consistently
unfairly is less physiologically stressful for employees than being treated fairly
sometimes and unfairly at other times. As another example, servant leadership
behaviors may exert a temporary effect on well-being: they may buffer the impact
of job demands on burnout only for a certain period of time and then become
ineffective at protecting against high job demands. McClean et al. (2019) offered
interesting suggestions for researchers interested in studying servant leader behavior
(and well-being) dynamism. Note that this question needs to be addressed with a
very focused lens, as different types of well-being variables might change in
different directions and through different (mediational) processes and might coexist
(Inceoglu et al. 2018).
Our review further reveals that the theoretical perspectives adopted in the
reviewed empirical articles, although relevant since they explain the process of
well-being, do not take into account the specificity of servant leadership to theorizing
its effects on well-being. Indeed, servant leadership distinguishes itself from other
theoretical leadership approaches by a focus on serving the needs of employees and
other stakeholders (Lemoine et al. 2019). Drawing on SDT, some researchers show
that servant leadership is positively related with global need satisfaction (Mayer et al.
2008; van Dierendonck et al. 2014) or fulfillment of each of the three basic
psychological needs (Chiniara and Bentein 2016). However, we do not know what
specific resources derived from a relationship with a servant leader may help
employees satisfy each of their needs. Future research might thus want to develop
a broader and more integrated view of the resources provided by servant leaders that
directly support the fulfilment of employees’ (and other stakeholders’) needs. Col-
bert et al.’s (2016) taxonomy of relationship functions that support employee’s
flourishing outcomes (i.e., finding meaning, experiencing positive emotions, and
finding satisfaction in life) may be useful in this regard, by providing a basis for
researchers to theorize on the distinctive resources provided by a servant leader.
Their taxonomy identified “a full range of work-relevant relationship functions”
(p. 1200) including some traditional functions (i.e., task assistance, career advance-
ment, and emotional support) but also less studied functions (i.e., personal growth,
friendship, and giving to other) that seem especially relevant for describing the types
of resources that servant leadership may generate and provide to others.
This chapter sought to provide an overview of the theoretical and empirical
literature on servant leadership and well-being. Generally speaking, even though
the number of studies exploring this link has been increasing steadily in the past few
years, the literature is still in its infancy and, as such, presents exciting challenges
and opportunities. We hope to have provided some useful insights and a road map to
guide future research on this important topic.
3 Servant Leadership 61

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Leadership and Safety
4
Lixin Jiang and Xiaohong Xu

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Defining Safety-Related Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Defining Safety Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
The Relationships Between Safety Leadership and Safety-Related Outcomes . . . . . . . . . . . . . . . . . 73
Why Does Safety Leadership Impact Safety-Related Outcomes: The Mediators . . . . . . . . . . . . . . . 75
When Does Safety Leadership Impact Safety Outcomes: The Moderators . . . . . . . . . . . . . . . . . . . . . 77
Safety Leadership Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Future Research Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Conceptual Distinctness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
A Within-Person Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
The Dark Side of Safety Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Reciprocal Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

Abstract
Leadership is one of the key factors that determines workplace safety. This
chapter provides a comprehensive review on a wide range of safety-related
outcomes and safety leadership styles and summarizes five theoretical perspec-
tives (i.e., social exchange theory, social learning theory, social information-
processing theory, expectancy theory, and self-regulation theory) and the empir-
ical evidence between safety leadership and employee safety-related outcomes.
The review suggests that safety leadership significantly influences employee

L. Jiang (*)
School of Psychology, University of Auckland, Auckland, New Zealand
e-mail: [email protected]
X. Xu
University of Texas, San Antonio, TX, USA
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 67

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_3
68 L. Jiang and X. Xu

safety-related outcomes via multiple mediation mechanisms (e.g., safety climate,

leader-member exchange) and under different conditions (e.g., safety climate,
perceived risk). Given the critical role of leadership in workplace safety, scholars
have also developed interventions to improve leadership behaviours and promote
employee safety-related outcomes. Building on previous research, we highlight
several promising future directions, including testing the distinctiveness and
usefulness of different safety leadership styles, adopting a within-person
approach to understand the relationships between safety leadership and safety-
related outcomes, examining the dark side of safety leadership with regard to
workplace safety, and investigating the reciprocal relationships between safety
leadership and safety-related outcomes.

Keywords
Leadership · Safety · Safety climate · Leadership interventions · Review

Introduction

Because leaders determine safety-related policies and practices in the organization,

such as the priority of safety over other goals (e.g., productivity) and resource
allocation to achieve these goals (Zohar 2010), leadership plays a vital role in
employee safety-related outcomes (Clarke 2013; Kelloway and Barling 2010).
Scholars have devoted considerable effort and time to investigate the effects of
leadership styles (e.g., transformational leadership, transactional leadership, ser-
vant leadership) on a wide range of employee safety behaviours and other safety-
related outcomes, such as accidents and injuries (e.g., Christian et al. 2009;
Nahrgang et al. 2011). There is also growing interest in developing safety leader-
ship interventions to change leader behaviours, with an ultimate goal to improve
employee safety-related outcomes (e.g., Kelloway and Barling 2010; von Thiele
Schwarz et al. 2016; Zohar 2002).
This chapter aims to provide a review on the current findings on leadership and
safety. First, we review the conceptualizations of safety-related outcomes and
safety leadership to establish a foundation for this review. Second, we provide an
overview of existing findings on the effects of different leadership styles on safety-
related outcomes, the mechanisms underlying these effects (i.e., mediators), as well
as their boundary conditions (i.e., moderators). Third, we offer an overview of
existing safety leadership interventions that are designed to change leader behav-
iours and promote workplace safety. Finally, while existing studies on safety
leadership significantly improve our understanding of the critical role of leadership
in determining workplace safety, several questions remained unaddressed in the
safety leadership literature. Thus, we delineate multiple gaps in our current knowl-
edge of safety leadership and suggest several promising directions for future
research.
4 Leadership and Safety 69

Defining Safety-Related Outcomes

The most commonly examined safety-related work outcomes include safety behav-
iours, accidents, injuries, other adverse events, and accident underreporting. There
are several conceptualizations of safety-related behaviours in the safety literature. Of
those, the best known one is by Griffin and Neal (2000). In line with research on task
versus contextual performance in the Organizational Behaviour literature (Borman
and Motowidlo 1993), Griffin and Neal (2000) distinguished between safety com-
pliance and safety participation. Safety compliance, similar to task performance,
refers to safety-related behaviours required by the employer, including following
safety procedures, the use of protective equipment, and practising risk reductions,
whereas safety participation, similar to contextual or organizational citizenship
behaviours, reflects extra-role behaviours that go above and beyond mere compli-
ance to improve safety within the organizational setting (Christian et al. 2009).
Examples of safety participation incorporate proactively helping co-workers resolve
safety problems, voluntarily participating in safety-related activities and training,
attending safety meetings, and voicing safety concerns to managers. Hofmann,
Morgeson, and Gerras (2003) further clarified behaviours subsumed by safety
participation (or “safety citizenship behaviour”), including dimensions of helping,
voice, stewardship, whistleblowing, civic virtue, and initiating safety-related change.
For example, as one specific aspect of safety participation, safety initiative refers to
employee personally driven and change-oriented behaviours aiming to improve
safety of a working environment (e.g., Marchand et al. 1998).
Another conceptualization of safety-related behaviours is proposed by Burke,
Sarpy, Tesluk, and Smith-Crowe (2002). Specifically, they defined safety perfor-
mance as “the actions or behaviours that individuals exhibit in almost all jobs to
promote the health and safety of workers, clients, the public, and the environment”
(p. 432) and identified four dimensions of safety-related behaviours: (1) using
personal protective equipment, (2) engaging in work practices to reduce risk,
(3) communicating health and safety information and (4) exercising employee rights
and responsibilities. Thus, Burke et al.’s dimensions provide greater specificity
within the broader categories of safety compliance and safety participation, where
dimensions 1 and 2 are examples of safety compliance and dimensions 3 and 4 are
examples of safety participation (Beus and Taylor 2018).
Upon reviewing various conceptualizations of safety-related work behaviours
(e.g., Burke et al. 2002; Griffin and Neal 2000; Hofmann et al. 2003), Beus and
Taylor (2018) provided a goal-focused typology of safety-related behaviours where
safety-focused goals aim to preserve or promote safety, but nonsafety-focused goals
aim to accomplish something instead of preserving or promoting safety. Specifically,
Beus and Taylor (2018, p. 403) defined safety-related work behaviours as “any
workplace actions or practices that affect the degree to which persons in and
immediately surrounding the workplace (e.g., employees, customers, and
community members) are free from physical threat or harm.” They differentiated
safety-related behaviours based on goal choice (i.e., safe vs. unsafe behaviours),
70 L. Jiang and X. Xu

goal-directedness (i.e., intentional vs. unintentional behaviours) and the means of

goal pursuit (i.e., commission vs. omission vs. prevention-focused behaviour). In
terms of goal choice, safe behaviour includes behaviours decreasing the likelihood
of harm, whereas unsafe behaviour refers to those increasing the likelihood of harm.
With regard to goal-directedness, intentional safe behaviours are those behaviours
that employees knowingly perform to maintain or foster workplace safety, whereas
intentional unsafe behaviour are those that employees knowingly perform despite
the understanding that these behaviours could compromise workplace safety.
Unintentional safe behaviours are those that unknowingly promote workplace safety,
while unintentional unsafe behaviours are those unknowingly performed without an
explicit realization that they could compromise safety.
Concerning the means by which employees choose to pursue selected goals,
committed (i.e., direct action) versus omitted (i.e., inaction) unsafe behaviours and
promotion versus prevention-focused safe behaviours are proposed. When unsafe
commission or omission is intentional, the difference between behavioural commis-
sion and omission lies in perceived causality, where it is more likely for employees
who intentionally engage in unsafe behaviour to do so because of omission than
commission. When unsafe commission or omission is unintentional, however, the
difference between behavioural commission and omission depends on the type of
deficiency causing the unsafe behaviours (e.g., lack of training or lack of attention).
On the other hand, promotion-focused safe behaviours facilitate the presence of
safety (e.g., encouraging co-workers to work safely), whereas prevention-focused
safe behaviours prevent the absence of safety (e.g., following safety protocol).
Therefore, prevention-focused safe behaviours, to some degree, correspond to safety
compliance, while promotion-focused safe behaviours parallel with safety partici-
pation. In sum, Beus and Taylor’s broader conceptualization of safety-related work
behaviours is multidimensional in nature, complementing the existing safety
research.
Although accidents and injuries are often treated interchangeably (Christian et al.
2009), a workplace accident is a broader term reflecting “any unplanned and
uncontrolled event that causes injury to the persons, damage to property, plant, or
equipment, or some other loss to the company” (Probst et al. 2019, p. 31). For
example, an accident involving a forklift might lead to damage to the vehicle, but not
an actual injury to the driver. Although previous research tends to count the number
and frequency of accidents and injuries, more recent research has considered the
degrees of severity of accidents and injuries, arguing that leadership may have
different impacts on accidents and injuries depending on their severity and that
major injuries are rare (Molnar et al. 2019). Indeed, injuries that range from minor
injuries requiring mild first aid treatment all the way up to fatal injuries can vary in
their severity. Additionally, other adverse events include errors, close calls, near
misses and other safety-related events.
Although international and national surveillance agencies collect statistics on
fatal and non-fatal workplace injuries and illnesses, research suggests that these
statistics may greatly underrepresent the frequency of actual workplace injuries.
Accident underreporting at the individual level reflects the discrepancy between the
4 Leadership and Safety 71

number of accidents, injuries and work-related illness that employees report to their
employer and the number of accidents, injuries and work-related illness that
employees actually experience. Thus, individual-level underreporting may reflect
safety rule violations in that employees fail to report accidents when safety rules
require them to report such accidents to relevant organizational officials. On the
other hand, accident underreporting at the organizational level reflects that the
employer fails to accurately report employee accidents, injuries and work-related
illness to regulatory surveillance authorities. Both factors may contribute to the
underestimation of occupational accidents and injuries (Probst et al. 2019).

Defining Safety Leadership

There is no clear consensus in defining safety leadership, where each study derives
their own conceptualization and definitions of safety leadership based on a particular
theoretical model. Nevertheless, the full-range leadership framework (Bass 1985)
dominates the leadership literature, including workplace safety (Willis et al. 2017).
The most popular and well-known leadership is transformational leadership. Defined
as “leader behaviours that transform and inspire followers to perform beyond
expectations while transcending self-interest for the good of the organization”
(Avolio et al. 2009, p. 423), transformational leadership consists of idealized influ-
ence, inspirational motivation, individualized consideration and intellectual stimu-
lation (Bass 1985). Applying this concept to workplace safety, safety-specific
transformational leadership has four characteristics. First, transformational safety
leaders emphasize the importance of safety, display idealized behaviours and behave
as role models. Second, they energize employees with inspirational motivation,
encourage them to transcend their individual interests for the collective benefit and
drive them to achieve high safety standards. Third, transformational safety leaders
provide individualized consideration and timely feedback related to workplace
safety, prioritize employee safety and well-being and respond to employee safety
concerns in a timely manner (Mullen and Kelloway 2009). Finally, intellectual
stimulation of transformational safety leaders motivates employees to voice their
concerns, discover new and better ideas and explore new approaches to solve safety-
related issues (Barling et al. 2002).
The full-range leadership framework (Bass 1985) also includes three types of
transactional leadership. The first type is contingent reward leadership, or the extent
to which the leader sets up constructive transactions with employees by clarifying
expectations and establishing rewards for meeting these expectations. The second
type is management-by-exception active (MEA) leadership where leaders set
standards, monitor performance that may deviate from these standards and take
corrective action as necessary (Avolio et al. 1999). The third type is management-
by-exception passive (MEP) leadership where leaders do not take corrective action
unless performance issues become serious. This framework (Bass 1985) also encom-
passes laissez-faire leadership where leaders avoid responsibilities and decision-
making, fail to clarify performance expectations and follow up on requests and are
72 L. Jiang and X. Xu

absent when needed by their subordinates. MEP and laissez-faire leadership have
been combined into a single higher-order factor (Avolio et al. 1999) as a type of
nonresponsive, passive and destructive leadership (Nielsen et al. 2016).
In contrast, active destructive leadership includes such concepts as abusive
leadership (Tepper 2007), petty tyrant (Kant et al. 2013) and tyrannical leadership
(Aasland et al. 2010) where leaders systematically humiliate, belittle and manipulate
employees to “get the job done” and typically achieve results at the expense of
employees (Einarsen et al. 2007).
Three relatively new leadership concepts examined by safety researchers are
authentic, empowering and servant leadership. Specifically, authentic leadership is
defined as “a pattern of leader behaviour that draws upon and promotes both positive
psychological capacities and a positive ethical climate to foster greater self-
awareness, an internalized moral perspective, balanced processing of information,
and relational transparency on the part of leaders working with followers, fostering
positive self-development” (Walumbwa et al. 2008, p. 94). Empowering leadership
is a leadership style where leaders share authority with employees in order to
enhance their intrinsic motivation (Srivastava et al. 2006). Empowering leaders
may encourage employees to participate in decision-making, coach employees,
lead by example, show concern and interact with employees and share critical
information (Srivastava et al. 2006). Finally, servant leadership builds personal
relationships, provides support to team members via dialogue promotion and open
communication and coaches people whose performance is suboptimal, thereby
unleashing their potential (Barbuto and Wheeler 2006).
The vast majority of aforementioned concepts have been more or less adapted to
be more specific to workplace safety (e.g., safety-specific transformational leader-
ship vs. general transformational leadership). Although related, safety-specific lead-
ership tends to account for additional variance in safety outcomes above and beyond
the variance explained by general leadership (Mullen and Kelloway 2009).
In addition to the above research focusing on safety leadership concepts from the
broad Organizational Behaviour literature, other researchers have developed their
own operationalizations of safety leadership based on safety-critical environments.
For example, Carrillo and Simon (1999) posited six critical safety leadership prac-
tices: to make the case for change, to create a shared vision, to build trust and open
communication, to develop capabilities, to monitor progress and to recognize
accomplishments. O’Dea and Flin (2001) identified four important safety leadership
behaviours, namely, visibility at the worksite and leading by example; developing
open, honest and trusting relationships with the workforce; workforce involvement
and employment in planning and decision-making; and being proactive about safety.
Bryden (2002) identified four types of critical senior managers’ behaviours in an oil
company: (1) articulating an attainable vision of future safety performance, (2) dem-
onstrating personal commitment to safety symbolically, (3) engaging everyone with
relevant experience in decision-making and (4) being clear and transparent when
dealing with safety issues. Wu (2005) demonstrated that safety leadership includes
safety caring, safety coaching and safety controlling. Similarly, Lu and Yang (2010)
described three safety leadership dimensions, including safety motivation, safety
4 Leadership and Safety 73

policy and safety concern. Griffin and Hu (2013, p. 200) defined safety leadership as
“specific leader behaviours that motivate employees to achieve safety goals” and
investigated leader safety inspiring, safety monitoring and safety learning. Casey,
Neal, and Griffin (2019) developed an evidence-based safety leadership scale with
four main “control strategies” used by team leaders to maintain employee safety
performance, including the leverage strategy, the energize strategy, the adapt strategy
and the defend strategy. Finally, according to Molnar et al. (2019, p. 181), safety-
specific leadership should “prioritize safety over speed and quantity, proactively
focus on safety work procedures as well as the absence of accidents and injuries,
keep track of potential risks and routine safety problems, provide feedback to
employee safety behaviours, imitative actions to improve safety, and communicate
safety issues and values during everyday work.”
It is worth noting that these different leadership styles have similarities with the
full-range leadership model by Bass (1985). For example, inspiring safety leader-
ship, or “the degree to which a leader presents a positive vision of safety that is
appealing and inspiring to the employees” (Griffin and Hu 2013, p. 196), is similar to
the inspirational motivation dimension of safety-specific transformational leader-
ship. Similarly, monitoring safety leadership, or “the degree to which a leader
monitors and responds to mistakes and errors of team members in relation to safety”
(Griffin and Hu 2013, p. 196), is similar to MEA.

The Relationships Between Safety Leadership and Safety-Related

Outcomes

Leadership may motivate or de-motivate employees to perform their work safely

(Hofmann and Morgeson 2004; Zohar 2011). Different types of leadership may
influence safety-related outcomes “in different ways and for different reasons”
(Hoffmeister et al. 2014, p. 68). We summarize five theoretical perspectives to
understand the relationships between safety leadership and safety outcomes. First,
the norm of reciprocity based on the social exchange theory indicates that employees
repay favourable workplace treatment with favourable behaviours of their own, as
well as adjust their behaviours downward in response to unfavourable treatment
(Cropanzano and Mitchell 2005). Therefore, positive safety leadership (e.g., servant
leadership) can facilitate safety practices, while neglectful and destructive leadership
(e.g., MEP) can decrease safety outcomes.
Second, social learning theory proposes that observations of, and interactions
with, others can facilitate learning in a social context (Bandura 1977). Applying the
social learning perspective to workplace safety indicates that when leaders transmit
messages about the importance of safety, encourage safety behaviours and model
safety behaviours, employees are more likely to follow suit. Therefore, empowering
leadership, for example, may enhance safety-related behaviours, while laissez-faire
leadership can be detrimental to safety outcomes.
Third, the social information-processing theory (Salancik and Pfeffer 1978)
argues that individuals process social cues from their work environment, especially
74 L. Jiang and X. Xu

those occupying leadership positions, to make sense of their work environment.

Thus, when leaders communicate the importance of safety, prioritize safety over
other issues during decision-making processes and personally commit to workplace
safety, employees are more likely to take workplace safety seriously and display
safety-related behaviours.
Fourth, expectancy theory (Vroom 1964) suggests that an individual’s decision to
engage in certain behaviours depends on three core cognitions: expectancy or the
extent to which an individual believe in his/her capability to enact the behaviour
required to achieve a particular goal, valence or the perceived desirability of the
outcomes associated with the behaviour, and instrumentality or the perceived con-
nection between the behaviour and the desired outcomes. Thus, when safety behav-
iours are noticed and rewarded by leaders (e.g., contingent reward leadership),
employees are more likely to engage in such behaviours.
Self-regulation theory from social psychology has also been used to understand
the relationships between safety leadership and safety outcomes. Specifically, self-
regulation is the psychological processes where individuals devote cognitive, affect
and volitional resources to set and achieve goals (Karoly 1993). Employees set their
own goals and monitor their progress towards their goals, thereby guiding their own
goal-directed activities and performance (Carver and Scheier 1981). Employees may
use different self-regulatory mechanisms to reach their goals, such as planning,
monitoring, motivating and emotional control (Sitzmann and Ely 2011). Leaders
may, therefore, engage in behaviours to assist employees to set and achieve safety
goals (Griffin and Hu 2013).
These theoretical frameworks all suggest that (safety-specific) transformational
leadership (e.g., Barling et al. 2002; Kelloway et al. 2006; Zohar and Luria 2004),
contingent reward leadership (e.g., Hoffmeister et al. 2014; Zohar 2002), MEA
(Clarke 2013), authentic leadership (e.g., Nielsen et al. 2013), empowering leader-
ship (e.g., Martínez-Córcoles et al. 2014) and servant leadership (Krebs 2005) are
beneficial for employee safety perceptions, attitudes and behaviours, leading to
fewer accidents and injuries. Similarly, the aforementioned safety leadership behav-
iours that are derived from safety-critical environments can also enhance safety-
related outcomes (e.g., Griffin and Hu 2013; Molnar et al. 2019; O’Dea and Flin
2001). On the contrary, abusive supervision is detrimental to employee safety
participation (Mullen et al. 2018). Similarly, based on theoretical perspectives
(e.g., social exchange theory, social learning theory) and indirect evidence, we
expect that petty tyrant and tyrannical leadership can lead to negative safety-related
outcomes (cf. Nielsen et al. 2015).
Although research has extensively investigated the linear relationships between
safety leadership and safety-related outcomes, little research has examined the
curvilinear relationships between safety leadership and employee outcomes. The
recent literature, however, has now started to investigate this relationship
(cf. Mackey et al. 2019). For example, Katz-Navon, Kark, and Delegach (2020)
found that transformational leadership produced a U-shaped curvilinear relationship
with safety initiative and safety compliance in a field study, as well as with safety
motivation in a scenario-based experiment. Consequently, they concluded that both
4 Leadership and Safety 75

low and high levels of transformational leadership are related to better safety-related
outcomes, but intermediate levels of transformational leadership may hinder safety-
related outcomes.

Why Does Safety Leadership Impact Safety-Related Outcomes:

The Mediators

In addition to having direct effects on safety-related outcomes, safety leadership may

also have indirect effects on safety outcomes via a number of mediators. The most
frequently examined mediator is safety climate (Clarke 2013; Mullen and Kelloway
2009; Zohar 2010). Safety climate is defined as employee shared perceptions of
organizational safety policies, procedures and practices that give priority to safety
issues (Zohar 2010). Meta-analytic evidence indicates that safety climate mediates
the association between transformational-transactional leadership and employee
safety behaviours (Clarke 2013). Recent studies have confirmed that safety climate
also mediates the relationships of contingent reward leadership, MEA leadership
(Martínez-Córcoles and Stephanou 2017), empowering leadership (Lee et al. 2019),
safety-related passive leadership (Kelloway et al. 2006; Smith et al. 2016) and
abusive supervision (Mullen et al. 2018) with various safety-related outcomes.
Another set of mediators linking safety leadership and safety-related outcomes
includes leader-member change based on trust, loyalty and integrity (Dulebohn et al.
2012), perceived organizational and supervisor support (Eisenberger et al. 1986;
Eisenberger et al. 2002) and trust. For example, positive safety leadership (e.g.,
safety-specific transformational leadership) may increase employee perceptions that
the organization and the supervisor care about their safety and well-being and,
therefore, build high-quality leader-member exchanges. Based on social exchange
theory, leader-member exchange as well as perceived organizational and supervisor
support may explain the relationships between positive safety leadership and safety-
related outcomes (cf. Hofmann et al. 2003; Kath et al. 2010). Alternatively, Conchie,
Taylor, and Donald (2012) showed that affect-based trust (but not cognition-based
trust) and disclosure trust intentions (but not reliance trust intentions) sequentially
mediated the relationship between safety-specific transformational leadership and
safety voice behaviours. That is, transformational leadership increases people’s
belief that the leader will act unselfishly towards others and show care and concern
for their welfare (i.e., affect-based trust), which in turn enhances employees’ will-
ingness to disclose sensitive information to the leader, which then increases their
voice behaviours.
Moreover, Conchie (2013), based on self-determination theory (Deci and Ryan
1985), found that safety-specific transformational leadership influenced employee
challenge safety citizenship behaviour (i.e., safety voice, whistleblowing) via intrin-
sic motivation (intrinsic motivation lies in the activity itself because it is challenging,
interesting, or enjoyable) as well as safety compliance behaviours via identified
regulation (the action is congruent with one’s personal goals, identities and values).
Moreover, the relationship between empowering leadership and safety participation
76 L. Jiang and X. Xu

can be explained by role clarity and collaborative team learning (Martínez-Córcoles

et al. 2012, 2014). In other words, empowering leaders with the aim to increase a
team’s self-management skills clarify their expectations regarding safety, provide
team autonomy and enhance knowledge sharing in teams, which, in turn, facilitated
safety participation. Indeed, a recent study by Lee et al. (2019) confirmed that
knowledge sharing is one of the mediators linking empowering leadership and safety
outcomes within the medical industry. Finally, the relationship between authentic
leadership and safety performance is mediated by feedback provided by leaders and
sequentially perceived organizational justice (Cavazotte et al. 2013).
Based on self-regulation theory, Kark, Katz-Navon, and Delegach (2015) argued
that one of the underlying mechanisms linking transformational leadership with
employee safety initiative is employee situational promotion focus, while one of
the mediators linking transactional leadership (i.e., contingent reward, MEA and
MEP) and safety compliance is prevention focus (Kark and Van Dijk 2007). In three
studies, they found that employee situational promotion focus mediated the rela-
tionship between transformational leadership and safety initiative. However, trans-
actional active leadership (i.e., contingent reward and MEA) was positively related
to employee situational prevention focus. Thus, the evidence for the relationship
between prevention focus and safety compliance is inconsistent where only the
experimental study (but not the online and field studies) supports the proposed
mediation relationship. Therefore, more research is needed regarding the mediation
role of regulatory focus in the relationships between safety leadership and safety-
related outcomes.
Leader behavioural integrity for safety indicates that leaders “walk the talk” or
“practice what they preach” in terms of safety (Simons 2002). Thus, leader
behavioural integrity for safety where leaders align their words and actions,
send consistent messages and build a trusting and safe environment may facilitate
a high team priority for safety (Zohar 2010) and high team psychological safety
(Edmondson 2004), which in turn improves overall safety. In a sample of
54 nursing teams, Leroy et al. (2012) found support for their hypotheses where
both team priority of safety and psychological safety mediated the linkage
between leader behavioural integrity for safety and reported treatment errors.
Interestingly, although team priority of safety is negatively related to the number
of reported treatment errors, team psychological safety where employees are
more willing to report experienced errors was positively related to the number
of reported treatment errors. Moreover, team psychological safety strengthened
the negative association between team priority of safety and the number of
reported treatment errors where a stronger, negative relationship between team
priority of safety and reported treatment errors is observed under high team
psychological safety. Therefore, the combination of team priority of safety and
psychological safety has the strongest effect on reported treatment errors
(Hofmann and Mark 2006). In other words, prioritizing safety over other aspects
of performance, as well as learning from failure through error investigation
(Rodriguez and Griffin 2009; Weick and Sutcliffe 2007), allows teams to achieve
excellent safety outcomes.
4 Leadership and Safety 77

When Does Safety Leadership Impact Safety Outcomes: The

Moderators

Each leadership behaviour has its time and place, with none being absolutely good or
bad. As a dynamic process, leader behaviour needs to fit the circumstances in order
to be effective (Nixon et al. 2012). Such a focus on moderation of the impact of
leadership aligns with the contingency approach to leadership, where contextual
factors are considered when understanding the effects of leadership behaviours
across various situations (Yukl 2006).
Similar to the investigated mediators, the most commonly examined contextual
factor altering the relationships between safety leadership and safety-related behav-
iours is safety climate. For example, Hofmann et al. (2003) found that safety climate
strengthened the relationship between high-quality leader-member exchange and
subordinate safety citizenship roles. Using a sample of 1238 employees in 33 orga-
nizations, Probst (2015), however, revealed that a positive safety climate at the
organizational level attenuates the effect of supervisor enforcement of safety policies
on underreporting. In other words, greater supervisor enforcement is related to
decreased employee underreporting under poor safety climate; in organizations
with positive safety climate, there is a low level of underreporting regardless of
supervisor enforcement. Thus, when organizations do not provide a clear frame of
reference for safe working, followers depend on the guidance of their leader in terms
of accident reporting. Conchie (2013; also see Conchie and Donald 2009) also
demonstrated that high levels of trust in leadership strengthen the indirect effect of
safety-specific transformational leadership on employee challenge safety citizenship
behaviour via intrinsic motivation, such that trust in leadership makes employees
more receptive to a leader’s influence.
Adopting a contingency perspective, Willis et al. (2017) investigated whether
active leadership is functional depending on the extent to which risk is perceived to
be high (i.e., perceived accident likelihood, perceived hazard exposure) within a
safety-critical context. With samples from an oil and gas service companies and a
food manufacturing company, they found that MEA is positively related to safety
participation when accident likelihood is high, while a negative relationship between
MEA and safety participation is observed when the perceived risk of accidents is
low. This suggests that leadership behaviours of actively monitoring behaviours,
proactively identifying adverse events and correcting errors may be more effective in
encouraging safe behaviours in high-risk situations.
Mullen, Kelloway, and Teed (2011) argued that leaders may alternate transfor-
mational and passive leadership styles, labelling this as inconsistent leadership.
Accordingly, they noted that passive safety-specific leadership attenuated the posi-
tive relationships of transformational safety-specific leadership with safety partici-
pation and safety compliance. In Katz-Navon et al.’s (2020) field study conducted in
a large security organization, under low group affective commitment to safety
(i.e., an emotional attachment to safety goals and values, internalized acceptance
and involvement in preserving safety), transformational leadership showed an
inverted U-shaped curvilinear relationship with workgroup accident rates, indicating
78 L. Jiang and X. Xu

that both low and high (vs. intermediate) levels of transformational leadership are
related to better safety outcomes. When group affective commitment to safety is
high, the relationship between transformational leadership and workgroup accident
rates is weaker. Together, it suggests that when a leader displays a certain behaviour
to a medium extent (Katz-Navon et al. 2020) and when a leader is inconsistent in
his/her behaviours (i.e., exhibiting a certain leadership behaviours at high levels at
times but low at other times; e.g., Mullen et al. 2011), employees are less likely to
behave safely due to the lack of clarity and consistency.

Safety Leadership Interventions

Given the importance of safety leadership in improving safety-related outcomes,

researchers have developed interventions to improve safety leadership, enhance
safety climate, promote employee safety behaviours and reduce accidents and
injuries (Kelloway and Barling 2010). Existing research on leadership interventions
has shown such interventions can be effective in improving workplace safety. Most
safety leadership interventions are based on behaviour modification principles. This
approach is known as the “behavioural safety” approach (Zohar 2002; Zohar and
Luria 2003) and adopts the Antecedents-Behaviour-Consequences framework
(i.e., the ABC framework, see Luthans and Kreitner 1985; Stajkovic and Luthans
1997) derived from reinforcement theory (Skinner 1974). For instance, antecedents
can be safety leadership interventions, training programmes or workshops targeting
managerial safety behaviours, and consequences can be feedback and incentives,
which are functionally equivalent to reinforcement.
Based on the ABC framework, researchers have developed feedback and
communication interventions to change specific leader or managerial behaviours
and subsequently employee safety-related outcomes, which in turn reinforces
leaders’ newly trained behaviours (e.g., Kines et al. 2010; Zohar 2002; Zohar and
Luria 2003; Zohar and Polachek 2017). For instance, Zohar (2002) demonstrated
that a safety leadership intervention providing line supervisors with weekly
feedback on the frequency of their safety-oriented interactions with subordinates
significantly promoted line supervisors’ safety-oriented interactions, which in
turn led to higher safety climate and employee safety compliance (e.g., earplug
use), as well as lower injury rates. Zohar and Luria (2003) also tested a similar
intervention consisting of providing supervisors with biweekly feedback about
the frequency of their safety-related interactions with subordinates, coupled with
communications of high safety priority from the superiors and senior manage-
ment. They found that this intervention significantly improved supervisory safety
practices, which in turn resulted in decreased employees’ unsafe behaviours and
improved safety climate perceptions. Similarly, Kines et al. (2010) conducted a
safety leadership intervention designed to coach construction site foremen to
include safety in their daily verbal safety communication with their employees.
As predicted, this intervention resulted in improved safety climate and higher
levels of safety outcomes at the construction sites.
4 Leadership and Safety 79

Moreover, combining different intervention approaches can also be effective

(Hale et al. 2010). Given that the behaviour-based approach to safety management
and the safety culture-based approach are the two most effective safety intervention
approaches (Lund and Aarø 2004), DeJoy (2005) proposed that an integrative
approach combining these two could be more effective. Based on DeJoy’s frame-
work (2005), researchers have developed integrative safety leadership interventions
to change both leader (and employee) behaviours and safety cultures (e.g., Kines
et al. 2013; Nielsen et al. 2015). For instance, Kines et al. (2013) developed and
tested the effectiveness of a safety leadership intervention consisting of a participa-
tory behaviour-based approach and safety culture initiatives. Specifically, this inter-
vention included “safety coaching” of managers with the goal of gaining
commitment from the leader(s), reflecting on their leadership role, increasing safety
communication, identifying safety issues and increasing employees’ dialogue and
“ownership” of dealing with current safety issues. As anticipated, this intervention
results in positive leader behaviour and culture changes. Nielsen et al. (2015)
developed a similar integrative intervention that involves workshops where super-
visors and employees discuss safety issues, and a workshop on safety management
and leadership (i.e., the behaviour-based approach), and several individual safety
coaching sessions with supervisors (i.e., the culture-based approach). This interven-
tion was found to improve safety leadership, safety knowledge, safety involvement
and machine safety.
Researchers have also developed safety leadership interventions based on lead-
ership theories from the general leadership literature. Most of these interventions
target transformational leadership (e.g., Mullen and Kelloway 2009). Specifically,
researchers have adopted a training approach focusing on increasing supervisors’
awareness and knowledge of transformational leadership behaviours and increasing
their motivation to engage in such behaviours, which in turn promote safety-related
outcomes (e.g., Mullen and Kelloway 2009). For instance, Mullen and Kelloway
(2009) developed a safety leadership intervention that helped managers understand
how to incorporate safety-specific transformational leadership into their work con-
text via goal setting and develop their personalized plans for setting specific,
challenging, but attainable goals regarding safety-specific transformational leader-
ship behaviours. This intervention significantly improved managers’ safety attitudes,
intentions to promote safety and self-efficacy, employees’ perceptions of leader
safety-specific transformational leadership practices and safety climate outcomes.
Scholars (e.g., Clarke 2013) have further suggested that the effectiveness of
safety leadership interventions may be improved by targeting a range of leader
behaviours or styles. Indeed, researchers have developed safety leadership interven-
tions promoting both transformational leadership and transactional leadership (e.g.,
Clarke and Taylor 2018; von Thiele Schwarz et al. 2016) with the expectation that
interventions promoting both leadership styles can improve workplace safety
through the encouragement of positive engagement with safety and via safety
compliance. Doing so is also consistent with the augmentation hypothesis – the
effectiveness of transformational leadership builds on the foundation of transactional
leadership (e.g., Bass et al. 2003). For instance, Clarke and Taylor (2018) developed
80 L. Jiang and X. Xu

a leadership intervention that provided supervisor training focusing on a range of

transformational and active transactional leadership behaviours and how to apply
these behaviours in safety-related contexts. This training produced significant
improvements in employee perceived safety climate in a high-hazard, safety-critical
context (i.e., a chemical processing plant). von Thiele Schwarz et al. (2016)
supported the effectiveness of a 20-day leadership training programme, which
included 360-degree feedback and on-the-job practices to promote leaders’ knowl-
edge and skills regarding both transformational leadership and transactional leader-
ship (i.e., contingent rewards, MEA). They found that this training programme
increased leaders’ safety leadership practices and employee perceived safety climate.
Interestingly, when examining whether the training program had differential effects
on safety-related outcomes, depending on managers’ specific focus on improve-
ments in safety, productivity or general leadership, they found that there is no added
benefit of focusing specifically on safety or productivity.

Future Research Directions

While existing studies provide insights into the role of different leadership styles in
safety-related outcomes, several important issues remain unaddressed in the safety
leadership literature. We elaborate four major issues below and hope that our
elaboration will spur researchers to address these issues and advance the literature
on safety leadership.

Conceptual Distinctness

Although existing research has supported the relationships between different types
of safety leadership and safety-related outcomes, there is a lack of integration of
leadership theories and constructs in the safety literature. In the broad leadership
literature, there have been concerns regarding the conceptual distinctness among
different leadership styles or behaviours (e.g., Avolio and Gardner 2005). For
instance, empirical studies have supported that transformational leadership is signif-
icantly related to other constructive leadership styles, such as authentic leadership
(Riggio et al. 2010), servant leadership (van Dierendonck et al. 2014) and ethical
leadership (Ng and Feldman 2015). Consistently, existing safety leadership research
suggests that there is considerable overlap among different safety leadership styles in
terms of their underpinning behaviours and attributes (Donovan et al. 2016). This
raises a concern regarding potential construct redundancy among different safety
leadership styles. Thus, future research needs to examine the distinctiveness and
usefulness of different safety leadership styles.
We suggest several avenues through which researchers may test the conceptual
distinctiveness of different safety leadership styles. First, researchers can test the
incremental validity of each safety leadership style in predicting safety-related out-
comes. The findings from this line of research will inform the optimal array of safety
4 Leadership and Safety 81

leadership styles and evaluate potential construct redundancy among these different
leadership styles. For instance, considering that transformational leadership is the most
commonly examined leadership style within the safety context (Clarke 2013) and there
are significant associations between transformational leadership and other leadership
styles (e.g., Ng and Feldman 2015; Riggio et al. 2010; van Dierendonck et al. 2014),
researchers can explore whether other safety leadership styles make unique contribu-
tions to explaining safety-related outcomes above and beyond safety-specific transfor-
mational leadership. Once the distinctiveness of different safety leadership styles is
supported, researchers can systematically investigate the relative impact (Tonidandel
and LeBreton 2011) of different safety leadership styles and identify the most effective
leadership style(s) in predicting safety-related outcomes. Testing the conceptual distinc-
tiveness and identifying the relative importance of different leadership styles has
important practical implications, as the results will help develop interventions that target
the most impactful leadership style(s) and thus save organizational resources.
A person-centred approach (e.g., latent profile analysis; Vermunt 2010) to diverse
safety leadership styles can also provide insights into the conceptual distinctiveness of
different leadership styles. That is, researchers may examine whether different profiles
of multiple safety leadership styles exist within individuals. For instance, researchers
can test the profiles of transformational leadership, empowering leadership and servant
leadership, as well as the relationships between the emerged profiles and safety-related
outcomes. If these profiles are qualitatively different from one another (i.e., having
different shapes) and have significantly different levels of safety-related outcomes,
then the distinctiveness of these safety leadership styles is supported. However, if
these profiles have similar shapes (i.e., the same level of transformational leadership is
associated with the same or similar levels of other safety leadership styles), then the
distinctiveness of these safety leadership styles is questionable.
It is worth noting that the lack of consensus on the conceptualizations of safety-
related outcomes adds to the challenge of testing the distinctiveness of different
safety leadership styles. That is, the varying conceptualizations and frameworks of
safety-related outcomes also hinder the integration of the safety leadership literature.
Clear conceptualizations and measurements of safety-related outcomes are crucial
for our understanding of the unique contribution of each safety leadership style in
predicting safety-related outcomes. Therefore, future research also needs to clarify
the conceptualizations and measurements of safety-related outcomes for testing the
uniqueness of each safety leadership style (cf. Donovan et al. 2016).

A Within-Person Perspective

Although the mechanisms specified by leadership theories usually operate within

individuals (e.g., Ashkanasy and Jordan 2008; Tepper et al. 2018), most research
testing these theories examines between-person relationships between safety leader-
ship and safety-related outcomes (Curran and Bauer 2011; Voelkle et al. 2014). This
disconnect between theories and research practices “constitutes a major threat to the
conceptual integrity of the field” (Voelkle et al. 2014, p. 193). Indeed, leader
82 L. Jiang and X. Xu

behaviours and employee safety-related behaviours tend to vary within individuals

over time as organizational policies, goals, priorities and environments constantly
change (e.g., Beus and Taylor 2018; Dalal et al. 2014). For instance, an employee
may behave safely (or unsafely) in one instance, but unsafely (or safely) subse-
quently, because his or her safety behaviours are influenced by various situational
factors including leader behaviours, which may fluctuate because of organizational
policies, goals and the broader social environment.
Further, it is important to study the same phenomena at different levels (e.g.,
between-person versus within-person) as relationships between variables might not
be the same across different levels (Chen et al. 2005; Kozlowski and Klein 2000).
Examining the relationships between safety leadership and safety-related outcomes at
the within-person level will clarify whether the leadership-outcome relationships at the
between-person level can be generalized to within-person levels (i.e., multilevel
homology). Support for multilevel homology will add to the parsimony and external
validity of the proposed effects of safety leadership on safety-related outcomes (Chen
et al. 2005; Kozlowski and Klein 2000). However, if multilevel homology did not
exist, then researchers have to refine and develop theories for within-person and
between-person relationships, respectively (Chen et al. 2005; Kozlowski and Klein
2000). Therefore, we encourage researchers to explore the associations between safety
leadership and safety-related outcomes at the within-person level.
Perhaps not surprisingly, the commonly employed between-person approaches in
the safety literature answer research questions fundamentally different from those
addressed by within-person approaches (Curran and Bauer 2011). Between-person
approaches focus on the associations between safety leadership and safety-related
outcomes by making comparisons between individuals (i.e., inter-individual pro-
cesses). For instance, individuals whose leader displays high levels of transformational
leadership, compared to other employees whose leader exhibits low levels of trans-
formational leadership, tend to have higher levels of safety performance (i.e., a
between-person association between transformational leadership and safety perfor-
mance). In contrast, within-person associations between safety leadership and safety-
related outcomes occur within an individual and focus on temporal fluctuations within
an individual (i.e., intra-individual processes), but not across individuals (Curran and
Bauer 2011). For instance, employees may have better safety performance on days
when the supervisor has more safety communication with them, compared to days
when the supervisor has less safety communication with them (i.e., a within-person
association between safety communication and safety performance). Therefore,
within-person approaches, as opposed to between-person approaches, are able to
capture leaders’ and employees’ experiences and behaviours, as well as work events
as they unfold over time in the work environment (Curran and Bauer 2011).

The Dark Side of Safety Leadership

Existing research has predominantly focused on the positive side of safety leadership
on safety-related outcomes, ignoring the dark side of safety leadership. The overlook
4 Leadership and Safety 83

of the dark side of safety leadership is manifested in two major aspects. First, most
research has focused on constructive safety leadership styles, particularly on trans-
formational leadership or at best passive destructive leadership (e.g., Clarke 2013).
There is limited research examining the effects of active, destructive leadership, such
as abusive leadership, petty tyrant and tyrannical leadership, on employee safety-
related outcomes. Future research is needed to explore how, why and when these
destructive safety leadership styles may influence employee safety-related outcomes.
Research findings describing destructive safety leadership could complement the
existing findings on safety leadership (Kelloway et al. 2006), provide a more
complete picture of the influence of safety leadership and offer practical implications
for controlling the negative consequences of destructive leadership behaviours on
workplace safety.
Moreover, all leadership styles have their own dark side (cf. Clements and
Washbush 1999; Conger 1990). Thus, constructive safety leadership (e.g., transfor-
mational leadership) might have unexpected negative impacts on safety-related
outcomes. However, existing research has exclusively focused on the bright side
of constructive safety leadership, ignoring its potential negative effects. For instance,
the dark sides of transformational leadership (Tourish 2013), including its associa-
tions with the dark triad of personality (i.e., narcissisms, Machiavellianism, psy-
chopathy; Conger and Kanungo 1998; Khoo and Burch 2008), callous-manipulative
behaviour in interpersonal relationships (Jones and Paulhus 2010; Rauthmann 2012)
and risky behaviours (e.g., Monteiro et al. 2018), may also influence employee
safety-related outcomes. Future research may explore the relationships between
the dark side of different constructive safety leadership styles and employee
safety-related outcomes.

Reciprocal Relationships

Finally, existing research has exclusively investigated safety leadership as the cause
of employee safety-related behaviours, overlooking the possible reversed effects of
employee safety-related outcomes on safety leadership. However, there might well
be bidirectional relationships between safety leadership and employee safety-related
outcomes. Indeed, scholars have long recognized that leadership is not a one-way
influence process but rather a reciprocal, dynamic process between leaders and their
subordinates, where leaders and their subordinates reciprocally influence one
another over time (Mumford et al. 1993). Specifically, Krasikova, Green, and
LeBreton (2013) argued that when leaders believe that the achievement of their
(personal or organizational) goals is thwarted by their subordinates, they might
adjust their leadership in order to influence the subordinates and change the situation.
Adjusting their leadership behaviours based on employee safety-related outcomes
may be necessary and strategic because poor safety-related outcomes may influence
the productivity of the employees and the effectiveness of the organization, which
may consequently jeopardize the status and power of the leader in the organization.
For instance, when employees consistently display poor safety performance, or
84 L. Jiang and X. Xu

when workplace accidents occur more often than expected in the organization, the
leader may have to adjust his or her behaviours, prioritize the safety issues and
increase safety-oriented interactions with the subordinates, such as enhancing safety
communications and showing more concerns for employee health and safety. This
perspective illustrates that employee safety-related outcomes may in turn cause
changes in safety leadership behaviours. Thus, researchers may devote their efforts
to understanding the reciprocal relationships between safety leadership and
employee safety-related outcomes.

Conclusions

Despite the diverse conceptualizations of both safety-related outcomes and safety

leadership, the existing literature generally agrees that constructive safety leadership
(e.g., transformational leadership, empowering leadership) has positive impacts on
safety-related outcomes, while destructive leadership (e.g., passive leadership) has
negative influences on safety-related outcomes. Building on social exchange theory,
social learning theory, social information-processing theory, expectancy theory and self-
regulation theory, we reviewed the key mediators explaining the relationships between
safety leadership and safety-related outcomes, key moderators altering the associations
between safety leadership and safety-related outcomes and organizational interventions
targeting safety leadership behaviours in order to improve safety-related outcomes.
Upon reviewing the rapidly growing literature on safety leadership, we offer
several avenues of investigation for safety researchers and practitioners. To that end,
we call for greater attention to the conceptualization and measurement of both safety
leadership and safety-related outcomes. In particular, we call research to demonstrate
the distinctiveness and usefulness of different safety leadership styles. Research is
additionally needed to adopt a within-person approach, to better understand the
relationships between safety leadership and safety-related outcomes. This review
calls for greater attention to the dark side of safety leadership with regard to
workplace safety and the reciprocal relationships between safety leadership and
employee safety-related outcomes. These research questions demand experience
sampling and longitudinal research designs, to more precisely test hypotheses and
explore feedback loops. By reviewing the current state of knowledge regarding
safety leadership and identifying the key gaps requiring research attention, we
hope that this chapter can stimulate future research to generate improved insights
into leadership and safety.

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Management Competencies for Health
and Wellbeing 5
Jo Yarker, Emma Donaldson-Feilder, and Rachel Lewis

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Why are Management Competencies Relevant to Employee Health and Wellbeing? . . . . . . . . 94
What Management Competencies are Important in this Context? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Management Competencies for Preventing and Reducing Stress . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Management Competencies for Sustainable Employee Engagement . . . . . . . . . . . . . . . . . . . . . . 99
Managing the Health, Safety, and Wellbeing of Distributed and Remote Workers . . . . . . . . 100
Management Competencies for Supporting Employees to Return to Work . . . . . . . . . . . . . . . 102
New Approaches to Management with Implications for Employee Health and Wellbeing . . . 104
Compassionate Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Mindfulness and Meditation Interventions for Managers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
How Can Management Competencies for Health and Wellbeing be Developed? . . . . . . . . . . . . . 106
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Abstract
A growing body of research demonstrates the impact of management behavior on
a range of individual and organizational health and wellbeing outcomes; however,
efforts to train and develop managers often fall short. This chapter focuses on
research to identify competencies–or the collection of skills, abilities, and knowl-
edge–required by managers to promote, protect, maintain, and support the health
and wellbeing of employees. A number of specific competency frameworks are
presented: for preventing and reducing work stress, enhancing engagement,
managing remote workers, and supporting return to work following sickness

J. Yarker (*) · R. Lewis

Affinity Health at Work and Birkbeck, University of London, London, UK
e-mail: jo@affinityhealthatwork.com; rachel@affinityhealthatwork.com
E. Donaldson-Feilder
Affinity Health at Work and Affinity Coaching and Supervision, London, UK
e-mail: emma@affinityhealthatwork.com

© Springer Nature Switzerland AG 2022 91

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_4
92 J. Yarker et al.

absence. Research examining the development of management competencies is

shared and the implications of new approaches to management such as compas-
sionate leadership and mindfulness are considered. Finally, learnings from inter-
ventions to develop management competencies for health and wellbeing are
discussed. This chapter aims to provide practical insights into how we can
develop managers so that they can better support their teams. We argue that if
we are to equip managers to manage the health and wellbeing of others, we must
not only raise awareness of health and wellbeing but also support the develop-
ment of the key skills, ability, and knowledge to take action. In doing so,
managing health and wellbeing is not a separate activity on top of managing
performance but rather becomes an integral part of the management practices.

Keywords
Line manager competencies · Manager competencies · Managing wellbeing ·
Managing engagement · Managing return to work · Healthy leadership ·
Preventing work stress

Introduction

Employers are increasingly recognizing the benefits of prioritizing the health and
wellbeing needs of their employees. It is well recognized that ill-health has significant
costs for individuals, organizations, and society. Estimates suggest that mental ill-health
alone costs the United States $1 trillion per year in lost productivity (World Health
Organization 2019) while a quarter of the European working population report having a
chronic disease and 44 million European Workers experience musculoskeletal pain that
impacts their work (Eurofound 2019). Everyday across the globe, millions of people go
to work while managing conditions such as mental ill-health, cancer, cardiovascular
disease, respiratory illness, hearing, and sight deterioration. Health has a significant
impact on our ability to sustain work and work can, if not designed and manage well,
cause or exacerbate ill-health and deplete our wellbeing.
Line managers play a vital role in the promotion, prevention, maintenance, and
support of health and wellbeing in the workplace. Managers are typically those indi-
viduals within the work environment in direct and regular contact with an employee.
They are in a position to identify and mitigate pressures placed on the employee; to
affect work and job design and can buffer or exacerbate the impact of the work
environment through their actions or inaction (e.g., Nielsen et al. 2006). Managers
play a central role in organizational development and change (Saksvik et al. 2002) as
exemplified in a recent evaluation of a health and wellbeing evaluation, where line
managers played a role in every step of the intervention process (Christensen et al.
2019). This importance of the in line manager’s role is of specific importance in the
context of preventative action whereby job redesign or organizational-level interven-
tions are used to address the sources of risk to ill-health at work.
5 Management Competencies for Health and Wellbeing 93

There is a robust and ever-growing evidence base that demonstrates the associ-
ations between line manager behaviors and employee health and wellbeing (e.g.,
Inceoglu et al. 2018; Montano et al. 2017; Skakon et al. 2010). Research to
understand the specific manager behaviors that foster or reduce wellbeing has largely
placed a focus on specific leadership styles or theories. Donaldson-Feilder et al.
(2013) provided a summary of the research and identified five clusters of leadership
styles relevant to health and wellbeing in the workplace including: supportive
behaviors (e.g., Offerman and Hellman 1996); task-relationship focused behaviors
(e.g., Nyberg et al. 2005); transactional and transformational leadership behaviors
(e.g., Nielsen et al. 2008); negative leadership behaviors (e.g., Einarsen et al. 2007);
and other supervisory indices (e.g., van Dierendonck et al. 2004). In addition, a less
studied health-specific leadership framework has been developed by Gurt et al.
(2011) who highlighted that the predominant leadership theories do not explicitly
prioritize the leaders’ active engagement in health and wellbeing. Specifically, Gurt
et al. (2011) proposed that health-specific leadership requires leaders to explicitly
raise health topics in interactions with their followers, communicate the importance
of health, role model, healthy and safe behavior, and actively support organizational
health-promotion activities.
Despite this compelling evidence base for placing line managers at the heart of
health and wellbeing activities, efforts to train and develop managers to protect and
promote health and wellbeing have been disappointing. A recent meta-analysis
conducted by Kuehnl et al. (2019) sought to assess the impact of manager training
on stress, wellbeing, and absenteeism. The authors examined both training aimed at
improving supervisor–employee interaction and training aimed at improving the
capability of designing the work environment (to mitigate risks to health and
wellbeing). Despite a comprehensive search including off-the-job and on-the-job
trainings, they concluded that while human resource training interventions are
widely implemented to improve managers’ knowledge, skills, and ability to take
responsibility and support employee health and wellbeing, few positive effects of
training on employee stress, wellbeing, and absenteeism could be identified. Kuehnl
et al. (2019) noted the variability of training content and design and highlighted the
weak study designs as contributing factors.
The reality for many employees is that they do not feel supported by their line
manager to manage their health and wellbeing. In the UK, managers have been
consistently cited as one of the top three sources of stress by employees in wide-scale
practitioner surveys (CIPD 2008; CIPD 2018). Only 11% report that they have
discussed their mental health with their line manager which is not surprising given
that only 24% of managers have received some form of training on mental health at
work (Stevenson 2017). This picture extends across the globe with four in ten US
workers indicating that managers are committed to their health and wellbeing (APA
2016) suggesting that many workers are not being supported with their health and
wellbeing needs. Together, this information points to an urgent need to explore
alternative ways to equip managers with the knowledge, skills, and abilities to
manage employee health and wellbeing.
94 J. Yarker et al.

Why are Management Competencies Relevant to Employee

Health and Wellbeing?

The research summarized above points to a wide range of manager behaviors that are
linked to the health and wellbeing, particularly those that involve individualized
consideration and/or interpersonally fair treatment and the empowerment of
employees (e.g., Nielsen et al. 2008). However, many of the leadership and man-
agement frameworks used in this field of research were designed to capture the
behaviors that drive performance, rather than taking a specific focus on the behaviors
relevant to health and wellbeing. Developing a clearer understanding of the specific
behaviors relevant to employee health and wellbeing offers opportunities not only to
better measure relevant behaviors when conducting research in this field, but oppor-
tunities to train and develop the knowledge, skills, and abilities specific to protecting
and promoting health and wellbeing.
Competency frameworks refer to a complete collection of skills and behaviors
required by an individual to do their job (Boyatzis 1982). Competencies are used
globally to articulate the expected outcomes of an individual’s efforts and make
explicit the behaviors required to carry out activities required of their job. The
concept of competency frameworks emerged in the 1980s as a response to organi-
zational drivers to define and measure performance. In 1982, “The competent
manager: a model for effective performance” written by Boyatzis provided a com-
prehensive introduction to the way in which competencies could be developed and
described and gave insights into how competencies could be integrated into person-
nel practices (as they were then referred to). This work had considerable influence on
the Human Resource Management profession and in the proceeding decades, com-
petency frameworks became increasingly accepted part of modern people manage-
ment practice (Rankin 2004). A proliferation of competency frameworks can now be
seen, with profession specific frameworks (e.g., in critical care nursing, Zhang et al.
2001) to those competencies required to execute specific tasks (e.g., competencies
for train driving Naguib 2020).
Competencies frameworks are used to guide a wide range of Human Resource
Management activities and are widely embedded in recruitment, training, perfor-
mance management, promotion, and talent management activities and redundancy.
For example:

• In a recruitment context, competency frameworks form part of job descriptions

and person specifications. Frameworks are used in situational interviews and
assessment center exercises enabling the behavioral criteria (how people do
things) to be assessed alongside task performance (what they do) and personal
characteristics. Competency-based interviews have consistently been found to be
the most popular method of selection (CIPD 2017).
• In training and development contexts, competency frameworks can be used to
identify training needs and training programs or modules can be designed and
delivered to develop specific competencies. This way, learners are only required
to engage in learning that is addressing a competency-gap rather than attend
5 Management Competencies for Health and Wellbeing 95

training for skills or abilities they may already hold. Furthermore, the focus on
behavior enables trainers to clearly articulate the desired behavior and therefore
the behavior change required to achieve the desired performance outcome.
• In a performance management context, competencies, and the behaviors that
underlie them, can be used to articulate what constitutes a competent performance
and can be measured by others, or integrated into a “balanced scorecard” system
to assess performance.
• In the context of organizational and culture change, competencies can be used to
drive and embed a culture shift. By articulating the competencies required by
managers, and by selecting, developing, and rewarding managers to behave in
these ways, these behaviors theoretically should become the norm.

Competency approaches are not without limitations. Criticisms include that they
exist as a “snapshot,” produced during a particular time and then used on an ongoing
basis, within a role that may change rapidly; that they lack sufficient behavioral
specificity; they can be lengthy and overwhelming for employees where there are
many performance-critical behaviors; and create workplaces whereby all employees
are selected for, and working to execute, the desired behaviors in order to achieve
performance goals. In practice however, competency frameworks are only as effec-
tive as the design processes used to develop them, and the strategies used to
communicate, assess, and embed them within the organization.
The benefits of considering the management competencies relevant to employee
health and wellbeing were highlighted by Yarker et al. (2007) and include the
following:

i. The clear and specific identification of the manager behaviors that are known to
protect, maintain, and promote health and wellbeing.
ii. The ease of integration into existing management frameworks, putting health
and wellbeing into a language or format that is accessible to managers already
familiar with this approach and therefore facilitating collaboration between
human resources, health and safety, and managers.
iii. The reduction of the cognitive load placed on managers, as managing health and
wellbeing is not seen as a separate activity but an integral part of management
activities.
iv. The ease of identifying gaps between existing management frameworks (e.g.,
technical and core organizational management competencies identified as rele-
vant to the job-specific performance) and the competencies required to protect
and promote the health and wellbeing of others.
v. The provision of a clear and specific set of skills, abilities, and behaviors that can
be targeted for the development in training interventions.

Competency frameworks are only beneficial within the context that they aim to
address: a competency framework designed to consider the performance of a specific
task or role, without the consideration of broader organizational objectives, is
unlikely to contribute to the realization of the broader organizational goals. There
96 J. Yarker et al.

has been a changing focus on competencies in recent years, with a move to combine
softer skills or meta-cognitions alongside the behavioral elements. This provides an
opportunity to align performance and health and wellbeing objectives and encourage
organizations to look beyond the role, and incorporate those management compe-
tencies that are relevant to protecting and promoting health and wellbeing.

What Management Competencies are Important in this Context?

Management Competencies for Preventing and Reducing Stress

In recognition of the challenges experienced by managers to prevent and reduce

stress and driven by the pursuit of making the management of health and wellbeing
of others an integral part of the job and as straightforward as possible, a three-phase
project aimed to identify the management competencies for preventing and reducing
stress at work (MCPARS; Yarker et al. 2007; Yarker et al. 2008; Donaldson-Feilder
et al. 2009). The program was sponsored by the UK Health and Safety Executive,
Investors in People, Chartered Institute of Personnel and Development and a con-
sortium of participating organizations. This collaborative approach between stake-
holders allowed for the differing priorities and perspectives to be represented
throughout the design and development process. For example, through health and
safety representation, the objective of reducing psychosocial risks in the workplace
was kept front of mind. Through representation from human resources professionals,
the considerations of people management practices across job design, recruitment,
performance assessment, and training and development could be considered. Finally,
organizational collaboration maintained a focus on enabling the embedding of the
identified behaviors into interventions and into existing organizational policies and
practices.
In phase one (Yarker et al. 2007), a critical incident technique interview (Flanagan
1954) was used to elicit the behaviors associated with both the effective and
ineffective management of stress in employees. 216 employees and 166 managers
and 54 HR practitioners were involved in interviews or focus groups and completed
written exercises. Participants were recruited from five sectors recognized as having
the highest prevalence of work-related stress in the UK. Using an iterative approach
of thematic and content analysis, the framework was developed and the final
MCPARs framework included 19 competencies, all but one of which included
both positive and negative behavioral indicators. This framework was mapped
onto ten other management frameworks, including frequently used models of trans-
formational leadership, to explore the overlap and gaps between existing manage-
ment and leadership competency frameworks and the newly developed
competencies derived with a focus on health and wellbeing. All competencies
were included in at least one of the frameworks, three of the competencies appeared
in all ten comparison frameworks (“Participative approach,” “Acting with Integrity,”
and “Communication”) but no framework covered all the competencies. This
highlighted that current measures of management competency do not include, and
5 Management Competencies for Health and Wellbeing 97

therefore do not encourage managers to enact or develop, the full complement of

management competencies identified as relevant to preventing and reducing work
stress. Furthermore, the approach enabled the framework to be applied and the
behaviors contextualized within each sector (e.g., within healthcare, Lewis et al.
2010).
In phase two, a quantitative approach was used to refine and reduce the MCPARs
framework and to develop a robust psychometric measure of the competencies
(Yarker et al. 2008). Following best practice principles for psychometric test devel-
opment (Rust and Golombok 1999), the interviews were reviewed to extract specific
observable behaviors to use as questions for an indicator tool. Stakeholders and
experts (n ¼ 21) provided feedback on the initial question set and items were refined.
The refined set of behaviors were quantitatively tested using a snowball sample of
employees (n ¼ 292). Following reliability analyses and item reduction, the ques-
tions were used as an upward feedback measure for 152 managers and 656 direct
reports working across 22 organizations. The direct report data was then subjected to
exploratory factor analysis revealing a four factor solution. Stakeholders and experts
(n ¼ 38) were invited to a workshop to share the findings and to name the four
factors and develop sub-clusters, resulting in three sub-clusters per factor
(or competency). Following final revisions, the measure was comprised of 66 ques-
tions across four competencies and was named the Stress Management Competency
Indicator Tool (SMCIT). The four competencies included: “Managing and Commu-
nicating Existing and Future Work,” “Managing the Individual Within the Team,”
“Reasoning and Managing Difficult Situations,” and “Respectful and Responsible:
Managing Emotions and Having Integrity.” Descriptions of the competencies and
the sub-competencies are provided in Table 1. Usability analysis indicated that a
large proportion of managers who used the SMCIT reported that it was easy to
answer, relevant to their role and accurate in terms of identifying key management
development areas. The MCPARs framework and SMCIT are frameworks
recommended as a practical approach to supporting organizational activity to man-
aging psychosocial risk (Eurofound 2019). While further empirical testing of the
competency model and validity of the tool was required, early indications of validity
and usability showed promise.
In phase three, a manager training intervention using the MCPARs framework
was trialed (Donaldson-Feilder et al. 2009). The intervention comprised of upward
feedback and a half day workshop including exercises to facilitate the reflection on
the four competencies and encourage action planning. 112 managers attended the
workshops, of whom 58 completed the pre- and post-measures (including the
SMCIT). Data from two timepoints was gathered from 95 managers that did not
receive the intervention and formed the control group. Data was also gathered from
209 employees whose managers received the workshop and the feedback, and a
further 385 employees whose managers formed control groups. The intervention was
found to be moderately successful. Those managers that saw themselves as ineffec-
tive saw the most significant positive change over time. This was true whether they
had received the intervention or not, suggesting that the process of completing the
SMCIT may have promoted self-reflection and action. Managers who had initially
98 J. Yarker et al.

Table 1 Overview of the management competencies for preventing and reducing stress including
each of the four competencies, the sub-competencies, and descriptions of each sub-competency is
shown in the table below
Management competency Sub-competency Description of sub-competency
Respectful and Responsible: Integrity Respectful and honest to employees
Managing emotions and Managing Behaves consistently and calmly
having integrity emotions
Considerate Thoughtful in managing others and
approach delegating
Managing and Proactive work Monitors and reviews existing work,
communicating existing and management allowing future prioritization and planning
future work Problem solving Deals with problems promptly, rationally,
and responsibly
Participative/ Listens and consults with team, provides
empowering direction, autonomy, and development
opportunities to individuals
Reasoning/managing difficult Managing Deals with conflicts fairly and promptly
situations conflict
Use of Seeks advice when necessary from
organizational managers, HR, and occupational health
resources
Taking Supportive and responsible approach to
responsibility for issues
resolving issues
Managing the individual Personally Available to talk to personally
within the team accessible
Sociable Relaxed approach, such as socializing and
using humor
Empathetic Seeks to understand the individual in
engagement terms of their motivation, point of view,
and life outside work

scored themselves as “effective” saw themselves largely unchanged by the interven-

tion while “Effective” managers who had not received feedback or attended a
workshop saw themselves as less effective at the follow-up point, perhaps more
cognizant of the need to display the relevant behaviors. For managers that received
no feedback, their employees’ reported their behavior largely unchanged 3 months
later, while employees managed by those who had received feedback (with or
without a workshop), employees felt that managers significantly improved on all
competencies over the 3-month period. A number of barriers and facilitators to
behavior change related to the competencies were identified during this phase and
are outlined later in this chapter.
Toderi et al. (2015) noted that the length of the SMCIT (66 items) limits its
practical applicability and sought to reduce the measure placing a focus on the
largest of competencies “Managing and Communicating Existing and Future
Work.” In a study of 178 employees working in two Italian public organizations
(a municipality and a hospital), their study found that the SMCIT demonstrated
5 Management Competencies for Health and Wellbeing 99

sound psychometric properties and strong associations with affective wellbeing and
team effectiveness. Toderi and Sarchielli (2016) sought to further test the validity of
the short 36-item version of the SMCIT finding support for the factorial structure and
criterion validity. Limited by the cross-sectional and self-report nature of the data
gathered thus far, Toderi and Balducci (2018) studied the stress management com-
petence of 84 supervisors, using the SMCIT, seeking upward feedback from
584 team members. Multilevel analysis suggested that the four competencies may
be influenced by a meta-competence factor given the strong intercorrelations and the
framework was found to affect affective wellbeing as mediated by factors in the
work context such as role clarity, but not work content such as job demands.
Houdmont et al. (2020) applied the SMCIT to English Policing. 263 police
officers completed a survey comprising the SMCIT. Findings demonstrated that
nearly half of the participants identified that their line manager had a development
need in three of the competencies: Approximately half the participants reported their
line manager had a development need on the “Managing and Communicating
Existing and Future Work,” “Managing the Individual Within the Team,” and
“Reasoning and Managing Difficult Situations” competencies, while a quarter iden-
tified a development need on fourth competency, “Respectful and Responsible:
Managing Emotions and Having Integrity.” Those officers that rated their line
manager as requiring development across all four competencies were four times
more likely to report psychological distress, resilience, and work engagement. The
authors point to the limitations of the cross-sectional design, specifically around not
determining causality or discounting reciprocal effects whereby poor wellbeing
outcomes of subordinates impair management competence; however, the findings
from this study add to our understanding of the relationship between SMCIT and
wellbeing outcomes and highlight the opportunities to use the SMCIT in a targeted
development program.
Together, these studies demonstrate the reliability and validity of the MCPARS
framework and resultant measure and show applicability across a range of organi-
zational sectors and job roles. While developed in the UK, the findings from Toterdi
et al. (2015) and Toderi and Balducci (2018) provide support for the relevance of the
framework beyond the UK. Early indications also demonstrate that the MCPARS
framework shows promise when used as a management development intervention
although further research is required to better understand the impact of both receiv-
ing feedback on management competence alone, and focused development to build
skills in the competency areas, on both the managers behavior and employee
outcomes.

Management Competencies for Sustainable Employee Engagement

It is generally accepted that employee engagement holds importance for organiza-

tions due to its significant and positive relationship with a broad range of organiza-
tional and individual outcomes of performance and wellbeing (i.e., Schaufeli and
Bakker 2010). Lewis et al. (2011) aimed to identify the specific manager behaviors
100 J. Yarker et al.

required to engender employee engagement. Using an evidence-based practice

approach (Briner and Rousseau 2011), combining qualitative and quantitative
methods (Lewis et al. 2011) 11 behavioral competencies were identified, grouped
into three overarching competencies resulting in the Management Competencies for
Managing Employee Engagement. The framework included the themes:
“Supporting employee growth,” “interpersonal style and integrity,” and “monitoring
direction” were tested with 506 employees and 126 managers working across seven
organizations and resulted in a 44-item measure that demonstrated good psychomet-
ric properties. At the sub-competency level, distinctions between the MCPARS and
Managing Employee Engagement could be made. As competencies are designed to
drive specified behavior, the two separate frameworks offer solutions for those
practitioners looking to drive behavior in a specific direction. However, given the
strong relationship between engagement and wellbeing, a degree of overlap was
unsurprising. With many organizations looking to prioritize engagement and
wellbeing and develop an integrated strategy, the practical benefits of combining
the frameworks were noted. Lewis et al. (2014) combined the 41-item Managing
Employee Engagement with the 66-item SMCIT and tested a combined model in
seven organizations. In this final phase of the research, a five factor, 54-item
“Managing Sustainable Engagement” framework emerged and demonstrated good
psychometric properties. A conceptual mapping of both the Managing Employee
Engagement and the MCPARS onto the combined Managing Sustainable Engage-
ment is shown in Fig. 1 to demonstrate the overlap between the competencies.

Managing the Health, Safety, and Wellbeing of Distributed

and Remote Workers

Managing the health, safety, and wellbeing of distributed and remote workers pre-
sents a challenge. Without the face-to-face contact and direct oversight that many
managers are afforded and the opportunities for spontaneous conversations within
the workplace environment, managers of remote workers may need additional or
different competencies in order to support the health and wellbeing of employees.
The majority of research examining the role of managers in managing employees
working remotely is focused on driving performance-related outcomes. While the
associations between specific manager behaviors and health and wellbeing outcomes
is less clear, three clusters of manager behavior are clearly seen as effective in a
remote working environment: providing clear communication, fostering social sup-
port, and enabling autonomy. These behaviors echo those examined throughout the
health and wellbeing field.
The quality and quantity of communication given by leaders to remote teams is
vital. As well as reduced contact time, the nuance of communication can be lost
when non-verbal cues are not available in a remote setting (Ford et al. 2017).
Research highlights that managers operating in a remote context should be clear
and aware of team members’ availability, deadlines, and how individual tasks fit
within an overall project (Hunsaker and Hunsaker 2008) and that regular and short
5 Management Competencies for Health and Wellbeing 101

Fig. 1 An overview of the relationship between managing for sustainable employee engagement,
MCPARS, and “Managing engagement” frameworks

feedback is most effective in a remote environment (Sim 2018). In addition, indi-

viduals working remotely may also require a greater degree of feedback on the
process they have gone through to conduct a task, as opposed to only feedback on
the performance outcome (Geister et al. 2006).
Hunsaker and Hunsaker (2008) noted that managers should develop an under-
standing of remote team members’ social environments and that providing social
support may reduce role conflict in remote workers (Nayani et al. 2018). Support at
an individual level through regular contact (e.g., emails, phones, and video calls) and
at a group level through developing an online community has been found to provide
important opportunities for remote workers to check-in and share knowledge (Orsini
102 J. Yarker et al.

and Rodrigues 2020). Research also suggests that managers who operate a shared
leadership model, where they delegate leadership tasks to their team members (Hoch
and Kozlowski 2014), increase trust and knowledge sharing, as well as improve
collaborative decision-making and behavior among remote teams (Hoch and
Dulebohn 2013).
Nielsen et al. (2017) conducted a four-phase project to leadership behaviors
required for managing the occupational safety and health (OSH) of distributed
workers, i.e., workers who work at least part of the week away from the main
work location. This research is particularly pertinent given the sharp increase in
distributed and remote working during the coronavirus pandemic. Drawing from
interviews with 51 stakeholders and questionnaires completed by 40 OSH practi-
tioners, 112 line managers, and 822 distributed workers completed the question-
naires the study examined the leadership styles employed when managing
distributed workers. Findings showed that health-and-safety-specific leadership
was positively related to distributed workers’ self-rated health, safety compliance,
and safety proactivity. Interestingly, line managers were not seen to model the
behaviors seen by their OHS practitioner and the drivers for whether line managers
display health and safety behaviors was not examined. These findings further
support the argument that specific manager behaviors are required to drive specific
employee and organizational outcomes.
Further research is required to better understand the specific manager behaviors
required to protect and sustain wellbeing of those working in remote environments.
Such efforts could usefully consider the interaction between manager behavior and
the individual and contextual factors that may play an intervening role. For example,
do different demographic groups or employees working remotely under different
conditions need different management behaviors to be displayed in order for them to
fulfill their health and wellbeing goals? As yet, our understanding of the complex
interactions is limited and therefore any efforts to develop managers may be
thwarted if programs are implemented with the expectation that there is a shared
and universal experience of remote working.

Management Competencies for Supporting Employees to Return

to Work

Managers do not only influence the health and wellbeing of employees at work, but
they play a vital role in supporting the return to work of employees who are absent
from work due to illness. Sickness absence is a significant cost for many organiza-
tions. Supporting people to return to work, and subsequently stay at work, is
challenging. In relation to mental health sickness absence alone, Norder et al.
(2017) found that 18% of returned employees had left employment 5 years post-
RTW, 25% of these resigned, 30% were dismissed, 6% were granted disability
pension, and 31% retired early.
Line managers are important in the return to work process for a number of
reasons: they are often the employees’ first point of contact when they are unwell
5 Management Competencies for Health and Wellbeing 103

and unable to attend work; they are responsible for the day-to-day management of
the employees on their return; they are the gatekeepers for implementing and
reviewing work adjustments. A good relationship and ongoing communication
during sick leave is crucial, and studies indicate that line managers often do
communicate with workers on sick leave (Negrini et al. 2018; Nieuwenhuijsen
et al. 2004).
Applying learnings from the development of the MCPARS approach, Yarker et al.
(2010) sought to understand the specific manager behaviors relevant to supporting a
successful return to work. Providing clarity around the manager behaviors required
provides an opportunity for managers to self-assess their competence, but also
allows organizations to identify those employees who are at risk from receiving a
lack of support or poor oversight of their return and either provide additional training
for the line manager or provide an additional point of contact for the employee (e.g.,
from within Human Resources or from an alternative manager within the business).
26 employees and 20 managers were interviewed using a critical incident interview
to develop an in-depth understanding of the role of the manager through the return to
work journey. Following thematic analysis, an item-bank was developed and
347 absent or recently returned employees and 177 managers who were managing
a returned employee completed the measure at time one of which, 111 employees
also completed the follow-up questionnaire 6 months later. A factor analysis of the
manager behavior items revealed four sub-scales: communication and support
during sick leave, inclusive behavior upon initial return, negative behaviors, and
general proactive support following return to work. This final competency was
further grouped into three sub-competencies following a discussion with the steering
group and included: managing the team, an open and sensitive approach and legal
and procedural knowledge. These competencies underpin the Supervisor Support for
Return to Work (SSRW) scale which was shown to have good test re-test reliability,
construct validity and concurrent validity as measured by work limitations and job
performance, and with wellbeing, as measured by a general wellbeing measure,
psychological distress, and job satisfaction (Munir et al. 2012). The overall SSRW
measure was found to predict work performance and wellbeing after 6 months.
Different aspects of the competency model were associated with different work and
health outcomes. This suggests that managers are required to demonstrate different
behaviors at different points of the return process, and for different reasons, in order
to support the employees’ return to work.
Many employees who return to work following sickness absence experience
reduced work functioning (e.g., Norder et al. 2017). Changes in work scheduling,
task modifications, or other arrangements are cited as commonly recommended
adjustments in both employee and employer guidance and practitioner literature
(Yarker et al. 2020). Yet, recent findings suggest that 41% of employees experienc-
ing a mental health problem achieve no changes or actions taken in the workplace to
help them manage their condition, which may be due to the lack of manager training
around reasonable adjustments and rehabilitation for mental health (only 8% of
managers reported receiving training in the UK, BITC 2018). There is a clear
disconnect between the need for support and the support available to employees
104 J. Yarker et al.

from their manager to secure work adjustments. While further research is necessary
to elucidate the manager behaviors relevant to the successful implementation of
work adjustments, recent research points to the role managers can play in facilitating
job crafting opportunities for returning employees. Job crafting “involves shaping
the task boundaries of the job (either physically or cognitively), the relational
boundaries of the job, or both.” (Wrzesniewski and Dutton 2001, p179). Returned
employees adopt a broad range of job crafting strategies, so it is vital that managers
afford returning employees the decision latitude to make the necessary adjustments
(Nielsen and Yarker 2020).This again brings the competency of managing the
individual within the team and the sub-competency of “participative/empowering”
management noted in the MCPARS framework (Yarker et al. 2007).

New Approaches to Management with Implications for Employee

Health and Wellbeing

Compassionate Leadership

The concept of compassion and its links with wellbeing are millennia old; however,
the study and application of compassion in the workplace is a more recent phenom-
enon (Rynes et al. 2012). Compassion refers to “an empathetic emotional response to
another person’s pain or suffering that moves people to act in a way that will either
ease the person’s condition or make it more bearable” (Lilius et al. 2003, p4). There
are now a number of authors and organizations arguing for the importance of
creating compassionate workplace cultures, particularly in health and social care
settings (e.g., Worline and Dutton 2017; West et al. 2020). There is an increasing
body of evidence that suggests compassion in the workplace enhances employee
health and wellbeing among other outcomes (e.g., Lilius et al. 2003; Meecham
2017).
As part of this developing interest in compassion in the workplace, the role of line
managers has been emphasized (e.g., Lilius et al. 2011), and models of compassion-
ate leadership developed (Poorkavoos 2017; Shuck et al. 2019; West et al. 2017).
West and Chowla (2017) proposed a model of compassionate leadership that is based
on the four components of compassion set out by Atkins and Parker (2012):

• Attending: paying attention to the other and noticing their suffering.

• Understanding: understanding what is causing the others’ distress, by making an
appraisal of the cause.
• Empathizing: having an empathic response, a felt relation with the others’
distress.
• Helping: taking intelligent (thoughtful and appropriate) action to help relieve the
others’ suffering.

This model is now widely used in UK health and social care settings and is seen as
a way of improving patient outcomes through improving employee experience and
5 Management Competencies for Health and Wellbeing 105

wellbeing (e.g., NHS Improvement 2019). Direct research evidence about the link
between these elements of leadership behavior and employee health and wellbeing is
currently limited, but a number of authors have reviewed relevant research literature
and concluded that higher levels of compassionate leadership will be linked to better
employee health and wellbeing (e.g., West et al. 2020).
Another model of compassionate leadership is that developed by Poorkavoos
(2017), who initially conducted research to develop a Compassion at Work Index.
This Index identified five factors of compassion in the workplace: being alive to the
suffering of others; being non-judgmental; tolerating personal distress; being
empathetic; and taking appropriate action. These factors were developed into a
model of compassionate leadership that involves managers both being compassion-
ate people themselves and aiming to create a culture in which seeking or providing
help to alleviate suffering is seen as the norm.
Similarly, Shuck et al. (2019) conducted a two-stage study in which they initially
explored the “building blocks” of compassionate leadership behavior, then subse-
quently developed and validated a “Compassionate Leadership Behavior Index”
(CLBI). The CLBI includes six factors: integrity, empathy, accountability, authen-
ticity, presence, and dignity. Shuck et al.’s (ibid) data suggested that employees who
reported experiencing high levels of compassionate leadership from their manager
also showed high levels of wellbeing and engagement, and low intentions to
turnover. Interestingly, this data also suggested that compassionate leadership behav-
ior was a unidimensional construct, which the authors conclude to imply that the
overall experience of compassion from the manager was important, rather than the
individual subsets of behavior (“the sum is greater than the parts”; Shuck et al. 2019,
p 557).

Mindfulness and Meditation Interventions for Managers

In considering recently developed leadership models and management development

approaches that are relevant to employee health and wellbeing, one area in which
there is a newly established literature is the link between mindfulness, leadership,
and management development. A number of models of mindful leadership have
been developed (e.g., Carroll 2007; Marturano 2014; Reitz et al. 2016) in which
higher levels of manager mindfulness are proposed to contribute to a range of
employee outcomes, including wellbeing. Meanwhile, there is an emerging body
of evidence exploring the use of mindfulness and other forms of meditation as a
methodology for management development that might benefit employee outcomes
such as health and wellbeing (Donaldson-Feilder et al. 2018).
Mindfulness and meditation date back thousands of years and tended to be seen in
a spiritual or religious context; however, mindfulness and meditation interventions
have been applied in secular contexts over the past 30 years and have seen increasing
use in workplace settings in more recent times (Jamieson and Tuckey 2017). There is
a growing body of evidence linking mindfulness-based interventions such as
Mindfulness-Based Stress Reduction (Kabat-Zinn 1990) and Acceptance and
106 J. Yarker et al.

Commitment Therapy (Hayes et al. 1999) with positive outcomes for wellbeing, and
a couple of systematic reviews have shown positive effects for employee wellbeing
from applying mindfulness interventions in the workplace (Jamieson and Tuckey
2017; Lomas et al. 2017). While less well established than that for individual
wellbeing applications, the body of literature exploring mindfulness and meditation
interventions for management development is growing (Donaldson-Feilder et al.
2018).
There are now both theoretical and empirical papers suggesting that mindfulness
and meditation, offered as part of a management development program, could not
only benefit the health and wellbeing of manager participants, but also develop
competencies that have a broader impact in the manager’s workplace. For example,
various authors have suggested that mindfulness and meditation interventions for
managers could: develop capabilities that contribute to leadership (e.g., Butler and
Gray 2006) or are associated with particular leadership models (Reb et al. 2015); and
result in positive wellbeing consequences for employees (Reb et al. 2014). Looking
at evidence from intervention studies, a recent systematic review by the current
authors drew together research in which mindfulness and meditation interventions
had been run for leader and manager participants, and examined the outcomes these
interventions were found to achieve (Donaldson-Feilder et al. 2018). The review
identified 19 relevant papers and the findings from the data extracted from these
studies suggest that there is promising evidence: a) that mindfulness and meditation
interventions improve the wellbeing of leader and manager participants; and b) that
these interventions improve capabilities that are related to leadership and capacities
in keeping with particular models of leadership. Multiple studies have found positive
results for these categories of outcome variables; however, the studies are highly
variable and, in many cases, limited in their design and execution, so the evidence
cannot yet be regarded as definitive. Given the relational nature of people manage-
ment, and particularly the importance of the manager–employee relationship for
employee wellbeing (e.g., Gregersen et al. 2016), a more recent study by the current
authors (Donaldson-Feilder et al. in press) proposes management development
interventions based on interpersonal or relational forms of mindfulness practice,
may have benefits over and above personal mindfulness approaches.

How Can Management Competencies for Health and Wellbeing

be Developed?

The research presented so far demonstrates the associations between a range of

specific manager behaviors or competencies and work and health outcomes. How-
ever, the extent to which these behaviors can be developed in managers is less
understood. The review by Kuehnl et al. (2019) concluded that interventions to
develop managers to improve employee work and health yield few positive out-
comes. While some research has shown that managers can be equipped with
behaviors that are important for employee wellbeing through provision of upward
feedback and learning and development activities (e.g., Donaldson-Feilder et al.
5 Management Competencies for Health and Wellbeing 107

2009), this research also showed that developing managers and seeking to change
manager behavior is hard, and that maintaining change is even harder. The context in
which management development takes place plays a significant role in the successful
implementation of interventions (Donaldson-Feilder and Lewis 2011; Day et al.
2014; Garavan et al. 2015). Therefore organizations need to create an appropriate
context in which to support and develop managers.
The experiences of learning following a workshop to develop management
competencies relevant to sustainable engagement were captured by Donaldson-
Feilder et al. (2014). Information was gathered from managers and stakeholders
about the organizational factors that affect success of interventions designed to
change manager behavior, with a specific focus on how to improve future partici-
pation rates and the learner’s experience. The following steps were identified:

– Create a steering group: Include representatives from across the organization to

improve visibility and buy-in.
– Present a united front: Involve as many stakeholder groups as possible from
across the business (HR, H&S, OH, Managers, senior managers, and direct
reports) to position the intervention as part of a wider program of activity rather
than a stand-alone project.
– Integrate the project into existing organizational policies and practices: Link the
program to existing strategy and approaches and embed into existing develop-
ment programs or induction processes.
– Rename the research: Identifying a name and using the right term for the
organizational culture is important. Not all organizations are receptive to “stress”
or “wellbeing” or “mental health.”
– Choose participants strategically: Address a need rather than using the interven-
tion as a “nice to have” through targeting at-risk groups or senior leaders first.

Lewis et al. (2016) developed the Maturity Model for Management Development
Programs aimed at addressing employee health, wellbeing, and engagement. In the
model, manager awareness, available support, and presence of strategic and contex-
tual factors are articulated to help practitioners determine the level of maturity within
their organization. In doing so, it aims to help practitioners identify what needs to be
in place to effectively support managers in their development. The research team
reviewed the evidence and invited organizations to share their experience of
implementing management development programs. 189 organizations completed a
questionnaire that identified the range of management development activities in
relation to health, wellbeing, and engagement and the context in which managers
were learning and working. Conditions required before, during, and after a manage-
ment development intervention were identified and combined into a checklist, to be
used in a similar way to a diagnostic tool. The maturity model allows an organization
to assess its methods and processes against a clear set of external benchmarks. This
approach also provides insights into where best activity and improvement should be
prioritized. The resulting maturity model has four levels, from “little or no capabil-
ity” to “competence” and is described in Table 2. For example, those organizations
Table 2 Maturity model for management development programs aimed at addressing employee health, wellbeing, and engagement (Lewis et al. 2016)
108

Maturity Level
Chronological 1 2 3 4
StaChroge Before Manager: Managers are Manager: Has not Manager: Starting to support Manager: Preparing managers
not being supported or supported or prepared managers around their management for the program and supporting
prepared for the program managers for the program skills them on developing self-
Intervention: Exploring Intervention: Thinking Intervention: Planning the program awareness and management
relevant training courses about the format in terms of in detail and considering effective skills
but not thinking of them a program of activities formats, ongoing support, and resources Intervention: Program is
as a long-term program rather than one off training Organization: Has in place some strategically embedded within
Organization: No Organization: Not organizational culture, policies, and the wider organization
consideration of the recognizing organizational other aspects that will support Organization: Clear about
importance of context as important effective management development. culture, role modeling, and other
organizational context Some understanding of supportive, organizational context aspects
meaningful, and satisfying job design that will support effective
management development
During Manager: Participating Manager: Most managers Manager: Starting to support the wider Manager: Managers are
managers are not are clear about, satisfied development of the manager, including supported in developing aligned
committed to, or satisfied with, and committed in behavior, values, and self-awareness behaviors, values, and self-
in their role their role Intervention: Detailed goal setting has awareness
Intervention: Lack of Intervention: Program been conducted with integration into Intervention: Program design
clear objectives of the objectives are clear and organizational systems. Support includes both pre- and post-
program. No real intervention design has activities focus on developing manager activities
consideration for ongoing considered ongoing support skills and confidence Organization: Clear about
support and resources for program Organization: Has in place some culture, role modeling, and other
Organization: No real Organization: Starting to organizational culture, policies, and organizational context aspects
consideration of the look at importance of other aspects that will support effective that will support effective
importance of job design organizational context in management development. Starting to management development. Clear
for manager performance terms of job design for focus on the wider team environment to understanding of importance of,
and application of wellbeing, health, and support and improve effectiveness of and need for, healthy team
learning from safety managers working, and employee
management development wellbeing and engagement
J. Yarker et al.
 5

After Manager: Lack of Manager: Managers Manager: Managers have the required Manager: Managers have not
evaluation in terms of generally have the required skills and feel motivated to, and only gained and intend to apply
whether the manager has knowledge and skills and confident in, using them new knowledge and skills, but
the required skills and feel motivated to, and Intervention: A range of supportive are working within roles
knowledge confident in, using them interventions and resources continue to supportive of this change
Intervention: Managers Intervention: Managers be offered to managers Intervention: Clear continuing
are asked to provide are encouraged to focus on Organization: Clear understanding of follow-up strategy for managers
evaluation of the course their goals and practice new the impact of both the direct input including mentoring, coaching,
via satisfaction learning (senior management, team) and the visual aids, and guided reflection
questionnaires only Organization: Starting to indirect effect (organizational change/ Organization: Organizational
(no real follow-up). Little understand importance of climate) of the organization on context is entirely supportive of
focus on ongoing support wider organization such as sustaining management development management development and of
and learning role of senior management employee health and wellbeing
Organization: No and teams in sustaining including avoiding letting
consideration of the wider management development change impact on integration of
organization (such as learning
senior management and
teams) in terms of
sustaining management
development
Management Competencies for Health and Wellbeing
109
110 J. Yarker et al.

who demonstrate competence are those who fully prepare their managers prior to the
training or development event, and there is clear integration with other activities and
expectations set and modeled by others. The program is likely to include pre- and post-
activities and the follow-up strategy for managers may include mentoring, coaching,
visual aids, and guided reflection. This maturity model provides practitioners over-
seeing management development programs with a quick-view checklist to ensure they
have the right organizational conditions to optimize the effectiveness of the training. It
also makes explicit for management development to operate within a whole-system
approach to health and wellbeing—efforts to develop managers are less likely to be
successful when they are done in isolation or as a stand-alone endeavor.
A whole-system approach to protecting and promoting health and wellbeing is
vital to the success of all interventions as noted by Nielsen et al. (2017). Their review
and meta-analysis identified the workplace resources at the individual, the group, the
leader, and the organizational levels as related to both employee wellbeing and
organizational performance. In reviewing 84 studies, the researchers found no
significant differences in employee wellbeing and organizational performance
between the four levels of workplace resources. While the findings of this review
suggest that interventions that focus on any of these levels have comparable stand-
ing, there are two limitations to be borne in mind: First, academics have historically
adopted a siloed approach to research. Our understanding of the nature and the
impact of the intervention may be limited by examining individual or leader vari-
ables in isolation. Second, research examining interventions at the manager level are
in their infancy with little research that adopts a specific, competency-based
approach to developing managers’ skills, abilities, and knowledge. The research
presented here suggests that an increased focus on interventions to develop manager
competencies for health and wellbeing may be of benefit.

Conclusions

This chapter aims to position management competencies as an important component

of organizational activities to support health and wellbeing. Together, the studies
presented in this chapter show that specific competencies can be developed
depending upon the desired health and wellbeing outcomes; that there are a number
of shared competencies across the frameworks suggesting that organizations would
do well to focus on these; and that competencies can be explicitly articulated,
measured, developed, and integrated into wider management practices. A notable
benefit of the management competencies approach is the ready integration of the
behaviors that promote and protect health and wellbeing into wider organizational
practices across recruitment, performance management, and development. Further
research is needed to examine the impact of these competencies on others and to
understand the ways in which competencies can best be developed and maintained.
Future research will need to take care to employ robust designs, learning from the
limitations noted by Kuehnl et al. (2019) who report the absence of well-designed
studies that examine the impact of manager training. Managers play a vital role in the
promotion, protection, maintenance, and support of employee health and wellbeing.
5 Management Competencies for Health and Wellbeing 111

As the prevalence of ill-health escalates across the globe, there is an urgent need to
explore solutions to equip managers with the relevant skills, abilities, and knowledge
to take timely action and feel confident in doing so. Management competencies to
managing health and wellbeing show promise as an approach and we encourage
others to contribute to this evolving body of evidence and practice.

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Beyond the Leadership/Followership
Dichotomy 6
Vicki Webster

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Defining Followership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Reviewing Followership Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Followership in the Context of Constructive Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Followership in the Context of Destructive Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Followership in the Context of Virtual Teams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Beyond the Leadership/Followership Dichotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Practical Implications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Conclusions/Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

Abstract
Over the past decade attention has been focused on the role of followership as part
of the leadership process. Conceptualizations and definitions of what follower-
ship is and how it is demonstrated in the workplace have evolved over time: from
follower as a passive recipient of leadership, to follower as an active participant,
to followership as a form of shared leadership, then moving beyond the concepts
of leadership and followership to gain a shared understanding of the process of
how people organize work together. This chapter provides a review of the
followership literature, in the context of both constructive and destructive lead-
ership. Key followership theories and frameworks are reviewed, practical impli-
cations discussed, and directions for future research offered.

V. Webster (*)
Griffith University, Brisbane, QLD, Australia
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 117

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_5
118 V. Webster

Keywords
Followership · Follower-centric · Proactive followership · Implicit followership
theories · Follower typologies

Introduction

This chapter will first consider the term followership, how the concept has evolved
and how it is defined, before providing a review of the followership literature.
Leader-centric, follower-centric, and relational views of followership will be inves-
tigated, within the contexts of constructive leadership, destructive leadership, and
leadership of virtual teams. Key followership theories, frameworks, and follower
typologies will be reviewed and critiqued. This chapter includes a discussion on the
practical implications of the followership research to date and whether the concept of
followership is still relevant in modern workplaces. It will conclude with an explo-
ration of directions for future research.
When viewed from an evolutionary approach, it has been hypothesized that
followership evolved as a strategy to solve a range of cooperation and coordination
problems in groups (e.g., collective movement, peacekeeping). Bastardoz and Van
Vugt (2019) suggested, from a historical perspective, egalitarian, seminomadic tribes
of about 150 individuals were bound together by kinship and reciprocity ties. They
cooperated by sharing food or coordinating gathering and hunting activities. Decision-
making was egalitarian, and followers formed coalitions to monitor leader decisions,
so that influential individuals had no coercive power over others. With the develop-
ment of agriculture and the opportunity to store food and accumulate wealth, the
relationship between leaders and followers fundamentally changed. Dramatic
increases in population sizes and social inequality in large-scale societies paved the
way for institutionalized leader-follower structures as ways to enable coordination and
cooperation. In the western world, order is associated with hierarchy, leading to an
assumption that someone must be in charge. The western view of leadership has been
contrasted with some eastern philosophies, such as Taoism, where power is seen as
asymmetrically distributed. Rather than assuming someone must be in charge, it is
simply acknowledged that some people have more power than others and how people
negotiate working together is a process (Prince 2005). Bastardoz and Van Vugt (2019)
suggested that, as a result of evolutionary processes, humans now have a flexible
followership psychology that enables them to know under what conditions to follow
and to switch from being a follower to a leader whenever appropriate.

Defining Followership

In early conceptualizations of followership, it was proposed that leadership can only

occur if there is followership and that without followers and following behaviors
there is no leadership, suggesting following behaviors are a crucial component of the
6 Beyond the Leadership/Followership Dichotomy 119

leadership process and that leadership and followership are interdependent (Hol-
lander 1992). Kelley (1992) set the scene for the concept of followership being
accepted as a field of study in its own right. Kelley (1998: 146–147) defined
followership as follows:

People who are effective in the follower role have the vision to see both the forest and the
trees, the social capacity to work well with others, the strength of character to flourish
without heroic status, the moral and psychological balance to pursue personal and corporate
goals at no cost to others, and, above all, the desire to participate in a team effort for the
accomplishment of some greater common purpose.

Rost (1995: 112) also moved away from defining follower as a passive recipient of
leadership or as an experiential requirement of leadership:

. . . followers do leadership, not followership. And while followers sometimes change places
and become leaders, they do have to be leaders to exert influence, to use power resources to
persuade others of their position. In sum, followers are active agents in the leadership
relationship, not passive recipients of the leader’s influence.

Building on previous conceptualizations of followership, Carsten et al. (Carsten et al.

2010: 559) defined followership as complementing leadership, as “upward
leadership”:

Followership is a relational role in which followers have the ability to influence leaders and
contribute to the improvement and attainment of group and organizational objectives. It is
primarily a hierarchically upwards influence.

Carsten et al. (2010) distinguished between followership and follower-centric

approaches to leadership. Followers were viewed as key components of the leader-
ship process through their enactment of followership (Uhl-Bien et al. 2014). As the
concept of followership has become increasingly relevant to both practitioners and
academics, interest has grown in how followers use their social influence with
leaders and enact their own role in the leadership relationship, with a focus on
their followership (e.g., the way they communicate with the leader, comply with
their instructions, and respond to their behavior; Barbuto 2000; Carsten et al. 2010;
Oc and Bashshur 2013; Uhl-Bien et al. 2014). However, leader-centric approaches to
followership have been criticized for being too narrow and one-sided. In many
contemporary organizations, employees are seen as competent, self-confident peo-
ple, who like to think for themselves. Many followers feel that they do not flourish in
a hierarchical context, where the leader is seen as crucial to the organizational
system. They can become increasingly frustrated targets of their manager’s leader-
ship attempts, showing cynicism and faked acceptance of their manager’s directions
(Alvesson and Blom 2018). Nevertheless, definitions of followership are often
constructed in terms of how the concept relates to leadership (see Crossman and
Crossman 2011).
120 V. Webster

Reviewing Followership Research

Four key reviews of the followership literature have been conducted, and their
findings are summarized here. All four reviews position followership within the
leadership process. Firstly, Bjugstad et al. (2006) categorized the literature into three
broad theoretical areas: literature relating to follower motivations, follower values
and trust, and the characteristics of effective and ineffective followers. In the second
review, Baker (2007) made four key observations about followership: how follow-
ership and leadership pertain to roles, followers are active rather than passive,
followers and leaders share a common purpose, and the significant relational
dynamics between followers and leaders. In the third review, Crossman and
Crossman (2011) divided the followership literature into three groups. The first
group was descriptive, giving actual behaviors exhibited by followers (active,
passive, disregarding, supporting, or in opposition to their leaders). The second
group was prescriptive, concentrating on idealized behaviors that followers should
exhibit, rather than those they necessarily do. The third group examined situational
factors of followership, e.g., how compatible particular leadership and followership
styles are when operating in relation to one another in certain contexts. In the fourth
review, Uhl-Bien et al. (2014) proposed that the study of followership is not the
study of leadership from the follower perspective. It is the study of how followers
view and enact following behaviors in relation to leaders. They investigated follow-
ership from the perspective of a) formal hierarchical roles (e.g., followers as “sub-
ordinates”) and b) followership in the context of the leadership process (e.g.,
following as a behavior that helps co-construct leadership). Therefore, they
suggested that the construct of followership includes a follower role (i.e., a position
in relation to leaders), following behaviors (i.e., behaviors in relation to leaders), and
outcomes associated with the leadership process. When adopting a constructionist
(process) approach, they considered the co-constructed nature of the leadership
process. Uhl-Bien et al. called for followership constructs to be operationalized
and provided the following examples (p. 96):

• Followership characteristics: characteristics that impact how one defines and

enacts followership. (Examples may include role orientations, motivations, intel-
lectual and analytical abilities, affect, and social constructions of followers and/or
individuals identified as engaging in following behaviors.)
• Followership behaviors: behaviors enacted from the standpoint of a follower role
or in the act of following. (Examples include the multiple expressions of overt
followership including obeying, deferring, voicing, resisting, advising, etc.)
• Followership outcomes: outcomes of followership characteristics and behaviors
that may occur at the individual, relationship, and work-unit levels. (Examples
include leader reactions to followers, such as burnout or contempt, follower
advancement or dismissal, whether leaders trust and seek advice from followers,
and how followership contributes to the leadership process, e.g., leadership and
organizational outcomes.)
6 Beyond the Leadership/Followership Dichotomy 121

More recently there has been a move from traditional definitions of leadership
(e.g., one individual holding hierarchical power and authority) to the concept of
shared leadership. Shared leadership has been defined as follows:

. . .a dynamic, interactive influence process among individuals in groups for which the
objective is to lead one another to the achievement of group or organizational goals or
both. This influence process often involves peer, or lateral, influence and at other times
involves upward or downward hierarchical influence. (Pearce and Conger 2003, p. 1)

This definition acknowledges that individuals may, at the same time, be followers in
one team, peers in another team, and leaders in another. The shared leadership
approach is based on the premise that it is neither leader-centered nor follower-
centered because it rejects the idea that there is a distinction between leaders and
followers (Crossman and Crossman 2011). Under shared leadership, followership is
dynamically determined, and team members need to develop their followership
skills and the ability to clearly recognize when they should be leading and when
they should be following. However, Chaleff (2009) suggested that conceptualizing
leadership as a shared responsibility had limited usefulness and that we need to
recognize that leaders rarely use their power wisely over long periods unless they are
supported by followers who have the courage to stand up to them and help them to
do so. Chaleff called for a model of “courageous followership” that recognizes the
dynamic leader/follower relationship, the need for followers to show courage,
power, integrity, responsibility, and a sense of service. Studies of followership
have applied a number of conceptual and theoretical lenses to their studies, including
followership roles, followership behaviors, relational dynamics, situational factors,
follower characteristics, typologies, and styles. This chapter proceeds with an
examination of followership theory within the context of leadership and then reviews
the conceptualizations of followership that move beyond the leadership/
followership lens.

Followership in the Context of Constructive Leadership

Employees’ perspectives on leadership and followership are informed by an indi-

vidual’s implicit leadership and followership theories. Implicit leadership theories
research proposed that followers have implicit beliefs for leader behavior that
influences the extent to which they attribute the leader as effective and evaluate
them as a “good” or “bad” leader (Hansbrough and Schyns 2010). These implicit
leadership beliefs are formed through socialization and past experiences and are
activated when followers match observed leader’s behaviors to preexisting proto-
types of leaders that they hold in their memory. These beliefs can determine whether
and when individuals are willing to follow a leader (see Uhl-Bien et al. 2014).
Implicit followership theories are defined as individuals’ personal assumptions about
the traits and behaviors that characterize followers, which are formed via socializa-
tion and their experiences with followers. Sy (2010) studied implicit followership
122 V. Webster

theories by investigating subordinates’ as well as managers’ views of followership.

Sy proposed that implicit followership theories are best fitted into a six-factor
structure: industry (hardworking), enthusiasm (excited and outgoing), good citizen
(loyal, reliable, good team player), conformity (easily influenced), insubordination
(arrogant or rude), and incompetence (uneducated). He also proposed a second-order
two-factor structure: followership prototype (industry, enthusiasm, and good citizen)
and followership anti-prototype (conformity, insubordination, and incompetence).
Understanding implicit leadership and followership theories and how they interact is
important because they are associated with relationship quality and follower perfor-
mance (Sy 2011). Leaders’ perceptions of followers may affect the level of trust
between the dyad, whether they evaluate the follower positively or negatively, and
that evaluation may influence leaders’ treatment of followers.
Carsten et al. (2010) proposed a followership approach which examines fol-
lowers’ perspectives of followship, rather than followers’ perspectives of leadership.
Carsten et al. investigated how individuals’ schemas of followership informed the
way they responded to and complied with their leader, on a continuum from passive
to proactive followership. They found passive followers held hierarchical views of
followership, regarding it as deference, subordination, and obedience, being less
willing to speak out or take risks (e.g., likely to comply with a leader holding a high-
level position within the organizational structure). Active followers saw their role as a
partner in delivering leadership outcomes and felt able to voice their opinions in a
positive way. Active followers were described as emphasizing the importance of
supporting their leader’s decisions, even if they didn’t agree with them. Proactive
followers were less concerned with obedience, preferring to take initiative and
ownership for outcomes. Proactive followers were described as being more likely
to voice their concerns and offer solutions to problems before being asked to do so.
So, what makes a bad follower? As discussed above, Sy (2010) identified three
components: conformity, insubordination, and incompetence. Bastardoz and Van
Vugt (2019) defined a bad follower as an individual who does not coordinate well
with the leader and/or with other followers. Bad followership behaviors include
cheating, social loafing, and self-serving behaviors, such as when followers accept
bribes and support bad leaders, undermine the leadership position (e.g., an extro-
verted individual competing for status at the leader and group expense); or are
unpredictable in their actions. Bastardoz and Van Vugt (2019) noted that while bad
followers can be morally good people, it is through their undermining of group
coordination that they produce suboptimal outcomes. In interdependent relationships
problems arise when either party denies or hinders the other in achieving their goals,
e.g., deliberately working toward their own personal ends to get ahead, rather than
working on group goals, or endeavoring to maintain the status quo when resisting
change (Branch et al. 2007; Salin 2003).
Bad followers can misuse their power by abusing the dependency managers have
on them to fulfill their organization’s objectives (Branch et al. 2007). Restructured,
flatter organizations, ongoing organizational change, and levels of uncertainty can
trigger followers to regularly engage in a pattern of counterproductive behaviors.
These behaviors tend to escalate from subtle to overt over time and can progress to
6 Beyond the Leadership/Followership Dichotomy 123

upward bullying (Patterson et al. 2018). Followers may use resistance and avoidance
tactics or display their disrespect for the manager by their facial expression, rolling
their eyes, or glaring. They can also misuse their power, for example, utilizing
coercive power such as humiliation tactics (making disparaging remarks in public,
engaging in gossip and rumors) and intimation tactics (making false accusations or
lodging complaints and grievances), structural power (e.g., withholding information
or expertise), or referent power (e.g., ingratiating themselves with influential people
such as senior management or with external organizations such as unions: Patterson
et al. 2018). It has been suggested that upward bullying may also be a retaliatory
response to destructive leadership (Wallace 2009). Alternatively, bad followership
can result from a failure to act when leaders exploit or abuse employees (Chaleff
2009; Kellerman 2008).

Followership in the Context of Destructive Leadership

Followership research has hypothesized reasons why people conform with destruc-
tive leaders’ demands and fail to challenge their negative behaviors (Padilla et al.
2007; Thoroughgood et al. 2012). Despite arguments that followers, with no appar-
ent power or authority, can influence leaders, often individuals choose not to act
against destructive leaders or to report them (Chaleff 2009; Kellerman 2008). This
failure to act can be due to a range of factors. It may be a specific skill or power the
leader has, such as holding expert knowledge or powerful relationships. Lack of
knowledge of the characteristics of destructive leadership can lead followers to
believe it is themselves, and not the leader, who are at fault. They may feel that it
is something about their personality or something that they have done that has
caused them to be treated in such a way. Failure to recognize their leader’s behavior
as toxic, reluctance to face conflict and the unpleasantness of addressing these
behaviors with the leader, or a fear of retribution can lead to a failure of courage in
acting (Chaleff 2009). Despite some recent theoretical exploration for how followers
may cope with destructive leadership, there has been little field research to validate
these theoretical frameworks (e.g., May et al. 2014; Yagil et al. 2011). As it is not
always possible to remove derailing or destructive leaders, it is important to under-
stand the coping strategies followers employ that may protect them from the harmful
effects of being the target of destructive leadership behaviors or, alternatively, may
contribute to further abuse from the leader.
A follower-centric approach, led by the abusive supervision literature, focused on
the subjective assessment that subordinates make of a leader’s hostile or abusive
behavior (Martinko et al. 2013). This research investigated both the role and
interaction of leader and follower personality characteristics, leader and follower
motivations, and how these are activated by environmental context and opportunity
(Thoroughgood et al. 2012). The followership approach can be considered a useful
lens to better understand why destructive leaders retain a following. Followers’ need
for safety, security, group membership, and predictability in an uncertain world may
make them susceptible to destructive leadership (Padilla et al. 2007; Thoroughgood
124 V. Webster

et al. 2012). Padilla et al. (2007) used the concept of a “toxic triangle,” to describe
destructive organizational outcomes as a result of the combination of destructive
leaders, susceptible followers, and conducive environments. They use a “systems
perspective, focusing on the confluence of leaders, followers, and circumstances
rather than just the characteristics of individual leaders” (Padilla et al. 2007, p. 179).

Follower Typologies Based on a relational view of leadership and followership

theory, followers will comply with destructive leaders’ demands and may even
support and promote destructive leadership. Padilla et al. (2007) defined two types
of susceptible followers: conformers, who lack a clearly defined self-concept and
comply with destructive leaders out of fear, to minimize personal consequences of
noncompliance, and colluders, who may share the leader’s values and actively
participate in the destructive leader’s agenda to seek personal gain through their
association with the leader. Thoroughgood et al. (2012) extended Padilla et al.’s
(2007) typology of conformers and colluders, to explain followership of destructive
leaders. Table 1 provides a comparison of these two key typologies. Thoroughgood
et al. (2012) drew on Barbuto’s theory of follower compliance in an attempt to
understand the psychological processes that motivate followers to comply with
destructive leaders’ demands. Barbuto (2000) proposed three conditions required
to achieve follower compliance: the leader’s perceived power bases, the follower’s
sources of motivation, and the follower’s resistance level. Compliance is likely to be
greater when the influence trigger employed by the leader (i.e., power base, goals, or
values) is aligned to the follower’s motivation (i.e., self-concept and desired out-
comes), and the follower’s resistance to the influence attempt is low.

Lipman-Blumen (2005), in her discussion of why followers willingly obey toxic

leaders, suggested that there exist three categories of followers who enabled and
supported bad leaders: (a) benign followers, gullible followers who fail to question

Table 1 Two typologies of susceptible followers

Padilla et al. (2007) Thoroughgood et al. (2012)
Conformers Lost souls
Comply out of fear Low self-concept and strong identification with the leader (susceptible
to referent power)
Bystanders
Passive, motivated primarily by fear to minimize costs and punishment
(susceptible to coercive power)
Authoritarians
Obey because of rank and status of leader (susceptible to legitimate
power)
Colluders Opportunists
Participate in leader’s Form alliance with leader as a vehicle for personal gain (susceptible to
agenda reward power)
Acolytes
Share congruent values and goals with the leader (susceptible to expert
power)
6 Beyond the Leadership/Followership Dichotomy 125

what the toxic leader is saying or requesting and following for pragmatic reasons
such as keeping their job (conformers); (b) the leader’s entourage, committed to the
leader’s agenda (colluders); and (c) malevolent followers, driven by greed, envy, or
competitiveness, who work against the leader and may wish to depose the leader in
order to become the leader themselves. Similar to Lipman-Blumen’s malevolent
followers, Kellerman’s (2008) typology of followers of bad leaders included an
additional contribution in the leader-follower interaction process: followers who
may, over time, become resisters of destructive leaders, working to overthrow or
remove them. Kellerman’s first two types fall into the category of submissive
conformers: isolates, who are detached and strengthen leader’s position by not
responding to the leader, and bystanders, who observe but do not participate.
Participants, who are engaged and trying to have an impact, may be perceived as
responding constructively. Activists work hard, either on behalf of their leader or to
undermine them; and diehards are prepared to die for their cause and are either
deeply devoted to their leaders or ready to remove them. Activists and diehards may
be perceived by the leader as constructive if they support the leader’s agenda and
aggressive or retaliatory if they are perceived to be working against their leader, thus
perpetuating abuse by the leader (Kellerman 2008; May et al. 2014). In a similar
typology to Carsten et al. (2010), Chaleff (2009) proposed four followership styles to
address the power dynamics between leaders and followers, based on the level of
support and challenge offered to the leader by the follower: partner (high support,
high challenge), implementer (high support, low challenge), individualist (low
support, high challenge), and resource (low support, low challenge).
These follower taxonomies provide a possible explanation for the individual
differences in responses to destructive leadership. They highlight follower charac-
teristics and make distinctions between types of followers. However, discussion on
theoretical explanations for how these different types of followers influence the
interaction between leader and follower is still in its early stages (Uhl-Bien et al.
2014). The typologies for followers of destructive leaders discussed above are
descriptive and help us to theorize how followers may react and behave toward a
toxic leader, for example, avoid, support, challenge, or overthrow the leader. How-
ever, individuals may self-identify in more than one follower type, or their follower
type may change over time depending on the context (Kellerman 2008). Perhaps due
to the relatively recent growth in conceptualizations of followership and follower
typologies in the context of destructive leadership, no empirical research validating
these theories and typologies is yet available. Further empirical research is required
to validate theoretical follower typologies in field studies, to identify how under-
standing follower types can assist individuals and organizations to respond more
effectively to destructive leadership.

Follower Coping with Destructive Leadership Follower typologies have been

critiqued as leader-centric, focusing on followers’ compliance with the destructive
agenda set by the leader and/or followers’ resistance to the leaders’ destructive
instrumental influence attempts. May et al.’s (2014) leader-follower interaction
process suggested an alternative view that follower responses to perceived
126 V. Webster

mistreatment by their leader may either trigger or prevent further interpersonal

mistreatment. If followers’ behavior is interpreted by the leader as either submissive
(conformers) or aggressive and retaliatory, the leader will maintain or increase their
destructive behaviors. Followers who are perceived by the leader to cope in a
constructive manner (such as colluders) are likely to be the recipient of constructive
leadership behaviors. May et al. argued that using this perspective enables a better
understanding of how followers cope with and respond to destructive leadership.

With destructive leadership shown to be related to occupational stress, it follows

that targets of destructive leadership behaviors may employ a range of coping
strategies when attempting to deal with this particular occupational stressor
(Nandkeolyar et al. 2014; Schyns and Schilling 2013). Destructive leadership
behaviors form part of the psychosocial occupational stressor antisocial behaviors,
which have been found to lead to anxiety, fear, depression, and avoidance behaviors
in affected individuals (O'Driscoll and Brough 2010; Yagil et al. 2011). In the
occupational stress and coping literature, occupational stress is hypothesized to
affect both well-being (e.g., the psychological, emotional, and physical health of
an employee) and coping responses (e.g., efforts to prevent or reduce the negative
effects of stress on well-being; Goh et al. 2010). Upon perceiving a threat, initially a
fight-flight-freeze stress response can be triggered, a physiological reaction that
occurs in response to a perceived threat. The fight or flight response is activated
when an individual believes there is a chance they can survive the threat. The freeze
response, however, is activated when an individual’s coping capacity is over-
whelmed, when they believe that there is no hope of dealing effectively with the
stressor (Webster et al. 2016).
May et al. (2014) proposed that followers of destructive leadership were likely to
engage in multiple problem-focused and emotion-focused coping strategies, and
these strategies would vary in the level to which they confronted the leader (e.g.,
degree of assertiveness and aggressiveness of the coping behavior). Problem-
focused approach coping may include strategies such as challenging the leader’s
behavior, employing upward influencing tactics such as ingratiation, or seeking
instrumental support. Emotion-focused approach coping may include strategies
such as cognitive restructuring (reframing) and seeking emotional support. Exam-
ples of problem-focused avoidance coping included avoiding all contact with the
leader. Examples of emotion-focused avoidance coping included denial of the
situation and wishful thinking. May et al. proposed perceptions by leaders of
submissive and/or aggressive reactions from followers would lead to leaders engag-
ing in further destructive leadership behavior. May et al. assumed the level of
follower confrontation would influence how leaders perceived the follower was
coping with their leadership and would determine their behavior in response to the
follower. There are three key limitations with this approach: (a) the leader must be
able to observe the follower coping strategy to be able to perceive it as submissive,
aggressive, or constructive. Emotion-focused strategies (e.g., cognitive
restructuring) in particular are largely unobservable; (b) the leader’s perception of
the follower’s coping behavior may not be accurate; and (c) the leader must have the
6 Beyond the Leadership/Followership Dichotomy 127

resources and inclination to follow up with constructive behavior when responding

to follower coping attempts (May et al. 2014).
In addition, one of the few research studies into coping with abusive supervision
and well-being found employees were more likely to use avoidance-focused (non-
assertive, nonconfrontational) coping strategies. Yagil et al. (2011), in their study on
follower coping responses to abusive supervision in two employee samples, found
that while problem-focused coping was associated with positive affect, most of their
participants chose emotion-focused coping strategies and, in particular, avoidance-
focused coping responses. These findings support the proposition that if an individ-
ual feels they cannot avoid the stressor, or their attempts to cope with the stressor do
not work, this may lead to learned helplessness, when the individual gives up,
resulting in them experiencing higher levels of stress outcomes and longer-term
harm after unsuccessful coping over time (Goh et al. 2010). Yagil et al. concluded
that individual employees do not know how to cope effectively with abusive
supervision.

Followership in the Context of Virtual Teams

Heifetz et al. (Heifetz et al. 2009:64) made the call for adaptive leadership to deal
with the uncertainty created by global crises by “giving people of all levels of the
organisation the opportunity to lead [and] adapt to changing times.” This is exem-
plified more recently by the rise of remote working due to the COVID-19 pandemic
restrictions (KPMG 2020). Regardless of where work is conducted, measurements
of performance increasingly focus on outcomes rather than inputs. In remote work-
ing, collaboration remains important and new, more effective ways to connect and
collaborate virtually are commonly required. A shift to flatter, task-based structures
is likely to follow, changing traditional, implicit theories of what it means to be a
leader or a follower.
As employees are increasingly working in virtual teams, they become engaged in
multiple leading and following roles, resulting in a call for new leading and
following models and competencies in the virtual space (Cunha et al. 2013;
Malakyan 2019). The concept of shared leadership (e.g., a collective within-team
process, engaged in by multiple team members) is advocated as beneficial for virtual
teams because it is linked with collaborative decision-making, which has been found
to be a predictor of team performance in virtual teams (Hoch and Dulebohn 2017;
Pearce and Conger 2003). Some studies have found that leaders tend to underesti-
mate followers’ capacity to lead themselves. As a result, formal team leaders may
provide insufficient levels of autonomy for team members to engage in shared
leadership (Hoch and Dulebohn 2017). Shared leadership is typically facilitated by
social interactions among team members, including informal conversations and
socializing both within and outside of work. These activities create commitment,
trust, and cohesion among team members. Informal interaction is less feasible in
virtual teams, where interaction is often characterized by scheduled virtual meetings,
structured for purposes of assigning particular tasks and reporting on progress with
128 V. Webster

projects. Thus, organizations need to make efforts to directly encourage and facilitate
shared leadership and followership.
Hoegl and Muethel (2007), in their examination of dispersed innovation teams,
adapted and extended the concept of shared leadership, proposing an element of
proactive followership. Proactive followership comprises individuals’ behaviors that
adapt to environmental circumstances. Individual team members actively seek
feedback and engage in social influence processes with other team members. Pro-
active followership focuses on the exchange between an individual team member
and other team members to deliver individual- and team-level work outcomes. A
formal team leader working remotely has fewer opportunities for direct and imme-
diate communication with team members; therefore they may not have sufficient
detailed information to correctly assess everyone’s information and task needs or to
initiate corrective action as needed. As a result, it is up to team members to undertake
proactive followership behaviors, to actively and individually seek feedback from
within and outside the team regarding the appropriateness of their own task strate-
gies, and to initiate corrective action as needed. There is little research on follower-
ship in the context of virtual teams to guide practice in organizations. It is likely that
the dichotomy of leadership and followership may become redundant in the new
world of work being conducted by virtual and semi-virtual teams.

Beyond the Leadership/Followership Dichotomy

Given the above discussion on the future of work, it may be useful to put aside
preconceived assumptions about leadership and followership and look at how people
actually relate to each other, to view leaders and followers as participants in a mutual
ongoing process and embrace the idea that leadership may be distributed throughout
the entire membership of a group, rather than being focused on one individual
(Gronn 2002; Prince 2005). Leadership and followership may be viewed as states,
conditions, or roles that can be occupied by different individuals at various times
(Bligh 2011). Leadership and the use of power may be seen as a fluid set of
interrelations. Followers who have the capacity to self-manage have the means
necessary to direct their own activities effectively toward the achievement of their
own, team, and organizational goals (Cunha et al. 2013). Alvesson and Blom (2018)
suggested that in successful organizations, managers, and employees make the effort
to come to a shared understanding of how best to work together by communicating
their views and expectations through open dialog. Alvessen and Blom caution
against taking a leader-centric view or over-relying on leadership, preferring to
work with a wider spectrum of ways of organizing people to work well together,
to explore other ways of providing inspiration, direction, advice, support, coordina-
tion, encouragement, and feedback. As a result, they proposed six modes of orga-
nizing: three vertical (leadership, management, power) and three horizontal
(teamwork, peer influencing, and autonomy) modes (see Table 2). Horizontal
modes are seen as complementing more traditional vertical modes of organization.
Each mode has advantages and limitations. People will have differential impact,
6 Beyond the Leadership/Followership Dichotomy 129

Table 2 Modes of organizing work (Alvesson and Blom 2018)

Horizontal Teamwork Team members share responsibility, learn from each other, and
work collectively on a common task. Influence based on
knowledge, ideas, and debate (sometimes referred to as shared
leadership)
Peer Team members seek and provide advice, support, encouragement,
influencing and inspiration outside the immediate work team
Autonomy Team members are self-directed at work. Plan and evaluate own
work and performance
Vertical Leadership Leader and followers interpersonally influence each other – sense
making of meaning, feelings, and values
Management Authority based on hierarchy (legitimate power). Planning,
supervising, controlling, and evaluating
Power Authority based on force, political skills, rewards, sanctions, and
group pressure

depending on their formal position, experience, and talent. Autonomy may be seen
as the result of competent employees refusing to define themselves as followers. All
parties are, to varying degrees, involved in these modes, through followership and
going beyond followership.

Practical Implications

The view of followership as a form of leadership has implications for leadership

development programs being extended to all staff, not just managers. Leadership
development programs can specifically focus on the process of leadership and the
role of followership – what it means and how it is demonstrated (e.g., collaboration
and cooperation skills and tactics). This may be supported by creating policies and
practices that encourage proactive followership. One avenue may be the develop-
ment of followership competencies or a valid and reliable questionnaire to measure
followership, e.g., a modified Multifactor Leadership Questionnaire (MLQ), which
acknowledges the idea of followership as upward leadership (Bligh 2011; Crossman
and Crossman 2011; Cunha et al. 2013; Uhl-Bien et al. 2014).
In practical terms, descriptions of follower typologies may assist in developing
some self-awareness by followers of their own needs and wants from a leader, and
their responses to leader behaviors, but have limited utility in assisting individuals to
develop personal initiative or resilience when dealing with the adversity caused by
destructive leadership behaviors (Thoroughgood et al. 2012). In addition, many of
the follower typology labels presented in the literature (e.g., colluder, malevolent,
isolate, bystander) are not useful terms for practitioners to employ in their endeavors
to support and assist followers to maintain well-being in the face of destructive
leadership. It would be more useful, for example, to better understand the conditions
that are required in order to exercise courageous followership (Chaleff 2009).
Specific training in dealing with destructive leadership and building political skill
130 V. Webster

may be a useful inclusion in resilience training. Role-playing activities could be

included to help followers to interact with authority in a way that is not too assertive,
while being able to raise issues in a way that they are heard (Bligh 2011). As we
move away from hierarchical organizational structures toward flat, networked,
matrixed organizational structures, the challenge is to identify and instigate mech-
anisms to help control or temper the behavior of those with power. Team building
and team coaching programs can be designed based on highlighting the dynamic
process between leaders and followers and the way team members organize work
and hold each other to account, whether collocated or working virtually.

Conclusions/Summary

The term followership still retains connotations of subordination and lack of control.
Simplistic dichotomies are increasingly out of step with how organizations are being
restructured and the move to diverse working arrangements. More research is needed
into how organizations can break down traditional hierarchical leader/follower
distinctions and refocus on the fluid boundaries between people; the dynamic,
interpersonal processes by which they engage, and the power dynamics they need
to navigate (Cunha et al. 2013; Prince 2005; Patterson et al. 2018). There is some
debate that the term “followership” is now an outdated concept and perhaps the term
follower could be replaced, e.g., member, collaborator, contributor, participant,
worker, and fellow (Bligh 2011; Cunha et al. 2013).
In the context of destructive leadership, more research is needed into how people
might be socialized in ways that help them balance their respect for authority with
the ability to challenge people in positions of power and to better understand the
factors that encourage followers to exercise their authority versus being
co-implicated in destructive leadership. While there are some measures of follower
typologies or styles in development, no measurement of followership itself currently
exists. An exploration of how the idea of followership contributes to the ethical
debate around the use and misuse of power and authority would also be useful,
including further research into whistle-blowing as a form of responsible followership
(Bligh 2011; Chaleff 2009; Kellerman 2008).
Alvesson and Blom’s (2018) work could be extended, to explore the ways
people work together, to build awareness of options beyond the leadership/follow-
ership dichotomy (e.g., co-leadership, collective leadership/followership: Bligh
2011), and to better understand how followers connect to other followers (e.g.,
inter-follower processes: Bligh 2011), particularly in the context of working
virtually. Given the increasing need for organizational agility, more research into
followers as a driving force for innovation and creativity is needed (Hoegl and
Muethel 2007). As we move into a future that is likely to bring marked changes to
how societies and workplaces are organized, we need to find ways to update our
followership psychology that match these new ways of working. This drives the
call to investigate ways to better manage power disparities between individuals, to
inform our understanding of what it means to be a good global and organizational
citizen in the modern world.
6 Beyond the Leadership/Followership Dichotomy 131

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Line Managers and Workplace
Accommodations 7
Ellie Fossey and Justin Newton Scanlan

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Disability in the Employment Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Work Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Workplace Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Benefits of Workplace Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Implementation Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Employee Perspectives: Knowledge, Disclosure Issues, and Workplace Relationships . . . 141
Employer and Manager Perspectives: Costs, Knowledge Gaps, and Access to Expertise . . . 142
Whole of Workplace Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Flexible Working Times . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Flexible Work Locations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Work-Task Allocation Based on Individual Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Idiosyncratic Deals (i-deals) as Workplace Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Universal Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Negotiating and Implementing Workplace Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Recruitment and Selection Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Handling the Disclosure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147

E. Fossey (*)
Department of Occupational Therapy, School of Primary and Allied Health Care, Monash
University – Peninsula Campus, Frankston, VIC, Australia
Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne,
VIC, Australia
e-mail: [email protected]
J. N. Scanlan
Discipline of Occupational Therapy, Sydney School of Health Sciences, Faculty of Medicine and
Health, The University of Sydney, Sydney, NSW, Australia
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 133

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_41
134 E. Fossey and J. N. Scanlan

Initial Implementation of Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148

Performance Review, Development, and Career Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

Abstract
Workplace accommodations are adjustments made to the work environments,
schedules, or tasks that enable workers to perform their work duties more
effectively. This chapter outlines the evidence for the benefits and effectiveness
of workplace accommodations to support optimal work participation and perfor-
mance. It also offers guidance to support managers in the process of
implementing workplace accommodations.
First, the extent of disability in the employment context and the nature of work
disability are explored. The concept of “workplace accommodations” is then
described in detail. Examples of common workplace accommodations, their
benefits to workers and employers, and commonly identified implementation
issues are described. A “whole of workplace” approach to accommodations is
presented – these types of accommodations can be made available to all workers,
including flexibility in relation to work schedule and location, and the allocation
of work tasks based on individual preferences. Subsequent sections then provide
a guide for managers to collaborate with workers for the implementation of
workplace accommodations through the employment cycle from recruitment
and selection through handling initial disclosure, devising and implementing
accommodations and ongoing performance review, career development, and
promotion.
While the chapter focuses primarily on workplace accommodations to reduce
work disability, the concepts presented in this chapter are also applicable to other
workers who may benefit from workplace accommodations for a variety of other
reasons.

Keywords
Workplace accommodations · Disability · Inclusion · Universal design ·
Discrimination · Disclosure · Injured workers · Return to work · Disability/
diversity management · Human resource management practices · Person-job fit

Introduction

This chapter offers guidance on workplace accommodation policies and practices

that facilitate the employment of workers and potential workers with disabilities,
whether long-standing or arising following injury, with benefits for employees and
workers. Disabilities may be readily apparent, known, or disclosed in the workplace,
but they may also be less visible. Workplace accommodations are essential to
7 Line Managers and Workplace Accommodations 135

equality of opportunity in employment, and important to consider across the employ-

ment cycle in relation to recruiting, hiring, retaining, and enabling career advance-
ment of workers. Wide-ranging workplace accommodation options are available to
address physical, social, and attitudinal barriers within the workplace. To maximize
the fit between the work, worker, and workplace, the selection of specific options
needs to take into account not only the nature of impairment but also on the person’s
abilities, skills, and preferences, and the nature of the job and work environment.
Most workers will require workplace accommodations at some point in their
working lives to secure employment on an equal footing with others, to retain their
employment, or return to work following an absence. While this chapter primarily
focuses on workplace accommodations for individuals with disabilities, the infor-
mation presented will also be useful for workers who require accommodations for
other reasons (e.g., older workers; workers with religious, cultural, family, and
caring responsibilities; and workers managing ongoing health conditions).
This chapter first considers the extent of disability in the employment context and
the nature of work disability. It then addresses what is meant by “workplace
accommodations,” followed by describing common types of workplace accommo-
dations, their benefits to workers and employers, and commonly identified imple-
mentation issues that impact the use of workplace accommodations in practice.
Subsequent sections then outline the implementation of workplace accommodations
and effective processes for negotiating and implementing reasonable accommoda-
tions for individual workers across the employment cycle.

Disability in the Employment Context

Worldwide, an estimated 15% of the global population live with disability, and rates
of employment are consistently lower among persons living with disability than the
general population of working age (Organisation for Economic Co-operation and
Development [OECD] 2010; World Health Organization [WHO] 2011). In 2018,
under half (47.8%) of working aged Australians living with disabilities were
employed, in contrast to 80% of those without disability (Australian Bureau of
Statistics [ABS] 2019); persons with sensory and speech difficulties were most
likely to be employed, followed by those with physical difficulties, while persons
with psychosocial difficulties were least likely to be employed (ABS 2019). Similar
figures are reported in Europe, Canada, and the USA (Bonaccio et al. 2020). Persons
with disabilities are also overrepresented in entry-level, part-time, and insecure jobs;
many are either underemployed or unemployed (Bonaccio et al. 2020; Konrad et al.
2013; Padkapayeva et al. 2017). This unequal access to employment is of concern,
because it represents discrimination from a human rights perspective, and restricts
the opportunities for economic self-sufficiency, prosperity, and career development
of persons with disabilities, as well as representing a substantial untapped labor force
(Brzykcy et al. 2019; International Labour Organization [ILO] 2016; Padkapayeva
et al. 2017; Schur et al. 2014).
136 E. Fossey and J. N. Scanlan

Taken together, these issues mean that employers and managers have important
roles to play in implementing workplace accommodation policies and practices
regarding disability and chronic illness within their workforce. At the same time,
employers’ concerns about how to implement workplace accommodations and about
their potential costs can limit their effectiveness in managing disability within the
workplace. To discuss what is meant by workplace accommodations, their purpose,
and implementation, it is useful to first consider what is meant by “disability.”

Work Disability

Over recent decades, disability has increasingly been recognized as a multi-

dimensional aspect of human life, to which personal, social, and environmental
factors contribute. The International Classification of Functioning, Disability and
Health (ICF) (WHO 2001) advanced a framework for considering these factors and
identifying the barriers that disadvantage persons with disabilities face in everyday
life, including in the context of employment. This is summarized in Box 1.

Box 1 International Classification of Functioning, Disability and Health (ICF)

The International Classification of Functioning, Disability and Health (ICF)
emphasizes the role of environmental factors in creating disability. In the ICF,
problems with human functioning are categorized in three interconnected
areas:

• Impairments, that is, problems in body function or alterations in body

structure – for example, paralysis, vision, or hearing problems – and may
either exist prior to an employee joining the workforce or result from an
injury incurred in or outside the workplace
• Activity limitations are difficulties in executing activities – for example,
walking or eating
• Participation restrictions are problems with involvement in any area of
life – for example, facing discrimination in employment or transportation

Disability refers to difficulties encountered in any or all three areas of

functioning. The ICF can also be used to understand the positive aspects of
functioning such as body functions, activities, participation, and environmen-
tal facilitation. The ICF adopts neutral language and does not distinguish
between the type and cause of disability – for instance, between “physical”
and “mental” health. “Health conditions” are diseases, injuries, and disorders,
while “impairments” are specific problems in body functions and structures,
often identified as symptoms or signs of health conditions.

(continued)
7 Line Managers and Workplace Accommodations 137

Box 1 (continued)
Disability arises from the interaction of health conditions with contextual
factors – environmental and personal factors as shown in the figure below.

The ICF contains a classification of environmental factors describing the

world in which people with different levels of functioning must live and act.
These factors can be either facilitators or barriers. Environmental factors
include the following: products and technology; the natural and built environ-
ment; support and relationships; attitudes; and services, systems, and policies.
The ICF also recognizes personal factors, such as motivation and self-esteem,
which can influence how much a person participates in society. It further
distinguishes between a person’s capacities to perform actions (activities)
and the actual performance of those actions in real life (participation), a subtle
difference that helps illuminate the effect of environment and how perfor-
mance might be improved by modifying the environment.
Adapted from: ILO 2016 and World Health Organization 2001, 2011, p. 5.

The ICF describes disability as reflecting the negative aspects of interaction of a

person’s abilities and other personal characteristics with particular social and phys-
ical features of an environment. In other words, disability is neither an attribute of a
person nor synonymous with functional limitations, such as in mobility, sight, or
hearing, as is often be assumed. Rather, disability is experienced when physical or
social features of an environment fail to accommodate human differences in ability.
That is, environments have major impacts on whether disability is experienced,
through the extent to which they hinder or restrict participation on an equal basis
(United Nations General Assembly 2006; WHO 2001).
In regard to employment then, disability is a part of human life; it is experienced
by many potential workers, as well as by many people in the workforce, and by
workers who have had illness or injuries and are seeking to return to work. People
with the same impairment or the same health condition can experience very different
types and degrees of restriction, depending on their work context. Not only physical
and social environmental barriers to work participation differ between workplaces,
but also barriers to work performance will differ depending on the nature of the work
138 E. Fossey and J. N. Scanlan

and tasks involved. Hence, information about the interaction between a person’s
impairment or health conditions, their work (job tasks), and workplace environment
(barriers and facilitators) is necessary to understand the extent of disability experi-
enced, as well as to determine the most suitable workplace accommodations.
Workplace accommodations, also referred to as work adjustments, serve to
address work disability by improving the fit between workers’ abilities, their work
environments, and work (job tasks), so as to enable work participation, as well as
safe and effective performance, on an equal footing with others in the workforce.

Workplace Accommodations

Workplace accommodations are an essential component of promoting diversity and

inclusion in the workplace and equality of opportunity in employment, workplace
training, and career development (ILO 2016). Most workers are likely to require
some form of workplace accommodation during their working lives, whether arising
from family and caring responsibilities, religious or cultural requirements,
experiencing disability, or age-associated changes in health and functioning. Work-
place accommodations allow workers to use their full work potential and in turn to
contribute to business success.
Disability-related legislation varies internationally (Degener and Quinn 2002).
Many countries prohibit discrimination on the basis of disability and protect the
rights of workers, including those with disabilities, in workplaces (e.g., Disability
Discrimination Acts in Australia and UK, the Americans with Disabilities Act in the
USA, and Employment Equity Acts in Canada and South Africa) (Degener and
Quinn 2002; Konrad et al. 2013). This legislation requires employers to provide
reasonable accommodations for workers with disabilities. What constitutes work-
place accommodations being reasonable is broadly defined, so that “reasonableness”
generally refers to the provision of accommodations necessary for a worker to
perform essential job functions and be productive, and that their provision should
not cause “undue hardship” to the employer (Konrad et al. 2013).
The International Labour Organization’s (2016) guide to workplace accommo-
dations suggests a number of factors commonly taken into account when considering
the “reasonableness” of requested workplace accommodations. Some of these fac-
tors include the following: their cost relative to the size and economic turnover of the
company or organization; whether more workers may benefit than solely the person
making the request; access to funding to recoup costs; occupational health and safety
requirements; and how the requested accommodations relate to the essential ele-
ments of the person’s job.
In other words, the intent of a reasonable accommodation at work is neither to
unduly burden an employer, nor to create an unfair benefit or advantage for one
employee over another. Rather, by providing one or more modifications or adjust-
ments, the intent is to accommodate difference through removing or reducing
barriers to equality of opportunity in employment, and enable all workers to work
safely and productively (ILO 2016).
7 Line Managers and Workplace Accommodations 139

Wide-ranging options are available for addressing the physical, social, and
attitudinal barriers to successful employment. Workplace accommodations may
focus on a single person or a workplace or organization. At an individual level,
their aim is to promote equal opportunity by removing barriers to work participation,
safe and effective performance, achievement, and satisfaction in work. At an orga-
nizational level, the purposes of workplace accommodations include improved
worker productivity, worker retention, and well-being, as well as ensuring safety
in the workplace (Nevala et al. 2015).
Padkapayeva et al. (2017) proposed a useful way to consider the different types of
workplace accommodations. Based on their evidence review of workplace accom-
modations used by employers to recruit, hire, retain, and promote persons with
physical disabilities since 1990, they described three broad types of workplace
accommodations:

• Physical and technological modifications, that is, accommodations to address

physical barriers and enhance workplace and workstation accessibility for safe,
comfortable, and optimal job performance
• Workplace flexibility accommodations, that is, accommodations aimed at
increasing workplace flexibility and a better fit between the worker and the job
role
• Social accommodations, that is, accommodations to promote workplace inclu-
sion, which include both human and policy supports in the workplace

Examples of each of these types of workplace accommodations are provided in

Table 1.

Benefits of Workplace Accommodations

Workplace accommodations can have a range of benefits for employers and workers
with disabilities that include not only upholding rights and enhancing workforce
diversity, but also reputational and economic benefits for businesses (Bonaccio et al.
2020; ILO 2016).
For workers with physical and psychosocial disabilities, reported benefits of
individual workplace accommodations include access to employment, job retention,
improved job tenure, and lower job turnover intentions, as well as an easing of
workplace limitations and improved worker well-being (Brzykcy et al. 2019; Konrad
et al. 2013; Nevala et al. 2015; Zafar et al. 2019). Conversely, given the known
benefits of employment, a lack of access to needed accommodations is likely to not
only limit employment opportunities and work participation, but also undermine
well-being through restricting personal growth and career development, mastery,
and status, as well as contributing to economic stress (Konrad et al. 2013; Williams
et al. 2016). Furthermore, active involvement in developing inclusive workplaces at
an organizational level may increase commitment, performance, and a sense of being
valued within the workplace (Bonaccio et al. 2020).
140 E. Fossey and J. N. Scanlan

Table 1 Examples of differing types of workplace accommodations

Workplace accommodation options Examples
Physical and technological modifications Assistive devices, equipment, tools, and
software – new custom-built, modified, and
commercially available
Access to quiet spaces, rest area
Change to spatial arrangements
(e.g., ergonomic setup, desk setup to reduce
distractions or alter noise levels)
Workplace flexibility accommodations Job restructuring (e.g., task order, pace, and
to support a better fit between the worker workload to adjust physical or cognitive task
and the role demands/intensity)
Task planning and prioritizing (e.g., to provide
familiar routine, to alter the amount of
interactions with others, and to enable forward
planning)
Scheduling accommodations (e.g., changing
work schedules, reducing hours, additional
breaks, and discretionary leave)
Work location and transport (e.g., work from
home/telework, accessible parking)
Alternative communication methods
(e.g., verbal, written, and visual)
Personal assistance (e.g., note-taker, sign
language interpreter, driver, and service animal)
Job training and coaching options
Customized job tasks during graded return to
work
Creating specifically designed job positions
Social accommodations Workplace supports (e.g., coworker support,
supervision, mentorship, and career
development)
Universal accommodations
Inclusive recruitment and hiring practices
Inclusive workplace culture: policies,
procedures, and training in inclusive practices
Employee Assistance Program resources and
support
Adapted from: Australian Human Rights Commission (2010), Padkapayeva et al. (2017), Mellifont
et al. (2016), Prince (2017), Schur et al. (2014)

Workplace accommodations have a number of benefits for businesses too (Carers

Australia 2014; ILO and United Nations Global Compact 2017). Evidence from a
number of studies highlight that accommodating disability makes good sense for
businesses. For instance, among employers, and human resource professionals
surveyed in large and small businesses in the USA, the most frequently reported
direct benefits from implementing workplace accommodations were employee
retention, increased worker productivity, and elimination of the costs related to
training a new employee (Solvieva et al. 2011). Indirect benefits of making work-
place accommodations also extend beyond the individual workers, notably including
7 Line Managers and Workplace Accommodations 141

improved interactions among coworkers and positive effects on company morale,

productivity, and workplace culture (Hartnett et al. 2011; Schur et al. 2014; Solvieva
et al. 2011). In addition, hiring and accommodating workers with disabilities pro-
vides access to broader sources of talent, skills, and experiences (Bonaccio et al.
2020; ILO 2016).
In these respects, it may be more helpful for employers and managers to view
workplace accommodations broadly as focused on accommodating the diverse
abilities and needs of the workforce, rather than solely on disabilities (Bonaccio
et al. 2020). Indeed, universal accommodations are thought advantageous for all
workers given their aim is to accommodate persons with diverse abilities in work
environments; they may also be beneficial in minimizing the necessity for individ-
ualized accommodations for workers with disabilities through enhanced inclusive
practices (Padkapayeva et al. 2017). Other identified benefits for businesses include
the following: ensuring compliance with legal and occupational health and safety
obligations, including reduced insurance costs, as well as enhanced public image and
reputational benefits associated with offering inclusive working environments
(Australian Human Rights Commission 2010; Bonaccio et al. 2020; ILO 2016).
Given these benefits to employers and workers, when and how should workplace
accommodations be provided?

Implementation Issues

Research suggests variable access to workplace accommodations, with less than half
of surveyed workers with physical, sensory, and mental health-related disabilities
reporting that they receive the accommodations needed (Schur et al. 2014; Wang
et al. 2011). Contributing personal, attitudinal, and organizational/systemic factors
that impact the implementation of workplace accommodations from the perspectives
of workers, and of employers or managers, are summarized below.

Employee Perspectives: Knowledge, Disclosure Issues,

and Workplace Relationships

Factors influencing workers’ access to workplace accommodations include lack of

knowledge regarding their rights to request accommodations, specific needs, or the
available options (Wang et al. 2011). This may be especially an issue during job
seeking and for workers who have had long absences from the workforce during
return to work processes (Gourdeau et al. 2020; Lindsay et al. 2018). In addition,
workers with disabilities may receive little training or counseling about workplace
accommodations, which may in turn limit a person’s ability to effectively request
and self-advocate for suitable accommodations (Gourdeau et al. 2020; Lindsay et al.
2018; Nevala et al. 2015).
Commonly reported reasons for not requesting workplace accommodations
include privacy, not wanting special treatment, and concerns about the consequences
142 E. Fossey and J. N. Scanlan

(e.g., negative reactions, being treated differently, and job loss; Mellifont et al. 2016). A
key factor here is that access to workplace accommodation relies on disclosing disability
in the workplace. This creates a dilemma for workers with disabilities who may fear
negative repercussions, given negative attitudes and misunderstandings about disability
as well as the potential for discriminatory responses (Bonaccio et al. 2020; Lindsay et al.
2018). The invisible or less obvious nature of the difficulties experienced by some
people, such as those associated with pain, fatigue, memory, anxiety, or depression,
makes this process more challenging both as job seekers and as workers (Bonaccio et al.
2020; Gourdeau et al. 2020; Prince 2017). As a result, the need for disclosure means
individuals need to weigh a complex set of challenges against the potential advantages
of access to workplace accommodations during the employment cycle, so as to enable
their safe and productive working and well-being. While this can also create frustration
for employers and managers, it does not necessarily mean an employee has been
misleading, given disability may change or emerge at differing points over a career.
Hence, managers have an important role in creating an organizational culture whereby
disclosure can be safely and constructively discussed (Bonaccio et al. 2020).
Relationships between workers and coworkers, line managers, or employers may
also impede or facilitate the implementation of workplace accommodations. For
instances, satisfactory negotiation of workplace accommodations may be more
challenging when a poor prior working relationship or lack of workplace support
exists, whereas successful experiences in accessing accommodations are more likely
among workers with long-standing, constructive, and supportive working relation-
ships with employers and coworkers (Gourdeau et al. 2020; Kensbock et al. 2017).

Employer and Manager Perspectives: Costs, Knowledge Gaps,

and Access to Expertise

Employer concerns about the employment of workers with disabilities are impor-
tant contextual influences on the implementation of workplace accommodations.
These include assumptions about the kinds of jobs and careers that workers with
disabilities are seeking; hiring practices as a potential barrier in themselves; and
concerns about the responses of coworkers, the integration of workers with dis-
abilities within the workplace, and the management of their performance
(Bonaccio et al. 2020).
More directly related to workplace accommodations, their potential cost is a
frequently reported concern among employers, although employers’ fears of high
costs and negative reactions of coworkers are not necessarily realized (Bonaccio
et al. 2020; Schur et al. 2014). Indeed, the benefits of workplace accommodations,
whether provided for workers with physical disabilities or workers with mental
illness, in general, outweigh the costs to employers, and most are inexpensive
(McDowell and Fossey 2015; Nevala et al. 2015; Padkapayeva et al. 2017; Schur
et al. 2014), especially if costs of staff turnover and hiring new staff are also
considered. Nevertheless, the costs may depend on the type of accommodations.
7 Line Managers and Workplace Accommodations 143

For instance, physical and technological accommodations may be more likely to

require one-off expense, whereas the costs of social accommodations may be more
hidden, and require ongoing effort by employers to support work flexibility, promote
and sustain an inclusive workplace culture (Gewurtz and Kirsh 2009; Zafar et al.
2019). Businesses and organizations may vary too in their scope for flexibility of
work schedules and other accommodations for disability (Nevala et al. 2015).
Hence, the implementation of workplace accommodations is not necessarily cost-
neutral, but, as previously noted, many accommodations can have positive benefits
for the whole workforce and the business itself.
Knowledge gaps and attitudinal issues related to disability among employers and
managers are identified as barriers to implementation of workplace accommoda-
tions. These issues may include limited knowledge and understanding about the
disability, and disbelief or negative attitudes regarding the impacts of disability
(Gewurtz and Kirsh 2009; Lindsay et al. 2018; Nevala et al. 2015). They also
include negative views about the capability of workers with disabilities, even though
poor performance may in fact reflect a lack of needed accommodations or other job
task or support-related issues (Bonaccio et al. 2020). Employers also report a need
for more training, access to expertise, and best practices related to accommodating
disability in the workplace (Bonaccio et al. 2020; Padkapayeva et al. 2017). To
increase their use, this suggests the importance for employers and managers of
understanding the business case for workplace accommodations, their potential
benefits for all workers, and the minimal costs associated with many accommoda-
tions, as well as guidance on how to implement workplace accommodations.
Evidence suggests that best practice requires a “whole of workplace” strategies
focused on inclusiveness, such as those referred to as “social accommodations” in
Table 1, combined with individual accommodations for disability or other reasons
(Bonaccio et al. 2020; LaMontagne et al. 2014; Padkapayeva et al. 2017). The
following sections first consider the implementation of organizational strategies by
employers and managers to foster inclusive workplaces. Then, the processes for
negotiating and implementing reasonable workplace accommodations across the
employment cycle are reviewed, with attention to the roles of managers in hiring
workers and during their employment.

Whole of Workplace Accommodations

Workplace accommodations that are available to all workers can have widespread
benefits, promote diversity, and support inclusion of workers with varied back-
grounds and experiences. The International Labour Organization (2016) has devel-
oped a guide that is freely available and very useful when considering “whole of
workplace” accommodations to support a diverse workforce. Some examples of
whole of workplace accommodations include flexible working times, flexible work
locations, work-task allocation based on individual preferences, and implementation
of universal design principles.
144 E. Fossey and J. N. Scanlan

Flexible Working Times

Flexible work times allow team members to work outside of the standard “9 to 5”
working day. This can have multiple benefits for a wide range of workers, including
those who have caring responsibilities, cultural or religious commitments. These flexible
arrangements demonstrate an organization’s commitment to workers and recognize
them as “whole people” rather than only as “workers.” This flexibility can promote
increased satisfaction, productivity, and retention (Azar et al. 2018). Flexible working
hours can include adjusted start and finish times and can allow for increased numbers of
breaks through the working day. For example, rather than the usual 9–5 working hours,
a parent might find it more useful to commence work at 10 a.m., work through until
3 p.m., and then work again from 7 p.m. to 10 p.m. Likewise, a worker with fatigue may
find it useful to spread their working hours over a longer period to enable regular,
extended breaks for recuperation. Despite the potential benefits of flexible working
times, there are some downsides. Where organizational policy supports flexible work
times, but team culture does not accept flexible work hours, this can be challenging for
workers, and the use of flexible working hours may be associated with lower levels of
work engagement (Timms et al. 2015).

Flexible Work Locations

Referred to as “telework,” “telecommuting,” “remote working,” or “working from

home,” flexibility in terms of locations where work is performed can also be very
useful for a variety of workers (Igeltjørn and Habib 2020; Smith et al. 2018).
Allowing workers to work remotely can reduce commuting time and provide
flexibility for workers juggling work and caring responsibilities. For workers with
disabilities, remote working can also reduce barriers such as inaccessible, irregular,
or costly transport and allow workers to use already-established home-based mod-
ifications (e.g., accessible workstations/facilities or psychologically calming envi-
ronmental setups) to support their work. Remote working may also reduce barriers
for those individuals who find social or public settings stressful. One consequence of
the COVID-19 pandemic in 2020 was the widespread adoption of remote working
and technology to support this. Many job roles previously considered impractical to
complete remotely were discovered to be possible, particularly with previously
uncommon practices such as videoconferencing becoming ubiquitous. This dramatic
change has been seen as creating many opportunities to enhance inclusion in the
workplace (Jesus et al. 2020).
There are also downsides to remote working that need to be considered. When only a
small proportion of the workforce works remotely, then this can lead to reduced
opportunities for informal networking and isolation of the remote worker (ILO 2020;
Smith et al. 2018). Meetings held with a mix of in-person and remote attendees can
inadvertently reduce the opportunity for remote workers to participate. Additionally,
remote working can also blur the work-home boundary and reduce opportunities for
recuperation (Igeltjørn and Habib 2020; ILO 2020; Brough et al. 2020).
7 Line Managers and Workplace Accommodations 145

Work-Task Allocation Based on Individual Preferences

Within a team, each individual will have a unique set of skills, interests, and
preferences. What is mundane for one individual may be captivating for another.
Based on this principle, individualized work-task allocation considers the full
breadth of tasks undertaken by a team, their frequency, and duration. Rather than
each worker taking up a similar range of work tasks, individualized allocations allow
individuals to identify those work activities that are most enjoyable to them (and
those that are least enjoyable) so that work tasks can be allocated accordingly.
Processes whereby workers can identify their own work preferences and set their
own individual goals are sometimes referred to as “job crafting” (Oprea et al. 2019).
While this job crafting process results in individualized work-task allocations, it
is generally preferable to complete the process as a team to avoid perceptions of
“favoritism” or injustice in allocations. This approach can be time-consuming to
establish and requires regular review (e.g., in response to changes in work duties or
when new workers join the team) but can return benefits in terms of increased work
engagement, satisfaction, and productivity. A recent systematic review and meta-
analysis of job crafting interventions found that job crafting interventions supported
increased productivity through greater work engagement and that the productivity
gains outweighed the initial cost of implementation (Oprea et al. 2019).

Idiosyncratic Deals (i-deals) as Workplace Accommodations

Combining features of flexible work times, locations, and work-task allocations,

idiosyncratic deals (i-deals) in workplaces have gained prominence over the last
decade. Much research has explored the potential benefits of i-deals for workers and
organizations. A meta-analysis (Liao et al. 2016) found that i-deals were associated
with increased commitment, increased satisfaction, and reduced turnover intention
for workers with i-deals. However, an important issue for consideration is “perceived
fairness” and “justice” where i-deals are only available to a small number of workers
and may lead to resentment and dissatisfaction in coworkers (Kong et al. 2020;
Laulié et al. 2019; Liao et al. 2016; Rofcanin et al. 2018; Marescaux et al. 2019).
When considering the impact of i-deals on the overall organizations, there is some
suggestion that outcomes are best when i-deals are broadly available (Liao et al.
2016).
I-deals can also be particularly valuable for accommodating disability in the
workplace. Brzykcy et al. (2019) completed a large study exploring the association
between i-deals and turnover intention (workers’ desire to leave their jobs). They
found that having an i-deal was associated with reduced turnover intention and
stronger sense of attachment to the organization for all employee types (those
experiencing disability, and those not). However, the effect of i-deals on reduced
turnover intention was greatest for workers experiencing disability associated with a
psychological condition and related to an increased sense of work ability gained
through the i-deal.
146 E. Fossey and J. N. Scanlan

Universal Design

The concept of “universal design” is based on the understanding that disability is

caused by environmental barriers rather than individual attributes or impairments.
Universal design principles support the design of environments that enable access by
a range of people with a range of abilities without the need for specific alterations
(International Labour Organization 2016). Seven principles of universal design have
been identified: (1) equitable use; (2) flexibility in use; (3) simple and intuitive use;
(4) perceptible information; (5) tolerance for error; (6) low physical effort; (7) and
size and space for approach (Story 1998). Where workplaces are designed using
universal design principles, the need for individual adjustments is substantially
reduced. This includes designs that incorporate alternatives to stairs; private spaces
for breastfeeding, prayer, or time-out; and automated doors and signage that can be
understood by individuals with vision impairment (ILO 2016). While principles of
universal design can be challenging to implement within an existing workplace, even
small changes such as the provision of height-adjustable or sit to stand desks can be
advantageous for a variety of workers.

Negotiating and Implementing Workplace Accommodations

Rather than seeing implementation of accommodations as a “once off” event, it is

generally more helpful to consider the implementation process as ongoing through-
out the employment cycle (Bonaccio et al. 2020). While their order will vary for
individual workers, key areas to consider include the following: recruitment and
selection; handling the disclosure; initial implementation of accommodations; and
performance review, development, and career planning.

Recruitment and Selection Processes

Building an inclusive organization starts before you even meet a potential worker. To
ensure that the most talented people can apply for positions, it is essential to consider
the recruitment process. There are several questions to consider. For example, are
application processes accessible? It is important to ensure that job postings are listed
on websites that are accessible (e.g., are compatible with screen readers) and that any
preemployment screening tests are unbiased (Bonaccio et al. 2020; ILO 2016;
Erickson et al. 2014). If job postings are inaccessible or preemployment screening
is biased against people with disabilities, then your potential pool of candidates will
be limited from the very beginning (McKinney and Swartz 2019).
Are work roles described clearly and explicitly? Being explicit about the work
roles can help potential applicants determine whether they have suitable skills and
capabilities to do the job and potentially start thinking about accommodations that
could be requested. At the point of “shortlisting” and interviews, it is also important
to recognize that other recruitment members may hold biases against individuals
7 Line Managers and Workplace Accommodations 147

with disabilities, and it is important to ensure that these do not influence the decision-
making process (Gewurtz et al. 2016; McKinney and Swartz 2019). Having a clear
outline of the requirements of the position (including those that are essential and
those that could be changed, removed, or adjusted) will support fair decision-making
processes, so that candidates are evaluated according to the requirements of the
position, rather than other potentially irrelevant factors.
Are your positions attractive to people with disabilities? Organizations or busi-
nesses that specifically indicate people experiencing disability (along with other
diversity groups) are encouraged to apply, and have systems in place to encourage
applicants to indicate accommodations required for interviews or in the workplace,
are more likely to be perceived as “good” prospective employers by applicants with
disabilities, leading to higher quality applicant pools (Bonaccio et al. 2020). One
study related to disclosure in the workplace suggested that individuals were more
confident when the organization had previously employed people with disabilities,
when the organization participated in disability-related events and when workers
with disabilities were involved in recruitment events (von Schrader et al. 2014).
Offering internships for individuals with disabilities and developing partnerships
with local disability employment services are also strategies that have been effective
in attracting a diverse pool of applicants (Erickson et al. 2014; Gewurtz et al. 2016).

Handling the Disclosure

As previously noted, the process of disclosing disability in the workplace can be

challenging, especially for those workers whose condition or impairment is not
immediately apparent (Lindsay et al. 2018; McKinney and Swartz 2019). Therefore,
the way a manager handles the initial disclosure is of critical importance. While the
most common reason for making a disclosure is due to the need to request accom-
modations, workplace culture is also important (Lindsay et al. 2018; von Schrader
et al. 2014). Individuals are more likely to disclose when they have a good relation-
ship with their manager, are aware that the organization is making active steps to
recruit and support people with disabilities, and have seen positive responses to other
workers’ disclosures (Lindsay et al. 2018; von Schrader et al. 2014). When disclo-
sures occur, it is important to acknowledge the disclosure, express appreciation for
the disclosure, and commit to working with the employee to find appropriate
accommodations. This sets a positive environment for planning and will relieve
some of the stress the employee is experiencing (Employer Disability Information
2020). When disclosures are not handled effectively, this can have a detrimental
effect on well-being and satisfaction (Kensbock et al. 2017).
During the disclosure conversation, it can be challenging for the worker to know
what information should be provided. Equally, it can be challenging for the manager
to know what questions to ask. There are resources that can be helpful to assist in this
process (e.g., AHEAD 2013; Employer Disability Information 2020). A key con-
sideration is to be open to listening to the worker and giving sufficient time for the
worker to explain their situation. Going into great detail about medical diagnoses,
148 E. Fossey and J. N. Scanlan

signs, and symptoms is generally unnecessary and almost always unhelpful, as the
same condition will impact on different workers and work roles in different ways.
Key things to explore are the ways in which the condition impacts on the person’s
ability to participate in work tasks. It is also important to focus on the individual’s
strengths and capabilities in this process (Lindsay et al. 2018). Using a detailed job
description or list of tasks can be helpful in this process as this can aid in the process
of thinking through individual work tasks and how the condition might impact on the
various responsibilities (Employer Disability Information 2020). These initial con-
versations are very constructive in starting to think through what accommodations
might be helpful as well.

Initial Implementation of Accommodations

Depending on when disclosure occurs, establishing workplace accommodations can

be completed as part of the onboarding process but can also occur at any time in the
employment cycle following initial disclosure. During this process, it is important to
seek advice and support. The individual employee will be an excellent source of
information – they are likely to have strategies that they already use in other areas of
their life that they have found useful (AHEAD 2013). Other supports that will be
available to individual managers could include specialized support from occupa-
tional therapists, ergonomists, or return to work coordinators in human resources
departments, from specialized disability employment services and from government
departments. When seeking support and advice, it is important to remember to
maintain the privacy of the worker, unless you have their consent to discuss the
details of their situation. Some governments and insurance providers will also offer
financial assistance to implement workplace accommodations. Many countries also
have specific advice services for employers to implement workplace accommoda-
tions (e.g., Job Accommodation Network in the USA, Employer Disability Infor-
mation in Ireland, and Job Access in Australia), and disability advocacy services can
provide guidance and support to find the most appropriate services. The most
important factor for managers to remain aware of throughout this process is that
you are not expected to be the “expert” in workplace accommodations, but that a
supportive and willing attitude will promote positive outcomes for the employee and
work team (Employer Disability Information 2020). As noted previously, when
considering what adjustments might be necessary, it is important to think broadly,
considering the “fit” between the individual, their skills, strengths, and limitations,
and their work tasks and the workplace (both in terms of the physical design and
setup as well as relationships with colleagues).
Implementing accommodations can sometimes be challenging in terms of the
perceptions of coworkers (Kensbock et al. 2017). This is especially the case where
the nature of the disability is not visible. Some coworkers may perceive that the
worker with a disability is receiving “special treatment” which could cause discon-
tent or conflict. This potential issue can be managed by workplace flexibility being
available for all, as noted above, so that the changes for the person after disclosure
7 Line Managers and Workplace Accommodations 149

are seen as a usual part of workplace processes (ILO 2016; Bonaccio et al. 2020).
Additionally, many coworkers are actually very accepting of accommodations
provided for others as it reflects the company’s commitment to its workers and can
build workers’ trust and commitment, giving them confidence that accommodations
may be provided for them if required in the future (Bonaccio et al. 2020).
The specific types of accommodations are quite varied, and their implementation
may also vary according to the type of work activities undertaken, the work
environment, and the specific impacts of the condition. Some examples are listed
in Table 1. Other reviews have summarized the types of workplace accommodations
that can be helpful in particular contexts. For instance, several previous reviews have
provided guidance on the selection of assistive technology (Gamble et al. 2006),
personal assistance services, and natural supports in the workplace (Dowler et al.
2011; Storey 2003). While no one size fits all, several recent reviews and studies
have also addressed workplace accommodations in the context of specific health
conditions. These include useful accommodations for workers with autism spectrum
disorder (Khalifa et al. 2020), traumatic brain injury (Gourdeau et al. 2020), as well
as mental illness and other conditions that are less visible in the workplace (Mellifont
et al. 2016; McDowell and Fossey 2015; Prince 2017; Zafar et al. 2019).
When implementing accommodations, it is important to review their use regularly
with workers to ensure the desired benefits are being realized. This review can be
integrated into regular performance review, development, and career planning
processes.

Performance Review, Development, and Career Planning

Regular reviews of performance and career development are important for all
workers, but this can be especially so for workers experiencing disability because
evidence suggests these workers often face numerous barriers in the workplace that
can undermine optimal performance, limit social interactions, and prevent workers
from progressing beyond “entry-level” positions (Gupta and Priyadarshi 2020; Van
Laer et al. 2019). Regular reviews allow for open communication between the
worker and line manager and for issues and opportunities for improvement to be
identified early. One of the issues that can be concerning for line managers is raising
issues of work performance for individuals with disabilities (Bonaccio et al. 2020).
Regular, less formal meetings allow issues to be raised early, before they become
problematic. This is also an opportunity to review the effectiveness of accommoda-
tions. Perhaps there were unforeseen issues that are interfering with work perfor-
mance, and further adjustments may support enhanced work performance (Bonaccio
et al. 2020). Exploring ongoing relationships with colleagues is also important, as
the social environment of the workplace can be a disabling factor impeding work
performance (Nevala et al. 2015). Sometimes, training and development is necessary
to support colleagues to better understand the needs and capabilities of their
coworkers which promotes greater levels of support and collaboration. Review
meetings can also serve to highlight the workers’ strengths. Given that workers
150 E. Fossey and J. N. Scanlan

Table 2 Summary of facilitators of successful implementation of accommodations according to

stage of the employment cycle
Facilitators of successful implementation of
Stage of employment cycle accommodations
Recruitment and selection Organizational support for recruitment of diverse
workforce, including people experiencing disabilities
Staff awareness and acceptance of diversity
Recruitment panel training and awareness of
antidiscrimination legislation and processes
Recruitment panel awareness of availability and types of
workplace accommodations
Accessible job advertisements
Job postings include clear statement that people
experiencing disability are encouraged to apply
Preemployment screening is nonbiased
Relationships with disability organizations
Opportunities to request accommodations for interviews
Job descriptions clearly articulate essential tasks and
responsibilities
Interview questions focused on core requirements of the job
Disclosure Workplace culture demonstrates acceptance of disability
and diversity
Availability of workplace flexibility for all workers
All staff provided training in how to request
accommodations
Manager responsiveness to disclosure
Focusing on strengths of the worker
Focusing on the impact of disability on work performance
rather than on the specifics of the condition/impairment
Implementation of Individual discussion with the worker about work tasks and
accommodations accommodations that would support
Timely on-site workplace evaluation of a worker’s needs
Access to knowledge of accommodation options and expert
supports to explore options and customize workplace
flexibility accommodations
Open discussions with employee to find accommodations
that will lead to most productivity/safe and effective
performance
Consider job restructuring and training options
Appropriate explanation of adjustments to coworkers
Consider how to reduce potential negative impacts of
modifications on opportunities for interaction among
workers
Performance review, Focus on strengths to foster organization-related self-esteem
development, and career planning of worker
Review effectiveness of accommodations and make
changes if required
Review team relationships and address issues early
Highlight worker’s strengths and support work-related self-
efficacy
Explore opportunities for taking on additional
responsibilities and work tasks
(continued)
7 Line Managers and Workplace Accommodations 151

Table 2 (continued)
Facilitators of successful implementation of
Stage of employment cycle accommodations
Explore opportunities for training and development
Review each new vacancy to determine if core
responsibilities could be undertaken by workers
experiencing disability to enable promotion and career
development
Other facilitators “Universal design” principles taken into consideration in
workplace refurbishment/building
Completion of accessibility audits by individuals with
disabilities to identify changes that would enhance
accessibility for all
Consider accessibility (universal design) when procuring
equipment (e.g., information technology), refurbishing, or
relocating

experiencing disability have often experienced work-related challenges, they may have
a lower belief in their own capabilities (Gupta and Priyadarshi 2020). Focusing on the
strengths of the worker and promoting work-related self-efficacy are important and can
support job tenure (Williams et al. 2016). One study found that transformational
leadership style was related to higher organization-based self-esteem for employees
experiencing disability, and this in turn was related to lower levels of emotional
exhaustion which was associated with higher productivity (Kensbock and Boehm
2016). Finally, regularly exploring growth opportunities (e.g., taking on additional
responsibilities, training opportunities, and career progression opportunities) for workers
experiencing disabilities, as with all workers, will support job retention and optimize the
employee’s contribution to the work team and overall organization.

Summary

The above processes across the employment cycle, together with facilitators of success-
ful implementation of accommodations, are summarized in Table 2 below. While it can
be daunting to undertake this process for the first time, remember that having a positive,
supportive approach is the most important element. Getting the optimal “fit” in terms of
the optimal kinds of workplace accommodations might take some time but will
generally create substantial benefits for the worker and the business.
Even though implementing workplace accommodations for the first time can be
challenging, the more often it is conducted, the easier it becomes. Additionally, it is
likely that through this process, similar to other change processes, “champions” will
emerge and support sustainability. Additionally, workers’ experiences of success-
fully implemented workplace accommodations become positive examples of inclu-
sive work practices and attract others to the organization, supporting the
development of a rich and diverse workforce.
152 E. Fossey and J. N. Scanlan

Conclusions

The World Report on Disability (WHO 2011) highlights not only the legal and
human rights obligations of managers and organizations to provide workplace
accommodations but also the benefits of employment for workers experiencing
disability. Evidence also demonstrates that workplace accommodations make good
sense for business (Bonaccio et al. 2020; ILO 2016). This chapter has provided an
overview of work disability, the nature and benefits of workplace accommodations.
It has offered practical suggestions in relation to how managers can support workers
experiencing work disability through the design and implementation of work accom-
modations to promote optimal work participation and performance. Knowledge
gained from this chapter will enable managers to enhance work environments by
providing responsive, flexible working arrangements and by attracting a diverse and
capable workforce.

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 Part II
Management of Change
Incremental and Disruptive Change
and Wellbeing 8
Christine Ipsen and Kasper Edwards

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Defining Organizational Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Incremental Change: Planned or Emergent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Disruptive Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Defining Wellbeing: The Primary or Secondary Objective of an Organizational Change . . . . 164
Wellbeing Is the Secondary Objective of an Organizational Change . . . . . . . . . . . . . . . . . . . . . . 165
When Wellbeing Is the Primary Objective of an Organizational Change . . . . . . . . . . . . . . . . . . 166
Linking Wellbeing and Organizational Performance to Organizational Changes . . . . . . . . . . 167
Sustainable Management of Change: How to Design for Wellbeing and Performance
in Organizational Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Organizational Capability to Change: Balancing Organizational Performance and
Wellbeing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Implications for Future Research and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Conclusions/Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172

Abstract
This chapter covers two main topics: types of changes (i.e., incremental and
disruptive) and employee wellbeing. We provide in detail how to understand
different organizational changes and wellbeing, and their relations. Organiza-
tional changes run on a continuum from incremental to transformational change,
where the latter includes disruptive changes. Although this topic is important,
there is still a lack of understanding of the role of wellbeing in organizational
change processes, as the intended target or unsolicited effect, which we term the
primary or secondary objective of an organizational change. Irrespective of the
type of organizational change, whether disruptive or incremental and the role of

C. Ipsen (*) · K. Edwards

DTU Management, Technical University of Denmark, Kgs. Lyngby, Denmark
e-mail: [email protected]; [email protected]

© Springer Nature Switzerland AG 2022 159

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_6
160 C. Ipsen and K. Edwards

wellbeing it involves changes in the organizational design. We therefore find that

the theory of organizational design is a valuable tool as it includes the concern for
wellbeing and performance. Following this, sustainable management of changes
that include concern for organizational performance and employee wellbeing is
essential if organizations aim for capabilities that will allow the organization to
respond to challenges and opportunities in the business environment while
including concern for employee wellbeing. Therefore, managers must learn
how to understand the role of wellbeing in organizational changes and the
organizational capabilities and prerequisites required to plan and execute change.

Keywords
Change management · Organizational change · Incremental change · Disruptive
change · Wellbeing · Organizational design · Sustainable management ·
Organizational capability · Maturity

Introduction

Organizations change due to different reasons or forces, internal or external,

demanding or allowing changes to happen. Thus, organizational change is an
important part of management that tries to ensure that the workplace/corporation
responds to the input it gets and/or the environment in which the organization
operates. In practice, organizational change is the process in which an organization
changes its structure, strategy, work processes/practices, technologies, etc.
Over the years, the phenomenon of change management and management of
organizational change has become a recognized discipline but also one of the most
difficult to conduct and understand. One reason is that organizational changes have a
high risk of failing. One of the explanations relates to people and how they respond
and act as part of the change. Therefore, it is also widely acknowledged that
successful and sustainable organizational changes are dependent on people and
they require attention. Thus, the literature has been concerned with people’s reac-
tions to change, job satisfaction, motivation, and how to minimize resistance, and
therefore, support better implementation.
In organizations in general, there is also an emerging consensus on the role of
health and wellbeing for individual and organizational performance in organizations
and vice versa. That places the role people’s wellbeing at the forefront of how to
understand and support wellbeing in organizational and sustainable changes.
In this chapter, we aim to provide insights into how organizational change, that is,
as a process, is linked to people’s wellbeing and how to understand the role of
wellbeing in different types of organizational changes. By gaining a better under-
standing of the role in the processes and the organizational design, it is possible to
support sustainable change to benefit organizational performance and employee
wellbeing and where the organizational goal is achieved without being at the
expense of wellbeing.
8 Incremental and Disruptive Change and Wellbeing 161

First, we consider two different understandings of organizational change pro-

cesses. We also describe how employee health and wellbeing are linked to organi-
zational changes. Then, we provide a holistic approach to sustainable management
of organizational changes that includes concern for wellbeing and organizational
performance and acts as a guide for future studies of sustainable management of
changes. In the last part of the chapter, we discuss new challenges, trends, and
suggestions for actions.

Defining Organizational Change

Organizational change has always been a central subject in management and is as old
as organizations themselves. An early description of organizational change is found
in the Old Testament in the Bible (Ex. 18:13-17). Having escaped the Pharaoh of
Egypt and now living in the desert, the Israelites approached their leader Moses
directly. Perhaps because Moses’ father-in-law, Jethro, was concerned with Moses’
mental health or saw him as a bottle-neck for decisions to be made, he suggested a
reorganization. The organizational change implied that only a few men would report
directly to Moses, and they would then be responsible for hundreds. A hierarchical
organizational structure was implemented.
In the industrial age, Frederick Taylor introduced “the principles of scientific
management” in 1911 as a management theory that analyzes workflows with the
main objective to improve efficiency and effectiveness (productivity; (Taylor 1998)).
The new theory set the stage for a systematic approach to organizational change but
also a separation between operations management and people (Human Resources)
where humans became a factor in optimizing processes and operations. In the 1920s,
the Hawthorne studies (Gillespie 1991) showed the importance of the human
dimension of organizational change and contributed to a new understanding of the
role of people in change processes. The new understanding of people’s role later laid
the foundation for organizational development which emphasizes the whole system,
clear steps and phases, and an underlying set of values to guide the process (Burke
2017). In addition, an understanding of social-technical systems acknowledges the
interdependence of people and technical systems in an organization (Burnes 2009).
Based on the vast literature of change management and organizational change, there
exist numerous understandings and models intended to guide, instruct, and manage
implementation of changes in organizations.
In short, today organizational change is an established field where scholars have
tried to define what change is. Organizational changes may be initiated with either a
reactive approach, where the organization reacts to a problem or challenge that the
organization faces, or a proactive approach, where the organization plans and
implements changes to avoid a (potential) misalignment. The typical foci of organi-
zational changes are processes, for example, information flows, resource allocation,
production systems, people, for example, competences, skills, or the organizational
structure, for example, authority lines, job roles, characteristics of business units, and
internal groups (Van de Ven and Poole 2005; Burnes 2009). Burnes (2009) viewed
162 C. Ipsen and K. Edwards

change as “running along a continuum” from being “incremental to transformational

change” where the former is about adjusting and redesigning the organization, and
the latter implies a substantial disruption of the organization and business. The focus
of this chapter is the two end points of Burnes’ continuum, in particular the
transformational changes that are disruptive.

Incremental Change: Planned or Emergent

There are a number of ways in which organizational change can be categorized.

Ackerman (1997) distinguished between different types of organizational change,
where an incremental change is a first-order change that may be either planned or
emergent. Emergent change, however, can be characterized as bottom-up, as it is
driven by employees making needed changes in their daily work (Van de Ven and
Poole 1995; Weick and Quinn 1999; Beer and Nohria 2000; Palmer et al. 2009).
Planned changes are infrequent and driven by senior management who have devel-
oped a plan for implementing the desired change.
Planned means that an organization identifies an area where it believes a change is
required and initiates a change process that is linear with a number of rational stages
that are meant to guide the process from start to finish. This type of change enhances
or corrects existing aspects of an organization, often focusing on the improvement of
a skill or process (Ackerman 1997). Kurt Lewin was the first to coin the term
“planned,” in 1947. The term aims to distinguish changes that are deliberately
planned by an organization as opposed to unplanned changes (Cummings and
Worley 2001).
Lewin’s (1947) widely used framework for planned change describes change as
taking place in three distinct stages: unfreeze, move, and refreeze (Cummings and
Worley 2001; Burnes 2004; Al-Haddad and Kotnour 2015). The unfreeze stage
characterizes the starting point where the organization prepares for change. This can
be inspired by an idea or a challenge that highlights problems in the current
organization that are desirable to change. The deliberate and purposeful develop-
ment of alternative solutions to the problem is the move stage. When the organiza-
tion chooses one of the possible alternatives, it makes a deliberate choice and
refreezes (Edwards et al. 2020).
Change models that rely on distinct stages can be referred to as n-step guides with
Lewin’s three-step model unfreeze, move, and refreeze (Burnes 2004) and Kotter’s
(1995) eight steps for leading change. David Collins (1998) raised a critique of the
well-known change management models and labeled these schematic models “n-
step guides” (p. 83). The key features of n-step guides include the following (p. 85):

• A “rational” analysis of organizational change

• A sequential approach to planning and managing change
• A generally upbeat and prescriptive tone

Part of his critique was the models’ inability to demonstrate sensitivity to the
“complexities and problems associated with planning, managing and researching
8 Incremental and Disruptive Change and Wellbeing 163

change within organizations” but also the “closed systems” approach to change.
Thus, these understandings fail to examine the context in which the change takes
place. Given that organizations are open systems, interacting with the wider society,
Collins called for models that are better able to “make sense of, and make room for
human agency and interpretation” (p 100) (Collins 1998).
Thus, Collins questioned whether organizational changes always are rational,
sequential, and prescriptive. He also pointed out that organizational changes can
have an emergent side, where there are no planned changes; the changes occur by
themselves. The dynamic and uncertain nature of the business environment under-
mines the case for planned change and emphasizes the need for an alternative
approach.
The theory of the emergent approach to change is based on the understanding that
change is not a linear process or an isolated event of incrementally planned changes.
Instead, organizational changes happen continuously in an open-ended, non-
prescriptive, and nonsequential unpredictable process of (re)aligning an organization
(Burnes 2009). Briefly, as organizational change is about changing structure, pro-
cesses, and people to support implementing the strategy, the terms realign or
redesign of an organization are used interchangeably in the literature.
Weick (2009) connected emergent organizational changes to sense-making and
saw them as “ongoing accommodations, adaptations, and alterations the produce
fundamental change without a priori intention to do so.” (p 238) Weick (2001)
differentiated between a change process as an architectural design that translates into
“blueprints,” planned change, and stable solutions to a current problem that will
change only incrementally (p. 57) or change as an improvisation. This metaphor
views an organizational design (i.e., organizational change) as a recipe, where the
process is continuously reconstructed and developed in accordance with the envi-
ronment (p. 60) (Weick 2001). The key point is that if organizations consider the
redesign of an organization as a fixed process, this could lead to lower performance.

Disruptive Change

Burnes’ continuum for organizational change has two ends. Having described the
key characteristics of incremental change, as planned or emergent, we discuss
disruptive changes, the other end of the organizational change continuum.
Disruptive change stems from the theory of disruptive innovation (Bower and
Christensen 1995). In organizations, disruption has emerged as a new type and pace
of organizational changes and is, for example, associated with economic variation,
supply randomness, and product innovation (Donald 2019). Incremental change
refers to efficiency and sustainability improvements in a company’s processes,
operations, and supply chains, all within the existing business model. However,
disruptive change occurs when business models are fundamentally challenged,
changed, and (re-)invented (Gilbert and Bower 2002).
In contrast to planned changes, disruptive changes may be completely
unpredictable with little or no planning. Consequently, the outcomes are also
impossible to predict, which may create various issues for the organization and
164 C. Ipsen and K. Edwards

people involved. However, organizations can plan and prepare for unpredictable and
disruptive factors, like environmental, societal incidents, safety (Donald 2019).
Given that organizational changes, independent of the type of change process,
affect the structures and work process, etc., people’s wellbeing is a key part of the
change. Thus, there is much knowledge of the role of employees and people, and
concern for them, such as how to include and empower them in the change process to
minimize resistance to the change. It has been argued that to improve the effective-
ness of organizational changes is to understand the influences on employee satisfac-
tion. It thus becomes essential for any leader, or manager, to interact with their
employees/ subordinates to understand the best possible way to interact and satisfy
them (Huppert and So 2013). Accordingly the change management literature focuses
on managers’ actions and traits (Brown 2012) and managing of change resistance
(Kotter and Schlesinger 2008). Determining how employee wellbeing relates and
resonates with change processes is thus an important research agenda.

Defining Wellbeing: The Primary or Secondary Objective of an

Organizational Change

Wellbeing is important to people in general and in the workplace as it has implica-

tions on both mental and physical health (Fisher 2014; Litchfield et al. 2016).
Historically organizations continue to search for improving or sustaining wellbeing
at the individual or organizational level with the aim to improve the performance of
daily operations and the organization (Taris and Schaufeli 2015a). Despite this focus
on wellbeing in organizations, one still sees challenges with wellbeing and the price
is high for both organizations, people, and society if there is poor wellbeing.
Therefore, wellbeing plays an important role on the international stage where the
UN have identified health and wellbeing (SDG 3) as one of the 17 Sustainable
Development Goals to ensure a sustainable development across the world. Alagaraja
states in a recent review of wellbeing in the workplace (2020) that the literature
includes several definitions of wellbeing and can be understood as subjective
wellbeing, quality of life, mental health, hedonic and eudemonic wellbeing, or life
satisfaction (p.20) (Alagaraja 2020).
According to Huppert and So (2013), several studies show that high levels of
wellbeing are good for individuals and for society and result in, for example,
effective learning, productivity, and creativity (Huppert and So 2013). Similar out-
comes are reported by Daniels (2019) who states that there is strong business case for
employee wellbeing (Daniels 2019). To achieve this, organizations should focus on
incentives, the social environment of people management (Daniels 2019), and
appeal to the strategy (Liversedge 2020).
Following this brief overview of how we can understand wellbeing, we are able to
draw the conclusion that the different understandings of wellbeing and its role in
organizations view wellbeing as part of the daily operations where it acts as a means
to achieve performance and organizational goals. It was noted earlier that in the
organizational change literature wellbeing is about reducing people’s resistance and
8 Incremental and Disruptive Change and Wellbeing 165

ensure successful implementation by involving them. Again, wellbeing takes the

same role, as a means or an enabler to ensure easier implementation of organizational
changes.
Although wellbeing is an important topic, there is a still a lack of understanding of
the role of wellbeing in organizational change processes, as an intended or deliberate
target or an unsolicited effect, a primary or secondary objective of an organizational
change. Is it the main target or a concern to include in changes?

Wellbeing Is the Secondary Objective of an Organizational Change

Studies have explored the effects of organizational changes on employee wellbeing

and resistance (Bryson et al. 2013), that is, when wellbeing becomes the secondary
objective of the change. Within the scope of incremental changes, the n-step guides are
characterized by many phases each with a different purpose conducted in a linear order
to make a successful organizational change but without considering the effect on the
people involved. An alternative approach to organizational change that considers the
effects of an organizational change is to look at which activities are required indepen-
dent of their sequence. Knoster (2002) developed such a framework that consists of six
activities or elements that are required for successful change. The framework differs
from the existing n-step guides in that this model includes possible negative outcomes
in addition to necessary activities. Other guides focus on the phases for ensuring a
successful outcome. In Knoster’s framework, the six elements are vision, consensus,
skills, incentives, resources, and an action plan. When the elements are collectively
built together, they form the basis for a successful organizational change. However, if
any of these elements is missing, the change effort will fail, with varying negative
experiences, such as confusion, anxiety, resistance, frustration, or “treadmill.” The link
between an element and its effect is as follows:

• If there is no vision, there is a risk of ending up with confusion because there is no

direction to guide the change process.
• If consensus is not established, the unwilling or unconvinced can actively work
against the change.
• If there is a plan for a change in the organization, but the skills needed in the new
setup are not in place, then people will be anxious as they are unprepared to do the
work and/or implement the new situations.
• If all the other elements are in place, but the incentives to go in the new direction
are omitted (i.e., recognition, rewards, acknowledgment, and praise), the process
will slow down, and people will direct their actions toward the existing way of
doing things, as the benefits or meaning of the change is not clear to them.
• If the physical or emotional resources are missing, but there is a plan, etc., people
will be frustrated, as it is not possible to work toward the new goals because staff,
time, or knowledge is missing.
• Finally, if the other elements are in place, but there is no action plan, there is a risk
that the process will be slower, and people will do as they have always done.
166 C. Ipsen and K. Edwards

Table 1 A framework for thinking about systems change

Vision + Consensus + Skills + Incentives + Resources+ Action Plan ¼ Change
Consensus + Skills + Incentives+ Resources+ Action Plan ¼ Confusion
Vision + Skills + Incentives+ Resources+ Action Plan ¼ Sabotage
Vision + Consensus + Incentives+ Resources+ Action Plan ¼ Anxiety
Vision + Consensus + Skills + Resources+ Action Plan ¼ Resistance
Vision + Consensus + Skills + Incentives+ Action Plan ¼ Frustration
Vision + Consensus + Skills + Incentives+ Resources+ ¼ Treadmill

Table 1 illustrates the link between the elements and the effects on people
(Knoster et al. 2000; Knoster 2002).
This framework is relevant to consider in organizational changes as it considers
outcomes and can be applied prescriptively when planning an organizational change.
The framework can also be used as an analytical and diagnostic tool to understand
why a change process failed building on people’s experiences of the change process.
Thus, this framework offers a potential remedy by identifying effects and insights
into the missing component of the change process that can then be restored.
The approaches to wellbeing in organizational change processes described thus
far are mainly concerned with how to minimize the negative effects and can be
considered the secondary objective of a change. However, from stress prevention
research, we know that employee wellbeing can also play a key role in organiza-
tional changes as the primary objective of the change.

When Wellbeing Is the Primary Objective of an Organizational

Change

Interventions to alleviate work-related problems and stress can have numerous forms
and can be categorized in three approaches to stress management, labeled primary,
secondary and tertiary interventions. These approaches focus on the organization (pri-
mary), the interrelation between the individual and the organization (secondary), or the
individual (tertiary) (Hurrell and Murphy 1996; DeFrank and Cooper 2013) See Table 2.
In organizational-level intervention research, we argue that wellbeing is the
primary objective as the starting point for the organizational change. This approach
to prevention and organizational change has spawned numerous intervention studies
and methods (Nielsen and Noblet 2018) and a continued discussion of what works
(Lamontagne et al. 2005; Nielsen et al. 2010; Daniels et al. 2017). Because primary
interventions are essentially organizational change initiatives, their success and
sustainability depend on their comprehensiveness and integration into daily opera-
tions (Ipsen and Jensen 2012; Nardelli and Broumels 2018). However, addressing
primary stress-preventative actions through organizational development and changes
requires an understanding of the relation between the sources of work-related
problems and the organizational design of the workplace (Smith and Sainfort
1989; Dettinger and Smith 2006; Salvendy and Karwowski 2011; Sørensen and
8 Incremental and Disruptive Change and Wellbeing 167

Table 2 Three stress intervention levels

Intervention level Intervention targets Examples
1. Primary Stressors at their Job redesign, load reduction,
Goal: Reducing potential risk source; organization of reorganizing the authority lines
factors or altering the nature of the work; work and restructuring construction of
the stressor before workers conditions a supporting climate, re-design,
experience stress-related or establishing a reward system
symptoms or disease
2. Secondary Employee responses to Cognitive behavioral therapy,
Goal: To help equip workers with stressors coping classes
knowledge, skills, and resources
to cope with stressful conditions
3. Tertiary Short term and Return-to-work programs,
Goal: To treat, compensate, and enduring adverse occupational therapy, medical
rehabilitate workers enduring health effects of job intervention stress
stress-related symptoms or
disease

Holman 2014). This is discussed in the following section about sustainable man-
agement following how wellbeing and organizational performance are interlinked
and can be addressed in tandem in primary interventions.

Linking Wellbeing and Organizational Performance

to Organizational Changes

As a concept, organizational performance reflects the function and outputs of an

organization, from its profitability and productivity to its competitive advantage. By
definition, an organization’s output depends on how effectively it functions, includ-
ing how effectively its people, or human capital, functions (Neely 2005). This means
that employee wellbeing and organizational performance are inherently
interconnected (Peccei and Van De Voorde 2016). Essentially, any organizational
change initiative that aims to improve organizational performance must attend to
employee wellbeing, and any organizational intervention targeting wellbeing must
attend to organizational concerns and targets. Thus, organizational interventions
(i.e., organizational changes) present important opportunities to align wellbeing
and organizational performance.
Westgaard and Winkel (2011) called organizations with a joint focus of employee
wellbeing and organizational performance sustainable production systems. How-
ever, organizations and managers still tend to think of wellbeing and organizational
performance as disconnected (Van De Voorde et al. 2012). Although businesses
prioritize organizational performance, they give less priority to wellbeing and
address it in an ad hoc manner (Jensen 2000; Hasle et al. 2019). Several scholars
suggested that wellbeing and organizational performance would benefit from being
managed together (Edwards and Jensen 2014; Taris and Schaufeli 2015b; Ipsen et al.
2020). Daniels adds to this and suggests linking wellbeing in an organization to the
168 C. Ipsen and K. Edwards

company’s strategy (Daniels 2019), where Pfeffer suggests to focus on job-(re)

design in the pursuit of lasting preventative solutions (Pfeffer 2019) to ensure
successful changes. Therefore, taking the understanding of sustainability a step
further and connecting it to organizational changes, sustainable management is
about being proactive to prevent stress and ensure wellbeing by redesigning work
and how it is organized and managed in relation to the overall goals, thus balancing
organizational performance and wellbeing.
To conclude, studies have explored the effects of organizational changes on employee
wellbeing and resistance, where wellbeing is an unsolicited or unintended objective of the
change (i.e., the secondary objective of the change). In contrast, wellbeing is the primary
objective in organizational-level interventions via workplace wellbeing. From that, we
can deduce that there are two roles that wellbeing can take in organizational changes – as
the primary or secondary objective. Building on the literature and the two objectives of
wellbeing in organizational changes (i.e., disruptive or incremental change), we can
provide a foundation for understanding how change processes and wellbeing are related.
This foundation can guide the understanding of people’s wellbeing in change processes
and develop management processes to design for sustainability, that is, including the
perspective of employee wellbeing and organizational performance be it directly as the
main objective or indirectly (as the secondary objective).
The role of wellbeing in organizational changes leads us to the question of how to
include concern for wellbeing in change processes. That concern should be viewed
from the perspective of the growing recognition that sustainable changes and work
include concern for employee wellbeing and organizational performance. The ques-
tion is not only how to ensure a joint focus on organizational performance and
employee wellbeing during change processes but also how to change work and
workplaces and ensure organizational performance and wellbeing.
Thus, there is a need for new knowledge about how job redesign can include
concern for organizational performance and employee wellbeing together. We find
that including theory on organizational design creates a valuable tool for bridging the
gap to preventative interventions that aim to redesign jobs and ensure organizational
performance and healthy workplaces (Ipsen et al. 2020).

Sustainable Management of Change: How to Design

for Wellbeing and Performance in Organizational Changes

Irrespective of the type of organizational change, it is evident that organizational

changes involve changes in the organizational design and can have an intended or
unsolicited effect on organizational performance and employee wellbeing. To include
concern about wellbeing in organizational changes, be it disruptive or incremental,
and ensure a link to an organization’s strategy, we find that the theory of organizational
design is a valuable tool. An organizational design can bridge the gap to organizational
changes that involve redesign of work and at the same time, ensure organizational
performance and wellbeing that is sustainable management of change.
8 Incremental and Disruptive Change and Wellbeing 169

Fig. 1 The Star Model by J.

Galbraith et al. (2002)

The Star Model by Jay Galbraith (1975) is a framework for thinking holistically
about five interdependent major components of an organization’s design (see Fig. 1).
The model works particularly well when designing and implementing changes, and
in business development when executing a business model (Osterwalder and Pigneur
2010). When all components are in alignment, the organization is most effective.
That is, the structure, processes, rewards, and people practices support the strategy
and form the foundation for the organization’s behavior, productivity, and perfor-
mance (Galbraith 1975; Galbraith et al. 2002).
One of the characteristics of the Star Model, compared to other systems models, is
that managers control and can influence the components directly. The strategy sets
the organization’s direction, the structure determines where formal power and
authority are located, and the processes support the collaboration. The reward
systems help align individual behaviors and performance with the organizational
goals and finally, people practices, an organization’s human resource policies that
govern recruitment, promotion, rotation, training, and development.
Different organizational designs result in different outcomes (i.e., “behavior”
and “performance”). If one component is changed, it is important to consider the
changes that will occur in the rest of the organizational design and what changes
are needed in the other components if a certain outcome is anticipated to avoid
misalignment. Acknowledging an organization as a system, the Star Model pro-
vides the opportunity to address the mutual interdependencies in an organization
which are all affected in an organizational change. Depending on how an organi-
zation is designed and the alignment of the components, they form the basis for the
success of an organizational change and wellbeing and organizational perfor-
mance. Acting as an analytical tool, the framework can identify a misaligned
design that has an unsolicited effect on wellbeing and performance, as well as
identify which components are affected by a strategic change and must be adapted
to fit the new situation.
170 C. Ipsen and K. Edwards

By taking a systemic approach to organizational changes, it is possible to include

consideration for wellbeing and organizational performance, as well as ensure that
there is a clear link to the strategy if the organizational design is aligned.

Organizational Capability to Change: Balancing Organizational

Performance and Wellbeing

It is well-known that many organizations experience obstacles when implementing

organizational changes (Kotter 1995) which may affect the outcome, time frame,
people’s wellbeing, and performance. One explanation could be that organizations
have different capabilities to change, and therefore, organizations have different
risks of failing with the implementation. Thus, what characterizes an organizational
capability to change should be considered.
According to Anderson and Anderson (2010), the capability to change is “the
ability of an organization to plan, design and implement all types of change
efficiently with committed stakeholders, causing minimal negative impacts on
people and operations, so that desired business and cultural results from change
are consistently achieved and integrated seamlessly into operations” (p. 107). This
understanding is process-oriented and focuses on being able to change, which means
that the better the organization is at implementing a change, the better the results
(Anderson and Anderson 2010).
In organizational change and intervention literature, there is consensus that one of the
most important ingredients for changes is strong leadership (Nielsen and Abildgaard
2013; Havermans et al. 2016; Lundmark et al. 2017). As organizational changes are about
changing the organizational design affecting tasks, processes, structures, etc., leadership is
concerned with the organizational development, process, and transformation to a new
design. However, leadership of change processes is more than supporting the process and
achieving the results. It is also a dynamic that evolves in tandem with the organizational
change itself (Ipsen et al. 2018). The effect of synchronous development is that the
leadership matches the new situation, as feedback and input are continuously given to
what is needed in terms of management. Therefore, organizational capability to change is
also about the organization supporting the leader in this change, and developing interven-
tion leadership and organizational resources is necessary to build effective intervention
leadership. In sum, there is a need for a more detailed understanding of the organizational
capabilities to change and implement organizational changes, including concern for
wellbeing and organizational performance, and the role of leadership during the changes.

Implications for Future Research and Practice

The aim of this chapter was to address the relationship between organizational
changes and wellbeing. We examined existing knowledge about these topics focus-
ing on how they are linked. We conclude by briefly presenting several directions for
future research and potential implications for practice.
8 Incremental and Disruptive Change and Wellbeing 171

As this chapter is exploratory and interpretive, it raises opportunities for future

research. More research is necessary to refine and further elaborate our findings.
First, future research projects would benefit from explicating the understanding of
the role of wellbeing in the organizational change. For example, is it the primary or
secondary objective of the change? This will allow scholars to understand potential
or avoid unintended impacts of wellbeing in organizational change projects. Second,
by acknowledging that wellbeing is linked to strategy, and by approaching organi-
zational changes from an organizational design perspective, it is possible to explic-
itly include concern for wellbeing from a proactive perspective. Therefore, further
exploration of the understanding that organizational change is not just about the
design of change processes but also involves the entire organization, expressed by
organizational design, is needed. Finally, the findings point to the need for
researchers and practitioners to investigate in more detail the organizational capa-
bilities to change but also the understanding that intervention leadership is a dynamic
process that evolves in tandem with the change. Thus, this process requires attention,
so that the new leadership fits the implemented change.
The findings presented in this chapter can also be applied to practice. The results
advance awareness of the role of wellbeing in organizational changes and impor-
tantly, invite practitioners to understand the role of the organizational design as a
means of linking wellbeing to the business strategy while designing and
implementing organizational changes.

Conclusions/Summary

What is the link between organizational changes, for example, incremental or

disruptive changes and employee wellbeing? We introduced the different types of
change and the role of wellbeing in change processes and examined how organiza-
tional changes and employee wellbeing are related. In particular, we investigated
what characterizes organizational changes (i.e., incremental and disruptive changes),
how we can understand wellbeing, and in particular, what characterizes the relation
(between organizational changes and wellbeing).
The analysis suggested that wellbeing takes different roles as the primary or
secondary objective in both types of changes, and further, that wellbeing is
interdependent with organizational performance and thus, linked to the business
strategy. Therefore, organizational design is a useful concept for studying organiza-
tional changes and wellbeing. Future studies should aim to explore the redesigning
of jobs and how this is linked to the organizational design and the business model to
understand the sustainable potential of the changes.
In conclusion, if organizations aim to be able to respond to challenges and
opportunities in the context of the organizations’ business environment, while
including concern for employee wellbeing, organizations and managers must learn
how to understand the role of wellbeing in organizational changes and the organi-
zational capabilities and prerequisites required to plan and execute organizational
changes.
172 C. Ipsen and K. Edwards

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Reorganizing and Downsizing
How Employees’ Health Is Affected According to
9
Epidemiological Research

Töres Theorell

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Theoretical Background in Stress and Leadership Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Earlier Research on Unemployment Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
More Recent Research on Full Spectrum Effects of Downsizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Other Kinds of Health Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Methodological Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Downsizing and Prescription of Medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
More Complex Effects of Downsizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Organization of Downsizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Youth Unemployment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Downsizing and Country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

Abstract
Whereas there has been extensive research on the health consequences of unem-
ployment, there has been less research on the wider health aspects of downsizing,
in particular for those who remain employed in the workplace. During the later
years, case-control and prospective epidemiological studies have been published
including both groups. They indicate that both the unemployed and those who
remain in the workplace (survivors) after downsizing may suffer from depression,
anxiety, and emotional exhaustion as well as physiological changes related to
exhaustion. Increased prescription of medication for anxiety, depression, and
sleeping difficulties has also been described for these groups. The research
indicates that downsizing is often poorly organized. With a better planning,
many health problems can be prevented.

T. Theorell (*)
Karolinska Institutet and Stockholm University, Stockholm, Sweden
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 175

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_7
176 T. Theorell

Keywords
Downsizing · Reorganising · Burnout · Depression · Ischemic heart disease · Sick
leave · Survival · Unemployment

Introduction

Our labor market is changing constantly. Historically, labor has changed slowly in a
process starting with work in small units in villages to the creation of big factories
based upon larger areas, then national conglomerates, and during later decades
international companies competing on a large-scale basis, supported by modern
communication technology. The result is that processes on the world market have
an increasing influence on local production. This also means increasing
unpredictability. As a consequence, needs for reorganization, reallocation, and
downsizing increase. It also means that there is an increasing need to do research
on possible health effects of such processes on employees. First of all, we need to
know if and how health is affected by downsizing, and we also need to know
whether there are possibilities in work organizations to prevent adverse effects on
health when these kinds of changes take place.
Research in this area has been relatively scarce, although the need for improved
knowledge has increased during later years, mainly because the rapid growth of the
world market and the modern information technology influence all levels of indus-
trial activity. This leads to unpredictable processes and sudden needs for downsizing
and reorganization.
Downsizing mostly occurs as a response to decreasing possibilities for a company
or agency to market a product or a service. It is only one of several possible
outcomes of such a process. The workplace could become reorganized which
means that most employees will have to change roles and/or workplaces. They
could also become unemployed, and finally their company could merge with another
organization. All of these situations create insecurity and role changes. In the worst
possible scenario for the individual subject, it could mean long-lasting unemploy-
ment. In the other end of the spectrum, staying in the employment (¼“survival”), the
individual who might have to cope with a reduced number of colleagues might face
excessive workload. The main focus of the present review is the evidence in
epidemiological research on health effects of downsizing.

Theoretical Background in Stress and Leadership Research

Why should we expect adverse health effects of downsizing? Findings in stress

research give us several clues. The whole downsizing process should be taken into
account, from early signs of company crises ultimately leading to downsizing up to
the final stages including long-term unemployment.
9 Reorganizing and Downsizing 177

In the early phases of downsizing, characterized by rumors and insecurity, the

underlying crisis may induce conflicts, worsened social support at work, poor
balance between demands and decision latitude (job strain) as well as between effort
and reward (effort-reward imbalance), high-pressure work, long working hours, a
feeling of job insecurity, and bullying. In a systematic review of longitudinal studies
of work environment factors in relation to depressive feelings among employees, all
of these factors (Theorell et al. 2015) were shown to have possible impact on the risk
of worsened depressive feelings in employees. Mainly because the number of
published high-quality studies has been small, the degree of evidence was relatively
low for most of the factors (evidence grade 2 out of 4), but job strain and bullying
had a stronger evidence degree (grade 3). In similar reviews of evidence regarding
work environment factors and development of ischemic heart disease, there is a
three-graded evidence for job strain and effort-reward imbalance (Siegrist and Wege
2020), as well grade 2 evidence for low support, job insecurity, and long working
hours (Theorell et al. 2016a). Finally, in a similar review for the development of
burnout symptoms, we came to similar conclusions (Aronsson et al. 2017).
There is evidence based upon longitudinal data showing that organizational
change as such increases the risk of bullying in a work site (Oxenstierna et al.
2012). This is important because bullying is one of the strongest predictors of
development of depressive feelings. Thus, when the downsizing process starts, a
number of processes are triggered which could increase the risk of ill health
development among employees. What employees may fear is not only losing their
jobs; they may also fear changes in work tasks and roles as well as adverse changes
in working schedules. Conflicts may arise because some individuals may want to
improve their chances of retaining their jobs – which may have adverse conse-
quences for colleagues. Supervisors will have increased importance in these situa-
tions. Unfortunately, in a longitudinal study of the general working population
(Theorell et al. 2012), we saw a parallel process on a societal level: When unem-
ployment rates increased between 2006 and 2008, the willingness among managers
to listen to their employees decreased.
In the early phases of downsizing, the stress mechanisms that dominate have to do
with the activation of the sympathetic nervous system mirrored in increased excre-
tion of the “immediate” stress hormones adrenaline and noradrenaline. It also results
in the activation of the hypothalamo-pituitary-adrenocortical (HPA) axis which
corresponds to an increased excretion of cortisol, the body’s own hydrocortisone.
These early activation mechanisms serve the body’s and the brain’s alertness and
ability to handle immediate challenges. One of the consequences of this is that the
threshold for psychological reactions is lowered, for instance, aggressive and anx-
ious reactions. This in turn increases the risk of conflicts in a worksite. One of the
early adverse consequences may be impaired sleep. This adversely affects health in
several ways. First of all, the resulting fatigue activates excretion of adrenaline and
noradrenaline adding to the low psychological thresholds. Secondly, sufficient sleep
is a necessary condition for the system of regeneration and anabolism that protects
the body from adverse effects of stress. The system responsible for that is the
hypothalamo-pituitary-gonadal (HPG) axis. Thus, if the stress reactions become
178 T. Theorell

long-lasting with rising conflict and stress levels and activation of the HPA axis, the
protective activity of the HPG axis is inhibited. This results in a general increase in
vulnerability to disease (summaries in Theorell (2016, 2020) and Mc Ewen (2012)),
partly due to the deterioration of sleep duration and quality.
There is a difference between the initial pattern of reactions when a stress period
starts with rumors about downsizing and the long-term effects that arise after a
longer period of exposure. If such a stress period with constant activation of the HPA
axis and depression of the HPG axis has been going on for many weeks or months,
two important consequences may arise. First of all, the regulation of the stress
response itself is affected, and this may result either in a depressed stress response
(no response when the accelerator is activated; which is common in depressive
states) or in lack of ability to downregulate the stress level (the brake does not work)
adding even more sleep difficulties. Secondly the lack of HPG axis activity makes
the body vulnerable. This affects many organ systems and could result in deterio-
rated functions such as impaired memory function, increased sensitivity to mechan-
ical injury in muscles, disturbed gastrointestinal function, decreased ability to heal
wounds, etc. This explains why so many different kinds of illness risks may increase
in employees exposed to downsizing.
An important scientific discussion relates to the possible role of genetic factors in
the relationship between work environment factors and mental health. In a large
twin-based study, self-reported working conditions were analyzed in relation to a
standardized measure of depressive feelings. The results showed that the central
associations between work psychological demands, decision authority, and skill
discretion on one hand and self-reported depressive symptoms could not be
explained away by genetic factors despite that there was a genetic contribution to
both the self-reported work environment and to the depressive symptom score
(Theorell et al. 2016b). Another way of saying this is that all deteriorating health
in employees during downsizing cannot be blamed on individual genetic vulnera-
bility. Thus, the environmental conditions are significant, and this is of course an
important basis for organizational prevention of complications during downsizing.
From a stress theoretical point of view, it should be possible to reduce many of the
threats that may arise during downsizing by means of improved work organization.
Several of the research findings to be reported below give ideas about how this could
be done. In this review I will focus on such organizational efforts, but it is also
possible to reduce employee risks by other means. Of course, general advice
regarding eating, smoking, and drinking habits as well as physical activity is
important. But such advice could not be isolated from the effort to provide a good
work environment in a crisis situation. Employees going through a crisis in their
workplace might even be negatively provoked by such health propaganda.
Another area with prevention potential is the provision to the employees of arts
stimulation. Employees who are offered participation in cultural activities together
with workmates may find that this increases togetherness and creativity, and this may
even help them in finding solutions (Theorell 2016). The managers themselves may
also benefit from such a program in their role in the crisis situation. In a randomized
control trial (Romanowska et al. 2011, 2016), we compared a year-long art-based
9 Reorganizing and Downsizing 179

intervention program for managers with a more conventional manager education

intervention. The art-based intervention had significantly better effects 18 months
after start on employee health (regenerative hormone in blood, mental health, and
coping pattern) than the more conventional program which was not based on arts.
The crucial effect benefiting the employees may have been that the managers in the
art program became more sociable and hence more engaged in their employees.
In the following presentation, a number of epidemiological studies of organiza-
tional aspects on downsizing will be described and discussed.

Earlier Research on Unemployment Effects

Health consequences of unemployment have been studied for a long time. One of the
first authors examining the relationship between unemployment and poor health was
Marie Jahoda et al. (1974) who published findings on an Austrian village where a
substantial part of the inhabitants had become unemployed (Linn et al. 1985). The
initial projects examining unemployment-health relationships were conducted by
sociologists. In addition, economists became interested in the field. In a series of
econometric analyses performed in several countries, M. Harvey Brenner could
show (Brenner 1977) that sudden increases in the unemployment rate in a country
was followed by increased suicide rates and also by increased cardiac mortality in
that country. These studies showed that the observations were generalizable across
countries and after adjustment for several country-based indicators such as selling of
tobacco and alcohol and demographic characteristics. They also showed that some of
the health consequences of increased unemployment could have a delay of a couple
of years. These studies were criticized methodologically because ecological corre-
lations cannot be applied to individuals. However, from national points of view, the
studies did show that increased unemployment in a country leads to increased
suicide rates and costs related to increased morbidity. During a later period, longi-
tudinal studies following subjects through different phases of unemployment begin-
ning with anticipation had been published. They showed (see Arnetz et al. 1991) a
number of short-term changes in stress endocrinology (cortisol and prolactin) and
immunology (reactivity) as well as more long-lasting changes in cardiovascular risk
factors. There seemed to be identifiable phases in the responses to unemployment,
with anxiety-related reactions during early phases and reactions related to depression
in later phases when subjects did not find new jobs for months.

More Recent Research on Full Spectrum Effects of Downsizing

During most downsizing or restructuring processes, unemployment is a frequent

consequence for some employees, and this has been studied rather extensively, as
described. However, those employees who stay as employees in the downsizing
company could also experience considerable changes which might affect health.
These are the survivors who may suffer after downsizing because they might have to
180 T. Theorell

manage the same workload as before with a more limited workforce. They might
also have to endure effects of reorganization. In addition, they may have bad
conscience because they have been allowed to stay and also feel anxiety because
they anticipate further downsizing in the near future. The survivors represent a group
that had not been in focus in unemployment research.
One might say that research on health effects of downsizing and restructuring
comprise two groups, of whom the first one, those becoming unemployed, has been
in focus for several decades. This research has shown that there are health effects of
unemployment related to anxiety (mainly in early phases, not the least during
anticipation) and depression (mainly in later phases) and that these effects can be
observed on a societal level in the form of very serious consequences, such as
increased suicide rate and cardiovascular mortality and also in the form of physio-
logical changes. The second group, the survivors, on the other hand, has been largely
neglected until recently. During later years, these groups have been examined
together in a number of studies.
Accordingly, the questions that this area of research is trying to address could be
summarized in the following way:

1. What is the extent of adverse health changes during and after downsizing/
reconstruction experiences?
2. Are there differences in health outcomes and their timing between those who
become unemployed and those who remain (the survivors)?
3. What is the nature of the mental health consequences with regard to exhaustion,
anxiety, and depression?
4. Do the preparations for downsizing in the company make a difference and do
employees’ ideas regarding the necessity of the reconstruction process make a
difference to the health outcomes?
5. Are there differences between countries with regard to health consequences? It
could be that in countries with a poor social safety net the consequences of
reconstruction and downsizing are worse than in other countries.

In my efforts to summarize possible answers to these questions, I shall rely

heavily on a study initiated by Harvey M Brenner – a European collaborative
study on the health effects of downsizing.
The European collaborative study (Andreeva et al. 2017) was designed as a case
referent study with data collected in four European countries, France, Sweden,
Hungary, and Great Britain. There were altogether 681 “cases” of participants who
had experienced compulsory recent (recent 2 years) redundancies and 775 “referents”
who had not had this experience. Adjustments were made for country, age, gender,
and education as well as smoking and alcohol habits. Separate analyses were made
for those who went through medium-sized (10–19%) and large-scale (>19%)
downsizing, respectively, and in each case the mental health effects were studied
separately for those who survived, those who were reemployed, and those who
remained unemployed. In addition, symptoms of anxiety, depression, and emotional
exhaustion were separated in the analyses. The participants in one of the
9 Reorganizing and Downsizing 181

participating countries, Great Britain, took part in a “strategic” process which means
that the employees were told about the organizational changes in advance and that
there were individual plans for redeployment of them – which also took place. In the
other countries, the processes were reactive restructuring/downsizing processes
which means that they happened in the “usual way.”
The most striking result in the European collaborative study was that “strategic”
downsizing had no significant effect on the mental health of the participants, neither
in medium-sized nor in large-scale downsizing. In reactive downsizing, on the other
hand, there were statistically significant effects on all the three outcomes. With
regard to depressive symptoms, medium-sized downsizing was associated with a
threefold increase in depressive symptoms (Odds ratio, OR ¼ 3.42) among the
unemployed with no effect on survivors. Large-scale downsizing, on the other
hand, was statistically associated with increased depression among survivors
(OR ¼ 2.87) but not among unemployed. Anxiety symptoms followed the same
pattern as depressive symptoms in the case of medium-sized downsizing – OR ¼ 4.2
among unemployed. However, there was no excess of anxiety in survivors in
medium-sized downsizing. On the other hand, in large-scale downsizing, both
survivors (OR ¼ 1.77) and unemployed (OR ¼ 3.81) had significantly elevated
anxiety levels. An interesting observation was that symptoms of emotional exhaus-
tion were in excess only in large-scale downsizing and then only among the
survivors (OR ¼ 2.00), thus not at all in medium-sized downsizing.
These findings illustrate that the survival role particularly during a large-scale
downsizing process – confirming other research (Dragano et al. 2005; Kivimäki et al.
2000; Sigursteinsdottir and Rafnsdottir 2015) – can be extremely taxing for
employees. Depletion of energy resources may be one consequence, particularly
when the downsizing experiences are repeated. Noer (1993) has emphasized the
destabilizing effects of repeated downsizing.

Other Kinds of Health Effects

That downsizing may also result in endocrinological changes in employees was

illustrated by a follow-up of endocrinological status in female healthcare staff
employed in a Swedish regional hospital during the Swedish national financial crisis
of the 1990s (Hertting and Theorell 2002). They had been exposed to repeated
episodes of downsizing starting in 1990. Blood samples were collected in 1997
when additional downsizing was planned (after promises from politicians that no
more downsizing would take place!), and then new blood samples were collected
1 year later. All the participants were survivors. The findings after the final down-
sizing showed flattened cortisol curves (morning to midday) which is a possible
indicator of physiological exhaustion (see above – poorer response when the
accelerator is activated). They also showed lowered levels of oestradiol which has
anabolic functions and therefore protects against adverse effects of stress. Finally,
there was a lowering of the levels of a protein that protects against atherosclerosis
(apolipoprotein A1). During the national financial crisis in Sweden, another
182 T. Theorell

epidemiological cross-sectional study (Westerlund et al. 2004) of 3904 white collar

workers in the Stockholm area showed that employees in the “questioned public
sector” as well as those in the “threatened private sector” workers (both categories
experiencing downsizing) had higher atherogenic blood lipid levels than other
employees. These observations are in line with the finding in the European collab-
orative study that large-scale reactive downsizing is associated with emotional
exhaustion in the survivors resulting in adverse physiological reactions.
The first four questions on the list above thus could be tentatively answered in the
following way, with the limitation that most of the studies reported so far in this text
have been cross-sectional which decreases possibilities to draw conclusions about
direction of causality:

1. There seem to be mental and physiological health consequences of downsizing/

restructuring for employees.
2. There seem to be differences in health outcomes for survivors and unemployed.
An interesting observation was that when the downsizing had been extensive, the
survivors seemed to suffer particularly from emotional exhaustion.
3. There was no excess level of depression and emotional exhaustion in those
participants who were unemployed after large-scale downsizing. The reason for
this is unknown, but one possibility is that during large-scale downsizing, being
unemployed is so common that there is less individual humiliation and less
individual effort than when the downsizing is less extensive.
4. When the downsizing was part of a strategic planning, the mental health of the
employees did not seem to be affected by the process. This will be discussed
below. Possible cross-country comparisons will also be discussed.

Methodological Questions

Before proceeding to more questions regarding organizational preparations and

differences between countries, we need to address an important methodological
question.
It could be argued that a cross-sectional study like the European collaborative
study cannot prove evidence of causality and not even temporality. What comes first,
the survival or unemployment or the mental symptoms? In order to address this
question, our group performed a longitudinal study (Andreeva et al. 2015) based
upon Swedish employees, with a 2-year follow-up perspective (2008–2010), both
“forwards” (downsizing preceding depressive symptoms) and “backwords” (depres-
sive symptoms preceding unemployment). One hundred ninety six of the partici-
pants had lost their jobs due to downsizing (at least medium-sized), and 1462 were
“survivors” after such an experience. One thousand eight hundred forty five partic-
ipants had not experienced downsizing. As in other studies, the degree of depressive
symptoms was assessed by means of a standardized internationally accepted
questionnaire.
9 Reorganizing and Downsizing 183

In initially depression-free subjects experiencing downsizing (medium- and

large-scale analyzed together), unemployment consistently predicted increased risk
of subsequent major depression among men (relative risk ratio, RRR ¼ 4.92) and
women (RRR ¼ 3.17). “Surviving” the downsizing, on the other hand, was signif-
icantly associated with subsequent major depression in women (RRR ¼ 1.59) but
not in men. It was also shown that women with major depression at start had
increased risks of exclusion from employment during follow-up (RRR ¼ 2.18)
when organizations downsized, whereas job loss in men was not significantly
influenced by this aspect of their mental health. The most important conclusions
from this longitudinal study are that the directions forwards and backwords seem to
exist together and also that effects on depressive symptoms can be shown in both
unemployment and survival during downsizing, with strong effects during resulting
unemployment but also clear effects at least for women during survival. That
depression at the time of downsizing diminished the likelihood of obtaining a new
job in women but not in men was an interesting observation which if supported by
other research would mean that employers tolerate depression in women less well
than they tolerate depression in men when they assess employability.

Downsizing and Prescription of Medication

Recently changes in prescriptions of anxiolytic and sedative drugs have been studied
(Blomqvist et al. 2018) in the Swedish working population (2,306,000 participants)
during the 4 years before to the 4 years following major (at least 18%) downsizing of
staff. The odds of purchasing anxiolytics increased significantly more for “stayers”
(¼ “survivors”), OR ¼ 1.03, and for unemployed, OR ¼ 1.08, than for unexposed
subjects. The findings were similar but weaker for purchases of sedatives. A parallel
study (using approximately the same study population but only 2 years before and
2 years after the period of major downsizing) of purchases of antidepressants using a
very similar design (Magnusson Hanson et al. 2016) was also performed. The results
showed that major downsizing was statistically significantly associated with a slight
increase in the odds of prescribed antidepressants among people without previous
sickness absence or disability pension. These are more indirect measures of health
change. The associations are quantitatively small on an individual basis but clearly
of interest in the societal evaluation of the consequences of downsizing.

More Complex Effects of Downsizing

A large-scale tax registry study combined with a national work environment survey
of a random sample of the entire Swedish working population (Ferrie et al. 2007)
during the national financial crisis years 1991–1996 provided a nuanced and diver-
sified picture of the national consequences for the work environment of downsizing.
For instance, during those years there were more beneficial than adverse effects on
the work environment in the public sector. In the private sector, on the other hand,
184 T. Theorell

the overall effect on the work environment of downsizing was negative. The effects
of major downsizing were mainly positive for men in the private sector but negative
for women in the public sector. Accordingly, the effects of downsizing could be
different for different groups and during different historical periods.
In another Swedish study (Theorell et al. 2003), sick leave patterns were studied
in relation to downsizing as well as expansion of staff. Five thousand seven hundred
twenty employed men and women were followed during the years 1992–1995. In
multiple logistic regressions, women with a high cardiovascular risk score were
shown to have a reduced likelihood of medically certified sick leave (15 days or
more) following both downsizing and expansion. The common denominator may
perhaps be that, during major changes in staff, women with vulnerable health status
may feel that their employment is being threatened and therefore avoid sick leave
despite their vulnerability. There were no such findings in men.

Organization of Downsizing

In the European collaborative study, Brenner et al. (2014) also asked the participants
how the conditions of the downsizing were perceived. Among the results, one could
note that only 39% considered the downsizing they had gone through as fair and
unbiased. Fifty percent described the experience as chaotic and disorganized, and
only 46% described it as transparent and understandable. Forty seven percent agreed
with management that the downsizing had been necessary. Only 11% thought that
they had had any influence, and 67% reported that they had received no forewarning.
Forty three percent reported that personal factors influenced the layoffs. In multi-
variate analysis, the perceived organizational factors that were statistically signifi-
cantly associated with a low prevalence of depressive feelings were transparent as
well as well-planned, democratic, fair, and unbiased conditions. Other significantly
protective factors were agreement that the downsizing was necessary, early warning
and financial compensation. Chaotic conditions increased the likelihood that the
participants would report depressive feelings.
When the findings regarding managerial context surrounding downsizing are
added to the observation that strategic downsizing was not associated with any
adverse changes in health among employees, it becomes obvious that good planning,
forewarning, organized financial compensation, and feeling of trust in the arguments
that the management presents regarding the downsizing are all factors that could
decrease adverse health changes.

Youth Unemployment

Research on long-term health effects of youth unemployment is important because

employment in early adult years may have a profound importance for health. On the
basis of longitudinally collected data from a cohort of young men and women
9 Reorganizing and Downsizing 185

followed from their last compulsory school year at age 16 up to age 42, Brydsten
et al. (2017) concluded that youth unemployment has long-lasting health conse-
quences particularly up to age 30. In addition, the same group (Strandh et al. 2015)
showed that special local programs providing alternative labor market jobs (despite
not being “real” jobs) do prevent some of the adverse health consequences of
unemployment in young years. These studies provide evidence that particular
attention should be paid to younger men and women during periods when down-
sizing becomes common.

Downsizing and Country

Does the surrounding societal environment have any influence on the health conse-
quences of downsizing? This question was also given attention in the European
Collaborative Study (European Commission 2011). Since the British participants
were employed in a company with a special beneficial program for employees
threatened by the downsizing process while participants in Hungary, France, and
Sweden represented the total population, the most relevant comparisons are between
the three latter countries. With regard to sleep deficit, depression, and anxiety, there
were no clear country-specific differences in the participants who had experienced
downsizing. However, with regard to life dissatisfaction, the Hungarian unemployed
subjects had much higher scores than participants in the other countries, particularly
when compared to the control subjects (not going through downsizing). Forty four
percent of the Hungarian participants who had become unemployed during the
downsizing reported life dissatisfaction. Corresponding numbers for unemployed
subjects in France and Sweden were 19 and 10%. Thus, although these national
comparisons are incomplete and methodologically flawed, it seems to us that the
mental health reactions in survivors and unemployed are similar cross-nationally
while the general social situation in the country (particularly perhaps with regard to
financial support programs which were worse in Hungary than in the other two
countries) may result in country differences in life satisfaction during downsizing.

Conclusions

Whereas there has been extensive research on the health consequences of unem-
ployment, there has been less scientific activity on the health consequences of wider
aspects of downsizing, in particular survival. However, the few studies that have
been published indicate that survival at the workplace after downsizing may result in
depression, anxiety, and emotional exhaustion as well as physiological changes
related to exhaustion and also in increased prescription of medication for anxiety,
depression, and sleeping difficulties. The research also indicates that downsizing is
often poorly organized. With a better planning, many health problems can be
prevented.
186 T. Theorell

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Managing OSH Through Recession
10
Hans H. K. Sønderstrup-Andersen

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Theories and Models of the Effect on Safety and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Effects and Management of Economic Recession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204

Abstract
The onset of the Great Recession in 2008 has put pressure on enterprises that in
turn have downsized, restructured, and reorganized. Research has shown that
economic recession has an effect on psychological and behavioral health that is
attributed to both general health and occupational safety and health. The objective
of this study is to unravel whether the onset of economic recession has had an
impact on public health and especially enterprises’ and public institutions’ man-
agement of occupational safety and health activities. This chapter provides a
comprehensive overview of research covering the recessional influence on the
management, on occupational safety, and on health and public health in general.
Moreover, insights are given on theories and models of the effect on safety and
health, and the chapter provides insights to research contributions that discuss a
series of determining factors that play a central role in understanding managing
through recession. Based on the reviewed research, it is concluded that all
stakeholders must have a focus on the management of both public health and
especially the management of safety and health activities in enterprises during a
period of economic recession. The literature points at a few procyclical effects
that need to be managed like, for example, a decline in accidents at work.

H. H. K. Sønderstrup-Andersen (*)
Department of People and Technology, Roskilde University, Roskilde, Denmark
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 189

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_8
190 H. H. K. Sønderstrup-Andersen

However, the majority of effects of the recession are countercyclical like, for
example, worsened suicide rates, increase in depression disorders, and increase in
psychosocial risk and physical health including worsened occupational safety and
health for lay-off survivors.

Keywords
Recession · Occupational safety and health management · Mental health ·
Physical heath · Public health · Unemployment · Psychosocial risk · Accidents at
work · Layoff survivors · Downsizing

Introduction

In everyday life, employed people spend a significant amount of time working. How
work is shaped and how the quality of work is perceived are closely related to how
quality of life and health in general is perceived. The quality of work life depends on
elements like, for example, meaning giving, variety, autonomy, sense of belonging,
and the collective at work not forgetting wages and employment security. However,
it also depends on institutional factors at the workplace and in society as a whole, and
how conflicting interests between these factors are recognized and handled by the
different interested social parties (Hvid and Falkum 2018). Several studies scruti-
nizing the psychological consequences of economic events have provided evidence
suggesting that objective living conditions such as income and macro-economic
societal anomaly factors like inflation or unemployment have a significant influence
on individuals’ evaluation of quality of life (see Frey and Stutzer 2007; Di Tella et al.
2001; Andersen 2009).
Most countries in the world have suffered from the worst financial crisis (now
named “The Great Recession”) since World War II (ILO 2012). The reasons for the
onset of the crisis have been much debated, but the International Monetary Fund in
their World Economic Outlook (April 2009) states that the outbreak of the US
subprime crisis in August 2007 led to mild economic recessions in mid-2008.
However, the Fund states that the fall of the US investment bank Lehman Brothers,
the deep financial problems of and the intervention into the leading US insurance
company American International Group, and a range of other major financial
institutions in USA and Europe led to the historic onset of a full-blown financial
crisis in the fourth quarter of 2008. As such, the developed countries witnessed deep
recessions with a 7½% drop in the economies. Apart from the financial problems in
the western part of Europe, trade in various countries also suffered severely. Housing
correction was a factor, and in several countries, major banks experienced deep
economic problems and some even collapsed. The crisis was combined with severe
real estate market problems due to a housing price bubble. A preceding generally
good economy, low interest rates, and innovative lending forms caused this price
bubble (Rangvid 2013).
10 Managing OSH Through Recession 191

In the last century, there were three severe recessions: the Great Depression in
1929, the collapse of the Soviet Union in the early 1990s, and East Asian financial
crisis in the late 1990s. Looking at the history of these preceding international
economic crises might be useful for understanding the impact of the 2008 recession
on public health and thus guide future approaches. However, it is not so easy to learn
from earlier recessions, because each one differs from the others and in addition they
vary due to a series of multifarious contextual factors (Stuckler et al. 2009b) that
influences the public health effects of economic recession. These are factors like
recession scale, government interventions, the conditions preceding the recession,
and the extent to which populations are exposed. Regardless of the problems in
comparing the different crisis, a range of existing studies have examined the impact
of the 2008 recession and found a series of negative effects. That is, several studies
found that the 2008 recession led to a rise in poor health status in many countries and
among the factors, data point to an increase in the proliferation of some infectious
diseases along with the fact that the rate of suicide has increased significantly.
With respect to the association between suicide rates and recession, Chang et al.
(2013) in a time trend analysis of suicides in 54 countries found that there was an
excess of suicides in 2009 compared to the 2000–2007 trend. The highest increase in
the number of suicides was in men in the 15–24 years age group (European
countries), and in the 45–64 years age group (American countries). There seems to
be an association between the increase in suicides and the magnitude of
unemployment.
In a study of Google search queries, Althouse et al. (2014) identified how health
concerns changed during the Great Recession in the USA. The Google search
queries were used to identify the concern by the query content and their prevalence
by the query volume. Excess health concerns were estimated between December
2008 and 2011. Data indicate excess physical health concerns during the Great
Recession. A significant increase was found in queries on stomach ulcer symptoms,
congestion, gastric pain, headache, joint pain, hernia, chest pain, and arrhythmia.
These results seem to differ from findings by Kondo et al. (2008) which shows that
following the East Asian financial crisis, there was an improvement in self-rated
health throughout the recession for Japanese men and women. On the other hand, the
study also reveals that occupational class-based inequalities in poor health widened
during the same period. Middle-class male workers and female homemakers were
particularly adversely affected by the crisis, compared with the highest-class
workers, while unemployed people had persistently poor health throughout the
period.
The recession also appears to have resulted in a higher incidence rate of mental
health diseases such as depression, anxiety, and psychosocial stress among those hit
by the recession and unemployment (McDaid et al. 2013; Wang et al. 2010; Quaglio
et al. 2013; Stuckler et al. 2009a; Karanikolos et al. 2013; Barr et al. 2012; Lopez
Bernal et al. 2013; Katikireddi et al. 2012).
These results were supplemented by findings in a survey study carried out by Gili
et al. (2013) of patients attending primary care centers in 2006 and 2010 respectively.
Compared with the pre-crisis period, the 2010 survey demonstrated a substantial
192 H. H. K. Sønderstrup-Andersen

increase in the frequency of patients attending primary care centers with mood
disorders (especially major depressive disorders), dysthymia (persistent depressive
disorders), anxiety disorders, somatic symptom disorders, panic attacks, depen-
dence, and occasional abuse of alcohol. Approximately one-third of these risks
were associated with household unemployment and mortgage payment difficulties.
The studies also show that not only does recession affect factors that determine
health, but it also affects the societal financial capacity to respond accordingly. On
the one hand, the impact on mortality is aggravated where people have easy access to
the means to harm themselves. On the other hand, the mortality rate declines in
societies with strong social cohesion and social protection systems. While the above-
mentioned studies focused on the relation between recession and public health, the
next section will scrutinize the associations between economic decline and occupa-
tional safety and health.

Theories and Models of the Effect on Safety and Health

At the World Day for Safety and Health at Work in April 2009, the International
Labour Organization (ILO) put the focus on the impact on a changing world and a
changing workforce (ILO 2009). The ILO argue that the rapid technological
advances and the scale of these achievements have an immense impact on how
companies and other organizations can be characterized and act. Moreover, the
demand for greater flexibility in the production to meet dynamic changes in the
markets affect employment patterns, the relationship between the management in
companies, other organizations, and their workforce. As a result, enterprises out-
source certain functions and in general downsize. In addition, there is an increase of
precarious work, people involved in informal work arrangements and demographic
change in the workforce towards older workers and more women working. These
and other changes sure influence the management of occupational safety and health.
On an overall basis, a recession affects the socioeconomic balance and this in turns
add to the changes in labor relations described (see Fig. 1).
The recession has put substantial pressure on companies that in turn have
downsized and reorganized business functions. The International Labour Office
(ILO 2009) has documented the effect of downscaling. Here ILO ascertained that
descaling has led to more part-time and temporary work, outsourcing, and sub-
contracting including business functions like the management of occupational safety
and health activities. In the same vein, ILO have later stressed that there is evidence
that the recession has had a negative impact on a series of occupational mental health
and risk factors. ILO further states that that there is a need for a more profound
understanding of the impact of recession on the management of the occupational
safety and health activities (ILO, Machida, 2013).
ILO points out that during recession, management in enterprises might look for
all possibilities to reduce overall cost. This includes managing safety and health at
work in terms of paying less attention and worse management of traditional risks at
the workplaces. Further, outsourcing, precarious work, more part-time work, and
10 Managing OSH Through Recession 193

Fig. 1 The financial crisis and its potential impact on safety and healthy at work. (Adapted from
ILO “Health and life at work: A basic human right,” 2009)

subcontracting lead to a more unpredictable working environment with more uncer-

tainty and misunderstandings with respect to responsibilities for managing occupa-
tional safety and health especially at large construction sites. Reducing production
might loosen up dense deadlines and intensification of work in production or
services before the onset of a recession. On the other hand, many companies
downsize and thereby make severe financial and staffing cuts. This means that
remaining employees might risk working longer hours and experience an escalation
in scale and pace of work that again could lead to physical and mental workload, and
fatigue. Moreover, management may give lower priority to the management of safety
and health activities. Small companies in particular might turn in to this solution
because of the lack of resources and expertise with respect to managing occupational
safety and health. Finally, the ILO stresses that a decline in public spending will
affect the occupational safety and health services and labor inspectorates in countries
around the world.
Not much research has focused on psychosocial working environment factors and
the national or international economy. This has been documented by a systematic
analysis of the content of two influential journals within the area of occupational
194 H. H. K. Sønderstrup-Andersen

health psychology. Here it was found that only a very limited number of the research
papers paid attention to the impact of economic factors on occupational factors in the
workplace (Kang et al. 2008).
Nonetheless, in a UK work force survey initiated during times of economic
recession it was found that a significant part of the workers share the opinion that
economic conditions have an influence on working environment factors, for exam-
ple, relationships with colleagues or working longer and harder (Mind/Populus
Workplace Health and Stress Survey 2010). Moreover, in the Stormont study it
was found that several psychosocial factors are negatively correlated with the onset
of economic recession (Houdmont et al. 2012). One of the conclusions brought forth
in the study is that there is a need for more focus on the management of preventive
safety activities in enterprises during a period of economic recession.
From a theoretical point of view models explain that several working environ-
ment psychosocial factors are negatively related to economic stress in two ways.
First, workers may be affected directly, depending on their ability to cope with
economic stress. Second, workers may be affected indirectly by enterprise organi-
zational changes with respect to managing occupational preventive safety activities.
In addition, Houdmont et al. (2012) demonstrate that much research within the field
of occupational safety and health has focused on work context. Houdmont and
colleagues’ argument is that this focus may be due to certain hegemonic research
paradigms that favor theoretical models of occupational stress that build upon
contextual features of work.
The job demand–control model has, for example, been very influential (Karasek
1979, Karasek and Theorell 1990; for a critical approach see, for example,
Kristensen 1995). The model has later been refined to incorporate social support
(Johnson and Hall 1988). Doef and Maes (1999) have carried out a systematic
review of 20 years of studies applying the model and its refined version. They
found that employees exposed to high job demand, low control, and low social
support have the highest risk of experiencing the most negative psychological well-
being.
However, as pointed out by Kristensen (1995), the model may carry theoretical
and methodological problems with it. Moreover, there is a growing body of research
that recognizes that occupational mental safety and health depends on local work
context in a combination of external global factors like international economy (Kang
et al. 2008). Wallis and Dollard (2008) have stressed that the job demand-control
model needs further refinement to incorporate job external factors. These could be
national globalization or free market forces including economic factors on a national
or international level. It could be argued that the same issues apply when it comes to
the companies’ and public institutions’ management of occupational safety and
health activities.
Research has shown that economic recession influences psychological and behav-
ioral health attributed to working environment problems (Catalano 1979; Boone and
Ours 2006; Goldman-Mellor et al. 2010). On the one hand, research suggests that
one of the mechanisms involved has a “countercyclical” effect. This means that a
financial crisis can lead to an increase in occupational safety and health problems
10 Managing OSH Through Recession 195

induced by, for example, stress caused by expectation of job loss. On the other hand,
it is suggested that recession can have “procyclical” effect. This means that the
decline in economy results in a decrease of occupational safety and health problems.
Boone and Ours (2006) point out that pro-cyclicality is at stake where workplace
accident rates seem to decrease during recessions, which again means that occupa-
tional safety and health seems to increase during financial crises. Ruhm (2000) found
strong evidence that occupational health increases in cases of economic decline. In
addition, pro-cyclical research points out that employees’ capacity to manage occu-
pational health safety increases when job demands in terms of time and quantity
decrease (Catalano et al. 2011).
This in is line with findings in a study by de la Fuente et al. (2014) scrutinizing the
impact of recession on all occupational injuries in Spain throughout the period 2000–
2009. The researchers found that from 2007, the unemployment rate started to grow,
while the rate of workplace injuries and injury rate began to reduce. The sectors with
the greatest decrease in workplace accidents were the construction and industrial
sectors. There was a rise in the average age of injured workers, a rise of injured
workers with more work experience, and a greater decrease in injuries of workers
with temporary contracts. On this basis, the study concludes that the recession
seemed to instigate natural selection of layoff survivors. That is, only the suited
employees will survive downsizing activities. These tend to be females, be older, be
more experienced, and on permanent contracts.

Effects and Management of Economic Recession

The effects discussed above on occupational safety and health were confirmed by a
study carried out by Devereux (2017). Based on a scientific literature review, a
review of annual reports from of 45 multinational enterprises with headquarters in
USA, UK, France, and Germany and semi-structured interview with representatives
from 13 multinational enterprises. Through a thematic analysis of the data, Devereux
identifies four emergent themes: distraction from safety and health to focus on
growth to meet market forces, increase in psychosocial risks among layoff survivors
due to organizational restructuring, budget costs, and losing skills and experience
needed to maintain safety and health system integrity. It was found that the MNE
included in the study had a decline in market fund of more than 50% during the
recession meaning strong pressure to reorganize resources including labor force. The
average revenue turndown was approximately 9% and employee size dropped
nearly 5%.
Downsizing personnel was the most common organizational restructuring strat-
egy leaving layoff survivors in a difficult situation since there is scientific evidence
that layoff survivors have an increased risk for negative health outcomes and
sickness absence (see summary of Westgaard and Winkel 2011 study below). This
is in line with findings from a longitudinal industrial study by Modrek and Cullen
(2013) of 13,000 employees in aluminum manufacturing. The study showed that
layoff survivors and downsizing were linked to increased risk of developing
196 H. H. K. Sønderstrup-Andersen

hypertension and diabetes among salaried workers at the plants with the highest level
of layoffs. The study also concludes that the general health impact of the Great
Recession is considerable larger than expected from earlier estimations.
Devereux (2017) outlines multiple risks that could influence layoff survivors’
psychosocial health. Workload intensification due to increased demands with less
access to organizational and/or individual resources especially means that layoff
survivors could be significantly affected by psychological distress like burnout, lack
of motivation, and losing job engagement. Moreover, increased workload has been
found to correlate with causes of accidents at work.
Evidence on the linking between work intensification, psychological distress, and
accidents at work can be found in the Devereux et al. study (2011) on the link
between high job demands, need for recovery after work, and employees experienc-
ing psychological distress. Evidence can also be found in the Crawford et al. study
(2010) on the link between job demands and resources to employee engagement and
burnout. Finally Devereux points to the study by Amati and Scaife (2006) on the
links between psychological ill-health, stress, and safety.
Other studies have shown that employees in general are exposed to higher
mental and physical workload and fatigue due to a lack of financial resources.
Westgaard and Winkel (2011) carried out a systematic review of production system
rationalization in terms of general restructuring (n ¼ 67 studies) and downsizing
(n ¼ 34 studies) measures and their association to health and risk factors in the area
of musculoskeletal and mental health. The review showed that 76% of the studies
point to negative downsizing health effects. Only 6% of the studies included
showed a positive effect of downsizing, while 11% showed mixed results. More-
over, the review revealed that in terms of general organizational restructuring
measures with downsizing excluded, 16% showed a positive effect and 16%
showed mixed results while an overwhelming 67% of the studies pointed to
negative health outcomes.
In line with this research, Snorradóttir et al. (2013) in a study of surviving
Icelandic bank employees differently involved in downsizing and organizational
restructuring following the Great Recession found that being directly involved in
organizational and structural change, as a cause of economic recession, was associ-
ated with the development of psychological distress. Both organizational
restructuring and psychosocial work environment factors were associated with
psychological distress. Being exposed to downsizing within own department, salary
cut, and transfer to another department were independently related to increased
psychological distress, though the negative effects of psychological distress could
be partly attenuated by empowering leadership and the psychosocial work environ-
ment factors of job control and job demands.
Further, a systematic review of the correlation between stress and recession found
that the 19 studies included pointed at negative impact on workers’ mental health
(Mucci et al. 2016). A majority of the studies documented that salary reduction
schemes, increase in workload, downsizing, organizational restructuring, and rise in
unemployment rate correlate with worsened mental health especially in terms of
depressive disorders.
10 Managing OSH Through Recession 197

Frasquilho et al. (2015) have scrutinized the possible association between eco-
nomic recessions and general mental health outcomes in a comprehensive systematic
review. The review included 101 studies from Europe, North America, Australasia,
South America, and Asia. Table 1 shows the key findings from the review. The
researchers underline that the findings give a global perspective and allow hypoth-
eses to emerge that could serve as a framework for future research on economic
recessions and mental health outcomes.
Overall, the study concludes that recession is related with negative mental health
outcomes in terms of common mental disorders, psychological wellbeing, substance
disorders, and suicidal behavior. Some people are especially vulnerable during
recession like those experiencing financial trouble, those that have lost their jobs,
those that suffer from poor mental health prior to the onset of recession, and families
with children.
Sickness absence patterns can be affected by recession. A study by
Sigurdsteinsdóttir and Rafnsdóttir (2015) among employees in Icelandic municipal-
ities showed that the proportion of employees who had never been absent due to
sickness dropped. Moreover, there was an increase in the number of days employees
remained off work due to sickness. Further, the proportion of those who had gone to
work while sick was higher at downsized workplaces. Finally, there were clear
indications that the increase in sickness was due to recession.
In a 2008 survey approximately half of the human resources and people devel-
opment professionals included in the survey reported that individual staff workload
increased because of the economic recession. In addition, a similar proportion of the

Table 1 Key findings from a systematic review of association between recession and mental
health. (Adapted from Frasquilho et al. (2015), page 36)
It is plausible that the actual recession increased the population’s psychological distress.
According to the evidence reviewed, periods of recession correlate with higher prevalence of
common mental disorders, substance disorders, and ultimately suicidal behavior.
That in order to cope with psychosocial stress people might turn to substance misuse.
Some key factors seem to make people more vulnerable to the effects of the recession: being
unemployed, having a precarious work situation, facing debts and economic strain, and having a
pre-existing mental illness.
Economic recession may also have a severe and long-term impact on mental health in children and
young people, especially if they face stress within the family because of economic hardship or
parental unemployment.
Some specific differences between countries and regions were found in this review. The authors
hypothesize that this may be explained by the socioeconomic response policy to recession (the
presence of unemployment benefits or social programs) which could influence changes in the
mental health outcomes of the populations; more research is needed concerning mediating factors
between the determinants of a recession and mental health outcomes.
More research from countries badly hit by the economic recession and from low- and middle-
income countries is needed.
The links between recession and direct effects on health appear to be very complex, and the lagged
effects have not been systematically studied because of a lack of longitudinal studies and therefore
a scarcity of long data series persists
198 H. H. K. Sønderstrup-Andersen

respondents said that employee stress levels increased (Wisdom et al. 2008). On the
other hand, statistics that are more positive indicate that in the USA and the UK,
there has been a decline of fatal work-induced accidents in the period just prior to
2008 compared to period just after (ILO 2013). Accordingly, the result of the
Europe-wide survey carried out by the European Agency for Safety and Health
shows that nearly two-thirds of the respondents claim that the recession could
adversely have a great (21%) or some (40%) effect on occupational safety and
health.
In response to these findings, the ILO claims that the decline could be due to the
reductions in economic activities in for example the construction sector. In addition,
results from a survey carried out by the International Social Security Association
(ISSA) in 2009 among the contributing organizations in its members’ states show
mixed results with respect to the consequence of economic recession on occupa-
tional health (ISSA 2010). One of the key findings in the survey was that health costs
are rising as an added effect to the financial crisis. However, the survey also showed
that different countries’ different social security systems seem to play an important
role in “buffering” elements of the crisis. In this way, social security systems
strengthen social cohesion, socio-economic stability, and public confidence.
On the other hand, ISSA also points out that recession can lead to less spending
on occupational preventive measures by employers. At the same time, employees
may be more reluctant to claim safe and healthy working conditions. As such, the
ISSA survey showed that during the crisis some countries (Argentina, Brazil,
Cameroon, Poland, and Spain) experienced fewer investments in preventive occu-
pational safety and health management systems, while other countries did not.
However, the ISSA survey is a snapshot of the situation in early 2009 before the
full-scale intensification of the economic recession.
Sønderstrup-Andersen and Bach (2018) also argue that the economic recession
had an effect on mental and behavioral health that is attributed to management of
occupational safety and health problems. The objective of their study is to unravel
whether the onset of a general economic recession has had an impact on enterprises’
and public organizations’ preventive occupational health and safety activities.
A central research question in their research is whether the onset of a general
economic recession has had an impact on enterprises’ preventive occupational
activities. They discuss trends in a period spanning from non-recession in 2006 to
a full-scale recession in 2011. The research introduced above on the hypotheses of
pro-cyclicality and counter-cyclicality indicate that the areas of overall safety
administration, industrial accidents, and the psychosocial work environment are
especially vulnerable to changes in economic factors.
Sønderstrup-Andersen and Bach explore changes in practices in the administra-
tion of the so-called workplace assessments in Danish companies and public orga-
nizations. Likewise, the study explores trends in the management of preventive
actions primarily related to the occupational risks within the areas of psychosocial
work environment, occupational accidents, and physical working environment. The
history behind the study is that in 2005 the Danish government initiated an occupa-
tional safety and health activity action program. Accordingly, during a 5-year period
10 Managing OSH Through Recession 199

focus was placed on four problem areas: psychosocial work environment, occupa-
tional accidents, noise at the workplace, and muscle-skeletal distress. In addition, it
was decided to follow the development of Danish enterprises’ occupational safety
and health activities through the 5-year period based on a survey questionnaire
(Sønderstrup-Andersen et al. 2010).
A baseline for the Sønderstrup-Andersen and Bach study named “Surveillance of
health and safety activities in enterprises” was established in 2006. Follow-up data
was collected in 2011 during the recession period. The 2006 sample consists of 9720
enterprises and public organizations and the 2011 sample consists of 6724 enter-
prises and public organizations. The participants were randomly selected from the
Danish national register of enterprises and public organizations. The survey was
anonymously administered and the organizations were free to answer and did not
receive any participation fees. The survey contains 80 items designed to measure the
general management of preventive occupational safety and health activities and to
measure preventive activities within the following occupational safety and health
areas: Work accidents, psychosocial working environment, physical working envi-
ronment, noise, and substances and materials.
Sønderstrup-Andersen and Bach (2018) found that that more enterprises in 2011
compared to 2006 recorded psychosocial occupational safety and health problems
and that as part of the analysis the companies have produced plans to take action to
solve the problems.
Another finding is that more enterprises implemented appraisal interviews and
job satisfaction surveys. They stress that such actions are quite costly and resource
intensive for the enterprises and organizations. Nevertheless, they posit that during
economic recession the enterprises seem to keep a focus on learning to operate more
effectively with respect to occupational safety and health. This could indicate that the
enterprises and institutions do not solely focus on cost cutting strategies. Overall,
Sønderstrup-Andersen and Bach stress that these findings within the psychosocial
safety and health area support the countercyclical hypothesis that economic reces-
sions result in an increase of occupational safety and health problems.
Furthermore, the study shows that fewer enterprises in 2011 produced a register
of occupational safety and health problems in relation to the area of accidents at work
compared to 2006 and fewer enterprises produced plans to deal with the problems.
Sønderstrup-Andersen and Bach argue that this could indicate that fewer acci-
dents at work are detected. In addition, fewer enterprises had implemented safety
rounds as part of the prevention of accidents at work and fewer enterprises had
initiated actions to prevent accidents caused by falling from heights like falling from
ladders and scaffolds.
When looking in more detail at the enterprises’ psychosocial work environment
in terms of industrial trades at risk, Sønderstrup-Andersen and Bach found an
increase of preventive activities initiated within several of these trades with respect
to employees’ possibilities for individual development at work and influence on own
work tasks.
Based on the findings, Sønderstrup-Andersen and Bach argue that it is difficult to
assess the role of variations of managing preventive activities related to safety and
200 H. H. K. Sønderstrup-Andersen

health introduced by the recession. This is, they say, because the enterprises suffer
from risk of reduction of activities and have to compete even harder and this could
again affect the management of preventive occupational safety and health activities.
Sønderstrup-Andersen and Bach emphasize that the regulatory agencies in different
societies play an important role in this respect and that the problem is that during
recessions state tax income is reduced making governments look for areas where
activities can be reduced. The line in their argumentation is that if the enterprises
compete in a way that makes the management of preventive occupational safety and
health activities suffer, which parts of the data from the study indicate, and the
regulatory authorities suffer from reductions, which happened in Denmark in the
period following 2008, then this could result in more accidents and in a worsened
psychosocial working environment.
Sønderstrup-Andersen and Bach found indications that enterprises have put more
focus on the psychosocial working environment and noise at the workplace during
the recession period. At the same time, a decrease was found in management
activities within the areas of work accidents and physical safety and health. In
many countries, there is an increased societal interest in decreasing psychosocial
risk at work. The hypothesis brought forth in the study is that enterprises may put
less focus on other occupational safety and health areas.
Overall, the results of Sønderstrup-Andersen and Bach study show that enter-
prises in 2011 have had more focus on managing psychosocial risk factors than they
did in 2006. It was found that this was the for preventive activities in terms of
increasing employees’ possibilities for personal development, for increasing the
possibility to exert an influence over own work, the initiation of plans for preventive
occupational safety and health actions, appraisal interviews, and job satisfaction
surveys. In addition, it was found that with respect to the management of preventive
activities within the area of occupational accidents, the picture is a bit different since
2011; fewer enterprises and public organizations have prepared occupational acci-
dent plans for preventive actions as part of their work assessments schedules. In
addition, the study points out that fewer enterprises in 2011 compared to 2006 have
initiated safety rounds on a regular basis. Finally, it was found that there has been a
decrease in several categories of preventive occupational safety and health activities
with respect to preventing falls form heights.
With respect to this theme on the recessionary effect on the management of safety
and health system integrity, Devereux (2017) in line with Sønderstrup-Andersen and
Bach (2018) found that the enterprises included in the investigation have made
specific changes to several safety and health management systems. For example,
changes were made with respect to stress or fatigue prevention programs, ergonomic
prevention programs, and establishment of health committees to take care of pre-
ventive safety and health activities within the enterprises (se also ILO 2013)
Devereux highlights several emergent themes that could affect the safety and
health managing activities in enterprises:

• Budget costs. Could lead to a negative influence on enterprise safety culture that
again affect safety and health prevention policies.
10 Managing OSH Through Recession 201

• Policy changes. Together with the reduction in safety and health professionals in
the enterprises, remaining professionals have witnessed a severe workload
increase due to more individual employee inquiries and enterprise recession-
induced policy changes especially focusing on psychosocial risk management.
• Management responsibility and accountability. A focus on growth and produc-
tivity and the many recession-induced restructuring activities might affect man-
agement in a way that leads to distraction on safety and health. Moreover, a focus
on outsourcing can destabilize system integrity increasing safety and health risks.
• Staff levels and training. Reduction of skill levels and experience of staff can
increase the risk of organizational or operational hazards resulting in increased
risk for severe accidents (especially in high hazard industries) and problems that
in the longer terms result in poorer health outcomes for employees.
• Planning, development, implementation, and audit procedures. Due to recession
constraint multinational enterprises have been forced (by government or govern-
ment agencies) to initiate a number of preventive activities. Such interventions
imply an increase in workload for management and professionals in planning to
access safety and health risks, performing audits, and taking part of safety and
health committees.
• Worker participation and investigation processes. Personnel at risk of losing their
jobs may be less likely to report on safety and health incidents, which means that
the company will not be able to learn from a given incident and to establish means
to prevent such incidents from happening again.

With respect to the mental health of general population, the World Health
Organization (2011) recommends that the mental health effects of economic crises
depend on action in five key areas:

• Active labor market programs that seek to keep or get workers people back in
jobs. In the study previously mentioned by Stuckler et al. (2009a) it was found
that that a 1% rise in unemployment makes the suicide rate grow 0.8%. Moreover,
it was found that in the EU each additional US$100 per person spent on active
labor market programs per year reduced the effect of a 1% rise in unemployment
rate on the suicide rate by 0.4 percentage points.
• Family support programs. Especially families with children and low income
suffer during economic downturns. In the study by Stuckler et al. (2009a), it
was found that each US$ 100 per person spent on family support programs
reduced the effect of unemployment on the suicide rate by 0.2 percentage points.
• Regulation of the marketing of alcoholic beverages. A report by WHO (2009)
shows that there is extensive and consistent evidence that alcohol policy and
especially policies that increase the price restrictions and taxation reduces
alcohol-related harm.
• Provision of quality and equitable access to primary care for those people at high
risk of mental health problems. Dealing with the mental health challenges of
recession entails not only protecting spending on mental health services but also
restructuring services to meet the needs of the population. Health services must
202 H. H. K. Sønderstrup-Andersen

improve responsiveness to impact of recession on factors like peoples social,

employment, and income status, and early recognition of mental health problems,
suicide, and alcohol abuse. This has been confirmed in a Finnish study on the
association between community mental-health services and suicide rate where
Pirkola et al. (2009) found that mental-health service-related factors such as 24-h
emergency services and prominence of outpatient services were associated with
decreased suicide risk. Moreover, WHO underline that offering psychological
support in health services can modify the effects of unemployment and
indebtedness.
• Debt relief programs and debt relief legislation on a national scale will assist in
decreasing mental health effects of recession. Pleasence et al. (2007) in a study on
the impact of debt advice on people’s lives confirmed that there are a variety of
causes of debt problems, with the most common being changing circumstances
like for example, ill-health relationship breakdown and loss of employment, and
particularly distressing impacts on parents’ relationships with their children. The
study found clear evidence of a positive impact of debt advice and that the
participants’ financial circumstances improved as well as their housing stability,
and general health relationships benefited from advice.

Managing occupational safety and health is very complex and depend on the
environment and context in which an enterprise or organization operates. The goal of
the European Framework Directive 89/391/EEC aims is to secure employees in all
states in the European Union (EU) with a common minimum level of protection from
occupational health risks. In a follow up analysis of data from the European Survey
of Enterprises on New and Emerging Risks (ESENER).
Walters and Wadsworth found some national effects that could not be explained
by other variables such as workplace size or industry sector. That is, ESENER data
showed that with respect to the management of occupational health and safety the
implementation level of the Directive 89/391/EEC differ from country to country as
well as work-place size and trade. To explain these differences in the practice of
managing health and safety risks between European workplaces Walters and
Wadsworth has identified and developed an explanatory representation of the rela-
tionships between a number of contextual and environmental factors that affect the
occupational safety and health management practices in EU member states (Walters
et al. 2013; Walters and Wadsworth 2014). These are shown in Table 2 below.
Walters and Wadsworth stress that the way enterprises react to the EU and supra-
national influences showed in Table 2 is determined by the interaction between the
determining factors in the different groupings of contexts and influences. In addition,
beyond the fact that the different determining factors directly affect management of
occupational safety and health at the enterprises Walters and Wadsworth emphasize
they in addition affect each other in a traversing manner that affects that actual
management practices (Walters and Wadsworth 2014).
The determining factors are under influence of the recession and the effects of the
resulting financial crisis. Walters et al. (2013) show that the recession has deterio-
rated improvements in occupational safety and health in many EU member states
10 Managing OSH Through Recession 203

Table 2 Factors determining enterprises occupational safety and health practices bases on findings
from ESENER national reports. (Adapted from Walters et al. 2013)
Contexts and influences Determining factors
EU and supra-national influences, including: The European Framework Directive 89/391/
EEC and other Directives that aim to introduce
measures to encourage improvements in the
safety and health of workers at work securing a
common minimum level of protection from
work-related risks in all EU Member States.
Wider political and policy influences such as
the level of emphasis on occupational safety
and health and the minimal implementation of,
for example, the EU social partners’ agreement
on work-related stress.
The “Europeanisation” requirements of
compliance.
The economic recession.
National governance and regulation and the Regulatory approach. In particular, the degree
occupational safety and health system, to which process orientated participatory
including: systems are embedded in traditional
approaches, and structures and provisions for
various forms of participation and consultation.
Wider political and policy influences, for
example, the level of emphasis on occupational
safety and health, deregulation, and the role of
occupational health professionals, as well as the
length and depth of research and political focus
on specific areas such as psychosocial risks.
The labor inspectorate for example, traditions
and changes in relation to their provision of
support, focus of attention, enforcement style,
and resourcing.
Labor relations, trades unions, and employers’ Employee voice, for example, arrangements for
organizations and processes, including: worker representation and consultation and the
balance of power between labor and capital.
Social dialogue in particular the traditions and
relative maturity of labor relations systems and
social partners’ support provision.
Other related systems for example social The priority of and data available on
welfare, health etc., including: occupational safety and health, for example,
workplace level understanding of the concepts
and practicalities of process-based occupational
safety and health management, and the
availability of reliable occupational safety and
health data.
Specialist services. Including their quality,
independence, and implications for enterprise
level expertise.
Insurance and other institutional agencies.
204 H. H. K. Sønderstrup-Andersen

that are striving to live up to EU directives and legislation but also the recession has
had a negative impact on policy and regulatory measures. Moreover, there has been
an immense pressure to cut budgets of regulatory agency resources and in general
downsize the public sector, which in turn has negative consequences for managing
occupational safety and health.

Conclusion

The overall conclusion to be drawn from the included literature is, that there a need
for more focus on the management of both general health in the population and
especially the management of occupational safety and health in enterprises during
economic recession. Based on the reviewed research it is concluded that all stake-
holders must focus on the management of both public health and especially the
management of safety and health activities in enterprises during a period of eco-
nomic recession. The scrutinized literature points at a few procyclical effects that
need to be managed like for example a decline in accidents at work. However, the
reviewed literature provides strong evidence that the majority of effects of the
recession are countercyclical like for example worsened suicide rates, increase in
depression disorders, increase in psychosocial risk, and physical health at work
including worsened occupational safety and health for lay-off survivors. The exam-
ined literature show that managing occupational safety and health is multifarious and
is determined by a series of factors in the environment and context in which an
enterprise operates. Important enterprise factors are: budget costs; policy changes;
management responsibility and accountability; staff levels and training; planning,
development, implementation and audit procedures; and worker participation and
investigation processes. In addition, the scrutinized research show that in general the
management of occupational safety and health depend a multifaceted interplay
between: EU and supra-national influences; national governance and regulation
and the occupational safety and health system; labor relations; trades unions and
employers’ organizations and processes; and other related systems, for example,
social welfare, health, etc.. More research waits ahead to dig further into these
mechanisms and the impact of economic recession on the management of occupa-
tional safety and health activities and general health in the population.

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Lean Management and Employee
Well-Being 11
Reconciling Conflicting Findings and Ensuring Successful
Implementation

Steven Kilroy and Patrick C. Flood

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
The Impact of Lean Management on Employee Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
The Impact of Lean Management on Employee Well-Being: A Job Demands-Resources
Model Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
The Effective Implementation of Lean Management for Sustainable Employee Well-Being . . . 218
Conclusions/Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224

Abstract
“Lean management” is a management system that focuses on ensuring the
efficient use of resources and eliminating waste, for the purpose of improving
product quality, efficiency of processes, and better responsiveness to customers.
At every step of the lean process, the question asked is “what value is being added
to the customer?”. The performance advantages of lean management have been
widely studied and consensus is emerging that lean management can pay divi-
dends for multiple stakeholders. However, the impact of lean management on
employee well-being is a current topic of lively debate. There is no consensus in
the literature as to whether lean management improves or impairs employee well-
being. Also, how to effectively implement lean to leverage improved and sus-
tainable employee well-being remains an important yet nascent topic of research
inquiry. The purpose of this chapter is to introduce the topic (and appeal) of lean
management before briefly reviewing the competing theoretical perspectives and

S. Kilroy (*)
Tilburg University, Tilburg, The Netherlands
e-mail: [email protected]
P. C. Flood
DCU Business School, Dublin City University, Dublin, Ireland
e-mail: patrick.fl[email protected]

© Springer Nature Switzerland AG 2022 209

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_9
210 S. Kilroy and P. C. Flood

empirical evidence on its impact on well-being. Following this, the chapter has
two central aims. First, it introduces a framework, based on recent empirical
research, which (1) helps reconcile the aforementioned conflicting findings,
(2) provides a platform for future research to more comprehensively investigate
the effects of lean management on employees, and (3) helps managers understand
what specific actions can maximize the benefits while minimizing the potential
harmful effects of lean management. Second, the chapter discusses some of the
central emerging themes explaining how lean management can be effectively
implemented so that employee well-being is sustainably maintained.

Keywords
Lean management · JD-R model · Lean job demands · Lean job resources · Lean
implementation · Well-being · HRM · HR practices

Introduction

Lean management is a multidimensional concept comprising a wide range of

management practices, for instance work teams, supplier management, just-in-time
(JIT) quality systems, and cellular manufacturing, which are all embedded into one,
integrated system (Shah and Ward 2003). Lean management was first implemented
in Japan, in the Toyota Motor Corporation (Pil and MacDuffie 1996). The Toyota
Motor Corporation production line was designed to enable continuous process
improvement, structured inventory management, waste reduction, and quality
improvement techniques (Black and Miller 2008). The success of the system
which was widely celebrated and often referred to as Toyotism left many American
companies struggling to compete (Handel 2014). Consequently, many corporations
in the USA and around the world commenced implementing lean principles and
practices themselves (Crute et al. 2003; Hasle et al. 2012). Lean management was
seen as the antithesis of corporate bureaucracy and the new competitive weapon to
deal with increased competition, changing markets, and economic crises that pre-
dominated in the 1970s and 1980s (Handel 2014). In this new work paradigm,
success was not embedded in work practices associated with scientific management,
but in making faster decisions, being flexible, and innovative as well as ensuring
employees were motivated, satisfied, and thrive at work. Naturally, lean management
became a central topic of academic research among scholars, with early results
demonstrating evidence for its positive performance effects (e.g., Dalton et al.
1980). Subsequent studies reveal copious performance advantages associated with
lean management including increased operational performance (e.g., Brown et al.
2006), financial performance (e.g., Eroglu and Hoffer 2014), marketing performance
(e.g., Kou et al. 2015), and entire supply chain performance (e.g., Agarwal et al.
2006). In fact, the operational improvements and organizational performance advan-
tages associated with lean management are apparent in much of the empirical
research although the performance gains are still not universally accepted (Samuel
11 Lean Management and Employee Well-Being 211

et al. 2015). While the interest in lean management originated in manufacturing with
many positive results (Parker 2003), it is not surprising to see its adoption has spread
to health care (e.g., Lawal et al. 2014), service organizations such as call centers
(Sprigg and Jackson 2006), banks (Bortolotti and Romano 2012), and public
administration (Radnor and Walley 2008) among many other contexts. Despite the
growing optimism about the potential performance effects of lean management, its
effects on employee well-being are significantly under-researched and this research
domain is an ambiguous one given that the existing empirical evidence to date has
yielded conflicting results (Bamber et al. 2014). We now turn to this debate, present
the competing theoretical perspectives, and provide a flavor of the competing
empirical evidence permeating the literature to date. The rest of the chapter will
articulate a key theoretical framework introduced into the lean management litera-
ture which represents significant progress in reconciling these conflicting findings
before more concretely addressing the key themes of how lean management can be
effectively implemented to ensure well-being is enhanced in a sustainable way.

The Impact of Lean Management on Employee Well-Being

Introducing lean management principles promised to change everything for the

better; eliminate waste, improve product quality, increase employee and customer
satisfaction, and bring productivity to a higher level (Womack et al. 1990; Womack
and Jones 1996). However, the effects that lean management actually has on the
employee’s experience are vigorously debated by scholars, and from a theoretical
and empirical standpoint, are highly under-researched (e.g., Bamber et al. 2014;
Cullinane et al. 2014; Handel 2014). The lean management ideology has both its
advocates and critics, and these views can be broadly classified into two perspec-
tives: the unitarist perspective and the pluralist perspective, respectively (Bamber
et al. 2014). The field of operations management, for example, tends to opt for a
unitarist perspective, emphasizing that lean management benefits organizations in
terms of performance and employees in terms of well-being. Many social scientists,
on the other hand, tend to adopt a pluralist perspective, and drawing from labor
process theory, argue that while lean management may be good for organizations, it
ultimately seeks to gain control over employees, and in doing so frequently and
significantly impairs their well-being (Anderson-Connoly et al. 2002).
From the more optimistic unitarist perspective, workers are believed to benefit
from lean management through enhanced participation and teamworking, which
enables them to engage in greater problem-solving, thereby improving task perfor-
mance (Taira 1996). Thus, lean management is viewed by many to benefit workers
through enhancing their skills development and by providing them with greater
autonomy, meaning, and involvement in process improvement decisions (Turner
2012). From its inception, the introduction of lean management sought to make tasks
more challenging and meaningful, thereby removing the “mind-numbing stress”
associated with mass production (Womack et al. 1990) and eliminating the possibil-
ity of strained working conditions more generally (Batt and Appelbaum 1995). For
212 S. Kilroy and P. C. Flood

example, the focus of lean management on reducing waste, errors, and rework could
reduce employees job demands such as workload and reduce the need for recovery
after a work day (de Koeijer et al. 2014). In the same vein, lean management has
been touted to improve other personal work outcomes for employees such as their
work characteristics (Parker 2003), morale (Bhamu and Sangwan 2014), intrinsic
motivation (De Treville and Antonakis 2006), satisfaction and commitment (Graban
2008; Holden 2011), and health and safety (Longoni et al. 2013).
Departing from the more optimistic view of lean management, an alternative
pluralist perspective challenges the notion that lean management is beneficial for
employee well-being. This view purports that the cost savings associated with lean
management are achieved by imposing excessive workloads on employees rather
than through real efficiencies such as shorter decision times, thereby simply
amounting to a “management by stress” managerial tactic (Parker and Slaughter
1988). A number of studies have indeed supported this negative perspective, dem-
onstrating how lean management leads to work intensification and heightened levels
of stress among employees (Anderson-Connelly et al. 2002; Bruno and Jordan 2002;
Carter et al. 2011; Lewchuk and Robertson 1996). Prior research has also revealed
that employees perceive higher levels of stress, fatigue, and tension working under a
lean management regime when compared to traditional operating companies
(Landsbergis et al. 1999). In this study, the demise in well-being was attributed to
the fast pace of work, the highly repetitive nature of the work, long working hours,
and the minimal rest breaks associated with lean management. In effect, this is why
the common question arises “Is lean mean?” (e.g., Conti et al. 2006). Reviews on the
topic of lean management have largely concluded that lean management produces
negative effects for employees’ health and well-being although there are quite a few
studies and reviews which reveal a mixture of positive and negative effects (e.g.,
Bhaumu and Sangwan 2014; Hasle et al. 2012).
In fact, many scholars, rather than adopting a purely unitarist or more nuanced
pluralist perspective, point out the contextual nature of lean management and
highlight its multifaceted nature, whereby some aspects of lean can positively affect,
while others can negatively affect, employee well-being (Anderson-Connoly et al.
2002; Beraldin et al. 2019; Cullinane et al. 2013; Seppala and Klemola 2004). In this
regard, many researchers highlight that the effects of lean management might have
different impacts and meanings for different groups of workers (e.g., Kashefi 2009).
For example, Seppala and Klemola (2004) revealed that, on average, white-collar
employees (production managers) perceived that their work had variety and offered
opportunities for one’s skills and knowledge utilization, albeit they also perceived
constant time pressure. On the other hand, blue-collar workers did not perceive
greater job variety, use of knowledge and skills, and had less opportunities for
decision-making and development. Similarly, Proctor and Radnor (2014) found
that while lean management lead to deskilling, task simplification, and much greater
work standardization, which significantly undermined worker satisfaction, at the
same time workers expressed satisfaction with the increased levels of teamworking.
In another study, Conti et al. (2006) found among 1,391 workers from
21 manufacturing sites in four UK industry sectors that while some lean
11 Lean Management and Employee Well-Being 213

management practices can be stressful, lean management as a whole is not inherently

stressful for workers. In fact, their study found evidence for a nonlinear effect
whereby the implementation of lean management was initially stressful but this
dissipated over time. Their study revealed that the important factor with respect to
the impact of lean management on employee well-being is the managerial decisions
taken in designing and implementing lean management. Indeed, job resources such
as supervisor support and colleague support were believed to play a critical role in
ensuring lean management eventually yielded positive outcomes for employees. An
additional interesting and perhaps rather surprising finding from their study is that
although lean management was characterized by a low control environment, this
benefited workers via increased automation, increased pride in the quality of prod-
ucts, and heightened job security, thereby reducing their stress levels.
The findings from the research reviewed here highlight a number of important
insights in relation to disentangling the effects of lean management on employee
well-being. First, they identify the multifaceted nature of lean management, which
can simultaneously include practices categorized as either soft or hard, and this can
explain the potential positive or negative effects on employee well-being (e.g.,
Beraldin et al. 2019). In the same vein, because lean management practices may
be pushing employee well-being in different directions, there is a high probability of
employee well-being trade-offs. For example, lean management might enhance
employees’ knowledge and skills, thereby improving well-being in the form of job
satisfaction, but at the same time increase their workload, thereby undermining their
health-related well-being indicators such as stress. This possibility of trade-offs
arising from management practices on different aspects of employee well-being,
i.e., happiness (e.g., job satisfaction), health (e.g., burnout), and relationship (e.g.,
trust) dimensions, is widely acknowledged in the strategic human resource manage-
ment literature (e.g., Van de Voorde et al. 2012) and represents an important area of
future research that needs to be entangled in the context of lean management
(de Koeijer et al. 2014). Overall, this means that viewing lean management in its
totality as well-being enhancing or well-being impairing may be myopic. In addition,
the amount or the extent to which the practices are adopted may also be an important
factor to take into account, as it is possible that lean management practices are
beneficial but, after they reach an inflection point, may then be harmful for employee
well-being (Conti et al. 2006). The possibility that the effect of management
practices is curvilinear has been widely stressed in the management literature in
recent years and referred to as the “too much of a good thing effect” (e.g., Pierce and
Aguinis 2013).
Second, the findings also demonstrate the necessity to encapsulate the wide range
of contextual factors to better understand the effects of lean management in all its
complexity. The role of context has been neglected in much of the organizational
behavior literature (Rousseau and Fried 2001) and has been often “controlled away”
by researchers rather than being empirically tested to understand its impact (Johns
2006, p. 289). In fact, the effects of lean management on employee well-being varies
according to many contingencies including the type of organization, the type of job
that employees perform (e.g., blue-collar vs. white-collar workers), and even the
214 S. Kilroy and P. C. Flood

particular national culture in which it is practiced (Wong 2007). Finally, related to the
contextual argument, the findings presented solidify the point that lean management
is rarely experienced by employees in isolation and the practices associated with lean
management are experienced by employees within a much broader organizational
context. There are many strategies that organizations can take, such as the provision
of appropriate job resources, which may enhance the positive effects or protect
against the negative effects, of lean management on employee well-being (Beraldin
et al. 2019; Cullinane et al. 2013) and these need to be borne out in future research on
this topic. Indeed, the context of lean management implementation cannot be
ignored (Fournier and Jobin 2018) and the type of managerial choices made in the
design and management of the actual change (Conti et al. 2006) will also have
profound implications for its effects on employee well-being.
In the following sections, we outline a contextual framework which encapsulates
these aforementioned contingencies and, in particular, helps us reconcile the
conflicting findings on the relationship between lean management and employee
well-being. The proposed framework offers practitioners guidelines to maximize the
benefits and avoid the perils of lean management, while at the same time offering a
comprehensive avenue for future research pursuits. Following this, we discuss the
key challenges for employee well-being with respect to the implementation of lean
management, and offer concrete strategies based on previous research, to indicate
how a sustainable culture change embodying lean management can be achieved
whereby employee well-being can be maintained and thrive.

The Impact of Lean Management on Employee Well-Being: A Job

Demands-Resources Model Perspective

In the quest to better understand the conflicting results regarding the effects of lean
management on employee well-being, scholars in recent years have applied a
comprehensive framework to the lean management context. Specifically, Cullinane
et al. (2014) suggest that the job demands-resources model (JD-R; Demerouti et al.
2001), a well-known and influential model in the field of occupational health
psychology, can be applied to the lean management context, in order to better
understand the mixed effects of lean management on employee well-being. The
job demands-resources model proposes that each workplace has its own specific job
demands and job resources. Job demands represent the physical, psychological, or
organizational aspects of the job that require effort which may have psychological,
social, and physiological costs for employees. Job resources are defined as those
physical, psychological, or organizational aspects of the job that are (1) functional in
achieving work-related goals, (2) reduce job demands and their associated physio-
logical, social, and psychological costs, and (3) stimulate personal growth and
development. The JD-R model highlights that job demands and job resources are
expected to lead to two distinct psychological processes, i.e., a health impairment
pathway whereby job demands lead to impoverished health/burnout and a motiva-
tional pathway whereby job resources lead to motivation/engagement (Bakker et al.
11 Lean Management and Employee Well-Being 215

2004). In addition, the model proposes an interactive role of job demands and
resources such that the negative effects of job demands on employee health/burnout
can be buffered by job resources (the “buffering effect”), while the positive effects of
job resources on employee motivation/engagement become increasingly salient in
the presence of high job demands (the “coping effect”; Bakker et al. 2007). Not-
withstanding its limitations and criticisms (see Schaufeli and Taris 2014), the core
propositions of the JD-R model have largely gained widespread empirical support in
the literature and therefore it represents one of the leading models to explain
employee well-being in the workplace (Bakker et al. 2004; Demerouti et al. 2001;
Schaufeli et al. 2009).
Applying the JD-R model to the lean management context, Cullinane et al. (2014)
demonstrated that there are lean management–related job demands and resources,
both aspects of lean job design, which have the potential to activate the health
impairment and motivational JD-R pathways. In Table 1, we outline some of the
most common lean-specific job demands and resources (which also represent hard
and soft lean management practices, respectively). Some examples of challenging
job demands are also provided. In line with the traditional JD-R model and in
particular the adaptations of Cullinane et al. (2014), we apply the JD-R model to
the lean management context as depicted in Fig. 1. The figure demonstrates how

Table 1 Lean-related job demands and resources

Lean hindrance job demands Lean challenge job demands Lean job resources
JIT demands Problem-solving Boundary control
Monitoring Production responsibility Performance feedback
Physical demands Learning and development Social support
Role overload Work pace Autonomy/Participation
Accountability Task interdependence Training and development
Standardization Work complexity Feedback

Lean job Burnout

demands

Organisational
Outcomes

Lean job
Engagement
resources

Fig. 1 The JD-R model in the lean management context. (Source: Adapted from Cullinane et al.
(2014))
216 S. Kilroy and P. C. Flood

there are lean management–specific job demands and job resources which activate
health and motivational outcomes for employees in the form of burnout and engage-
ment, respectively. Burnout and engagement, in turn, are expected to be negatively
and positively related to organizational outcomes, respectively. The diagram further
depicts how lean-specific job resources may protect or buffer against lean-specific
job demands and how lean-specific job resources become increasingly pertinent in
the face of lean-specific demands.
The application of the JD-R model to the lean context has profound implications
for understanding the effects of lean management on employee well-being. First, the
fact that the JD-R model can simultaneously evoke a motivational and health
impairment pathway means that we cannot regard lean management as a technique
which has uniform positive or negative effects on employee well-being (Hasle et al.
2012). Instead, lean management has job design features that produce an environ-
ment which is demanding and resourceful, thus having both exhausting and moti-
vational properties (Cullinane et al. 2014). As a result, researchers are now much
more attuned to the important distinction between the “soft” and “hard” practices
which together comprise a lean management strategy (Beraldin et al. 2019).
Second, the propositions of the JD-R model suggest interactive relationships.
This further emphasizes that lean management is unlikely to have universal positive
or negative effects but instead raises the question of how it can be implemented such
that its benefits are maximized and its costs minimized (Hasle et al. 2012; Huo and
Boxall 2018). Indeed the JD-R model shows, in a comprehensive way, how the
impact of lean management on employee well-being is likely to depend on whether
employees have sufficient and appropriate resources to combat the specific lean-
related job demands experienced. Specifically, lean-specific job resources can buffer
against the potentially negative effects of lean-specific job demands on employee
burnout. In addition, lean-specific job demands can interact with lean-specific job
resources such that the full benefits of resources can be reaped when employees are
confronted with demands. The rationale for this interactive effect emanates from the
conservation of resources theory (Hobfoll 2002) and proposes that the effects of job
resources on outcomes can be modest but become increasingly important when
employees really need them (Schaufeli and Taris 2014). That is, in highly stressful
situations, it is likely that employees will require resources to cope with the specific
demands they are confronted with to reduce their stress. For researchers, the prop-
ositions of the JD-R model involving such interactive relationships highlight how
important it is to go beyond testing direct relationships between lean management
and employee well-being to fully understand its effects.
Third, the application of the JD-R model to the lean management context draws
attention to the fact that the demanding nature of lean management is not necessarily
always a bad thing for employee well-being (Cullinane et al. 2013). Building on the
work of Crawford et al. (2010), Schaufeli and Taris (2014) have distinguished
between “hindrance” and “challenging” job demands in the JD-R model and note
how they can have differential effects on employee outcomes. In this respect,
hindrance demands are those demands that constrain individual’s development and
work accomplishment and consequently can cause burnout and result in a passive
11 Lean Management and Employee Well-Being 217

coping response manifested in disengagement (LePine et al. 2005). Examples of

lean-specific hindrance demands might include work overload (Huo and Boxall
2017), physical demands, work pace, and monitoring pressure (Cullinane et al.
2013). Demands of this nature can cause negative emotions and impoverish
employees’ capacity to deal with such demands and to accomplish their work
goals. On the other hand, challenging demands can be energy depleting but at the
same time motivational in nature. Indeed, while challenging demands can be stress-
ful, they are also viewed as motivational because they are linked to prospects for
advancement and achievement (Crawford et al. 2010). In other words, such demands
are viewed by employees as opportunities to learn, grow, achieve, and display their
skills that may be rewarded in the future. Examples of lean-specific challenging
demands might include heightened work complexity (Huo et al. 2019), problem-
solving demands and production responsibility (Cullinane et al. 2013), and work
pace and task interdependencies (Beraldin et al. 2019). In the meta-analysis of
Crawford et al. (2010), the authors were able to demonstrate more generally how
challenges were positively related to both work engagement and exhaustion. In the
lean context, the potential of lean-specific job demands to represent either a “hin-
drance” or “challenge” has been acknowledged in the literature (Cullinane et al.
2013). Subsequent research has also acknowledged the complexity of demands in
the lean context and highlight that in the case of challenging demands, which can be
simultaneously motivational and exhausting, it is important that they are also
accompanied by the appropriate resources to maximize their advantages and mini-
mize their disadvantages. For example, Huo and Boxall (2018) found that job
resources (training, participation in decision-making, and line manager support)
had a “buffering effect” in the relationship between problem-solving demands and
emotional exhaustion in a lean management context. The authors also found empir-
ical support for the “coping effect” whereby the aforementioned resources were
more strongly related to employee engagement when problem-solving demands
increased. Similar findings were borne out by Beraldin et al. (2019) who found
that softer lean management practices (SLPs) in the form of participation and
managerial support, framed as positive resources, reduce the effects of just-in-time
(JIT) hindrance job demands on exhaustion, and JIT-related hindrance demands
enhance the positive effects of SLPs on work engagement. As a whole, this impor-
tant advancement in the JD-R model in general and in the lean management context
in particular highlights that demands are not always harmful and that to understand
the effects of lean-specific job demands on employee well-being, it is paramount to
consider the accompanying job resources and in particular to acknowledge the
specific type of job demand considered, because such demands have the potential
to be simultaneously motivational and energy depleting.
The above discussion pinpoints the important role of the JD-R model in recon-
ciling the conflicting results on the impact of lean management on employee well-
being. The core message is that lean management is unlikely to lead to uniform
positive or negative employee outcomes. Instead, the question concerns how lean
management is actually supported by the organization and more broadly, how it is
implemented. We now turn to a discussion of some of the key themes which have
218 S. Kilroy and P. C. Flood

emerged advising on what can be done to ensure lean management is successfully

implemented so that employee well-being prospers in a sustainable fashion.

The Effective Implementation of Lean Management

for Sustainable Employee Well-Being

The effects of lean management on employee well-being, as depicted above, invari-

ably depends on which particular lean management practices are used, contextual
factors, and whether job resources are balanced with, or buffer against, lean-specific
job demands that could threaten employee well-being. One thing which is hard to
find evidence on is how lean management is actually implemented and, in particular,
what strategies are used to ensure employees’ needs are catered for, so that the
potential benefits of lean management materialize and are sustained. While there are
countless examples of where lean management has been successfully implemented
and sustainable outcomes achieved, there are as many examples where lean man-
agement has drastically failed to deliver for all the stakeholders involved. A seminal
case on organizational benefits can be seen in the example of Virginal Mason
Medical Center in the USA, whereby lean management implementation was a
success story, with benefits including improved quality of patient services care,
reduced waiting times, optimization of space, and scheduling of operating rooms,
as well as improved well-being outcomes (Danese et al. 2018). However, there are
also cases which depict a bleaker picture in terms of lean management implemen-
tation. In Saskatchewen in Canada in 2008, the ministry of health implemented a
multimillion dollar investment which brought lean management to the provinces
health care system. Evaluating the subsequent impact of lean management, research
revealed that for every one dollar saved by lean management, Saskatchewan spent
$1,511, while patient outcomes did not improve, workload increased, and staff
morale declined (Moraros et al. 2016).
The latter example highlights that lean management implementation is not
straightforward and “getting it right” is important, in order to avoid negative out-
comes for both organizations and employees. In fact, the implementation of lean
management is believed to be fraught with difficulties and the rates of successful
lean initiatives are rather low (Bhamu and Sangwan 2014). The evidence suggests
that positive and sustainable outcomes from lean management often fail to materi-
alize because of inadequate attention to and concern for employees’ needs and well-
being in the process. Indeed, as the above review illustrates, lean management in
itself has the potential to impair employee well-being without the appropriate
conditions. Asked whether lean management is compatible with employees health
standards, Adler and Landsbergis (1998) responded with a “maybe-conditional on
good implementation.”
In a large-scale study in the USA involving surveys and focus groups of over
1,000 employees and union leaders, employees reported widespread dissatisfaction
with lean management and noted a drastic change in the levels of support by the
organization and many broken promises (Bruno and Jordan 2002). The researched
11 Lean Management and Employee Well-Being 219

employees noted a drastic change in the levels of support and care by their organi-
zation after implementation. While initially promising daily meetings, new work-
place practices which were reasonable, and greater empowerment, these conditions
did not arise and amounted to broken promises. Employees instead described their
new working life under lean management as having less say over work processes,
having little time to accomplish good work because of the pace of the production
line, that safety had been neglected, and that the accelerated physical demands were
draining (Bruno and Jordan 2002). In another study, Lewchuk and Robertson’s
(1996) research among 1,670 workers revealed that while workers were promised
more control over work, as well as more varied and challenging tasks, the conditions
at work had severely worsened with control dissipating, work pace and load increas-
ing, tasks becoming more repetitive, and increased performance expectations intro-
duced which significantly undermined the employees health. These studies highlight
the management and implementation challenges surrounding lean management
inducing employee grievances and impaired well-being. In particular, it appears
that more often than not, successful lean management implementation is dependent
on whether the “soft” or people-oriented issues are center stage or not (McMackin
and Flood 2019). How to successfully manage the implementation of lean manage-
ment and how to ensure the sustainability of such changes while maximizing
employee well-being is still not fully understood (Bamber et al. 2014). A systematic
literature review consisting of 240 studies from 2003–2015 indicated that very few
studies have attempted to develop models for lean management implementation
(Danese et al. 2018). We now discuss some of the central and recurring themes
which have emerged in this scant literature, in order to explain what can be done to
ensure that people issues are highlighted as a critical aspect of sustainable lean
management. Our review of suggestions is by no means exhaustive but covers a
relatively broad spectrum of the latest thinking on how to ensure the effective
implementation of lean management for maximizing employee well-being in a
sustainable manner.
A general but central theme which emerges to account for why implementation
problems arise with respect to lean management is the overemphasis on the technical
pillar at the expense of the social (people) pillar of lean implementation (Danese
et al. 2018; McMackin and Flood 2019). The neglect of such social issues goes
against the prescriptions of socio-technical systems theory which purports that work
design, including lean management, should equally attend to the human and techni-
cal context in which the work is undertaken (Mumford 2006). Failing to do so is akin
to a form of ultra-Taylorism with detrimental ramifications for employee well-being
(Adler and Cole 1993). Reviewing selected systematic reviews on the topic,
McMackin and Flood (2019) highlighted that there has been a welcome increase
in studies examining the relevant factors associated with the social pillar of lean
management implementation. These important factors, regarded as essential for
successful lean implementation, include: organizational culture, team empowerment,
continuous learning, leadership and manager behaviors, HR strategy, and change
management. Integrating these factors, among others, they propose an overarching
theoretical framework for the social pillar of lean management, whereby relational
220 S. Kilroy and P. C. Flood

coordination theory is integrated as a crucial component for successful lean man-

agement implementation. Relational coordination theory postulates that for success-
ful work coordination, it is paramount that employees have shared goals, shared
knowledge, and mutual respect, which are supported by and enable frequent, timely,
and accurate information. In an environment characterized by high levels of rela-
tional coordination, McMackin and Flood (2019) argued that shared problem-
solving, rather than a blame culture, is critically necessary in the challenging
situations of lean management implementation. At the same time, the process of
implementation will be smoother and maintain employee well-being in the long
term. This is because the relationship/people or social pillar of lean implementation
is given priority, with a focus on the relationships between workers, the relationship
between workers and their leaders, and the relationship between workers and
customers. The full model is depicted in Fig. 2. The model specifically highlights
how organizational factors referred to as “lean foundations” (which include HR
strategy and a lean culture) affect employee behaviors at the group level (which are
in essence “relational coordination” and the “lean change process,” i.e., how the
change process of transitioning to lean management is managed), which in turn
influence employee responses (in the form of attitudes, behaviors, and performance).
The recursive arrows in the diagram also recognize that the proposed relationships
are not necessarily linear but simultaneously occur in both directions. In doing so,
the model encapsulates the complex and interdependent relationship between the HR
strategy and lean management culture. More broadly, the model showcases the wide

Fig. 2 Theoretical framework for the lean social pillar.. (Source: Adopted from McMackin and
Flood (2019))
11 Lean Management and Employee Well-Being 221

spectrum of management actions that can be deployed to successfully implement

lean management, so that performance in addition to positive employee reactions
such as employee well-being will be enhanced.
Related to the aforementioned model and in particular the important link between
HR strategy and lean management, another predominant theme of the HR function
has emerged to explain the conditions for successful lean management implementa-
tion (Danese et al. 2018). What role (if any) HR specialists play (or should play) in
the introduction of lean management and the implications for HR policies and
practices is still not fully clear (Bamber et al. 2014). However, scholars have
suggested that “the extent to which an organisation’s HR system and culture are
aligned with lean requirements will be positively related to employee reactions to
lean implementation” (McMackin and Flood 2019, p. 49). Although focusing on
performance rather than employee well-being per se, de Menezes et al. (2010) found
that a high degree of integration between operations management and HRM is
crucial to the success of lean management implementation. Specifically, the authors
found that the continuous improvement required by lean management cannot be
achieved, without employee participation and involvement. This is not surprising
since adapting to and adhering to lean management requires employee commitment,
motivation, and attitude, thus workers cannot be disassociated from the implemen-
tation process if real cultural change is to be achieved (e.g., Fournier and Jobin
2018). Focusing on employee well-being, de Treville and Antonakis (2006) argued
that when there is too much of a focus on slack reduction without appropriate
employee involvement, lean management will have negative consequences for
employee well-being. The challenge, however, is that production systems based on
lean management imply standardization of routines and operational uncertainty
which, although they may produce efficiency, often manifests in lower levels of
employee involvement and control. Indeed, practices such as total preventative
maintenance (TPM), JIT inventory control, and cycle time-time reduction facilitate
managerial, rather than employee, control over the pace of work and the production
process (Huo et al. 2019). In essence, this is why the influential job demands-control
model of Karasek (1979) was found to be of limited use in the lean management
context for explaining employee health and well-being (Conti et al. 2006). There-
fore, within the confines of lean management principles, managers need to creatively
make use of empowering or involvement-oriented HR practices, both in the imple-
mentation of lean management and in combination with other lean management
practices in the long term. The feeling of such empowerment will be paramount for a
sustainable lean management culture which maintains employee well-being in the
process (Jones et al. 2013).
Similarly, to maintain employee being, at the implementation stage and beyond,
HR professionals have an important role in cooperating with unions when
implementing change, and ensuring the HR practices of hiring, performance man-
agement, rewards, and empowerment are compatible with the principles of lean
management (Fournier and Jobin 2018). HR plays a key role in facilitating lean
management by ensuring employees are ready for the associated organizational
changes and that the practices are complementary rather than opposing (Bamber
222 S. Kilroy and P. C. Flood

et al. 2014). To better understand this complementary nature of HR practices in the

lean management implementation process, the framework of de Koeijer et al. (2014)
is informative. de Koeijer et al. (2014) introduced a theoretically driven conceptual
framework which links lean management, enabling HRM, strategic climate, and
well-being outcomes. The central tenet of the framework is that when lean manage-
ment is combined with enabling HRM, mutual gains can be created in the form of
improved organizational performance and well-being. The enabling bundle of HR
practices consist of the following: training and development, performance appraisal
and rewards, teamworking and autonomy, participation and job design, recruitment
and selection as well as work-life balance and employment security. These HR
practices are typically considered progressive HR practices in the strategic HRM
literature and are typically referred to as high-performance work practices, high
commitment HR practices, or high involvement work practices. Such practices have
been found to yield positive performance outcomes and improve employee well-
being (See Peccei and Van de Voorde 2019 for a review of studies).
The added value of adopting enabling HR practices in the context of lean
management implementation is that they signal and reinforce the values of the
lean management strategy and make it more meaningful for employees by paying
attention to the social pillar (people aspects) of work. Indeed, a climate of continuous
improvement is more likely to materialize in a tangible way when HR practices
encourage and reinforce employees to respond and behave in ways that support the
objectives of lean management (de Koeijer et al. 2014). In addition (and in line with
the previously presented JD-R model), such HR practices can constitute vital job
resources in themselves, which may buffer against the potential negative aspects of
lean management for employee well-being, while at the same time enhancing their
potential positive effects. For instance, providing employees with job security may
buffer against the negative effects of lean management on relationship well-being in
the form of trusting relationships (Graban 2008).
Similarly, advanced training and development practices linked to the specific
requirements of lean management can be seen by employees as a growth and
learning opportunity (challenge demand) and as a positive resource enabling them
to better accomplish their tasks and successfully adhere to lean protocols (Cullinane
et al. 2014; Huo and Boxall 2017). This could manifest in terms of higher satisfac-
tion (improved happiness well-being) and lower stress (improved health-related
well-being). The use of empowerment-/involvement-oriented HR practices could
also constitute a valuable resource, instrumental in helping employees cope with the
new lean management–specific requirements. Indeed, if employees are involved and
empowered to champion lean management from the outset, they will have a greater
say in what the procedures will be, how they will be accomplished, and when they
will be accomplished, thereby having profound implications for their happiness and
health-related well-being. In summary, enabling HR practices are likely to buffer
against the potential negative effects, and enhance the positive aspects, of lean
management on employees’ well-being (Koeijer et al. 2014).
The final prominent theme associated with successful lean management imple-
mentation concerns the role of the frontline manager (e.g., Huo et al. 2019; Huo and
Boxall 2018). Related to the role of enabling HRM discussed above, it should be
11 Lean Management and Employee Well-Being 223

noted that frontline managers are the ones who are actually charged with the
responsibility for implementing HR practices (Purcell and Hutchinson 2007). For
example, line managers play a central role in offering training and development,
carrying out the performance appraisal (and performance management more gener-
ally), and making pay decisions for employees. In effect, lean management cannot be
implemented successfully without the support of frontline managers (Huo and
Boxall 2017). In addition to their role in enacting lean management practices and
enabling HRM practices, frontline managers also act as a pivotal resource to help
employees deal with the accompanying demands associated with lean management.
Frontline managers are likely to have a deep understanding of the particular demands
faced by their employees and are thus in the best position to help them and offer
support (Ray and Miller 1994). Support of such kind can be instrumental, i.e., filling
in for absent workers or directly helping employees with their heightened workload
caused by certain lean management practices.
However, support could also be emotional in nature, whereby frontline managers
show empathy to employees and listen to their concerns, thereby demonstrating care
for their well-being. Huo et al. (2019) found that line manager support represents a
vital job resource that helps employees cope with the work intensity under lean
management settings, which in turn protects against the development of burnout and
impaired well-being. Beraldin et al. (2019) also found that managerial support buff-
ered against the negative effects of JIT job demands on burnout. Conti et al. (2006)
found that support from the line manager was central in ensuring that the implemen-
tation of lean management eventually lead to successful employee outcomes, i.e.,
improved well-being. Therefore, in the context of lean management implementation,
the role of the frontline manager in endorsing lean management (in addition to
providing the appropriate support to employees) and successfully implementing HR
practices which are synchronized with the lean management philosophy, is imperative
for success. However, given the increased expectations put on frontline managers in
the context of lean management whereby they need to implement and manage lean
management practices, and enact and deal with a broader spectrum of people man-
agement issues (Townsend and Russell 2013), their own workload is likely to escalate
and their own well-being may also deteriorate. Therefore, it is critical that senior
managers pay attention to this issue and provide the appropriate support, training, and
rewards for line managers so that they have the ability, skills, and motivation to
support their own employees and successfully implement the lean management–
related and general HRM policies and practices (Huo et al. 2019). Empirical support
has found that providing frontline managers with lean management–related training,
top management support, and higher levels of remuneration is especially relevant for
enhancing their engagement in a lean context (Huo and Boxall 2017).

Conclusions/Summary

Lean management has become a ubiquitous term in organizational life and is

practiced across virtually all sectors of today’s industry and service sectors. The
appeal of lean management lies in its performance advantages which empirical
224 S. Kilroy and P. C. Flood

research has widely substantiated across many organizational and cultural contexts.
However, the performance advantages of lean management can sometimes outweigh
the advantages for employees and especially their well-being. As depicted by the
wide variety of studies reviewed in this chapter, there is fierce and ongoing debate
about whether lean management improves or impairs employee well-being. To
reconcile the conflicting evidence which permeates the literature, this chapter
draws on recent work which integrates the JD-R model to the lean management
context. This all-encompassing contextual model recognizes the multifaceted nature
of lean management practices and, in particular, acknowledges that lean manage-
ment is unlikely to lead to uniform positive or negative consequences for employees.
Instead, lean management can have both motivational and exhausting properties and
the central priority for managers should be to ensure that there is an adequate and
appropriate balance of lean job demands and job resources. The integration of the
JD-R model, however, also shows us the complexity of understanding the effects of
lean management from a research and practical point of view, as the model assumes
any job demand and job resource is likely to influence employee well-being.
Therefore, this is only the start of the journey for researchers to ascertain what
specific lean job demands and job resources, and their combination, is likely to work
best to enhance employee well-being in a specific context. We are in special need of
future empirical studies to examine the interrelationship between lean management
and HR strategy, to decipher how they can support each other to ensure sustainable
employee well-being. What also becomes clear from anecdotal cases depicting
organizational failures with lean management as well growing empirical evidence
on the topic, is that “getting right” the implementation process of lean management
is imperative. In particular, focusing on the technical aspects of lean management
from the outset while neglecting the social (people) aspects is a recipe for failure. On
the basis of accumulating conceptual and empirical work, this chapter pinpoints
what can be done to address these people aspects. Specifically, we see significant
promise arising from lean management when it is implemented with a supporting
culture and with a supporting HR strategy aimed at fostering relational coordination
in the organization. In addition, HR professionals, historical guardians of employee
well-being, will play a vital role in ensuring the social (people) aspects of lean
management are not neglected at the implementation stage and beyond, and that line
managers are equipped to deal with the change process and strategy implications of
lean management initiatives.

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Corporate Boards and Employee Well-Being
12
Ulrica von Thiele Schwarz and Caroline Lornudd

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
Why OHS Matters for Companies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Four Ways in Which Employee Health and Well-Being Affect Organizational
Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
Organization of OHS: From Sidetrack to Integrated Business Component . . . . . . . . . . . . . . . . . . . 234
Governing OHS and Employee Health and Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Incentivizing and Controlling CEOs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Supporting and Encouraging CEOs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Socially Influencing CEOs’ Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
A Champagne Tower of Influence and Enablement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
What Do Boards Do to Influence Employee Health and Well-Being? . . . . . . . . . . . . . . . . . . . . . . . . 236
Making OHS a Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Establishing a Culture of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Measuring and Rewarding What You Want to See More Of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Overseeing Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
What Influences Boards’ Engagement in OHS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Board Members’ OHS Competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Five Drivers of Engagement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Opportunities and Constraints Impacting Boards’ Engagement . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
A Practical Guide to Increase Board Engagement in Employee Health and Well-Being . . . . . 242
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244

U. von Thiele Schwarz (*)

School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden
e-mail: [email protected]
C. Lornudd
Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 229

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_10
230 U. von Thiele Schwarz and C. Lornudd

Abstract
Management and employment practices affect the health and well-being of millions
of people around the world. Much of the working population is employed in the
private sector, and the way companies manage employee health and well-being
impacts a significant portion of the workforce and, thus, society at large. Private
companies are governed by boards of directors. They represent shareholders, are
legally responsible for companies, and set strategic agendas to ensure profitability.
Through chief executive officers and top management, boards’ actions have
cascading impacts on operative organizational levels, throughout their organiza-
tions. They set the tone and influence whether employee health and well-being are
priorities. A board may reinforce a focus on employee health and well-being by
making occupational health and safety a strategy, establishing a healthy culture,
setting and measuring priorities and rewarding people for meeting them, and
overseeing what is going on in the organization so action can be taken when
necessary. Yet, some boards regard employee health as an operative question and
only engage in issues reactively. Others view health as a business opportunity or
even a moral obligation. Specific occupational health and safety competence
among board members is uncommon, but developing it is one way of ensuring
boards understand their role in employee health and well-being.

Keywords
Board of directors · Corporate boards · Governance · Health · Human resource
management · Leadership · Management · Occupational health and safety ·
Private companies · Strategic leadership

Introduction

I feel that the board’s commitment should come with an impact. There should be a force, a
sun should shine on these issues – both on profitability and on employees, on other issues. A
sun should glow from the board. Chairperson, construction industry

In private corporations, the board of directors is ultimately responsible for

governing the company (Boardman and Lyon 2006). Board responsibilities are
regulated by corporate laws, and although they differ somewhat between countries,
boards tend to be fundamentally responsible for companies’ legal compliance and
long-term value. A multitude of studies have suggested that boards impact a range of
organizational processes and outcomes (Dalton et al. 1999; Sarto and Veronesi 2016;
De Villiers et al. 2011).
Yet, when it comes to how organizations impact their employees’ health and well-
being, little attention has been paid to the role of boards. Rather, health and well-
being has been largely considered a matter for operative management (Boardman
and Lyon 2006). Particularly focus has been on first-line managers, the managerial
level closest to employees (e.g., Skakon et al. 2010), but also higher operative
12 Corporate Boards and Employee Well-Being 231

managers such as chief executive officers (CEOs) have received some attention
(Hasson et al. 2018). This one-sided focus on operative management may be the
consequence of a traditional view of employee health and well-being as separate
from organizational performance – the business – which is definitely a concern for
strategic boards. However, the relationship between employee well-being and finan-
cial performance has been increasingly recognized, and there is today little doubt
about the existence of a relationship between employee health and well-being and
organizational performance (Krekel et al. 2019).
As the bodies with the ultimate responsibility in private companies, boards are in
a position to influence both individuals’ health and well-being and the performance
of companies. However, the boards’ impact does not stop there. The negative
influence of work-related ill health is also felt at the societal level, with economic
costs estimated at an average of 4% of national GDP across the world (Takala et al.
2014). Private companies play a big part in driving that number, as many employees
work in the private sector. Over 90% of workers in the developing world, 84% in the
United Kingdom, and 70% in Sweden work in a company that is privately owned,
funded, and/or controlled (International Labour Organization). Thus, private com-
panies and their boards can either be a part of the problem with work-related
ill-health or a significant part of the solution.
Compared to public organizations, private companies start from a disadvantaged
position when it comes to promoting employee health. The private sector has more
precarious employment conditions, including lower wages, temporary contracts, and
less job security. It offers more low-skilled jobs, less access to continuing education,
less health coverage, and lower pensions, and the unions are weaker (Hugrée et al.
2015). Yet, from a governance perspective, private companies also have the advan-
tage of operating in a less political and regulatory environment, which means less
bureaucracy, fewer organizational levels, less top-down command, and clearer
governance goals. All this adds up to an opportunity for boards of directors to assert
a significant impact on employee health and well-being.
This chapter focuses on the role of corporate boards in employee health and well-
being and occupational health and safety (OHS) (we will use the words interchangeably
in the text). We begin with an explanation of why employee health and OHS matter for
companies, including how employee health and well-being can affect the bottom line.
Then, to set the context within which boards operate, we describe how OHS is
commonly organized and managed in organizations. Further, we discuss through
which means boards can exert their influence before we elaborate on what motivates
engagement in OHS from the perspective of boards. Finally, we present some ideas on
what boards might want to start with to level up their involvement in OHS.

Why OHS Matters for Companies

Every year, 2.78 million people die from occupational accidents or diseases and
374 million suffer from nonfatal accidents or illnesses (International Labour Orga-
nization 2019). These are conservative estimates of the suffering caused by poor
232 U. von Thiele Schwarz and C. Lornudd

working conditions, since “softer” outcomes such as pain and distress, which are
harder to quantify, are not included in these numbers (Schulte et al. 2017).
Physical problems (e.g., low back pain) and physical risks (e.g., exposure to
asbestos, risk of injury, and poor ergonomics) have historically received more
attention than psychosocial risks, but this is gradually changing (Wang et al.
2020). With a growing awareness of psychosocial and organizational risks associ-
ated with increased time pressure, deskilling of work tasks, and insecure employ-
ment contracts, expectations on organizations to focus on occupational stress, mental
health, and quality of life and promote a healthy organizational culture have
increased. This shift from avoiding ill health to promoting health in a broader
sense is in line with the WHO 1948 definition of health as “a state of complete
physical, mental and social well-being,” not only absence of disease or illness (Jain
et al. 2018).
Thus, it is now widely acknowledged that OHS encompasses both prevention of
risks and promotion of health and well-being of employees through employment and
working conditions (physical, social, and organizational). It is also acknowledged
that employee health and well-being are affected by a multitude of business deci-
sions, whether that is the intention or not (Jain et al. 2018). OHS permeates
operations in companies and has significant consequences from a human perspec-
tive. However, it can be argued that there also is a business case – not only a moral
case – for why employee health and well-being matter for companies.

Four Ways in Which Employee Health and Well-Being Affect

Organizational Performance

A growing body of research shows that employee health and well-being are linked to
business outcomes, including productivity, quality, and cost of production as well as
financial metrics, such as profitability (Pagell et al. 2014; McLellan 2017; Krekel
et al. 2019).
Employee health and well-being may impact organizational performance in four
ways: (1) through direct and indirect costs associated with sickness absences,
(2) through decreased productivity when people are present at work but not in
good health, (3) through motivational processes, and (4) through employer branding
(i.e., when excellent working conditions are viewed as an asset that can attract and
retain talent). The first three are related to the existing pool of employees, whereas
the fourth relates to other stakeholders, such as future employees and customers.
First, poor working conditions can cause employee ill health and thus increase
sickness absences and the costs associated with that. Depending on governmental
regulations that may vary between countries, this may include sickness benefits for
employees, health insurance, and/or medical costs. Companies generally also need to
cover the time lost by absent employees, adding additional expenses for replace-
ments in terms of overtime or temporary workers who seldom achieve the same
productivity levels as the more experienced employees they replace. In addition to
the direct costs associated with sickness absences, indirect costs are also a concern,
12 Corporate Boards and Employee Well-Being 233

particularly related to decreased productivity. For example, it has been suggested

that every 1% increase in sickness absences results in 0.66% decrease in productivity
(Grinza and Rycx 2020).
Second, poor working conditions also result in increased sickness presenteeism,
which is when employees are at work despite being sick. This has negative impacts
on organizational performance. For example, a Swedish study reported that an
employee with a salary of 3000 euros a month costs the employer about 100 euros
a day when working while sick due to lower performance (Strömberg et al. 2017).
Thus, for an employee attending work for 5 months (100 working days) with stress
symptoms, such as exhaustion and problems with memory, concentration, and
decision-making, the cost is 10,000 euros. Multiply that by the number of employees
that suffer from work-related illnesses, and the financial impact is significant.
Third, working conditions may affect employee ability, opportunity, and willing-
ness to perform. For example, social, structural, and infrastructural conditions that
make doing a job difficult (organizational constraints) may inhibit performance by
decreasing motivation and increasing workload and strain (Pindek et al. 2019;
Pindek and Spector 2016). At the same time, organizations that are perceived as
fair and just, give employees room for job crafting, and nurture good quality
relationships between employees and leaders may see the positive implications of
the connection between employee well-being and organizational performance (Niel-
sen et al. 2017). Factors such as increased work engagement (Kim et al. 2013) and
organizational citizenship behavior – that is, employees’ willingness to do more of
what is required (i.e., extra-role performance; Aggarwal and Singh 2016) – may be
part of the explanation.
Finally, the relationship between organizational performance and employee
health may not only be about current employees’ wellness and performance. A
company that serves its employees well may itself be seen as an asset because
such a reputation gives the company a competitive advantage on the market. For
example, being perceived by current and future employees as a desirable employer
and a great place to work is one way of improving business performance by
attracting and retaining talent (Backhaus and Tikoo 2004). From this perspective,
OSH can be viewed as part of a strategic ambition to create an attractive workplace,
not merely an operative task of avoiding harm or mitigating risks. The idea that
employees are assets with economic value can be traced back to the human capital
model, which outlines the collective value of employees’ capabilities, knowledge,
skills, and motivations in a company (Grossman 2000). This notion is reinforced in
sustainability concepts, including corporate social responsibility and the triple bot-
tom line (planet, people, profit), both of which suggest that a business’s performance
includes outcomes for the planet and people as well as profit (Elkington 1994).
In summary, both individuals and companies suffer the consequences of poor
work conditions, and both employees and employers can benefit from a well-
functioning workplace. Yet, so far, OHS and employee well-being have tended to
be managed separately from the core business. However, the silo approach to
managing employee health and well-being is being challenged in new ways of
organizing OHS.
234 U. von Thiele Schwarz and C. Lornudd

Organization of OHS: From Sidetrack to Integrated Business

Component

Companies often have separate systems and processes for managing OHS and opera-
tions (Pagell et al. 2014). A company may even have separate processes and structures
for managing the different ways in which it influences employee health and well-being:
one human resource unit focuses on training and development, another on employee
relations, and a third on health protection and promotion. Many companies even split
health protection (the focus on prevention of risks) and health promotion (the focus on
broader employee health, including off-the-job factors) (Hymel et al. 2011). This means
that the factors an organization can influence that matter to employee health and well-
being often have separate budgets, personnel, and policies with little or no coordination
or integration (Baker et al. 1996). This piecemeal approach to the management of
employee well-being has several disadvantages. First, it can prevent an overview of
different aspects of employee well-being that are in fact interrelated. Second, it can lead
to unnecessarily complex bureaucracy with redundant or conflicting procedures and,
therefore, higher costs (Hymel et al. 2011; Shain and Kramer 2004). Finally, this
approach may also retain OHS as a purely operational concern, thus limiting reasons
for it to be a concern for the board of directors.
However, recent decades have seen some developments toward integrated systems
(Kontogiannis et al. 2017), which may facilitate the shift of OHS from purely opera-
tional to more strategic. Through these systemic approaches, OHS is no longer managed
in a silo. Instead, it is integrated into other management, business, and/or quality
management systems. As such, it has become more strategic and performance oriented.
The shift toward the triple bottom line (planet, people, profit), employee branding, and
other initiatives that point to employees as fundamental to business performance further
accentuates OHS’s potential from a business perspective, aligning it with other key
business objectives and pushing it toward the strategic world of boards of directors.

Governing OHS and Employee Health and Well-Being

Boards of directors are normally responsible for establishing a strategic direction,

setting standards and values for operations and defining boundaries for operative
management, holding management accountable, overseeing internal controls, and
accounting for owners’ and other stakeholders’ interests. Boards’ influence on
strategy and business performance is primarily enacted through interactions with
CEOs and top management. There are at least three different roles that a board may
take in these interactions, according to three governance theories described below.

Incentivizing and Controlling CEOs

According to agency theory (Jensen and Meckling 1976), boards have a primarily
controlling function. Operative managers are viewed as agents for owners but are not
necessarily expected to share the same agenda. Instead, they are assumed to act in self-
12 Corporate Boards and Employee Well-Being 235

interest. This is based on the view of humans as rational homo economicus engaged in
maximizing their own profit. The task of boards, therefore, is to control the top
operative management and hold them accountable (Jensen and Meckling 1976). In
relation to employee health and well-being, this may, for example, entail setting up a
performance management system that incentivizes managers to improve employee
well-being or by holding management accountable for poor OHS performance.

Supporting and Encouraging CEOs

Boards may also take on a more supportive and encouraging role in relation to
management, as outlined in stewardship theory (Davis et al. 1997). Stewardship
theory posits that people – including CEOs and other top managers – will normally
act in the interest of the organization and may very well be intrinsically motivated to
perform well instead of motivated only by tangible and monetary rewards. From this
perspective, boards assume that they share an agenda with management, so there is
little need for control mechanisms. Instead, boards adopt more of an advisory and
collaborative role to jointly develop strategies and oversee performance. In relation
to OHS, boards might, for example, work with operative management to set prior-
ities, develop a vision, and offer advice on how to improve employee health.

Socially Influencing CEOs’ Priorities

The agency and stewardship theories indicate that CEOs and other executive direc-
tors do not operate in a vacuum – they are expected to be impacted by the controlling
or collaborative actions boards take. To illuminate how this influence translates into
CEOs taking certain actions, we turn to a third theory – behavioral governance
theory (Westphal and Zajac 2013). This theory puts the spotlight on social context
and notes that in order to understand a person’s actions, we need to acknowledge that
perceptions, decisions, and actions are based on interpretations that are influenced by
social surroundings (i.e., we need to understand that CEOs are socially situated and
constituted agents; Westphal and Zajac 2013). What happens in the interaction
between boards and CEOs may thus shape CEOs’ actions. In terms of employee
health and well-being, this could take the form of a board requesting that the CEO
focus on increasing safety observation reports until the next board meeting. The
behavioral result of the CEO undertaking this task is a pleased board at the next
board meeting, which increases the likelihood of the CEO continuing to engage in
the issue. Thus, boards may consciously try to use the social context they constitute
to influence CEOs to prioritize employee health and well-being.

A Champagne Tower of Influence and Enablement

This kind of social influence on behaviors and activities does not solely take place at
the highest organizational levels but throughout the hierarchy, with higher levels
influencing lower ones more so than vice versa (Malott 2003).
236 U. von Thiele Schwarz and C. Lornudd

For example, an integrated review concluded that managers’ willingness to be

involved in employee wellness programs is to a large extent influenced by factors
such as support from senior management (Passey et al. 2018). In line with this,
another study reported that first-line managers need senior managers to clearly and
consistently show that OHS is prioritized in order to prioritize it themselves (Hasson
et al. 2014). The first-line managers in that study pointed out that senior managers
tend to be invisible once the decision had been made, leading to a sense that other
things are more important.
This social influence higher organizational levels have on lower ones can be
likened to a champagne tower, a tower of glasses filled with champagne layer by
layer by pouring champagne into the top glass (Lornudd et al. 2021). The cham-
pagne trickles downward and is analogous to the priorities transmitted from higher
organizational levels and distributed downward. The issues that an upper organi-
zational level focus and follow up on influence the actions of the level below. In
this way, what boards put the spotlight on and follow closely impacts CEOs’
actions, which in turn impacts the actions of senior management, which impacts
middle management, and so on. Hence, the direct impact of first-line managers –
the next lowest level in the champagne tower – on employees’ health and well-
being needs to be understood in light of the cascading impacts of all the organiza-
tional levels above, which provide cues as to whether employee health and well-
being are important.
Does employee health have to be prioritized at the strategic board level to be
satisfactory? No. CEOs can pursue better employee health without support from
boards. However, if a company’s ambitions in this regard is solely placed on the
shoulders of the CEO, it will be highly influenced by the CEO’s personal interests.
Instead, a more robust solution is integrating OHS work in a corporate governance
model. In such cases, OHS is the tone from the top (Lornudd et al. 2021).
We will now turn to how such a cascading effect can be enacted – that is, what can
boards do to influence the organizations’ performance in relation to employee health
and well-being?

What Do Boards Do to Influence Employee Health and Well-

Being?

As outlined above, boards are ultimately responsible for governing companies

(Boardman and Lyon 2006). Thus, boards can be expected to be involved in issues
that impact companies’ performance. The ways in which boards assert their influ-
ence in general applies to OHS as well. In the following section, we describe what
research suggests boards can do regarding OHS in relation to four broad areas of
influence: (1) making OHS a strategy, (2) establishing a culture of health, (3) deter-
mining what is measured and rewarded, and (4) overseeing operations. The section is
based on a scoping review of the literature on the role and influence boards have in
OHS work (Ebbevi et al. 2021).
12 Corporate Boards and Employee Well-Being 237

Making OHS a Strategy

Boards with knowledge of the relationship between employee well-being and long-
term profitability can incorporate OHS into strategies for long-term value creation.
In such an integrated approach, employees are seen as a long-term strategic
resources (Clarke 2015). Compared to companies with short-term profitability
horizons, companies with long-term profitability horizons may refrain from risky
high-profitability projects, make investments without expectations of instant return
on investment, and adopt a pace of organizational change relevant to both
employees and business. This provides a more stable and predictable context for
employees, which in turn fosters good work conditions and a safe and healthy
workplace.
OHS as part of a strategy for long-term profitability could also include plans for
recruitment (e.g., when appointing senior managers) and communication strategies,
ensuring that it becomes part of the company’s identity and brand, thus contributing
to the establishment of the organization as an attractive place to work (Ferguson
2015). Yet, many boards stop short of that and retain a strategic view of OHS as one
of daily operations’ risk mitigation, management, and legal compliance issues
(Klettner et al. 2014), rather than viewing it as vital for business.

Establishing a Culture of Health

Another way in which boards can support employee health and well-being is by
setting standards and values that show the organization that OHS is considered
important and valuable. Creating a culture is, of course, not a one-time action but
an ongoing process involving consistent communication and actions that show that
the health and well-being of employees are important. A culture supportive of OHS
can be facilitated by developing safety/OHS visions, policies, and goals (Ferguson
2015) and by encouraging a safety first attitude that goes beyond compliance with
regulations. It may also include an openness to and encouragement of reports on
OHS problems; this primarily pertains to CEOs and other executive directors but
also includes risk observations reported by employees. Part of the culture further
includes responding to reports and performance measures (Wright et al. 2006) and
celebrating good OHS performance. It may further entail advocating for and
supporting OHS initiatives, showing commitment by prioritizing safety in the
agenda, and doing safety walk-arounds.
Yet, it is not sufficient to communicate a healthy culture only in situations of
obvious relevance to employee health. Boards aspiring to create a culture supportive
of employee health need to enact their culture across different situations, showing
that they understand that employee health and well-being are affected by myriad
decisions sometimes seemingly unrelated to OHS. Thus, an OHS culture needs to be
reflected across boards’ actions.
238 U. von Thiele Schwarz and C. Lornudd

Measuring and Rewarding What You Want to See More Of

A third way through which boards traditionally try to influence operative managers
is with performance management systems. There is a general agreement that boards
should set key objectives and develop performance indicators related to health and
safety (Ferguson 2015; Boardman and Lyon 2006; Bunn et al. 2001). Performance
indicators for health and safety can include strategic measures, such as safety
performance and culture; outcome measures, such as sickness absences, accidents,
and injuries; and process measures, including training measures and employee
surveys.
There is more disagreement around whether boards should also create OHS
incentive structures for CEOs and senior management. In favor of incentive
schemas, it has been argued that organizations get what they measure, including
OHS performance (Boardman and Lyon 2006). On the other hand, it has also been
argued to be morally questionable to incentivize something that should be a part of
human decency and reside in organizational DNA (Lornudd et al. 2021). The
efficiency of incentive for OHS has also been questioned (Mackenzie 2007). By
tying a bonus to certain OHS aspects, CEOs have little motivation to act upon new
OHS issues that emerge during the year. Nevertheless, whether in favor of incentives
or not, boards may want to ensure that the general incentive structure does not
contradict and hence disincentive OHS performance, and they can do this by
focusing on the potential trade-off between OHS and other indicators, such as
financial performance (Klettner et al. 2014).

Overseeing Operations

Fourth, boards may influence employee health through their regulatory role, which
is what they use to oversee how companies are run. In the case of OHS, this may
entail ensuring that they have insights into how risks are managed (Ferguson 2015;
Boardman and Lyon 2006). To assert internal control, boards need information
about how organizations are doing. Boards are generally aware that there is an
information asymmetry they need to address (a board has less information about
the business than operative management). Most of boards’ information comes from
direct communication with CEOs and reports from executives. For example, 70%
of UK boards of companies with >250 employees received audit and performance
reports related to health and safety (Wright et al. 2006). Many boards consciously
attempt to add to such reports by engaging directly with other stakeholders, such as
employees, when they have the opportunity. This may include participating in
safety walks and inspecting sites (Ferguson 2015). Boards that have employee
representatives as members may find that such engagements offer valuable per-
spectives on how companies are doing in relation to employee health and well-
being. A CEO in the trade industry that was interviewed from one of our studies
described it like this:
12 Corporate Boards and Employee Well-Being 239

I think the model with employee representatives generates significant value. If the CEO, and
also the chairperson, develop a good relationship with them, you get incredibly valuable
input.

Boards may also request specific reports in the form of audits, reviews, or diligence
reports (Ferguson 2015). Such reports may include trends in OHS indicators,
statistical data, a detailed description of OHS in one business unit (another unit is
the focus of the following month), details on major risks, analyses based on themes
(such as safety culture, vehicle risks, or plant maintenance), and the indicators of
comparable industries.
Having a system for internal control of OHS means that executives can be held
accountable for employee health and well-being (Boardman and Lyon 2006). This
helps establishing a culture that puts health and safety first.

What Influences Boards’ Engagement in OHS?

Boards’ differ in their degree of engagement in employee health and well-being,

both between different boards, and within the same board, over time. Both internal
and external factors influence engagement: board members’ OHS competence,
motives for engaging in OHS, and the contextual constraints or opportunities that
impact the priority OHS is given (Lornudd et al. 2020).

Board Members’ OHS Competence

Boards’ level of OHS competence is vital to their engagement. There is also some
evidence that when boards’ OHS knowledge and engagement increase, organiza-
tions’ OHS performance does too (Bunn et al. 2001).
There seem to be general agreement that boards need at least a basic understand-
ing of OHS and that they also need to specifically understand their legal and formal
responsibilities. Nevertheless, when it comes to the recruitment of board members,
OHS seems to be an underprioritized competence. For example, a Canadian study
found that members of an OHS subcommittee lacked any formal OHS education or
qualifications, and the authors concluded that this situation would never be accepted
in, for example, a financial subcommittee (Murphy 2016).

Five Drivers of Engagement

One consequence of OHS competence on boards is that OHS will more likely be
considered as a part of a solution to business challenges. This was suggested in an
interview study that focused on boards’ motives for engaging in OHS (Lornudd et al.
2020). Five reasons that drive board engagement were identified: legal compliance,
untoward events, external demands, business beliefs, and moral standpoints.
240 U. von Thiele Schwarz and C. Lornudd

First, most boards are motivated to ensure that their legal obligations are fulfilled
(although this is sometimes a belief rather than a reality). Second, many boards take
action if there is an untoward event, as such events pose immediate threats not only
to daily operations but also long-term value development. This is particularly true in
high-risk industries in which an accident can cause irreparable damage to a
company’s reputation or production (Smallman and John 2001). Third, boards
may realize that they need to engage in employee wellness because there are external
pressures to do so: stakeholders, such as consumers or the local community, may
expect them to, or competitors may drive changes in market expectations and
demands. For example, companies on the Scandinavian market are expected to
work collaboratively with stakeholders and are under significant pressure from the
public to act with consideration for sustainability, transparency, and workplace
equity (Strand et al. 2015).
In addition to these drivers and the reactive approaches they spark (complying
with legislation, dealing with untoward events, meeting external demands), there are
two drivers that elicit more proactive and strategic approaches. The first is business
related. Some boards, particularly those with OHS competence, believe that pro-
moting employee health and well-being is good for business in terms of high
employee performance, talent attraction, lower sickness absence, and less sickness
presenteeism. The second is a moral standpoint that may include both a perceived
moral obligation toward the broader community of which the company is a part and
toward individual employees.
Thus, boards see many different reasons to engage in OHS. It has been suggested
that these reasons can be understood as organized on a continuum from the most
rudimentary to the most sophisticated (Smallman and John 2001; Lornudd et al.
2020). Drivers are added, rather than replaced, along the continuum. Rudimentary
drivers are those related to legislation, untoward events, and external requirements,
which a majority of boards acknowledge. Sophisticated drivers require a deeper
understanding of the relationship between employee well-being and company value
maximization or a more reflective and philosophical outlook on the role employers
play related to people and society at large.

Opportunities and Constraints Impacting Boards’ Engagement

Having OHS competence and a set of drivers that motivates engagement may be
necessary but not sufficient for action. The degree to which boards engage in OHS is
also influenced by factors that may amplify or dampen that engagement.

An Enabling Organizational Structure

Both board structure and organization of OHS may influence how boards engage in
matters related to employee health and well-being. For example, the formation of the
board can have an impact. Having employee representation on the board can be a
way of mitigating the information asymmetry boards often face by giving them
access to information about what happens “on the floor.” Electing a human resource
12 Corporate Boards and Employee Well-Being 241

director as an executive director is another way of introducing an employee per-

spective to the discussions and decision-making in the boardroom. Another structure
that influences boards’ engagement is if it is part of a multinational corporate group.
National boards in these companies can have limited decision authority, and in such
instances, the corporate group board and the executive management team above the
national boards is the body that sets the tone from the top (Lornudd et al. 2021).
The way OHS is organized within a company can also influence how OHS is
enacted. It can be organized so it is handled by the whole board, in subcommittees
specific to OHS, or in other subcommittees, such as renumeration or audit committee
(e.g., concerning whistleblowing or code of conduct-oversight). There are pros and
cons to each. On the one hand, OHS subcommittee can be disassociated from
business issues. On the other, keeping it on the main board may ensure OHS does
not play second fiddle or lead to exactly that when it has to compete with, and may
lose to, all other potential foci (Boardman and Lyon 2006). Specific OHS commit-
tees are more common in companies with high-risk operations (e.g., the mining and
oil industries) and are a way of ensuring that those managing and governing OHS
have specific competence to manage it and that it does not get lost among more
pressing issues. At the same, subcommittees may reinforce the view of OHS as
disassociated from the core business.

OHS-Interested Owners and Stakeholders

In the same way that first-line managers’ engagement in OHS is influenced by senior
managers and senior managers by boards, boards influence owners, i.e., share-
holders. In for-profit companies, the focus is on generating profit for shareholders.
This is stipulated in the corporate legislation of most countries and reflected in the
neoclassical theory of shareholder primacy, which postulates that the role of a
corporation is to maximize shareholders’ value (Berle Jr 1930). Because of this
tenet, it has been argued that any investment that withholds profit from shareholders
is not only beyond the corporation’s responsibility but may even be considered
illegal (Skog 2015). This implies that boards are likely to be sensitive to signals from
owners about whether they consider engagement in employee health and well-being
a priority. For example, being a model company with an explicit concern for
employees and having expectations of short-term profitability are signals share-
holders may send.
Owners can influence boards both directly through an owner directive and
indirectly as investors with certain requirements tied to their investments. For
example, in 2020, the CEO of a world-leading asset management company for the
first time publicly recommended investors invest in companies who pursue sustain-
ability, including employee safety, since such companies are believed to maintain
long-term profitability and growth.
Yet, other stakeholders also affect boards’ engagement in employee health and
well-being (Bower and Paine 2017). This is in line with stakeholder theory, which
emphasizes that boards represent all stakeholders whose participation is central to
the survival of the corporation, such as employees, customers, suppliers, the public,
regulators, and communities (Clarke 1998; Friedman and Miles 2002). This suggests
242 U. von Thiele Schwarz and C. Lornudd

that a corporation’s long-term survival and value creation are dependent on its
board’s ability to understand, integrate, or make trade-offs between shareholders
and other stakeholders’ interests. (Klettner et al. 2014). The theory has influenced the
sustainability movement, including corporate social responsibility, by pointing to
broader responsibilities related to the planet and people as well as profit (Kolk and
Van Tulder 2010).
From these perspectives, boards may be inclined to go further to ensure employee
health and well-being than what is required by legislation or called for by a narrow
profit perspective (Klettner et al. 2014). There is indeed some empirical support for
boards considering the perspectives of other stakeholders rather than only share-
holders (Parmar et al. 2010). Yet, though companies have faced increased pressure to
embrace a broader social responsibility in the last decade through new legislation
and increased pressure from media, consumer groups, and employees (Gulyás 2009),
the focus have been more on the well-being of the planet and people in the society
the company operates in (e.g., the environment, the work environment along the
production chain, etc.) than on the health and well-being of its own employees.

When Other Things Are More Urgent

Finally, boards have a lot on their tables. OHS will never be the only or even most
predominant issue that they need to attend to. Therefore, there will always be
competition for boards’ attention, and thus, the time and effort they spend on
employee well-being issues will always be determined in relation to other issues.
The board has to prioritize between competing needs. A pandemic that forces people
into lockdown will detract focus from the board of a retail company that no longer
has any customers, but the same pandemic may push employee health and safety to
the very top of the agenda for a health-care organization that needs to ensure its
employees can work safely. OHS is always at risk of being underprioritized when it
is not seen as a solution to current problems.

A Practical Guide to Increase Board Engagement in Employee

Health and Well-Being

Of all the things boards can do to improve employee well-being, which one should
they start with? A good starting point is identifying activities that are both expected
to have a large impact on OHS performance and be easy to implement. This has been
called a go-zone (Trochim and Kane 2005). In the following section, we present five
ways boards can move toward a greater focus on employee health and well-being
(This list was developed as part of a research project on the role of boards for a
sustainable working life. In the project, a group of experienced board members
worked together to identify where boards that want to focus more on employee
health and well-being can start. https://www.afaforsakring.se/forskning/pro
jektkatalog/Projekt/38701/).
12 Corporate Boards and Employee Well-Being 243

1. Develop the board’s competence: As outlined above, competence in OHS will

affect the degree of board engagement. Ensuring that a board is competent will
increase its ability to make an informed prioritization of OHS in relation to other
organizational challenges, and it will also likely ensure that boards perceive
employee health and well-being solutions to other challenges. A board’s OHS
competence also affects what it demands of the CEO and other executive
directors, which is in line with the champagne analogy outlined above.
2. Use key performance indicators to promote health and well-being: Continuous
follow-up of key performance indicators is one of a board’s most important tools
for obtaining information on a company’s performance. However, key figures
also influence management’s choice of focus. They are therefore also powerful
tools that a board can use to influence OSH work. Reactive key indicators should
be combined with more proactive and activity-based indicators.
3. Set the agenda to ensure attention from the CEO, management, and organization:
Directing the attention of the CEO and management to health and well-being is
about integrating the issue into the board’s usual way of working. It sets the tone
from the top, from executive directors to the rest of the organization. This is not
done via a fancy yearly event or an item on the agenda once a year – it is done via
assiduous repetition throughout the year.
4. Act actively for an open conversation climate in the boardroom: A board is
dependent on getting relevant information about the business operations in
order to prioritize and make informed strategic decisions. This requires trust
between the board and those who have good insights into the operative business,
such as the CEO and other executive directors. An open-discussion climate can be
developed by pointing out that problems are shared and by members striving to be
solution oriented rather than blame oriented.
5. Let employee health and well-being drive long-term profitability: A company
should generate profits for its owners. Since good working conditions are asso-
ciated with higher employee performance and increase the opportunities for
recruiting the best employees, the issue of employee health and well-being is
strategically important for long-term growth and profitability. In line with this,
companies may see a competitive advantage in creating a brand that is associated
with sustainable employee practices.

Conclusions

Promoting employee health and well-being is not only an operative question for first-
line managers and human resource specialists. How companies manage OHS has
widespread implications for their company’s ability to perform, meet its objectives,
and have the long-term impact it intends to have. This makes employee health and
well-being and working conditions matter for the organ that has the final responsi-
bility for the performance of the company: the board of directors. Boards set the tone
from the top by how they act, both within and outside the boardroom. In this, they
244 U. von Thiele Schwarz and C. Lornudd

determine if employees, first-line managers, specialists in OHS and human

resources, and others that work to facilitate employee health and well-being thrive
or fight uphill battles.

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Organizational Change and Employee
Health and Well-Being 13
A Review and Recommendations for Future Research

Alannah E. Rafferty

Contents
Empirical Research on the Relationship Between Objective Measures of Organizational
Change Events and Employee Health and Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Conclusions: Research Using Objective Indicators of Organizational Change . . . . . . . . . . . . . . . . 253
Empirical Research on the Relationship Between Subjective Measures of Organizational
Change and Employee Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Subjective Measures of Other Aspects of Organizational Change Events . . . . . . . . . . . . . . . . . . . . . 257
Conclusions: Research Using Subjective Measures of Organizational Change . . . . . . . . . . . . . . . 259
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
Recommendations for Future Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264

Abstract
In this chapter, I review research that examines the relationship between exposure
to an organizational change event and employee health and well-being. Consid-
eration of the work in the area reveals two types of studies have been conducted.
One group of researchers have focused on objective measures of exposure to
change, while a second group of researchers have assessed change recipients’
subjective experience of change exposure. I consider whether consistent findings
have emerged in these bodies of work. I also examine the extent to which research
in these areas has identified similar or different mediating and moderating factors.
My review suggests that organizational change events – regardless of whether
they are assessed with objective or subjective measures – have a negative impact
on a wide range of measures of employee health and well-being. However, recent
research reveals that some aspects of change (e.g., the planning of change) also

A. E. Rafferty (*)
Griffith Business School, Griffith University, Brisbane, QLD, Australia
e-mail: a.rafferty@griffith.edu.au

© Springer Nature Switzerland AG 2022 247

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_11
248 A. E. Rafferty

may be positively associated with employee health and well-being. This review
identifies directions for future research including the need to consider additional
aspects of the context of change and the processes used when introducing change
as antecedents of employee health and well-being. There is also a need to consider
a more consistent and wider range of mediating and moderating processes that
link organizational change events with employee health and well-being.

Keywords
Organizational change and employee health and well-being · Exposure to
organizational change · Objective measures of exposure to organizational
change · Subjective measures of exposure to organizational change

Technological advances, a global workforce, and deregulation of markets have

resulted in rapidly shifting and complex environments (De Meuse et al. 2010;
Worley and Mohrman 2014), which require organizations to continuously change
in order to survive (Ford et al. 2020; Gordon et al. 2000). Research indicates that
companies made moderate to major changes at least every 4–5 years (Ford et al.
2020; Lewis 2000), and that up to 70% of change efforts fail to achieve their
intended goals (Aiken and Keller 2009; Jacquemont et al. 2014; Meaney and Pung
2008). Traditionally, researchers focused on performance outcomes when studying
change. However, there also is a considerable body of recent research addressing the
consequences of change for employee health and well-being. There is a clear moral
imperative to address employee health and well-being before, during, and after
change is implemented. However, there are also pragmatic reasons to focus on
employee health and well-being before, during, and after change implementation.
Specifically, some theorists have argued that poor employee health may reduce the
likelihood of change success and act as an impediment to future change efforts
(Loretto et al. 2010).
Danna and Griffin (1999) suggested that “health” generally encompasses both
physiological and psychological symptomology. In contrast, well-being tends to be a
broader and more encompassing concept that takes into consideration the “whole
person.” In organizational research, well-being has generally been used when
referring to generalized job-related experiences (e.g., job satisfaction, job commit-
ment, and turnover intentions), and facet-specific dimensions (e.g., satisfaction with
pay or coworkers) (Danna and Griffin 1999). In this chapter, I focus on empirical
studies that consider the influence of exposure to organizational change on
employees’ health and well-being.
Existing reviews have concluded that organizational change events have a some-
what mixed impact on employees’ health and well-being (Bamberger et al. 2012;
de Jong et al. 2016; Quinlan and Bohle 2009). Bamberger et al. considered the
impact of exposure to transformational change, as determined by the authors’
assessment that employees had been exposed to large-scale change, on mental
health. Based on 17 studies, Bamberger et al. concluded that their review did not
13 Organizational Change and Employee Health and Well-Being 249

provide strong evidence of an association between organizational change and ele-

vated risk of mental health problems. In contrast, Quinlan and Bohle examined
exposure to downsizing and the accompanying job insecurity on occupational health
and safety outcomes. Their analyses suggested that 85% of the studies examined
revealed poorer occupational health and safety outcomes occurred after downsizing.
Similarly, in a review of the impact of restructuring between 2000 and 2012, de Jong
et al. reported that restructuring (with and without job losses) had a negative
influence on employee well-being. One potential explanation for the mixed results
from these reviews is that the way in which exposure to organizational change is
assessed is a potential influence on study outcomes. However, researchers have not
yet considered whether the measurement of exposure to change influences study
outcomes. I undertake this task in this chapter.
I identify two distinct approaches that have been adopted when considering the
impact of exposure to organizational change event(s) on employee health and well-
being. One group of studies has adopted “objective” measures of change. Exam-
ples of objective measures of change exposure include classifying individuals into
groups experiencing “minor” versus “major” downsizing based on government
registry data (Østhus 2012; Theorell et al. 2003). Other authors have identified
change exposure groups based on departmental membership (Axtell et al. 2002;
Ferrie et al. 1998, 2002; Hansson et al. 2008; Probst 2003). In contrast, other
researchers have linked the number of change activities experienced with
employee health and well-being (Greenglass and Burke 2000; Ingelsrud 2014;
Jensen et al. 2018; Loretto et al. 2010; Tsutsumi et al. 2002). In contrast, a second
group of authors have used “subjective” measures of change exposure. I define a
subjective measure of change exposure as one that requires a manager’s or
employee’s personal judgment of their own experience of change or the experience
of their team members. Examples of subjective measures of change that have been
used include change recipients’ assessments that they have been exposed to a
change event(s) (Bernstrøm and Kjekshus 2015; Fløvik et al. 2019; Verhaeghe
et al. 2006), the degree of change they have experienced (Dahl 2011; Loretto et al.
2010; Rafferty and Griffin 2006; Rafferty and Jimmieson 2017), the planning
involved in change (Nery et al. 2019; Rafferty and Griffin 2006), and the extent
of “direct” versus “indirect” contact with change (Grunberg et al. 2001; Moore
et al. 2004, 2006).
To date, researchers have not considered whether studies using objective mea-
sures of change exposure versus those using subjective measures of change
exposure result in similar findings regarding the influence of change on employee
health and well-being. In addition, it also is not clear whether researchers adopting
an objective versus subjective approach to the study of organizational change and
employee health and well-being have examined similar mediating and moderating
processes through which change exposure influences health and well-being.
I address these issues in this chapter with the aim of identifying directions for
future research. Below, I first consider empirical research addressing relationships
between objective measures of exposure to change events and employee health and
well-being.
250 A. E. Rafferty

Empirical Research on the Relationship Between Objective

Measures of Organizational Change Events and Employee Health
and Well-Being

Researchers have considered exposure to a range of different types of organizational

change events using objective measures. Researchers have focused on a range of
different types of objectively assessed changes including downsizing (Kivimäki
et al. 1997, 1998, 2000; Theorell et al. 2003; Vahtera et al. 1997) and upsizing
(Theorell et al. 2003), restructuring (Bourbonnais et al. 2005), privatization (Ferrie
et al. 1995), reorganization (Hansson et al. 2008), and mergers (Kjekshus et al. 2014;
Netterstrøm et al. 2010) on employee health and well-being. Recently, several
authors have collected objective measures of exposure to different types of changes
that have been implemented under the umbrella of a single large-scale change
(Grønstad et al. 2019; Netterstrøm et al. 2010). I consider research on these different
types of objectively assessed change in more detail below.
Downsizing. Several studies reveal that objectively assessed downsizing has a
negative impact on employee health and well-being (Kivimäki et al. 1997, 1998,
2000; Vahtera et al. 1997, 2004). In particular, objectively assessed downsizing has
been positively associated with certified sick leave (Kivimäki et al. 1997, 1998,
2000; Vahtera et al. 1997, 2004), cardiovascular deaths (Vahtera et al. 2004), the rate
of disability pensions (Vahtera et al. 2005), musculoskeletal pain and disorders
(Kivimäki et al. 2001, 2003;Vahtera et al. 1997, 2005), psychotropic drug prescrip-
tions (Kivimäki et al. 2007), trauma (Vahtera et al. 1997), and poor self-rated health
(Kivmäki et al. 2001, 2003).
In contrast, several studies that use objective measures of downsizing have
reported minimal or no effects of this type of change on employee health and
well-being (Netterstrøm et al. 2010; Østhus 2012; Østhus and Mastekaasa 2010;
Theorell et al. 2003). Several issues may at least partially explain why objectively
assessed downsizing in these studies was not significantly associated with poor
health and reduced well-being. First, Østhus (2007) and Theorell et al. (2003)
conducted cross-sectional studies, which contrast with the longitudinal designs of
many of the studies that reported that downsizing has negative effects on
employee health and well-being. It may be that the health and well-being impacts
of change only emerge after an extended time period. Second, most studies
supporting a link between the extent of downsizing and employee health and
well-being have been conducted in Finland. In contrast, the studies that are not
supportive of a link between objectively assessed exposure to downsizing and
employee health and well-being were conducted in Norway and Sweden. It may
be that there are differences between countries in the influence of downsizing on
employee health and well-being. Third, two of the studies that did not reveal a
negative impact of exposure to downsizing on employee health and well-being
(Østhus 2012; Østhus and Mastekaasa 2010) combined an objective and a
subjective rating of change exposure. It is not clear that it is appropriate to
combine such measures as they appear to capture different types of information
about change.
13 Organizational Change and Employee Health and Well-Being 251

Researchers have identified several factors that mediate relationships between

objectively assessed downsizing and employee health and well-being. Kivimäki
et al. (2000) found that the relationship between downsizing and employee health
was partially mediated by increased physical demands and job insecurity and a
reduction in job control that accompanied the downsizing process. Kivmäki et al.
(2001) reported that increases in physical demands (especially for women and lower-
income earners), increased job insecurity, reductions in skill discretion, and changes
in health-related behaviors mediated relationships between exposure to downsizing
and musculoskeletal issues. In contrast, Kivmäki et al. (2001) found that decreased
job control was the single most important mediator of the relationship between
downsizing and self-rated health. However, the largest proportion of the association
between downsizing and health was explained by all the changes in work combined
(i.e., decreased job control, high job insecurity, and increased physical demands).
Some attention has considered moderators of relationships between objectively
assessed downsizing and employee health and well-being. Most attention has concen-
trated on the role of gender. Kivimäki et al. (1997) reported that the relationship
between downsizing and absence was moderated by gender such that women were
more vulnerable to the effects of downsizing. In contrast, Kivimäki et al. (2003)
reported that downsizing increased the risk of mental distress but only for male
employees who stayed in the organization. Kivmäki et al. (2007) reported that the
relationship between downsizing and psychotropic drug prescriptions differed for men
and women. The relationship between downsizing and hypnotics was strongest for men
while the association between downsizing and anxiolytics was strongest for women.
Other researchers have considered the role of employee personality (Kivimaki
et al. 1998) and age (Vahtera et al. 1997) as moderators of relationships between
objectively assessed exposure to downsizing and employee health and well-being.
Kivimaki et al. found that in men, hostility increased the risk of sickness absence
after change exposure for cases of absence due to trauma. In women, hostility
increased the risk of absence through overall sickness and due to musculoskeletal
disorders. Vahtera et al. reported that when the proportion of employees who were
older than 50 years was high, downsizing increased the individual risk of absence
because of ill-health by 3–14 times, depending on whether the absence was for
musculoskeletal disease or trauma. In contrast, when the proportion of employees
over 50 years was low, downsizing only had slight effects of health.
Restructuring. Several researchers have considered the influence of
restructuring (which also has been labeled reorganization in some studies) on
employee health and well-being. Bourbonnais et al. (2005) reported that
restructuring negatively influenced sick leave (mean and duration) over the course
of restructuring. In contrast, Hansson et al. (2008) found no significant differences
between an exposure versus a control group in terms of self-reported health, work
satisfaction, or work-related exhaustion. However, Hansson et al. did find hormonal
differences between the groups at Time 2, which the authors argued indicates that
there was a lower possibility of recovery for those involved in the restructuring
compared to those in the control group. Overall, both studies revealed a negative
influence of objectively assessed restructuring on employee health and well-being.
252 A. E. Rafferty

While Bourbonnais et al. (2005) do not test mediated relationships, they suggest
that psychosocial characteristics including low-decision latitude, high job strain, and
low support may act as mediators of the relationships between restructuring and poor
employee health and well-being. In contrast, Bourbonnais et al. did examine the
moderating role of rewards. Results suggested that rewards moderated relationships
between restructuring and job strain and sick leave for all diagnoses. Nurses who
reported high rewards were no longer at risk of sick leave after restructuring.
Privatization. I was only able to identify one study that used an objective
measure of privatization and considered the health and well-being effects of this
change. Ferrie et al. (1995) conducted a 4-year longitudinal study with civil servants
in the UK in a department expected to experience privatization. Employees were
classified (exposed to change versus a control group) based on departmental mem-
bership. Findings highlighted that there were consistent negative effects of privati-
zation on men’s health and well-being in the exposure group compared to men in the
control group. In contrast, there were fewer consistent differences between women in
the exposure and control groups. These results suggest that gender is a moderator of
relationships between objectively assessed privatization and employee health and
well-being.
Mergers. Several authors have utilized objective measures of mergers and
considered the influence of these changes on employee health and well-being. This
research has revealed mixed findings. Kjekshus et al. (2014) conducted a study of
23 mergers that occurred over a 9-year period in Norway. The occurrence of a merger
was determined based on data obtained from a national registry. The authors
concluded that there was a significant but modest effect of mergers on long-term
sickness absence in the year of the merger, and in years 2, 3, and 4 after the merger.
This effect was significant for women but was only significant in year 4 after the
merger for men, suggesting that gender is a moderator of relationships. In contrast,
Netterstrøm et al. (2010) conducted a study of Danish public servants 8 months
before a merger and 16 months after a merger. The type of organizational change
experienced by employees (i.e., membership of merger, new job, or no change) was
determined based on departmental membership. Netterstrøm et al. reported that there
was not a significantly increased risk of depression or increase in depressive
symptomology among employees exposed to a merger.
Other Aspects of Organizational Change Events. Several researchers have
considered exposure to different types of change events within a larger change using
objective measures (Grønstad et al. 2019; Netterstrøm et al. 2010; Westerlund et al.
2004). For example, Grønstad et al. conducted a study in a large Norwegian hospital.
Employees’ exposure to six types of changes including mergers, downsizing, spin-
off, upsizing, outsourcing, or stability was identified based on hospital records.
Different types of change were differentially related to employee health and well-
being. For example, unit-level upsizing resulted in a significantly reduced risk of
both short- and long-term sickness absence in the change quarter and in the subse-
quent quarter. In addition, unit-level downsizing was significantly associated with a
reduced likelihood of short-term sickness absence in the quarter prior to change,
compared to stability. However, unit-level downsizing correlated significantly with
13 Organizational Change and Employee Health and Well-Being 253

increased risk of short-term sickness absence in the change quarter and in the
following quarter, compared to stability.
Westerlund et al. (2004) conducted a study in Sweden over a 6-year period with
the extent of downsizing or upsizing determined based on data obtained from a
national registry. Data were used to classify organizations as experiencing moderate
expansion, major expansion, moderate downsizing, and major downsizing. Results
revealed that a large expansion of the workplace (greater than 18%) was related to
increased sickness absence and hospital admissions. Moderate downsizing (between
8% and 18%) was associated with a decreased risk of hospital admission. Results
also revealed that gender and industry (private vs. public sector) affected relation-
ships. For example, the strongest associated between repeated exposure to change in
workplace size and long-term sickness absence was for women in the public sector.
Researchers have considered how employee health and well-being vary at differ-
ent points in the change process (Bourbonnais et al. 2005; Grønstad et al. 2019).
Bourbonnais et al. conducted a 6-year longitudinal study of health facilities in
Canada. Five distinct stages of stage were identified based on the occurrence of
objectively assessed organizational change events. Findings revealed variations in
sick leave at different points in the restructuring process. For example, mean certified
sick leave was lower before restructuring and higher during the anticipation period
and the first year after restructuring. During the second year after restructuring, mean
certified sick leave dropped 7.5 days from the preceding period but was still 24 days
above the baseline level, before the restructuring. For mental health sick leave, there
was a significant increase in the sick leave incidence rate over the five stages. For the
last two periods after restructuring, the incidence rate was higher than during the
period before restructuring.

Conclusions: Research Using Objective Indicators

of Organizational Change

The largest number of studies adopting objective measures of change exposure

focused on the impact of downsizing on employee health and well-being. This
research reveals that objectively assessed downsizing is negatively associated with
a wide range of health and well-being outcomes. Several factors that mediate
relationships between downsizing and employee health and well-being have been
identified including psychosocial factors (Kivimäki et al. 2000, Kivimäki, Vahtera,
Ferrie, et al. 2001, Kivmäki, Vahtera, Pentti, et al. 2001), impaired support from
one’s spouse (Kivimäki et al. 2000), and changes in health behaviors (Kivimäki et al.
2000). In addition, several moderating factors have been identified with most
research focused on gender (Kivimaki et al. 1998, 2001, 2003, 2007; Theorell
et al. 2003), although the age distribution of staff (Vahtera et al. 1997) also has
been examined.
Research using objective measures of change also has examined the impact of
restructuring on health and well-being (Bourbonnais et al. 2005; Hansson et al.
2008). There was not a clear set of consistent negative effects of restructuring on all
254 A. E. Rafferty

the measures of health and well-being considered. Only one study (Ferrie et al. 1995)
using an objective measure has examined the influence of privatization. This study
revealed negative effects of privatization on employee health and well-being,
although these effects were primarily found in women. Two studies (Kjekshus
et al. 2014; Netterstrøm et al. 2010) objectively assessed mergers, and these studies
reveal somewhat mixed findings. Kjekshus et al. found that exposure to a merger
consistently increased long-term sickness absence for women over time. In contrast,
Netterstrøm et al. found that mergers did not significantly influence employee
depression. Researchers also have used objective measures to assess other aspects
of change. This research revealed that the effects of change depend on the type of
change experienced (Grønstad et al. 2019; Netterstrøm et al. 2010; Westerlund et al.
2004), and the health and well-being impacts of change vary depending on the stage
of change (Bourbonnais et al. 2005; Grønstad et al. 2019).
In summary, there is evidence that objective exposure to organizational change
events negatively influences employee health and well-being. However, apart from
research using objective measures of downsizing, attention has not generally iden-
tified the mediators or moderators of relationships between objectively assessed
change events and employee health and well-being.

Empirical Research on the Relationship Between Subjective

Measures of Organizational Change and Employee Well-Being

A considerable number of studies have examined relationships between employees

and managers’ perceptions of the content of organizational change events and
employee health and well-being. Authors have focused on exposure to different
types of change as reported by change recipients (Axtell et al. 2002; Bernstrøm and
Kjekshus 2015; Ferrie et al. 1998; Kalimo et al. 2003; Østhus 2007; Virtanen et al.
2010). Research also has considered the effects of exposure to change at different
time points (Geuskens et al. 2012). A range of other aspects of the content of change
events have been considered including individuals’ perceptions concerning the
degree of change (Dahl 2011; Loretto et al. 2010; Rafferty and Griffin 2006; Rafferty
and Jimmieson 2017), the planning involved in change (Nery et al. 2019; Rafferty
and Griffin 2006), the occurrence of “negative” change (Väänänen et al. 2011),
“direct” versus “indirect” contact with layoffs (Grunberg et al. 2001; Moore et al.
2004, 2006), the number of changes experienced (Tsutsumi et al. 2002), the breadth
of change (Dahl 2011), and the experience of a decline in job position as a result of
change (Väänänen et al. 2004).
In contrast, some research has bypassed a consideration of the content of change
and has instead focused on psychosocial indicators such as the experience of job
insecurity (Ferrie et al. 2002) that are likely to be impacted by change. Other
researchers have asked change recipients to report on characteristics of the context
in which change is implemented (Rafferty and Jimmieson 2017). Finally, some
researchers have considered the influence of the change processes used when
13 Organizational Change and Employee Health and Well-Being 255

implementing change on employee health and well-being (Rafferty and Jimmieson

2017; Rafferty and Restubog 2010), rather than considering the influence of the
change event itself, on employee health and well-being. Change processes refer to
the specific methods used to implement organizational change (Self et al. 2007).
Downsizing. A number of studies have considered change recipients’ subjective
assessments of the content of downsizing events and their impact on employee
health and well-being (Burke and Greenglass 1999; Fløvik et al. 2019; Greubel
and Kecklund 2011; Grunberg et al. 2001; Kalimo et al. 2003; Moore et al. 2004,
2006; Østhus 2007; Sigursteinsdóttir and Rafnsdóttir 2015). Authors have consid-
ered individuals’ subjective exposure to a single type of change (Kalimo et al. 2003;
Sigursteinsdóttir and Rafnsdóttir 2015), exposure to different types of changes
during downsizing (Fløvik et al. 2019; Greubel and Kecklund 2011; Moore et al.
2004; Østhus 2007), and the extent of direct or indirect contact with downsizing
(Grunberg et al. 2001; Moore et al. 2006).
Overall, this research suggests that subjectively assessed exposure to downsizing
is negatively associated with job satisfaction (Burke and Greenglass 1999; Greubel
and Kecklund 2011; Østhus 2007), psychological well-being (Burke and Greenglass
1999), subjective health (Greubel and Kecklund 2011), sleep (Greubel and Kecklund
2011), and recovery (Greubel and Kecklund 2011). In contrast, studies have found
that subjectively assessed downsizing is positively associated with role ambiguity
(Moore et al. 2004), work demands (Greubel and Kecklund 2011), intent to quit
(Moore et al. 2004, 2006), work stress (Greubel and Kecklund 2011), sleepiness
(Greubel and Kecklund 2011), work-related health problems (Østhus 2007), symp-
toms of poor health (Grunberg et al. 2001), being sick at work (Sigursteinsdóttir and
Rafnsdóttir 2015), visiting a doctor because of illness or ill health (Sigursteinsdóttir
and Rafnsdóttir 2015), eating changes (Grunberg et al. 2001), alcohol consumption
(Grunberg et al. 2001), mental distress (Fløvik et al. 2019), and depression
(Grunberg et al. 2001; Moore et al. 2006). In addition, studies reveal subjectively
assessed downsizing has negative relationships with psychosocial work characteris-
tics including job security (Grunberg et al. 2001; Moore et al. 2004, 2006; Østhus
2007), work demands (Østhus 2007), social support (Greubel and Kecklund 2011),
and decision latitude (Greubel and Kecklund 2011).
Surprisingly little attention has considered variables that mediate relationships
between subjectively assessed downsizing and employee health and well-being.
Grunberg et al. (2001) reported that job security partially mediated the effects of
downsizing contact on health-related outcomes. Similarly, little attention has
been directed to identification of moderators. While there is some suggestion in
Greubel and Kecklund’s (2011) study that the stage of change may moderate
relationships between the extent of downsizing and employee health and well-
being, this hypothesis was not tested. Burke and Greenglass (2000) considered
whether employment status moderated the relationship between subjectively
assessed downsizing and employee health and well-being. Results indicated
that full-time staff reported significantly more negative effects of restructuring
efforts on maintenance and physical aspects of the workplace than did part-time
workers.
256 A. E. Rafferty

Restructuring. Authors have considered a range of subjective measures of the

content (i.e., what is changed) of restructuring such as employees’ rating of their
exposure to restructuring at different points in the change process (Geuskens et al.
2012), the extent of restructuring experienced (Burke and Greenglass 2000), and
managerial ratings of the extent of restructuring (Ingelsrud 2014; Jensen et al. 2018;
Probst 2003). Overall, research suggests that restructuring has a negative relation-
ship with a range of indicators of employee health and well-being including satis-
faction (Burke and Greenglass 2000; Probst 2003), affective reactions (Probst 2003),
psychological well-being (Burke and Greenglass 2000), general health (Geuskens
et al. 2012), emotional exhaustion (Geuskens et al. 2012), absence due to sickness
(Ingelsrud 2014; Jensen et al. 2018), organizational commitment (Probst 2003), time
pressure (Probst 2003), and job security (Probst 2003). In addition, empirical
research also suggests that restructuring is positively associated with turnover
intentions (Probst 2003) and voluntary turnover (Jensen et al. 2018). Only one
study by Geuskens et al. identified mediating processes. These authors found that
job insecurity partly explained the negative impact of prolonged restructuring on
general health and emotional exhaustion. None of the studies in this area considered
moderators of relationships.
Privatization. Two studies have adopted subjective measures of exposure to
privatization and its impact on employee health and well-being (Ferrie et al. 1998;
Virtanen et al. 2010). Ferrie et al. assessed exposure to change based on employees’
response to a survey question. In a multiple wave survey study with medical data
collected on employees in a civil service agency in the UK, Ferrie et al. found a range
of significant negative health effects due to change exposure. For example, at Time
3, compared to the control group, men in both exposure groups (i.e., exposure to
change and anticipation of change groups) experienced significant increases for
health self-rated as average or worse, General Health Questionnaire (GHQ) caseness,
and mean number of symptoms experienced in the last fortnight. Adverse changes
were seen in blood pressure and body mass index (BMI) for men in both exposure
groups compared to control men. Adverse changes were seen in all clinical measures
among women in both exposure groups, except for diastolic blood pressure among
women anticipating change. These findings suggest that gender and stage of change
may be potential moderators of relationships between subjectively assessed privat-
ization and health and well-being. Virtanen et al. conducted a multiwave study over
an 8-year period with civil servants in the UK, who reported on whether they had
experienced privatization. Results revealed that the risk of work disability was
higher among employees who reported that they were transferred to an executive
agency compared with the employees whose job was not transferred. No mediators
or moderators of relationships were identified in this study.
Mergers. Two studies have explored relationships between subjective measures
of the content of a merger and employee health and well-being (Väänänen et al.
2004, 2011). These studies provide support for the negative influence of mergers on
exhaustion (Väänänen et al. 2004), functional incapacity (Väänänen et al. 2004),
psychiatric events (Väänänen et al. 2011), and depression (Väänänen et al. 2011).
Väänänen et al. (2004) conducted a study of a merger with data collected twice
13 Organizational Change and Employee Health and Well-Being 257

before the merger began and once after the merger. The authors assessed change
subjectively by asking change recipients to indicate how their standing at work
changed over the last 2 years. A subjective decline in job position was positively
associated with exhaustion and functional incapacity after the merger. Blue-collar
workers, who had a higher rate of sickness absence prior to the merger, and who
experienced a decline in their job position, were at higher risk of suffering from poor
subjective health after the merger compared to white-collar workers. Strong
coworker support increased exhaustion and functional incapacity when an employee
reported a decline in their job position due to change.
In a later study, Väänänen et al. (2011) examined a merger that occurred between
two companies originally from Finland and Sweden. Data were collected twice
before the merger and twice after the merger. Employees’ experience of the merger
was assessed at Time 3 by asking them to answer three survey items assessing
changes in their personal standing at work, the development of the work unit, and
trends in the whole organization during the preceding 1–2-year period. Responses to
these items were used to create a scale assessing individuals’ experience of “negative
change.” As individuals’ perception of negative change increased, so did the risk of
psychiatric events. Nonmanual employees who reported negative organizational
change had a twofold increased risk of subsequent psychiatric events whereas
manual employees were not significantly affected by the organizational changes.
Again, these findings suggest that blue- versus white-collar employment status acted
as a moderator. Results revealed that the subjective experience of negative change
was related to subsequent depression

Subjective Measures of Other Aspects of Organizational Change

Events

Several other studies utilizing subjective measures of change exposure have

occurred including a study focused on the implementation of technology. Axtell
et al. (2002) considered change recipients’ subjective perceptions of the implemen-
tation of new technology. The effects of exposure to new technology varied by
occupational group. For operators, openness to change improved among the high-
exposure group while the low-exposure group experienced a slight decrease in
openness. Managers and engineers displayed the opposite pattern. Overall, these
results suggest that occupational group acted as a moderator of relationships between
subjectively assessed implementation of technology and employee health and well-
being.
Other researchers have recognized that a single large-scale change event such as a
“merger” may involve multiple changes and have considered individuals’ subjective
exposure to a range of changes that occur when experiencing a large-scale transfor-
mation (Breinegaard et al. 2017; Tsutsumi et al. 2002; Verhaeghe et al. 2006).
Breinegaard et al. conducted a cross-sectional study of public servants in Denmark,
with data on organizational change obtained from heads of work. After adjustment
for characteristics of the psychosocial work environment, the rate of early retirement
258 A. E. Rafferty

was significantly higher among employees who experienced a change of manage-

ment. Tsutsumi et al. conducted two surveys separated by a year with employees’
subjective experience of different types of change collected in the second survey.
Findings indicated a potentially stronger effect of restructuring changes for those
employees who experienced multiple organizational changes. Verhaeghe conducted
a cross-sectional study of registered nurses in Belgium. Results revealed that the
occurrence of different types of change was related to psychological distress.
Changes appraised as threatening were negatively related to job satisfaction and
eustress, and positively related to distress and sickness absence (frequency and
duration).
Authors also have considered change recipients’ subjective reactions to a range of
other aspects of the content of change. For example, researchers have considered
change recipients’ assessments of the degree of change (Dahl 2011; Rafferty and
Griffin 2006; Rafferty and Jimmieson 2017), the breadth of change (Dahl 2011)
(Bernstrøm and Kjekshus 2015), the planning involved in change (Nery et al. 2019;
Rafferty and Griffin 2006), and the degree of risk involved in change (Nery et al.
2019). Some research also has considered the influence of an aspect of the context of
change – the circumstances surrounding the implementation of a change – on
employee health and well-being. Specifically, Rafferty and her colleagues (Rafferty
and Griffin 2006; Rafferty and Jimmieson 2017) considered the influence of the
frequency of change on employee health and well-being.
In a study in an Australian public sector organization, Rafferty and Griffin (2006)
found that employees’ perceptions that change involved high levels of planning were
indirectly positively related to job satisfaction and indirectly negatively related to
turnover intentions though psychological uncertainty. Transformational change
(i.e., an assessment of the degree of change) displayed a direct positive relationship
with intentions to turnover. In contrast, the perception that change occurred very
frequently – an aspect of the change context – was indirectly negatively associated
with satisfaction and positively associated with turnover intentions via uncertainty.
Dahl (2011) conducted a study in Denmark and collected data on organizational
change from a survey completed by company CEOs. Results revealed that
employees employed in organizations changing along multiple dimensions simulta-
neously were more likely to receive stress-related medicine prescriptions for insom-
nia, anxiety, and depression. Change implemented to increase coordination and
cooperation across the organization had significant and negative effects on stress.
Rafferty and Jimmieson (2017) collected data from a range of employees from
different organizations experiencing a wide array of change events. Results revealed
that employees’ subjective perceptions that they had experienced transformational
change and frequent change were indirectly positively associated with insomnia and
negatively associated with psychological well-being through affective resistance to
change. Nery et al. (2019) conducted a three-wave study in a public organization in
Brazil undergoing a strategic reorientation. These authors assessed change recipi-
ents’ subjective assessment of the planning involved in change and the degree of risk
involved in change. When employees reported that change involved planning, it was
positively associated with well-being at all three time points.
13 Organizational Change and Employee Health and Well-Being 259

Bernstrøm and Kjekshus (2015) collected data over 2 years from Norwegian
hospitals. Direct care providers reported whether they had experienced eight types of
changes (four patient care changes and four structural changes) in the preceding
12 months. Results revealed that a higher frequency of structural changes within
hospitals was associated with an increased likelihood of sickness absence among
employees. Härenstam et al. (2004) drew on manager descriptions of change to
identify four different types of organizational change. Conversion to a lean organi-
zation was the most negative of the changes in terms of outcomes including extrinsic
rewards, obstacles at work, and strenuous work, and for women worry and conflict.
However, employees in these organizations also reported increased control and
opportunities for development.
Ferrie et al. (2002) focused on the impact of a change event on job insecurity,
rather than assessing employees’ subjective reactions to a change event itself.
However, one limitation of focusing on psychosocial characteristics likely to be
impacted by a change event is that researchers are unable to determine what it is
about the change that influences psychosocial characteristics. So, while Ferrie et al.
found, for example, that loss of job security was associated with poor self-rated
health and minor psychiatric morbidity, they were not able to establish what it was
about the change event itself that resulted in heightened job insecurity.
Another group of studies have focused on the influence on the change processes
used when implementing change (e.g.., information, participation, and fairness)
(Amiot et al. 2006, 2007; Jimmieson et al. 2004; Rafferty and Jimmieson 2017;
Rafferty and Restubog 2010), rather than considering the influence of the change
event itself, on employee health and well-being. In an 18-month study of regional-
ization in the Australian public sector, Jimmieson et al. focused on the influence of
change information on burnout, client engagement, and job satisfaction. Findings
revealed that the provision of change information was indirectly positively related to
employee psychological well-being, client engagement, and job satisfaction, through
employee self-efficacy. Amiot et al. (2006) conducted a two-wave survey study of an
airline engaged in a merger. Results revealed that change recipients who perceived
that the change had been implemented in a positive manner (i.e., they felt consulted,
perceived that leadership had been effective, and felt informed) reported stronger
self-efficacy at the beginning of the merger and appraised the change as being less
stressful compared to change recipients who reported that the change had been
implemented poorly.

Conclusions: Research Using Subjective Measures

of Organizational Change

A good deal of research has utilized change recipients’ subjective assessments of

their exposure to different types of organizational change events including down-
sizing, mergers, and restructures. This research has revealed that these change events
are consistently negatively associated with a wide range of indicators of employee
health and well-being. Other researchers have focused on other aspects of
260 A. E. Rafferty

individuals’ subjective experience of the content of change. This research has

identified some aspects of the content of change that are positively associated with
employee health and well-being such as planning (Nery et al. 2019; Rafferty and
Griffin 2006). In contrast, other research has enabled identification of those aspects
of organizational change that have a negative impact on employee health and well-
being such as subjective perceptions that transformational change has occurred
(Rafferty and Griffin 2006; Rafferty and Jimmieson 2017). In addition, when
employees report that change involves multiple organizational dimensions (Dahl
2011), employees’ health and well-being are negatively affected.
Research focused on subjective measures of change; recipients’ experience of
change also has identified several mediating factors. There is some evidence that job
security (Geuskens et al. 2012; Grunberg et al. 2001), psychological uncertainty
(Rafferty and Griffin 2006), affective resistance to change (Rafferty and Jimmieson
2017), employees’ appraisals of change (Verhaeghe et al. 2006), and changes in
employees’ health-related behaviors (Ferrie et al. 1998; Grunberg et al. 2001)
mediate relationships between the subjective experience of change and employee
health and well-being. Researchers also have identified several moderators of rela-
tionships between subjectively assessed change and employee health and well-
being. There is some evidence to suggest that occupational group (Axtell et al.
2002), having a blue-collar versus white-collar job (Väänänen et al. 2011), and the
type of changes experienced (Breinegaard et al. 2017; Dahl 2011; Tsutsumi et al.
2002) may moderate relationships between subjective measures of change and
employee health and well-being.

Discussion

In this chapter, I examined research that has utilized objective and subjective
measures of exposure to organizational change events and linked this with employee
health and well-being. Several key points have become evident when reviewing this
research. First, until recently, relatively little attention has been directed toward
considering the content of the change event beyond that provided using a broad
description of the change (e.g., downsizing, restructuring, and merger). However,
researchers have begun to consider change recipients’ subjective assessments of a
wider range of aspects of the content of change such as the planning involved in
change (Nery et al. 2019; Rafferty and Griffin 2006), the degree of change (Dahl
2011), and the breadth of change (Dahl 2011).
With few exceptions (Amiot et al. 2007; Jimmieson et al. 2004; Rafferty and
Jimmieson 2017; Rafferty and Restubog 2010), most studies examining the impact
of change on employee health and well-being have not considered that characteris-
tics of the change context or the processes used to implement change may impact on
employee health and well-being. This is an important omission as research in the
change field indicates that all three aspects of change – the content and context of
change, and change processes – are likely to influence change outcomes including
employee health and well-being (Amiot et al. 2006, 2007; Armenakis and Bedeian
13 Organizational Change and Employee Health and Well-Being 261

1999; Jimmieson et al. 2004; Pettigrew et al. 2001; Rafferty and Restubog 2010,
2017). Such findings suggest that all three aspects of change should be considered as
antecedents of employee health and well-being during change. As such, it is
recommended that these three sets of factors are incorporated into models of the
health and well-being of employees experiencing change. Failure to consider the
content, context, and the processes used to implement change means that researchers
are ignoring important sources of variation in employee health and well-being during
change and therefore mis-specifying models.
Second, although empirical research using objective and subjective measures of
change exposure rarely reference the other body of work, the findings from these two
bodies of work reveal broadly consistent conclusions about the negative influence of
change on employee health and well-being. For example, most research on down-
sizing, whether it adopts an objective or subjective approach to change exposure,
suggests that downsizing has negative effects on employee health and well-being.
Studies using objective measures of change exposure have identified several medi-
ators of relationships between experience of change and employee health and well-
being including psychosocial factors such as job insecurity and job control
(Kivimäki, Vahtera, and Ferrie et al. 2001; Kivmäki, Vahtera, and Pentti et al.
2001), impaired support from one’s spouse (Kivimäki et al. 2000), and changes in
employee health behaviors (Kivimäki et al. 2000). In contrast, studies using subjec-
tive measures of exposure to change events have identified job insecurity (Geuskens
et al. 2012) as a mediator.
In terms of moderators of relationships between objective measures of change
and employee health and well-being, factors that have been identified include gender
(Kivimaki et al. 1998, 2001, 2003, 2007; Theorell et al. 2003), the age distribution of
staff (Vahtera et al. 1997), income (Kivimäki et al. 2001; Vahtera et al. 1997),
workplace size (Vahtera et al. 1997), poor health prior to change (Vahtera et al.
1997), socioeconomic status (Vahtera et al. 2005), and employment status (Vahtera
et al. 2004). Studies using subjective measures of change events have focused on
several moderators including the stage of change (Ferrie et al. 1998; Greubel and
Kecklund 2011), gender (Ferrie et al. 1998), blue- versus white-collar position
(Väänänen et al. 2004, 2011), coworker support (Väänänen et al. 2004), and
occupational group (Axtell et al. 2002). Except for gender, there is little overlap in
the factors identified as moderators in the two areas of research.

Recommendations for Future Research

Several recommendations for future research emerge out of my review of the

literature. First, it is surprising that researchers have not simultaneously considered
the influence of objective and subjective measures of change exposure on employee
health and well-being in a single study. Recent theorizing in the change field
suggests that a focus on objective measures of change exposure may result in an
underestimation of the effects of organizational change on employee well-being. In
particular, researchers have argued that the key to understanding organizational
262 A. E. Rafferty

change processes is the way in which individuals acquire, organize, and make sense of
change (George and Jones 2001; Loretto et al. 2010; Rafferty and Griffin 2006; Weber
and Manning 2001). This perspective suggests that the world does not consist of
events that are meaningful in themselves (Bartunek and Moch 1987; Weber and
Manning 2001). Rather, organizational members interact with and affirm the existence
of events, casting them in a particular light through the process of sensemaking
(Dutton 1993). As such, individual sensemaking processes are essential to understand-
ing employees’ experience of and reactions to organizational change. However,
objective measures of change exposure do not capture employee sensemaking during
change. This suggests that it would be useful for future research to consider relation-
ships between objective and subjective measures of organizational change.
Loretto et al. (2010) suggested that they examine both objective and subjective
measures of an organizational change event. However, all the measures of the
change event assessed in this study were based on employees’ ratings of the change,
which would then suggest that these are subjective measures. It is critical that we
begin to compare relationships between objective and subjective measures of change
and different measures of employee health and well-being. By including both
objective and subjective measures of change exposure within a single study,
researchers can then directly answer questions about whether objective measures
underestimate the effects of organizational change on employee health and well-
being. Practically, it is essential that we assess the extent to which different types of
measures of organizational change events are associated with employee health and
well-being so that we are better able to manage the implications of change. If we are
underestimating the impact of change events on health and well-being when using
objective measures, this will require change practitioners and managers to reconsider
how they implement and manage change to reduce the negative impacts of change
on employee health and well-being.
A second recommendation for future research concerns the need for models of the
antecedents of employee health and well-being during or after change to account for
a much broader range of factors that have been identified as influencing change
outcomes. Research in the change field suggests that change processes used when
introducing organizational change (e.g., information, participation, and justice)
influence employee health and well-being (Bordia et al. 2004; Miller et al. 1994;
Schweiger and DeNisi 1991). In addition, other research suggests that aspects of the
change context such as an employee’s perceptions that change occurs very fre-
quently (Rafferty and Jimmieson 2017; Rafferty and Restubog 2010) and that their
organization has a poor change history (Rafferty and Restubog 2010) influence
employee health and well-being. Overall, there are several antecedents of employee
health and well-being during change that have been largely ignored by researchers in
both the objective and subjective exposure to change areas. I argue that there is a
need to consider not only the content of change, which is what current models have
focused on, but also on the context of change and the processes used when
implementing change.
The third recommendation for future research is that there is an enhanced focus
on identifying mediating and moderating factors that influence relationships between
13 Organizational Change and Employee Health and Well-Being 263

exposure to change and employee health and well-being. Some attention has con-
sidered mediators and moderators of relationships between objectively and subjec-
tively assessed organizational change and employee health and well-being.
However, as noted earlier, there is little commonality in terms of the variables
identified by researchers using objective versus subjective measures of change.
Apart from a focus on psychosocial work characteristics such as job insecurity, there
is little overlap in the mediators identified by authors focused on objective versus
subjective measures of change. Except for gender, there is little overlap in the factors
identified as moderators in the two areas of research. It would be useful to consider the
broad range of moderators that could influence the strength and/or direction of
relationships between change exposure and employee health and well-being.
Also, of note, is that there has been a distinct lack of focus on the role of
individuals’ personality characteristics when developing models of the factors that
predict employee health and well-being during and after change. Only one study
(Kivimaki et al. 1998) explored the role of an employee personality characteristic –
hostility – as a moderator of relationships. However, it is likely that a range of
employee personality characteristics and other individual differences are important
in determining their responses to change. For example, research has identified
employee dispositional resistance to change (DRTC) as an important predictor of
employees’ responses to change events (Oreg 2003, 2006). People who are high on
DRTC prefer to stick to a routine, are more likely to experience a negative emotional
reaction to change, focus on short-term outcomes of change events, and are cogni-
tively rigid in that they do not like to change their thinking. DRTC has been found to
be associated with resistance to change attitudes (Oreg 2006). Evidence suggests that
dispositional resistance to change is likely to be associated with poor well-being
(Turgut et al. 2016). It is likely, for example, that DRTC will moderate relationships
between exposure to change (assessed objectively and subjectively) and poor
employee well-being such that people who are higher on this characteristic will
experience poorer health and well-being when confronted with change. As such,
I would suggest that future research needs to incorporate relevant personality
characteristics and individual difference variables as moderators of relationships
between exposure to change and employee health and well-being.

Conclusion

This review suggests, in general, change events – regardless of whether they are
assessed with objective or subjective measures – have a negative impact on a wide
range of measures of employee health and well-being. More recent research that has
focused on a wider range of aspects of the subjective content of change reveals that
some aspects of change also may be positively associated with employee health and
well-being. This review identifies several directions for future research in the area
such as inclusion of a wider range of aspects of the content of change, and
consideration of the change context and the change processes used when introducing
change as antecedents of employee health and well-being. Future research also
264 A. E. Rafferty

should consider including objective and subjective measures of change in a single

study to enable comparison of the relationships between these measures and
employee health and well-being. Finally, there is a need to consider a wider range
of mediating and moderating processes that link organizational change events with
employee health and well-being.

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Psychological Contracts and Employee
Health 14
Jacqueline A-M Coyle-Shapiro, Sandra Costa, and Chiachi Chang

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Psychological Contracts: Conceptualization and Consequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Empirical Evidence: What Do We Know? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Theoretical Links Between Psychological Contract Breach and Health . . . . . . . . . . . . . . . . . . . . . . . 271
Empirical Evidence Linking Psychological Contracts and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Moderators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
PC Breach and Post-Breach States: Acute Versus Chronic Health Problems . . . . . . . . . . . . . . . . . 275
Future Research Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279

Abstract
The primary thrust of psychological contract (PC) research has focused on
employees’ outward directed responses when they experience contract breach
and violation. These responses have been primarily directed at the organization as
the source of the psychological contract breach. In doing so, the inward-focused

J. A.-M. Coyle-Shapiro (*)

Department of Management, London School of Economics, London, UK
Jack H. Brown College of Business and Public Administration, California State University San
Bernardino, San Bernardino, CA, USA
e-mail: [email protected]
S. Costa
ISCTE – Instituto Universitário de Lisboa, Business Research Unit (BRU-IUL), Lisbon, Portugal
e-mail: [email protected]
C. Chang
International Business School Suzhou (IBSS), Xi’an Jiaotong Liverpool University (XJTLU),
Suzhou, China
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 269

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_12
270 J. A.-M. Coyle-Shapiro et al.

consequences of breach on employees’ health have been relegated to the side-

lines. We place the spotlight on the health consequences of psychological con-
tracts and, in particular, employees’ experience of contract breach and violation.
In this chapter, we begin with a brief review of the conceptualization of psycho-
logical contracts and examine the theoretical links between psychological con-
tracts and health. We present the emerging empirical evidence on the deleterious
effects of breach and violation on employee health. We review potential moder-
ators that may strengthen or weaken the effects of contract breach/violation on
health. Given that contract breach occurs regularly, how do individuals cope post-
breach and what are the effects on their health? Finally, we outline a number of
avenues for future research to advance knowledge on the relationship between
psychological contracts and employee health.

Keywords
Psychological contract breach · Psychological contract violation · Health and
well-being · Job demands-resources model · Effort-reward imbalance model ·
Conservation of resources theory · Acute and chronic health · Post-violation
model

Introduction

The employee-organization relationship is a fundamental one for employees (Coyle-

Shapiro et al. 2004), and the exchange relationship that develops has important
consequences for both the organization and employees. Psychological contracts
capture “an individual’s beliefs regarding the terms of conditions of a reciprocal
exchange agreement between the focal person and another party” (Rousseau 1989,
p. 123). The predominant theory is the social exchange (Blau 1964) and the norm of
reciprocity (Gouldner 1960), and to this end, it provides a relevant explanation for
the consequences of an individual’s evaluation of their psychological contract and, in
particular, contract breach and violation. However, the emphasis of research atten-
tion has been on examining the outward-oriented consequences of psychological
contract breach to the detriment of understanding the inward-focused consequences
– employee health.
To stimulate research attention, we place the spotlight on the health consequences
of psychological contracts. To start, we provide a brief review of the psychological
contract, its conceptualization prior to examining the theoretical links between
psychological contract breach and health. We then examine the emerging empirical
evidence and potential moderators that could accentuate or dampen the effects of
contract breach on health. In light of the prevalence of contract breach, how do
individuals “live with contract breach” and when it is likely to have a deleterious
effect on health? We present an initial conceptual model to explore this. Finally, we
outline avenues for future research to help advance knowledge on how psycholog-
ical contracts affect employee health.
14 Psychological Contracts and Employee Health 271

Psychological Contracts: Conceptualization and Consequences

Psychological contract breach and violation are the primary mechanisms for the
association between psychological contract and negative outcomes. Psychological
contract breach is defined as “the cognition that one’s organization has failed to
meet one or more obligations within one’s psychological contract in a manner
commensurate with one’s contributions” (Morrison and Robinson 1997, p. 230).
Psychological contract violation is described as “an intense reaction of outrage,
shock, resentment, and anger” (Rousseau 1989, p. 129) and captures the emotional
and affective response that may arise from a breach (Morrison and Robinson 1997;
Zhao et al. 2007; Dulac et al. 2008). Psychological contract breach can be experienced
in different ways: as a discrete event (i.e., promised promotion did not materialize) or
the ongoingness of micro-incidents or events (Conway and Briner 2002; Chang et al.
2015) that accumulate to form an overall perception of psychological contract breach.

Empirical Evidence: What Do We Know?

Psychological contract breach has dominated empirical investigations in the pursuit of

understanding how employees react to “broken promises” by their organization. The
bulk of the research has focused on outward-directed attitudes and behavior toward the
organization – psychological contract breach is associated with decreased attitudes
toward the organization such as lower commitment (Coyle-Shapiro and Kessler
2000), lower trust in the organization (Robinson 1996; Zhao et al. 2007), lower job
satisfaction (Raja et al. 2004; Robinson and Rousseau 1994), and more cynical attitudes
toward the organization (e.g., Johnson and O’Leary-Kelly 2003). A corresponding
effect exists with employee behavior. Employees are less willing to engage in positive
work behaviors (e.g., organizational citizenship behavior, work performance), more
likely to increase negative behavior (e.g., counterproductive work behavior) as a form
of revenge seeking to rebalance the perceived inequity in the exchange relationship
(Bordia et al. 2008; Coyle-Shapiro and Kessler 2000; Doden et al. 2018; Lester et al.
2002; Robinson 1996; Robinson and Morrison 2000). Overall, these findings and those
from the meta-analyses (Bal et al. 2008; Zhao et al. 2007) are consistent in demonstrat-
ing that employees reciprocate the perceived behavior of their employer through
adjusting their attitudes and behavior. Given the emphasis on a “tit for tat” explanation,
why would psychological contract breach and violation affect employees’ health?

Theoretical Links Between Psychological Contract Breach

and Health

Research exploring the linkage between psychological contract breach and health is
on the ascendency, and potential theoretical explanations have been uncovered to
include job demands-resources model (Demerouti et al. 2001), effort-reward imbal-
ance model (Siegrist 1996), and conservation of resources theory (Hobfoll 1989).
272 J. A.-M. Coyle-Shapiro et al.

Job demands-resources model (Demerouti et al. 2001) posits that job demands
and job resources determine employees’ well-being. Job demands refer to any aspect
of the job that requires physical or psychological effort for employees. On the
contrary, job resources include aspects of the job that can reduce physical and/or
psychological costs, facilitate the attainment of work goals, or contribute to an
individual’s growth (Hakanen et al. 2008). Higher job resources trigger employee
engagement, leading to other positive work outcomes (Schaufeli and Bakker 2004).
Drawing on these insights, Parzefall and Hakanen (2010) conceptualize psycholog-
ical contract fulfillment as a job resource providing employees with a sense of being
cared for and promoting their safety. Such fulfillment would enhance employee
health. In a sample of Finnish public sector employees, they found that psycholog-
ical contract fulfillment facilitated greater employee engagement, which had enhanc-
ing effects on their mental health.
Siegrist (1996) proposed the effort-reward imbalance model to explain how the
psychosocial work environment at work impacts employees’ health outcomes.
Specifically, this model focuses on the balance between the effort, such as spent
energy and working hours, and the reward, such as pay, job security, and recognition,
for employees. High effort and low reward are detrimental to employees’ health and
well-being. Noordin and Panatik (2015) posited that the imbalance of effort and
reward itself would lead to psychological contract breach, and Reimann and Guzy
(2017, p. 3) stated that “psychological contract breach is a perceived imbalance that
acts as a psychosocial work stressor and affects employee health as a result of
negative stress reactions, similar to the imbalance between efforts and rewards.” In
an empirical study of German employees, the authors found that psychological
contract breach affected mental and physical health, and these effects were contin-
gent upon the nature of the contract breach. Their findings demonstrate that mental
health partially explained the impact of psychological contract breach on physical
health. A nuanced finding was that psychological contract breach of long-term job
security and job autonomy significantly predicted both mental and physical health,
whereas psychological contract breach of career opportunities and high pay did not
predict any health outcomes.
Hobfoll (1989) introduced conservation of resources theory to explain how
individuals experience stress. Individuals strive to maintain or gain internal and
external resources that foster goal attainment, and factors that induce the loss of or
threaten the loss of resources are regarded as stressors. Based on conservation of
resources theory, Deng et al. (2018) argued that psychological contract violation
acts as an organizational stressor because it engenders emotional and cognitive
challenges for employees as they strive to acquire, retain, and protect psycholog-
ical resources. Along similar lines, Priesemuth and Taylor (2016) proposed that
psychological contract violation induces depressive moods because broken prom-
ises deplete and drain employee resources, leading to a state of depression. Their
findings reveal that psychological contract violation was a positive predictor of
depressive moods, and this effect was stronger for employees with high psycho-
logical entitlement as their sense of deservingness amplifies the perceptions of
resource loss.
14 Psychological Contracts and Employee Health 273

Empirical Evidence Linking Psychological Contracts and Health

An early meta-analysis (Robbins et al. 2012) found that psychological contract

breach explained additional variance in burnout, stress, and negative emotions
above that accounted for by distributive, procedural, and interactional justice.
When employees experience broken promises, this acts as a psychosocial stressor
leading to psychological stress reactions. Broken promises can reduce predictability
and control in the employment relationship as employees no longer know what to
expect (Chambel and Oliveira-Cruz 2010). Empirical examination of the relation-
ship between psychological contract breach and health is still in its infancy, but the
evidence to date supports the tenet that psychological contract breach leads to
negative health outcomes. Conway and Briner (2002) found that psychological
contract breach was associated with reduced well-being. In addition, two studies
found that psychological contract breach was associated with employee burnout
(Cantisano et al. 2007; Chambel and Oliveira-Cruz 2010), and Guest and Clinton
(2010) found that unfulfilled obligations were associated with increased sickness
absence and poorer general health.
Reimann and Guzy (2017) found that mental health partially mediated the
relationship between psychological contract breach and physical health, suggesting
that psychological contract breach is a harmful stressor. Duran et al. (2020) extend
this line of investigation by demonstrating that unfairness and self-efficacy mediated
the relationship between psychological contract violation and stress and anxiety.
Therefore, the experience of psychological contract violation undermines an
employee’s self-efficacy because of the absence of job resources, while the lack of
perceived organizational reciprocation creates unfairness. The resultant outcomes
are stress and anxiety.
The emerging and growing evidence suggests that employees’ experience of
psychological contract breach and violation has an effect on their mental and
physical health. We now turn to exploring some of the boundary conditions that
may attenuate or accentuate this relationship.

Moderators

We explore three types of moderators: individuals’ characteristics, employment

relationship, and the macro context in which they are embedded. These may provide
additional insights on the factors that promote or reduce the negative impact of
psychological contract breach and violation on health outcomes.
Individual Characteristics. Regarding individual characteristics, two types of
moderators can be identified: stable dispositions and personal resources. Previous
research has shown that dispositions may play an important role in how psycholog-
ical contract breach impacts one’s health. Specifically, Karagonlar et al. (2016)
examined reciprocation wariness, which is a stable disposition concerning a suspi-
ciousness of other’s willingness to follow the norm of reciprocity (Cotterell et al.
1992; Lynch et al. 1999), as a moderator in the psychological contract fulfilment-
274 J. A.-M. Coyle-Shapiro et al.

perceived organizational support relationship. High reciprocation wariness was

found to eliminate the positive effects of psychological contract fulfillment and
exert additional influence on psychosomatic strain and voluntary turnover. This
occurs because high-wary employees interpret psychological contract fulfillment
as a way for the organization to take advantage of the norm of reciprocity to promote
its own objectives (Karagonlar et al. 2016). Psychosomatic strain reflects the expe-
rience of physical complaints such as fatigue, sleep problems, and headache.
Other research examined the role of personal resources (or lack of) as moderators.
On the one hand, drawing from the job demands-resources model, Costa and Neves
(2017a) tested revenge and forgiveness cognitions as personal resources that
strengthen or dimmish the relationship between psychological contract breach and
emotional exhaustion. Findings indicate that forgiveness cognitions have a buffering
effect, which suggests that individuals who forgive the organization for the trans-
gression feel less emotionally exhausted (Costa and Neves 2017a). In addition,
Garcia et al. (2018) studied the relationship between PC breach and insomnia
among older workers (above 40 years old) drawing on conservation of resources
theory. They further assessed generativity concerns as a personal resource that would
buffer the negative impact of psychological contract breach. Generativity is “the
concern in establishing and guiding the next generation” (Erikson 1963, p. 267). In
two studies using employee-spouse dyads, they reported that psychological contract
breach is related to insomnia via psychological distress for those with low levels of
generativity concerns. On the other hand, Achnak et al. (2018) also drawing from
conservation of resources theory argued that fatigue, as a result of lack of resources,
moderates the relationship between psychological contract breach and negative
emotions with further implications to stress levels, because “the levels of energy
available when facing an affective work event such as a psychological contract
breach, will influence the intensity of the emotional reaction” (p. 3) and the ability to
effectively cope with the event.
Organizational Context. How individuals perceive their employment relation-
ship in terms of commitment and identification can also influence how their health is
impacted following psychological contract breach. Specifically, Reimann (2016)
found that overcommitted employees are at a higher risk of developing poor mental
health if they experience psychological contract breach compared to those who are
not overly committed to their work. Because overcommitted employees exert
increased effort on behalf of the organization and sustain that effort for a long
time, they find it harder to make sense of and cope with imbalanced situations
(Reimann 2016) and find it harder to deal with negative experiences. Deng et al.
(2018) found that the relationship between psychological contract violation and
resource depletion is stronger among those individuals who strongly identify with
their organization. The opposite pattern was found for those who strongly identify
with their profession. Another important perception of the organizational context to
consider is job insecurity. So far, three studies reported job insecurity as an anteced-
ent of psychological contract breach (Costa and Neves 2017b; Piccoli and De Witte
2015; Shoss et al. 2018). Both job insecurity and psychological contract breach have
been conceptualized as stressors that further impact one’s health (Cheng and Chan
14 Psychological Contracts and Employee Health 275

2008; Costa and Neves 2017b). Accordingly, the accumulation of stressors can
exacerbate the negative impact on an individual’s health and well-being.
Macro Context. The employee-organization context is rarely examined yet pro-
vides important insights about how individuals interpret their exchange relationship
with their employer and reciprocity. Most studies on psychological contracts and
health have been conducted in Western countries. Preliminary evidence shows that
culture impacts the intensity of relationships between psychological contract breach
and outcomes (Costa et al. 2017). However, due to the paucity of studies capturing
health outcomes, it is not possible to gauge whether there are any differences
between PC breach and health-related constructs across cultural contexts. It is
plausible that, for instance, individuals in high power distance countries feel less
stressed when they experience a breach because they are more accepting of negative
events out of respect, esteem to authority figures, and loyalty (Farh et al. 2007).
The industry in which the studies take place is rarely considered in the discussion of
the findings. An exception is Garcia et al. (2018), who upon reflecting on the fact that
the effects of psychological contract breach on distress and insomnia may have been
intensified by compassion fatigue (i.e., less capable of being empathetic toward
other’s suffering, Figley 1995), representative of caring professionals and influences
the experience of psychological distress (Adams et al. 2006).
The empirical evidence that exists conceptualizes the experience of psychological
contract breach and violation as a harmful stressor that damages psychological and
physical health. That said, there is an absence of empirical investigations that
examine when this is more likely to occur and what counteracting factors can nullify
this effect. As employees’ experience of psychological contract breach occurs
frequently (Conway and Briner 2002; Reimann and Guzy 2017), are the effects on
health short-lived or do they linger over time?

PC Breach and Post-Breach States: Acute Versus Chronic Health

Problems

After a negative disruption of psychological contract (i.e., breach), some employees

quit their organization (Turnley and Feldman 1999), but other employees stay
employed with the same employer (Tomprou et al. 2015). For those who stay, they
need to cope with the disruption of their psychological contract. The coping process
and the organization’s actions are critical to reaching a resolution and a positive
psychological contract status (i.e., psychological contract reactivation or thriving;
Tomprou et al. 2015). However, if the post-breach events are not focused on a
resolution, the employee’s psychological contract may remain impaired or even be
dissolved (Tomprou et al. 2015). This section will discuss the possible health out-
comes of a positive or a no resolution of the psychological contract breach. The
distinction between acute and chronic health problems conveys a more comprehen-
sive and granulated view of the impact of psychological contract breach and
subsequent psychological contract status on individuals’ health. Acute health prob-
lems are those that are of short duration and tend not to involve restriction of
276 J. A.-M. Coyle-Shapiro et al.

activities nor medical attendance, whereas chronic health problems are defined
broadly as conditions that last 1 year and require ongoing medical attention or
limit activities of daily living or both (CDC 2021).
To develop an understanding of how psychological contract breach leads to acute
and chronic health problems, we draw on the effort-recovery model (Meijman and
Mulder 1998), previous knowledge about psychological contract breach as a stressor
(Costa and Neves 2017; Gakovic and Tetrick 2003), and the post-violation model
(Tomprou et al. 2015). The effort-recovery model states that events requiring
individual effort lead to stress reactions such as fatigue and that once the individual
is no longer exposed to the stressful event, the reactions are reversed and recovery
follows (Meijman and Mulder 1998). Putting this model in the context of psycho-
logical contract breach, acute health-related problems may occur after the individual
experiences a psychological contract breach event. Positive resolution of the psy-
chological contract breach only happens if the organization provides an effective
remedy and if the individual copes effectively and accepts the situation. A positive
resolution means that the psychological contract can go back to its previous terms or
be better than the previous version (reactivation or thriving, respectively; Tomprou
et al. 2015). Consequently, the psychophysiological processes activated during the
psychological contract breach return to the baseline, and the individual recovers
(Meijman and Mulder 1998) (Fig. 1).
A completely different scenario materializes when following a psychological
contract breach and acute reaction: there is no resolution. No resolution means that
the organization does not intend to provide a remedy or solution and the individual is
not able to cope with the situation. In worse cases, individuals can also perceive
accumulated psychological contract breaches. As a consequence, the psychological
contract will be impaired (i.e., psychological contract is less beneficial than before)
or dissolved (i.e., continuous, chronic, and dysfunctional state of felt violation)
(Tomprou et al. 2015). Individuals who remain in these states are likely to develop
chronic health-related issues. The main underlying reason is linked to the activation
of psychophysiological systems, which are maintained over long periods (Meijman

PC Reactivation PC Thriving

Organizational Positive
response Recovery
Resolution
Baseline

Acute stress
PC breach
reaction

Sustained Activation
No Chronic Health
Individual coping Resolution Problems

PC Impairment PC Dissolution

Fig. 1 Model of psychological contract breach and psychological contract states on acute and
chronic health problems
14 Psychological Contracts and Employee Health 277

and Mulder 1998). This prolonged and sustained activation with no return to the
baseline levels leads to an accumulative process, which in turn results in chronic
health problems (Meijman and Mulder 1998), such as chronic fatigue, tension, and
persistent sleep problems (Sluiter et al. 2001; van Hooff et al. 2005).
Whether an employee’s health suffers as a consequence of psychological con-
tract breach is also contingent upon the organization’s subsequent actions in terms
of remedies. Recently, Henderson et al. (2020) found that repair tactics, such as full
penance (i.e., offering full reparation), partial penance, apologies, and excuses,
were effective in the mitigation of the negative effects of psychological contract
breach on outwardly focused outcomes. Costa and Neves (2017a) also found that
when individuals forgive the organization, they feel less emotionally exhausted
after the experience of a psychological contract breach. Combining these prelim-
inary findings, it is possible that the remedies put in place by the organization may
“fix” the psychological contract and prevent or minimize negative health
outcomes.

Future Research Directions

Theoretical development and empirical investigation into the impact of psycholog-

ical contract breach and violation on health are still in its infancy. We highlight future
research directions that pertain to (a) psychological contract breach as a stressor,
(b) potential operationalizations of these links (mediators), (c) factors that can
exacerbate or ameliorate the relationship between psychological contract breach
and health outcomes, (d) attention to differential outcomes of post-breach states,
and (e) appropriate methodologies.
Building on current frameworks viewing psychological contract breach as a
psychosocial stressor influencing employee health, future research could examine
these theoretical links and unpack the nature of such stressors. Wheaton (1996)
differentiated event stressors (discrete and observable events with clear onset and
offset points) from chronic stressors (the accumulative stress from everyday trans-
actions with the environment). Following Wheaton’s conceptualization, Chang et al.
(2015) argued that event-based psychological contract breach (salient and discrete
perception of a broken promise) should be differentiated from an accumulative
psychological contract breach process (ambiguous, continuous, and minor erosion
of promises). They suggested that the discussion of accumulative psychological
contract breach process may add value to the understanding of psychological
contract breach and health, because there may be different mechanisms leading to
differential health outcomes. Specifically, they have posited that event-based psy-
chological contract breach may trigger instant and intensive physical response (e.g.,
blood pressure change), whereas accumulative psychological contract breach pro-
cess induces prolonged physiological change (e.g., immune response). Future
research should tackle whether the two types of psychological contract breach
stressors have differential effects on employees’ health.
278 J. A.-M. Coyle-Shapiro et al.

Additional research examining factors that can exacerbate or minimize the effects
of psychological contract breach on health-related outcomes is needed. Based on
previous research on personality and psychological contract (e.g., Ho et al. 2004;
Orvis et al. 2008), traits such as conscientiousness, neuroticism, and agreeableness
may explain variance in health reactions to psychological contract breach events. For
instance, neuroticism has been found to differentially influence cognitive and emo-
tional responses to breach (Ho et al. 2004) and also to be related to physical and
mental health outcomes (Hooker et al. 1992).
Following the conceptualization of psychological contract breach as a stressor
(Costa and Neves 2017; Lapointe et al. 2013) and job demands-resources model
(Demerouti et al. 2001), personal and job resources enhance the individual’s ability
to control and cope with stress at the workplace (Hobfoll et al. 2003) and buffer the
relationship between stressors and outcomes. Personal resources such as resilience or
positive psychological capital are malleable and open to development, and therefore,
they can be trained (Luthans et al. 2008). For instance, PsyCap (which comprises
self-efficacy, hope, resilience, and optimism) have been shown to minimize the
impact of PC breach on performance and deviant behaviors (Costa and Neves
2017b), and an individual’s PsyCap is also associated with employee well-being
(Avey et al. 2010). Having social support promotes health by acting as a protective
buffer from stress as it helps individuals reframe the situation as well as providing
the individual with instrumental resources to cope (Heaphy and Dutton 2008).
Therefore, social support is likely to dampen the effects of contract breach on health.
Physical exercise is another buffer in developing psychological resistance to psy-
chological stress (Schmidt et al. 2016). The inclusion of these types of moderators
would help identify which employees are more susceptible to experiencing negative
health outcomes following psychological contract breach.
Research on the post-breach state of psychological contract is mostly conceptual
(Tomprou et al. 2015; Rousseau et al. 2018), and thus empirical investigations are
warranted. In the previous section, we propose a model that combines Tomprou
et al.’s (2015) work with the effort-recovery framework (Meijman and Mulder
1998), which we hope will foster further research on the impact of psychological
contract breach and psychological contract states on individuals’ health. Moreover,
understanding the impact of a single psychological contract breach versus accumu-
lated psychological contract breaches without resolutions may also provide interest-
ing insights into this relationship. Previous research found that mistreatment leads to
rumination (Rafaeli et al. 2012). Intense sense-making activity may lead to rumina-
tion, which in turn has the potential to explain the heightened effects of psycholog-
ical contract breach on one’s health. This may happen because rumination is
associated with personal distress (Vough and Caza 2017), impaired somatic health
(Marcus et al. 2008), and chronic illness (Soo et al. 2009).
Finally, evidence from public health demonstrates a positive relationship between
paid work and health, and these effects endure over a 10-year period into retirement
(Di Gessa et al. 2020). However, what is missing is an account of the quality of the
employment relationship, which if characterized by the prolonged accumulation of
14 Psychological Contracts and Employee Health 279

psychological contract breach or regular events of breach may nullify the health-
enhancing benefits of being employed. Future longitudinal research could explore
the relative effects of paid work vis-a-vis the longevity of psychological contract
disturbances on subsequent health outcomes in the short and longer term. Field
research that combines employee perceptions of psychological contract breach
with capturing cortisol and oxytocin concentrations, blood pressure, and heart rate
would uncover the physiological effects on the cardiovascular and neuroendocrine
systems.
Studying the effects of psychological contract breach and violation on health
outcomes poses relevant questions about what methodologies researchers should
use. Previous research relied in self-reported methodologies asking participants
through surveys or interviews to rate their health (somatic complaints, sleep quality,
burnout, etc.). To achieve a more comprehensive view of the impact of psychological
contract breach, alternative research designs are needed, for instance, daily measures
of breach events as well as different health indicators that go beyond self-reported
measures. For example, a currently available option is the use of technologies such
as smart watches which have the ability to register information regarding sleep
quality, exercise time, blood pressure, and breathing quality. Finally, proxies for
health outcomes such as frequency of sick absences may be gathered from organi-
zational records.

Conclusion

Our goal was to highlight how an employee’s evaluation of their psychological

contract impacts their psychological and physical health. We reviewed the existing
empirical evidence which points to the experience of psychological contract breach
and violation as having a deleterious effect on employees’ health. As an extension,
we examine potential moderators that may facilitate or dampen the negative impact
of breach and violation. We outline how contract breach may lead to chronic health
problems by integrating effort-recovery model and the post-violation model. In
closing, we provide a number of directions for future research to help advance our
understanding of how and when organizations’ broken promises have a damaging
effect on employees’ health.

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Fairness at Work
15
Constanze Eib, Constanze Leineweber, and
Claudia Bernhard-Oettel

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
What Is Fairness at Work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Definitions and Measurement of Organizational Justice and Fairness at Work . . . . . . . . . . . . 287
Relevance of Fairness at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Consequences of Fairness at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Work-Related Consequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Health-Related Consequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
The Wider Consequences of Fairness at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296
Fairness at Work and Organizational Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298
Fairness at Work Before the Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Fairness at Work During and After the Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300
Change and Stability in Fairness Due to Organizational Changes . . . . . . . . . . . . . . . . . . . . . . . . . 301
How Can Organizations Manage Fairness Effectively During Organizational Changes? . . . . . 302
Boundary Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
Intervention Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305

C. Eib (*)
Department of Psychology, Uppsala University, Uppsala, Sweden
Division of Epidemiology Stress Research Institute, Stockholm University, Stockholm, Sweden
e-mail: [email protected]
C. Leineweber
Stress Research Institute, Stockholm University, Stockholm, Sweden
e-mail: [email protected]
C. Bernhard-Oettel
Department of Psychology, Stockholm University, Stockholm, Sweden
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 285

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_13
286 C. Eib et al.

Abstract
Fairness at work is a crucial factor for lasting work performance and well-being at
work. The chapter begins with the conceptualizations of fairness at work and
organizational justice, its different dimensions and developments over time, as
well as the multiple ways on how to measure the concepts.
Next, the chapter condenses the extensive empirical evidence on the conse-
quences of fairness at work for employees’ work-related attitudes and behaviors
as well as the consequences for groups, customers, and other stakeholders. We
particularly highlight the growing literature on fairness and health, providing an
account of longitudinal studies on a selection of health outcomes, underlying
mechanisms for the justice-health relationships, and evidence of reversed effects.
The chapter focuses on several aspects of fairness at work that are relevant at
different stages of organizational changes. It is outlined how fairness at work can
help employees manage uncertainties, threatened identities, and changed inputs
and outputs that organizational changes often trigger. It is presented how, why,
and when fairness perceptions may themselves undergo a change, triggered by
organizational changes.
Lastly, we briefly present issues relevant for implementing fairness at work
effectively, outlining relevant boundary conditions and available intervention
studies.

Keywords
Justice · Organizational justice · Fairness · Occupational health · Organizational
change

Introduction

In this chapter, we present fairness at work as a crucial factor to well-being and

health and as an important aspect to consider during organizational changes.
Although there are vast amounts of evidence that fairness at work is important,
there is far less knowledge on how to manage fairness effectively. Scholars describe
fairness at work often in relation to organizational justice. Byrne and Cropanzano
(2001, p. 4) defined organizational justice “at its most general level, [. . .] [as] an area
of psychological inquiry that focuses on perceptions of fairness in the workplace.”
Much of the literature uses the terms organizational justice and fairness at work
interchangeably but emphasizes that any inquiry is always a subjective perception
and personal judgement made by an individual.
In addition to the concepts of justice and fairness (In this chapter, when referring
to a specific study, we use the word justice when the study participants were asked to
evaluate whether justice rules were adhered to or were violated. We use the word
fairness, when study participants were asked directly to evaluate the fairness of the
conduct by, for instance, a supervisor or an organization. However, even though we
15 Fairness at Work 287

aim for consistency as much as possible, the breadth in scales and measurement
options made it difficult to reliably denote a concept as justice or fairness), scholars
regularly use the expressions injustice and unfairness as well as low justice and low
fairness to refer to violations of justice rules or the absence of fairness. Since there is
a validated scale on injustice (Colquitt et al. 2014), providing evidence that justice
and injustice are not the diametrical opposite, we will use the expressions of low
justice/low fairness when describing study results based on justice measures and use
the expressions of injustice when study results were based on the validated scale of
injustice.
The chapter is organized as follows. First, we give an introduction to the
organizational justice and fairness at work literature, outlining the concept develop-
ments and relevance. Second, we provide an overview of the consequences of
organizational justice and fairness at work. Here, we focus particularly on health-
related consequences and review mostly longitudinal studies, which provide stron-
ger evidence for possible causal relationships. We also discuss reversed effects, that
is, health may influence subsequent justice perceptions and possible mechanisms
that may underlie the justice-health relationship. Third, we focus on the role of
organizational justice and fairness in times of organizational change. We conclude
with a brief outlook on how to manage fairness at work effectively, highlighting
studies on conditions that can alter justice effects and on interventions.

What Is Fairness at Work?

Definitions and Measurement of Organizational Justice and Fairness

at Work

The organizational justice and fairness literature has a long scientific tradition
(Colquitt et al. 2005). Between 1949 and 1976, most scholars focused on aspects
of distributive justice, and several theoretical models (relative deprivation, social
exchange theory, equity theory) were proposed relating to this aspect. Distributive
justice refers to the appropriateness of outcome allocations. For instance, employees
may assess whether the outcomes they receive are appropriate given their effort,
contribution, and performance. There are various rules to guide outcome allocations,
among others, the equity rule (rewarding employees according to contributions), the
equality rule (allocating similar resources to all employees), and the need rule
(providing compensation based on personal need) (Deutsch 1975). Distributive
justice is a relevant issue during performance appraisals and salary negotiations
but also work task allocations among team members, promotion decisions, and
layoffs and terminations during organizational change initiatives. The fairness of
outcome allocations is a highly sensitive topic for employees and regularly leads to
conflicts, frustrations, and negative employee reactions.
Despite the relevance of outcome fairness to employees, scholars recognized that
the procedures that lead to outcome allocations are another crucial factor in under-
standing employee reactions. In the years until the late 1990s, empirical findings in
288 C. Eib et al.

relation to procedural justice were prominent in the organizational literature. Proce-

dural justice refers to the appropriateness of the procedures in decision contexts.
Employees judge whether procedures that lead to outcome allocations follow rules
of consistency (all employees are treated in the same way), accuracy (accurate
information is used as basis for decisions), correctability (mistakes can be revoked),
ethicality (professional conduct is upheld), bias suppression (no discrimination), and
representativeness (relevant groups have a say) (Leventhal 1980; Thibaut and
Walker 1975). From the 1980 to the early 2000, various theoretical models were
introduced, which integrated the different justice dimensions (e.g., fairness theory,
fairness heuristics theory, group engagement model).
Another important development in the literature regards the growing consensus
that interpersonal treatment is an additional major ingredient to employees’ fairness
perceptions. Research on interactional justice (sometimes also called relational
justice) appeared after the 1990s (Bies 2001), and with it, extensive debates on
how many different dimensions or facets of justice exist. Interactional justice refers
to the appropriateness of the conduct of organizational members, and it was later
split into two separate dimensions: interpersonal and informational justice. Interper-
sonal justice is characterized by the conduct of a supervisor who follows rules of
respect and dignity (treating employees with politeness) and propriety (refrain from
improper remarks). Informational justice is about whether adequate accounts, suffi-
cient, timely, and truthful explanations are given to employees when communicating
outcome allocations. Since Colquitt’s work in 2001, it has been widely accepted to
consider organizational justice as consisting of four dimensions: distributive, proce-
dural, interpersonal, and informational justice. He summarized different conceptu-
alizations and justice rules and proposed items for each dimension that assess
whether a specific justice rule is adhered to or not (Colquitt 2001).
Another extensive debate among scholars followed adding to the depth of the
concept and measurement. Specifically, it was cast into doubt to what extent
individuals go through the cognitively burdening process of evaluating whether,
for instance, a supervisor has followed each of the various justice rules. Instead,
several scholars proposed that individuals form a general sense of fairness. This
movement gained real momentum when Ambrose and Schminke (2009) developed a
measure for overall justice, defined as global assessment of the fairness of social
entities. To keep with our definitions provided in the introduction part and in line
with Colquitt and Rodell (2015), we label this concept overall fairness: the items ask
individuals to evaluate the appropriateness of conduct of social entities and do not
ask whether specific justice rules were adhered to or not. Most often, overall fairness
is considered in relation to the whole organization, yet it also can pertain to different
sources, such as the supervisor. An open question is whether overall fairness can also
pertain to specific events, such as whether a restructuring process was generally fair
(for a discussion, see Colquitt and Rodell 2015). Several theoretical and practical
advantages of focusing on overall fairness instead of the four justice dimensions
have led to an increase in the number of studies on overall fairness (Ambrose et al.
2015). Overall fairness is considered a more accurate reflection of the fairness
employees experience in the workplace. It is also assumed to be a stronger predictor
15 Fairness at Work 289

for outcomes as it summarizes different justice dimensions, and it may provide better
predictions when the outcomes of interest are rather broad, such as job satisfaction or
performance. To date, the examination of the four justice dimensions remains
popular and relevant, yet the amount of studies using overall fairness also increases.
Given the various definitions and concepts, different measurements are available
to capture justice or fairness at work. Figure 1 presents two well-known approaches
to measure justice and fairness. It is possible to adapt Colquitt’s 2001 measure to
several entities, such as the organization or the supervisor, or to refer to multiple or
single events, such as decision outcomes in general or specific organizational change
programs, performance appraisals, and promotion decisions. The overall fairness
measure can be easily adapted to various entities.

Relevance of Fairness at Work

The organizational justice literature has put forth several perspectives of why
individuals care about justice. The three most well-known perspectives are of
instrumental, relational, and deontic nature (Cropanzano et al. 2001). The instru-
mental perspective suggests that individuals value justice as far as it guarantees them
favorable outcomes in the long run. The idea was based on studies on conflict
resolution, where individual’s justice perceptions were impacted by how much
voice and input they had in the decision-making (Thibaut and Walker 1975). Within
the instrumental perspective, we also include the idea that justice is relevant for
employees as it can help to manage uncertainty and increase predictability of the
actions from decision-makers (Lind and van den Bos 2002). The relational perspec-
tive puts the focus on the idea that an adherence to justice rules by decision-makers
provides individuals with information about their identity, such that it reassures them

Fig. 1 Sample items for two measures of justice and fairness perceptions. (*Items taken from
Colquitt 2001. **Item taken from Ambrose and Schminke 2009)
290 C. Eib et al.

of their self-worth and self-esteem. Fair treatment conveys information about the
individual’s relationship quality with decision-makers and group members (Tyler
and Lind 1992). The deonance perspective highlights that people also value justice
in and of itself. The model emerged from studies showing that individuals can
behave against their own self-interest in order to punish unfair decision-making of
others (Folger and Glerum 2015).
At this point, the reader may wonder, why unfairness and injustice still persist in
organizations, when justice and fairness are so important to employees for various
reasons. Indeed, most of the literature has so far focused on the recipient of
treatment, the employee. Justice enactment concerns the active role of the manager.
Box 1 gives a brief summary of the justice enactment literature.

Box 1: Justice Enactment

Most of the literature on organizational justice/fairness at work has focused on
the role of the recipient (i.e., the employee). However, the actor (i.e., the
manager) and the observer (e.g., co-workers, customers) have been given
more focus in recent years (for an overview, see Brockner et al. 2015). It is
argued that the literature on organizational justice is limited when not taking
into consideration managers’ motivation, ability, and discretion to behave
fairly (Graso et al. 2019). Similar to employees, managers may act fairly out
of instrumental, relational, or moral reasons (Scott et al. 2009). For instance,
managers may adhere to justice rules as an impression management tactic to
create a specific reputation of oneself, receive social approval, or as a power
tactic. Managers may also behave fairly in order to create trustful relationships
with their subordinates and increase positive attitudes and behaviors from
them. Moral reasons may also be a motive for managers to adhere to justice
rules, because they think it is the right thing to do. One of the challenges with
the enactment of justice is that managers often lack the discretion from their
organization to behave in a certain way. It has been argued that managers have
the most discretion over interpersonal justice and the least over distributive
justice (Scott et al. 2009). Being fair also takes a toll on the managers
themselves, such that following procedural justice rules is associated with a
depletion of self-regulatory resources (Johnson et al. 2014). However, there
are also benefits to enacting justice to the managers themselves, for instance,
they may enhance their own psychological well-being if they succeed in
creating a justice climate within their work groups (Bernerth et al. 2016).

While this chapter focuses on the employees’ perspective, like much of the
organizational justice literature has done so far, an increased attention to the side
of the manager (as well as the combination of employee-manager justice perceptions
and enactment) promises a deeper understanding of why feelings of injustice and
unfairness have a high prevalence in today’s organizations.
15 Fairness at Work 291

Consequences of Fairness at Work

Work-Related Consequences

Aside from the motives of being fair or wanting to be treated fairly, the importance of
organizational justice can also be demonstrated by looking at the wide range of its
work-related consequences. The relationships between organizational justice per-
ceptions and employee’s work-related attitudes and behaviors have been well
documented in several meta-analyses (Cohen-Charash and Spector 2001; Colquitt
et al. 2001, 2013; Rupp et al. 2014). In sum, the meta-analyses show that perceptions
of organizational justice have positive associations with work-related attitudes and
behaviors, such as job satisfaction, organizational commitment, and job perfor-
mance. Moreover, when employees perceive justice at their workplace, they are
more likely to engage in organizational citizenship behaviors (including civic virtue,
loyalty, and sportsmanship) and are less likely to engage in counterproductive work
behaviors (including sabotage, retaliation, theft, and aggression). Organizational
justice perceptions also associate with positive workplace relationships in terms of
organizational support, trust, identification, and leader-member exchange. The
strengths of the associations, however, vary by outcome variable, justice dimension,
and source of the justice. Generally, meta-analyses provide evidence that organiza-
tional justice dimensions have strong associations with aspects of the social
exchange relationship (trust, support, commitment, leader-member exchange). In
comparison, associations with task performance, citizenship behaviors, and coun-
terproductive work behaviors are generally weaker in strength. There is an ongoing
discussion on whether justice perceptions referring to the supervisor have stronger
effects to outcomes than justice perceptions referring to the organization (as found
by Colquitt et al. 2013) or whether the strength of the relationships with outcomes
depends on the similarity between the source of justice and outcome (called target
similarity model, as found by Rupp et al. 2014). Independent of which idea is true,
both studies imply that individuals’ justice and fairness perceptions are influenced
not only by the organization but also, to a great and potentially larger extent, by the
individual supervisor.

Health-Related Consequences

Employee health has long been a topic of interest for organizations, but the literature
on the health and well-being outcomes of organizational justice is rather young
(Elovainio et al. 2013), with an increase in interest starting around the millennium
shift. According to the WHO, health is “a state of complete physical, mental and
social well-being and not merely the absence of disease or infirmity” (WHO 1946)
and can be measured through a plethora of different concepts and measures. This fact
is mirrored in the literature, where studies have investigated organizational justice in
relation to, among others, mental health, general health, sickness absence, and
coronary heart disease. Below, we will provide a short summary of the latest research
292 C. Eib et al.

and thinking in the area of justice and health. In that, we will preponderantly
concentrate on longitudinal studies, which allow for stronger conclusions on
causality.

Longitudinal Evidence
Although the organizational justice-health relationship has gained increasing atten-
tion during recent years, the number of longitudinal studies is still scarce, and the
number of studied populations is even smaller. Many of the research findings stem
from a small number of longitudinal studies, among others the Whitehall II study
from the UK and the Finnish 10-Town study and, to some extent, the Swedish
SLOSH study. Here, we give a short overview over the existing literature without
claiming to provide a systematic review.
One of the most commonly studied health outcomes in relation to organizational
justice is mental health. Overall, research suggests that organizational justice is
positively associated with mental health. A systematic review of prospective studies
on organizational justice and mental health (Ndjaboué et al. 2012) identified 11 pro-
spective studies of sufficient quality. A summative assessment of these studies
provided evidence for an association between relational and procedural justice,
respectively, and mental health, while evidence for distributive justice was less
conclusive due to a lack of prospective studies. Since this review, a few more
longitudinal studies have been published. Eib et al. (2018) reported significant
effects from procedural justice to subsequent depressive symptoms and sickness
absence in a representative sample of Swedish employees. Herr et al. (2019) studied
changes in a combined measure of procedural and interactional justice over 2 years
and found that an increase in justice is associated with an increase in self-rated
mental health. Most of these articles measured mental health using self-reports. One
exception provides an article using prescribed antidepressants, which found that
employees who reported a decrease in procedural justice over 2 years had a higher
risk for antidepressive medication prescription than those who reported stable high
procedural justice (Persson et al. 2020).
Another commonly studied health outcome is self-rated general health. While
self-rated health is often measured with a single item, it has been shown to be a
reliable predictor of morbidity and mortality (Idler and Benyamini 1997). Findings
regarding a possible association between organizational justice and self-rated health
are mixed. Studies based on Finnish hospital employees revealed that lower levels of
procedural justice related to poor self-rated health among women, but not among
men, and no association was found with relational justice (Elovainio et al. 2002;
Kivimäki et al. 2003). Contrary to these findings, Kivimäki et al. (2004) reported that
only men exposed to low relational justice or who experienced an adverse change in
justice were at higher risk of poor health at later times. One study that investigated
change in procedural justice in relation to self-rated health found that procedural
justice was significantly associated with self-rated health over time and that improve-
ments in procedural justice were associated with improvements in self-rated health
(Leineweber et al. 2016). Likewise, Herr et al. (2020) found that an increase in a
combined measure of procedural and interactional justice is associated with an
15 Fairness at Work 293

increase in self-rated health. To summarize, there are some results suggesting an

association between organizational justice and self-rated health, but results are far
from clear and not supported in all studies.
While coronary heart disease (CHD) has been commonly studied in relation to
other factors of the psychosocial work environment, especially so job demands, job
control, and effort-reward imbalance, its relation to organizational justice is less well
documented. Only few prospective studies have investigated the association
between organizational justice and CHD. Based on a large cohort of British civil
servants, Kivimäki et al. (2005) found that employees who experienced high levels
of relational justice had a lower risk of incident CHD than employees with a low or
intermediate levels. In a later study with similar data (Kivimäki et al. 2008), it was
tested whether lower blood pressure and lower rates of hypertension are one of the
underlying reasons why employees perceiving high organizational justice are at
lower risk of CHD than those who perceive low justice. Although organizational
justice was related to both lower blood pressure and lower risk of CHD incidence,
neither blood pressure nor hypertension did mediate the relationship. Two studies
based on Finnish data have also been published. One found that procedural and
relational justice were related to cardiac regulation (Elovainio et al. 2006a). The
other only asked participants one question about the fairness of their supervisor and
found that employees who reported high supervisory fairness had a 45% lower risk
of cardiovascular death than those reporting low or intermediate justice (Elovainio
et al. 2006b).
The association between organizational justice and sickness absence has also
received some attention. While sickness absence is not a direct measure of health, it
is strongly related to it. One of the advantages with using sickness absence is that it is
often studied using objective data, derived from employers or national registries (and
thus is less susceptible to self-report bias). Generally, studies suggest that low
organizational justice perceptions increase the risk of sickness absence. However,
there is little consistency in the results, and between-study differences are immense
(Robbins et al. 2012). This may be explained by the use of different measures of
sickness absence ranging from all-cause sickness absence to sickness absence due to
specific diagnoses, as well as the use of different lengths of sickness absence and
follow-up times. Several longitudinal studies relying on large datasets and that have
assessed sickness absence in an objective manner found support for an association
between various justice indicators and sickness absence (Hjarsbech et al. 2014;
Väänänen et al. 2004). Another study looked at any-cause and cause-specific
disability pension and found that the highest risk for both types of disability pension
was when employees reported several stressors at the same time, such as low
organizational justice (average of procedural and interactional justice) together
with high job demands and low job control (Juvani et al. 2018). This highlights
that stressors at work often appear together and that the combined effect of stressors
likely has a stronger impact on health than individual stressors do.
To conclude, the number of longitudinal large-scale studies provides evidence
that there is an association between organizational justice and fairness at work and
health outcomes. Still, existing longitudinal studies often use different (proxy)
294 C. Eib et al.

measures of organizational justice/fairness and focus on specific dimensions of

justice, which make it difficult to draw conclusions on all justice dimensions and
overall fairness. Future longitudinal studies with good measures of organizational
justice and fairness are needed to test different time lags as well as studies with an
increased focus on understanding mechanisms underlying justice-health
relationships.

Underlying Mechanisms
Although there is increasing empirical interest in the direct effects between justice
perceptions and health-related outcomes, limited attention has been given to better
understand the underlying processes. Different mechanisms have been suggested,
some based on justice theories and others based on stress theories. Despite the
diversity of ideas, most scholars clearly point out organizational justice and fairness
at work as the cause and health as the outcome.
Related to the health literature, two main mechanisms have been suggested to
underlie the causal relation between work stressors, for example, low organizational
justice, and health. Those are the psychophysiological mechanism and the behav-
ioral lifestyle mechanism (Kompier and Taris 2011). The first mechanism suggests
that long-term exposure to a stressor disturbs recovery from stress due to prolonged
activation of the bodily systems including the immune system. The second mecha-
nism suggests that stressors lead to increased unhealthy behavior, such as increased
alcohol intake, smoking, and less physical exercise. These two mechanisms are not
mutually exclusive and may both be present. Still, while there is some empirical
evidence for the first, psychophysiological pathway (Eib et al. 2015b; Manville et al.
2016), the second, behavioral lifestyle mechanism, has been less investigated and
also received less support (Elovainio et al. 2003).
Specifically, several studies investigating the underlying mechanism for the
justice-health relationship focused on aspects of recovery. Two studies suggested
that organizational justice perceptions are related to health outcomes through the
effect on sleep problems (Elovainio et al. 2003, 2009). Manville et al. (2016) added
onto that research and found support for their proposed serial mediation; such higher
levels of organizational justice are related to fewer musculoskeletal disorders
through fewer sleep disorders and less emotional exhaustion. Eib, von Thiele
Schwarz, et al. (2015b) proposed that low organizational justice constitutes an
important stressor to employees, triggering an increase in ongoing work-related
thoughts, which prolongs the activation of the stressor of low justice and undermines
health over time. They found that overall justice was associated with mental health
and work-family conflict through the effect of ongoing work-related thoughts.
However, Eib et al. (2018) found only cross-sectional associations between proce-
dural justice and ongoing work-related thoughts but not over the period of 2 years. In
one of the few studies using diary data, Wang et al. (2019) showed that day-to-day
changes in interpersonal justice perceptions changed recovery experiences, which, in
turn, predicted daily affective states. A different approach took Judge and Colquitt
(2004), who suggested fair organizations are likely to help employees with questions
regarding work and private life. They found that organizational justice perceptions
15 Fairness at Work 295

were negatively associated with work-family conflict, which, in turn, was associated
with higher stress levels. In sum, while different mechanisms for the justice-health
relationship have been proposed, empirical tests with quality data are still largely
lacking.

Reversed Effects
While research generally assumes the causality to go from work stressors to health,
the reversed relationship, where health affects perceptions of the work environment,
has been acknowledged to exist as well. Generally, there are two ideas of how health
may affect the work environment. The first idea is that health changes the perception
of the work environment; the second idea is that health produces an actual transfor-
mation of the work environment (Kompier and Taris 2011). For health and organi-
zational justice, these ideas have been called “affective perception” and “affective
reaction” assumptions (Lang et al. 2011). The perception effect suggests that healthy
employees view the treatment they receive as more positive, whereas workers with
impaired health perceive fairness as more negatively. The reaction effect proposes
that the work environment becomes less fair to unhealthy workers over time.
Employees with impaired health may express more negative affect and withdraw
from others, which likely undermines their relationship with co-workers and super-
visors. Over time, the behavior of co-workers and supervisors may include avoiding
employees with impaired health, and, as a result, employees with impaired health
may perceive less social support and fairness from people at work. In this sense,
health problems create a less fair environment for employees over time.
An overview over the underlying mechanisms for the causal and reversed rela-
tionships between fairness at work and health is provided in Fig. 2.
Empirical findings for the relationship from health to organizational justice
perceptions are mixed. While the number of studies investigating reversed effects
is limited, of those that did, many found significant relationships in both directions
(justice -> health; health -> justice, the latter referring to reversed effects). Ybema
and van den Bos (2010) found that sickness absence, but not depression, predicted
distributive justice a year later and also that distributive justice contributed to lower

Fig. 2 Proposed underlying mechanisms for the causal and reversed relationships between fairness
at work and health
296 C. Eib et al.

depressive symptoms and sickness absence in the following year. However, effects
from organizational justice to health were much stronger than reversed effects, and
they conclude that depressive symptoms and sickness absence rather are conse-
quences than predictors of organizational justice. Similar results were reported by a
Finnish study (Elovainio et al. 2013), where, in addition to causal effects from
procedural and interactional justice to sickness absence, limited evidence for
reversed causality was found. Sickness absence predicted procedural but not inter-
actional justice. Likewise, a Swedish study investigating the effects of procedural
justice on self-rated health found that a change in self-rated health predicted proce-
dural justice, while also a change in procedural justice predicted self-rated health
(Leineweber et al. 2016). In an attempt to not only test the direction of effects but
also underlying mechanisms, Eib et al. (2018) found significant effects from health
(depressive symptoms, sickness absence, self-rated health) to procedural justice.
These reversed relationships were mediated by social support. Interestingly, while
self-rated health was a predictor of justice, procedural justice did not predict self-
rated health over time. Similarly, Lang et al. (2011) found only evidence for a
reversed effect, such that depressive symptoms were associated with subsequent
organizational justice perceptions. No longitudinal lagged effects between all four
organizational justice dimensions and employee’ depressive symptoms were found.
To conclude, there is some evidence for causal as well as reversed effects, but studies
report mixed results and are somewhat inconclusive. While some studies found only
significant effects from health to justice, other studies report effects in both direc-
tions. Yet other studies found only associations from justice to health, rather than the
other way around (Elovainio et al. 2015).

The Wider Consequences of Fairness at Work

Organizational justice and fairness perceptions do not only have an impact on the
employees themselves. Particularly mistreatment has been studied and been found to
have effects on other individuals within the same organization, but even beyond the
employing organization to various stakeholders, such as customers or clients. Justice
climate has also been given increasing attention. Justice climate refers to how a work
group as a whole is treated (Naumann and Bennett 2000). The idea is that justice
experiences can be shared among team members, and team members can create a
shared mental model about decision-making, procedures, and interpersonal treat-
ment. Studies generally support that team-level justice perceptions affect employees’
attitudes and behaviors beyond the effect of individual-level justice perceptions
(Li et al. 2015). Also, justice climate affects team-helping behaviors and can also
spread to organizational outsides and affect customer satisfaction. The effect that
justice perceptions can affect stakeholders has also been empirically investigated,
albeit to a more limited extent (Skarlicki et al. 2015). For instance, guest’s loyalty
has been found to be related to how hotel management treated staff members
(Zoghbi-Manrique-de-Lara et al. 2013). When employees treat each other poorly,
bystanders evaluate the employing company more negatively (Porath et al. 2010).
15 Fairness at Work 297

Moreover, supervisor’s justice perceptions have been found to affect subordinate’s

family member perceptions of work-life conflict through subordinate’s justice per-
ceptions (Hoobler and Hu 2013).
It is complicated to predict how observers of unfairness will react (Skarlicki et al.
2015). For instance, a whole line of studies has shown that observers are sometimes
willing to punish transgressors at their own cost, reduce citizenship behaviors toward
the transgressor, engage in ostracism or gossip toward the transgressor, or actively
try to solve conflicts. However, a particularly worrisome way that observers can
react to mistreatment is victim blaming. Here, a relevant aspect for understanding
these reactions is that many people want to believe in a just world were people get
what they deserve (Lerner 1980). When observing others being unfairly treated,
observers can be motivated to restore their belief in a just world, by deeming the
victim of mistreatment as responsible and deserving of what they received. For
instance, it was found that managers and co-workers gave lower evaluations and
performance ratings to an employee who was treated unfairly by a former employer
or their current line manager than to an employee who was treated fairly independent
of the objective performance information (Skarlicki and Turner 2014). Observers of
unfairness can both punish transgressors or help victims depending on individual
and situational factors, where attributions of blame and emotions play a large part in
determining the behavior of observers.
The way in which justice perceptions can affect others within and outside of the
organization has been investigated under the umbrella term trickle-down effects
(Wo et al. 2019). These explain how, why, and when perceptions and evaluations
flow down an organizational hierarchy. For instance, it has been found that a
supervisor’s interactional justice received from his or her manager can affect sub-
ordinates’ interactional justice received from their supervisor (Ambrose et al. 2013).
Similarly, the effects of justice and fairness perception can trickle out to people
outside the organization, trickle up from subordinates to managers, trickle in from
customers to employees, etc. Several ideas about the underlying mechanisms have
been discussed. One idea is that middle managers imitate the behavior of upper
management through social learning. Another idea is based on social exchange
theory, such that employees who feel treated fairly by their organization want to
reciprocate and return the favor to the organization by treating clients more fairly. A
third idea is that behavior is more affect-laden, such that a middle manager who feels
unfairly treated and as a result is frustrated and angry, will displace this aggression
and target subordinates with violations of justice rules as subordinates are less
powerful and lower in the organizational hierarchy. Empirical tests points to the
validity of all of these three ideas depending on what type of justice and behavior is
investigated (Wo et al. 2019).
To conclude, justice and fairness are important topics for individuals, organiza-
tions, and the wider society, as justice and fairness perceptions are related to a variety
of work- and health-related outcomes. Studies have shown that justice and fairness
affect not only the direct receiver of the treatment but also have importance for
colleagues, family members, and customers. In the next part, we focus on how
organizational justice and fairness at work during organizational change.
298 C. Eib et al.

Fairness at Work and Organizational Change

Organizational changes can take many forms, and there has been extensive debate in
the change literature on how to best classify them. Organizational changes can be
continuous or not, planned or emergent, leading to a transformation or adaption,
need to take place urgently or over long time, and can be implemented with varying
degrees of participation (Maes and Van Hootegem 2011). Depending on the attri-
butes of the organizational change, individuals may face a range of consequences.
For example, downsizing or mergers can involve layoffs with more part-time or
temporary staff hired instead. There may be changes to work groups and manage-
ment structures, and the workload may increase to make organizations more effec-
tive. However, the change may also lead to better job and career opportunities,
learning possibilities, or new work practices that are more functional and better
match changed needs. All of these examples imply that organizational changes, in
one way or another, affect organization’s resource allocations, policies, or proce-
dures. Therefore, organizational justice and fairness at work are important aspects
for the successful management of organizational change.
This part of the chapter focuses on the relevance of organizational justice and
fairness at work in times of organizational change. We present the relevance of, and
change in, justice and fairness perceptions relative to three time points: before the
organizational change is implemented, during the organizational change, and when
organizational outcomes become evident. Naturally, it is easier to point out the
before, during, and after in a planned change program, whereas these phases may
be less distinct in a continuous process of organizational improvements and adjust-
ments. Furthermore, the pre-change time is often more distinct, whereas the time
during and after change can be difficult to separate, since changes often are
implemented stepwise in an organization. Figure 3 illustrates the relevance of
various aspects of justice along the proposed time line and serves as a guide to
structure this part of the chapter. Our literature review is not exhaustive but summa-
rizes and discusses the empirical evidence that spans across different aspects of
organizational justice and fairness perceptions in various types of organizational
change processes.

Fig. 3 Relevant fairness-related factors in the organizational change timeline

15 Fairness at Work 299

Fairness at Work Before the Change

The announcement of organizational changes creates high levels of uncertainty and

worries ranging from the rationale behind the change, the process of implementation,
to employees’ concerns about their future responsibilities and career prospects
(Burke 2011). Uncertainty is an aversive state that motivates employees to search
for information to overcome that state (van den Bos and Lind 2002). The uncertainty
management model (van den Bos 2001; van den Bos and Lind 2002) poses that
fairness is important for employees, because it helps them handle uncertainty. The
model is based on its predecessor, the fairness heuristics theory, which states that
employees face a “fundamental social dilemma” (Lind 2001) in that they contribute
to an organization with their skills and resources but run the risk of getting exploited
in turn. This dilemma of not knowing whether to trust management is unsettling to
employees and creates the desire to solve that predicament. It has been suggested
that employees use their fairness perceptions as a heuristic to decide whether to trust
the organization (Lind 2001). In other words, perceiving fairness helps employees in
times of uncertainty, since it removes the uncertainty or reduces much of the
discomfort that uncertainty otherwise entails (van den Bos and Lind 2002). Empir-
ical evidence generally supports the uncertainty management model. For example,
one US study found that employees reported the lowest job satisfaction when they
did not perceive their organization to adhere to justice rules and in addition to that
performance expectations were unclear and uncertain (Diekmann et al. 2004). In a
Finnish study, sickness absence spells were highest among women who perceived
low procedural and low interactional justice as well as experienced recent organiza-
tional changes in the organization as negative (Elovainio et al. 2005). In a similar
study, the authors found that low procedural and low interactional justice was
associated with more stress symptoms and emotional exhaustion when employees
perceived higher levels of job insecurity (Kausto et al. 2005).
A recent study (Matta et al. 2017) put a slightly different spin to the relevance of
uncertainty by showing that consistently unfair treatment can be less stressful to
employees than being treated inconsistently fairly, i.e., some days fairly and other
days unfairly. Specifically, employees who had larger variations than others in their
overall fairness perceptions experienced more daily stress on days where they
perceived more uncertainty at their work. Employees who perceived less variability
in their overall fairness perceptions over the period of 3 weeks reacted with less
stress ratings on days with higher uncertainty at work. That means, fairness is
relevant to understand employee reactions in circumstances without organizational
change and uncertainty, but it might be even more relevant when organizations
undergo change. Even when the change has not been started but only announced,
fairness matters for how employees will think about upcoming changes, that is,
fairness perceptions are relevant for forming anticipatory justice perceptions.
The role of anticipatory justice (the expectation whether one will experience
justice in relation to a future event) is particularly relevant for organizational
changes. When an organizational change is first announced or rumored about,
employees form expectations about the fairness of the change (anticipations), and
300 C. Eib et al.

these will impact change-related attitudes and behaviors. For instance, perceiving
procedural and interactional justice (as combined measure) during the planning
phase of an upcoming change increased trust and intentions to stay with the organi-
zation (Korsgaard et al. 2002). Furthermore, the past overall fairness perception can
shape employees’ anticipatory justice perceptions. In a study before and after a
smoking ban was implemented in a hospital, it was found that overall supervisory
fairness had positive associations with anticipatory justice perceptions, which, in turn,
shaped experienced justice perceptions (Rodell and Colquitt 2009). Anticipatory
justice perceptions were related to post-change justice perceptions, and these relations
were stronger among employees who judged the organizational change as less
favorable and creating more uncertainty about their future in the company.
In sum, in the start phase of an organizational change, fairness at work is
particularly relevant because employees are confronted with a lot of uncertainty.
When employees perceive fairness at the workplace, this will guide their attitudes
and behaviors to the change; it can help reduce resistance to change and increase
support for and commitment to change.

Fairness at Work During and After the Change

Employees who feel treated fairly during an organizational change develop positive
change-related attitudes and behaviors and report better well-being. Those who feel
that organizational decisions and treatment from management are unfair will experi-
ence negative emotions, withdraw their support for the change, and may even have a
desire for retribution (Folger et al. 1999). Here, equity theory that originally was
formulated by Adams may be an appropriate approach to guide our understanding of
employees’ reactions to perceived distributive (in)justice (Adams 1965). The basic
idea of equity theory is that employees attempt to strike a balance between the input
they give in their work and the output they receive in return in comparison to some
kind of referent (e.g., a colleague at the workplace, a friend who works in a similar
position for another organizations). If the ratio of inputs and outputs to the referent is
equal, fairness is perceived. If the ratio is unequal, employees are motivated to
establish equity through cognitive or behavioral means. Cognitive strategies may
include modifications to the choice of referent (e.g., they may choose another col-
league for comparison). They may also modify their perceptions of inputs and outputs
(e.g., they may remind themselves that they also got an extra bonus or that their
colleague had taken over extra work duties). Behavioral strategies can include turn-
over, withdrawal, or resistance to change but also theft and sabotage. One can assume
that employees are used to a status quo in their work life, and that status quo is deemed
as at least partly legitimate (Folger et al. 1999). Organizational change often means
that employees have to adapt to new procedures or tasks, to learn new skills or
software, or to participate in the change program, while maintaining profitability or
service quality. If this means that employees have to increase their input without
simultaneously increasing their output, employees may perceive the organizational
change as unfair. Alternatively, if organizational change leads to a new balance
between increasing inputs and outputs to comparable others, by, for instance, creating
15 Fairness at Work 301

better distribution of work, better job conditions, and increased flexibility and oppor-
tunities to grow, employees are more likely to view organizational changes as fair.
Perceptions of distributive justice in relation to change have been found to associate
negatively with cynicism to change and positively with commitment to change among
employees (Bernerth et al. 2007; Foster 2010; Fuchs and Edwards 2012).
Justice perceptions that pertain to the fairness of procedures and social interac-
tions have also been proposed as highly relevant for organizational change pro-
grams. During organizational mergers, for instance, employees’ cooperation is
warranted, yet their identities are often threatened and need to undergo change.
The group engagement model (Tyler and Blader 2003) proposes that fairness in
procedures and interactions provides individuals with information that they are
valued group members; it communicates respect from others, which increases
identification, commitment, cooperation, and engagement. In a merger of two
governmental agencies, it was found that the pre-merger status of the two organiza-
tions was of vital importance to the results (Lipponen et al. 2017). The authors
argued that lower status members are more sensitive to justice information, more
uncertain about the treatment they will receive, and also more concerned about
exploitation. Indeed, for the employees who worked at the organization with the
lower pre-merger status, fairness perceptions during merger process had stronger
associations with post-merger identification with the new organization. Several other
studies have found similar results, such that fairness during a merger plays a critical
role for post-merger identification (Amiot et al. 2007; Gleibs et al. 2008; Tyler and
De Cremer 2005). A variety of studies with different methodologies, participants,
and organizational change types provide empirical support that procedural, interper-
sonal, and informational justice relate to change attitudes and behaviors. For
instance, among German academics, procedural justice of the change implementa-
tion was positively associated with affective commitment to the change over time
through organizational identification (Michel et al. 2010). In a Finnish study follow-
ing a relocation, procedural justice with reference to the organization and interac-
tional justice with reference to the supervisor both helped reduce perceptions of
stress and threat associated with the change (Koivisto et al. 2013).
In sum, organizational changes often provide a threat to employees as many
organizational changes are not necessarily viewed as creating better conditions for
employees. However, independent of the valence of the organizational changes,
studies consistently show the attenuating effects of managing the change process in a
fair way and communicating in a respectful and truthful manner.

Change and Stability in Fairness Due to Organizational Changes

Above, we have already hinted at the fact that organizational changes may also mean
that perceptions of justice and fairness, even if they initially may guide expectations,
are subject to change. To better understand how changes of justice or fairness
perceptions come about, we will first further elaborate on a particular aspect within
fairness heuristics theory. The theory proposes two different phases (Lind 2001).
During the use phase, overall fairness perceptions are used to guide behaviors,
302 C. Eib et al.

incoming information is assimilated, and specific justice dimension perceptions are

formed in line with the overall fairness heuristics. The original idea was that fairness
heuristics remain relatively stable once formed, because a heuristic would be less
valuable when it needs to be revised too frequently. That means, unless circum-
stances prompt employees to revise their fairness perceptions, fairness perceptions
are relatively stable, and employees rely on them as a guide for their behavior toward
the organization. They “use” their justice perceptions without questioning them or
evaluating them all the time. The second phase proposed by fairness heuristics
theory is the judgment phase, which is the stage in which individuals form their
fairness perceptions. For that, they use available justice-relevant information from
interactions, procedures, or distributions to create a new overall fairness perception.
Individuals switch between the use and the judgement phases in a phase-shifting
process. Such a process can be elicited by events that force employees to reconsider
their overall fairness heuristic and potentially form a new one. The likelihood that
employees change their overall fairness perceptions increases when an event is
highly unexpected, important, or unfavorable, such as a large organizational change
(Jones and Skarlicki 2013). In an empirical study during a merger, Soenen and
colleagues studied what makes employees change from use phase to judgment phase
(Soenen et al. 2017). It was found that employees were more likely to shift phases
when they viewed the merger as a fundamental rather than as minor change. In
addition, in the same study, it was found that the likelihood to switch from use to
judgment phase is higher when employees perceived their colleagues to not support
the change and when their individual disposition was characterized by low cognitive
rigidity. Furthermore, when the merger was perceived as a phase-shifting event, new
fairness perceptions were formed. That is, pre-change fairness perceptions were not
used to inform expectations about the fairness of the organizational change.

How Can Organizations Manage Fairness Effectively During

Organizational Changes?

Before concluding this chapter, we want to give some final pointers that are relevant
when working with fairness at work in practice. As is true for most topics within the
organizational psychology literature, there is not one recipe or one-size-fits-all
approach on how to create fair workplaces. However, we are able to highlight a
few important conditions that seem to alter the effect justice can have on attitudes,
behavior, and health and to provide information about a few available intervention
studies that illustrate how fairness may be changed in organizational contexts.

Boundary Conditions

As is true for much in psychology, individual and situational factors interact in

producing behavior. To date, there is no comprehensive overview of the entire
literature of individual and situational moderators of justice effects. Hence, we
provide only a few examples of a much broader literature.
15 Fairness at Work 303

The organizational justice literature has long maintained that fairness matters to
everyone. There are, however, differences between people that affect how treatment by
organizational representatives is perceived, how justice perceptions are construed, and
how individuals react to justice perceptions. In the following, we highlight individual
factors, such as gender and personality, but also workplace-related factors to exemplify
boundary conditions that moderate the relationship between justice and its outcomes.
Gender and organizational justice have quite a complex and nuanced connection that
is impacted by socialization, inequity between genders, and gender norms. Early studies
on the role of gender for justice effects maintained that women will care more about
procedural justice and men more about distributive justice, with the reasoning that
procedural justice addresses relational concerns, which are more important for women
than for men (Sweeney and McFarlin 1997). Both the evidences for the differential
importance of the justice dimensions to women and men are mixed and not conclusive,
as well as explanations for potential gender differences are under debate. For instance,
Bell and Khoury (2016) argued that women may be more sensitive to procedural justice
because they are aware of systemic gender inequality that still exist in society and at
workplaces. The authors showed that women who perceived higher levels of procedural
justice also perceived less powerlessness and less dehumanization at work compared to
men, which, in turn, was associated with lower turnover intentions.
Various personality differences have also been found to make a difference for
justice outcomes. For instance, for individuals with a higher sensitivity to justice
aspects, associations between justice perceptions and well-being outcomes have
been found to be stronger (Schmitt et al. 1995). Associations between justice
perceptions and performance are also stronger for individuals high in risk aversion
and high in trait morality (Colquitt et al. 2006). Another study found that individuals
high in dispositional negative affect and low in agreeableness are more likely to
retaliate against their employer when they feel unfairly treated (Skarlicki et al. 1999).
A variety of workplace-related factors have been studied for their impact on justice
reactions, for instance, culture, organizational structure, and job characteristics. A meta-
analysis found that justice perceptions had stronger effects on work-related outcomes in
national cultures characterized by individualism, femininity, high uncertainty avoidance,
and low power distance (Shao et al. 2013). The organizational culture also matters for
the strengths of justice effects. One US study found that employees are more sensitive to
procedural justice in organizations that are more bureaucratic and formal than in
so-called organic organizations. In organic and more informal organizations, interac-
tional justice showed to be more influential for creating a positive relationship with the
organization (Ambrose and Schminke 2003). Another study found that the associations
between low overall fairness to intentions to stay and physical health were buffered by
high levels of job control and social support from colleagues (Eib et al. 2015a).

Intervention Studies

Within the organizational justice literature, there are a few intervention studies,
which focused on increasing justice perceptions for employees, training managers
to be more fair, and helping employees manage their reactions to unfairness.
304 C. Eib et al.

As part of a cost-cutting program, manufacturing workers faced a long-term

pay freeze (Schaubroeck et al. 1994). Half of the employees participated in a
workshop on stress (control group), and the other half participated in workshops
designed to provide information about the pay freeze (treatment group). Specif-
ically, information included that management attempted to spare employees
from layoffs due to intense economic pressure facing the company, that all
employees were equally affected by the pay freeze, and how management
communicated the decision in a respectful and unbiased manner. The
researchers found that work-related attitudes did not differ between treatment
and control group when participants reported low economic hardship due to the
pay freeze. When participants reported that the pay freeze created economic
hardship for them, job satisfaction, organizational commitment, and intentions
to stay were lower for the control group, whereas levels of work-related attitudes
stayed the same for the treatment group. In other words, employees were helped
handling the unfavorable nature of the organizational change when they
received thorough explanation and rationale for decisions and clear communi-
cation regarding the procedures for the decision-making. A different study
basing its intervention on equity theory showed that positive effects of the
intervention on reduced rates of burnout, absenteeism, and inequity between
inputs and outputs can last for at least 1 year (van Dierendonck et al. 1998).
There are also a few interventions attempting to change managers’ behaviors. In
two hospitals in the USA, the payment scheme was changed for nurses, which
resulted in a substantial decrease in mean pay. Nurses’ sleep problems were
recorded and compared to a control group of nurses without a payment scheme
change. Results showed that nurses who received less pay due to the change
reported an increase in sleep problems. The levels of sleep problems were atten-
uated and decreasing over time among those nurses whose managers received
interactional justice training (Greenberg 2006). In another intervention study,
training in procedural and interactional justice of trade union leaders increased
union members’ reported organizational justice perceptions and citizenship behav-
iors (Skarlicki and Latham 1996). These two studies highlight the relevance of
training managers in the area of justice. At the same time, it is unclear what the
mechanisms are of why these interventions worked. As a result of the interven-
tions, managers may act more fairly, or they were more confident in taking up
difficult topics with their subordinates. The new rise in studies on justice enactment
(see Box 1) can help uncover what can be done to support managers and to
understand how justice training of managers can transfer to justice perceptions of
employees.
In intervention studies focusing on the individual, expressive writing about an
unfair work experience in a structured manner over several occasions increased
individuals’ reported well-being and facilitated forgiveness (Barclay and Saldanha
2016; Barclay and Skarlicki 2009). Another recent study found that participants who
underwent a gratitude intervention for 2 working weeks, as compared to a control
group, had increased self-control resources, which, in turn, related to fewer incivility
and mistreatment to colleagues at work (Locklear et al. 2020).
15 Fairness at Work 305

Summary

The empirical evidence is very strong that organizational justice and fairness at work
matter to all individuals, yet to slightly different degrees. Fairness at work is
positively associated to job satisfaction, commitment to change, performance, and
organizational citizenship behaviors. It is also related to long-term mental health,
reduced sickness absence, and a variety of well-being indicators. Moreover, fairness
at work is shared between organizational members; fairness affects team members,
managers, as well as family members, customers, and suppliers. Fairness at work is
particularly a concern for employees and management before, during, and after
organizational changes. Fairness can bind people together to work effectively and
increase well-being. The rules of justice outlined in the four dimensions of justice
perceptions can help design organizational processes that are more fair. And even if
organizations have to take decisions that are unfavorable to employees, having fair
procedures, thorough information and respectful communication, helps buffer poten-
tial negative consequences. Fairness perceptions are malleable and can be changed
for the better or worse. There is compelling evidence for the role of justice and
fairness in the workplace, but more research is needed to better understand the
dynamic nature of fairness perceptions over shorter and longer time spans, mecha-
nisms behind justice interventions, and more evidence on how to support managers
in adhering to justice rules and enacting fairness.

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 Part III
Human Resource Management Practices and
Wellbeing
Work-Based Learning and Wellbeing
16
David Watson and Olga Tregaskis

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314
The Scope and Definition of Learning at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Theorizing Wellbeing and Learning at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Benefits and Trade-Offs: Learning for Wellbeing in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . 319
Implementing Learning for Wellbeing at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Conclusions/Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326

Abstract
Learning is widely considered to support wellbeing and is therefore treated as a
high societal priority. In the workplace learning is considered core to the success
of individuals and organizations yet is not typically considered in terms of its
relation to wellbeing. Rather learning is viewed as fundamental to work compe-
tence, innovation and competitive advantage, justifying investment in Human
Resource Development (HRD). While a broad range of theory and empirical
research has explored wellbeing at work, learning remains peripheral to these.
Evidence suggests that learning can act as a buffer to the demands and strains of
work whereas restricted opportunities for learning are likely to form part of a
negative work environment for wellbeing. However, the relationship between
learning and wellbeing is not always positive and much more work is required to
unpack the relationship between learning and wellbeing in the workplace. This
chapter reviews literature on work-based learning and wellbeing drawing out
practical implications, while also making the case for further research and
practical attention to this topic.

D. Watson (*) · O. Tregaskis

Norwich Business School, University of East Anglia, Norwich, UK
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 313

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_14
314 D. Watson and O. Tregaskis

Keywords
Work-based learning · Wellbeing · Human resource development (HRD) ·
Human resource management (HRM) · Informal learning · Formal learning ·
Training · Productivity

Introduction

There exist a “bewildering array” of models for understanding work-based learning

(WBL) arising from the variety of theoretical perspectives, methodologies, fields of
study, contexts and differing perspectives of organizational actors (Manuti et al.
2015, p. 3). Likewise the study of WBL in relation to wellbeing is fragmented
(Tikkanen 2005), with a variety of disciplines or fields of study being concerned with
learning in organizations, such as Adult Education, Organisational Psychology, and
Human Resource Management (HRM). The literature on wellbeing in the workplace
is itself similarly vast and therefore the aim of this chapter is not to set out a specific
model mapping out the different features of WBL and how it relates to wellbeing, but
to review some of the literature that is relevant to understanding the connection
between these two areas.
The first section stakes out some boundaries for the chapter in defining learning at
work, considering how it has been conceptualized. Although it is a relatively brief
overview, it is important to establish how we think about learning in relation to work
since it has major implications for how it relates to wellbeing. For example, consider
learning in formal work-based training programs in comparison to the informal learning
that takes place through the course of work, the former is a much more limited context
and incorporates processes and outcomes liable to be quite different to the latter. This is
not to suggest that one or the other is more important for wellbeing, but what is
considered as WBL necessarily has an impact on how it relates to wellbeing.
Section 2 reviews some of the more common models of stress and wellbeing at
work with a view to identifying features of those models that are particularly relevant
to WBL. It is surprising that a widely held assumption that learning is associated
with wellbeing and vice versa (Watson et al. 2018) has not really been explored
extensively in the organizational literature. Much of the research on wellbeing at
work originates from the field of Human Resource Management (HRM), yet despite
the close relationship with the field of human resource development (HRD) there has
been little cross-fertilization with studies of learning and wellbeing in the workplace
few and far between (Tikkanen 2005). However, conceptualizing wellbeing at work
and different theoretical perspectives offer some starting points for thinking about
how learning connects with wellbeing. For example, evidence suggests that job
satisfaction, which is perhaps the most widely used measure of wellbeing at work, is
influenced by learning opportunities, the how of this relationship is less clear –
learning might influence job satisfaction by enhancing organizational commitment
(Wang et al. 2010) and/or increasing work competency through the transfer of learnt
skills (Egan et al. 2004).
16 Work-Based Learning and Wellbeing 315

Building on the previous section, the third section of the chapter focuses on
evidence that supports a link between WBL and wellbeing and the nature of the
relationship. Despite a general dearth of studies investigating WBL and wellbeing
those studies which do exist are informative and also identify some trade-offs
between learning and wellbeing. While learning can be considered as key to building
resources that help workers to meet the demands of work, the requirement for
learning can also be seen as ongoing demand in itself. Furthermore there is a tension
in the purpose and outcomes of WBL when driven by individual success versus
organizational success. Understanding the link between both WBL and wellbeing
with performance and other organizational priorities is therefore key. Notwithstand-
ing the limited amount of literature explicitly looking at wellbeing and WBL this
body of work is illuminating and suggests a path forward for further research as well
as having practical implications.
The fourth and final section considers how the literature can inform organiza-
tional practice in relation to WBL and wellbeing. Despite the acknowledged impor-
tance of learning in the modern workplace, little organizational practice is informed
by understanding of research. Furthermore there remain significant gaps in under-
standing the relationship between WBL and wellbeing that if addressed could
helpfully develop organizational practice. The body of literature that explores
WBL and wellbeing is small and disparate, but can provide some guidance for
practice. There are potential benefits from more actively shaping WBL with
wellbeing in mind although research indicates that wellbeing cannot be assumed to
arise from WBL. This section provides some guidance for practitioners in organi-
zation, but it also acknowledges that much more work is required from researchers to
develop theory and the evidence base that can inform WBL in practice from a
wellbeing perspective.

The Scope and Definition of Learning at Work

Work and learning have historically been considered as separate categories, work
consists of producing or doing things that enable individuals to earn a living whereas
learning occurs prior to work and is concerned with education in order to prepare a
person for work (Boud and Garrick 2000; Clark et al. 2019). This old fashioned view
of learning at work as limited to some initial on the job training, has long ceased to be
relevant as the boundaries between work and learning have dissolved and learning
has become more central to work (Cunningham et al. 2004; Manuti et al. 2015). The
heightened importance of WBL is due in no small part to the changing nature of
work. Increasing digitalization, continuous organizational change and high cognitive
demands of many workplaces necessitate continuous learning (Lemmetty and Collin
2020). The shift from long-term employment with the same employer to shorter-term
employment with a succession of organizations and portfolio working also mean that
WBL has become more fluid and connected with individual employability (Fenwick
2004; Manuti et al. 2015). The way in which changes to work have emphasized the
importance of WBL means that there has also been increased attention on informal
316 D. Watson and O. Tregaskis

learning at work, which is considered to be more responsive to worker needs (López

2020; Schwartz 2019).
There are a variety of definitions of WBL, but in general terms it means any
experiential activity undertaken with the purpose of acquiring the competencies or
resources intended to meet current and future work demands, including engaging in
formal training programs or education and development courses and activity outside
of these programs (Jacobs and Park 2009, p. 134). Within this definition is the well-
trodden distinction between formal and informal learning that there has been much
discussion of in the literature (see Manuti et al. 2015 for a review). What is
considered informal learning constitutes a significant part of learning in the work-
place, much of what people learn through their work occurring on the job and outside
of structured learning environments, yet many businesses remain focused on formal
learning (Manuti et al. 2015). The distinction between formal and informal learning
has been conceptualized in a range of ways, with Sambrook (2005) describing the
difference between learning at work (formal) and learning in or through work
(informal) as well as noting that learning outside of work can also be relevant for
work. Other authors have distinguished different types of informal learning or
adopted different terms such as non-formal, which has been used to describe any
WBL that is not formal (Eraut 2000) and learning that remains structured, but takes
place outside of educational institutions (Kyndt et al. 2009). Different types of
informal learning which are less intentional and more implicit or absorbed through
organizational culture have also been referred to as incidental (Marsick et al. 2008)
and or tacit (Eraut 2000).
This discussion of definitions highlights the divergence in how WBL is concep-
tualized and the broad range of ways in which people learn in organizations. Workers
can be removed from the working context to undertake formal training, but much
learning occurs through interaction with colleagues, mentoring, and professional
networks. Not all of this learning is explicitly planned and nor might workers be
fully aware of how or why they are learning and what the outcomes are. While there
is some variation in how learning is described, with some seeing this as more of a
spectrum (Lukosch and de Vries 2009), typically though WBL is described in binary
terms of formal and informal with some variation in terminology (Manuti et al.
2015). However these attempts to put different forms of WBL into specific models
with set definitions somewhat ignores the diverse and multiple ways in which people
learn in organizations. Billett (2002) therefore argues that this binary categorization
is unhelpful and that learning should be regarded as a social practice, where what is
considered formal or informal are simply different instances of social practices. This
broad understanding of WBL sees work as a learning environment and recognizes
the structured nature of workplaces, shaped by norms, values and practices which
determine learning opportunities and are often intentionally shaped around learning.
Using the example of hairdressing Billett (2002) shows how two workplaces in the
same industry create very different learning pathways according to the structure of
workplace practices as determined by organizational values and models of business.
This underlines the importance of organizational priorities in shaping learning,
particularly performance which is also important in influencing HRM practices
16 Work-Based Learning and Wellbeing 317

and in turn employee wellbeing (Cook et al. 2016). Furthermore it points to a tension
between individual goals of development by learning through work practices and
organizational goals of performance and continuity in practices (Billett 2002), a
tension which is also reflected in the pursuit of individual wellbeing through work
despite “mutual gains” perspectives (Ho and Kuvaas 2020; Guest 2017).
It is clear then that the organizational context is important in shaping WBL.
Factors such as work demands, performance management systems and targets,
organizational structure and culture all influence how individuals learn (Sambrook
2005). Although these factors should not be regarded as deterministic, since indi-
vidual agency also determines how people interact with the organizational context
for learning (Billett 2002). The role of organizational context in learning has also
been considered through organizational learning and the concept of the “Learning
organization” which was popularized by Senge (1990). However, this concept has
been highly ambiguous in its interpretation and application (Bartell 2007; Örtenblad
2004) making evaluation of efforts to create learning organizations difficult and rare
(Watson et al. 2018; Kiedrowski 2006). In general terms research exploring learning
organizations and organizational learning are concerned with how organizations
prioritize, develop and facilitate learning with academic and practical interest
being driven by the same trends as those driving increased attention to WBL more
generally: The decline of the industrial age with associated command and control
management techniques and the rise of the information, digital society and the need
for flexible and less hierarchical organizations (de Vries and Lukosch 2009;
Kiedrowski 2006). While explicit evaluation of learning and wellbeing in organiza-
tions is limited, discussion of the conceptualization of WBL suggests that both how
the individual experiences WBL and how the organization approaches it are likely to
be important for wellbeing. Considering further how wellbeing has been theorized in
organizations is helpful in thinking about the role learning plays.

Theorizing Wellbeing and Learning at Work

The body of literature dedicated to the study of wellbeing in the workplace is large
with a range of theoretical perspectives. While there has been little attempt to
explicitly theorize WBL and wellbeing in a particular model, wider literature
suggests learning influences wellbeing (Jenkins and Mostafa 2015; Duckworth and
Cara 2012). Although the question of how learning and wellbeing are defined is
critical in determining how the relationship between the two is understood (Michalos
2008) with evidence suggesting that informal learning may be more important in
influencing wellbeing than formal education (Jenkins and Mostafa 2015; Dolan et al.
2012). In general though learning is considered to contribute to wellbeing in a range
of ways (UNESCO 2016; Michalos 2008) and this is reflected in various approaches
to wellbeing at work that incorporate elements connected to WBL.
One of the most commonly applied frameworks for exploring wellbeing at work
is the Job Demands-Resources (JD-R) Model (Lesener et al. 2019; Schaufeli and
Taris 2014). The JD-R model looks at job characteristics conceptualizing them as
318 D. Watson and O. Tregaskis

demands – aspects of a job that require physical or mental effort, and resources –
aspects of a work that reduce demands, support personal growth or development and
underpin job competence, enabling employees to achieve work goals (Schaufeli and
Taris 2014, p. 45). In this respect WBL might be thought of as a resource in that it
supports personal development and worker competence in their job role, moreover
learning is also integral to the functioning of other job resources like feedback and
supervisor support, which enable employees to learn and improve in their jobs,
fostering engagement (Bakker and Demerouti 2007). In this respect learning can be
seen as important in the operation of JD-R model as well as individual experience of
demands and resources in the workplace.
Although demands are typically considered to be negative for wellbeing, not all
demands are experienced in the same way and are experienced differently by
individuals – they are qualitatively different and individual experience and percep-
tion varies, the same is also true for resources. Consider autonomy in work, which is
associated with engagement and considered a resource in the JD-R model (Lesener
et al. 2019). While for some individuals autonomy may provide an opportunity to
learn though work, without support and time for WBL, this autonomy may be
experienced as stressful. On the other hand, workload and responsibility are usually
considered demands, but might also be experienced as “challenges” to be overcome,
which promote personal development and mastery (Schaufeli and Taris 2014). The
nature of learning is somewhat problematic for models of wellbeing or stress in the
workplace that take a relatively narrow view of wellbeing, in that learning can be
experienced as demanding or challenging, yet also considered rewarding in
supporting development. Furthermore, what view is taken will likely depend on
individual factors, the wider work environment and the point in time. For example
learning which is experienced as difficult and demanding in one moment might later
be regarded quite differently.
In Karasek’s (1979) Job Demands Control (JD-C) model from which the JD-R
model originates learning is also important and jobs that combine high demands with
a high degree of control are theoretically likely to produce higher job satisfaction
because of opportunities to learn and achieve mastery of a particular job (Kwakman
2001), although empirical findings underline a more complex and mixed picture
(Kain and Jex 2010). Both the JD-C and JD-R models are about balance and in
particular the employees ability to balance positive and negative work factors in their
daily experience of work. This balance is also captured in the Effort Reward
Imbalance (ERI) Model (Siegrist 2017) and connects with a key strand of research
on personal resources that links all of the stress models discussed here. This strand of
research explores employees’ ability to develop personal resources that enable them
to cope with their working environment and maintain resilience (Schaufeli and Taris
2014). Clearly these resources have a very direct connection with wellbeing and the
management of stress in the workplace, and as a result organizations have used
training interventions to foster the development of such resources, such as mindful-
ness training, which has become increasingly popular (see Lomas et al. 2017 for a
review). It is in the assessment of training programs like this that arguably the most
thorough evaluation of learning and wellbeing in the workplace has taken place
16 Work-Based Learning and Wellbeing 319

(Watson et al. 2018). While evidence does suggest that such training can be effective,
this barely scratches the surface in terms of thoroughly examining the relationship
between WBL and wellbeing, since there is much learning that takes place outside of
formal training programs that is important for employee wellbeing.
It is quite clear that learning plays an important role in various models of
workplace stress and wellbeing. Learning is also important in other classic and
widely applied models of workplace wellbeing, such as Warr’s vitamin model
(Warr 1987, 1990) and the job characteristics model (Hackman and Oldham
1975), both of which posit that the existence of particular characteristics or “vita-
mins” that support wellbeing at work. These perspectives attribute importance to
skill utilization, task variety, autonomy among other resources, yet pay little atten-
tion to theorizing WBL, which has also been largely absent from the wider literature
on stress and wellbeing in the workplace. At the same time the volume of research
drawing attention to the importance of learning at work for individuals and organi-
zations has been expanding rapidly, but has largely overlooked the interplay of
wellbeing with WBL. However there does exist research exploring both, which
can also point to a further agenda for research (and practice) in WBL and wellbeing.

Benefits and Trade-Offs: Learning for Wellbeing in the Workplace

As noted in the previous two sections, how wellbeing and learning at work is defined
shapes our understanding of how they relate to one another. It is also important to
understand influence of other organizational objectives, in particular performance or
productivity, which remains an important priority for organizations if not the most
important. Learning is believed to be central to innovation and productivity gains for
organizations (Salas et al. 2012; Park and Jacobs 2011; Aguinis and Kraiger 2009;
López et al. 2005). The dividend that investment in employee learning pays has
therefore been considered predominantly from the gains it supports in employee and
organizational performance, a perspective consistent with a resource-based view of
the firm. The resource-based view sees investment in HRM – and therefore HRD as a
key source of competitive advantage for organizations (Felstead et al. 2015). There is
a well-established literature exploring the mutual gains that can be realized for
performance and wellbeing through investment in HRM (see Ho and Kuvaas
2020; Jo et al. 2020 for recent examples). However, despite the connection with
HRD and WBL there is much less research exploring the mutual gains that might be
fostered through investment in WBL, moreover the role of learning within the debate
around mutual gains has been overlooked.
Notwithstanding the theoretical importance of learning in a range of workplace
wellbeing and stress models, these models seem to be much better equipped to
measure stress than assess the role of learning in the workplace (Kwakman 2001).
More close attention to the role of WBL in assessing employee wellbeing and
performance (both independently and as mutual gains) can be revealing. As
observed by Ho and Kuvaas (2020), the relationship between implementation of
HRM practices considered likely to support employee wellbeing cannot be assumed
320 D. Watson and O. Tregaskis

to be overwhelmingly positive nor can it be assumed to impact on different aspects

of wellbeing equally. The alignment of learning opportunities and individual moti-
vation and interest in learning is likely to be important for both performance and
wellbeing (Felstead et al. 2015) although individual and organizational priorities
may not always be in sync (Jacobs and Park 2009). An employee who finds
themselves in a work situation that is demanding, but provides a high degree of
control and opportunity to learn may find this work rewarding and satisfying.
However, they may experience more anxiety as a result of the challenges posed
through work, although an employee who does not experience these challenges may
report less stress or anxiety yet find work unfulfilling, although much may depend on
their individual learning disposition and ambition. While significant gaps in the
literature on WBL and wellbeing limit our understanding, some trends are well
established.
Organizations that provide extensive opportunities to learn tend to be associated
with positive work outcomes (Felstead et al. 2015). Rowden and Conine (2005)
report a significant association between the provision of learning opportunities and
job satisfaction arguing that those organizations which prioritize learning resources
and opportunities see wellbeing benefits. Researchers have also identified an asso-
ciation between learning culture and job satisfaction (Egan et al. 2004), as well as
affective wellbeing (Rebelo et al. 2017). This association is unsurprising given that a
strong organizational learning culture is seen as being underpinned by a focus on
people, promotion of co-operation and communication among other features
(Rebelo et al. 2017; Marsick and Watkins 2003). Research highlighting the associ-
ation between learning climate, culture and opportunities at the organizational level
and individual wellbeing outcomes suggest that learning is a good thing for
employees, however this research explores proxies for learning rather than the
impact of learning directly (Huo and Boxall 2020). Much of the research is also
cross-sectional, reporting associations rather than providing strong evidence of
causal mechanisms and obscuring individual differences. As a result theorizing the
relationship between WBL and wellbeing remains challenging, much of it being
limited to particular models of stress and wellbeing (as discussed above).
As Felstead et al. (2015) observe individual fit with the learning environment is
important in determining outcomes, but is predominantly confined to the study of
other forms of learning not WBL. Felstead et al. (2015) highlight individual factors
than can be associated with an increased likelihood of learning in organizations that
offer “expansive” learning experiences. This is in contrast to job roles that offer
“restrictive” learning environments and are associated most with part time work.
This study sheds important light on how different working contexts are likely to
provide environments more or less conducive to learning, moving the literature on
from simply finding associations between positive learning cultures and positive
work outcomes. Those in managerial, professional and associate professional roles
report the strongest motivation to learn, while higher pay, qualifications, and com-
pany size are all associated with increased likelihood of being in an expansive
learning environment at work. Women on average, report less motivation to learn,
but this may reflect gendered attitudes to learning that can be explained by traditional
16 Work-Based Learning and Wellbeing 321

occupational segregation according to gender and expected societal roles (Felstead

et al. 2015). Whereas men in part time work are particularly likely to experience a
more restrictive working environment and the hospitality and retail sectors emerge as
those with the most limited learning opportunities in work. Despite establishing the
importance of individual learning dispositions and their alignment with work situ-
ations Felstead et al. (2015) acknowledge that in general terms expansive learning
environments at work are associated with wellbeing generally.
The evidence suggests that investment in WBL is worthwhile in a general sense,
but this does little to address the question of how different interventions, initiatives,
or organizational approaches to WBL might offer value. It cannot be assumed that
the benefits of learning are additive as Ho and Kuvaas (2020) note in relation to
investment in employee wellbeing; moreover, the constant and continued expecta-
tion of learning can also operate as a work demand (Lemmetty and Collin 2020).
Watson et al. (2018) review the literature on interventions in workplace learning and
wellbeing with the aim of specifically focusing on intentional efforts by organiza-
tions to improve wellbeing through learning. The review shows the concentration of
evidence in the area of training that supports the development of personal resources.
Here the evidence on the impact of this kind of WBL on wellbeing is strong because
it relates directly to models of workplace stress that place emphasis on the develop-
ment of personal resources as a way of coping with stress. Beyond the models
discussed in the previous section, the Conservation of Resources theory posits that
individuals are motivated to build, replenish and protect resources in the mainte-
nance of the self (Hobfoll 1989). Theoretically this suggests self-interest and moti-
vation in this kind of learning is key, but much WBL is informal and individuals do
not always consciously choose to learn in this manner, particularly if the outcomes
are not clearly related to work. Typically learning for personal resources occurs
through formal interventions and the reliance on self-selection and high dropout
rates in many of the studies evaluating personal resources suggests that wider
wellbeing benefits from this kind of WBL is likely to be limited by employees’
motivation to engage in the active cultivation of personal resources (Watson et al.
2018).
The Watson et al. (2018) review also highlighted a greater volume of studies
evaluating of WBL on wellbeing in the health and social care sector, with a general
lack of studies that assess interventions to develop professional competencies for
their impact on wellbeing. Clearly a lot of WBL occurs outside of interventions, but
as Billett (2002) observes, this type of learning cannot necessarily be regarded as
informal or lacking structure because workplaces are organized with a view to how
employees will learn through their work. Organizational effort to facilitate learning
is often undertaken with a view to developing work competencies, but studies
evaluating WBL have tended to focus on learning outcomes or process rather than
organizational context or outcomes (Tikkanen 2005). There is a disconnection
between understanding whether learning within organizations actually translates
into enhanced ability to perform in work as expected and precisely how these
gains materialize and in what context (Van Ruysseveldt et al. 2011). From a
wellbeing perspective this is important, because it is through the enhancement of
322 D. Watson and O. Tregaskis

work abilities and the associated satisfaction with work that learning is thought to
support wellbeing. In this respect theoretical approaches and empirical study that
evaluate WBL alongside wellbeing can also contribute to the debate around mutual
gains, since it is through increased effectiveness in work that learning is also
considered to enhance wellbeing. Whereas critical views of HRM have argued that
employee wellbeing has been considered of secondary importance to organizational
effectiveness (Ho and Kuvaas 2020; Guest 2017).
While the links between learning and positive work outcomes are often assumed
(Rose et al. 2009), there is evidence that supports some of these assumptions. Rose
et al. (2009) while noting the limitations of the evidence base provide support for the
association between organizational commitment and organizational learning oppor-
tunities. Learning opportunities have also been indicated to be associated with better
health outcomes at work (Rau 2006) and act as a buffer against emotional stress
(Proost et al. 2012; Nikolova et al. 2014). However, while job demands can stimulate
learning, they can also frustrate it, in line with theorization according to the JD-R
model cognitive demands can promote learning opportunities whereas excessive
workload is detrimental (Proost et al. 2012; see also Lemmetty and Collin 2020; Rau
2006). The JD-C model places a high emphasis on the level of control people
experience in their work and the interaction of workload with autonomy to respond
to workload is also important in determining benefits of learning opportunities (Van
Ruysseveldt and Van Dijke 2011). Whether excessive workload limits create stress
by frustrating learning opportunities as the JD-C model suggests (Kwakman 2001) is
something that needs to be explored through further exploration of the interaction of
learning and stress or wellbeing in the workplace. Other organizational factors are
then key in shaping positive effects arising from WBL for wellbeing as are other
organizational actors.
Research has indicated that social support of colleagues and supervisors in the
workplace can be important in facilitating learning (Else Ouweneel et al. 2009).
Although colleagues and managers do not necessarily support WBL in the same
way. The relationship between managers and their subordinates is quite different to
that between colleagues, and supervisors play a more central role in determining and
delivering training (Huo and Boxall 2020). Context remains important, as Huo and
Boxall (2020) show in a study examining different responses to learning from
supervisors and colleagues in Chinese organizations. In this context the supervisory
relationship is more important in mediating the relationship between social support
and wellbeing as well as training at work, but in organizational and cultural contexts
where hierarchical relationships are not likely to be as influential findings may differ.
The wellbeing benefits of learning for the individual are not necessarily direct either,
leadership training can be effective for followers, but not necessarily the leader
(Kelloway and Barling 2010). For individuals themselves the benefits of learning
are also not always immediate and may be experienced long after learning has taken
place, supporting personal development in a general sense rather than improving
specific work competencies (Van der Heijden et al. 2016). Therefore it is not only
planned learning that is important in supporting continual development and wellbeing,
but also those “fortuitous encounters” that stimulate learning (Molloy and Noe 2010).
16 Work-Based Learning and Wellbeing 323

It is not just the immediate context that is important in influencing WBL and
employee attitudes toward it, as employees also consider their career trajectory and
future employers in how they engage with learning (Molloy and Noe 2010). This is
unsurprising given the trends that are driving academic and practical interest in WBL
are also creating increasingly insecure jobs and shorter job tenures, raising questions
and potential conflicts of interest for both employers and employees. For employers
this raises the question of whether their investment in learning will be realized by the
organization given the fluidity of careers and mobility of workers. For the employee,
the question is whether the learning an organization facilitates or asks them to
engage in is of real benefit to them or purely the organization. Informal learning
can act as a form of cultural control within organizations by shaping employee
identity and subjectivity in order to align it with organizational priorities and thereby
enable work intensification (Manuti et al. 2015, pp. 8–9). Lases et al. (2019)
conceptualize learning climate as a potentially effective resource, but also point
out the role of the “hidden curriculum” (p. 325) – influences that function at the level
of organizational culture and structure – that may be detrimental to learning and
wellbeing. Reconciling possible tensions between employees and organizations in
the pursuit of wellbeing and learning depends on how WBL is put into practice. A
focus on wellbeing in the design and evaluation of WBL could be significant though.
Wellbeing benefits arising from learning can be experienced in the short term
contributing to organizational performance and thereby offsetting the potential cost
of an employee leaving an organization as they develop. Likewise a wellbeing
benefit at the individual level might also override employee concerns about the
future relevance and applicability of WBL. Both organizational and individual
factors are key then in determining how WBL interacts with wellbeing, Billett’s
(2002) conceptualization of WBL as a social practice is helpful in thinking about
how these factors come together in organizational settings and how WBL should be
implemented.

Implementing Learning for Wellbeing at Work

The discussion of the literature above indicates that there are strong reasons for
connecting thinking about WBL and wellbeing not just in theory, but in practice also.
Much more active consideration of wellbeing in the design of training for work can
have a positive impact on wellbeing, but also on engagement and transfer of the
learning for employees and their organization. For example, where workers consider
themselves to have been subjected to mandatory training which has no clear rele-
vance or resonance with their work environment this is likely to have limited or even
negative impact in terms of learning and wellbeing. For work-based training that is
focused on wellbeing, the link is obvious and many of these programs or interven-
tions measure their impact through wellbeing outcomes (Watson et al. 2018).
Mindfulness, resilience, stress management, and problem solving training are just
a few examples of the kind of wellbeing related training now widespread in the
workplace. While these kinds of training have been shown to have varying degrees
324 D. Watson and O. Tregaskis

of effectiveness, more attention to the theorization of how learning occurs and the
impact of other organizational factors would be beneficial. The expectation that
training staff to develop personal resources that help them cope with stress at work
will be effective hinges on how well a training program engages staff and their
ability to put training into practice in the context of other work demands (see
Lemmetty and Collin 2020).
Much of the formal training undertaken as WBL is not wellbeing focused, yet
taking into account wellbeing is important. It is unlikely that learning will be
effective if it simply places additional demands on workers. Equally if demands
are high and the wellbeing of workers is already low then learning could play an
important role in reducing these, but only if organizations dedicate time and
resources that enable learning to be effective in increasing competency and thereby
reducing demands. This is particularly relevant in contexts of organizational change
or uncertainty, learning may form a key component of dealing with this, but only if
individual and organizational resources can put this learning to use. Investment in
WBL will not reap any benefit if there is not the means to put this learning into
practice through work, therefore the transfer of learning into work practices needs to
be gauged and enabled. Models of work stress suggest that work capabilities link
closely to the demands of the job and therefore efforts to support WBL offer scope
for impact on wellbeing alongside the development of skilled expertise. It is likely
that this holds true for a wide range of occupations and workplaces, but the current
evidence is mainly limited to the health and social care sectors (Watson et al. 2018).
Those few examples that do exist are insightful for practitioners and researchers. For
example, Yamagishi et al. (2008) investigate training that seeks to develop career
identity skills for nurses, which is considered as a cognitive technique to help nurses
more positively self-identify in order to foster personal resources to improve well-
being, but the training also includes career goal planning supporting professional
development.
Clearly wellbeing is not the only or overriding purpose of learning, but how it
interrelates with a particular form of WBL needs to recognized for learning to be
successful. For many organizations learning is at the core of their approach to HRM
and underpins performance, organizations are increasingly moving away from
transactional approaches to HR and appraisal with a whole person view that is
developmental. The alignment in this space of individual learning motivations
with organizational interests is key to resolving any tensions that may frustrate
wellbeing and learning. How an individual fits with the learning environment
provided through work will determine if it also provides wellbeing benefits and
how, whether it be through career progression, enhanced confidence or work abilities
more can be done to understand specific mechanisms by which WBL benefits well-
being rather than assuming it is the case. However, it is not always possible for
tensions to be resolved and for individual and organizational priories to be aligned.
The increasing fluidity of people’s working lives creates opportunities for them to
pursue learning in other organizational contexts, but this also creates a constant
demand for learning. Moreover from an organizational point of view, increasing
mobility of workers undermines the case for investment in them as a resource. When
16 Work-Based Learning and Wellbeing 325

looking at learning and wellbeing together there is then a case for employers to take a
longer term view and provide opportunities for individuals within an organization so
they don’t lose valued skills and expertise. It will not always be possible to accom-
modate workers appetite for learning and progression within an organization, partic-
ularly for smaller companies and arguably there is also a role for government in taking
a more proactive approach to supporting adult learning in and through work with
policies that support employers and employees. If WBL has the potential to benefit
both the wider economy and the wellbeing of workers, but may be at the expense of
individual organizational performance, then this can create a disincentive for invest-
ment in WBL at the organizational level which harms productivity as a whole.
The question of how wellbeing and the role of work based learning within it is
viewed is not just a question for government or academics, but for organizations and
the individuals who comprise them also. Organizations may consider their respon-
sibilities for employee wellbeing in relatively narrow terms, for example providing a
safe working environment and support for stress and return to work where necessary,
whereas a more expansive view may consider WBL as more fundamental to
wellbeing. The approach an organization takes to wellbeing has implications for
how it supports wellbeing, whereas the former may reduce anxiety and absenteeism
it may be less effective at supporting meaningful work and job satisfaction, for which
WBL is likely to be a key antecedent or element. Organizations can realize gains in
performance and through innovation by investing in WBL, but a performance
oriented outlook alone may be short-sighted. WBL offers an opportunity to improve
people’s experience of their work and also their performance, these benefits are
additive in the sense that increased job satisfaction is associated with increased
performance. However, employers who invest in WBL only with a view to improv-
ing performance are liable to be perceived as inauthentic by employees who may see
themselves as means to the organizations ends.
While some evidence suggests that learning can have a negative impact, the
weight of evidence overwhelmingly points to benefits arising from WBL; however,
this does not support unlimited investment in learning. Notwithstanding the returns
in performance that organizations will expect from investment in WBL, its influence
on wellbeing will vary according to the need, desire and benefit from continual
learning through work that alters with age along with variation in individual orien-
tations (Felstead et al. 2015). Obviously there is much that can be done to support
WBL and wellbeing in tandem through formal training programs and planned
interventions, but as this chapter has recognized much of the learning that takes
place at work is considered informal. Informal does not mean that the work envi-
ronment does not structure learning opportunities (Billett 2002) and therefore
employers also need to give thought to how the culture in an organization shapes
learning opportunities. There is evidence of an association between learning culture/
opportunities and wellbeing at work, but much less research has been done to inform
how organizations achieve this in practice, but given the emphasis on informal
learning and the shift to less structured working environments this is likely to be
key for the future. Organizational culture, processes, and structures can act as a
“hidden curriculum” that shape learning experiences and opportunities
326 D. Watson and O. Tregaskis

unintentionally, turning attention to this can support the development of a “work-

place curriculum” to fully achieve the potential of the workplace as learning envi-
ronment (Billett 2002). Learning can be considered a key aspect of job design and
job quality, with skill utilization typically a feature of the measurement of job quality
(Irvine et al. 2018). Despite the role of WBL in models of job quality, it is not
explicitly measured extensively, and while the assumption that learning is a key
feature of good quality jobs is common place, theorization on the role of WBL in
relation to job quality and wellbeing remains underdeveloped.
In some respects then it seems that practice could in fact be further advanced than
academic research and theory in relation to WBL and wellbeing. Although learning can
be found in various models of wellbeing and a number of models of learning at work
exist there is very little theory or research that can serve as a guide for practitioners
seeking to implement approaches to WBL that are integrated with wellbeing. In many
organizations though learning is given a high priority and is central to efforts to support
employee wellbeing. Although this is not universally the case and critical attention to the
efforts of organizations and the limitations of particular organizational contexts to
provide WBL opportunities is also needed, since it cannot be assumed that WBL
automatically supports wellbeing nor that all working environments provide adequate
opportunities for WBL or wellbeing to be realized.

Conclusions/Summary

This chapter has discussed the links between work-based learning and wellbeing
providing a summary of the literature and some guidance for practice and future
research. Acknowledging the diversity of learning that takes place in the workplace,
the chapter advocates a broad understanding of learning as necessary to fully
recognize the potential wellbeing benefits of WBL. Notwithstanding this broad
approach the particular way in which different forms of learning take place and
their context remains important. Learning can be seen as quite central to various
ways of understanding and practicing wellbeing in the workplace and this is
underpinned by an assumption that the two are mutually reinforcing. The chapter
has drawn attention to the evidence that supports the link between wellbeing and
learning at work, but also highlighted serious gaps in research and our understanding
of precisely how the relationship between WBL and wellbeing unfolds. More
explicit attention to the interrelation of wellbeing and learning in the workplace is
required to develop workplace practice that benefit employees and organizations, but
there is also a need for academics to develop theory and empirical evidence than can
more adequately inform this practice.

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Management of Equity and Diversity
17
Katherine J. C. Sang, Jennifer Remnant,
Olugbenga Abraham Babajide, and James Richards

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332
Diversity Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332
Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
Race and Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334
Varied Experiences of Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347

Abstract
COVID-19 has brought acutely to wide attention a range of inequalities in
working life, including the gendered household division of labor. However, it
has also offered opportunities for more inclusive working practices such as home
working. The support for a diverse workforce can be considered “diversity
management” which attempts to harness the benefits of diversity for organiza-
tional gain. Through a discussion of the intersectional experiences of often
marginalized employees, this chapter explores the discriminations reported by
many employees. We focus specifically on disability, presenting historical and
contemporary explanations of disability at work, with illustrative examples. This

K. J. C. Sang (*) · O. A. Babajide · J. Richards

The Centre for Research on Employment, Work and the Professions, Edinburgh Business School,
Heriot Watt University, Edinburgh, Scotland, UK
e-mail: [email protected]; [email protected]; [email protected]
J. Remnant
Chancellor’s Fellow, Scottish Centre for Employment Research, Strathclyde Business School,
Glasgow, Scotland, UK
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 331

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_15
332 K. J. C. Sang et al.

chapter concludes with suggestions for more inclusive practices at work to benefit
both employees and employers.

Keywords
Disability · Diversity · Equality · Gender · Inclusion

Introduction

Recent global events including the COVID-19 pandemic have sharply revealed the
diverse needs and experiences of workers. The move to remote or teleworking for
many white-collar employees has put the spotlight on caring responsibilities, digital
inequalities, and increased risks to poor physical and mental health. This chapter
discusses the experiences of diverse workers, particularly experiences of discrimi-
nation, and strategies which can be employed by employers to move toward inclu-
sion in the workplace. We begin by setting out diversity management and then move
toward discussions of gender and racial inequalities at work (the experiences of
LGBTQI workers are discussed elsewhere in this handbook) and then focus specif-
ically on disability inequality at work. We draw on academic research, best practice,
and case studies from our own work to illustrate the experiences of disabled workers
and identify ways forward toward disability inclusion.

Diversity Management

Many countries have antidiscrimination legislation that is designed to protect the

traditionally marginalized, discussed further later in this chapter. In the UK, the
Equality Act (2010) offers protection against discrimination on the grounds of nine
protected characteristics: sex, gender reassignment, race and ethnicity, pregnancy
and maternity, disability, religion, age, marriage and civil partnership, and sexual
orientation. The legislation also allows a limited degree of protection based on dual
characteristics, for example, a female employee who is disabled. The Equality Act
2010 is strongest in the prevention of discrimination and harassment in health,
education, transport, housing, and accessing public services and businesses, where
organizations are legally obliged to anticipate the needs of people defined by
protected characteristics. However, in the employment and disability context,
employer organizations are only legally obliged to react to requests from employees
who may need some form of workplace adjustments.
A feature of contemporary organizations is the increasing evidence of workplace
diversity management. This can be seen as important recognitions of an increasingly
diverse workplace. This workforce diversity includes a wide variety of visible and
hidden differences between workers. Successful management of these differences
can improve organizational productivity (Kandola and Fullerton 1998; CIPD 2018).
Much of the responsibility for diversity managements falls to individual line
17 Management of Equity and Diversity 333

managers who increasingly have responsibility for human resource management

(Richards et al. 2019). However, most research and practice within diversity man-
agement focus on gender and race/ethnicity, with little emphasis on disability. The
chapter will now move to a brief consideration of the most frequently researched
protected characteristics.

Gender

Despite equality legislation in many countries, women’s progress in paid employment

still faces constraints. A gender pay gap persists whereby we see the average earnings
of men and women differ, with women earning less than men (Auspurg et al. 2017).
This has historically been explained by women’s overrepresentation in lower paid
work, and part-time work. However, there is also an equal pay gap, where, despite
legislation, women are paid less than men for doing the same work across several
sectors in the UK including science and engineering (O’Neill 2019), and medicine
(Moberly 2019). This pattern is replicated across the world with evidence of a gender
pay gap within job roles in Japan (Estévez-Abe 2013), North America (Meara et al.
2020), Brazil (Guimarães and Silva 2016), and Denmark (Smith et al. 2011).
Employment is still characterized in many countries by horizontal and vertical job
segregation (Siboni et al. 2016). Horizontal job segregation refers to the types of
occupations occupied by men and women, for example, we tend to see women
focused in occupations associated with caring (e.g., teaching), while men are often
found in sectors such as construction. In contrast, vertical job segregation refers to
where men and women sit in hierarchies, for example, women are more likely to be
found in more junior and lesser paid roles, while disproportionately, more men can
be found in senior roles. This is particularly so in female-dominated sectors such as
teaching, social work, and nursing (Lane and Flowers 2015). There is increased
understanding that discrimination contributes to the persistence of the gender pay
gap across the world (Lips 2013). Similarly, as occupational fields become more
female dominated, it is reported that pay in those fields decreases (Miller 2016).

Race and Ethnicity

Turning to the race pay gap, it is a complicated picture. Overall, data in the UK
suggests that there is a significant pay gap between White employees and those from
ethnic minorities, with the most recent data suggesting a pay gap in London in excess
of 20% (ONS 2018). Data from the UK government shows the national trends in
employment each year. The most recent data shows a range of employment trends for
different ethnic groups (GOV.UK Employment 2020). There are differences in
employment rates, with White people of working age more likely to be in employment
than all other ethnic groups in the UK. Conversely, White people are also less likely to
be unemployed. The data shows variations between minority ethnic groups, with those
from Pakistani and Bangladeshi backgrounds the least likely to be in employment.
334 K. J. C. Sang et al.

Historically, within the UK, there was also a “color bar.” This term originated in
South Africa as a reference to the Mine and Works Regulations Act (1912) which
gave White workers a monopoly on skilled operations. Over time though, “color
bar” was used to refer to a collection of government regulations, employment
practices, and legislation to prevent Black people from competing for certain
categories of job (Durrheim et al. 2011). The UK “color bar” also functioned to
prevent workers from ethnic minority backgrounds from certain forms of employ-
ment. As McIvor (2013) points out, the UK’s race-relations at work differ from other
countries’ due to a complex colonial history and a skills shortage after World War
II. Many studies illustrate the marginalization and discrimination that people of color
report in the workplace. Many readers will be familiar with the Black Lives Matter
movement which started in the United States in response to police killings of African
American men and women and has subsequently become a global movement toward
racial equality. More recently, researchers have started to ask if Black lives matter
within organizations, taking the Black Lives Matter movement from police violence
toward understanding persistent discrimination in the workplace and ethnic pay gap
(Brynin and Güveli 2012). Opie and Roberts (2017) explored whether Black lives
matter in organizations, concluding that historically the lives of White employees in
the global north have been privileged by not experiencing workplace racism, and as a
result not having to navigate the additional obstacles faced by ethnic minority
colleagues (Offermann et al. 2014). For example, Black women report being rou-
tinely discriminated against due to the texture and color of their hair (Greene 2011).
Despite this, there are numerous reasons to encourage ethnically diverse workplaces
as they cultivate dynamic workplaces where organizations can utilize varied per-
spectives, opinions, and problem-solving abilities in strategic decision-making
(Krome 2014). As such, it is important for employers to work with, elevate, and
support Black and other racialized employees to establish and sustain workplace
inclusivity and recognize the value of diverse lived experiences.

Disability

Disabled people experience considerable difficulties in relation to employment and,

for that reason, are the focus of this diversity management chapter. They represent a
heterogenous group with varied experiences and challenges. However, before mov-
ing to a discussion of these lived experiences, it is first necessary to define disability
including the use of disability language in this chapter.

Models of Disability
Historically, disability has been considered from a medicalized perspective, whereby
“disability” resides within the individual and the medical profession’s aim was to
remove the illness or condition which caused the disability. For example, efforts
were made by medical communities to “cure” Autism or Asperger’s Syndrome.
However, this approach not only stigmatizes disability and medical conditions and
neglects the experiences and voice of disabled people, but it also does not recognize
17 Management of Equity and Diversity 335

the disabling effects of the built and social environments which we all occupy
(Richards 2012). In response to the medical model of disability, disability theorists
and activists developed the social model of disability, which draws a distinction
between “impairment” (e.g., a medical condition) and disabling barriers in the
environment (Oliver 1983).
Under the social model, disability is not the condition, but the social oppression
faced by those diagnosed with an impairment interacting with an environment which
is not accessible or inclusive. Therefore, under the social model, we do not use
person-first language (person with a disability), rather we say “disabled person” to
show we understand that the person is disabled by their environment not their
“impairment.” Doing so moves us away from considering the disabled person
from being the problem, toward recognizing the disabling effects of the environment
in which people live and work. If we use the social model of disability, we can
consider carefully how our actions, policies, and practices might be disabling to
people with impairments. Disability scholars, however, such as Shakespeare (2006),
have constructively criticized the social model of disability for neglecting the role of
impairment in the lived experience of disabled people. Nevertheless, the social
model remains a remarkable and useful tool that holds society accountable for
constructing disability. The social model has helped in shifting the conversation
from focusing on “fixing” individuals to how we might better accommodate diverse
human needs (Williams and Mavin 2012). Indeed, one of the core notions of the
social model is that society creates disability, and “it is the society that has to change
not individuals” (Oliver 1983, p. 37). Use of the model enables improved awareness
of how to refer to and interact with disabled employees as well as address the
physical accessibility of the workspace. This awareness, or organizational knowl-
edge, can be referred to as “disability literacy.” Therefore, employers must be aware
of social barriers (e.g., stigma) and physical barriers (e.g., lack of wheelchair ramp or
lift) experienced by disabled workers.
More recent disability theorizing has been linked closely with feminists’ under-
standings of gender whereby gender is seen as a form of social oppression. Similarly,
Thomas argues disability as social oppression, whereby those designated with
“impairments” are oppressed by those designated without “impairments.” This
social relational model of disability builds closely on the social model of disability,
by exploring the political, emotional, material, economic, structural, and personal
dimensions of disability (Thomas 2004). By doing so, we can create opportunities
for understanding how disability is created and reproduced as a result of unequal
social relationships (Goodley 2013). For example, for some disabled people, dis-
ability is not part of their self-identity; it is a product of discrimination and prejudice,
seeing themselves as “normal” unless treated differently by others (Watson 2002).
Both the social model and the social relational models shift the focus away from
an illness or impairment, toward understanding how the physical and social aspects
of work disable employees. This shift is important for managers as it allows us to
understand how adjustments at work can help to support disabled people not only to
access employment, but also to thrive at work.
336 K. J. C. Sang et al.

Disability at Work
We shed light and provide insights on disability at work, particularly in British
employment. In most of the management and organizational studies and literature,
disability is under-researched (Ozbilgin et al. 2011). Most disability work in Human
Resource Management (HRM) is informed with medicalized and individualistic
viewpoints (Williams and Mavin 2012). Management and organizational literature
are paying less attention to the voices and knowledge of disabled people (Williams
and Mavin 2012). Under the British Equality Act (2010), a person is legally
considered as disabled if the person has “a physical or mental impairment that has
‘substantial’ and a ‘long-term’ negative effect on their ability to undertake normal
daily activities” (Ibid). This definition was incorporated from the Disability Dis-
crimination Act (DDA 1995:2005), the preceding piece of disability-related legisla-
tion in the UK. Despite the introduction of legislative protections for disabled people
in the UK, offering workplace protections from discrimination and harassment (and
ostensibly enabling disabled people to access, and remain in secure work), many
academics and activists have expressed reservations about its efficacy (Bambra and
Smith 2010; William 2016). The employment gap between nondisabled working age
people and their disabled contemporaries in the UK has not improved since before
the DDA (1995) static (Jones and Wass 2013), and there continues to be criticisms
from disabled people of ableist workplaces and reports of overwork completed by
disabled workers across the global north (Johnsson et al. 2010; Pagan 2018;
Stergiou-Kita et al. 2016; Wells et al. 2013). Particular criticisms of UK equality
legislation and key explanations for ongoing disability exclusion in more enlight-
ened times include how such legislation puts the onus on employees to know and act
upon their rights, and how UK employer obligation is limited to reacting to
employee requests for adjustments. With many of the above in mind, in this section,
we discuss the misconception of dis/ability and productive work, including the
disabling and undervaluing of disabled people at work or in employment, and
provide strategies for disability inclusion at work or organizations.

The Misconception of Dis/Ability and Productive Work

Disability at work is an important and stimulating topic (Turner et al. 2017). Work
and productivity are central to policy-based and legislative definitions of disability
(Rose 2015). However, the assumption that disability is an inability to do productive
work hardly reflects the reality of the lived experience of disabled people at work
(Adams et al. 2015). The in/ability to perform productive work has been important to
the meaning of disability across cultures (Turner et al. 2017). The problem is that
disability is misunderstood for different reasons. First, among these reasons is the
absence of a neutral language for a collective or global understanding of disability
which has influenced how disability is perceived and understood (Clark and Marsh
2002; Loeb 2013). Loeb (2013) illustrates that disability may be perceived with
negative associations (e.g., feeling of stigma or shame) in some cultures and could
make individuals feel reluctant to self-identify with disability. In contrast, in other
cultures, disability may be perceived in terms of severity. For example, someone
17 Management of Equity and Diversity 337

who can walk within their home but are not capable of walking to the market may
consider their impairment effects as not severe enough to be considered having a
disability even though their daily activities are restricted. Therefore, there is a notion
of cultural differences that influence the perception or interpretation of disability.
Similarly, the prefix “dis” in disability carries a negative connotation that portrays
disabled people as the binary opposite of nondisabled people without impairments.
Historically, notions of disability resulted in moral judgments. Often based in
religious or cultural traditions, they suggested that the presence of disability implied
evil or idleness in the individual or sometimes punishment for past offences (Harpur
2012). Though many of these historical prejudices have diminished over time, they
have a legacy – particularly in relation to idleness. The label of “disabled” continues
to inform negative assumptions and misconception that disabled people are not able,
or willing, to be productive at work. The difference between abled and disabled
bodies has become paired with the notion of the productive body in a manufacturing
industrial system. As a result, disabled people have come to be understood in terms
of being nonproductive or deficient (Adams et al. 2015). This has shaped widely held
misconceptions of disability. It is important to understand that disability is not the
opposite of ability. Rather, the opposite of disabled is not abled or able-bodied but
nondisabled or enabled (GOV.UK 2018). Useful models or tools that help address
these misconceptions of disability and provide a meaningful solution for societal or
social change are the previously mentioned social and social relational models of
disability.

Disabling Disabled People at Work

In 2011, the World Health Organization’s (WHO 2011) report on disability acknowl-
edged that the employment rates of working-age disabled people are lower compared
to nondisabled people in developing and developed countries even though most
disabled people can do the same jobs as their peers if the workplace is supportive. As
Turner et al. (2017) identify, discrimination, productivity norms, prejudice in the
workplace, and inflexible social security systems for disabled people are factors
affecting disabled people’s opportunities in employment. They represent both supply
and demand issues related to accessing and maintaining secure work and are
indicative of institutional discrimination which systematically marginalizes disabled
people via established laws, customs, and practices and instituted through broadly
shared values, beliefs, and attitudes (Yeo and Moore 2003). In response to these
obstacles, disability research and activism have been focused on challenging insti-
tutional discrimination (Barnes 1992a) in organizational systems that support able-
ism (discrimination toward disabled people in favor of the nondisabled) and
disableism (discrimination against disabled people).
Alongside supporting disabled workers, it should also be incumbent on
employing organizations to ensure robust health and safety protocols are in place
to avoid occupational illness and impairment. Some conditions are concentrated in
specific sectors, for example, in the Dutch construction industry, and musculoskel-
etal conditions (including lower-back pain) have been recognized as a leading cause
of morbidity, long-term absence, and disability (Burdorf et al. 2005). Likewise,
338 K. J. C. Sang et al.

studies suggest that amendable occupational factors (e.g., poor social support or not
receiving a homecoming brief) among British Armed Forces personnel could result
in disability such as post-traumatic stress disorder [PTSD] (Iversen et al. 2008).
Some occupational conditions result from exposure to specific substances, such as
asbestos. Others are a complex combination of poor organizational health and safety
measures, limited access to medical support for employees, and limited social
security systems for ill-health forcing people to return to work before they have
recovered. Appropriate health and safety precautions in the workplace are important
not only to avoid employee injury or illness, and the potential subsequent litigation,
but also to protect disabled workers who may have additional needs for some
situations. For example, in the event of a building evacuation, it benefits all
employees to have clear exit routes free from obstacles.

Undervaluing Disabled People in Employment

Exploring diversity management in relation to work provides the opportunity to
critique the nature of work itself and a lens to understand the economic mechanisms
that continue to undervalue people who cannot meet productivity standards (Turner
et al. 2017). In modern society, work not only helps to construct an individual’s
identity as an adult, but it also provides an opportunity to demonstrate capability by
constructing a connection between income and autonomy (Ibid). In the UK and the
USA, the dangers that surround industrial workplaces have provided the possibility
for legal compensation to injured workers; however, this legislation operates to
portray those with existing impairments as expensive burdens at work (Rose
2017). One particular example is that of Ford Motors Company where newly
disabled workers did not have their financial needs met by their employer nor receive
compensation (Ibid).
In the UK, social policy has created the “disability category” by separating those
considered incapable of doing productive work due to their age or impairment, from
workers with nondisabled and therefore interchangeable bodies. Nondisabled, and
therefore presumed more productive, workers are favored in the industrial system
while workers in the “disability category” are excluded and marginalized (Turner
et al. 2017). There is extensive evidence that disabled people are undervalued in
employment at the micro- (e.g., poor disability management at work) and macrolevel
(e.g., government policies). Stone (1984) stated that the contemporary “disability
category” was constructed by “industrial capitalism and the welfare systems it
engendered” (Turner et al. 2017, p. 2). Stone stressed that the medical management
of “disability category” serves as an instrument of the state in controlling the supply
of labor and facilitates class interest (Barnes and Mercer 2010). In recent years, this
same argument has been made by social policy scholars such as Baumberg (2016)
and public health scholars specializing in work and employment (Bambra 2011).
The first major British legislation to address the employment needs of disabled
people was the Disabled Person’s Employment Act (1944), after World War II, to
provide and keep disabled people (men) in employment and included both “demand-
side” and “supply-side” measures (Hyde 2000; Woodin 2015). The “demand-side”
measure obliged employers with more than 20 employees to ensure that at least 3%
17 Management of Equity and Diversity 339

of their workforce were disabled workers. However, most employers were under
quota, and only ten prosecutions were made of employers that have failed to comply.
The “supply-side” measures included job-search advice, financial incentives for
employers, and “rehabilitation” for disabled workers (Hyde 2000). This legislation
corresponded with further social policy alterations that provided out of work sick-
ness benefit payments to those not in work, as well as the establishment of the UK’s
National Health Service (NHS) in 1947. There is an argument that accesses out of
work welfare payments, and health services that were free at the point of delivery
limited the enthusiasm of disabled people to return to work, a notion that still has
currency now (Garthwaite 2011). An alternative argument points to the inflexibility
of welfare provision in the UK, both historically and currently, highlighting how
disabled people face the removal of welfare support if they are deemed capable of
work, irrespective of whether there is work available to them. This early legislation
significantly influenced contemporary social policy regarding the labor force and
disability. It highlights the financial insecurity of disabled people seeking long-term
employment and illustrates the importance of inclusive workplaces to provide
economic security to disabled colleagues.
Disabled people still live with medicalized and other discriminatory assumptions
that posit disabled people as not being able to achieve a reasonable standard of living
with their efforts as a result of their physical or psychological impairment (Barnes
1992b). Despite the rejection of such assumptions by disabled people and their
organizations (Barnes 1992b), disabled people remain less likely to be in employ-
ment in comparison to nondisabled people. The UK employment rate among
working-age disabled in 2016 was 46.5% (4.1 million) in comparison to 84% of
nondisabled people (Brand 2018). The proportion of working-age disabled people
(44.3%) who are economically inactive or unemployed is almost quadruple the
proportion of nondisabled people (11.5%) who are economically inactive or unem-
ployed (Brand 2018). These figures put ableism and disableism into perspective in
employment and highlight the disproportionate disadvantage in the UK labor market
(Barnes and Roulstone 2005). This employment gap is the result of institutional and
organizational discrimination, economic inequality, poor diversity management, and
limited meaningful inclusion in UK workplaces. Rectifying this requires further
research attention, improved strategies for disability inclusion, and appropriate
means of enforcement (Barnes 1992b).

Varied Experiences of Disability

When many people think of disability, they imagine a wheelchair user and
associate this with specific accessibility requirements, such as ramps, to access
office buildings or reserved parking spaces at work. However, “disability” covers
a very broad range of conditions, health issues, and impairment effects or
symptoms. In this section, we consider three broad categories to explore this
variety: (1) hidden impairments; (2) life limiting impairments, and (3) stigmatized
impairments.
340 K. J. C. Sang et al.

Within the UK, disability has a legal definition whereby a person is seen as
disabled if they have any condition which affects their day-to-day functioning for
12 months or more (Equality Act 2010). There are a number of conditions which
automatically confer protection under the Equality Act (2010) including cancer and
HIV (GOV.UK nd). The definition within the US Americans with Disabilities Act
(1990) is broadly similar, requiring a formal record of such an impairment (eeoc.gov
nd) which, consequently, requires that the individual in question has a formal
medical diagnosis. For several conditions, such as endometriosis, fibromyalgia,
and a selection of mental health conditions, employees can spend many years
securing a diagnosis during which time access to workplace support and adjustments
can be difficult (if not impossible) to secure.
An important aspect to disability that employers must consider, is that it is not
necessarily apparent that an individual is disabled. “Hidden” impairments can raise
several workplace obstacles for individuals who need to consider how to disclose
their condition in order to access workplace support. As Richards and Sang (2016)
highlight, such “impairments” can include neurodiversity, a term which covers a
range of so-called neurological impairments such as autism, ADHD, dyslexia, and
dyscalculia, which are all associated with a range of negative employment outcomes.
The case study below shows the difficulties that a disabled man at work might
experience in managing a hidden impairment which he believes is stigmatized.

Case Study
Brian works as an engineer for UKTrains [nationwide train company in the UK],
where he has worked for 25 years. After several distressing incidents at work, such
as when Brian was laughed at by colleagues for making spelling errors in his written
work, reminiscent of Brian’s childhood experiences at school many years before
that, Brian approached his family doctor and was referred to a learning specialist.
The learning specialist diagnosed Brian as dyslexic and recommended he see the
UKTrains occupational health team to develop a strategy for workplace adjust-
ments. Brian reluctantly met with the occupational health team and reported that he
was very embarrassed as he was worried he would be laughed at and that he would
not be taken seriously by his team and colleagues should they find out he is dyslexic.
He tells the occupational health nurse that he feels undermined at work by the
“mistakes” others have pointed out in public, and he has been asking his wife and
daughter to proofread his work before he submits it for his team to see. The
occupational health nurse advises Brian that there is an array of options for support
including software he can download to his work laptop, and he should speak to the
IT manager to secure this software. Six months later, Brian has not approached the
IT manager stating that he is too embarrassed to do so, and he does not want the IT
manager to know he is disabled as he fears gossip will be spread and he will be
laughed at again. Brian continues to rely on his wife and daughter for proofreading
and other support and has kept his diagnosis secret from his team.

Brian’s experiences show the difficulties which can be experienced by disabled

employees whose condition or impairment requires disclosure in order to be
17 Management of Equity and Diversity 341

accommodated. Those who are living with conditions which are hidden, such as
autism or dyslexia, face a range of dilemmas at work and discrimination which can
lead to complaints made to employers (Van Wieren et al. 2008). From Brian’s
description of his working life, we can learn that he fears stigma, and due to the
forced requirement to disclose in order to secure any adjustments, he has elected to
continue to hide his condition and remains struggling at work. An employer may
wish to consider whether their reporting requirements fulfill the requirements of the
local legislative frameworks and the associated impact on Brian’s and therefore the
company’s performance. It can be difficult for employers to accommodate the
additional specific needs of some employees if they have not disclosed information
relating to those needs. Key organizational solutions to this include establishing a
positive inclusive atmosphere where employees feel confident disclosing health
conditions or medical diagnosis. To cultivate employee comfort and confidence of
this kind, it is important that organizational materials and policies provide the clear
and unambiguous message that workplace diversity and the resultant increase in
perspectives, creativity, and experience are welcomed in the work environment. This
would be an instrumental first step in creating a more inclusive workplace, where
workforce diversity is a strategic priority and welcomed.

Life-Limiting Conditions
Experiences of illness and impairment are incredibly varied and encompass limitless
symptom trajectories, varied prognoses, and social impacts. Though many HRM
policies assume that after a period of sickness an employee may recover, this is
increasingly not the case, for example, over half of all people diagnosed with cancer
in the UK, right now, are alive 10 years after being diagnosed (Cancer Research UK
2020). The risk of acquiring a long-term health condition increases with age, and the
UK – as with the rest of the world – has an aging workforce. To address this, this
section explores the management of disabled staff experiencing long-term, life
limiting conditions in the workplace, with a specific focus on cancer. Cancer offers
a useful lens by which to explore managing diversity at work as it is experienced as
an acute illness and long-term condition, with a collection of treatment options
including surgery, chemotherapy, and radiotherapy. There are over 200 types of
cancer, with a range of prognoses trajectories including receiving curative treatment
through to terminal diagnoses (National Cancer Institute 2020). As with many
impairments and long-term health conditions, the risk of being diagnosed with
cancer increases with age (US Cancer Statistics Working Group 2013). As the global
workforce ages, it is likely that the number of people who are in work when
diagnosed with life-limiting illnesses such as cancer will increase.
The management of employees diagnosed with life-limiting conditions is likely to
involve the use of sick leave, sometimes for lengthy periods, or frequent short
absences. In many workforces, it is possible to support this, and employees benefit
from clear guidelines and access to information about what occupational sick pay
they are entitled to. Employers who benefit from skill retention will need to reflect on
how to maximize the employees time at work and limit the cost of their absence.
Musculoskeletal health conditions, stress, and cancer are the most common reasons
342 K. J. C. Sang et al.

why employees take sick leave in the global north (Brage et al. 2010; Kim 2017;
Young and Bhaumik 2011).
Sometimes, symptoms experienced by employees with life-limiting conditions
can be managed for long periods of time; however, in other instances, there is no
effective treatment, and employees experience a reduction in their capability. This
can result in fear and distress relating to their job. Across the world, work provides
the primary source of income for most households, and life-limiting conditions pose
a substantial threat to domestic budgets. From an employee perspective, it is often
important to maintain an income, irrespective of their prognosis or because work can
be a helpful distraction from their illness (Grunfeld et al. 2013). In other instances,
work is not compatible with their situation, or employees may rather spend their
remaining time with family and friends, and to get their affairs in order. Whatever
choice a person makes, it is reasonable to expect sensitivity and support from their
employer, though there is extensive evidence that employees experiencing life-
limiting conditions are subject to mistreatment by their employing organization,
referred to as “healthism” (Roberts and Weeks 2018).
As discussed previously in the section “Undervaluing Disabled People at Work,”
there are numerous different global legislative contexts regarding workplace pro-
tections for people experiencing illness or disability. In the UK, cancer is defined as a
disability under the Equality Act (2010). As a result, UK employers are obliged to
make efforts to accommodate the additional needs of employees with cancer to allow
them to work and apply for jobs equally to nondisabled colleagues. Referred to as
“reasonable adjustments,” workplace accommodations can include alterations to the
physical environment, working hours, or organizational policy. There has been some
speculation that the legal definition of cancer as a disability in the UK and use of the
Equality Act (2010) might have resulted in the improved management of employees
with cancer in UK workplaces. However, there is extensive evidence that people
experiencing long-term and life-limiting conditions experience negative employ-
ment outcomes (Bambra 2011; Bartley et al. 2004). US citizens with long-term and
life-limiting conditions are protected under the Americans with Disabilities Act
(1990) but report similar employment outcomes (Lerner et al. 2000). This suggests
that disabled employees with cancer face mistreatment in the workplace even where
they are subject to specific legislative protections; this reflects the wider experiences
of disabled workers with conditions and diagnoses other than cancer.
There is increasing evidence that the provision of workplace accommodations for
employees with life-limiting conditions across Europe and North America is lacking
(Mehnert 2011; Vornholt et al. 2018). In the UK, this has resulted in a trade union
campaign called “dying to work” to demand better workplace support for employees
with terminal diagnoses (Trade Union Congress 2020). The support currently avail-
able reflects that offered to disabled employees more broadly in that it manifests as
managerial goodwill rather than entitlement and that employer provisions of support
are individualized and unplugged from the structural exclusion of disabled workers
(Foster 2007; Remnant 2019; Shuey and Jovic 2013). The employment rate of
people with cancer mimics wider disability employment gaps (De Boer et al.
2009), and accounts of poor management from employees with cancer correspond
17 Management of Equity and Diversity 343

to criticisms of ableist workplaces and reports of overwork reported by people with

disabilities across the Global North (Johnsson et al. 2010; Stergiou-Kita et al. 2016;
Wells et al. 2013).
In the context of a globally aging workforce, life-limiting illnesses such as cancer
will become more prevalent among the working age population. There are pessi-
mistic projections about the quality of work across the Global North, which fosters
an increasing sense of precarity (Standing 2011) especially for older workers and
workers experiencing poor health. Ill-health also poses a challenge to employers
though, who may have concerns about employee capacity and performance in the
event of illness, low team morale, and the loss of skilled workers. However,
individual employers can address these issues by engaging in supportive and
inclusive practice that adequately responds to health-based diversity in the work-
place. Below is an example of good workplace support for an employee diagnosed
with life-limiting cancer.

Case Study
Dave and Pete are both shift supervisors at a large private factory. The factory
employs over 500 employees and is a major feature of the local economy and
community. The factory has excellent employee retention, with most employees
working there for over 10 years, forming close friendships with their colleagues.
The organization is part of a multinational corporation and has in-house human
resources and occupational health teams.
Dave and Pete have line management responsibilities (they supervise 12-hour
shifts). One of their employees, Trevor, a worker in his late 50s, requested some
annual leave. On returning from this leave, Trevor asked for a meeting with Dave
and Pete. He explained to them that during his annual leave he had experienced
some symptoms and had gone to the doctor. He had been told that he had cancer and
was waiting to hear back about his prognosis.
Both Dave and Pete reassured Trevor that they would do all that they could to
support him, and both managers requested cancer-specific workplace training
which they then attended. They asked Trevor if it would be alright to refer him to
their occupational health team and to let human resources know. They explained that
he did not need to take annual leave to attend further appointments, but to let them
know with as much notice as possible and they would cover his shifts.
Unfortunately, it was bad news and Trevor was given a terminal diagnosis. He
needed to take time off for treatment but expressed a strong desire to continue
working. Between the three of them, they decided on a short weekly phone call to
keep Trevor in the loop. Dave and Pete also arranged a meeting with Trevor and
occupational health staff. Between them, they came up with a plan to keep Trevor as
engaged as possible with work. At first, while his symptoms were manageable, this
included working shorter shifts, completing fewer physical tasks, and supporting on-
the-job training for more junior colleagues. As his symptoms became less manage-
able, Dave and Pete met with human resources and health and safety staff, and they
wrote a risk assessment and altered organizational policy to allow for Trevor to be
on-site in the workplace cafeteria and staff rooms to meet with his colleagues.
344 K. J. C. Sang et al.

As Trevor entered the last months of his life, a human resource representative
visited him at home to discuss financial matters. Throughout his sickness, he
received full pay (he was contractually obliged to full pay for 12 months sickness).
It was agreed that he would remain on the pay roll until he died, meaning that his
wife would receive both his death in service payment, and pension. Trevor was
reassured that his wife would be financially secure when he died.

This case study offers a collection of examples of good practice for organizational
management. In the first instance, the organization responded to managerial requests
for condition-specific training, meaning that the managers felt comfortable
approaching Trevor and discussing his needs with him. It also meant they were
aware of their legal duties to Trevor (in the UK, under the Equality Act (2010)). They
considered the options available to them to meet the business needs of their
employer. This resulted in Trevor passing on his specialist skills as part of an
informal training program, meaning that his important skills were not lost by the
organization, and his role became less physical. They also considered Trevor’s needs
as an employee, which resulted in small changes in policy, allowing Trevor to access
the organization’s property legally and safely during his illness. Their management
was fully transparent, and Trevor was party to all financial negotiations. Not only
was this beneficial to Trevor’s morale, but also to the morale of his colleagues who
saw an example of an employer that supported employees in tragic circumstances.
Improving disability inclusion is often perceived as an expensive burden, but as this
case study shows, several workplace accommodations were relatively low cost and
made a meaningful difference when implemented in the workplace (Rose 2017).
There are some important ways that employers can support staff with life-limiting
conditions, including small and medium size organizations with limited financial
resources. A key feature of the above case study was employer transparency.
Keeping an employee informed and discussing the available options for their support
can help employees feel valued. It also offers a positive example to other employees,
facilitating continued employee goodwill. The above case highlights that there is
both a moral and business case for employers to provide sensitive support of
employees with life-limiting conditions.

Disability and Intersectionality

Intersectionality was coined by Kimberle Crenshaw (1990) to reveal the ways that
racism and sexism interact to qualitatively affect the experiences of Black women.
The term intersectionality is commonly used to explain how categories of difference
intersect in complex ways, although Crenshaw’s work specifically refers to the
experiences of Black women. More recently, there have been attempts to understand
how disability and ableism interact or intersect with other protected characteristics.
Data suggests that disability may interrupt men’s sense of masculinity at work, with
negative consequences for career progression, particularly within male-dominated
industries (Sang et al. 2016). Further, bodily processes which are not themselves
“disability” could impact a person’s life to the extent it does constitute disability.
There are issues when stigmatized experiences or bodily processes are involved
17 Management of Equity and Diversity 345

which are gendered, for example, gynecological health conditions. While bodily
processes such as menstruation do not qualify as disability, if there are associated
gynecological health conditions which affect a person’s day-to-day working life, they
may fall under “disability.” Taylor (2019) draws on a recent case, Davies v Scottish
Courts and Tribunal Service, in Scottish law where serious effects of menopause were
ruled to confer protection under the UK Equality Act, where such effects constituted
disability in their severity and duration. An increasing number of employers are
implementing “period leave” whereby those who experience problematic menstrua-
tion can take a limited number of days off work (Kohili 2020). Such employer
initiatives may help to overcome the debilitating effects of pain and heavy menstrual
bleeding which many women and trans-/nonbinary people report during the first few
days of their period (Sang 2017). Disability can intersect with other protected char-
acteristics to inform the patterns of privilege and disadvantage employees may
experience at work. It is therefore essential that managers and human resource
management practitioners are sensitive to these intersecting patterns.

Strategies for Disability Inclusion

It is important, when working toward disability inclusion at work, to work with
disabled people. This could be via a disability staff group where disabled employees
are able to give feedback on proposed changes at work to ensure that there are no
unintended negative consequences for disabled people.
Some strategies include the following:

• Changing the environment not the person. For example, consider how your
working practices and culture may place disproportionate burdens on certain
staff who are living with a chronic health condition.
• Setting up a disabled staff network. Such networks can allow staff to provide
input into new policy and the design of new working environments.
• Making workplaces more inclusive, for example, through disability training,
flexible working, and the provision of disability leave, whereby absences related
to disability (e.g., hospital appointments) are not calculated as part of an
employees’ absence record.
• Working with trade unions to embed disability awareness at the strategic levels in
organizations. Working with trade unions, and taking a collective approach,
allows employers to move beyond the limited equality legal framework which
is largely set up to promote individualistic and reactive approaches to managing
disability.

These strategies can be considered when reading the below case study. In the case
of Alexandra, it is apparent that the implementation of the above strategies could
prevent some of the issues she faced due to workplace mismanagement.

Case Study
Alexandra is a project manager working for a large employer in England. In that last
2 years, Alexandra has developed an, as yet, undiagnosed progressive neurological
346 K. J. C. Sang et al.

disorder which affects her mobility. There are days where she uses a wheelchair, and
other days where she can walk short distances. Alexandra’s line manager is very
sympathetic and is keen to support Alexandra to be able to attend work. Alexandra
approached her employer’s occupational health team who suggested she would
benefit from a designated parking space near the front door of the building she
works in. After approaching the Director of Estates, Alexandra was told that she
would need to complete a 12-page form on why she requires a designated parking
space. Alexandra completed the paperwork, although she was very embarrassed at
having to disclose her condition to someone she did not know, and was then told by the
Director of Estates that since she did not have a confirmed diagnosis, she would not be
allowed a designated parking space. This caused Alexandra considerable distress.
Following raising a complaint with Human Resources, Alexandra was allocated a
parking space that was 2 km away from her office. Alexandra had to challenge this
decision and was finally awarded a parking space by the front door of her office.
However, many days when Alexandra gets to work, her parking space has been taken
by another colleague, and she has to return home and miss work.

Alexandra’s story is a typical one. We can see that there were many barriers put in
Alexandra’s way as she tried to secure herself a workplace adjustment. The onus was
on Alexandra to secure her own adjustments, which involved an exhausting and
bewildering journey of navigating an organizational bureaucracy just to secure
adjustments she had a legal right to (remember that England is part of the United
Kingdom where the Equality Act (2010) gives disabled employees a legal entitle-
ment to reasonable adjustments). Alexandra’s story also shows us that adjustments
do not need to be costly, despite the fears of many employers. However, when these
adjustments are not available or are difficult to access, there is harm caused to both
the employee and the employer. Good practice would be to make these processes as
straightforward as possible, removing unnecessary bureaucracy and enabling col-
leagues to keep their medical details confidential. In this example, this might mean a
shorter document to complete to ensure accessible parking. An established work-
place staff disability network could have meant that Alexandra’s workplace was
already more inclusive and avoided the obstacles she experienced altogether by
having improved access routes and clear, supportive policy. The provision of
disability training could well have meant colleagues inappropriately using accessible
parking bays would be more sensitive to the potential needs of others.
Working with trade unions can also be a productive avenue for disability inclu-
sion. Studies conducted in the UK have demonstrated that trade unions can act as
powerful advocates for disability inclusion in employer policies (Bacon and Hoque
2015), as well as offering facilitation for disabled people and their interests in
workplaces through networks of trained disabled staff representatives and case-
workers (Richards and Sang 2016). Employers and human resource managers
should also consider working with local disability advocacy groups, which are
often led by disabled people. In general, it is important for managers to remember
the principle of accessibility, whereby if work is organized in a way which is
accessible for disabled people it will be accessible for all employees.
17 Management of Equity and Diversity 347

Summary

Globally, workforces are becoming more diverse although gender, race, and disabil-
ity pay gaps are still evident. Women, disabled people, and people of color report a
range of disadvantages at work, many of which may result from intersections of
disadvantage. Research and practice show that disabled people experience discrim-
ination at work, and this can be particularly acute for those living with stigmatized
conditions. However, there is considerable scope to improve marginalized people’s
working lives which will benefit employees and improve organizational perfor-
mance. Strategies for inclusion can benefit from working closely with representa-
tives of marginalized employees and trade unions to ensure inclusion measures
support both employee and employer needs.

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Employee Voice as a Route to Wellbeing
18
Sarah Brooks and Adrian Wilkinson

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 352
Defining Voice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354
Defining Wellbeing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 356
The Relationship Between Voice and Wellbeing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
Job-Demands Resources Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358
Behavioral Activation and Behavioral Inhibition Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359
Psychosocial Safety Climate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 360
Whose Responsibility Is Voice About Wellbeing? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
The Role of the Employee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
The Role of the Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362
The Role of HR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362
Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 364
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365

Abstract
For many years, evidence has been growing to indicate that subjective well-being
is linked to higher worker productivity. However, it has only been more recently
that an absence of voice, known as silence, has been linked to a reduction in well-
being and productivity. Therefore, this chapter presents an up-to-date review of
theoretical perspectives drawn from organizational behavior (OB), employment
relations (ER), and human resource management (HRM) literature to highlight

S. Brooks
Sheffield University Management School, Sheffield, UK
e-mail: s.brooks@sheffield.ac.uk
A. Wilkinson (*)
Sheffield University Management School, Sheffield, UK
Business School, Griffith University, Nathan, QLD, Australia
e-mail: adrian.wilkinson@griffith.edu.au

© Springer Nature Switzerland AG 2022 351

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_16
352 S. Brooks and A. Wilkinson

the motivations and outcomes that underpin voice about wellbeing. Analyzed
across three levels, the societal level (macro), the organizational or departmental
level (meso), and the individual level (micro), it can be seen that the traditional
focus of organizations has been on collective well-being rather than individual
well-being. Yet, if we are to truly encourage worker voice about well-being, we
suggest that there must be a greater focus on how individuals, managers, and HR
departments can create an organization capable of responding to voice about
individual well-being. Serving not only to deepen our understanding of voice
about well-being, this chapter also highlights significant gaps in the literature and
suggests important avenues for further research. Importantly, we highlight one
key question which deserves more attention: Whose responsibility is voice about
well-being?

Keywords
Voice · Wellbeing · Human resources · Psychological safety · Job demands-
resources

Introduction

Getting workers to voice provides a win-win solution to a central organizational problem –

how to satisfy workers’ needs while simultaneously achieving organizational objectives.
(Strauss 2006, p. 778)

Voice has traditionally been considered a way of enabling employees to express

dissatisfaction and change situations which are not amenable to them (Hirschman
1970). In this way, voice can be considered a critical mechanism for employees to
improve working conditions and enable them to change situations which may lead
them to feel exhausted or to withdraw from the workplace (Sherf et al. 2020).
However, individuals are sometimes reluctant to voice concerns about personal
circumstances to a manager for fear of embarrassment or adverse career outcomes
(Milliken et al. 2003; Brinsfield 2013). Therefore, when considering voice and
wellbeing, it could be that individuals do not voice concerns about their own
wellbeing as readily as concerns which affect the wider organization.
From an employment relations (ER) perspective, when considering voice as a route
to wellbeing, a tension between employee wellbeing and organizational performance
must be acknowledged (Shahinpoor and Matt 2007). ER scholars have long been aware
that voice is not just a mechanism for employees to raise grievances but is also
associated with higher worker productivity and lower exit (Freeman and Medoff
1984). Over the years, more evidence has supported a link between higher levels of
subjective wellbeing and greater labor productivity (Isham et al. 2020), and it has been
found that an absence of voice (silence) could be highly detrimental to wellbeing as well
as a cause of lower productivity within organizations (Sherf et al. 2020). However,
despite evidence to support this tension, there appears to have been very little direct
exploration of the way that voice can be encouraged for employee wellbeing.
18 Employee Voice as a Route to Wellbeing 353

Key to understanding voice and employee wellbeing are three important charac-
teristics of the employment relationship. Firstly, employees sell their labor in
exchange for payment, which means that they need to be willing and able to work
if they are to be useful to the organization. Secondly, the employment relationship
between individuals and the organization is unequal given that most individuals are
required to take on work for financial reasons and therefore are wary of having their
employment terminated by upsetting those that employ them. This situation holds
true for employees and managers at all levels of the organization. Thirdly, the
employment relationship shifts over time in line with different economic and
political contexts (Colling and Terry 2010). This means that employee wellbeing
might be seen by organizations as less of a priority than organizational performance
during an economic downturn and therefore employees may be less likely to speak
up if their ability to gain other employment is limited.
The topic of voice has been addressed from a number of different perspectives
(OB, ER, HRM) and recent literature reviews combining these perspectives have
highlighted that voice can be underpinned by a wide range of motivations and
desired outcomes (c.f. Wilkinson et al. 2020a). But these disciplines diverge quite
significantly in how they conceptualize and study voice, and as a result, the extant
research on voice is very much within self-contained siloes (Wilkinson and Fay
2011; Kaufman 2014). When considering each of these perspectives in relation to
wellbeing, it is possible to see that each provides a different insight into the way that
voice and wellbeing could be linked. For example, voice occurs, is influenced by,
and can be examined at the societal (macro) level, the organizational or departmental
(meso) level, and the individual (micro) level. The macro level consists of the
regulatory framework, which determines organizational policy around voice. It is
at this level that we see a dominance of ER scholars who examine state support and
other institutional mechanisms which vary between countries and regions. The meso
level, where much human resource management (HRM) research takes place, relates
to the voice systems that organizations establish and the extent to which these are
utilized in practice. In contrast, at the micro level, the field of organisational
behaviour (OB) examines the individual-level motivators and inhibitors to voice,
such as dispositions, attitudes and perceptions, emotions, and beliefs (Wilkinson
et al. 2020a). While the ER literature can set the context, the focus of our chapter is
primarily the meso and micro levels and therefore draws heavily on HRM and OB
perspectives of voice.
When it comes to voice about wellbeing, there is an important distinction between
individual wellbeing and collective wellbeing, for each individual has different
requirements which are not necessarily catered for through one-suits-all decisions
that are made about working conditions and arrangements. The OB literature has
focused on direct voice between employee and manager and therefore provides a
good insight into the individual influences that shape voice for employee wellbeing.
However, given its focus on informal prosocial voice, its insights are likely to be
more relevant to wellbeing issues which affect employees collectively. Similarly, the
ER literature, which has focused on indirect voice, is also more likely to provide a
good insight into indirect formal voice which affects collective employee wellbeing.
354 S. Brooks and A. Wilkinson

In this way, it is possible to see that both OB and ER conceptualizations of voice

have blind spots when it comes to individual wellbeing issues. Finally, HRM
conceptualizations of voice have focused on garnering insight into systemic issues
which affect wellbeing but there has been more of a focus on organizational
performance. As highlighted earlier, employee wellbeing does affect organizational
performance, and therefore, for organizations to perform well, it is important that
employees take an interest in their own wellbeing and speak out to ask for what
they need.
The fact that individual wellbeing is important but appears to have been over-
looked in the literature highlights a need for this chapter to focus on how individuals,
managers, and HR departments can contribute towards an organization which
harnesses voice as a route to ensuring individual employee wellbeing. The chapter
will therefore tease out the common threads from both the voice and silence and
wellbeing literatures and use theoretical underpinnings and constructs within each
type of literature to suggest a way forward. Each literature provides different insights
into the question of how employees can use voice to protect and enhance their
wellbeing, yet when attempting to understand how voice and wellbeing are linked,
we find that there are significant gaps in our understanding. Therefore, this chapter
acts as a call to action for scholars to devote more attention to the links between
voice and wellbeing. The outline for this chapter is as follows. Firstly, voice and
wellbeing will be defined and a brief overview of the overlaps in the literature
provided. Next, one key area which acts as an important lens to understand how
voice can serve as a route to wellbeing will be highlighted: Whose responsibility is
voice about wellbeing? Finally, direction on key areas for further research will be
discussed.

Defining Voice

The focus of ER scholars is about voice as the expression of worker interests that are
separate and distinct from those of the firm, and as a vehicle for employee self-
determination (Budd 2004; Wilkinson et al. 2020b). Employees seek voice to have
some input into decisions that have a material impact on what they do in the
workplace. Formal institutions, such as trade unions, collective bargaining, and
grievance procedures, are viewed as important in facilitating genuine employee
voice so as to deal with any dissatisfaction with their working conditions.
The field of employment relations was one of the first to identify the concept of
voice as important for organizational functioning. One of the earliest definitions of
voice and which provides the common intellectual foundation for all voice scholars
is “any attempt at all to change, rather than escape from an objectionable state of
affairs whether through individual or collective petition to the management directly
in charge, through appeal to a higher authority with the intention of forcing a change
in management, or through various types of actions and protests, including those that
are meant to mobilise public opinion” (Hirschman 1970: 30). Hirschman empha-
sized voice as a constructive response to dissatisfaction and highlighted the
18 Employee Voice as a Route to Wellbeing 355

importance of employees having access to mechanisms through which they could

redress situations which caused them concern. His Exit-Voice-Loyalty model iden-
tified that workers usually chose either to remain with the organization or voice their
concerns in an attempt to rectify them, which he argued demonstrated loyalty, or they
chose to exit the organization. His model was expanded several years later by the
addition of neglect (now known as the Exit-Voice-Loyalty-Neglect model) meaning
that employees might remain with the organization but be neglectful in their duties
rather than exiting (Rusbult et al. 1998). Neglect can be defined as “passively
allowing conditions to deteriorate through reduced interest or effort, chronic lateness
or absences, using company time for personal business, or increased error rate”
(Rusbult et al. 1998: 601). Therefore, a lack of voice could lead to absenteeism as a
form of neglect which is widely recognized as an indicator of negative wellbeing. A
more recent definition of ER voice refers to “all of the ways and means through
which employees attempt to have a say about, and influence, their work and the
functioning of their organisation” (Wilkinson et al. 2020b: xxx). This definition
acknowledges that voice encompasses a range of different topics such as working
conditions, reward, and work organization, and can occur through a variety of
mechanisms: formal and informal, direct and indirect, and individual and collective.
As can be seen, ER scholars have tended to focus on voice as a means of
expressing collective grievances and pushing for better working conditions. On the
other hand, OB scholars have moved more towards an understanding that voice is an
individual behavior and as such tends to take place on a more idiosyncratic basis
between employee and manager. An OB definition of voice defines it as “informal
and discretionary communication by an employee of ideas, suggestions, concerns,
information about problems, or opinions about work-related issues to persons who
might be able to take appropriate action, with the intent to bring about improvement
or change” (Morrison 2014: 174). As a result, OB voice can be considered to be
about facilitating constructive change for the organization or the work unit through
individual action (Tangirala and Ramanujam 2012; Morrison 2014), but like ER
voice, it is less about improving individual situations in the workplace and more
about collective gains.
With regards to encouraging voice, ER scholars would consider it important to
give employees opportunities to be involved in decisions about their wellbeing and
working environment via the provision of formal voice mechanisms, whereas OB
scholars would consider that employees would find a way to speak up directly to
their manager if they so desired, placing less emphasis on the need to provide voice
mechanisms specifically. This difference has manifested a change in perspectives
over appropriate voice mechanisms with the ER literature focusing heavily on the
value of collective voice mechanisms such as trade unions and works councils,
whereas the OB literature has focused on direct voice between the employee and
manager such as email and face-to-face meetings.
In contrast to the ER and OB views of voice which place the employee and the
manager as central to voice in the organization, the HRM literature has adopted a
processual view of how voice can be harnessed and used. Drawing on both OB and
ER disciplines, HRM perspectives of voice have tried to integrate the behavioral
356 S. Brooks and A. Wilkinson

insights from OB into the system level approach of HRM (Wilkinson et al. 2020a).
As a result of this processual view, voice has become marginalized except where
high-performance work system (HPWS) exists, and voice systems are designed to
improve organizational performance through voice (Harley 2014). Despite the
differences in perspective on voice, all literatures consider that voice can only be
defined as voice when it is targeted at an authority figure in the organization who can
make a change to the existing situation. Empirical evidence has confirmed the
importance of the power differential between voicer and target which is required
for voice to be effective (McClean et al. 2013), so acknowledging that voice must be
to an authority figure highlights that talking to peers, colleagues, friends, or family
cannot be classed as voice because of their lack of power to influence outcomes.
From a HRM perspective, it could be said that the focus on organizational perfor-
mance forces managers to make a choice between prioritizing their energies on
managing voice or managing performance (Guest 2017).
With regards to wellbeing, voice which captures employee perspectives is impor-
tant for organizational performance, but also highlights that voice is an opportunity
for employees to have their interests taken into account during organizational
decision-making. In essence, voice provides employees with an opportunity to
have some control over their working lives which is important in terms of wellbeing
(Wilkinson and Barry 2016). However, it could be that employees do not always
voice their needs or take part in activities designed to find out their views on
decisions. As a result, the way that employees use voice is largely determined by
opportunities for voice, the way that managers encourage and respond to voice, and
the attitude of the organization to the value that employee voice can provide to the
running of the organization.
In summary, the OB voice and silence literature has placed a large emphasis on
the idiosyncratic relationship between a manager and their employees, and has
largely neglected a wider focus on the organizational or group dynamics which
may also shape voice (see Morrison and Milliken 2000) for an exception). On the
other hand, the HRM/ER literature has focused on role of systems and mechanisms
as a way of understanding how voice can be fostered but it has neglected the way in
which motivations for voice shape outcomes. Taken together, there is an opportunity
for understanding voice as a route to employee wellbeing from micro, meso, and
macro levels.

Defining Wellbeing

Wellbeing can be defined as “the positive affective states associated with happiness
and meaningfulness at work” (Avey et al. 2012:25). There is disagreement among
scholars about how wellbeing should be defined with it once being described as
“intangible, difficult to define and even harder to measure” (Thomas 2009: 11 as
cited in Dodge et al. 2012). There is even disagreement as to whether positive
wellbeing and negative wellbeing even appear on the same continuum or might be
distinct constructs, the implication being that achieving positive wellbeing may be
18 Employee Voice as a Route to Wellbeing 357

more difficult than simply targeting areas which seem to negatively affect wellbeing.
Nevertheless, there have been attempts to define and measure it, leading to a
literature replete in indicators of positive and negative wellbeing. Furthermore,
there is strong evidence to show that being at work is good for mental and physical
wellbeing (Waddell and Burton 2006; Diener and Chan 2011).

The Relationship Between Voice and Wellbeing

The quest to understand how best to encourage voice has resulted in a literature
replete with the exploration of antecedents to voice (e.g., Morrison 2014; Kaufman
2015). Table 1 shows that a number of indicators of negative and positive wellbeing
have also been identified as antecedents of voice and silence. The result is a wide
array of variables which can be difficult to translate into practice and use to predict
when voice is most likely to take place. However, a clear pattern appears to be that
silence is more common than voice, especially for such issues as unfair treatment of
self or others, unethical behavior, concerns about the performance of manager or
colleagues, disagreement with organizational decisions or personal issues and con-
cerns (Milliken et al. 2003; Brinsfield 2013). In other words, things that are likely to
lead to negative wellbeing. The reasons cited for silence frequently involve fear of
damaging relationships with managers or colleagues, retaliation or ostracism (Milli-
ken et al. 2003), and are likely to be associated with forms of voice which challenge
the status quo or prevent damaging behaviors in the workplace.
Despite a number of variables which provide a link between the voice and silence
and wellbeing literatures, there has been very little direct exploration of the direct

Table 1 Wellbeing indicators which have also been discussed in the voice literature
Indicators of poor Indicators of good
wellbeing wellbeing Link to voice literature
Absenteeism (Lamb and Lows levels of Absenteeism is the result of a lack of
Cogan 2016) absenteeism (Cooper voice (Dundon et al. 2004)
and Dewe 2008)
Presenteeism (linked to Engagement (Bakker Voice leads to employee commitment
disengagement) (Isham and Demerouti 2017) (Hirschman 1970)
et al. 2020)
Increased turnover Reduced intention to Voice reduces intention to leave and
(Isham et al. 2020) leave (van der Vaart actual turnover (McClean et al. 2013);
et al. 2013) employee retention (Spencer 1986)
Dissatisfaction (Wood Satisfaction (job and Job satisfaction/dissatisfaction is linked
2008) life) (Wood 2008) to voice behavior (Holland et al. 2011)
Lack of control and Control and autonomy Control and autonomy is linked to
autonomy (Schaufeli and (Schaufeli and Taris propensity to voice (Tangirala and
Taris 2014) 2014) Ramanujam 2008)
Stress and burnout Engagement (Dollard Employee voice and engagement (Kwon
(Dollard and McTernan and McTernan 2011) and Farndale 2016)
2011)
358 S. Brooks and A. Wilkinson

link between voice and wellbeing. Therefore in order to make sense of the ways in
which voice might serve as a route to wellbeing, three theoretical underpinnings
have been identified which aim to help interpret the findings in each literature to
identify possible links and provoke new avenues of research: the job demands-
resources model (Schaufeli and Taris 2014), psychosocial safety climate (Dollard
et al. 2012), and behavioral approach and inhibition system (Carver 2006). Each of
these theoretical underpinnings provides an opportunity to consider the micro- and
meso-organizational levels of analysis, important to a fuller understanding of voice
at the macro level.

Job-Demands Resources Theory

The job-demands resources theory argues that an individual can use their
resources (work-related and personal) to buffer demands or challenges encoun-
tered in the workplace (Bakker and Demerouti 2017). Its fundamental premise is
that job demands and resources have the potential to shape motivation and fitness
for work through the management and avoidance of burnout and disengagement
(Han et al. 2020). Job demands refer to “those physical, social or organizational
aspects that require sustained physical or mental effort” (Demerouti et al.
2001: 501), whereas resources refer to the physical, psychological, social, or
organizational aspects of the job that help an individual to reduce job demands,
achieve work goals, or stimulate personal growth (Demerouti et al. 2001). Dodge
and colleagues suggest that wellbeing is the “balance point between an individ-
ual’s resource pool and the challenges [demands] faced” (2012: 230). The job
demands-resources (JD-R) model is used extensively in the wellbeing literature
(see Schaufeli and Taris 2014 and Bakker and Demerouti 2017 for reviews of the
JD-R model and wellbeing) to provide guidance on the types of variables which
count as resources and those which count as demands. In this way, it is able to
serve as an effective way to identify the types of demands which may lead to
withdrawal, exhaustion, and subsequent burnout, and the types of resources that
may help to prevent it (Schaufeli and Taris 2014). For example, drawing on the
wellbeing literature, harassment, unfair treatment, and work pressures constitute
job demands which, if not addressed, lead to outcomes including disengagement,
absenteeism, intention to leave, and physical and mental health problems
(Schaufeli and Taris 2014). Although the JD-R theory considers that when
demands and resources are utilized effectively, it ensures an equilibrium for the
employee (recognized as positive wellbeing), the JD-R model is limited in its
ability to guide individuals in how to manage their demands and resources to
achieve this outcome (Bakker and Demerouti 2017).
Linked to the JD-R theory is the conservation of resources theory which
examines how individuals, when under stress, choose to either protect existing
resources or use the opportunity to build additional resources as a way of
moving forward. A meta-analysis of 55 studies showed a negative association
between job stress and voice, meaning that when people experience stress, they
18 Employee Voice as a Route to Wellbeing 359

are less likely to voice than remain silent. Job stress, which is considered to be
a demand, included factors such as a lack of job autonomy, poor interpersonal
relationships with colleagues and managers, or feelings of risk when speaking
up about dissatisfaction (Ng and Feldman 2012). It is possible that individuals
do not always speak out when they are dissatisfied, because they may find that
speaking out adds to their stress rather than reducing it, thereby acting as an
additional demand, rather than a resource (Hirst et al. 2020). Therefore, it is
important to consider that the variables that cause an individual to speak out or
remain silent can be experienced as either resources or demands according to a
set of different circumstances and to predict how an individual may use voice in
relation to their wellbeing, a picture of their overall perceived demands and
resources is needed.

Behavioral Activation and Behavioral Inhibition Systems

Behavioral approach describes how an individual is motivated towards the achieve-

ment of a rewarding goal such as promotion, whereas behavioral inhibition describes
how an individual is motivated away from a negative outcome such as losing their job
or damaging relationships with colleagues and managers (Carver 2006). Behavioral
inhibition is strongly correlated with negative emotions such as fear and anxiety
(Carver and White 1994; Morrison et al. 2015), and frequent triggering of BIS can
have a wellbeing cost by increasing fatigue, stress, or strain (Sherf et al. 2020: 12).
Behavioral approach and behavioral inhibition have been used as ways of describing
how an individual may respond when their personal sense of power is threatened
(Morrison et al. 2015). Personal sense of power can be defined “as the perception of
one’s ability to influence another person or other people” (Morrison et al. 2015: 551).
Morrison and her colleagues found that individuals who feel powerful in their ability
to influence others are more likely to voice because they are focused on the successful
outcomes (BAS). On the other hand, those who feel less powerful in their ability to
influence others are less likely to voice because they are focused on the risks associated
with voicing (BIS) (Morrison et al. 2015). These findings were supported more
recently by Sherf et al. (2020) who combined the BAS/BIS approach to study the
effect of perceived impact (similar to personal sense of power) and psychological
safety on burnout, using voice as a mediator. They found that silence was positively
and significantly associated with burnout more strongly than voice was negatively
associated with burnout (Sherf et al. 2020: 24). This would suggest that voice may not
be successful at reducing negative wellbeing, but that reducing silence could be
important for reducing negative wellbeing. Therefore, voice may not best serve as a
route to wellbeing directly, but as a way of preventing negative wellbeing in the first
place. Furthermore, Sherf et al. (2020) found that psychological safety does not
directly increase voice. Instead, they found that it reduced triggers of the BIS, meaning
that silence was less likely where psychological safety existed, but in order to
encourage voice, a heightened perceived impact was required to trigger the BAS so
that voice could take place.
360 S. Brooks and A. Wilkinson

Table 2 Examples of voice and silence using BAS/BIS

Voice – BAS – asking for a specific wellbeing Silence – BAS – intentionally remaining silent
goal or target you want to achieve (e.g., to ensure you achieve your specific wellbeing
expressing views in favor of flexible working) goal or target (e.g., not returning a ballot for
strike action because you cannot afford it but
understand that others want to strike)
Voice – BIS – speaking up to ensure a goal or Silence – BIS – consciously withholding your
target considered detrimental to wellbeing does views to ensure an outcome detrimental to
not happen (e.g., providing a dissenting view wellbeing does not take place (e.g., taking sick
against the decision to move from weekly pay leave when you have a grievance hearing with
to monthly pay) HR)

Table 2 shows examples of how voice and silence related to wellbeing could
manifest when shaped by approach and inhibition tendencies.

Psychosocial Safety Climate

Psychosocial safety climate (PSC) refers to a climate for psychological health and
safety. A PSC is created by managers using workplace policies, practices, and
procedures in order to protect worker psychological health and safety
(Dollard et al. 2012). Therefore, it reflects a balance of concern by management
between psychological health and productivity (Dollard and McTernan 2011). Orga-
nizations with a PSC are more likely to have higher levels of wellbeing because they
effectively enable the using of resources to reduce demands (Dollard et al. 2012).
A PSC also has the greatest impact on psychological health when compared with
variables of “control” and “rewards” when used as moderators on emotional
demands, and a PSC is thought to act as a “resource passageway” which facilitates
the use of resources to counter demands (Loh et al. 2018). As such, it has been
described as a moderator of moderators (Loh et al. 2018), placing it as a fundamental
enabler for both voice and wellbeing.
One variable which is considered to be important in the voice and silence
literature and has been studied extensively is that of psychological safety. Psycho-
logical safety can be defined as “the extent to which an individual perceives it to be
safe to express himself or herself at work” (Liang et al. 2012: 80). One key source of
psychological safety for employees comes from the relationship they have with
leaders and managers (Detert and Burris 2007). Numerous studies have shown a
positive correlation between high relationship quality and voice (Van Dyne et al.
2008; Botero and Van Dyne 2009) with there being a widespread acknowledgement
that spending time investing in building relationships is beneficial for voice. It is an
important prerequisite for certain types of voice such as upward challenge (Brooks
2018) and prohibitive voice (Liang et al. 2012) and in encouraging employees to
share emotions (Chamberlin et al. 2017). An absence of psychological safety
suggests that employees perceive voice as risky and hence are less likely to voice
(Morrison 2011) and individuals who are not able to voice are more likely to suffer
from burnout (Sherf et al. 2020). It is important to note that a perceived lack of
18 Employee Voice as a Route to Wellbeing 361

openness to employee voice and fear of retaliation are considered to be organiza-

tional stressors in the wellbeing literature (Ng and Feldman 2012) meaning that
remaining silent has the potential to reduce feelings of overall wellbeing.

Whose Responsibility Is Voice About Wellbeing?

The previous section outlined three theoretical models which can provide an impor-
tant link between the voice and silence and wellbeing literatures. The JD-R theory
suggests that wellbeing is likely to be achieved by finding a balance between
demands and resources, with excess in either direction leading to negative wellbeing.
The BAS/BIS theory shows that when a personal sense of power and psychological
safety are high, voice is more likely to take place because of the reduction in risks
which trigger the BIS and an increase in safety which triggers the BAS. Finally, the
fostering of a psychosocial safety climate (PSC) appears to moderate the relationship
between resources and demands and wellbeing, suggesting that it could be the single
most important variable that links the relationship between voice and wellbeing.
This section will now consider an important question which provides a greater
insight into the role of voice as a route to wellbeing: Whose responsibility is it to
speak up about wellbeing?

The Role of the Employee

Employees have the ability to use voice in ways which serve their wellbeing but
little is known about how they choose whether to voice or remain silent about
wellbeing. In much OB research, there is an underlying assumption that
employees generally want to speak up, because there are issues that they care
about but the prosocial nature of voice indicates that voice is more likely to be
about issues which are common to everyone, not themselves individually. Sim-
ilarly, there is a view that managers should value this voice because of its
potential benefits for the organization as well as potential risks of not addressing
important issues (Wilkinson et al. 2020a: 100677) The JD-R theory posits that it
is the role of the employee to use their own resources to buffer what they
perceive to be demands. When considering their options for voice, employees
have recourse to formal and informal, direct and indirect, individual and collec-
tive voice mechanisms although in practice how viable these mechanisms are and
how easy they are to navigate is another issue. But to some extent it may be that
for employee wellbeing to occur it falls to individuals to speak up and take action
if their wellbeing is suffering. Hence, voice arrangements for supporting
employees are important. Drawing on research about psychological safety, it is
possible to see that employees have a certain amount of control over the decision
of whether, when, and how to speak, but ER literature assumes perceived levels
of safety are more likely to be shaped by wider organizational forces and their
relationship with their manager.
362 S. Brooks and A. Wilkinson

The Role of the Manager

The literature on psychological safety climate suggests that it is the manager’s role to put
into place certain practices and policies which enable employees to utilize the resources
which are important to them (Dollard et al. 2012). This places the manager as a key
facilitator of voice climates in the organization. However, although individual managers
may be concerned about employee wellbeing, their main focus is likely to be on
organizational performance (Guest 2017). For example, although managers may recog-
nize that employee wellbeing is important too (including their own), the strong focus on
meeting performance targets means employee wellbeing is likely to be less of a priority
for managers. In fact, employee wellbeing issues can be seen as a demand on managerial
time which prevents managers from focusing on organizational performance. It can
therefore be said that management, through agenda-setting and institutional structures,
can create silence over a range of issues making it difficult for them to speak up
(Donaghey et al. 2011).
The role of line managers is instrumental in ensuring voice systems are effective
(Townsend and Mowbray 2020). Yet, the purpose of management has traditionally been
to ensure that employees meet organizational targets. In effect, employees did not have a
voice because there were no valid reasons for not being able to carry out the tasks as
requested by the manager. However, in contemporary organizations, managers are
expected to manage voice from employees but they are often ill-equipped with the
skills to listen to, and deal with voice. Therefore, drawing on findings by Knoll and
colleagues (2018) which showed that emotional exhaustion was more likely where
silence was imposed, some important questions are raised around the extent to which
managers and organizations impose silence and whether the silence is an actual inability
to voice or a perceived inability to voice.
The prescriptive management literature has always set out an optimistic scenario in
which line managers move from being holders of expert power to facilitators and hence
take on new skills and responsibilities including the ability to facilitate employee voice
(Wilkinson et al. 2013). However, research suggests this might be a rosy view of what
happens on the ground. Indeed, managers do not always believe in the principles
underlying employees having a say, regarding it instead as “soft management.” Others
have concerns as to its actual operation in the context of current organizational pressures.
In many organizations, voice and engagement are considered a poor second to produc-
tion or service goals. In addition, the failure to reward line managers for spending the
time to encourage voice may be an issue as is a lack of training on how to encourage and
manage voice, this latter point speaking powerfully about the relative importance senior
managers attach to the practice of voice (Fenton-O’Creevy 2001). As such, in order to
encourage voice, leaders may benefit from generating opportunities for impact, rewards,
or success (Sherf et al. 2020) which are likely to trigger BAS experiences in individuals.

The Role of HR

The role of a human resources department is to ensure that the business functions are
aligned to the strategic direction of the organization. In recent years, the main focus
18 Employee Voice as a Route to Wellbeing 363

in the HRM field has been around performance, with the high-performance work
system (HPWS) approach dominant since the mid-1990s. The HPWS describes the
organization-level model of an HRM system through which investment in a strate-
gically aligned package of advanced, commitment-type HR practices (a focus on
shared values and goals which increase organization performance through team-
working) yields higher operational-financial performance from a higher-skilled,
motivated, and empowered workforce (Kaufman et al. 2020). Despite voice being
recognized as an important contributory factor to organizational performance in
HPWS (Harley 2014), the emphasis has been very much on how HR practices can
lead to performance outcomes with much less focus on employee wellbeing (Guest
2017). Accentuating this emphasis has been the discursive dominance of the HR
business partner model as developed by Urich (see Keegan and Francis 2010). As a
result, pressures to reduce costs, increase competitiveness, and achieve a tighter
alignment between business strategy and HRM have led HR to lose touch with
employees and employee wellbeing. An example of this was seen by Francis and
Keegan when one of the CIPD advisers interviewed suggested “no-one wants to be
an employee champion (employee advocate). They think it is ideologically unsound.
I think they see it as them being in opposition to the organisation . . . and it suggests
their management credentials are suspect” (Francis and Keegan 2006: 242). There-
fore, it can be said that HRM has overemphasized its strategic role and, in an attempt
to gain a seat at the top table, has neglected or ignored key components of its unique
contribution. In particular, HRM’s fixation on short-term performance goals and
shareholder demands has led it to downplay longer-term sustainable contributions
based on values and fairness for employees (Marchington 2015).
As was seen previously, OB studies of voice assume that individual voice
behavior centers around the relationship between the individual worker and man-
agement (Wilkinson and Barry 2016). Therefore, it is widely considered that indi-
vidual managers have the responsibility for creating environments and contexts
which make their employees feel psychologically safe when voicing. However, it
may also be important to consider the influence of institutional context on individual
voice behavior (Dundon et al. 2004; Wilkinson et al. 2004). For example, Klaas and
colleagues (2012) suggest that unions reduce the perception of risk to employees by
asking them to raise voice in a formal context, thereby enhancing their psychological
safety through anonymity. Similarly, Bryson et al. (2013) reported that job-related
anxiety was ameliorated when employees worked in a unionized workplace and
were involved in the introduction of the changes. So there is clearly a role for
HRM to establish systems to provide supportive organizational contexts for voice
(Marchington 2007).

Future Directions

The previous section highlighted that the responsibility for voice about wellbeing
needs to be a joint effort driven by employees and managers, with HR departments
providing a context which makes possible a balance between employee wellbeing
and organizational performance. With that in mind, a number of future directions
364 S. Brooks and A. Wilkinson

have been suggested which highlight how the examination of voice as a route to
wellbeing could yield important insights which could ultimately lead to improved
wellbeing outcomes for individuals in the workplace.
Firstly, evidence showing that the individual employee-manager relationship
leads to improvements in both voice and wellbeing independently, would suggest
that a combination of the two could be more powerful. For example, it could be that
high relationship quality between employee and manager leads to voice which in
itself leads to higher wellbeing because voice serves as a means of contributing or
sharing concerns. On the other hand, it could be that voice leads to greater wellbeing
because managers are able to make changes which result in reduced demands. Future
research directions here could include how individuals learn to ask for what they
need, and how managers recognize voice about wellbeing specifically so certain
types of voice can be prioritized.
Secondly, there is a recognition that psychological safety is an important prereq-
uisite for voice. It is individuals themselves who gauge the extent to which they feel
safe when voicing, but it is also possible to see that organizations can create
psychosocial safety climates which help individuals to feel safe. Therefore, under-
standing the variables which managers and HR departments can put in place can give
the responsibility to both employees and managers for creating psychological safety
for voice about wellbeing.
Third, using JD-R theory to consider voice as a route to wellbeing suggests that
voicing could be an important resource which could alleviate individual job
demands as well as helping managers to prioritize their attention to issues which
may affect organizational performance. Therefore, it is important to understand the
situations in which voice can be considered a resource, and alternatively a demand,
which in turn will provide a greater insight into the ways in which wellbeing needs
can be catered for in the workplace.
Fourth, adopting a behavioral approach and inhibition perspective enables a
consideration of the range of individual, organizational and societal issues which
contribute to feelings of power and emotional attitudes towards voicing. Such a
perspective allows scholars to think more broadly about the importance of encour-
aging voice about wellbeing.
Finally, is it possible to assume that individuals are able to articulate exactly what
they need to ensure their own wellbeing, or do managers need to be able to read
between the lines? Ultimately, voicing is about asking for what is needed, and when
it comes to wellbeing, each individual has different requirements which are not
necessarily catered for through one suits all decisions that are made about working
conditions and arrangements.

Conclusion

Through the examination of three theoretical models to understand how voice might
serve as a route to wellbeing, it can be seen that voice and silence are linked to both
positive and negative wellbeing in complex ways. Furthermore, following a
18 Employee Voice as a Route to Wellbeing 365

consideration of how voice could be used as a route to wellbeing, it has become clear
that existing definitions do not provide sufficient clarity and a new definition of voice
is required. Therefore, voice about wellbeing can be defined as “raising awareness
of, asking for, or telling others what is needed to improve individual wellbeing.”
This definition specifies the purpose of voice for individual wellbeing and assumes
an awareness by the voicer that they are voicing specifically because they are
motivated by a desire to contribute to their own wellbeing. Furthermore, it places
an emphasis on the individual to get to know themselves sufficiently well so that
they know what they need in order to counteract any demands. This definition does
not consider voice about the wellbeing of others or voice about organizational
performance because these considerations are picked up under other definitions of
voice. For example, OB voice is about prosocial motives and speaking up for the
greater good whereas ER and HRM perspectives on voice consider that employees
speak up for their own interests which might be different to those of management.
However, when considering voice about wellbeing, it must be acknowledged that
individuals need to speak up for themselves regardless of managerial agendas or
organizational priorities because otherwise, they are not able to function as human
beings with a sense of fulfilment.

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HRM Practices, Employee Well-Being,
and Organizational Performance 19
Chidiebere Ogbonnaya and Samuel Aryee

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 370
Conceptualizations of HRM Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Integrationist Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372
Isolationist Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 374
HRM Practices, Performance, and the Black Box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Mutual Gains Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Critical Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Implementation of HRM Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 380
Methodological Issues (Multilevel Analysis) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382
Methodological Issues (Reverse Causality) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386

Abstract
In this chapter, we discussed the accumulating evidence on what constitutes an
HRM system as well as how, why, and when it influences organizational perfor-
mance and employee well-being. To this end, we reviewed the two competing
configurations of HRM systems (integrationist and isolationist) as well as the
resource-based view (RBV) and ability, motivation, and opportunity (AMO)
perspectives in accounting for the performance effects of HRM systems. To
counterbalance the predominant performance focus in HRM research, we
reviewed the critical perspective that highlights the deleterious consequences of
HRM systems on employee well-being. To resolve these research contradictions
C. Ogbonnaya (*)
University of Sussex Business School, University of Sussex, Brighton, UK
e-mail: [email protected]
S. Aryee
Surrey Business School, University of Surrey, Guildford, UK
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 369

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_17
370 C. Ogbonnaya and S. Aryee

and drawing on the notion of workforce sustainability, we reviewed the mutual

gains perspective and questioned the applicability of the AMO perspective. We,
instead, suggested social exchange and self-determination theories as an appro-
priate theoretical lens with which to account for the performance and well-being
outcomes of HRM systems. We concluded by calling for future research to be
grounded in the mutual gains perspective and for its rigorousness to be enhanced
by addressing issues of level of analysis and causality.

Keywords
HRM Systems · Employee Well-Being, Performance · HR Perspectives · HRM
Systems Implementation

Introduction

During the last few decades, research on Human Resource Management (HRM)
practices (e.g., staff training and development, performance management, workplace
participation, and compensation) has gained prominence among management
scholars and practitioners, with several articles reporting positive effects on
employee attitudes, well-being, and organizational performance (see reviews:
Combs et al. 2006; Jiang et al. 2012; Van De Voorde et al. 2012; Jiang and
Messersmith 2018). When implemented consistently throughout the work environ-
ment, HRM practices enhance employee skills, motivate employees to perform their
jobs at optimal levels, exercise discretional effort, and thereby improve organiza-
tional effectiveness (Macky and Boxall 2007; Ogbonnaya et al. 2017a). Conse-
quently, employees are able to achieve a sense of fulfillment through their work,
while helping the organization to create and sustain competitive advantage. The
most frequently cited benefits for employees include job satisfaction, work engage-
ment, organizational commitment, well-being, and greater control over key aspects
of the job. For organizations, the benefits of HRM practices include high-quality
customer service, profitability, reduced absence rates, and enhanced labor produc-
tivity (Jiang et al. 2012; Martinaityte et al. 2019; Van De Voorde et al. 2012).
Despite growing theoretical and empirical interests in the importance of HRM
practices, a key issue concerns how different practices complement and interrelate
with each other. On the one hand, HRM practices are said to have mutually
reinforcing properties and should therefore be configured in coherent “bundles” or
“systems” that enable an organization to achieve its goals (Authur 1994; Beltrán-
Martín et al. 2008; Huselid 1995). In contrast, others subscribe to the view that each
practice within the HRM system has unique characteristics and exerts independent
effects on different aspects of employee well-being and organizational performance
(Kalmi and Kauhanen 2008; Ogbonnaya et al. 2017a). Moreover, researchers have
debated whether or not the performance effects of HRM practices are actually
achieved at the expense of employee well-being (Van De Voorde et al. 2012). A
key aspect of this debate is that employees managed under high-performance HRM
19 HRM Practices, Employee Well-Being, and Organizational Performance 371

regimes may feel that their work has been intensified, leading to lower levels of
well-being (Ramsay et al. 2000). Because employers are often torn between business
strategies that promote organizational performance versus those that are favorable
for employee well-being, the implementation of HRM practices might be exploit-
ative, and employees may suffer increased work demands and stress (Godard 2001;
Macky and Boxall 2008).
In this chapter, our goal is to discuss the current and emerging trends, issues, and
concepts relating to the effects of HRM practices on employee well-being and
organizational performance. Specifically, we address three main but interrelated
objectives: (i) to synthesize the existing body of evidence on the different strategic
approaches to managing people in organizations; (ii) to reflect on this knowledge in
creating a more comprehensive understanding of the links between HRM practices
and different aspects of employee attitudes, well-being, and organizational perfor-
mance; and (iii) to delineate current thinking about the implementation of HRM
policies and activities. We begin this chapter by providing an overview of key
concepts in HRM research, focusing on the different configurations of HRM prac-
tices, the integrationist perspective (i.e., the idea that HRM practices should be used
together in coherent systems or bundles), and the isolationist perspective (i.e., the
idea that individual HRM practices have unique and independent effects on out-
comes). Regarding the nature of the relationships between HRM practices and both
employee well-being and performance, we focus on the black box model of HRM,
the mutual gains perspective, and the critical perspective (i.e., the idea that HRM
practices influence performance at the expense of employee well-being). Building on
these themes, we review the literature on implementation of HRM systems,
highlighting both content and process issues, as well as the role of line management
in HRM implementation. We conclude the chapter with a discussion of some
methodological issues associated with the study of HRM practices and outcomes.

Conceptualizations of HRM Practices

HRM practices are concerned with all aspects of how people are attracted, moti-
vated, and retained in organizations (Boxall and Purcell 2003). They include a wide
variety of people-management policies and activities aimed at improving the quality
of employees’ jobs, as well as their capacity to promote and achieve organizational
objectives. Although there is a general lack of consensus regarding the best set of
HRM practices for ensuring effective functioning of both employees and organiza-
tions, certain practices exist which collectively support organizations in achieving
competitive success irrespective of the organizational setting or industry (Jiang and
Messersmith 2018; Paauwe and Boselie 2003; Redman and Wilkinson 2009). Based
on their review of 92 HRM studies, Combs et al. (2006) identified 13 practices for
which some consensus has emerged regarding the main constituents of an effective
HRM system: incentive compensation, staff training, compensation level, participa-
tion, selectivity, internal promotion, HRM planning, flexible work arrangements,
performance appraisal, grievance systems, team working, information sharing, and
372 C. Ogbonnaya and S. Aryee

employment security. Subramony (2009) further noted that these practices could be
categorized into three different subsystems of HRM practices, including skill-
enhancing, motivation-enhancing, and empowerment-enhancing HRM practices.
Subramony (2009) focused on highlighting the importance of these subsystems in
improving the organization’s human capital and operational effectiveness.
Traditionally, HRM practices have been characterized by mainly hierarchical work-
place activities (e.g., top-down managerial communication and control), task speciali-
zation, and centralization of employees’ roles to elicit greater work effort from them.
This approach, often described as the “hard version of HRM” (Jenkins and Delbridge
2013; Truss et al. 1997), focuses on driving performance and securing bottom-line
success often at the expense of employee well-being. The hard approach to HRM has
some advantages, such as allowing organizations to make managerial decisions quicker,
exert full operational control over employees, and drive performance through cost-
cutting activities. However, it is often criticized as being an exploitative approach to
managing people in organization (Ramsay et al. 2000). Other researchers have described
this approach as “control-oriented HRM practices” given the general focus on rules
enforcement, performance evaluation, direct monitoring of employees’ actions, and
measuring employees’ outputs through incentives and rewards (Arthur 1994; Boselie
et al. 2003; Hauff et al. 2014; Whitener 2001). Hauff et al. (2014) further explained that
control-oriented HRM practices emphasize the maintenance of tasks through narrowly
defined jobs for employees, direct forms of control, and cost reduction strategies
(i.e., reducing direct labor costs in order to improve efficiency).
In recent years, HRM research has witnessed a progressive shift from the hard
approach toward a more flexible, participative organizational system aimed at
developing employees’ knowledge, skills, and abilities. This shift has followed the
growing recognition of employees as a competitive resource or as the primary source
of achieving sustainable competitive advantage for an organization (Kaufman 2015).
Researchers have often described this as the “soft version of HRM,” concerned with
attracting, retaining, and motivating employees to perform work more efficiently and
with minimal managerial control (Appelbaum et al. 2000; Jenkins and Delbridge
2013; Truss et al. 1997). Others have variously described this approach as “com-
mitment-oriented HRM practices” aimed at developing committed employees and
improving job security, internal promotions, and incentives (Arthur 1994; Boselie
et al. 2003; Tsui et al. 1997; Whitener 2001); high-involvement-oriented HRM
practices characterized by decentralized decision-making, employee participation,
and information sharing (Guthrie 2000; Wood et al. 2012); and high-performance
work systems characterized by selective staffing, intensive training and develop-
ment, and individual and group incentives (Appelbaum et al. 2000; Huselid 1995).

Integrationist Perspective

The integrationist perspective is arguably the most common approach to studying the
effects of HRM practices on employee and organizational performance. It is based
on the principle of “internal consistency,” also known as “internal fit” (Delery 1998;
19 HRM Practices, Employee Well-Being, and Organizational Performance 373

Macky and Boxall 2007; Youndt et al. 1996), comprising both “vertical fit” (align-
ment between HRM practices and the organization’s business strategy) and “hori-
zontal fit” (using multiple HRM practices together in coherent systems or bundles).
Once the outward-facing strategic business objectives are set by senior executives of
an organization (i.e., external fit), HRM practices should be integrated into a
consistent, mutually reinforcing system of practices aimed at achieving such objec-
tives (i.e., horizontal fit). In so doing, internal coherency among HRM practices is
maximized such that their combined effects are significantly greater than the sum of
their individual influences on employee and organizational performance (Huselid
1995; Delery 1998; Appelbaum et al. 2000). As an illustration, consider the use of
“sales training programs” alongside “sales performance-related pay” to boost sales
performance (i.e., achieve the sales targets set by the senior executives of an
organization). Given these two HRM techniques are designed to influence different
aspects of sales performance, their combined effects, when used together rather than
separately, would more likely exceed their unique and independent effects.
There are several principles for describing internal consistency among HRM
practices. One principle is the idea of “complementarity,” which highlights the
possibility that individual HRM practices will generate overall additive effects
when used together in combination rather than separately (Delery 1998; Combs
et al. 2006; Wood and De Menezes 2008; Jiang et al. 2012). In this context, each
HRM practice within the complementary system of practices makes its own unique
contribution to the overall additive effects generated by the system (MacDuffie
1995; Becker and Gerhart 1996). The term “additive effects” implies that the overall
consequence of two or more practices acting together will be equal to the simple sum
of the effects of each practice acting independently (Wood and De Menezes 2008).
For example, two distinct selective hiring practices (such as panel interview versus
cognitive skills assessment), when used separately in a recruitment exercise, might
be effective in measuring two different job-related skills. However, when used
together in a complementary manner, they might be able to generate stronger
additive effects on the desired recruitment outcome. In this sense, the unique and
independent effect of one selective hiring practice, relative to the other selective
hiring practices, makes a significant additive contribution toward the overall effec-
tiveness of the selective hiring system (Becker and Gerhart 1996; Delery 1998).
Another principle for describing internal consistency is the idea of “synergistic”
effects, emphasizing the overall multiplicative effects of HRM practices (Guerrero
and Barraud-Didier 2004; Wood and De Menezes 2008). Compared to additive
effects, multiplicative effects imply that the overall consequence of two or more
practices acting together will be equal to the product of their independent effects.
The key issue here is the extent to which individual HRM practices might interact
with each other such that their combined effects are greater than the sum of their
individual influences (Huselid 1995; Delery 1998; Appelbaum et al. 2000). For
example, the value of staff training on employees’ job performance could be
strengthened if training is offered alongside job autonomy and opportunities to
participate in workplace decision-making activities. If, on the contrary, staff training
is offered without job autonomy or the opportunity to directly influence the nature of
374 C. Ogbonnaya and S. Aryee

one’s job, the level of skills acquired by employees will be constrained, and
consequently, the value of training offered will not amount to significant benefits
on employee performance (Combs et al. 2006). In other words, synergistic HRM
practices are likely to amplify each other’s effects when used together in combina-
tion rather than separately (Guerrero and Barraud-Didier 2004; Wood and De
Menezes 2008).

Isolationist Perspective

The more traditional approach to studying the effects of HRM practices is the
isolationist perspective (Ogbonnaya et al. 2017a). This approach is based on the
idea that systems or bundles of HRM practices do not, in themselves, play the only
role in explaining the effects of such practices on employee and organizational
outcomes; instead, much of the variance explained on outcomes is, at least, partially
driven by the constituent parts of such systems (Kalmi and Kauhanen 2008; Delery
1998; Guerrero and Barraud-Didier 2004; Subramony 2009; Ogbonnaya and
Messersmith 2019). When HRM practices are used together in combination, rather
than separately, their unique and independent characteristics are weakened, leading
to only a partial estimation of their true idiosyncratic effects (Boxall et al. 2011).
Thus, while the logic of combining individual HRM practices into coherent systems,
as stipulated by the integrationist perspective, has gained prominence among HRM
researchers, some of its assumptions have been challenged by those in favor of the
isolationist perspective. For example, it is argued that the existence of multiple
management goals (e.g., cost reduction versus human capital development) may
cause discrepancies that undermine the level of interconnectedness among compo-
nents of HRM systems (Macky and Boxall 2007). Such discrepancies create strate-
gic tensions that invalidate the notion of internal consistency thereby causing
individual components of HRM systems to pull in different and conflicting direc-
tions (Boxall et al. 2011). From this perspective, it is often argued that combinations
of HRM practices may not necessarily generate the kinds of universal effects as
prescribed by the integrationist perspective (Ogbonnaya et al. 2017a).
Based on the foregoing principles, researchers have reported two main explana-
tions as to why we might be interested in the unique and independent effects of HRM
practices, instead of focusing primarily on their integrated or combined effects
(Becker et al. 1997; Delery 1998; Gould-Williams 2004; Combs et al. 2006; Boxall
et al. 2011). The first, described as “substitution effect,” is a type of combination in
which the impact of a single practice within an integrated system of practices is
suppressed by the presence of another practice within the same system (Delery 1998;
Combs et al. 2006). Where two substitutable HRM practices are used together in an
integrated system, their combined effect on employee and organizational perfor-
mance would be equal to the effect of using only one of such practices (Becker et al.
1997). For example, if a group of employees, who were selectively hired based on
their interpersonal skills, are offered training on issues such as effective communi-
cation and conflict-management techniques (both of which are associated with one’s
19 HRM Practices, Employee Well-Being, and Organizational Performance 375

interpersonal skills), then the levels of training offered will potentially amount to no
further development of their interpersonal skills (Combs et al. 2006). In this regard,
the expected benefits that would have been accrued from investing in two different
HRM practices – i.e., selective hiring based on interpersonal skills and training to
further improve such skills – would amount to the benefit of implementing only one
of such practices.
The second explanation is often described as “deadly combination” (Becker et al.
1997; Delery 1998; Combs et al. 2006). This is based on the assumption that HRM
practices, which independently have beneficial effects on employee and organiza-
tional performance, may end up having detrimental effects when used together in
combination (Becker et al. 1997). In this sense, internal consistency among HRM
practices is said to impede rather than improve performance. For example, if team
working is used alongside compensation schemes that assess individual-based rather
than group-based performance, such a combination is likely to weaken performance.
In such circumstances, team members may resort to competing among each other for
higher pay, thereby creating an atmosphere of distrust and interpersonal conflict
thereby undermining team performance. There are other possible examples where
job autonomy is used alongside group-based performance appraisal, or
implementing remote working arrangements in work environments where
employees require direct supervisory support and assistance. Unless further under-
standing of the unique and independent properties of individual HRM practices is
gained through further research on the isolationist perspective, researchers might
find it challenging to identify valuable combinations of HRM practices (Ogbonnaya
et al. 2017a).

HRM Practices, Performance, and the Black Box

HRM scholars have identified at least three different conceptualizations of organi-

zational performance: human resource outcomes, organizational outcomes, and
financial outcomes. Human resource outcomes (e.g., absenteeism, turnover, and
individual and group performance) are more directly influenced by HRM practices.
They are the most proximal to HRM implementation and are closely associated with
employees’ attitudes and behaviors at work (Dyer and Reeves 1995; Ogbonnaya and
Valizade 2018, Sun et al. 2007). Organizational outcomes focus more on operational
measures of performance, including productivity, customer service quality, effi-
ciency of production, and shrinkage. Organizational outcomes are also proximal to
HRM implementation, but less so compared to human resource outcome (Dyer and
Reeves 1995; Jiang et al. 2012; Martinaityte et al. 2019). Financial outcomes (e.g.,
profitability, expenses, revenues, return on investment, and assets) are more distal to
HRM practices, in that they are more directly influenced by other organizational
resources such as corporate strategy, market performance, and selling price to costs.
Many believe that these outcomes tend to represent a causal order from HRM
practices to human resource outcomes, organizational outcomes, and then financial
376 C. Ogbonnaya and S. Aryee

outcomes (Becker and Huselid 1998; Dyer and Reeves 1995; Schmidt and Pohler
2018).
More recently, the role of employee well-being and performance has become
more central to HRM research, reflecting the view that HRM practices shape
organizational performance mostly through their influence on employee outcomes
(Guest 2017; Van De Voorde et al. 2012). Based on this perspective, employee’
attitudes and well-being are regarded as vital ingredients for promoting organiza-
tional effectiveness. Employee attitudes are defined in terms of individuals’ overall
psychological and behavioral disposition toward their experiences of work (Dunford
et al. 2001). Employees’ attitudes at work include a variety of constructs such as job
satisfaction, organizational commitment, and employees’ trust in management
(Whitener 2001; Gould-Williams 2004). In slight contrast, employee well-being
relates to the overall quality of employees’ mental health and psychological func-
tioning at work (Danna and Griffin 1999; Daniels et al. 2008). It could be described
in terms of “negative affect” (feeling frustrated, stressed out, anxious, and worried in
the context of work) and “positive affect” (feeling enthusiastic, energetic, joyful, and
motivated in the context of work). Employee well-being may also include measures
of both physical health and cognitive functioning (Daniels et al. 2008). Although
both employee attitudes and well-being are often used interchangeably in HRM
research (see Appelbaum et al. 2000; Macky and Boxall 2008; Wood and De
Menezes 2011), it is possible for HRM practices to exert contradictory effects on
different aspects of employee attitudes and well-being (Van De Voorde et al. 2012).
In line with earlier research on the strategic partner status of HRM practices and
performance, recent research has focused on explicating the processes that underpin
this relationship. Often referred to as the “black box” of HRM, this idea focuses on
the intervening or intermediary linkages that exist between HRM utilization and
subsequent organizational outcomes (Boxall et al. 2011). Nevertheless, researchers
believe that the actual workings of the “black box” remain somewhat mysterious and
elusive (Chowhan 2016). On the one hand, it is argued that positive employee
outcomes serve as mechanisms through which HRM practices influence organiza-
tional performance. This assumption reflects the idea that HRM practices promote
organizational performance by increasing the commitment of employees and shap-
ing their positive attitudes and behaviors at work. The research thus illustrates a
triangle of positive relationships between HRM practices, employee outcomes, and
organizational performance (Boxall et al. 2011; Ogbonnaya and Valizade 2018;
Peccei and Van De Voorde 2019b). On the other hand, a growing number of
empirical studies indicate that HRM practices are designed to elicit greater work
effort from employees, which negatively affect the health and well-being (including
exhaustion, stress, and burnout) of the workforce (Van De Voorde et al. 2012). These
findings indicate the possibility of a complex pattern of effects and trade-offs
between HRM utilization and different aspects of well-being and organizational
performance outcomes.
A few theoretical models have since been developed to explicate the intermediary
links in the HRM-performance chain (Jiang and Messersmith 2018). One example is
the resource-based view, arguably the most illustrative model for linking HRM
19 HRM Practices, Employee Well-Being, and Organizational Performance 377

practices to both employee outcomes and organizational performance (Kaufman

2015; Saridakis et al. 2017; Wright et al. 2001). The premise of this theory is that
employees are a vital source of sustained competitive advantage. By investing in
HRM practices and improving employees’ knowledge, skills, and abilities, organi-
zation can strengthen their human capital pool, making it more valuable, rare, and
inimitable. Based on this fundamental principle, several studies have reported
positive links between HRM implementation and several aspects of employee and
organizational performance. Arthur (1994), for example, showed how investments in
HRM practices improve production efficiency and the overall quality of employee
performance in US steel minimills. Similarly, Shaw et al. (2013) argued that the
implementation of internally consistent HRM practices helps in developing
employees’ core competencies and their ability to exert themselves on behalf of
the organization. Effective HRM implementation thus promotes better alignment
between employee-employer interests, leading to long-term improvements in orga-
nizational performance (Beltrán-Martín et al. 2008).
Another influential model for linking HRM practices to both employee outcomes
and organizational performance is the Ability-Motivation-Opportunity (AMO)
model (Appelbaum et al. 2000; Macky and Boxall 2007; Ogbonnaya et al. 2017).
This model suggests that the benefits of HRM systems are influenced by three main
categories of practices. Ability-enhancing practices are those designed to attract and
retain talented workers, improve their skills and ability to perform work more
efficiently. This set of practices include selective hiring, skill-enhancement activities,
and extensive training programs. Motivation-enhancing practices are important
contributing factors for extrinsic motivation among employees (Subramony 2009).
These practices, including management support, incentive pay, and effective feed-
back systems, encourage employees to direct their effort toward achieving desired
organizational goals. The third dimension, opportunity-enhancing practices, pro-
vides opportunities for employees to maximize their skills, engage in problem-
solving activities, and express their voice in organizational decisions (Gardner
et al. 2011). These practices include job autonomy, team-based working, and
workplace participation. The consensus among commentators is that all three
dimensions should be applied consistently if the organization is to achieve expected
benefits (Appelbaum et al. 2000; Combs et al. 2006; Van De Voorde et al. 2012).

Mutual Gains Perspective

In recent years, researchers have begun focusing more directly on the concept of
employee well-being, looking more explicitly at its role in explaining the links
between HRM practices and organizational performance (Guest 2017; Peccei and
Van De Voorde 2019b; Van De Voorde et al. 2012). In the mutual gains perspective,
HRM practices are thought to have positive effects on both employee attitudes and
well-being, as well as organizational performance (Jo et al. 2020; Ogbonnaya and
Messersmith 2019; Ramsay et al. 2000; Sparham and Sung 2007; Valizade et al.
2016; Wood and Ogbonnaya 2018). Consistent with the notion of workforce
378 C. Ogbonnaya and S. Aryee

sustainability (Pfeffer 2010), this perspective suggests that the implementation of

HRM practices creates conditions for employees to be treated as assets to be
leveraged to enhance organizational performance. For example, access to training
helps to reinforce employees’ key competencies, whereas contingent pay and work-
place support provide inducements that boost employees’ morale and productivity
levels. Ultimately, through the implementation of HRM practices, employees are
inspired to be more committed, satisfied, and motivated to contribute positively
toward organizational performance. Along these lines, the mutual gains perspective
is associated with a “win-win” situation whereby organizational performance is
achieved through the positive influences of HRM practices on employee attitudes
and well-being (Appelbaum et al. 2000; Valizade et al. 2016).
One influential theoretical frame within the mutual gains tradition is social
exchange theory. This theory describes the quality of exchange relationships that
take place in work environments (Eisenberger, Fasolo, and Davis-LaMastro 1990).
The key tenet is that employees develop positive or negative social behaviors based
on perceptions about the quality of treatment received from the organization. When
organizational treatment is experienced favorably, employees develop perceptions of
trust or confidence that the organization is supportive and committed to improving
their well-being (Ogbonnaya and Babalola 2020). This creates a type of positive
reciprocity wherein employees feel obligated to exert themselves, or put forth greater
effort, on behalf of the organization. In applying social exchange principles, we
argue that HRM practices convey positive signals about the extent to which
employees are valued and respected by the organization (Cropanzano and Mitchell
2005). Employees receive these signals as positive treatment from the organization,
or as an indication that they are supported and cared for by the organization. This, in
turn, creates a sense of obligation on the part of employees, to respond through
favorable attitudes directed toward organizational goals (Sun et al. 2007; Whitener
2001). Drawing on the principles of social exchange, Tregaskis et al. (2013) reported
positive links between HRM practices and subsequent levels of workers’ safety, job
satisfaction, and productivity. Tregaskis et al. (2013) explained that the implemen-
tation of HRM practices encourages sustained and beneficial workplace behaviors
because employees are exposed to tangible improvements in their working
conditions.
An emergent theory in accounting for mutual gains is self-determination theory
(SDT, Deci and Ryan 2008; Deci et al. 2017). SDT is predicated on the universalism
of the three basic psychological needs of autonomy (a need to exercise control over
one’s actions in accordance with one’s integrated sense of self), competence (a need
to have an effect on one’s outcomes) and relatedness (a need to feel connected and
mutual respect with others). Deci and Ryan (2000, p. 229) posit that “needs specify
innate psychological nutriments that are essential for ongoing psychological growth,
integrity, and well-being.” As a macrotheory of motivation, SDT considers features
of the work environment such as HRM and leadership practices and their resulting
working conditions as providing the nutriments to satisfy these basic psychological
needs. Although research has examined them independently, these basic psycholog-
ical needs are assumed to operate synergistically (overall need satisfaction) to
19 HRM Practices, Employee Well-Being, and Organizational Performance 379

promote optimal human functioning including well-being (Trepanier et al. 2015).

Research has either theorized and/or empirically shown HRM practices to relate to
need satisfaction (Gardner et al. 2011; Marescaux et al. 2013; Martinaityte et al.
2019) which, in turn, has been reported to relate to well-being. Indicative of SDT’s
potential in accounting for the mutual gains perspective is Jo et al. (2020) finding
that HRM practices relate to both psychological well-being and performance through
thriving at work. Additionally, they report thriving at work and psychological well-
being to serially mediate the effect of HRM practices on performance. SDT’s
relevance as a theoretical anchor for the mutual gains perspective is reinforced by
Boxall et al.’s (2016) observation that the AMO framework constitutes a theory of
performance, and therefore inappropriate in accounting for employee well-being,
and therefore the mutual gains perspective.

Critical Perspective

Increasingly, scholars are paying closer attention to the so-called “dark side” or
conflicting outcomes approach to studying the effects of HRM practices. The critical
perspective is based on the assumption that the positive effects of HRM practices,
particularly on employee well-being and performance, may be offset by increased
job demands, work intensity, and stress on employees (Ramsay et al. 2000; Macky
and Boxall 2008; Harley et al. 2007; Gould-Williams 2004). Because HRM practices
are implemented primarily to elicit employees’ effort and drive improvements in
organizational performance, employees are often compelled by managers to work
too hard and take on greater job responsibilities at the expense of their well-being
(Kroon et al. 2009; Ogbonnaya 2019). The most crucial element with the critical
perspective is the notion of “work intensification,” the measure of the amount of
effort expended at work in relation to the amount of hours invested in the conduct of
one’s job (Kelliher and Anderson 2010; Ogbonnaya and Valizade 2015; White et al.
2003). Work intensification can be instigated by multiple stressors such as long
working hours, work overload, insufficient time to undertake one’s job, tight dead-
lines, high working speed, and work-related pressure (Green 2001).
The critical perspective is informed by labor process theory, a theoretical model
whose original version (see Braverman 1974) draws on Marx’s writing on the links
between organizational processes and worker alienation in capitalist work systems
(Ramsay et al. 2000; Sparham and Sung 2007; Thompson and Smith 2009). Labor
process theory suggests that employees’ experience of work-related strain and stress
stems from the tendency of “capitalist” managers (perhaps, driven by the need to
maximize labor input) to impose higher work demands and long working hours on
employees, without providing commensurate levels of support. In such capitalist
work environments, employees’ jobs are typically characterized by the routinization
of work, increased levels of managerial control, and insufficient opportunities for
employees to show initiative at work. HRM practices are seen as an important
organizational tool for eliciting greater work effort from employees. Thus, while
the implementation of such practices might in fact increase profits and production
380 C. Ogbonnaya and S. Aryee

efficiency, the performance effects come at the cost of work intensification, stress,
and poor well-being for employees (Jensen et al. 2013; Ramsay et al. 2000; Sparham
and Sung 2007; Thompson and Smith 2009).
Although the critical perspective, at least compared to the mutual gains perspec-
tive, has received relatively less attention in the HRM literature, few studies are
worth mentioning. For example, Kroon et al. (2009) demonstrated strong positive
links between systems of HRM practices and employees’ experience of work
intensification and job strain. Kroon et al. described such HRM systems as salient
stress factors likely to create continuous feelings of work-related pressure and strain
among employees, thereby increasing their experience of burnout and emotional
exhaustion. Similarly, Godard (2001) showed how the organizational benefits of
HRM practices might be offset by increased stress and pressure imposed on
employees by managers. Because HRM practices are utilized primarily to drive
organizational effectiveness, it is possible that their implementation might, perhaps
inadvertently, compel employees to work too long and too hard toward achieving
organizational goals. From this perspective, HRM practices can be seen as an
organization-wide strategy for eliciting greater work effort from employees, with
little or no direct benefits for employee well-being (Godard 2001; Kroon et al. 2009;
Macky and Boxall 2008; Ogbonnaya and Valizade 2015).
Researchers have also linked individual components of HRM systems to the
critical perspective. Team working in particular has been associated with increased
work intensification and consequently a deterioration in employee attitudes and well-
being (Barker 1993; Godard 2001; Ogbonnaya 2019; White et al. 2003). The
reasoning is that team-based work activities have the potential to increase both
task and interpersonal conflicts particularly where there is a degree of vagueness
in assigning team member roles (i.e., role ambiguity), or perhaps where team
members have inadequate time and resources to fulfill their team roles and obliga-
tions (i.e., role overload). Other components of HRM systems (e.g., compensatory
monetary rewards, performance appraisals, and participative decision-making) have
also been associated with work intensification, and poor well-being (Brown and
Benson 2005; Tubre and Collins 2000; Ogbonnaya, Daniels and Nielsen 2017b;
Ogbonnaya and Valizade 2015). For example, when employees’ job performance is
tied to monetary rewards, employees tend to work harder, in order to obtain these
rewards, and are therefore exposed to higher levels of work-related strain and,
possibly, poor work-related attitudes (Ogbonnaya et al. 2017b). Similarly, perfor-
mance appraisal may increase work intensification where there are too many per-
formance measurement criteria for assessing employees’ job performance (Brown
and Benson 2005).

Implementation of HRM Practices

Researchers have recognized the important role of effective HRM implementation in

promoting employee well-being and organizational performance (Kehoe and Han
2020; Nishii and Wright 2008; Purcell and Hutchinson 2007; Sikora and Ferris
19 HRM Practices, Employee Well-Being, and Organizational Performance 381

2014). HRM implementation refers to the pattern of planned people-management

deployments and activities intended to help motivate and reward employees, deal
with performance issues, and enable an organization to achieve its corporate goals
and objectives (Purcell and Hutchinson 2007). However, effective HRM implemen-
tation requires full knowledge of the nature, extent, and scope of people management
activities designed to help an organization manage its workforce in the most efficient
and effective manner possible (Katou et al. 2014). Consequently, a considerable
amount of research has been devoted to carefully distinguish between the content
and process of HRM (Bowen and Ostroff 2004; Sanders et al. 2014). The content of
HRM refers to the range of practices, policies, and activities within an organization’s
HRM system. The content of HRM is therefore concerned with the various people-
management activities that can be delivered, enacted, and experienced within the
work environment (Sikora and Ferris 2014). The process of HRM, on the other hand,
refers to the enactment of HRM practices, including the various ways in which they
are communicated to allow employees understand the desired and appropriate
responses, and form a collective sense of what is expected (Bowen and Ostroff
2004, p. 204).
To help understand the process of HRM implementation, researchers have gen-
erally made a distinction between intended practices and the actual enactment or
implementation of such practices (Khilji and Wang 2007; Piening et al. 2014; Wright
and Nishii 2013). In this regard, intended HRM practices refer to those people-
management policies designed to support employees and improve organizational
performance, but are not yet enacted, practiced, or made salient in the work envi-
ronment (Boxall and Purcell 2003). These policies are usually formulated as part of
the organization’s strategic plan; however, until they are put into actual day-to-day
practice, they are not able to yield tangible benefits (Jiang and Messersmith 2018;
Khilji and Wang 2007). Actual HRM practices, on the other hand, are those people-
management policies that are fully operationalized in the work environment and are
therefore experienced by employees (Khilji and Wang 2007; Meijerink et al. 2020;
Wright and Nishii 2013). Once HRM policies are formulated as part of the organi-
zation’s strategic plan, they can be carefully enacted or put into day-to-day practice
by line managers and/or department heads. A careful implementation of HRM
policies ensures they are more distinctive and readily observable by a large propor-
tion of employees (Bowen and Ostroff 2004; Sanders et al. 2014; Van De Voorde and
Beijer 2015).
Increasingly, researchers are paying closer attention to employees’ own experi-
ences of HRM practices, rather than managerial reports as to how such practices are
being enacted or implemented in the work environment (Alfes et al. 2013; Meijerink
et al. 2020; Nishii et al. 2008; Ogbonnaya and Messersmith 2019). Employees’
experienced or perceived HRM practices represent their shared perceptions about the
nature and quality of the organization’s HRM strategy (Alfes et al. 2012). Compared
to intended or actual practices, perceived HRM practices are likely to influence
employees’ attitudes and behaviors more decisively (Alfes et al. 2012; Aryee et al.
2012; Jiang et al. 2013; Nishii et al. 2008). Accordingly, when organizations invest
in the development and implementation of HRM practices, they convey positive
382 C. Ogbonnaya and S. Aryee

signals about what the organization expects of employees, and what employees can,
in turn, expect from the organization. Employees perceive these signals as an
indication that they are valued and respected by the organization; such perceptions,
it is argued, are the main determinants of employees’ work-related outcomes and
include well-being and performance (Meijerink et al. 2020; Ogbonnaya and Valizade
2018; Whitener 2001).

Methodological Issues (Multilevel Analysis)

Over the last few decades, there has been a fundamental shift in management
research from the use of single-level analytical approaches toward multilevel
methods and techniques (Peccei and Van De Voorde 2019a). This shift was spurred
by criticisms that single-level approaches tend to ignore the possibility that HRM
practices and organizational performance may operate at a different analytical level
from employee outcomes (Croon, Van Veldhoven, Peccei, and Wood 2015). Such
studies do not account for interdependences among employees, nested within the
same organization, and therefore fail to handle sources of errors more rigorously
(Shen 2016). Another drawback of applying single-level analysis to cross-level data
is that the assumption of independent observations is violated, leading to biased
standard error estimates (Preacher et al. 2010). A typical example is a study where a
single respondent, usually a senior HR professional, is required to complete a survey
and provide data on the existing HRM practices within an organization as well as the
outcomes. Such methods implicitly assume that all employees receive the same
practices and therefore fail to explicitly account for the various ways in which
individuals and groups may experience and respond differentially to HR systems
within organizations (Nishii and Wright 2008). Such methods also fail to accurately
capture the variability in employees’ experiences of HRM practices and their role in
explaining the HRM-performance relationship.
Multilevel analysis is a viable technique for addressing such errors. Statistically,
this is because it (multilevel analysis) enables investigation of both within-unit and
between-unit relationships and therefore considered more accurate (MacKinnon
2008; Preacher et al. 2010). Such conceptualizations and analytical strategies have
been increasingly utilized in empirical studies where data for an organizational-level
phenomenon are used to examine relationships that exist across multiple levels
within the organization. In other words, the distinguishing feature of multilevel
models, compared to single-level models, is that they “take into account factors at
higher or lower levels that may influence focal constructs of interest residing at a
different level” (Peccei and Van De Voorde 2019a, p. 789). Although research in the
HRM domain has generally lagged behind other areas of management scholarship in
this respect, scholars have become increasingly interested in the application of
multilevel approaches since the late 2000s (e.g., Aryee et al. 2012; Jensen et al.
2013; Liao, Toya, Lepak, and Hong 2009; Takeuchi, Chen, and Lepak 2009;
Ogbonnaya and Valizade 2018; Wood and Ogbonnaya 2018). Interest in multilevel
approaches has been facilitated by the development of sophisticated statistical
19 HRM Practices, Employee Well-Being, and Organizational Performance 383

software programs, data analytics, as well as researchers’ interest in understanding

employees’ perceptions of and reactions to HRM systems.
Peccei and Van De Voorde’s (2019a) recent review outlines best practices for
applying multilevel theory and techniques to the study of HRM practices, employee
well-being, and organizational performance. Of particular interest here is multilevel
mediation models where the predictor (HRM practices), mediator (employee well-
being), and outcome (organizational performance) are measured at different levels of
analysis. Takeuchi et al.’s (2009) study of Japanese establishments is one of the first
to apply multilevel mediation analysis to HRM research. Using data from 324 man-
agers and 522 employees, they found evidence that employee job satisfaction and
affective commitment fully mediated the links between high-performance work
systems and establishment-level concern for employees’ climate. More recently,
Ogbonnaya and Valizade’s (2018) study of healthcare workers reported how a
coherent bundle of HRM practices can increase patient satisfaction and reduce
sickness absence through job satisfaction. Because satisfied workers are well posi-
tioned to interact more favorably with patients and act in ways consistent with
organizational goals, job satisfaction plays an important role in transmitting the
cross-level effects of HRM systems on both patient satisfaction and sickness
absence. With the development of more advanced analytical techniques, the adop-
tion of multilevel methods and approaches in the field of HRM will continue to
evolve and contribute significantly to future research in this area (Jiang and
Messersmith 2018).

Methodological Issues (Reverse Causality)

Despite accumulating evidence on the outcomes of HRM practices, scholars have

criticized the methodological designs of existing studies, noting that the reliance on
cross-sectional methods precludes deeper insights into HRM systems and long-term
effects on both employee and organizational outcomes (Boselie et al. 2003; Schmidt
and Pohler 2018; Tregaskis et al. 2013; Wright et al. 2005). Paauwe (2009, p. 135)
stressed that the dominance of cross-sectional designs is one of the most salient
factors plaguing advancement of HRM research. To date, there is limited evidence
on whether HRM systems predict subsequent changes in both job satisfaction and
organizational performance, and also, whether these changes follow a linear or
nonlinear trajectory over time. Compared to cross-sectional studies, longitudinal
designs are more effective in explaining how the causal ordering between variables
develops and changes over time (Paauwe 2009; Schmidt and Pohler 2018; Shin and
Konrad 2017; Wright et al. 2005). Longitudinal research is also appropriate for
capturing both direct and reciprocal effects, and addressing some of the causal
complexities surrounding HRM practices and outcomes.
One of the main considerations for investing in HRM practices is the possibility
that past outcomes will influence the nature and quality of future HRM practices
(Paauwe 2009; Roca-Puig et al. 2019; Wright et al. 2005). Because investing in
HRM practices requires time, effort, and considerable financial resources, evidence
384 C. Ogbonnaya and S. Aryee

of prior success provides the necessary resource flexibility to encourage future

investments in such practices (Shin and Konrad 2017). When outputs such as
performance are relatively strong, the organization has a greater capacity to build
and maintain relevant input processes such as HRM activities thereby enhancing
employees’ attitudinal responses. For instance, an organization experiencing perfor-
mance improvements after investing in HRM activities would encounter greater
resource flexibility to continue investing in such activities in the future. In contrast,
an organization experiencing deficits or declining performance after investing in
HRM activities would have limited resource flexibility to encourage further invest-
ments in such activities. The organization may instead focus on retrenchment
initiatives as a way to cut costs and reduce human capital expenditure. These
arguments illustrate a recurring focus in recent HRM debates: that past levels of
performance determine the nature of subsequent organizational investments in HRM
practices (Roca-Puig et al. 2019; Shin and Konrad 2017; Schmidt and Pohler 2018).
General systems theory provides a theoretical basis for linking past performance
to changes in HRM implementation (Shin and Konrad 2017). This theory considers
an organization as a dynamic system associated with a positive feedback loop
mechanism, i.e., outputs generate inputs required to reinforce and maintain the
system over time (Kast and Rosenzweig 1972; Von Bertalanffy 1968). In financial
service institution, for example, outputs might include high-quality customer ser-
vice, labor productivity, and reduced staff absence rates, whereas inputs represent the
set of people-management practices designed to influence these outcomes. When
outputs are high, the organizational system generates critical resource flows to
amplify input processes and reinforce the overall system over time (Shin and Konrad
2017). This implies that previous improvements in outputs will, in turn, strengthen
the quality of HRM implementation over time, leading to sustainable improvements
in the organizational system (Schmidt and Pohler 2018; Shin and Konrad 2017).
However, when output levels are low, the system lacks adequate resource flexibility
to reinforce input processes over time, resulting in an overall worsening of the
organizational system.
Going by the foregoing, it is argued that past levels of organizational performance
will determine subsequent changes in HRM implementation. That is, the quality of
previous performance outcomes, measured in terms of customer service perfor-
mance and labor productivity, for example, would generate relevant resource flows
to maintain good levels of HRM implementation over time. Moreover, the quality of
previous performance outcomes would serve as persuasive cues that assist the
organization in discerning whether further investments in HRM activities are
required, and whether such investments would add value to future organizational
performance (Roca-Puig et al. 2019). In other words, when past performance out-
comes are relatively strong, this offers an indication as to whether continued
investments in HRM practices are both valuable and warranted (Schmidt and Pohler
2018). It will also generate adequate slack resources for the organization to support
longer-term investments in its HRM infrastructure (Shin and Konrad 2017). Along
these lines, one could argue that past levels of organizational performance would
determine the nature and quality of future HRM practices.
19 HRM Practices, Employee Well-Being, and Organizational Performance 385

It is further argued that past levels of organizational performance will influence

positive changes in employee attitudes and behaviors. As part of the general systems
argument, organizational systems comprise separate but interconnected subsystems
that reinforce input and output processes over time (Kast and Rosenzweig 1972;
Wright and McMahan 1992). These subsystems could be operational rules or pro-
cedures (e.g., HRM activities), as well as economic and financial resources, public
relations (e.g., branding and the organization’s external interface), and human
experiences (e.g., workplace relationships and well-being). Because organizational
subsystems are relatively interconnected, factors affecting one part could also
influence other aspects (Kast and Rosenzweig 1972). That is to say, the same
positive feedback loop mechanism characterizing the performance-HRM part of
the system (i.e., past performance generating resource flows to develop HRM
systems over time) may also affect other aspects such as job satisfaction. It follows
therefore that evidence of past improvements in performance may not only encour-
age HRM investments, but also the organization’s capacity to directly support
employees and improve their levels of satisfaction.
Previous studies have indeed examined employee performance as a possible
consequence of organizational performance (Goodman and Atkin 1984; Schneider,
Hanges, Smith, and Salvaggio 2003). In a seminal work by Lawler and Porter
(1967), the authors applied principles of workplace motivation in explaining why
past levels of performance might influence subsequent levels of employee well-
being. Lawler and Porter (1967) argued that good performance is intrinsically
motivating for employees because high levels of performance are often accompanied
by positive emotions such as the feeling of having accomplished something of real
value, or the feeling of having made a meaningful and worthwhile contribution at
work. In support, other studies have reported significant effects for organizational
performance and different facets of employee attitudes or behaviors (Goodman and
Atkin 1984; Goodman and Garber 1988; March and Sutton 1997; Ryan, Schmit, and
Johnson 1996; Schneider et al. 2003; Tharenou 1993). The common theme across
these studies is that performance outcomes will exert both direct and reverse causal
effects on HRM practices as well as employees’ attitudinal or behavioral reactions to
these. Consequently, it is imperative that extant research at the minimum controls for
the effect of past performance in research on the outcomes of HRM practices.

Conclusion

In this chapter, we provided a systematic review of key themes as well as method-

ological issues in the extant HRM literature. Specifically, we discussed configura-
tions of HRM practices highlighting the integrationist (which focuses on the
synergistic operation of HRM practices) and isolationist (which focuses on the
interaction of constituent HRM practices) perspectives and their impact on employee
well-being and organizational performance. Given the much-documented effects of
HRM practices on outcomes, we reviewed the RBV and AMO perspectives in
accounting for the “black box” in HRM research. Countervailing the performance
386 C. Ogbonnaya and S. Aryee

orientation in HRM is the critical perspective which argues that the much-
documented performance effects of HR systems are accomplished through intensi-
fication of work with its deleterious effects on employee well-being. Drawing on
concerns about workforce sustainability, we reviewed the mutual gains perspective.
We noted that although well-being has been variously conceptualized, the extant
research largely supports this perspective suggesting that performance need not be
accomplished at the expense of employee well-being. We argued that because of its
performance implications, the AMO perspective is less appropriate as a theoretical
lens in accounting for the mutual gains perspective relative to social exchange theory
and the growing recognition of self-determination theory in this research stream.
The increasing attention to implementation in HRM research coupled with the
divergence between actual and experienced HRM systems has precipitated a focus
on issues of content and process in the literature. Consequently, a major theme in the
contemporary HRM literature is the question of the role of line managers in the
implementation of HRM practices. We reviewed the extant literature and called for
research that formally integrates the role of line managers to provide a more
complete understanding of how, why, and when HRM practices influence their
documented outcomes. To enhance the rigorousness of HRM research, we reviewed
the key methodological issues of level of analysis and causality and noted that future
research that addresses both content and process issues, and anchored in the mutual
gains perspective, must be designed to address these methodological issues. We
argued that this is necessary to enhance the applicability of the resulting findings to
promote workforce sustainability and ultimately, organizational performance.

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Developmental HR Practices as Tools
to Support Employee Well-Being 20
Adelle J. Bish

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
Employee Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
Developmental HR Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 396
Practices Included in the Developmental HR Practice Bundle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
How Developmental HR Practices Serve as Tools for Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
Supporting Well-Being Through Skill Development and Career Satisfaction . . . . . . . . . . . . . 401
Supporting Well-Being Through Employee HR Perceptions and Attributions . . . . . . . . . . . . 401
Supporting Well-Being as Organizational Resources to Achieve Goals . . . . . . . . . . . . . . . . . . . 402
Potential Moderating Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403
Manager Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403
Low-Quality Employee–Employer Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
Trade-Offs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
Career Stage and Employee Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
Directions for Future Research and Theoretical Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410
Communicating Purpose of HR Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411
Longitudinal Studies Investigating Impact over Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411
Managing Developmental HR Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413

Abstract
Developmental HR practices have a shared purpose directed toward the ongoing
development of employees and shaping their attitudes, behaviors, motivations,
well-being, and performance. This chapter serves as a guide to the research
investigating the use of developmental HR practices as tools to support and
enhance employee well-being. Of specific interest are the mechanisms involved

A. J. Bish (*)
Willie Deese College of Business and Economics, North Carolina Agricultural and Technical State
University, Greensboro, NC, USA
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 393

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_18
394 A. J. Bish

in this relationship and an overview of empirical findings in this field of HRM.

This chapter considers employee well-being as a desired employee outcome,
identifies common approaches to well-being in HRM research, and presents
theoretical arguments and evidence for why they may serve as tools to support
employee well-being. Mechanisms involved in this relationship are explored
from three perspectives: (a) skills development and career satisfaction,
(b) employee HR perceptions and attributions, and (c) organizational support
resources to achieve objectives. Potential moderators of the developmental HR
practices–well-being relationship are also identified. The chapter concludes with
discussion of directions for future research, theoretical development, and man-
agement practice.

Keywords
Developmental HR practices · Well-being · Employee HR perceptions · HR
process · HR attributions · Employee health · Mutual gains · Happiness · Career
satisfaction

Introduction

Human resource management practices provide a framework of support throughout

an employee life cycle – from selection and onboarding to development, career
growth, promotion and compensation, and rewards. Within the field of human
resource management, in practice and in scholarship, there has been an increasing
emphasis upon the ways in which human resource management practices also
address and impact upon the well-being of employees (Guest 2017; Ramsay et al.
2000). These efforts emphasize the potential role of a specific bundle of human
resource management practices known as developmental HR practices (Kuvaas
2008).
Developmental HR practices have a shared purpose directed toward the ongoing
development of employees and shaping their attitudes, behaviors, motivations, well-
being, and performance outcomes. Employers invest in these practices to develop
consistent expectations about performance and to support opportunities for career
development and to build a strong employer brand in the talent marketplace.
Therefore, these practices support the recruitment, retainment, and development
goals of the organization. From an employee perspective, the implementation of
developmental HR practices indicates that the employer values ongoing professional
development of individuals and well-being. It is believed that employees develop a
greater sense of obligation to the employer due to this investment over time and are
motivated to support organizational goals (Lee and Bruvold 2003). In addition to the
benefits to the employer, developmental HR practices benefit employees. Through
ongoing investment in the development of knowledge and skills, employees have the
capacity to perform their jobs effectively and experience increased job satisfaction,
career satisfaction, and organizational commitment.
20 Developmental HR Practices as Tools to Support Employee Well-Being 395

This chapter serves as a guide to the research investigating the use of develop-
mental HR practices as tools to support and enhance employee well-being. Of
specific interest are the mechanisms involved in this relationship and an overview
of empirical findings in this field of HRM. The chapter begins with consideration of
employee well-being as a desired employee outcome and identification of common
approaches to well-being in HRM research. This is followed by an overview of what
human resource development practices are and the conceptual arguments for why
they may serve as tools to support employee well-being. Next, in terms of the “how,”
theory and evidence from three perspectives are discussed in terms of mechanisms:
(a) skills development and career satisfaction, (b) employee HR perceptions and
attributions, and (c) organizational support resource to achieve objectives. Then,
potential moderators of the developmental HR practices–well-being relationship are
presented. The chapter concludes with discussion of directions for future research,
theoretical development, and management practice.

Employee Well-Being

Historically HR professionals, especially those in hazardous working environments,

tracked and reported on metrics associated with occupational health and safety such
as workplace accidents and injuries, lost time, and near misses. The focus was upon
quantifiable, sometimes preventable, negative employee outcomes, mainly associ-
ated with physical health. As such, organizational responses were focused on
monitoring hazards, mitigating risk, reducing lost time due to injuries, educating
employees on safe practices, and rehabilitation for return to work. Organizational
efforts to a certain extent were driven by external forces, such as occupational health
and safety legislation and union agreements (Quinlan et al. 2010).
Now, the term “employee well-being” is increasingly used to refer to the overall
quality of an employee’s experience and functioning at work (Warr 1987). Going a
step further, Danna and Griffin (1999) define well-being as the state of the individ-
ual’s mental, physical, and general health as well as their experiences of satisfaction
both at work and outside of work. Under this broader definition, employee well-
being is influenced by pleasure or dissatisfaction with the job itself as well as
interactions with colleagues and supervisors. These conceptualizations reflect a
shift toward a broader view of employee well-being as an important consideration
in the management of people in organizations (Zanko and Dawson 2012), beyond
reducing the risk of accidents and injuries to a more holistic view of employee health
and well-being and a focus on reduction in stress, increased job satisfaction and
intentions to stay, professional growth, and resilience.
Why is this important? The increase in HR research investigating employee well-
being as a primary outcome (Van De Voorde et al. 2012) is indicative of this shift in
focus both in research and practice. HR practitioners also position employee well-
being as a key strategic focus in order to promote engagement, resilience, and
organizational commitment (see, e.g., SHRM Foundations (2011) “Promoting
Employee Well-being” publication as part of the SHRM Foundations Effective
396 A. J. Bish

Practice Guidelines Series) as well as to support talent management initiatives by

creating a value proposition based on development and career growth that appeals to
job candidates (Lawler 2005). Furthermore, it reflects changes in societal and
employee expectations (Guest 2017) and in the perspective of management toward
consideration of alternative positive drivers of performance.
As researchers grapple to illuminate the way in which HRM influences perfor-
mance and employee outcomes, evidence suggests that HR practices promote
performance indirectly through their positive influence on employee well-being
(Marescaux et al. 2019; Nielsen et al. 2017; Van De Voorde et al. 2012). Often
conceptualized from a “mutual gains” perspective (Guest 2017; Marescaux et al.
2019; Van De Voorde et al. 2012) where HR practices are viewed as delivering
benefits to employees (enhanced job satisfaction) and the organization (workplace
productivity) (Nielsen et al. 2017), and from a social exchange perspective, the
organization shows that it considers employee well-being and takes care of people,
and in turn people perform well (Marescaux et al. 2019). Some HRM researchers,
such as Guest (2017), believe employee well-being should be a primary goal, as a
means to obtaining other outcomes such as performance. As such, researchers
continue to investigate the differential effects of HR practices on well-being
(Marescaux et al. 2019).
HRM research typically considers one or more of the three dimensions of well-
being proposed in Grant et al. (2007) model: (a) happiness (e.g., job satisfaction,
commitment), (b) health (e.g., stress, exhaustion), and (c) social well-being (e.g.,
trust, social support) (Van De Voorde et al. 2012; Clinton and van Veldhoven 2013;
Marescaux et al. 2019). The growth of research on employee well-being represents a
move toward investigation of HRM practices that reduce negative employee out-
comes, and indeed create work environments that foster and sustain employee well-
being proposed, with specific interest on developmental HR practices.

Developmental HR Practices

Developmental HR practices are defined as a subset of a larger system of HR

practices, high performance work systems, representing an approach to human
resource management that has a core purpose of supporting the ongoing develop-
ment of employees. The terms “high performance work systems,” “high perfor-
mance work practices,” “high involvement,” and “high commitment management”
have been used to reflect various interconnected HR practices that attempt to
enhance skills, participation, motivation, and performance (Appelbaum et al. 2000;
Becker et al. 1998; Huselid 1995; Boxall and Macky 2009). As these practices are
believed to produce positive outcomes for organizations and employees, for some
time HR scholars have been investigating the mechanisms that support these pro-
posed relationships (e.g., Messersmith et al. 2011; Ramsay et al. 2000; Takeuchi
et al. 2007). The term “developmental HR practices” was used by Kuvaas (2008) in
an investigation of 593 employees working in banks in Norway and has been
adopted since then to differentiate practices focused primarily upon development
20 Developmental HR Practices as Tools to Support Employee Well-Being 397

of employees. From the organizations’ perspective, this represents “high commit-

ment” on their behalf, an investment in employees development (knowledge, skills,
competencies) over the longer term (career development), with the ultimate aim of
supporting and enhancing continued performance to aid the organization in achiev-
ing its objectives. While all high performance HR systems have a developmental
focus at the broader level (Takeuchi et al. 2007), they also include other HR practices
that go beyond this focus, for example, compensation and selective staffing practices
(Jung and Takeuchi 2018). Developmental HR practices are regarded as “best
practices” to enhance employees’ abilities, motivation, and opportunity utilization
(Jiang et al. 2012).
A central point in this theoretical relationship between the use of developmental
HR practices and employee performance and well-being is that the adoption of these
practices by the employer is perceived positively by employees and that this in turn
motivates employees to perform (Guest 1997; Lee and Bruvold 2003). Thus, there is
a win–win outcome – employers reap the benefits of investment in training and
ongoing development of employees, and employees feel that they are valued and
capable of performing their roles. Employee well-being is one outcome of these
practices, through higher levels of job satisfaction, reduced stress and demand
(as they have the required knowledge and skills to perform), increased perceptions
of career success, and higher levels of organizational commitment. In sum, Kooij
et al. (2013, p. 20) propose that developmental HR practices “help employees to
reach higher levels of functioning.” This approach is also intended to consistently
signal to employees (Bowen and Ostroff 2004) that development is valued and
developmental HR practices are implemented deliberately to support professional
development, well-being, and performance.

Practices Included in the Developmental HR Practice Bundle

The most notable HR practices included under the banner of developmental HR

practices are training, career development, and developmental performance appraisal
(Kuvaas 2008), as shown in Table 1. Collectively, the objective of these practices is
to ensure that employees receive appropriate training to fulfill job requirements and
in some cases prepare them for other opportunities, support for career development,
and ongoing management of performance that is developmental in nature. Develop-
mental HR practices are characterized by a focus upon the future and development
over time, with participation from employees in ongoing training and development,
career management, and reflection upon current performance, responding to feed-
back and working toward developmental goals.
Each developmental HR practice serves its own purpose while contributing to the
broader bundle of practices. Training in both formal and informal programs that are
developed and managed by the organization aims to ensure that employees have the
appropriate knowledge and skills to perform their roles effectively. The provision of
training, how training is deployed throughout the business, and the ongoing nature of
training are all aspects that support an organization’s ability to attract and retain
398 A. J. Bish

Table 1 Developmental HR practices and example measures

Developmental
HR practice Example survey items Author(s)
Training Training is continuous Jung and Takeuchi
Training programs are comprehensive (2018) (adapted from
Training programs strive to develop firm- Takeuchi et al. 2007)
specific skills and knowledge
The training programs emphasize on-the-job
experiences
Jobs are designed around their individual skills
and capabilities
Employees are involved in job rotation
Considering the work I do, the training and Kuvaas (2008)
development I have received are not sufficient
(reversed)
I am satisfied with the training and development
I have received
The company provides appropriate job training Kooij et al. (2010)
My employer encourages me to extend my
abilities
Career It seems like my organization really cares about Kuvaas (2008)
development my career opportunities
This organization puts in a great deal of effort in
organizing for internal career development
My organization provides me with the Kooij et al. (2010)
opportunity to achieve my career goals
I have the opportunity for advancement in my
company
Jobs are clearly defined and are designed to
make full use of people’s skills
Developmental Performance is based on objective, quantifiable Jung and Takeuchi
performance results (2018)
appraisal Performance appraisals include management by
objective with mutual goal setting
Performance appraisals include developmental
feedback
The feedback I receive on how I do my job is Kuvaas (2008)
highly relevant
My organization seems more engaged in
providing positive feedback for good
performance than criticizing poor performance
Other HR practices that support developmental HR practices
Incentives related The incentive system is tied to skill-based pay Jung and Takeuchi
to performance Our compensation is contingent on performance (2018)
Employee Employees are empowered to make decisions Jung and Takeuchi
involvement (2018)
Job design Jobs are clearly defined and are designed to Kooij et al. (2010)
make full use of people’s skills
20 Developmental HR Practices as Tools to Support Employee Well-Being 399

talent. Opportunities for career development, formal and informal career discussions,
and the articulation of career pathways serve as strong indicators that an organization
is interested in long-term relationships with employees and values professional and
personal growth over time. Even with the push toward self-managed careers, with
employees being held more accountable for being proactive managers of their own
career development and growth, organizations gain advantage from providing infra-
structure to support employee efforts (Jung and Takeuchi 2018). As with training,
the inclusion of career development frameworks and practices supports recruitment
and retention efforts in competitive marketplaces. Developmental performance
appraisal/management theoretically operates as a continuous process of setting
performance expectations, setting goals, receiving feedback, and reflecting and
reviewing performance outcomes and action planning for ongoing development.
Taken together, these three practices work closely with each other to influence
employee attitudes, behaviors, performance, and well-being (Kuvaas 2008;
Van De Voorde et al. 2012).
As shown in Table 1, measurement of developmental HR practices typically
seeks employee evaluations of the practice and the extent to which they perceived
the practice as an investment in employee development. For example, Kuvaas’s
(2008) measures of perceived developmental HR practices consist of eight items to
measure training opportunities addressing satisfaction with training, the suffi-
ciency of training received, and the comparability of training investments with
that provided by other organizations, e.g., “I am satisfied with the training and
development I have received.” The career development measure includes six items
about the perceived importance to the organization of employee career develop-
ment, advancement, and the opportunity for personal development, such as “It
seems like my organization really cares about my career opportunities” (Kuvaas
2008, p. 10). Finally, the measure of performance appraisal focused on the per-
ceived importance of performance appraisal to the organization, the adequacy of
feedback they receive, and overall satisfaction with feedback processes in the
organization, with items such as “My organization seems more engaged in provid-
ing positive feedback for good performance than criticizing poor performance”
(Kuvaas 2008, p. 10).
Developmental HR practices can also be viewed as providing what Jung and
Takeuchi (2018) refer to as “Organizational career management” as these practices
work together over time to provide support, resources, and generally an infrastruc-
ture to complement employee’s efforts of self-managing their careers. Jung and
Takeuchi (2018) adopted a lifespan perspective to understand career self-
management and satisfaction and the role of developmental HR practices and
organizational support. Even with the prevailing view that careers are self-
managed, they argue that the organization needs to provide support (and infra-
structure) to make this happen effectively, and developmental HR practices are an
example of this. Jung and Takeuchi (2018) found that for young employees the
positive relationship between career self-management and satisfaction was stron-
ger when developmental HR practices were high; they referred to this as a
synergistic effect.
400 A. J. Bish

An example of developmental HR practices in action can be seen in the way in

which Deloitte has invested in the renewal of its performance management system.
Deloitte’s implementation of “strength-based performance conversations” is a radi-
cal departure from their previous performance rating system. In this new, employee-
driven approach, partners engage with and coach employees to develop and enhance
their strengths (and contributions to the firm) to provide a more meaningful perfor-
mance development framework (Buckingham and Goodall 2015). This strategy is a
dramatic move away from a time-consuming global system, focused on ratings and
rankings by partners with little or no exposure to those they were making decisions
about. An internal review of the system revealed that it was inefficient and not fit for
purpose within an organization that recruits the brightest and talented employees
from across the globe. The new strategy is an investment in a performance devel-
opment approach that should attain better outcomes (in terms of retention, perfor-
mance, career satisfaction, and well-being) as well as meeting the expectations of
their workforce – already high performers – who are motivated by professional
development and ongoing opportunities for growth (Buckingham and Goodall
2015). When viewed through the perspective of developmental HR practices,
these fundamental changes can also be seen to signal to employees (Bowen and
Ostroff 2004; Nishii et al. 2008) that they are highly valued, that they have core
strengths that are recognized by the business, and that the business intends to keep
providing opportunities to enhance and capitalize on these capabilities over time.
Other knowledge-intensive firms in the consultancy field and beyond have also
followed suit. This example serves to illustrate the point that formal and informal
consideration of training, career growth, and performance conversations that are
focused on opportunities for development collectively aims to motivate, engage, and
retain employees.
Of note, the work of Kuvaas (2008) and Jung and Takeuchi (2018) highlights the
importance of understanding the employee’s perceptions of HR practices, not just
the strategic intent and/or implementation of these practices, when it comes to
understanding their influence on well-being and other employee outcomes. This is
consistent with HRM literature (Bowen and Ostroff 2004; Nishii et al. 2008; Wang
et al. 2020) that shows employees’ perceptions of organizational practices or support
are more directly linked to their work attitudes and behaviors than actual organiza-
tional programs (Nishii et al. 2008). Accordingly, studies investigating the relation-
ship between developmental HR practices and employee well-being and
performance tend to adopt measures that consider the employee’s perspective of
each HR practice as they have experienced them (as shown in Table 1).
Note that, in addition to developmental HR practices, other HR practices also
have been shown to affect well-being (Nielsen et al. 2017), such as job design (see
Hackman and Oldham’s job characteristics model 1980) and organizational support
through resources (e.g., the Job Demands-Resources (JD-R) model) (Demerouti
et al. 2001; Bakker and Demerouti 2017). There has been consistent meta-analytic
support that work resources are related to both employee well-being and individual
performance outcomes (e.g., Crawford et al. 2010; Halbesleben 2010; Nielsen et al.
2017).
20 Developmental HR Practices as Tools to Support Employee Well-Being 401

How Developmental HR Practices Serve as Tools for Well-Being

In terms of how developmental HR practices serve as tools to support employee

well-being, continued research on mechanisms that support the relationship between
HR practices and outcomes provides some insights. Theoretically, the HRM litera-
ture provides at least three perspectives for why developmental HR practices posi-
tively impact employee well-being and the mechanisms through which this occurs.
These are (a) skill development and career satisfaction perspective, (b) employee HR
perceptions and attribution perspectives, and (c) organizational support resource
perspective.

Supporting Well-Being Through Skill Development and Career

Satisfaction

First, the skill development perspective argues that the adoption of developmental
HR practices enhances employees capabilities over time, builds resilience, and as
such reduces job stress and strain, increasing job satisfaction and sense of well-being
(Huselid 1995; Kuvaas 2008; Jiang et al. 2012). In this sense, the relationship
between developmental HR practices and well-being is an indirect one, where the
practices influence well-being by impacting upon employees knowledge and skills
and career development. Employee well-being is a by-product, achieved due to the
focus upon skill development, career development, and the corresponding increase
in knowledge and skills, resilience, and job satisfaction. Career satisfaction is an
important aspect, as evidence suggest that developmental HR practices influence
employee well-being indirectly through career satisfaction. Employees report higher
levels of career satisfaction if they believe that the organization is providing support
for their goals through organizationally managed developmental programs (Ng et al.
2005; Lent and Brown 2006). Conversely, Ng et al.’s (2005) meta-analysis indicates
that a lack of support and “career sponsorship” impedes goal progress and reduces
satisfaction.

Supporting Well-Being Through Employee HR Perceptions

and Attributions

HR process and HR attribution researchers propose that developmental HR practices

support employee well-being by sending messages of organizational support to
employees (Jung and Takeuchi 2018). These researchers argue that there is a need
to consider employee “perceptions” of the implementation of HR practices because
these perceptions are more linked to their attitudes and behaviors than actual HR
practices (Nishii et al. 2008). From this perspective, implementing developmental
HR practices signals to employees that individual development needs are valued and
supported by the business (Bowen and Ostroff 2004) and that organizational success
is aligned with their own successful development over time (Kuvaas 2008). It is
402 A. J. Bish

these positive messages that have generated the proposed links to employee well-
being and the investigation of developmental HR practices as tools to support well-
being in the workplace. For these practices to have a positive impact, employees
need to believe that the adoption of the HR policy is intended to benefit them (as well
as the business) (Nishii et al. 2008).
For example, employees who believe that HR practices are implemented through
concern for their well-being as well as to improve service quality are more commit-
ted and exhibit stronger service-related behaviors than where the converse is the case
(Nishii et al. 2008). In addition, Van De Voorde and Beijer (2015) found that HR
commitment attributions, where the organization employs HR practices in order to
foster employee well-being and service quality, give rise to reduced job strain and
higher well-being. Conversely, employees who attributed the HR practices to the
organization’s intention to get the most work out of their employees reported higher
levels of job strain. Furthermore, Hewett et al.’s (2018) review of attribution theory
as a lens to investigate the processes involved in HR–employee outcome relationship
in 65 HRM studies identified that the attributions employees make regarding the
intent of HR practices, including developmental HR practices, are likely to inform
employees’ commitment to the organization as well as their well-being. From a
practice perspective, it is important to note that evidence suggests that to ascribe
commitment attributions, employees have to believe that these developmental HR
practices are in the control of management (Nishii et al. 2008), for employees to
believe that the organization is implementing these practices to enhance employee
well-being and development (rather than driven or demanded by external factors).
HR attribution researchers are still exploring the antecedents of employee attribu-
tions of HR practices (Hewett et al. 2019) as these are a key part of the puzzle. Jung
and Takeuchi (2018, p. 93) in their review article capture this point very clearly: “In
order for employees to perceive developmental HR practices as useful resources for
generating career satisfaction, both HR and line managers in the organization need to
clearly and consistently communicate . . .(the) availability of all relevant practices. . .
and how each would be useful and supportive to employees, particularly regarding
future career development and advancement. HR must work towards ensuring that
the messages are accurately interpreted (that they are ‘strong’ according to Bowen
and Ostroff 2004), and explicitly explain the practices and how they aim to assist
employees.”

Supporting Well-Being as Organizational Resources to Achieve Goals

Nielsen et al.’s (2017) review and meta-analysis of workplace resources to improve

well-being provides compelling support that developmental HR practices may also
influence well-being by serving as organizational resources (for skill development
and motivation) to balance job demands and achieve goals. Based on the JD-R
model (Bakker and Demerouti 2017), developmental HR practices that focus on
development opportunities, social support, and feedback may be considered as
organizational support resources (Guest 2017). Indeed, the dominant theoretical
20 Developmental HR Practices as Tools to Support Employee Well-Being 403

perspectives used to investigate employee well-being are Conservation of Resources

(COR) theory and Job Demands-Resources theory as developmental HR practices
help individuals obtain their goals (Jung and Takeuchi 2018). Through skill devel-
opment and performance feedback, employees’ abilities are strengthened, facilitat-
ing the attainment of personal and organizational goals and well-being (Bakker and
Demerouti 2007; Wheeler et al. 2013). Jung and Takeuchi (2018, p. 93) conclude in
their review of developmental HR practices and career self-management and satis-
faction that “given the findings that organization-based support resources generally
enhance employee career satisfaction, organizations are strongly encouraged to
adopt developmental HR policies, practices and career development support to
enhance employees’ career satisfaction. Career satisfaction is important not only
for an individual’s well-being and happiness but also for a wide array of organiza-
tional outcomes.”
This section has presented three perspectives from the HRM literature on how
developmental HR practices serve as tools to support employee well-being. Table 2
provides a summary of these three perspectives (mechanisms) supporting well-being
and key research findings. The next section considers potential moderating factors
that may lessen the positive influence of developmental HR practices on well-being.

Potential Moderating Factors

As the previous section illustrated, the relationship between adopting developmental

HR practices and observing enhanced employee well-being outcomes is a complex
one. For researchers and practitioners, there is danger in oversimplifying the rela-
tionship and not considering other factors that may impact the strength of the
relationship (Kuvaas 2008). In this section, four factors that potentially moderate
the developmental HR practices–well-being relationship are discussed: (a) manager
behaviors, (b) low-quality employee–employer relationship, (c) trade-offs, and
(d) career stage and employee age. Importantly, these factors highlight the need to
consider context when investigating developmental HR practices and adopting this
approach in organizational settings.

Manager Behaviors

As is the case with HRM research more broadly, unraveling the complex and
nuanced relationships between DHRP and employee well-being is challenging.
There is growing recognition within HRM research that context matters in the
study of impact of HR practices on employee outcomes. Specifically, in terms of
the influence of developmental HR practices, managers, as a more proximal organi-
zational representative (Newton et al. 2020; Van De Voorde et al. 2012), play a
unique role. Managers are responsible for the implementation of developmental HR
practices, and their interpretation of policy has been considered as a potential
moderating factor in the developmental HR practices–well-being relationship.
404 A. J. Bish

Table 2 Summary of perspectives on how developmental HR practices serve as tools to support

employee well-being
The role of How developmental Example theoretical
developmental HR HR practices support works and empirical
practices well-being findings Well-being type
Enhanced skill Bolsters capabilities Essentially employee Job satisfaction
development Boosts resilience by well-being is an Career satisfaction
Performance developing required outcome of
feedback knowledge and skills investment/
commitment in skills
development and
career development
over time; a
by-product of these
activities that aim to
enhance performance
as well as employee
outcomes (Kuvaas
2008)
Antecedents of work-
related well-being
include opportunity
for skill use, variety,
and externally
generated goals (Warr
1987)
Demonstrates Communicates value From HR process and Happiness
commitment to and support, HR attributions Job satisfaction,
employee interested in perspectives, if organizational
development and individual employees’ commitment (Nishii
signal that development and attribution of intent et al. 2008)
individual growth well-being (why they believe the Improved happiness
and development is Signals to employees organization is and social well-being
valued by the that the organization implementing these at the expense of
business values growth and policies) is that the health well-being (see
Facilitates well- development practices are Van De Voorde et al.
being through Employees implemented to 2012)
perceptions of value understand purpose support and enhance
of practices and well-being
perceive that the employees, show
intent is for higher organizational
individual-related commitment, and are
outcomes of more satisfied (Nishii
professional growth et al. 2008) and lower
and well-being levels of job stress
and higher levels of
well-being (Van De
Voorde and Beijer
2015)
The “why” (purpose
of practice) is
important in this
(continued)
20 Developmental HR Practices as Tools to Support Employee Well-Being 405

Table 2 (continued)
The role of How developmental Example theoretical
developmental HR HR practices support works and empirical
practices well-being findings Well-being type
process, the beliefs
that employees form
about why the
organization is
implementing
specific HR practices,
and the “how”
(HR process) as these
influence behavior
(Ostroff and Bowen
2016; Wang et al.
2020) and
consistency and
consensus of
messages about
purpose of practices
(Bowen and Ostroff
2004)
Causal attributions
significantly
influence how
employees develop
their understanding of
and reactions to their
workplace
environment (Kelley
and Michela 1980);
developmental HR
practices may serve
as an important
antecedent in the
employee attribution
process (Hewett et al.
2019)
There may be
inherent trade-offs;
developmental HR
practices improve
both happiness and
social well-being and
as such boost
performance, but at
the expense of health
well-being.
Therefore, one could
argue mutual gains
perspective or
conflicting outcomes
(continued)
406 A. J. Bish

Table 2 (continued)
The role of How developmental Example theoretical
developmental HR HR practices support works and empirical
practices well-being findings Well-being type
depending on the
well-being dimension
being considered
(Van de Voorde et al.
2012)
Support resources to Serve as an Well-being (low Work engagement
achieve objectives organizational burnout and stress, Health:
support resource to high levels of work Burnout: Low
help counter the engagement) is a Stress: Low
demands of the job or function of balancing
work environment the demands of work
and to achieve and the resources
individual and available to do the
organizational goals work Guest (2017)
Based on Job
Demands-Resources
model (Bakker and
Demerouti 2017;
Demerouti et al.
2001), developmental
HR practices as
support resources
include social
support, development
opportunities, and
feedback (Guest
2017; Nielsen et al.
2017; Wheeler et al.
2013)
Organizational Career development Organization support Career satisfaction
career management focus for career Job satisfaction
Career satisfaction management Work engagement
Adopting long-term positively impacts Job-related affective
view of employment well-being (Jung and well-being:
relationship Takeuchi 2018) Anxiety – Low
Individuals more Depression – Low
likely to be satisfied Enthusiasm –
with their career, if Average
they perceive that the (Mäkikangas et al.
organization is 2011)
providing support for
their goals with
developmental
programs (Lent and
Brown 2006; Ng et al.
2005)
Conversely lack of
support impedes goal
(continued)
20 Developmental HR Practices as Tools to Support Employee Well-Being 407

Table 2 (continued)
The role of How developmental Example theoretical
developmental HR HR practices support works and empirical
practices well-being findings Well-being type
progress and reduces
satisfaction; meta-
analysis evidence that
organizational career
sponsorship together
with training and
development strongly
related to career
satisfaction and well-
being (Ng et al. 2005)
The need for type of
developmental HR
practices changes
over lifespan and
career (Jung and
Takeuchi 2018); older
workers more
concerned with
maintenance-related
practices
(performance
appraisal) (Kooij
et al. 2013) and less
with development-
related activities
Utility of HR
development
practices from
employee perspective
is not stable and
changes with age and
career stage (Kooij
et al. 2010)

Indeed, the actions of managers are so crucial for the delivery of HR that their
behaviors should be considered as an essential part of the HRM system
(Marescaux et al. 2019). In acknowledging the influence, power, and position
of managers to influence well-being, Kelloway and Barling (2010) argue that
interventions focused at leader behaviors (Skakon et al. 2010) may be a cost-
effective way of influencing well-being. In the case of developmental HR prac-
tices, managers may decide not to approve training and development requests,
fail to discuss relevant career development pathways, and/or provide little feed-
back or input to action planning activities in performance reviews. Equally
important from a strategic HR perspective is that there will be variance across
the business in terms of mangers’ engagement with developmental HR practices.
Thus, it is challenging to create systems and processes that ensure reliability in
408 A. J. Bish

terms of consistent delivery of HR messages regarding the purpose and intent of

HR practices (Wang et al. 2020) and implementation of HR practices. This may
be particularly relevant when it comes to training and development activities, as
they may be seen by managers as being less crucial to day-to-day operations and a
budget item to reduce when resources are tight. In their study of leadership
behaviors as a moderator of the developmental HR practices–well-being rela-
tionship, Marescaux et al. (2019) found that the developmental leadership behav-
ior of line managers influences the way in which developmental HR practices
affect employees. Nielsen et al.’s (2010) meta-analysis of organizational
resources to improve well-being and performance identified that at the leader
level the most often studied resource was leader–member exchange (LMX) – a
good-quality relationship between a leader and employees (Graen and Uhl-bien
1995).

Low-Quality Employee–Employer Relationship

Some research findings suggest that developmental HR practices are not always
related to positive outcomes. For example, evidence from Kuvaas (2008), Kuvaas
and Dysvik (2010), and Van De Voorde and Beijer (2015) indicate that develop-
mental HR practices can have an adverse effect on work performance for employees
experiencing a low-quality employee–employer relationship. Adopting a contin-
gency approach, Kuvaas (2008) provides an example of a company that has an
economic focus and a transactional approach to managing people. In this context,
employees may not take up developmental opportunities that are offered to enhance
emotional or social ties with employees. Kuvaas (2008, p. 17) concluded that there
are contradictions in applying a one-size-fits-all model of HR best practices as some
organizations that have low-quality employee–employer relationships may “perform
well without a focus on investing in employee development by perhaps adopting a
control-focused HR approach that is aligned to business strategy.”
Theoretically, researchers assert that positive employee perceptions of develop-
mental HR practices increase the perceived quality of the employee–organization
relationship, which, in turn, will increase work performance and decrease turnover
intention. However, there is evidence that a high-quality employee–organization
relationship may be necessary in order for developmental HR practices to influence
work performance positively (Kuvaas 2008; Kuvaas and Dysvik 2010). Kuvaas
(2008, p. 17) concludes that “The positive relationship between perception of
developmental HR practices and work performance for employees reporting high
levels of perceived organizational support, procedural justice and interactional
justice, indicates that a high quality employee–organization relationship may be
necessary in order for developmental HR practices to impact work performance
positively.” Finally, Zhang et al. (2013) and Alfes et al. (2012) report similar findings
that the overall relationship with the organization matters, such that a high-quality
relationship (e.g., characterized by trust) counters the exhausting effects of HR
practices.
20 Developmental HR Practices as Tools to Support Employee Well-Being 409

Trade-Offs

In addition to considering context and quality of relationships, research in the

area of developmental HR practices and well-being remain cognizant of the fact
that this bundle of HR practices do not operate within a vacuum. The simulta-
neous deployment of other HR strategies and practices may have an impact upon
outcomes, in much the same way that pulling different levers causes different
cogs to turn. For example, Conway et al. (2016) found that performance man-
agement can increase employees’ exhaustion, but this can be offset by granting
employees voice in decision-making. The underlying argument is that voice can
act as a job resource to help employees cope with increasing performance
demands and influence the process. Van De Voorde et al.’s (2012) meta-analysis
of the relationship between HRM, well-being, and performance reviewed
36 quantitative studies including one or more of the three dimensions of well-
being (Grant et al. 2007) and concluded that implementing HRM practices
implies a “trade-off” between increasing happiness and social well-being while
decreasing health well-being. Subsequently, researchers have studied all three
dimensions of well-being simultaneously to try to further unpack this with mixed
findings. As Marescaux et al. (2019, p. 318) report in their review, while some
studies find positive effects found for HR practices that “foster job satisfaction,
commitment, and reduce strain (e.g., Boxall and Macky 2009; Veld and Alfes
2017), others find a “unilateral destructive effect on both happiness and health
well-being (e.g., Heffernan and Dundon 2016).”

Career Stage and Employee Age

Kooij et al.’s (2010) meta-analysis looking to see if age influences the associations
between high commitment/high involvement HR practices and affective commit-
ment and job satisfaction included developmental HR practices related to advance-
ment, growth, and accomplishment intended to facilitate higher levels of
performance (e.g., training and internal promotion). Their meta-analysis (of 83
studies) found employees’ perceptions of HR practices are positively related to
their work-related attitudes and that calendar age influences this relationship. Per-
haps not surprisingly, older workers are more concerned with maintenance-related
practices (e.g., performance reviews (Kooij et al. 2013)) and less with development-
related activities. Based on these findings, Kooij et al. (2010, p. 1112) concluded that
the impact of human resource practices, their “utility” from an employee’s perspec-
tive, changes with age. This is consistent with career stage research that suggests that
in the later career stages employees react positively to development that is more
focused on keeping skills current and helping to sustain employability (Conway
2004) and job enrichment practices (Kooij et al. 2013) and career self-management
behaviors (Jung and Takeuchi 2018). These findings suggest that as employee
perceptions change with age and career stages there is an effect on the extent to
which developmental HR practices influence well-being.
410 A. J. Bish

Directions for Future Research and Theoretical Development

Researchers are pursuing several promising lines of inquiry, with some agreement
and some divergence in views about what is needed. First, Van De Voorde et al.’s
(2012) call for a more balanced approach to investigating the impact of HRM on
well-being, where they emphasize that there was only one study in their qualitative
review that studied happiness, social well-being, and health at the same time. HRM
research must be able to develop a more accurate picture of the potential detrimental
effects to one dimension of well-being even though potentially the other two are
positively impacted by HR practices. Van De Voorde et al. (2012) identify Orlitzky
and Frenkel (2005) as the only study that adopted a mutual gains perspective and
conflicting outcomes perspectives as well as including all three well-being types
within the same study. Orlitzky and Frenkel (2005) study reported both positive and
negative outcomes of HR on all three well-being types. However, Van De Voorde
et al. (2012, p. 402) note that these relationships were tested in separate analyses and
called for studies to “simultaneously investigate the effects on all three types of well-
being to further validate this reviews results.” Some studies have since responded to
this call, investigating multiple dimensions of well-being, especially those that
appear to be creating trade-off situations (see Boxall and Macky 2009; Heffernan
and Dundon 2016; Veld and Alfes 2017).
The conflicting outcomes perspective will continue to generate research interest
as the impact of some HR practices increases strain and intensifies work, bringing
more threats to well-being (Guest 2017), with performance goals pursued at the
expense of well-being (Ramsay et al. 2000). In sum, Van De Voorde et al. (2012,
p. 402) assert that understanding the optimal balance and “optimization of the trade-
off between organizational performance and (types of) employee well-being”
requires further theoretical development and research. This is particularly relevant
given the rising costs of health care. To inform sound management practices, more
evidence is needed to ensure that gains made in the areas of happiness and relation-
ship types of well-being do not create negative impacts upon employee health (both
in the short and long term).
Conversely, researchers also propose that future research needs to better under-
stand the differential effects of individual HR practices (Hewett et al. 2018),
including those conceptualized as being part of the bundle of HR practices on
well-being. There is no definitive set of developmental HR practices. No one set
rule for categorizing HR practices into bundles. For example, Kooij et al. (2013)
highlight that Kuvaas (2008) conceptualized developmental HR practices as career
development, training opportunities, and performance appraisal, while Zaleska and
de Menezes (2007) included training received, developmental opportunities, and
career management. Clearly, each HR practice can “fit” into different bundles. For
research to assist practitioners in the implementation of the most effective HR
practices for well-being, there needs to be improved clarity about employee’s
experiences with each practice and the impact of each practice on well-being and
the potentially unique antecedents of each of the three dimensions of well-being and
their “distinctive consequences” (Guest 2017). In addition, we need to better
20 Developmental HR Practices as Tools to Support Employee Well-Being 411

understand what the most effective bundle of practices looks like – to obtain the most
impactful synergistic effects on well-being (Nielsen et al. 2017).
As discussed earlier, there are competing views on whether the impacts of HR
practices are always positive, and there is evidence to support the view that HR
practices at times are detrimental to well-being. There have been calls to adopt a
different approach, where employee well-being is the primary goal of HR practices,
as argued by Guest (2017), with the usual predominant goal of performance being
achieved by other means/pathways. Guest (2017, p. 31) presents provisional HR
practices that are designed to promote well-being arguing that these need to be
implemented to drive well-being, and this in turn creates opportunities for perfor-
mance investing in employees (recruitment and selection, training and development,
mentoring, and career support), providing engaging work (includes feedback),
positive social and physical environment (no bullying, fair collective rewards),
voice (extensive two-way communication, representation), and organizational sup-
port (involvement, participative management, flexible, family-friendly work
arrangements, developmental performance management). This provisional frame-
work emphasizes the impact that a range of HR practices may have on employee
well-being, beyond the bundle of practices typically considered developmental HR
practices.

Communicating Purpose of HR Practices

As discussed throughout this chapter, research on employee perceptions of HR

practices indicates that HR practices function as a mechanism of communication
between employer and employees. As such, there is a need to incorporate established
communication theories shown to be useful in understanding the phenomenon of
“communication and information processing in managerial settings, particularly in
the areas of information processing, signaling, and sense making” (Wang et al. 2020,
p. 151). Current research continues to work toward understanding the antecedents of
employee HR perceptions (Hewett et al. 2018) and the extent to which employees
understand the intent of HR practices and why the organization has implemented
them (Wang et al. 2020). Theoretical development and research efforts aim to clarify
the impact of the relevance of information being communicated (from the
employee’s perspective) as well as the consistency of the message (Kelley and
Michela 1980; Hewett et al. 2019).

Longitudinal Studies Investigating Impact over Time

Our theoretical understanding of the impacts of developmental HR practices over

time must include greater consideration to career and life stages and employee age,
and these relationships require greater investigation. A systematic review by
Mäkikangas et al. (2016) of the longitudinal development of employee affective
412 A. J. Bish

well-being (operationalized as burnout, engagement, and job satisfaction) suggests

that well-being is not very stable; it changes over time. It cannot be assumed that the
effects of HR practices are stable over time or that employee needs are stable
throughout the employee life cycle (Kooij et al. 2013); thus, more longitudinal
studies are need.

Managing Developmental HR Practices

Wang et al. (2020), based on their review of the employee perceptions of HR

research, argue that the impact of HR research on professional HR practice can be
improved by looking for avenues for management action to address employee
issues. They call for researchers, who are considering how best to influence
employee well-being, to take stock of what potential antecedents are within the
control of management that can be influenced by management action and
decision-making and ensure that these are investigated. Managers are in a
prime position to remove barriers to well-being and have direct influence on
some of the mechanisms that can influence the strength of the relationship
between developmental HR practices and well-being. As discussed in this chap-
ter, one of these antecedents that management can directly impact is communi-
cations. Jung and Takeuchi (2018, p. 93) recommend that “. . .for employees to
perceive developmental HR practices as useful resources for generating career
satisfaction, both HR and line managers in the organization need to clearly and
consistently communicate. . . detailed information about the company’s develop-
ment HR practices.” For example, management should ensure that information
regarding availability of all relevant developmental practices and how each
practice intends to benefit employees, and how to access these practices, is
regularly discussed with employees. These conversations need to be led by
managers, and they need to check to make sure that employees are cognizant of
what opportunities are available to them. Furthermore, managers should be held
accountable for this communication process, through performance management
processes, together with the effective implementation of all relevant HR prac-
tices. As noted here, manager behaviors are critical to the success of HR initia-
tives particularly in terms of demonstrating support. Through their actions they
can improve interactions with employees, strengthen working relationships, and
advocate for the professional development needs of individuals. HR practitioners
must also be mindful of the need to cater for individual differences in terms of
career stages and age in regard to what types of support provided by develop-
mental HR practices are going to resonate and best serve their employee demo-
graphic. In addition to management behaviors, other related HR practices can
also support well-being objectives. Nielsen et al. (2017, p. 114) recommend that
organizational resources, such as job design that allows a high level of job
autonomy, those that promote job crafting, social support, and good quality
relationships between leaders and employees, be utilized.
20 Developmental HR Practices as Tools to Support Employee Well-Being 413

Conclusions

The aim of this chapter was to present key research findings of the relationship
between developmental HR practices and employee well-being. Specifically, the
chapter has focused on the way in which developmental HR practices serve as tools
to support well-being. Theoretical and empirical evidence has been presented
regarding the nature of the relationship. In summary, the majority of studies indicate
support for the mutual gains perspective. As such, developmental HR practices play
a positive role in supporting well-being in terms of happiness and social relation-
ships. However, the story is not entirely positive. Research suggests that these
positive gains may occur at the expense of employee health. What is clear in existing
literature is that HRM scholars are still working toward unraveling the complex
relationships at play between the adoption of HR practices, including developmental
HR practices, and outcomes such as well-being. Researchers have called for more
research, of a multilevel, longitudinal nature to explore and investigate the potential
trade-offs, differential effects of HR practices, impact on each type of well-being
simultaneously, investigation of the antecedents of perceptions of developmental HR
practices, and greater integration of communication theories to build an understand-
ing of signaling and information processing in relation to employee perceptions of
developmental HR practices.

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Ethical Culture and Management
21
Mari Huhtala

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 418
What Is an Ethical Culture? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 418
How Strong Is your Organization’s Ethical Culture? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420
Ethical Culture Is Rooted in Virtues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422
Drivers of an Ethical Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425
Role of Management in Supporting Ethical Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
Outcomes Related to the Embeddedness of an Organization’s Ethical Culture . . . . . . . . . . . . . . . 429
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431

Abstract
An unfortunate marker of the current times is the scale of unethical behavior and
corporate corruption committed by business leaders. A powerful antecedent of
unethical behavior is organizational culture. This chapter discusses what consti-
tutes and drives an ethical culture. It defines the concept of ethical culture and
reviews different approaches that have been used to measure ethical culture in
organizations. The Corporate Ethical Virtues model is reviewed in more detail as
one example of a reliable and valid way to operationalize ethical organizational
cultures. Finally, specific management strategies to maintain and minimize poten-
tial threats to an ethical culture are also provided.

Keywords
Ethical culture · Organizational values · Ethical virtues · Ethical leaders ·
Unethical behavior

M. Huhtala (*)
Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
e-mail: mari.huhtala@jyu.fi

© Springer Nature Switzerland AG 2022 417

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_19
418 M. Huhtala

Introduction

Combining the terms “business” and “ethics” is no longer seen as such an oxymoron
or laughing matter as it might have been some decades ago. However, current trends in
corporate ethics still continue to show some worrisome results. For example, in 2020,
a large US survey targeted more than 14,500 employees across several industries and
found that almost one in four people felt everyday pressure to act unethically at work
(Ivcevic et al. 2020); this pressure is in addition to the larger scale scandals of unethical
practices that have been exposed and attracted widespread media attention.
Previously the attempts to prevent and address unethical behavior have focused on
individual trangressors, picking out the “bad apples” in an organization (Treviño and
Youngblood 1990). However, the focus has since shifted towards looking at organiza-
tions as a whole – especially their ethical culture – as a better way to account for
unethical behavior (Kaptein 2011). Ethical culture refers to the moral environment in a
workplace, and it sometimes manifests itself in public statements regarding the
company’s values, in codes of ethics, and in reports. However, this ethically correct
image may be merely a case of “window-dressing ethics” (Sims and Brinkmann 2003).
It is more accurately the workforce itself that will truly define whether a work culture is
ethical or not (Shanahan and Hopkins 2019). In this respect, an ethical culture depends
on collective efforts made by its members to act in a just and fair manner (Chun 2005),
and these are stimulated and supported by organizational structures.
This chapter is built around three main questions central to creating and
maintaining an ethical work environment. Firstly, what is an ethical culture? Defining
the concept is a necessary first step for determining the boundaries of the phenomenon
and of then deciding what is possible within them. Secondly, how can ethics in a work
culture be actually measured? In order to evaluate, develop, and then re-evaluate just
how embedded those ethics are within an organization, we need reliable and valid
measures that provide trustworthy results. Only then will it be possible to compare
different organizations and work units with each other and to assess change over time.
Here, one approach to conceptualizing ethical culture will be discussed in more detail
– in terms of ethical virtues in organizations. Thirdly, what drives an ethical culture
and what is the role of management in creating and maintaining such a culture?
Managers and leaders have a crucial role in setting the formal boundaries for ethical
behavior as well as providing informal examples of desired (and tolerated) conduct.
Therefore, it is important to understand the mechanisms through which leaders affect
an organization’s ethical culture. Finally, after providing answers to these questions,
some examples will be given of the different positive effects that a strongly embedded
ethical culture can have on the members of an organization.

What Is an Ethical Culture?

Culture is the social glue that helps to form and maintain groups and guide their
behaviors. Culture consists of the shared meanings, norms, symbols, and values that
create a common understanding within a certain group. It helps us define who we are,
21 Ethical Culture and Management 419

why we are here, and what our common goal is (Schein 1990). Within organizations,
culture includes observable features such as office design, logos, formal rules, styles
of interaction, codes of conduct, value statements, and so on; but on a deeper level, it
also includes the values and beliefs that are held to be important within the organi-
zation. For example, whether employees are seen as an asset that create a compet-
itive advantage and profit the organization, or more as invaluable individuals whose
wellbeing and development the organization has an obligation to foster. These
underlying structures of culture are transmitted from one organizational member to
another through socialization. The longer the organization exists, the more custom-
ary these norms and practices (both formal and informal) become, guiding the
members’ behaviors and attitudes. Thus, the deeper level of culture often remains
subconscious to those who are part of it.
Ethical culture can be defined as a subset of the broader organizational culture and
includes what people in the organization think of as right and wrong. This overall
perspective on (business) ethics governs how members behave when engaged in
organizational activities (Sinclair 1993). It includes their experiences, presumptions,
and expectations with regard to how unethical behavior should be prevented and
ethicality encouraged in their organization (Treviño and Weaver 2003). Ethical
culture has its origins in the underlying ethical values that can be formally defined
and fostered by the management (via, for instance, codes of ethics and reward
systems). However, ethical culture is also shared and redefined by members through
informal practices such as peer behavior, role models, and traditions (Treviño 1990;
Treviño et al. 1998). The formal systems help to outline and communicate the
artificial level of ethical culture both to members (via official codes of conduct)
and outsiders (via value statements on the company website), but organizations can
never specify a set of explicit rules that are directly applicable in every situation.
Here is where the informal systems are needed: the deeper levels of culture (such as
the underlying norms for accepted behavior) provide implicit knowledge about how
to react in a certain situation, how the organization works, and what is expected from
its members.
A question that often arises concerning ethical contexts in organizations has to do
with the difference between ethical culture and ethical climate. Are these two
concepts separate from each other or do they overlap, and if so, to what extent?
One way to clarify the relationship between climate and culture is to distinguish
substantive elements of the context from those which are procedural (Kaptein 2008,
2011). Ethical climate is substantive insofar as it describes the perceptions of what is
seen as ethical behavior within the organization (Victor and Cullen 1987), while
ethical culture can be classified as procedural, because it includes all the formal and
informal systems for sending messages to employees that either support or do not
support their ethical conduct (Treviño et al. 2017). Ethical culture therefore refers to
the conditions that can stimulate ethical conduct. Although there has been criticism
of making too strong a distinction between ethical climate and culture (Denison
1996), at least two studies have found that ethical culture has a stronger association
with ethical behavior than ethical climate (Kaptein 2011; Treviño et al. 1998). So
although the two concepts clearly have much in common with each other, they
420 M. Huhtala

capture somewhat different contextual aspects: climate is more related to employee

attitudes (regarding what is ethical about their organization), while ethical culture is
related more to actually influencing behavior (so that the organization is more
ethical).

How Strong Is your Organization’s Ethical Culture?

Because ethical culture includes very similar elements to corporate culture in general –
tacit knowledge, subtle hints and drivers for certain (favored) behaviors, myths and
stories, role models and heroes – we can assume that ethical culture is neither an
objective truth nor an unambiguous phenomenon. Indeed, it is debatable whether
organizational culture is a construct that can be measured at all (see e.g., Cameron
and Quinn 2006). However, any attempt to change ethical culture should always begin
with a thorough assessment of the status quo: what does the current ethical culture look
like? In this respect, we do need to have some way of quantifying and measuring it.
Because ethical culture consists of socially transmitted norms, values, and expec-
tations, the messages that employees get in their everyday work life might not
always translate as directly as the management intended. Furthermore, as already
mentioned in the previous section, existing norms and habits become difficult to
observe by those who are part of a culture that is increasingly taken for granted over
time. All efforts to map and improve an organization’s culture should thus start with
asking members directly about their perceptions of it there and then (Treviño et al.
2017). Ideally, this should include all employees and managers from all units or
subgroups in the organization. This kind of broadly gathered information is partic-
ularly important, as working in different hierarchical, occupational, professional, or
functional subcultures within one organization (Hofstede 1998) can lead to very
different perceptions of the quality and strength of the ethical culture. For example, a
survey of only top managers might well give a rosier view than asking employees
from the ground level up (Huhtala et al. 2018; Treviño et al. 2008).
One important question here is whether ethical culture should be taken as a
one-dimensional construct or as having separate dimensions related in different
ways to unethical behavior (and other relevant outcomes). Some researchers have
called for more parsimonious, one-dimensional measures (Mayer 2014), while
others highlight the value of using multiple components for ethical culture (Kaptein
2008; Treviño et al. 2017). These different approaches to measure ethical culture in
organizations are what will be looked at next.
The first attempt to tap values as indicators of ethical organizational culture was
the three-dimensional corporate ethical values scale developed by Hunt et al. (1989).
This scale measured employees’ perceptions of the ethical actions and concerns of
their managers; how ethical behaviors were rewarded; and how unethical behaviors
were sanctioned in their particular organization. Its main disadvantage was that the
scale consisted of only five items in total, in which only the rewards dimension was
measured with more than one item – meaning it provided only a narrow represen-
tation of ethical culture.
21 Ethical Culture and Management 421

Treviño and her colleagues (1998) thus went on to develop a broader measure of
ethical culture based on previous theoretical work (Treviño 1990). The dimensions
included in this scale mapped both formal and informal elements of an ethical
culture: rewards for ethical behavior; sanctions for unethical behavior; norms that
supported ethical conduct; peer behavior; leaders as role models of ethical conduct
within the organization; expectations for employees to obey authority figures with-
out question; and the reporting of unethical behavior by employees. Items in this
measure nevertheless had a built-in assumption that the organization in question
would have a formal ethics code – thus ruling out those without one.
Key (1999) responded to this drawback by modifying the measure so that any
items referring to an ethics code were removed and parts of other items were
reworded. This modified Ethical Culture Questionnaire (ECQ-M) was then used to
compare mean ratings of ethical culture in different organizations. Key (1999)
reported that they found no significant differences in ethical culture between the
organizations they studied and no agreement among group members within each
organization. Even though these conclusions were based on a one-way analysis of
variance, without using any multilevel sampling or hierarchical models to assess
shared variance in more detail, she concluded that ECQ-M succeeded in measuring
individual perceptions about ethical aspects of an organization rather than its ethical
culture per se (Key 1999). Perhaps because of this, ECQ-M remained only margin-
ally applicable for the best part of a decade. It was not until 2008, when Muel
Kaptein introduced the first multidimensional, normative model and scale for mea-
suring ethical organizational culture – “Corporate Ethical Virtues” (CEV) as he
called it – that any further steps could be made. This was a virtue-based approach
to organizational ethics: where the focus is on the importance of aspiring to do one’s
best and on the motivation to pursue moral excellence – at both individual and
corporate levels (Cameron et al. 2004). The driving forces for sustainable business
practices here are clearly based on moral character and moral virtues (Moore 2015).
The CEV model takes a normative stand on ethical culture, assessing organizations
as moral entities in terms of eight key virtues, seen as necessary for ethical behavior
to flourish. These virtues indicate the degree to which the strategy, structure, and
culture of the organization will stimulate employees to behave ethically (Kaptein
1998). The CEV model was the result of four interlocking studies, which examined
the eight key virtues and showed that identifiable ethical cultures existed between
different organizations (Kaptein 2008). The CEV model remains one of the few
which offer an evidence-based instrument to measure virtue at both the organiza-
tional (Kangas et al. 2014; Morales-Sánchez and Cabello-Medina 2015) and team
levels (Cabana and Kaptein 2019), and as such, it is also a reliable and valid way to
operationalize ethical virtues. These strengths distinguish it from other attempts that
have been made to identify the key virtues of individuals (see e.g., Shanahan and
Hyman 2003; Morales-Sánchez and Cabello-Medina 2015) or organizations (Solo-
mon 1992; Moore 2015).
Finally, the most recent advance in measuring ethical culture has been the
development of a new scale that integrates compliance- and integrity-oriented
approaches (Tanner et al. 2019). The aim behind creating this new measure was to
422 M. Huhtala

create stronger links with managerial practice at the same time as showing how
organizations can be supported and steered towards being more ethical. In their
study, Tanner et al. (2019) draw attention to two very different strategies that can be
used to minimize and prevent ethical misconduct: “command and control”
(or compliance-oriented approaches) use control, detection, and threats of punish-
ment as a means of enforcing rules and ethical standards, while integrity-oriented
approaches encourage moral self-governance and a sense of responsibility for shared
values. The latter rely on the assumption that employees can be trusted and that they
intrinsically want to follow organizational rules, and it was also found to explain
slightly more variance in deviant workplace behavior. This led Tanner et al. (2019) to
conclude that encouraging employee’s self-responsibility and moral motivation
might be a more fruitful approach in strengthening organizational ethics than control
and command strategies. However, their German Ethical Culture Scale (GECS) is
currently restricted to the German language, so there is a need to translate, test, and
validate it in other linguistic contexts too, to better investigate its properties and
applicability (Tanner et al. 2019).
In sum, one major limitation to measuring ethical culture in organizations comes
from the fact that there are few directly comparable results as there has been little
consistency in the instruments used to measure it (Mayer 2014). This means we still
lack proper empirical evidence to know if these different measures are assessing a
similar construct. Of those mentioned, the next section will therefore focus in greater
detail on the CEV model (Kaptein 2008), as it has so far received the most empirical
evidence. The CEV scale has also received support for its reliability and validity in a
range of contexts (see Huhtala et al. 2018), so it is the best candidate for assessing the
embeddedness of ethical virtues within organizations. However, it needs to be
stressed here that future studies should nevertheless strive towards examining
more than one measure of ethical culture at the same time, as this would be the
best way to test their relative validity against each other.

Ethical Culture Is Rooted in Virtues

The origins of Kaptein’s (2008) model for ethical culture in organizations go back to
the ancient Greek and Aristotelian concept of virtue. Robert Solomon (1992, 2004)
had a seminal role in arguing that virtue needs to be cultivated not only in individ-
uals, but also in the corporate world. He emphasized that individuals need to have
virtuous characteristics that can be expressed in their actions, while the community
must act as an agent for facilitating moral and social responsibility. Corporations
should thus nurture individual morality through “a morally rewarding environment
in which good people can develop not only their skills but also their virtues”
(Solomon 1999, p. 24). This supports the human need to pursue what Aristotle
saw as the highest human good – eudemonia – or a certain level of welfare and
prosperity.
Kaptein (1998, 2008) developed the CEV model as a means of implementing
Solomon’s approach. He argued that both individuals and organizations can and
21 Ethical Culture and Management 423

should possess virtues that will manifest themselves in ethical practices. After
several years of theoretical and empirical research, he identified and validated
seven key virtues that organizations should strive for. These virtues are (i) clarity,
(ii) congruency, (iii) feasibility, (iv) supportability, (v) transparency,
(vi) discussability, and (vii) sanctionability. Each virtue represents a different orga-
nizational condition for and capacity to stimulate ethical behavior depending on the
degree these virtues are embedded in organizational practices (Kaptein 2017). It
should also be noted that different virtue sets to those in the CEV model have been
suggested by previous research (e.g., Murphy 1999) but, going back to his previous
distinction, Kaptein argues that these “sets are substantive (i.e., more climate-
related) and organization-specific instead of procedural and generic” (Kaptein
2008, p. 944).

(i) The first virtue in the CEV model is clarity and refers to the way moral
expectations are communicated by an organization to its members. The
employees should have concrete, comprehensive, and understandable infor-
mation available about what is morally expected of them (Kaptein 2011).
Virtues are, by definition, the pivotal point between two vices – that is, between
the two extremes of excess and deficiency (Kaptein 2017). If clarity, for
instance, was taken to its vicious extremes, the organization would be either
too rigid and detailed in its moral expectations (excess) or too unclear and
vague (deficiency) about them (Kaptein 2011).
(ii) Congruency refers to how supervisors and senior management set a moral
example. Does their behavior match what is expected of other employees? The
underlying theory of congruency comes from social learning (Bandura 1986),
which shows that people learn by observing how others behave and by
witnessing the consequences of their actions. If ethical role models are there-
fore absent or defy the organization’s rules and norms, it implies that unethical
actions can be overlooked or even positively allowed. At its most vicious
extremes, excessive incongruency will expose the organization to ethical
breaches (Kaptein 2008, 2011), while excessive congruency might come
across as mere sententiousness: if managers pretend to be more ethical than
is credible, employees can view them as hypocritical and estranged from the
everyday ethical challenges of the job, and as unattainable, saint-like role
models (Kaptein 2017).
(iii) The virtue of feasibility (or “achievability”; Kaptein 2008, 2017) refers to the
concrete resources that are available in the organization for employees to fulfill
their ethical responsibilities and the possibilities for them to achieve these.
Individuals should thus be provided with sufficient time, information, budgets,
equipment, and authority. In a high-pressure culture, complying with ethical
standards can become superfluous and other aims – such as meeting financial
goals – are given precedence (Kaptein 2011). At its vicious extremes, a lack of
feasibility means there is a heightened risk of unethical behavior, as employees
are unable to achieve their goals via legitimate means (Kaptein 2017), while an
excess of feasibility is lavishness. Although this is less common, misusing
424 M. Huhtala

resources and paying a disproportionate amount of time to ethical issues at the

expense of other vital organizational practices can lead to a degree of reck-
lessness, inefficiency, or passivity, which all increase the risk of unethical
behavior (Kaptein 2017).
(iv) The virtue of supportability focuses on the shared commitment of employees
and the organization to ethical conduct, leading to an atmosphere of trust and
fair treatment for all (Kaptein 2008, 2011). When an organization cultivates
values that are identifiable to its members, it boosts their internal motivation,
satisfaction, affective commitment, and involvement in the organization (Tyler
and Blader 2005). At its vicious extremes, however, excessive support leads to
an over-zealous and possibly even fanatic commitment to ethical conformity
(Sims 1992), while a lack of support will encourage animosity, indifference,
and opportunistic or selfish behavior (Kaptein 2017).
(v) Transparency (also referred to as “visibility,” Kaptein 2008) encourages
ethical behavior by increasing employees’ awareness of the positive and
negative consequences of certain actions. In a transparent organization, the
ethical consequences of their behavior are observable to others. Potential
perpetrators can thus expect that it will be known about long before they
would even consider doing something unethical (Gibbs 1975). At its vicious
extremes, low transparency leads to employees being unaware of each other’s
behavior and remote management practices, while too much not only violates
employees’ privacy, but can also lead to information overload, difficulty
making decisions, stress, confusion, and feeling a lack of control (Kaptein
2017).
(vi) Discussability refers to how easy it is for employees to raise and discuss ethical
issues at work, including alleged unethical behavior (Kaptein 2008). A culture
that encourages open discussions about ethics can increase shared learning,
provide support for all, and reassure employees that ethical concerns are seen
as important. At its vicious extremes, a lack of discussion can lead to a work
culture of moral muteness (Bird and Waters 1989) – significantly increasing
the chances of unethical behavior (Kaptein 1998), while an excess can endan-
ger privacy and lead to indecisiveness, as all discussions remain open – in
extreme cases this can result in anarchy (Kaptein 2017).
(vii) The final virtue is sanctionability. It refers to the ways an organization rein-
forces certain ethical behavior through rewards and sanctions. According to
reinforcement theory – applied in the work context by, for example, Luthans
and Kreitner (1985) – rewards should lead to repetition and punishment to
avoidance of those behaviors. At its most vicious extremes, excessive “laxity”
or complete absence of sanctions (Kaptein 2017) indicates that unethical
conduct is acceptable or even desirable (Ball et al. 1994), while overly
excessive sanctions lead to oppressiveness, translating into disproportionately
high rewards for some employees and severe punishments for others. Kaptein
(2017) has discussed several ways in which oppressiveness is likely to increase
the risk of unethical conduct; it might, for instance, encourage employees to
covertly – and therefore falsely – “improve” their ethical performance.
21 Ethical Culture and Management 425

Drivers of an Ethical Culture

There are two primary ways to create and support the ethical culture of an organi-
zation. The first is to adopt the integration perspective (Martin 1992) and create a
unified corporate culture around ethical values. The role of management is particu-
larly important here for creating a clear strategy and code of ethics that will apply to
all members of the organization. It is based on clearly predetermined norms and
values that are deeply embedded in long-term guidelines about how all employees
should act (Sinclair 1993). Rewards, punishments, and rituals in the organization are
structured so that they reinforce this uniform culture. The second approach, however,
is to adopt the differentiation perspective (Martin 1992), which focuses more on
embracing different subcultures within an organization. In this case, the role of
management is to aim to understand and value all the different views held, instead
of trying to impose one uniform culture on everyone; in this approach, everyone’s
differences are thus seen as an asset.
Neither of these approaches is superior to the other, nor exclusively recommend-
able – both have their advantages and disadvantages. A strong unified ethical culture
can encourage commitment towards the organization (Huhtala and Feldt 2016) and
lead to lower levels of staff turnover (Kangas et al. 2016), but while a strong culture
might indeed reinforce employee commitment, it can also lead to a conformity and
rigidness which might make it harder for the organization to adapt to changes
(Sinclair 1993). In addition, a cohesive culture does not directly imply ethical
conduct. Members might, for example, resort to unethical actions if they believe
that these actions benefit the organization as a whole (Umphress et al. 2010).
Benefits of the differentiation approach are that interactions between different
groups in the organization (e.g., monitoring or criticizing) could actually cause
members to behave more ethically. These subcultures can also act like positive
“social cocoons” (Greil and Rudy 1984), where organizational members can find
ethical role models, like-minded moral colleagues, or other “pockets of virtue”
(Weaver 2006) that can support ethical behavior and identification. The main
disadvantages of this approach are the possible lack of implementation and risk
that the microcosms might end up behaving unethically (Brief et al. 2001). If such
microcosms are sufficiently isolated and those leading the organization cannot create
a shared foundation of core values, members of a subculture can begin to normalize
their own (unethical) norms. New members may then become socialized within said
subculture, making these unethical and divergent ways of behaving increasingly
acceptable (Treviño et al. 2006).
Another way to define the drivers of an ethical organization is to differentiate
between the formal and informal factors that support ethical actions (James 2000).
This can be done by focusing on individual organizational members and, for
instance, providing them with ethical codes and training. However, these informal
processes become efficient only when they are reinforced with organizational struc-
tures, such as official reward systems, evaluation criteria for work performance
(including the kinds of actions allowed to reach work goals), and the different rights
and responsibilities related to decision-making (James 2000). These formal official
426 M. Huhtala

structures have a direct influence on employees and their actions and are determined
by the leaders of the organization. They can provide rules and concrete consequences
(e.g., punishments and rewards) for actions, but do not give employees the inner
motivation to behave ethically. Culture itself is needed as an informal system to
complement the formal structures. When both these components are aligned and
balanced, they provide the best basis for supporting the ethical conduct of employees
(James 2000).
Any attempt to change and strengthen the ethical culture should begin with a
thorough assessment of the current situation. This should be done using standard-
ized, validated measures (Treviño et al. 2017), allowing a reliable, comparable
assessment that can then be used as a benchmark, when the procedures are evaluated
over time. Once the existing ethical culture has been evaluated and recorded, the
organization should design and implement interventions that are targeted towards
strengthening their ethical values and practices. The effectiveness of these interven-
tions can then be evaluated by comparing how ethical culture ratings have changed
from the earlier baseline measurements. This can create a continuous process where
members of the organization experiment and learn from previous interventions and
develop new ones based on accumulating long-term evidence (Treviño et al. 2017).
One approach for planning these interventions is to target those dimensions of
ethical culture that got the lowest baseline evaluations. These tailored procedures
should include different elements depending on the specific weaknesses identified in
the current ethical culture. For example, if organizational members were to give poor
evaluations of the role modeling and behavior of top management, this would
indicate that the organization should invest in training, coaching, and selection
procedures for top management. If, however, the most prominent problems relate
to a lack of clarity, the interventions should focus on creating more visible, coherent,
and well-communicated ethical expectations for employees.
Approaches that focus on reinforcing these virtues even seem to be more effective
in reducing unethical behavior than traditional methods of ethical training.
Tenbrunsel and Messick (2004), for instance, have criticized the narrow focus of
more traditional ethics education methods as inefficient – training employees to take
specific actions based on certain ethical principles is not enough, because people
have an innate psychological tendency to fade ethics out of dilemmas they face.
Because of this, employees would likely gain more from support that would increase
their ethical awareness, that is, their ability to recognize ethical dilemmas. Strength-
ening ethical virtues in the organization, such as providing clear expectations,
cultivating shared support and discussions about ethical issues, and promoting
transparent actions between organization members, can provide the consistent sup-
port they need so that they are not only conscious of ethical issues but also want to
act upon them.
Because culture is a socially embedded, partly unconscious collection of deeply
rooted values and assumptions, interventions might not always be easily or effi-
ciently implemented. Values that have become implicit and taken for granted over
time might well be difficult to even recognize, let alone change. One way to
overcome this is to start from the more superficial levels of culture, such as the
21 Ethical Culture and Management 427

formal processes and ethical codes. For example, clarity – setting concrete and
comprehensible expectations and norms for ethical behavior – might be a virtue
that can be embedded and supported quite easily and with little extra investment by
the organization. It can also act as a cornerstone for all the other virtues and the
ethical culture as a whole (Stöber et al. 2019). If members are clearly and convinc-
ingly informed about what is expected from them, it can make it easier for them to
behave ethically. When ethical behavior is supported with rewards (and unethical
actions have visible, punitive consequences), a virtuous cycle is hopefully set in
motion. New members will be socialized into these ethical expectations, and over
time, shared practices can help to change the culture at deeper levels too. However,
we still lack a broader understanding of how ethical culture might develop over time.
This is because the field of ethical culture research has been heavily dominated by
cross-sectional studies (even up to 90 per cent; for reviews, see Mayer 2014;
McLeod et al. 2016; Huhtala et al. 2018). More work is thus necessary before we
have reliable evidence on the best practices for strengthening ethical virtues over
time. On a positive note, the scale for corporate ethical virtues has been shown to be
time-invariant (Huhtala et al. 2016), so this means it can be used in longitudinal
studies to reliably indicate any changes in strength of the ethical virtues measured.
Finally, when an organization is planning any interventions or baseline measure-
ments, these actions should also be ethically carried out (i.e., in line with the virtues
mentioned above). There are two main reasons for this. First, we know that change
can meet with resistance, and implementing it does not automatically guarantee that
the proposed changes will be adopted (Dextras-Gauthier et al. 2012). One way to get
employees more motivated and committed to the process is to involve them in it
from the very start and to treat them with openness, clarity, and transparency.
Employees should not only have the chance to engage in open discussions, but
also be provided with sufficient resources at work to actively participate in making
those changes. Equally, supervisors and managers should set a positive example by
the actions they take during the process. If as many people as possible “practice what
is preached” when implementing change, then new policies are not only more likely
to endure, but also the ethical principles behind them will have been reinforced.

Role of Management in Supporting Ethical Culture

Managers have a key role in fostering the ethical culture of their organization, and
according to some scholars, they are possibly even the most important element in it
(Treviño 1990; Brown and Treviño 2006). Managers essentially need to take con-
scious actions to create and support environments where ethical norms can emerge
and flourish (Schminke et al. 2005). As discussed in the section defining the concept
of ethical culture above, there are two main approaches to “building” this ethical
culture; these present managers with two very different tasks. Because the integra-
tion perspective aims at a unified corporate culture, it requires managers to define
and introduce a clear ethical strategy and code that will apply to all members of the
organization. However, because the differentiation perspective embraces all the
428 M. Huhtala

different subcultures within an organization, it requires an understanding and appre-

ciation of the diverse ethical values in each subculture. In the latter case, human
resources management is especially important so that there is discussion between the
different subcultures and that they trust each other (Pučėtaitė et al. 2010). In both
these approaches, the managers have several options available to them for influenc-
ing others. For example, managers can exercise direct power by allocating resources
and by creating reward systems, ethical codes, and norms (Treviño and Weaver
2003); they can also indirectly influence actions by, for instance, choosing the
criteria for staff to make decisions and by making value decisions – such as setting
strategic directions and aims for the organization. Each of the above managerial
actions will have a significant impact on the ethical culture of the organization (Paine
1997; Giberson et al. 2009). Because of their influential role in making crucial
decisions, managers must also embrace the fact that they have the greatest respon-
sibility for building and maintaining an ethical culture.
Regardless of the strategy the organization follows, it is important to recognize
that managers will always be role models for other members whether they want that
or not. As well as making practical decisions, they are modeling and communicating
ethical norms and values to their followers via social learning due to their position
and status in the organization (Bandura 1986). In the social learning process,
employees are influenced by observing – both consciously and unconsciously –
their managers as role models. They learn vicariously about appropriate behavior by
observing which actions attract positive or negative attention and which do not.
Several studies have supported this theory (e.g., Kaptein 1998; Brown and Treviño
2006; Mayer et al. 2009, 2010) – employees will watch for cues from managers
about the kinds of behavior that are acceptable and even mimic them.
Social learning can lead to positive effects, especially if the leader has a strong
moral identity (Aquino and Reed 2002) and a high level of cognitive moral devel-
opment. These personal qualities are more likely to be translated into actions where
the leader represents and explicitly communicates high ethical standards, engages
followers in discussions touching on ethical matters, and sets goals to achieve fair
profits rather than profit maximization (Brown et al. 2005; Brown and Treviño 2006;
Treviño et al. 2006). However, the influence of leaders can also be unethical if, for
instance, they lack moral awareness, do not have a personally meaningful set of
moral values, or highlight monetary goals above basic ethics. These less-than-ethical
values are likely to impact and spread to the employees (Sims and Brinkmann 2003;
Higgins and Currie 2004) precisely because the manager shows employees that
unethical actions will go unpunished. This, in turn, exposes the organization to
breaches of ethicality.
This managerial influence can occur at two levels. The first is at the level of
supervisors or line managers, who work directly with employees in their teams, work
groups, or units. The second refers to the more senior level, where managers extend
their influence beyond the immediate work groups. Both levels play an important
role in ethical role modeling despite their somewhat different functions. Supervisors
often play a significant role in affecting employees’ behavior due to their frequent,
close interaction with them (Mayer et al. 2009). Employees who work in the same
21 Ethical Culture and Management 429

work community largely share their perception of their supervisor’s ethical conduct
(Huhtala et al. 2014) and this, in turn, adds further importance to the example shown.
By the same argument, employees might find senior management somewhat distant,
especially in larger organizations, so their ethical example might not be witnessed
lower down the hierarchy (Falkenberg and Herremans 1995). In this respect, one
could argue that direct supervisors (who can also be senior management in smaller
organizations) have the most influential role in guiding employees’ ethical behavior.
Then again, because of their higher position in the hierarchy of an organization,
senior management’s example attracts the attention of a wider range of people and so
more meaning and importance can be attached to it (Treviño and Weaver 2003). In
this respect, both senior and floor managers/supervisors should act and be seen to act
in accordance with the ethical standards they stand by – they must “walk the talk”
(Brown et al. 2005).
In short, it is the personal actions of managers – what they pay attention to and
how they react to critical ethical dilemmas – that really count. Managers who show
ethical behavior and exert moral authority are those who can create and sustain an
ethical culture. Once these ethical values become cultural beliefs and norms that are
collectively shared, then a virtuous circle is set in motion, making it increasingly
likely for others in the organization to be motivated to apply these ethical conven-
tions in their interactions with others and decreasing the likelihood of misconduct
(Mayer et al. 2010).

Outcomes Related to the Embeddedness of an Organization’s

Ethical Culture

Finally, I will review some of the implications of an organization’s ethical culture for
its members. Ethical culture is, by definition, a positive resource for any organiza-
tion. When members share and express ethical values, which are deeply embedded in
daily practices, it provides several supportive resources for everyone. Ethical culture
is “rooted in virtues,” as has been outlined in the section earlier. These virtues ensure
practices which offer, for example, clear ethical expectations, support for ethical
decisions, and the practical conditions for carrying these out – for example, time and
sufficient personal autonomy. It is possible, however, that both employees and
managers have created a culture which lacks these virtues – characterized, for
instance, by vague and ambiguous ethical expectations, insufficient resources to
carry them out, lack of organizational support for them, and a general lack of
discussion about ethical issues.
The most obvious effects of a strong ethical culture are that it decreases the
likelihood of misconduct (Treviño et al. 1999; Kaptein 2011). Organizations that
expect and encourage ethical behavior are more likely to have employees who make
morally right choices (Sims and Keon 1999). Indeed, most theoretical and empirical
approaches to studying ethical organizational culture have focused precisely on this
– how best to decrease the likelihood of unethical behavior; but an alternative or
complementary approach is positive organizational scholarship (POS; Cameron et al.
430 M. Huhtala

2003). POS focuses on positive forms of “deviant” behavior, or “intentional

behaviors that depart from the norms of the referent group in honorable ways”
(Spreitzer and Sonenshein 2003, p. 209). Verbos et al. (2007) have come up with
a concept they call a “living code of ethics,” which is based on POS and refers to
the cognitions, feelings, and behaviors of members that exceed existing ethical
norms and expectations. This is a way of looking at the organization’s culture
with a heightened awareness of ethical viewpoints and a positive attitude towards
ethics.
Although ethical culture includes normative dimensions, which are thought to
improve the ethical behavior of employees and deter their misconduct, virtues can
also promote other positive outcomes among employees. For example, there are a
growing number of studies which focus on associations between ethical culture and
wellbeing. It has already been shown that, for example, organizational justice can
lead to a 13–48 per cent lower rate of absence through sick leave (Elovainio et al.
2002). A less ethical culture can also associate with increased experiences of
ethical strain associated in turn with high emotional exhaustion (Huhtala et al.
2011). In addition, perceptions of a procedurally just and distributively fair orga-
nizational environment have been found to lead to higher job satisfaction and
commitment (Treviño et al. 1998), which leads in turn to greater affective com-
mitment and lower staff turnover (Baker et al. 2006). A good ethical culture can
also reduce stress by reinforcing members’ perception that their job is meaningful
(Jaramillo et al. 2013) and mitigate the negative influence of an external locus of
control for the job’s meaningfulness (Mulki and Lassk 2019).
Poorly implemented virtues also increase the likelihood of unethical behavior
(Kaptein 1998, 2008, 2011) and create a stressful work environment. Organizations
that suffer from virtue deficiency can be characterized by a certain vagueness and
ambiguity about ethical expectations, by unethical leadership, and by the unfair
treatment of its members (Kaptein 2017). For example, employees may be unable to
carry out their responsibilities in an ethical manner because of limited resources, and
unethical behavior might be tolerated or even encouraged. It has been shown that
when an ethical culture is weak, ethical dilemmas are faced with increasing fre-
quency and stress is commonly felt in these situations (Huhtala et al. 2011). In such
an environment, employees are also likely to experience reactions related to collec-
tive stress, such as higher emotional exhaustion (Huhtala et al. 2015). Poor occupa-
tional wellbeing has immense costs to both the individuals and organizations
affected. Therefore, the potential of an ethical work environment that alleviates
work-related stress among employees merits further study.
Ethical culture is by definition a socially created phenomenon, and (although this
number is growing) there are only a few studies that apply organization-, unit, or
team-level hierarchical designs (Kaptein and Van Dalen 2000; Kaptein 2011;
Schaubroeck et al. 2012; Huhtala et al. 2015; Kangas et al. 2017; Huang and
Paterson 2017; Cabana and Kaptein 2019). This growing number is a positive
trend, as the existence of a culture surely lies within its social relationships – in
other words, in the shared values and norms that are created and reproduced through
interactions among its members.
21 Ethical Culture and Management 431

Conclusions

According to the survey results by the Yale Center for Emotional Intelligence
(Ivcevic et al. 2020), almost one third of US respondents claimed they had witnessed
unethical behavior at their workplace – meaning it was an unhealthy work environ-
ment. There is thus clearly an urgent need to put more emphasis on studying those
organizational contexts which are pushing people to take unethical actions. In this
chapter, several important aspects have been outlined that could help organizations,
leaders, and employees to cultivate virtues which could help with this in their
everyday work and which could turn out to be a powerful counterweight to ethically
questionable actions.

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The Effective Management
of Whistleblowing 22
The Whistleblowing Response Model

Paula Brough, Sandra A. Lawrence, Eva Tsahuridu, and A. J. Brown

Contents
Whistleblowing Introduction and Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438
Theoretical Perspectives Explaining Whistleblowing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Multilevel Theoretical Explanations of Whistleblowing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 440
The Necessity for the More Effective Management of Whistleblowing . . . . . . . . . . . . . . . . . . . . . . . 441
Advancing the Field: The Whistleblowing Response Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
Impact of the Regulatory Context on Whistleblowing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 444
Impact of the Organization on Whistleblowing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 446
Impact of Managers on Whistleblowing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 448
Impact of the Reporter on Whistleblowing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449
Interactions Between the Levels of the Whistleblowing Response Model . . . . . . . . . . . . . . . . . . . . 450
Empirical Test of the Whistleblowing Response Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451
Research Implications of the Whistleblowing Response Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 453
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 454
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455

P. Brough (*)
Centre for Work, Organisation and Wellbeing, Griffith University, Brisbane, QLD, Australia
e-mail: p.brough@griffith.edu.au
S. A. Lawrence
Griffith Business School, Griffith University, Brisbane, QLD, Australia
E. Tsahuridu
Melbourne, VIC, Australia
A. J. Brown
Centre for Governance and Public Policy, Griffith University, Brisbane, QLD, Australia
e-mail: a.j.brown@griffith.edu.au

© Springer Nature Switzerland AG 2022 437

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_20
438 P. Brough et al.

Abstract
While reports by whistleblowers of organizational wrongdoing are increasing
within the popular media and recognized in legislation, there remain major
research gaps concerning the effective management of whistleblowing. Research
has established that the reporting of suspected wrongdoing is an important
contributor to organizational integrity and performance. The majority of
whistleblowing research has focused upon the reporter’s personal characteristics
and experiences. Parallel research within the legal field has focused upon the
characteristics of organizational policies. What is missing is investigations into
the methods by which organizations actually manage this disclosure process and
the effectiveness of these methods for encouraging employee’s reports of wrong-
doing and ensuring beneficial outcomes. In this chapter, we integrate key multi-
disciplinary perspectives of whistleblowing and propose a multilevel model to
inform and encourage research focused on the effective management of
whistleblowing. The hypothesized “whistleblowing response model” identifies
four levels (regulatory context, organization, manager, and reporter) of key
characteristics, responses, and outcomes, which have both direct effects and
interactional relationships upon the effective management of an organizational
report of wrongdoing. We integrate these discussions within the new model,
already demonstrated in large-scale research in Australia and New Zealand, to
guide subsequent whistleblowing research.

Keywords
Whistleblowing · Wrongdoing · Ethical decision-making · Organizational justice

Whistleblowing Introduction and Definitions

Whistleblowing assists in the maintenance of employees’ ethical and legal behaviors

in organizations and is managed by formal organizational policies and procedures.
For 40 years, whistleblowing has been associated with the pursuit of positive social
and organizational change (Elliston 1982). However, recent media reports continue
to describe the considerable negative impacts commonly experienced by
whistleblowers, indicating that a more effective way of managing whistleblowing
is still required. Whistleblowing is formally defined as “the disclosure by organiza-
tion members (former or current) of illegal, immoral, and illegitimate practices under
the control of their employers, to persons and organizations that may be able to effect
action” (Near and Miceli 1985, p. 4). Thus, the primary purpose of whistleblowing is
to prevent observed wrongdoing from continuing (Near and Miceli 2016). Up to
40% of organizational fraud and corporate corruption is identified by internal
employee whistleblowers (Association of Certified Fraud Examiners 2016; Price
Waterhouse Coopers 2016). Therefore, the costs of not reporting wrongdoing or
responding inadequately to (i.e., mismanaging) wrongdoing reports can be extreme,
in some instances amounting to billions of dollars (Near and Miceli 2016).
22 The Effective Management of Whistleblowing 439

Extant whistleblowing research within the organizational behavior field has pri-
marily focused on the antecedents and consequences of whistleblowing from the
individual reporter’s perspective, concentrating upon the reporter’s personal charac-
teristics and experiences (e.g., Culiberg and Mihelič 2017; Mesmer-Magnus and
Viswesvaran 2005). However, whistleblowing research within the legal and manage-
ment fields has predominately focused on the characteristics of organizational policies
for the effective management of whistleblowing (e.g., Bereskin et al. 2020; Lee and
Fargher 2013; Vandekerckhove and Lewis 2012). The lack of systematic investiga-
tions into the methods by which organizations manage this disclosure process, and the
effectiveness of these methods for both encouraging employee’s reports of wrongdo-
ing and ensuring beneficial outcomes for all involved, is a recognized gap which has
only recently received attention (e.g., Vandekerckhove et al. 2014; Vandekerckhove
and Phillips 2017). In this chapter, we discuss this research shift and argue that a more
sophisticated model is required to inform and encourage organizational research
focused on the more effective management of whistleblowing. We present a discussion
of theoretical perspectives related to organizational whistleblowing, in order to better
assimilate and comprehend this vital organizational behavior and to identify and
address its associated risks. To advance this field, we propose a multilevel explanation
of the whistleblowing response, which identifies four levels of key factors that together
influence the effective management of a wrongdoing report. The hypothesized
whistleblowing response model is offered to inform subsequent research and reflects
a multidisciplinary theoretical perspective of whistleblowing. We begin with a discus-
sion of these theoretical whistleblowing perspectives and of the theoretical models of
whistleblowing they have informed and conclude with results testing parts of this
model from the large-scale Whistling While They Work 2 research project in Australia
and New Zealand.

Theoretical Perspectives Explaining Whistleblowing

Organizational whistleblowing is not explained by any single major theoretical

approach; instead numerous perspectives have been applied to account for specific
components of the whistleblowing process. An array of social psychology theories, for
example, have been utilized to explain an individual whistleblower’s motivations and
behaviors, especially for the submission of reports which offer minimal individual
gain to the whistleblower. Miceli and Near (1985) utilized expectancy theory (Vroom
1964) to explain an observer’s motivations for formally reporting organizational
wrongdoing, suggesting that reporting was dependent on the observers’ perceptions
of the expected consequences. Similarly, the social psychology theory of self-deter-
mination (SDT; Deci and Ryan 1985) has been applied to explain how an employee’s
intrinsic and extrinsic motivations to report wrongdoing are directly influenced by the
organization’s prosocial culture (Ugaddan and Park 2019). These theoretical perspec-
tives overlap, to some extent, with recent discussions focusing on employee ethical
behaviors and organizational ethical cultures (e.g., Craft 2013; Kaptein 2011).
Other scholars have suggested that social identity theory (Tajfel 1974) is a useful
perspective to account for the situational and temporal contexts inherent within
440 P. Brough et al.

individual motivations when considering a report of wrongdoing (Vadera et al.

2009). More specifically, the social identity constructs of organizational identifica-
tion (Ashforth and Mael 1989) and moral identity (Aquino and Reed 2002) have
been applied to explain why whistleblowing occurs in situations when the predicted
outcomes will not favor the individual reporter, i.e., risk-taking behaviors (Zhou
et al. 2018). Similarly, social exchange theory (SET; Cropanzano and Mitchell 2005)
has been utilized to explain a reporter’s motivations and perceived obligations to
report wrongdoing. The relationships occurring between employees and their man-
agers and/or organizations are the focus of SET in this instance, and it is similar to
the discussions of the “psychological contract,” which explains employee behaviors
due to their perceptions of accepted organization values (Rousseau 1989). Other
theoretical perspectives explaining the occurrence of whistleblowing have focused
specifically on the reporter’s ethical decision-making process (Agle et al. 2014; Ford
and Richardson 1994). Multiple ethical decision-making (EDM) theoretical models
have been proposed describing how an individual’s cognitive and affective processes
influence their moral judgment and behaviors (for a review, see Schwartz 2016). The
EDM literature reports mixed findings and numerous refinements to the many types
of EDM models. Schwartz (2016), for example, proposed an integrated ethical
decision-making (I-EDM) model, which described both the process of decision-
making and the key factors influencing this process, including moral awareness,
emotion, and reason.
The study of whistleblowing thus benefits from a multidisciplinary approach with
multiple theoretical perspectives informing this field. These perspectives have
proven useful to explain a reporter’s individual motivations and likely behaviors.
What is surprising is the more limited attention paid to considerations of the broader
organizational and external contexts, which also directly influence the
whistleblowing process. It is especially surprising that mainstream theories of
organizational behavior, such as organizational justice (Greenberg 1990), workplace
conflict management (De Dreu et al. 2001), and even occupational stress (Brough
et al. 2018), have not contributed more directly to this field. Instead, whistleblowing
remains somewhat of a “niche” area largely overlooked by mainstream organiza-
tional behavior perspectives.

Multilevel Theoretical Explanations of Whistleblowing

We acknowledge that the value of assessing whistleblowing via multilevel theoret-

ical explanations has been recognized, albeit with considerable limitations. For
example, a multilevel theory of whistleblowing was proposed by Vadera et al.
(2009), who identified the value of integrating whistleblowing factors within two
levels (individual and situational) to produce a basic meso-level explanation of
whistleblowing. Vadera et al. suggested that employee whistleblowing behaviors
are influenced by the values (e.g., moral responsibility verses compliance) conveyed
by an organization’s ethics training program. While this theory has not been empir-
ically tested, the central tenant of the theory is realistic: that employees’ behaviors
22 The Effective Management of Whistleblowing 441

are influenced by an organization’s inherent values – be they expressed to employees

explicitly and/or implicitly.
However, this and other proposed multilevel models of whistleblowing have
primarily focused on explaining reporting decisions and generalized relationships
between reporting, situational factors, and individual outcomes. These models
contain scarce consideration of neither the processes nor the managerial behaviors
which influence these outcomes. Also, for the few existing multilevel proposals
which include response factors, they focus primarily on just two levels: individual
and organizational levels. For example, Near and Miceli (1985) identified four key
decisions occurring across the individual and organizational levels which impact
whistleblowing outcomes, namely an employee’s identification of an observed
behavior as wrongdoing, employee’s decision to report the wrongdoing, organiza-
tion’s decision to cease the observed behavior, and organization’s decision to
respond (positively or negatively) to the whistleblower. More recent normative
arguments have assumed, plausibly, the importance of key, positive management
responses (Near and Miceli 2016). Although this multilevel model of
whistleblowing provides a useful framework to assess the relevant research con-
structs inherent within these levels, its validation via empirical assessments is rare.
In a recent expansion of Near and Miceli’s (1985) model, Watts and Buckley
(2017) proposed a “dual-processing model of moral whistleblowing” incorporating
three levels: an individual level (individual differences and reporting characteristics),
an organizational level (organizational culture, whistleblowing response, and orga-
nizational consequences), and a societal level (government agencies and the media).
While their model was also not empirically tested, Watts and Buckley (2017)
concluded that whistleblowing was reliant on interactions between a reporter’s
deliberative and intuitive (dual) processes. They suggested that the application of
this model to provide realistic ethical decision-making training would benefit orga-
nizations via the improved management of the whistleblowing process, primarily by
improving employee’s levels of moral courage.
A notable limitation to both Near and Miceli’s (1985) and Watts and Buckley’s
(2017) models is the exclusion of the specific assessment of a manager’s character-
istics and responses when receiving a wrongdoing report. As we discuss below, it is
the manager’s response to, and relationship with, the whistleblower, which is
crucially important in determining both the effective response of the organization
to the report and the overall treatment of the whistleblower (Chiaburu et al. 2013).

The Necessity for the More Effective Management

of Whistleblowing

Considerable evidence has identified the negative consequences commonly experi-

enced by employees who report organizational wrongdoing. Irrespective of what
type of wrongdoing is involved, formal reporting is still commonly associated with
whistleblower workplace mistreatment, including reprisals, harassment, isolation,
negative performance appraisals, demotions, suspensions, and expulsion (Dasgupta
442 P. Brough et al.

and Kesharwani 2010; Henik 2015; Kaptein 2011; Kenny 2019), as well as signif-
icant declines in the reporter’s mental and physical health outcomes (Lennane 1993;
Nisar et al. 2018). Hall and Brown (2018) discussed the substantial history of
whistleblower mistreatment, including pervasive historical perceptions of
whistleblowers being considered as “traitors.” Whistleblowing is still, therefore,
often perceived to be a risky endeavor for those who identify wrongdoing, helping
explain why so many choose to remain silent. Indeed, Alford (2002, pp. 19–20)
suggested that whistleblowers are defined by the retaliation against them:

Of the several dozen whistleblowers I have talked with, most lost their houses. Many lost
their families. It doesn’t happen all at once, but whistleblowers’ cases drag on for years,
putting a tremendous strain on families. Most whistleblowers will suffer from depression and
alcoholism, and half went bankrupt. Most whistleblowers will be unable to retire. A typical
fate is for a nuclear engineer to end up selling computers at Radio Shack.

Not all whistleblowers experience reprisals, of course, and adverse consequences

arising from a whistleblowing incident are often more nuanced (Smith 2014). While
some incidences of whistleblowing are incited due to interpersonal conflicts in the
workplace, an employee’s decision to report observed wrongdoing is commonly
influenced by the seriousness of the incident, its associated costs, and the availability
and quality of supporting evidence (Ahmad et al. 2014). Crucially, when
whistleblower mistreatment does occur, this mistreatment principally originates
with managers rather than co-workers or other parties (Bjørkelo et al. 2011; Smith
2010). Thus, the appropriate responses of the whistleblower’s immediate managers
to a whistleblowing report are critically important.
It is important to consider the managers’ responsiveness to the disclosure of
wrongdoing and to increase employees’ faith in the adequate management of the
whistleblowing process, as these are both vital elements during employees’ consid-
erations of whether to report wrongdoing. Evidence clearly indicates that a percep-
tion of being disbelieved or ignored is the primary reason why employees do not
report wrongdoing (Near et al. 2004; Wortley et al. 2008). A fear of experiencing
reprisals from the wrongdoer, from immediate/senior management, and/or from
colleagues also directly hinders the reporting of wrongdoing (Near and Miceli
2016). Whistleblowing is suggested to occur more frequently within organizations
with clear reporting procedures, a context that encourages disclosure, and where a
positive outcome or a change by the management is perceived as likely to occur
(Miceli et al. 2009). Interestingly, the evidence suggests that incidents of retaliation
against whistleblowers increase as legal protection also increases (Miceli et al.
1999). This implies that a fear of retaliation may not necessarily deter
whistleblowing, nor does statutory protection adequately safeguard reporters.
It is apparent, therefore, that in many organizations employees’ reporting of
wrongdoing remains an undesirable and problematic behavior. This perception
contrasts with the recent emphasis that the reporting of wrongdoing is a valuable
contributor to organizational integrity, legitimacy, and the identification and man-
agement of risks (e.g., Hall and Brown 2018; Tsahuridu 2011). Miceli et al. (2009),
22 The Effective Management of Whistleblowing 443

for example, suggested that organizations with effective whistleblowing practices

would benefit from an associated improved organizational culture and increased
levels of employee job satisfaction. Evidence indicates that by adopting a fair and
just management of wrongdoing reports, organizations can discourage malicious or
retaliatory complaints, and instead encourage the pro-social reporting of wrongdoing
(Aquino et al. 2006; Near et al. 2004). In contrast to employers’ common negative
perceptions, it is apparent that whistleblowing should not be simply considered as a
threat to an organization’s authority and cohesiveness. Instead, whistleblowing is
increasingly being recognized as a beneficial means of protecting the organization
and of enhancing its performance (Tsahuridu 2011). This shift in focus is producing
useful research and practice recommendations concerning, for example, the dynam-
ics of “speaking up” (Kenny et al. 2019).
However, while these more positive organizational responses are recognized as
having a greater impact on the whistleblowing process, as compared to the
whistleblowers’ own personal characteristics (Vandekerckhove et al. 2014), research
has only just begun to empirically assess the specific mechanisms which produce
positive reporter outcomes. We suggest that despite the economical, health, and
social implications of whistleblowing, the effective management of the
whistleblowing process remains significantly under-researched, with remarkably
limited attention offered by the field of organizational behavior.
While the perceptions of whistleblowing are beginning to improve and organi-
zations are increasingly recognizing their role in encouraging, rather than avoiding,
internal reports of wrongdoing, the development of effective whistleblowing
responses with clear roles, policies, procedures, and practices is still lacking in
many contexts. The application of organizational theories specifically focused on
employee ethical behaviors has encouraged recognition of the positive consequences
of internal whistleblowing. To date, these primary ethical organizational theories
applied to whistleblowing include ethical decision-making (Craft 2013), ethical
leadership (Den Hartog 2015; Mayer et al. 2013), ethical culture (Kaptein 2011),
and workplace compassion (Dutton et al. 2014). We recommend that the scholarly
advancement of this field should emerge from an application of these ethical
organizational theories combined with a multidisciplinary consideration of the
organizational whistleblowing process.

Advancing the Field: The Whistleblowing Response Model

In consideration of the existing explanations of whistleblowing, it is apparent that

organizational whistleblowing behaviors clearly occur within a multilevel context:
governed by legislation and societal or industry contexts; influenced by specific
organizational policies, procedures, and cultures; affected by a manager’s character-
istics and anticipated responses; and dependent upon an individual reporter’s moti-
vations, actions, and experiences. These four context levels have each been
individually identified as necessitating further research. However, we suggest that
it is vital to recognize their simultaneous influence and the interactions between these
444 P. Brough et al.

International/national/state/workplace legislation
Regulatory Regulatory & integrity agencies and programs
context

Characteristics Responses Outcomes

Ethical culture Investigative action Reporting/inaction rates

Ethical climate Procedural & interpersonal justice Investigation competence
Strategic orientation (integrity) WB processes (1. Risk assessment; Organisational reforms
Organization WB polices & procedures 2. Support provision; 3. Proactive Performance
Size management; 4. Recognition & Absenteeism rates
remediation) Turnover rates

Seniority
Training Job satisfaction
Support provision
Experience of managing WB Work engagement
Attitudes & emotional reactions
Manager Attitudes to WB towards reporter Mental health
Ethical/Authentic leadership Investigative involvement Absenteeism
Moral efficacy Turnover
Workload
Personality

Seniority/tenure Reporter repercussions

Training Investigative Job satisfaction
Reporter Moral efficacy Official
involvement Work engagement
Willingness to report report of
wrong-doing Support Mental health
Workload mobilisation
Job control Absenteeism
Job support Turnover
Personality

Fig. 1 Hypothesized multilevel whistleblowing response model

four levels in order to most effectively inform and manage the whistleblowing
process. Consequently, in consideration of existing research, we integrate the key
discussions in this field by proposing a hypothesized multilevel whistleblowing
response model (Fig. 1).
Specifically, we propose a four-level explanation of the whistleblowing process
by identifying the key constructs impacting whistleblowing within the regulatory
context (e.g., national laws and institutional policies governing the reporting of
wrongdoing), organizational level (e.g., procedural justice and organizational ethical
culture), manager level (e.g., ethical leadership, moral efficacy, support provision)
and individual (reporter) level (e.g., perceived job characteristics, personality,
whistleblowing experiences). We identify these constructs as key characteristics,
responses, or outcomes of the whistleblowing process across each of the three
reporter, manager, and organizational levels. Below we describe the components
within each of the four levels of this model, beginning with the level focused on the
regulatory context.

Impact of the Regulatory Context on Whistleblowing

From Fig. 1, it can be observed that the two key components of the regulatory
context consist of the relevant anti-corruption and/or specific whistleblowing legis-
lation, which may occur at international, national, state, or workplace (e.g. sector,
industry) contexts, as well as other regulatory and integrity agencies and programs.
This regulatory context is hypothesized to have an impact upon the characteristics
and responses of the three other layers of the whistleblowing process. The external
regulatory environment has a critical impact upon the effective management of the
22 The Effective Management of Whistleblowing 445

whistleblowing process, although its influence is not particularly well understood or

even overtly considered within many whistleblowing research investigations. The
assessment of which regulatory approach works more effectively to encourage and
support whistleblowers is a vital consideration for effective knowledge advancement
in this field. Despite advances of specific whistleblower protection laws in many
countries, there is scarce empirical research which assesses and compares the
impacts of these different regulatory environments (Miceli and Near 2013). Assess-
ments of the impacts of different regulatory approaches are especially important
when the whistleblowing protections and legislation differ for private- and public-
sector workers, as occurs within many jurisdictions (Hall and Brown 2018). Conse-
quently, an assessment of which are the “best” regulatory approaches for the
effective management of whistleblowing remains undetermined and is certainly
overdue.
A common regulatory approach adopted by the USA, the UK, and Australia
focuses on “anti-retaliation” models (Dworkin and Brown 2012; Lombard and
Brand 2020; Vaughn 2012). This approach seeks to encourage both internal and
external organizational reports of wrongdoing via legally protecting whistleblowers
from experiences of retaliation (Lee et al. 2018). However, many legal variations
remain, such as whether protection is available for unsubstantiated wrongdoing
reports (Miceli and Near 2013). Legislation in other countries adopts different
perspectives. In Germany for example, a whistleblower’s perceived disloyalty to
an employer is legally upheld, often resulting in the dismissal of employees who
disclose wrongdoing (Forst 2013). Interestingly, this approach opposes EU rulings
on an employee’s freedom of speech (Lee et al. 2018) and reinforces the different
ways in which EU countries may “transpose” the legislative requirements of the
EU’s new directive on whistleblowing (Transparency International 2019).
In one comparison of the potential impact of different regulatory approaches,
Miceli and Near (2013) reviewed large samples of public-sector workers from
Australia, Norway, and the USA. They reported that more employees in Norway
(76%) had formally submitted an organizational wrongdoing report, compared to
employees in both the USA (48%) and Australia (39%). However, only 4% of the
Norwegian sample reported experiencing retaliation, compared to 38% of US and
22% of Australian reporters. While noting that some of these variations were almost
certainly owed to methodological differences – itself a major problem for systematic
research – Miceli and Near (2013) concluded that the seriousness of the observed
wrongdoing, relationship between the whistleblower and their manager, specific
national legislative frameworks, whistleblower protections, and national norms/
cultures likely also influenced these variations in experiences.
Other research offers a slightly different perspective. For example, Moloney et al.
(2018) focused on the whistleblowing experiences of international civil servants
(i.e., employees of the UN, the World Bank, etc.) and reported the occurrence of their
widespread difficulties, including retaliation and restitution concerns, regardless of
the specific country in which the report originated. Moloney et al. (2018) concluded
that managers commonly act to discourage rather than encourage wrongdoing
reports, and they reinforced the traditional perception that regardless of the national
446 P. Brough et al.

context “blowing the whistle is a perilous activity” (p. 1). Even where national
legislation has similar objectives and principles, different institutional arrangements
and their likely effectiveness upon whistleblowing have only recently begun to be
systematically compared (Loyens and Vandekerckhove 2018).
The proposed multilevel whistleblowing process model (Fig. 1) suggests that the
impact of the regulatory context is informed by the impact of national “anti-retali-
ation” legislation in encouraging organizational reports of wrongdoing, principally
by guiding the acceptable responses of the organization to the whistleblower (Lee
et al. 2018; Vaughn 2012). Reports of whistleblowing experiences by reporters
employed by international bodies (e.g., the World Bank; Moloney et al. 2018)
necessitate the inclusion of relevant international protections within this category.
Overall, the impact of the regulatory context upon the management (in addition to
the reporting) of an internal whistleblowing process appears to be significant but has
not to date been formally assessed.

Impact of the Organization on Whistleblowing

The second level of the proposed multilevel whistleblowing process model focuses
upon the influence of the organization for the wrongdoing report. The organizational
level of the whistleblowing response model includes the key characteristics, which
impact whistleblowing (discussed in detail below), namely ethical culture and
climate (e.g., Victor and Cullen 1988), the organization’s strategic orientation
(i.e., degree of integrity; e.g., Schwartz 2016), its size and structure (e.g., Fieger
and Rice 2018), and its internal whistleblowing policies and procedures (e.g., Smith
2013). These characteristics are directly associated with the common organizational
responses including investigative actions to a whistleblowing report, but also with
the presence or absence of processes identified more recently as directly important to
the welfare of whistleblowers, such as risk assessment, support provision, proactive
management, and recognition and remediation in the face of risks (e.g., Brown and
Olsen 2008a, b; Lee and Fargher 2013; Tsahuridu 2011). They are also expected to
be specifically associated with organizational levels of procedural and interpersonal
justice (Colquitt 2012; Greenberg 1990). These responses, in turn, influence key
organizational outcomes including whistleblowing reporting and inaction rates (e.g.,
Kenny et al. 2019), the conduct competence of whistleblowing investigations,
organizational reforms (Bereskin et al. 2020), performance, and rates of employee
absenteeism and turnover (e.g., Hall and Brown 2018; Henik 2015).
The research focus on organizational level variables associated with internal
whistleblowing is highly pertinent for the acknowledgment that workers do not
operate in isolation. That is, individual characteristics are not wholly responsible
for a worker’s experiences and actions – including whistleblowing. Instead,
employees are directly influenced by the features of their workplace environments.
Similar recognition has occurred to describe the occurrence of other adverse work
experiences, most noticeably, for example, occupational stress and burnout (e.g.,
Brough et al. 2014).
22 The Effective Management of Whistleblowing 447

A key organizational level characteristic strongly associated with whistleblowing

is the impact of the organization’s ethical climate and culture. Seminal work by
Victor and Cullen (1988) described ethical climate as the responsibility that organi-
zations have for both the ethical and unethical behaviors of their employees. For
instance, the organizational ethical climate explains how an organization’s moral
code of conduct influences employees’ behaviors, including the occurrence of
whistleblowing detrimental to an individual reporter’s self-interest. While some
early research reported minimal relationships between the dimensions of an organi-
zation’s ethical climate and incidences of internal whistleblowing (e.g., Rothwell
and Baldwin 2006), recent reports support this relationship (Ahmad et al. 2014;
Exmeyer 2020; Liu et al. 2018). Zhou et al. (2018), for example, demonstrated that
employees who considered their organization to have a strong ethical climate had a
greater sense of belongingness and attachment to the organization
(i.e., identification), and this in turn increased their whistleblowing reporting
behaviors.
Other pertinent organizational level variables positively associated with internal
reporting of wrongdoing include organizational justice and procedural justice (Soni
et al. 2015; Ugaddan and Park 2019), power–distance ratios (i.e., structure and size
of organization; Fieger and Rice 2018; Puni and Anlesinya 2017), and strategic/
high-performance human resource policies (Lewis and Vandekerckhove 2018; Pillay
et al. 2017). Most public-service workers, for example, are employed in highly
structured bureaucracies, commonly classified as a “high risk” for individual expe-
riences of occupational stress and interpersonal conflicts (e.g., Brough et al. 2016).
The reporting of wrongdoing in these organizations has been likened to igniting a
“tinderbox” of adverse responses directed at the whistleblower (Moloney et al.
2018). However, Smith (2013) provided a pertinent discussion suggesting that
organizational bureaucracies should not automatically be considered as negative
entities and instead identified the scarcity of investigations assessing how specific
organizational characteristics actually impact whistleblowing. Smith (2013) also
identified common features of well-functioning bureaucratic organizations, which
can be considered to have a positive impact upon the whistleblowing process. Such
features include clear reporting lines due to the existence of organizational hierar-
chies, formal reporting of decisions and actions which record the whistleblowing
process, and clearly stated organizational rules regarding wrongdoing. The fact that
whistleblowing reports occur more frequently in well-functioning bureaucratic orga-
nizations provides support for Smith’s (2013) arguments. That is, organizations
deemed by employees to be receptive/responsive to reports of wrongdoing com-
monly experience higher levels of internal whistleblowing (see also Lee and Xiao
2018).
Clearly, employment in a highly structured bureaucracy is not necessarily asso-
ciated with a nonethical organizational environment. Instead, adverse
whistleblowing experiences are often dependent to a greater degree upon the inad-
equate behaviors and responses of managers to whom the wrongdoing is reported.
More specifically, managers who fail to follow the formal processes relating to
wrongdoing reports are directly responsible for negative experiences by
448 P. Brough et al.

whistleblowers. Smith (2013, p. 13), for example, stated: “The problems encoun-
tered by whistleblowers often stem from too little managerial commitment to
bureaucracy, rather than too much.”

Impact of Managers on Whistleblowing

The third level of the whistleblowing process model (Fig. 1) focuses on managers
and/or organizational governance professionals who initially receive the wrongdoing
report. Supervisory managers are, in the majority of circumstances, the first and most
important point of disclosure for employees who perceive any wrongdoing (Donkin
et al. 2008). However, the ability of employees to raise issues with their supervisors
is often compromised. For example, Locke and Anderson (2011) conducted research
across multiple industry sectors and noted that an estimated 85% of employees felt
unable to raise a critical issue with their manager and 70% of employees stayed silent
when their manager made an obvious mistake. The importance of increasing
employees’ courage to report wrongdoing in these situations has been recognized
and defined as reporting behaviors undertaken despite a significant fear of the
consequences (Jones and Kelly 2014; Kilmann et al. 2013).
Trust in supervisors is, therefore, a key antecedent of whistleblowing, and the
breaking of this trust clearly produces adverse outcomes (Bhal and Dadhich 2011;
Mesmer-Magnus and Viswesvaran 2005). It is surprising, then, that the impact of a
manager’s specific attributes and responses within the whistleblowing process has
rarely been assessed. For example, in a collection of work discussing whistleblowing
and employee voice (Burke and Cooper 2013), only 1 of 14 chapters focused on
managing the whistleblowing process (Chiaburu et al. 2013). In a rare assessment of
532 randomly selected managers employed within 15 Australian public-sector
organizations, collected as part of the first Whistling While They Work research,
Vandekerckhove et al. (2014) analyzed answers to the question of “what was the best
way to respond” to challenges experienced during the management of a
whistleblowing report. The results demonstrated that the managers’ attitudes
towards whistleblowing (i.e., perceptions of the occurrence of vexatious reports),
their level of training on managing whistleblowing, and their levels of seniority and
previous experience in handling whistleblowing incidents all influenced their per-
ceptions of the type and level of protector action (i.e., extent of efforts to protect the
reporter from retaliation), which would represent the “best” response.
Additionally, the consideration of an organization’s ethical climate upon the
whistleblowing process has also encouraged an assessment of ethical and moral
characteristics exhibited by organizational managers and leaders. Preliminary
research has found that whistleblowing occurs more frequently in organizations
characterized by ethical and transformative leadership styles (Bhal and Dadhich
2011; Mayer et al. 2013) and a strong ethical culture (Mecca et al. 2014). More
specifically, evidence indicates that an employee’s reporting of wrongdoing occurs
more frequently to managers who demonstrate high levels of ethical leadership (Wen
and Chen 2016; Zhang et al. 2016), transformational leadership (Caillier 2015), and
22 The Effective Management of Whistleblowing 449

authentic leadership (Wong and Laschinger 2013). Transformational leadership was

developed in the 80s, authentic leadership in 2002, and ethical leadership in 2005.
These three leadership styles have a high degree of commonality and emphasize a
manager’s unbiased integrity, transparent decision-making, and high ethical stan-
dards. Liu et al. (2015, p. 107), for example, succinctly summarized why such
leadership traits are important for the whistleblowing process: “Employees who
trust leaders are more likely to report the wrongdoing to their leaders or organiza-
tions than those who do not.” Evidence also indicates that authentic leadership also
encourages positive psychological characteristics in followers, most noticeably
psychological safety and personal identification (Avolio et al. 2004). By encouraging
such characteristics in their followers, authentic leaders emphasize a safe psycho-
logical working environment, which in turn encourages and supports internal reports
of wrongdoing.
It is, therefore, apparent that a manager’s training, leadership style, and ethical
beliefs are all highly relevant to the whistleblowing process. More specifically, these
factors are influential for both the encouragement of the initial report of wrongdoing
and the treatment of the reporter throughout the whistleblowing process. From the
whistleblowing research produced to date and discussed above, it is apparent that the
key characteristics of these managers, which impact an official wrongdoing report
being submitted, include their seniority, training, and experience of managing
whistleblowing (e.g., Vandekerckhove et al. 2014); their attitudes to whistleblowing,
levels of moral efficacy, and ethical leadership characteristics (e.g., Zhang et al.
2016); their workload (i.e., experiences of occupational stress (Brough et al. 2018);
and their personality and demographic characteristics (Chiaburu et al. 2013). These
characteristics influence the manager’s response to the wrongdoing report, specifi-
cally their attitudes, emotional reactions, and support provisions offered to the
reporter (e.g., Liu et al. 2015), as well as their recommendations and involvement
in the formal investigative process (e.g., Miceli and Near 2013). The manager’s
responses, in turn, influence their own work-based psychological outcomes, includ-
ing their levels of job satisfaction, work engagement, mental health (i.e., strain and
well-being; Brough et al. 2018), and performance outcomes of absenteeism and
turnover.

Impact of the Reporter on Whistleblowing

The final level of the whistleblowing process model (Fig. 1) focuses on the individ-
ual reporter. As was described in the beginning of this chapter, research has clearly
demonstrated the relevance of a reporter’s individual characteristics within the
whistleblowing process (e.g., Burke and Cooper 2013). These key characteristics
are summarized in Fig. 1 and include the reporter’s seniority and tenure with the
organization (e.g., Culiberg and Mihelič 2017), ethical training and moral efficacy
(e.g., Craft 2013), willingness to submit a formal wrongdoing report (e.g., Ahmad
et al. 2014), psychosocial job characteristics (workload, support, and control;
Brough et al. 2018), and their personality and demographic characteristics
450 P. Brough et al.

(e.g., Mesmer-Magnus and Viswesvaran 2005). These characteristics are directly

associated with the reporter’s decision to submit an internal wrongdoing report (e.g.,
Ahmad et al. 2014), which in turn results in their involvement with the investigation
and their support seeking behaviours (e.g., Lawrence et al. 2015; Smith 2014). The
key outcomes of this process for the reporter are also widely identified in the
literature, as we noted at the start of this chapter, and include their experiences of
positive/negative treatment and any negative repercussions (e.g., Henik 2015), their
work attitudes (job satisfaction and work engagement; (Brough et al. 2014), mental
health (e.g., Nisar et al. 2018), and job performance outcomes (absenteeism and
turnover; Near and Miceli 2016). Notably, however, our model considers the reporter
as the final level within this overall, much larger context – not as the first or only
level.

Interactions Between the Levels of the Whistleblowing

Response Model

Importantly and uniquely, the hypothesized whistleblowing process model (Fig. 1)

also summarizes the interactions between the four levels, which, we suggest, are vital
for the accurate assessment of the reporter/manager/organizational outcomes arising
from any internal wrongdoing report. It is apparent that the characteristics within each
level influence the reporting of wrongdoing, the response to this report, and the
outcomes of the report across other levels. For example, the manager’s response to a
report of wrongdoing is directly influenced by both their own leadership characteristics
and ethical attitudes (Chiaburu et al. 2013) and also by the characteristics of their
organization, including the organization’s size, clarity of the whistleblowing proce-
dures, ethical climate and culture, and the organization’s procedures relating to proce-
dural justice and components of the formal investigative process (i.e., risk assessment,
support provision, proactive management, and recognition and remediation; Lee and
Fargher 2013). In turn, both the organization’s characteristics and their whistleblowing
responses are directly influenced by the external regulatory context (i.e., national
employment legislation; Lee et al. 2018). Similarly, the outcomes for a whistleblower
in terms of their job attitudes, health, and work performance (e.g., Henik 2015; Nisar
et al. 2018) are directly influenced by both their experience of the reporting process and
the attitude of, and the support received from, their manager (Near and Miceli 2016).
Organizational outcomes assessed by the numbers of whistleblowing reports and
inaction, investigation competence, reforms, and personnel performance (productivity,
absenteeism, turnover; e.g., Kenny et al. 2019) are directly influenced by the organi-
zation’s formal responses to the whistleblowing report (e.g., Tsahuridu 2011) and also
by the attitudes and performance of both the managers and the individual employees
involved in the report.
Thus, the multilevel whistleblowing process model identifies the simultaneous
influence arising from each level involved with an organizational wrongdoing report
and suggests that the assessment of these multilevel interactions is vital to adequately
explain the process of whistleblowing. We acknowledge the complexity inherent
22 The Effective Management of Whistleblowing 451

within this whistleblowing process model, especially in terms of the empirical

testing of the model’s components. However, we suggest that this complexity pro-
vides a more “realistic” account of the multiple processes involved with any
reporting of organizational wrongdoing. We suggest that acknowledging, rather
than ignoring, this complexity is vital to advance this field and to provide improved
outcomes for whistleblowers and their organizations. We suggest that extending
whistleblower research to more effectively assess the entire whistleblowing process
(i.e., before, during, and after the disclosure) within a multilevel explanation is a
significant advancement of our knowledge about this organizational phenomenon
and has important implications for organizational practice.

Empirical Test of the Whistleblowing Response Model

To test the whistleblowing response model, we empirically assessed the roles played
by key organizational factors in shaping the process of whistleblowing and the
impact this had for both organizations and reporters, predominantly at the second
level of the model. As part of the Whistling While They Work 2 research project, we
collected survey data from N ¼ 6304 employees of 38 Australian and New Zealand
organizations, falling into two groups: both whistleblowers (reporters) and managers
or other governance professionals who had dealt with whistleblowing cases. Infor-
mation regarding formal whistleblowing policies were obtained for each organiza-
tion from a relevant internal governance expert. Full details of the method and
sample are described by Brown et al. (2019). In this instance, direct and indirect
(mediation) associations were assessed via the PROCESS program (Hayes 2013). To
measure the organizational internal wrongdoing processes, these analyses focused
on the organizational support provided to the reporter, the competence of the conduct
of an investigation, and the treatment received by whistleblowers. The results for
each group are summarized in Fig. 2.
Significant associations were produced between each of the three whistleblowing
processes and the outcomes. For example, it can be seen that the level of support
provided by managers was significantly associated with (1) better reporter treatment
outcomes and lower repercussions and (2) positive organizational reforms. Similarly,
procedurally just investigations were significantly associated with investigation and
reform outcomes. These results provide important confirmation that the key pro-
cesses on which current guidance and governance efforts are already focused, as
discussed above, really do matter for achieving success in the effective management
of whistleblowing.
Figure 2 also summarizes the results of the assessment of what actually contrib-
utes to effective internal reporting processes. No significant results were found for
either the managers’ assessments of their organization’s internal processes or the
strength of the organization’s whistleblowing policies. These results imply that a
clear dissonance exists between organizational whistleblowing policies and their
translation into “frontline” practice. However, four of the six assessed organizational
ethical culture factors (senior management ethical leadership, confidence and
452 P. Brough et al.

Fig. 2 Partial test of whistleblowing processes from the whistleblowing response model

awareness of the whistleblowing process, and ethical behavior reinforcement) were

each significantly associated with the whistleblowing processes (i.e., provision of
procedural justice, support, and interpersonal justice) and their subsequent positive
effects on the five assessed outcomes. Specifically, whistleblowing processes were
improved when:

• Ethical behavior was reinforced in the employee’s immediate work area

(i.e., ethical conduct was valued and rewarded, and unethical conduct was fairly
punished).
• There was an awareness of the organization’s whistleblowing processes, includ-
ing availability of support.
• There was confidence in the organization’s responsiveness to whistleblowing
(i.e., a belief that reports would be taken seriously and that management was
serious about staff protection).
• The reporters’ positive experience of the whistleblowing processes was
influenced by ethical leadership demonstrated by their senior managers (e.g., by
senior managers clearly and convincingly communicating the importance of
ethics and integrity, and by the senior managers’ personal demonstrations of
appropriate ethical conduct).

These results support the research discussed above, indicating that ethical lead-
ership positively influences employee attitudes, performance, and ethical behaviors,
22 The Effective Management of Whistleblowing 453

including their internal reporting of wrongdoing (Den Hartog 2015; Cheng et al.
2019). They also indicate that low levels of an organizational ethical culture are
associated with both increased unethical behavior and a reluctance to report wrong-
doing (Kaptein 2011). The results also confirm that the successful embedding of
whistleblowing processes relies on an employee’s awareness of the processes and
management responsiveness for supporting any reporting. Importantly, these results
indicate that the effective championing and reinforcement of an organizational
ethical culture are vital. In particular, senior management ethical leadership and
behavior reinforcement are clearly critical for the maintenance of a supportive
organizational environment in which appropriate wrongdoing investigation out-
comes and benefits are achieved.

Research Implications of the Whistleblowing Response Model

The four-level whistleblowing response model incorporates three important

research implications. First is the identification of the scarcity of whistleblowing
research, which considers that the antecedents of whistleblowing outcomes occur
at multiple levels of analysis. As noted above, the majority of published
whistleblowing research has to date focused upon individual-level (reporter)
attributes. However, we suggest that this simplistic approach is inadequate to
provide effective assessments for the management of employee health and well-
being outcomes. Instead, our hypothesized model and initial results show that the
inclusion of multilevel context variables is an essential consideration for mean-
ingful advances in whistleblowing research, and especially for the accurate expla-
nation of whistleblower outcomes.
Second, we argue the value of identifying a clear typology of both organizational
and managerial positive and negative responses and outcomes to individual reports
of whistleblowing. From the evidence reviewed, it is clear that a reporter’s immedi-
ate manager has a direct impact both upon the reporter’s treatment and outcomes and
upon the organizational outcomes of the actual wrongdoing process (Bjørkelo et al.
2011; Vandekerckhove et al. 2014). Our research model is unique in specifying the
impact of managers within the whistleblowing process. We suggest that the charac-
teristics and responses of a manager to an employee reporting wrongdoing are a vital
consideration if whistleblower treatments and outcomes, and broader organizational
performance, are to be improved. Similarly, we also specifically include the broad
regulatory context as a distinct level within this model to demonstrate the direct
impact that different anti-corruption approaches have upon the whistleblowing
process.
Finally, with this model, we specifically advance the application of the field of
organizational behavior to the study of whistleblowing. The noticeable absence of
whistleblowing research within the specific context of organizational behavior is
difficult to understand, especially given the acknowledgment of whistleblowing as
a component of organizational justice and organizational integrity (Chiaburu et al.
454 P. Brough et al.

2013; Tsahuridu 2011). Above we identified how other topics within organiza-
tional behavior similar to whistleblowing, such as experiences of toxic leadership,
bullying and harassment, and occupational stress, have experienced considerable
research attention, especially in terms of reducing these experiences via organiza-
tional interventions focused on increasing the provision of effective managerial
support (e.g., Brough and Biggs 2015; Webster et al. 2016). The impact of
reporting internal organizational wrongdoing, we suggest, overlaps with these
other adverse work experiences within organizational behavior research.
Whistleblowing research can, therefore, directly benefit from the increased appli-
cation of an organizational behavior perspective, especially in respect to advanc-
ing current organizational training and interventions to reduce the adverse
consequences of whistleblowing for employees, specific workgroups, and
organizations.

Conclusion

This chapter reviewed the current evidence concerning the whistleblowing process
and the implications that this reporting of wrongdoing has for both reporters and
their organizations. It is apparent that the majority of whistleblowing research has
focused on the characteristics of the individual whistleblower and/or on the
situational characteristics of the committed wrongdoing. It is also apparent that
far too many whistleblowers still experience mistreatment and adverse conse-
quences when reporting wrongdoing. In an attempt to advance scholarly knowl-
edge in this field and to stimulate organizational interventions focused on
improving employee experiences of the whistleblowing process, we proposed a
multilevel whistleblowing response model, which uniquely incorporates the key
considerations currently under discussion. The hypothesized model describes how
key reporter, manager, and organizational characteristics and responses influence
outcomes within and between these three levels. The model also demonstrates how
a fourth level of regulatory context influences the reporters’, managers’, and
organizations’ whistleblowing experiences. The model uniquely emphasizes the
impact of managers within the whistleblowing process, with initial results from
our large-scale Australian and New Zealand research especially confirming their
centrality both to the level of organizational ethical culture and to organizational
processes such as support provision, associated with better organizational and
individual level outcomes. Together, the model and results confirm the value of
considering the whistleblowing process from an organizational behavioral per-
spective. The model is presented to stimulate and inform further research in this
field and ultimately to encourage the more effective management of an internal
whistleblowing report.

Acknowledgments We thank the Australian Research Council and our partner organisations (see
www.whistlingwhiletheywork.edu.au) for funding this research (grant number LP150100386).
22 The Effective Management of Whistleblowing 455

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Psychosocial Safety Climate (PSC)
23
Sari Mansour

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460
PSC: Theoretical Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
PSC and the JD-R Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
PSC and Safety Signal Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 462
PSC and the Effort-Reward Imbalance (ERI) Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463
PSC and Job Demands-Control-Support Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464
PSC and the COR’s Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
PSC: A New Extension of Strategic Human Resource Management (SHRM)? . . . . . . . . . . . 466
PSC: Predictor, Moderator, or Mediator? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467
PSC: Countries and Occupations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469
PSC: Research Design and Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 472
PSC: Practice and Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474

Abstract
PSC multilevel theory aligns with other work stress models, including the job
demands-control (JD-C) model (Karasek, Adm Sci Q 224 :285–307, 1979), the
effort-reward imbalance (ERI) model (Siegrist, J Occup Health Psychol 1 :27–41,
1996), and the job demands-resources (JD-R) model (Demerouti et al,. J Appl
Psychol 86 :499–512, 2001). It also can be linked up to the signal theory (Lohr
et al., Clin Psychol Rev 27 :114–126, 2007) and COR’s theory (Hobfoll, J Occup
Psychol 84 :116–122, 2011) as well as to the field of strategic human resource
management. This chapter aims to present the “theory” of PSC as an extension of
these different theories and models. It summarizes the evidence of the PSC’s
functions (as a predictor or a moderator) provided by previous researches and

S. Mansour (*)
School of Business Administration, University TÉLUQ, Montreal, QC, Canada
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 459

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_21
460 S. Mansour

offers a new insight into the role of PSC (as a mediator). It highlights the
validation and universality of PSC across countries and occupations. The chapter
also provides evidence of a variety of research designs used to examine this
concept and introduce its validity and its measures. Finally, the chapter indicates
how PSC can be applied in practice.

Keywords
Psychosocial safety climate · Work stress · Working conditions · Psychological
health · Caravan passageway · Safety signal · Strategic HR

Introduction

By introducing the concept of psychosocial safety climate (PSC) to work stress

theories, Dollard and Bakker (2010) and Dollard and Karasek (2010) were innova-
tive in the field. PSC is a specific form of organizational climate referring to
employee perceptions of organizational policies, practices, and procedures regarding
the value that management places on workers’ psychological health and safety
(Dollard and Bakker 2010). These are reflected in four distinct dimensions including
management commitment, organizational communication, management priority, and
organizational participation concerning the value of the psychosocial health and
safety of employees in the workplace (Idris et al. 2014; Dollard 2012; Dollard and
Bakker 2010; Zadow and Dollard 2015). The first dimension is about management
support and commitment for stress prevention in the organization, through employee
involvement in interventions designed to this effect. The second dimension is
concerned with management making psychological health and safety a priority,
rather than prioritizing productivity goals. Organizational communication about
psychological health and safety comes as a third dimension, with management
listening to the contributions of employees in this matter. The fourth dimension
refers to the involvement of various actors at all levels of the organization around
psychological health and safety matters, through consultation and problem-solving
with employees, unions, and occupational health and safety representatives. There-
fore, in organizations where the level of PSC is high, employees feel that their
psychological safety and well-being are protected, prioritized, and supported by
senior management (Bond et al. 2010). Furthermore, they have the sense that their
concerns regarding their psychological health can be addressed, discussed, and
communicated at all levels of the organization without fearing sanctions. While
PSC is close to the concepts of safety climate and team psychological safety, it is
distinct from them (Dollard and Bakker 2010; Idris et al. 2014). Indeed, while safety
climate refers to employee perceptions that their employer values and ensures their
physical health and safety at work (Zohar 1980), PSC refers to psychological health
and safety. Moreover, contrary to team psychological safety which refers to “a
shared belief held by a work team that the team is safe for interpersonal risk taking”
(Edmonson 1999, p. 354), PSC deals with perceptions of commitment to
23 Psychosocial Safety Climate (PSC) 461

psychological safety at the management level rather than perceptions of psycholog-

ical safety at the team level. Many researchers including Dollard and Bakker (2010)
and Bond et al. (2010) demonstrate empirically that PSC is a valid and reliable
construct concerning working conditions and psychological health problems. This
chapter will cover the theoretical background of PSC, its functions (predictor,
moderator, and mediator), its application in countries and occupations, its measure,
and how to use it as a tool for intervention in organizations.

PSC: Theoretical Background

We will see in this section how PSC can align with different work stress theories.

PSC and the JD-R Theory

Dollard and Bakker (2010) proposed the PSC, as an extension of the job demands-
resources (JD-R) model (Bakker and Demerouti 2017) and considered it as an
antecedent of working conditions, defined as job demands and job resources (Bakker
and Demerouti 2017). Job demands are defined as “those physical, social, or
organizational aspects of the job that require sustained physical and or psychological
effort and are, therefore, associated with physiological and or psychological costs”
(Xanthopoulou et al. 2007, p. 122). Job resources are defined as “are those physical,
social, or organizational aspects of the job that (i) are functional in achieving work-
related goals, (ii) reduce job demands and the associated physiological and psycho-
logical costs, and (iii) stimulate personal growth and development” (Xanthopoulou
et al. 2007, p. 122). Job demands can include, for example, workload, time pressure,
emotional demands, job insecurity, work conflict, and work-family conflict while job
resources cover skill discretion, decision authority, supervisor support, coworker
social support, and work rewards. JD-R theory stipulates two process paths: the health
erosion path and the motivation pathway (Schaufeli and Taris 2014). Bakker and
Demerouti (2017) argue that individuals with less resources and more job demands
face more stress and burnout (health erosion path) while those with greater access to
workplace resources gain additional job-related psychological resources that buffer
stressors or high demands (motivation path). Theoretically, as PSC is considered as an
antecedent of job design, it predicted both job demands and job resources (Idris and
Dollard 2011). For instance, Dollard and Bakker (2010) showed that it plays an
important role in the motivational pathway of the JD-R theory as a beneficial resource
at individual, team, and organizational levels. Indeed, if the organization provides a
stimulating and supportive environment via a good PSC, resources are likely to be
sufficient leading therefore to not only decreasing job demands and burnout (Idris et al.
2011), but also to increasing work engagement and better performance of health
workers (Bakker et al. 2012). For almost a decade, study on PSC using JD-R model
has mad evidence of the effect of PSC on JD-R components in various occupations,
countries, and level of analyses (Afsharian et al. 2016; Dollard and Bakker 2010). For
462 S. Mansour

instance, in a sample of 269 employees in Malaysia, Idris and Dollard (2011) analyzed
at the individual level the links between PSC, job demands, job resources, anger, and
depression. They found that PSC was negatively related to job demands and positively
related to job resources. It was also revealed that job demands mediated the relation-
ship between PSC and anger and depression and that job resources mediated the link
between PSC and engagement. Using hierarchical linear modeling (HLM), Krasniqi
et al. (2019) found in a study of 404 employees in Malaysia that PSC was negatively
related to emotional demands and positively to supervisor support, and PSC was also
negatively associated to employees’ boredom mediated by both emotional demands
and supervisor support. Their results show the importance role of PSC as a predictor of
work outcomes at work unit level. It should be noted that while most of researchers on
PSC topic have closely aligned it to the JD-R theory, PSC can be aligned in to other
work stress theories and models (e.g., Schulte-Braucks and Dormann 2019; Mansour
and Tremblay 2018a, b, 2019; Loh et al. 2018) as we will see in the next sections.

PSC and Safety Signal Theory

The safety signal theory (Lohr et al. 2007) can be employed to clarify how PSC can
encourage workers to use resources at the workplace to decrease the effect of
demands on psychological health. Theoretically, as an important kind of organiza-
tional climate (Dollard and Karasek 2010), PSC is perceived as a social signal that
alarms employee when he will experience demanding psychosocial work conditions
(cf. high workload), and how he should behave to be rewarded and supported (e.g.,
teamwork) and not sanctioned (e.g., bullying behavior) (Loh et al. 2019). In other
words, when workplace is characterized by stressful working conditions such as
workload, emotional demand, and workplace bullying, a high level of PSC helps as a
safety signal offering possibility to use available resources to counterbalance the
aversive stimuli, and decrease psychological distress (Lohr et al. 2007). According
to Law et al. (2011), the safety signal function included in PSC can help employees
to safely utilize available resources at work. Indeed, when psychological health is
clearly held as a priority at all levels of the organization and throughout the hierarchy
line, it acts as a signal that it is safe and encouraged to use any resources designed to
prevent psychological harm or to voice a concern (Law et al. 2011; Loh et al. 2018).
By caring about employees’ psychological health and safety, management offers
employees a supply of various job resources, which will lead to safer working
conditions (Idris et al. 2011). If employees feel safe and not threatened, they are
likely to obtain more resources (Hobfoll 2001). Moreover, having more resources
such as an adequate promotion prospects regarding one’s work and achievements, as
well as being acknowledged and receiving praise for one’s good work in the
organization, send a signal to employees that their work is valued and that the
organization is looking to establish a long-term exchange relationship with them.
Such perceptions logically align with views that the organization is interested in
safeguarding their psychological health and safety. Evidence of this signal function
is found in some previous studies. For instance, a high level of PSC would ensure
23 Psychosocial Safety Climate (PSC) 463

flexible workplace practices were in place and employees felt safe and confident that
their managers or supervisors support them to utilize these policies, and this could
improve employees’ well-being (Dollard et al. 2012). Hall et al. (2013) in a sample
of 2343 employees in Australia revealed that PSC functioned as a macrolevel
resource and safety signal to reduce work-related depression. Recently, Mansour
and Tremblay (2018a) found that nurses at health care professionals perceiving that
their organization and/or supervisor pays attention to the issue of reconciling work
and family will feel they have more safety resources at work and can therefore
transfer resources to the family domain. The authors advance that discussing family
difficulties with managers and/or supervisors becomes easier and safer when senior
management supports PSC and considers the psychological health of employees to
be a priority. Consequently, such a support leads to less work-family/family-work
conflict. Loh et al. (2018), using longitudinal data from 429 Malaysian health care
workers from 53 teams, examined two different mechanisms: PSC as a resource
passageway (see the next section) and PSC as a safety signal. They supported that
PSC acted as a resource passageway rather than as a safety signal (Zadow et al.
2019). In that sense, PSC is indeed a very important workplace factor (Dollard and
Bakker 2010; Dollard et al. 2012) because of its strong signaling effect on
employees’ perceptions that they have a wide range of resources (Hobfoll 1989,
2011) to do their work and adapt a good behaviors in a psychologically safe
environment.

PSC and the Effort-Reward Imbalance (ERI) Model

Most transactional theories of stress focus on the cognitive processes and emotional
reactions that underlie the subject’s interaction with his environment. The model of
Siegrist (1996) also fits into this perspective. It is a model based on the employment
contract and is based on the notion of social reciprocity. Siegrist (1996) indicates that
the best definition of a state of chronic stress is to describe it as a gap between the
efforts made at work and the gains obtained in return. According to this model, the
professional environment interferes with the social environment which requires
efforts from the worker through different demands or commitments and in return
provides him with a reward for these efforts and services provided. Thus, the
imbalance and lack of reciprocity between efforts and rewards produces stress for
employees. In other words, when the rewards received are not sufficient or even
inadequate with the efforts, the reciprocity is not respected, which generates negative
emotions and stress with long-term negative consequences on health (Siegrist 2016).
Regarding the efforts, they are composed of extrinsic efforts (professional con-
straints such as time constraints, overtime, interruptions during the performance of
a task, responsibilities, physical load and workload, or overwork) and intrinsic
efforts, or “over-engagement” (behaviors, motivations, and a strong ambition to be
appreciated (Siegrist 1996). As for the rewards, according to Siegrist (1996, 2016),
they are composed of monetary satisfactions and the possibilities of promotion,
socio-emotional recognition or esteem, and job security. The model of Siegrist was
464 S. Mansour

supported by significant evidence by researchers in epidemiology and psychology.

Studies using the model of Siegrist have revealed that it predicted several outcomes
including cardiovascular disease, sleep turbulences, burnout, emotional exhaustion,
alcohol dependence, musculoskeletal pain, depression, decreased immune system
functions, and coronary heart disease (Bosma et al. 1998; Peter and Siegrist 2000;
Joksimovic et al. 2002; Kudielka et al. 2004; Head et al. 2004; Ota et al. 2009;
Siegrist 2010; Jolivet et al. 2010; Kikuchi et al. 2010; Rugulies et al. 2017; Dragano
et al. 2017). Since PSC is conceived to predict work stress, and is an indicator of
work conditions, it can be associated to ERI as this model defines working condi-
tions as efforts and rewards. PSC can create environments that help to either balance
or imbalance efforts and rewards leading to better productivity and health outcomes
(Owen et al. 2016). These authors have conducted a multilevel study in 119 organi-
zations and 850 participants in Australia to examine PSC as a multilevel extension of
ERI. Their results shown an association from individual and organizational PSC to
the various dimensions of the ERI model: efforts, rewards, and the ERI interaction,
and they also revealed that PSC triggered the ERI model. According to the authors
results, at the individual level PSC activated the ERI process by indirectly influenc-
ing workers’ physical and psychological health, as well as motivational outcomes,
via workers’ perceptions of ERI. They also revealed that at the organizational level,
PSC affected positively workers’ job satisfaction, via organizational rewards and
organizational ERI, and negatively and indirectly workers’ physical and psycholog-
ical health, via organizational demands. The researchers found evidence that the PSC
can be considered as an extension of ERI model.

PSC and Job Demands-Control-Support Framework

A widely used model in the literature on work stress is the model of Job Demands-
Control-Support of the psychologist Robert Karasek (1979). This theoretical model
states that demands are not sufficient to explain work stress and that stress appears
when the individual is subjected to strong psychological demands associated with a
low level of decision latitude. In other words, in certain professions, heavy job
demands could not be a problem when they are accompanied by a high level of
autonomy. On the other hand, high demands associated with low autonomy consti-
tute a significant source of stress, which can lead to exhaustion. Karasek (1979)
demonstrated this theory through secondary analyzes of data collected in the USA
and Sweden, finding that workers with limited level of decision-making latitude and
high level of job demands were more likely to report health problems and low
satisfaction. Karasek (1979) defined “job control” as the control or mastery a worker
can have over his tasks throughout the working day influences decisions (decision
authority) and the possibility to use skills and be able to learn new things (skill
discretion). Job demands are commonly operationalized in terms of qualitative
demands, such as emotional demands and time pressure (Karasek et al. 1998). Social
support “refers to overall levels of helpful social interactions available on the job
from both co-workers and supervisors” (Karasek and Theorell 1990, p. 69). Like the
23 Psychosocial Safety Climate (PSC) 465

link between PSC and work stress theories (e.g., JD-R, ERI), PSC is a precursor or
the “cause of the causes” (Zadow et al. 2019) to these job design “causes” of work
stress and therefore to JDCS theory (Dollard and Jain 2019). According to these
authors, organizations where the level of PSC is high can “meet the basic psycho-
logical needs of employees, such as by bolstering job control and social support, and
making job demands manageable” (p. 84).

PSC and the COR’s Theory

Recently, authors (Mansour and Tremblay 2018a, b, 2019; Loh et al. 2018; Taylor
et al. 2019) started to conceptualize PSC according to the conservation of resources
(COR) theory (Hobfoll 1989; Hobfoll 1988). Each PSC dimension (management
commitment, management priority, organizational communications, and organiza-
tional participation) can be seen as resources that employees want to secure in order
to gain or preserve what they centrally value, such as “health, well-being, peace,
family, self-preservation, and positive sense of self” (Hobfoll 2011, p. 117). Indeed,
COR theory postulates that, through a motivational process, individuals strive to
retain, protect, and build resources and are threatened by the potential or actual loss
of these valued resources (Hobfoll 1989). Resources are categorized either as object
resources (e.g., tools and house), condition resources (e.g., supportive work relation-
ships and seniority), personal resources (e.g., key skills and personal traits such as
self-efficacy and self-esteem), or energy resources such as knowledge and credit
(Hobfoll 2011, p.117). Resources can further be categorized into contextual
resources, that is, resources found in one’s immediate environment, and personal
resources, located within individuals themselves (Hobfoll 2001). In this light, PSC
can be conceived as the perceived presence or lack of psychosocial resources
(contextual condition resource) in one’s work environment. COR theory further
involves several key principles, which have been summed up in Hobfoll’s (2011)
work. Individuals who lack resources are vulnerable to resource loss, and an initial
resource loss likely leads to future resource losses (Hobfoll 1989). Conversely,
individuals can find themselves in cycles or spirals of resource gains such that the
more resources one possesses, the more one is likely to orchestrate the gain of new
resources (Hobfoll 2001, 2011). In other words, as individuals are motivated to
protect their current resources (conservation) and to acquire new resources (acqui-
sition) (Halbesleben et al. 2014), they invest in resources or try to put in place a
strategy of coping to adapt to stressful situations threatening their well-being
(Hobfoll 2001). However, resources are often beyond individuals’ control (Hobfoll
and De Jong 2014) which makes it difficult for the latter to accumulate them. This is
why Hobfoll (2011) extended COR theory by developing the concept of “resource
caravan passageways,” which are “environmental conditions that support, foster,
enrich, and protect the resources of individuals, sections or segments of workers, and
organizations in total, or that detract, undermine, obstruct, or impoverish people’s or
group’s resource reservoirs” (Hobfoll 2011, p. 129). Hobfoll (2011) explains that
resources are rarely found alone but rather travel in packs or aggregates. This means
466 S. Mansour

that the presence of one resource entails the presence of others, and increases their
efficiency. Hobfoll (2011) argues that it is necessary to foster ecologies of resource
gains within organizations to ensure employee well-being and firm performance.
PSC can thus be seen as a resource’s passageway, resources are created, maintained,
and fostered in such conditions (Hobfoll et al. 2018). Mansour and Tremblay (2018a,
b, 2019) were the firsts authors to consider PSC a resources caravan passageway.
They examined, using a sample of 562 participants from the nursing and health
sector, a multidimensional mediating model of PSC and work-family interference.
The authors tested the direct and indirect effects of PSC on work-family conflict
(WFC)-time, family-work conflict (FWC)-time and, WFC/FWC-strain via family
supportive supervisor behavior (FSSB). The results demonstrated that PSC could act
as a resource passageway allowing employees in health care sector to better balance
their work and family responsibilities. They also revealed that PSC could also
indirectly alleviate WFC-time, FWC-time, WFC-strain, and FWC-strain by increas-
ing FSSB. The authors propose that PSC would be an appropriate target for
intervention to improve work-family imbalance. In another article in the same sector
(Mansour and Tremblay 2019), they treated PSC as a passageway to deal with
burnout and safety workarounds behaviors in the health care. Loh et al. (2018)
argue that PSC is a “resource caravan passageway” which encourages the formation
of a resources caravan, in other words the accumulation and linking of resources.
Taylor et al. (2019) reported evidence that PSC is correlated with adaptive manage-
ment and interdepartmental coordination, which together constitute such a caravan
passageway.

PSC: A New Extension of Strategic Human Resource Management

(SHRM)?

In an effort to respond to recent calls for more exploration of the interplay between
employee well-being and performance in strategic HRM field (Boxall et al. 2016;
Mansour et al. under review) offered in an international sample of 1664 flight
attendants in Canada, Germany, and France an important insight regarding how
various bundles of high-performance work practices (HPWP) influence PSC. They
also examined the mediating role of PSC between HPWP and service recovery
performance. HPWP typically impact employees’ productive behaviors by either
enhancing their abilities, motivation, or by giving them opportunities to contribute,
which is known as the AMO framework (e.g., Appelbaum et al. 2000; Lepak et al.
2006). AMO-enhancing HPWPs impact various components of employee perfor-
mance (Jiang et al. 2012). The ability dimension encompasses employee knowledge,
skills, and abilities (KSA) which can be enhanced with various practices such as
training, professional development, and knowledge-based practices, among others.
The ability-PSC combination acts as a caravan passageway placing employees in a
spiral of resource gain which makes them able to cope and deal efficiently with service
failures, whereas the lack of ability or PSC could make them feel resourceless and
trigger the opposite chain of reaction (Mansour et al. under review). Motivation-
23 Psychosocial Safety Climate (PSC) 467

enhancing practices encompass incentives for employee effort, such as performance-

based compensation, employment security, or profit sharing, but also work-life poli-
cies such as schedule flexibility. Combined with PSC, job security, for example,
generates a safe environment in which employees can do their job without fearing
any backlash or job loss leading them to engage in service recovery (Mansour et al.
under review). The third dimension, opportunity, refers to practices giving employees
opportunities to contribute in the organization, such as empowerment, teamwork, or
voice mechanisms. A positive atmosphere where a sense of camaraderie and solidarity
is present, as well as a climate that encourages and empowers employees to solve
occupational safety problems together (i.e., PSC), employees are likely to improve
their performance (Mansour et al. under review). Interestingly, these authors found that
motivation-enhancing HPWP has a significantly stronger impact on PSC compared to
the two other dimensions (ability and opportunity) indicating that certain HR practices
might work better in specific climates than others, for instance. They advance that
“employers who implement work-life policies and job security show some consider-
ation for employees’ lives beyond the workplace, acknowledging their being individ-
uals with needs rather than solely workers at the service of the company. Such
practices signal that management does not only care about productivity but is also
concerned with their employees’ welfare, therefore increasing perceptions of PSC.”
These finding advances the strategic HRM filed and PSC theory by showing that PSC
can act as a mediator between HPWP and employee outcomes, since so far PSC has
mostly been studied as an antecedent to (Dollard and Bakker 2010), or a moderator of
(Dollard et al. 2012; Garrick et al. 2014; Hall et al. 2013), job demands, and resources.

PSC: Predictor, Moderator, or Mediator?

PSC has mainly two functions in the work stress process. Firstly, it plays an
important role as a precursor of the working conditions that lead to work stress
process; in this regard, it determines employees’ health and productivity (Dollard
and Neser 2013) as well as predicting workplace bullying and harassment (Bond
et al. 2010). Secondly, PSC moderates the effects of working conditions, and
particularly job demands on psychological health outcomes (Dollard and Karasek
2010; Law et al. 2011). This moderating role also reflects that PSC acts as a safety
signal and/or caravan passageway as we have just seen above.
In regard to PSC as a predictor, many studies found evidence of this function. For
instance, Law et al. (2011) in a study of 30 organizations and 220 employees in
Australia have extended the job demands-resources (JD-R) framework in a multi-
level way by showing that organizational PSC was negatively related to workplace
bullying and harassment (demands) and in turn psychological health problems
(health impairment path). They also showed that PSC influenced positively work
rewards (resources) and in turn work engagement (motivational path). Dollard et al.
(2012) used a 24-month cross-level lagged data to study the effects of PSC on
psychological strain through work conditions. Using hierarchical linear modeling
and employing an advanced design where data from two distinct samples of nurses
468 S. Mansour

working in remote areas were used across time (N ¼ 202, Time 1; N ¼ 163, Time 2),
matched at the work unit level (N ¼ 48), the researchers revealed that nurses’
perception of PSC at the unit level was related to work conditions (workload,
control, and supervisor support) and psychological strain in different nurses in the
same work unit, 24 months later. Their findings demonstrated also that the between-
group relationship of unit PSC influenced psychological strain via Time 2 work
conditions (workload and job control) and Time 1 emotional demands. Idris et al.
(2012) examined the effect of PSC on job demands and psychological health in
samples from two different cultures: an Australian sample (N ¼ 126 workers in
16 teams within a primary health care organization) and a Malaysian sample
(N ¼ 180 workers in 31 teams from different organizations and diverse industries).
They found that, compared to other team level climate measures, PSC predicted
more effectively both job demands and psychological health problems. Results
showed that job demands mediated the link between PSC and psychological health
problems. In a multilevel longitudinal study in 36 Malaysian private sector organi-
zations (n ¼ 253, Time 1) (at Time 2, 27 organizations, n ¼ 117 employees), Idris
et al. (2014) investigated if PSC was a predictor of job characteristics (e.g., emo-
tional demands), and psychological outcomes (i.e., emotional exhaustion and
depression). Hierarchical linear modeling revealed that there were cross-level effects
of PSC (measured at Time 1) on emotional demands and emotional exhaustion but
not on depression (all measured 3 months later at Time 2). The study also showed
evidence for a lagged mediating role of emotional demands between PSC and
emotional exhaustion. Owen et al. (2016) in an effort to rely PSC to ERI have
found in a multilevel research in 119 organizations and 850 participants in Australia
that PSC was related to both efforts and rewards. Mansour and Tremblay (2018a, b)
in an individual study in health care in Canada found that PSC could indirectly
alleviate WFC-time, FWC-time, WFC-strain, and FWC-strain by increasing FSSB.
Ansah et al. (2018) in a study of 876 attendants from four major oil marketing
companies (OMCs) in Ghana to examine the effect of PSC showed that PSC affected
directly, and indirectly, via the path of job resources, health, and safety of the
attendants.
Concerning the moderating function, there were support for this role of PSC. For
example, Law et al. (2011) examined if PSC could play a moderating role on the
psychosocial hazard effects. They revealed that PSC, as an organization-based
resource, had a moderating effect of the positive relationship between bullying/
harassment and psychological health problems, and on the negative relationship
between bullying/harassment and engagement. Dollard et al. (2012) examined the
moderating effect of PSC in a study using sample comprised of police from 23 police
units (stations) with longitudinal survey at two time points separated by 14 months
(Time 1, n ¼ 319, Time 2, n ¼ 139). They hypothesized that a high level of job
demands will lead to psychological distress and that this relationship will be
counterbalance when there are high job resources, but this interaction will really
happen at high levels of PSC which will enable the safe utilization of resources to
decrease demands. The findings confirmed the interaction between emotional
demands and emotional resources (measured at the individual level), in the context
23 Psychosocial Safety Climate (PSC) 469

of unit psychosocial safety climate (aggregated individual data). More precisely,

high emotional resources moderated the positive relationship between emotional
demands and change in workgroup distress but only when there were high levels of
unit PSC. Hall et al. (2013) conducted an individual-level cross-sectional research in
a sample of 2343 Australian workers to examine the moderating effect of PSC on the
link between work conditions and psychological health outcomes. Their findings
revealed that PSC moderated the effects of job demands on depression and further
moderated the effects of depression on positive organizational behaviors (POB).
Garrick et al. (2014) in a sample of Australian school teachers (N ¼ 61) conducted a
diary study for 5 consecutive days that was repeated three times over the course of
approximately 8 months. Multilevel analyses confirmed that between-individual
PSC moderated the within-individual relationships between (1) job demands and
fatigue, (2) job demands and engagement, (3) recovery and fatigue, and (4) recovery
and engagement. The researchers showed evidence of the PSC moderating function
to protect teacher’s mental health. Lawrie, Tuckey, and Dollard (2017) in a multi-
level diary study analyzed a sample of 57 employees, primarily working in educa-
tion, health care, and finance, who completed a diary for 5 days within a 2-week
period. They found that PSC moderated the effect of job control on mindfulness.
Using longitudinal data from 429 Malaysian health care workers from 53 teams, Loh
et al. (2018) revealed that team PSC was a stronger moderator of emotional demands
than control or rewards on psychological health problems (emotional exhaustion and
somatic symptoms). The analysis of three-way interaction of team PSC at Time
1 with demands and resources (rewards only) at Time 2 demonstrated that PSC is
able to moderate the moderation relationship of demands and resources.
Importantly, while PSC has mostly been considered as an antecedent or a
moderator in previous researches, the results of Mansour et al. (in review) in an
international sample of 1664 flight attendants in Canada, Germany, and France
provide some evidence for the mediating role of PSC in the relationships between
AMO (ability enhancing, motivation enhancing, and opportunity enhancing) and
service recovery performance. For instance, according to these authors, empowered
and autonomous employees (opportunity) will participate in stress prevention pro-
grams and perceive that management is committed to ensuring their psychological
health and safety; they are thus likely to manage service failures with success. The
research of Mansour et al. (in review) offers new insight into how PSC can transmit
the benefits of resources offers at work (AMO) and thus help employees to better
perform at work. More research is needed to validate their results.

PSC: Countries and Occupations

The PSC concept has been carried out in several countries (Australia, Canada,
France, Germany, Iran, Malaysia, the Netherlands, the USA, and Vietnam) and in
different sectors (e.g., education, finance, and fuel attendants, health care, policing,
public sector, flights attendants, and consumer goods production).
470 S. Mansour

As for cultural context, some researchers conducted comparative studies to test

the PSC effect across cultures. For example, Idris et al. (2012) surveyed workers in
two different cultural contexts: Australia (N ¼ 126 workers in 16 teams within a
primary health care organization) and Malaysia (N ¼ 180 workers in 31 teams from
different organizations and diverse industries). The results of this study showed that
the level of PSC is higher in Australia than in Malaysia. The authors indicated that
the differences in PSC levels might due to cultural differences between Malysia with
Muslim culture, high power distance, and collectivism and Australia with a high
level in individualism and low level of power distance. Following this initial study,
and using a data obtained for 31 European countries, Dollard and Neser (2013)
found differences between countries with regard to PSC level. Moreover, the results
demonstrated that in countries with high level of PSC the quality of work was
reported more favorably. In other continent, Afsharian et al. (2016) conducted a
comparative study to examine the PSC levels and the theoretical paths of the
extended JD-R model in 33 work groups in an Iranian hospital (N ¼ 257), then
compared with an Australian sample of hospital employees (N ¼ 239, across
21 work groups). The findings indicated that Australian hospital employees stated
higher levels of PSC, skill discretion, and decision authority, and lower levels of
emotional demands, compared to the Iranian sample. The results also demonstrated
that team PSC was significantly and negatively associated to psychological demands
and emotional exhaustion, and significantly and positively associated to job
resources, decision authority, and work engagement for both countries. More
recently, McLinton et al. (2018a) performed benchmarks for working conditions in
health care industries across three hospitals in Australia (N ¼ 1258) and Malaysia
(N ¼ 1125). For both Australia and Malaysia, psychosocial safety received less
attention than physical safety climate. The results also indicated that Malaysian
health care workers reported significantly higher level of PSC than Australian health
care workers. To validate the Chinese version Psychosocial Safety Climate scale
(PSC-12), and to examine the relationship between PSC, workplace violence, and
self-rated health, Pien et al. (2019) conducted a two-part study (405 nurses, 1690
nurses from 73 hospitals). They found a comparable validity and reliability of the
Chinese version PSC-12 with the original PSC and they pointed out that this
difference might be because of cultural differences. Mansour et al. (under review)
found in an international sample of 1664 flight attendants in Canada, Germany, and
France that the mediating role of PSC between AMO and service recovery perfor-
mance was stronger in Canada compared to France and Germany. The authors
explain these differences are according to different culture dimensions like individ-
ualism/collectivism, level of uncertainty avoidance, and long-term orientation,
among others. It seems thus that the level of PSC could differ from country to
another and we need more research to further our understanding in this regard.
In regard to occupational context, PSC has been carried out in many industries
and results shows that the level of PSC differs from sector to another. Indeed, the first
model of PSC was tested in the education sector by Dollard and Bakker (2010).
Other studies have also been carried out in the education sector (Becher et al. 2018;
Garrick et al. 2014; Nielsen and Noblet 2018; Yulita et al. 2017; Zinsser and Zinsser
23 Psychosocial Safety Climate (PSC) 471

2016). The model of PSC was also verified in other sectors, especially in health care
sector (Idris et al. 2012; Mansour and Tremblay 2018a, b; Loh et al. 2018; McLinton
et al. 2018a, b, c), oil and energy sector (Ansah et al. 2018), police officers (Rasdi
et al. 2018), and university context (Potter et al. 2019). For example, using a sample
of 876 attendants from four major oil marketing companies (OMCs), Ansah et al.
(2018) found a high risk of PSC perception among the attendants. Only one study
was conducted in the university context by Potter et al. (2019). This study tended to
identify the specific characteristics or operationalization of high levels of PSC. Using
qualitative data, this research has emerged three themes in work setting: (a) shared
sense of meaningful work and social support, (b) high level of employee job crafting,
and (c) middle management support for employee psychological health. The authors
argue that these three themes explain a high PSC environment which lead to positive
employee well-being. Rasdi et al. (2018) tested the prevalence of stress among
Malaysian police officers who were randomly selected from nine different depart-
ments (N ¼ 105). The results indicated that team psychological safety and physical
safety climate are significantly related to psychosocial safety climate level. Using a
data of Australian police constables (n ¼ 409, n ¼ 36 work units), Dollard and
colleagues (2019) found that police constables perceived only moderate levels of
PSC in general underlined by a lack of priority, strategies, policies, and procedures to
avoid damage and manage psychological health at work across work units. The
authors highlighted that work contexts were characterized by low levels of PSC
which increase the levels of psychosocial risks and affect consequently psycholog-
ical health and motivational outcomes. Mansour et al. (under review) found that
flight attendants perceived a low level of PSC. It seems that PSC has been received
more attention in education and health care sectors. For instance, the majority of
studies conducted in health care sector indicated that the level of PSC in health care
is lower than other sectors. Using longitudinal data from 429 Malaysian health care
workers, Loh et al. (2018) found the psychological safety of frontline health care
workers acquired less attention in policy and from management than either physical
safety or productivity goals. Also, the author noted that the mean of PSC in health
care industry is higher than the mean reported by Idris et al. (2012) among Malaysian
private sector workers (20.03 vs. 41.76 at Time 1 and 43.19 at Time 2). The authors
believe that the difference in the results between these two studies may be due to the
difference in the work conditions between the two sectors studied. McLinton et al.
(2018, a) compared health care with non-health care general working populations
data (Australia, N ¼ 973; Malaysia, N ¼ 225). The results showed that health care
organizations pay less attention to PSC compared to other industries and this is valid
in both countries. The study revealed that unlike physical safety, psychosocial safety
gets less attention and PSC was lower than physical safety climate. The authors
explain their results by the nature of work in health care industry which is charac-
terized by a high frequency of critical incidents and high standardization of job
procedures which are rarely accompanied by a debrief process that would otherwise
occur in different industries. These different researches indicate that the level of PSC
could be different from one sector to another and highlight therefore the need for
more research in other industries to explore the importance and validity of PSC.
472 S. Mansour

PSC: Research Design and Measurement

Overall, the quantitative method was the dominant research design (i.e., Dollard and
Bakker 2010; Hall et al. 2010; Dollard and Karasek 2010; Idris and Dollard 2011;
Idris et al. 2011; Law et al. 2011; Dollard et al. 2012; Rickard et al. 2012; Winwood
et al. 2013; Dollard and Neser 2013; Yulita et al. 2014; Bailey et al. 2015;
Bronkhorst 2015; Afsharian et al. 2016; Bronkhorst and Vermeeren 2016;
Havermans et al. 2017; Nguyen et al. 2017; Dormann et al. 2018; Mansour and
Tremblay 2018a, b; Loh et al. 2018; Mansour et al. under review). Some recent
studies have used either a diary (i.e., Garrick et al. 2014; Yulita et al. 2017; Lawrie
et al. 2017) or interviews (i.e., Kwan et al. 2016; Zinsser and Zinsser 2016). More
recent researches have employed a mixed method (quantitative and qualitative)
(i.e., Dollard et al. 2017; Dormann et al. 2018; Becher et al. 2018; McLinton et al.
2018b). Most survey research was either cross-sectional (i.e., Hall et al. 2010; Idris
and Dollard 2011; Idris et al. 2011; Hall et al. 2013; Winwood et al. 2013; Dollard
and Bailey 2014; Havermans et al. 2017; Nguyen et al. 2017; Mansour and Tremblay
2018a, b) or longitudinal (i.e., Dollard and Karasek 2010; Rickard et al. 2012; Idris
et al. 2014; Bailey et al. 2015; Potter et al. 2017; Zadow et al. 2017; Dormann et al.
2018; Becher et al. 2018). Most study has used either a multilevel analysis
(i.e., Dollard and Bakker 2010; Bond et al. 2010; Idris et al. 2012; Dollard and
Neser 2013; Yulita et al. 2014; Bronkorst and Vermeeran 2016; Zadow et al. 2017;
McLinton et al. 2018c), or an individual one (i.e., Idris and Dollard 2011; Idris et al.
2011; Rickard et al. 2012; Hall et al. 2013; Winwood et al. 2013; Dollard and Bailey
2014; Bailey et al. 2015; Havermans et al. 2017; Nguyen et al. 2017; Dollard et al.
2017; Dormann et al. 2018; McLinton et al. 2018a; Mansour and Tremblay 2018a, b;
Loh et al. 2018; Mansour et al. under review).
As for the measure of PSC, it can be measured using the PSC-12 scale (Hall et al.
2010). There are four subfactors each with three items. Items are measured on a five-
point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree).

Management Commitment
1. In my workplace senior management acts quickly to correct problems/issues that
affect employees’ psychological health.
2. Senior management acts decisively when a concern of an employee’s psycholog-
ical status is raised.
3. Senior management show support for stress prevention through involvement and
commitment.

Management Priority
4. Psychological well-being of staff is a priority for this organization.
5. Senior management clearly considers the psychological health of employees to be
of great importance.
6. Senior management considers employee psychological health to be as important
as productivity.
23 Psychosocial Safety Climate (PSC) 473

Organizational Communication
7. There is good communication here about psychological safety issues which
affect me.
8. Information about workplace psychological well-being is always brought to my
attention by my manager/supervisor.
9. My contributions to resolving occupational health and safety concerns in the
organization are listened to.

Organizational Participation
10. Participation and consultation in psychological health and safety occurs with
employees, unions, and health and safety representatives in my workplace.
11. Employees are encouraged to become involved in psychological safety and
health matters.
12. In my organization the prevention of stress involves all levels of the
organization.

Bailey et al. (2015) have developed a benchmark level of PSC using several
Australian samples that were representative of the national working population. As
the PSC-12 scores range from 12–60, they determined benchmarks of organizational
PSC (range 12–60) for low levels of risk (PSC > 41) and high levels of risk
(PSC < 37) for employee job strain and depressive symptoms. In addition, Dormann
et al. (2017) suggested a critical value of PSC ¼ 26 as a benchmark that signals the
urgent need for intervention to prevent incidents of persistent depression.
Dollard (2019) validated a short scale (4 items) to measure PSC. This include:
1. Senior management show support for stress prevention through involvement and
commitment; 2. Senior management considers employee psychological health to be as
important as productivity; 3. There is good communication here about psychological
safety issues which affect me; and 4. In my organization, the prevention of stress
involves all levels of the organization. These four items are representing the four
dimensions of PSC. The finding of her study provides evidence of the validity and
reliability of PSC-4 which demonstrated a very high concordance with PSC-12. The
PSC-4 was associated to a range of work conditions, health, and engagement outcomes
across time, and the strength of relations were consistent with those relating to PSC-12.

PSC: Practice and Intervention

Organizations should consider ways to improve PSC, especially so in high-risk

industries such as the health care industry or the airline industry where potentially
traumatic incidents such as injury, hazards, sick leave, and accident are very fre-
quent. PSC should be integrated in programs and interventions as a tool to effec-
tively manage psychosocial hazards and risks at work (Bailey et al. 2015). These
authors indicated some practical steps allowing organizations and employers to
include PSC tool into existing policy and procedure and providing them a guide to
manage health and safety issues at work. Many studies also outlined the importance
474 S. Mansour

of PSC in this regard. For instance, Mansour and Tremblay (2018a, b) found a very
interesting results concerning the PSC intervention. Their study in the health care in
Quebec (Canada) showed that PSC could be a good tool to manage work-arounds
behaviors in this sector. Indeed, facing the complexity of care within a system that
increasingly requires standardization, “employees develop inconsistent and idiosyn-
cratic work patterns that they believe increase their performance and patient safety”
(Wheeler et al. 2012, p. 547). These practices are called “workarounds” (Mansour
and Tremblay 2018a, b). Authors recommended to health care organizations to
create a good PSC that can help workers feel safer, more resourceful, and more
creative in their problem-solving efforts which could make them less likely to use
work-arounds or translate the possible negative effects of work-arounds into positive
contributions.

Conclusion

PSC multilevel theory aligns with other work stress models, including the job
demands-control (JD-C) model (Karasek 1979), the effort-reward imbalance (ERI)
model (Siegrist 1996), and the job demands-resources (JD-R) model (Demerouti
et al. 2001) which all examine how working conditions affect individual psycholog-
ical health. Thanks to its predicting role, it adds to these models by demonstrating
how the psychosocial climate of an organization or work unit shaped the work
conditions defined in these models. This chapter showed that PSC can be linked
up to the signal theory (Lohr et al. 2007) and COR’s theory (Hobfoll 2011) since
researchers conceptualize it as a safety signal or a resource passageway (due to its
moderating function). Thanks to this function, PSC buffers stressors or high job
demands. It should be however noted that most previous PSC researches were
closely associated to the JD-R model. We need more study to further our under-
standing of the relationship between PSC and other work stress models. For exam-
ple, an innovative function of PSC was proposed by Mansour et al. (under review)
who found that it can mediate the relationship between AMO and performance.
Their study offers thereby a new insight into how PSC can work in organizations and
invite researchers for future investigation on the topic. While PSC might be univer-
sally important as it was validated across different countries and occupations, the
chapter outlines the importance of more research on the topic to further our under-
standing of the effects of PSC in different cultural settings and occupations. We
believe that PSC theory provides a theoretical model and practical tool for both
researchers and practitioners to measure and manage organizational, team level, and
individual factors of stress and ameliorate working conditions.

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Challenges and Opportunities for LGBTQI+
Inclusion at Work 24
Jordana Moser, Jonathan E. Booth , and T. Alexandra Beauregard

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 482
What Is Inclusion and Why Do Organizations Want to Have It? . . . . . . . . . . . . . . . . . . . . . . . . . . 482
Challenges Faced by LGBTQI+ Individuals in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . 484
The Risk of Tokenism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 486
The Question of Disclosure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 487
Employee Resource Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 491
Collective Engagement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 494
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497

Abstract
Over the past 40 years, an early emphasis on equal opportunities among both
human resource management (HRM) practitioners and scholars has gradually
shifted to a focus on diversity management and, more recently, a burgeoning
interest in inclusion (Oswick C, Noon M, Br J Manag 25:23–39, 2014). This
chapter examines inclusion in the context of lesbian, gay, bisexual, transgender,
queer, and intersex (LGBTQI+) employees and provides an overview of the current
state of play and further opportunities for employers to facilitate the full and free
participation of these workers. After defining inclusion and its appeal to

J. Moser
Ipsos MORI, London, UK
e-mail: [email protected]
J. E. Booth (*)
Department of Management, London School of Economics and Political Science, London, UK
e-mail: [email protected]
T. A. Beauregard
Department of Organizational Psychology, Birkbeck, University of London, London, UK
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 481

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_36
482 J. Moser et al.

organizations, we will review organizational challenges to the inclusion of

LGBTQI+ workers, including those unique to members of this community relative
to other minority groups and also those posed by the diversity within this group.

Keywords
LGBTQI+ · Gender · Sexual orientation · Diversity · Inclusion · Stigma ·
Employee resource groups

Introduction

Over the past 40 years, an early emphasis on equal opportunities among both human
resource management (HRM) practitioners and scholars has gradually shifted to a
focus on diversity management and, more recently, a burgeoning interest in inclusion
(Oswick and Noon 2014). This means that while the primary goal of most organi-
zations used to reside in “levelling the playing field” for women and members of
minority and marginalized groups, organizational attention now centers on leverag-
ing workforce diversity for profit and productivity: “managing” diversity as a
resource to be exploited. The concept of inclusion refers to organizational efforts
to make employees feel valued, respected, and able to contribute to organizational
processes as a fully belonging member.
This chapter examines inclusion in the context of lesbian, gay, bisexual, trans-
gender, queer, and intersex (LGBTQI+) employees and provides an overview of the
current state of play and further opportunities for employers to facilitate the full and
free participation of these workers. After defining inclusion and its appeal to
organizations, we will review organizational challenges to the inclusion of
LGBTQI+ workers, including those unique to members of this community relative
to other minority groups and also those posed by the diversity within this group.
How can organizations successfully celebrate diverse identities without perpetuating
stereotypes or outing individuals against their wishes? How can employers ensure
that LGBTQI+ voices are represented in the design and delivery of organizational
initiatives without adding extra (unpaid) labor to their existing workloads? From the
discussion of these issues, the chapter will go on to explore steps that organizations
can take to increase inclusion, such as continuous engagement initiatives, employee
resource groups, and environmental cues that normalize diversity in sexual orienta-
tion and gender identity expression. We will then conclude by looking ahead to
remaining challenges for LGBTQI+ employees and multinational organizations in
the context of increasing social conservatism in many countries.

What Is Inclusion and Why Do Organizations Want to Have It?

Inclusion has been defined in a variety of ways, most of which feature the idea of
belongingness. According to Shore et al. (2011, p. 1265), inclusion is “the degree to
which an employee perceives that he or she is an esteemed member of the work
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 483

group through experiencing treatment that satisfies his or her needs for belonging-
ness and uniqueness.” Taking a more critical approach and linking inclusion to the
business case for diversity, Baker and Kelan (2015) characterize inclusion as “a
change process focusing on engaging, integrating and valuing individual
employees” (p. 81) in order that they might be “harnessed to increase the effective-
ness of an organisation’s human capital” (p. 82). In keeping with this notion of
organizational effectiveness, common reasons for prioritizing inclusion include
positive effects on brand building among potential customers or clients; reducing
incidence of discrimination or harassment that might otherwise result in costly
litigation; and improving recruitment and retention, particularly among younger
workers who are more aware of social diversity issues and more attuned to
employers’ equality and diversity credentials (Gibson and Fernandez 2018). Meet-
ing legal obligations with regard to equality legislation and fulfilling corporate social
responsibility imperatives are also drivers of inclusion initiatives in organizations, as
are expectations of greater employee productivity.
Empirical evidence supports the positive impact of inclusion on job-related atti-
tudes and behaviors. For example, Downey et al. (2015) found that organizational
diversity practices predict increased employee engagement via the establishment of a
trusting climate, and the relationship between diversity practices and trust climate is
moderated by employee perceptions of inclusion. Inclusive organizational practices
and leader behaviors have been positively associated with perceived organizational
performance in public sector employees (Sabharwal 2014) and with increased quality
of care among human service employees, via increased innovation and job satisfaction
(Brimhall and Mor Barak 2018). In a study of LGBT US federal employees,
Sabharwal et al. (2019) found that perceptions of an open and supportive workplace
environment were associated with lower levels of intentions to leave the organization.
Recent research on the extent to which LGBTQI+ employees experience work-
place inclusion shows that while the situation has improved over time, inclusion
remains elusive for many. According to the Human Rights Campaign Foundation’s
(2018) report, nearly half of LGBTQ workers in the United States are closeted at
work, while over 70% of both straight and LGBTQ workers report that they are
comfortable talking about their partner, spouse, or dating to their colleagues, 36% of
straight workers say they would be uncomfortable hearing an LGBTQ co-worker
talk about dating, and just under 60% of straight workers think that it is
“unprofessional” to discuss sexual orientation or gender identity in the workplace.
In the United Kingdom, research from the LGBT rights charity Stonewall found that
more than a third of LGBT workers report having concealed their sexual orientation
or gender identity within the past year to avoid discrimination (Bachmann and
Gooch 2018). Other findings demonstrated how a significant minority of LGBTQI+
individuals would not feel comfortable reporting homophobic or transphobic bully-
ing in the workplace to their employers and that nearly one third of transgender
workers who identify as nonbinary don’t feel able to wear work clothing that
represents their gender expression. Looking at corporate signals, only 34% of
FTSE250 company websites mention sexual orientation (Stockdale et al. 2018),
and only 17% of FTSE100 company websites refer directly to transgender individ-
uals (Beauregard et al. 2018).
484 J. Moser et al.

How Can Organizations Improve This Situation for Their LGBTQI+

Employees and Work Toward Inclusion for All?
Given the sizeable LGBTQI+ umbrella and the diversity that falls underneath it,
organizations have much to consider and manage to ensure that appropriate policies
and practices are implemented, are working effectively, and are sustainable. This
section discusses the unique challenges that LGBTQI+ individuals face in the
workplace. Further, we discuss how organizations can adequately celebrate sexual
orientation and gender identities without making LGBTQI+ employees feel
tokenized. We also consider that not all LGBTQI+ individuals desire to be “out”
at work and that some organizational programs, even though perhaps meant from
“good” intentions, have potential to be perceived as invasive.

Challenges Faced by LGBTQI+ Individuals in the Workplace

The challenges of LGBTQI+ individuals do not merely arise while employed in an

organization and navigating their respective organization’s practices and policies.
Due to prejudices related to being LGBTQI+, these individuals often speak to
limited employment access and career paths that are often delayed, hindered, or
sabotaged. Early career issues can occur with LGBTQI+ youth, as many are not
getting the right direction and coaching from career advisors as these advisors may
not be adequately equipped nor have knowledge about how to best serve the needs of
LGBTQI+ youth (e.g., Goodrich 2012). LGBTQI+ youth also tend to be more
attentive to their identity development than their future career prospects (Schmidt
and Nilsson 2006; Scott et al. 2011). Career selection is put on hold as cognitive
resources required to make these early career decisions are being usurped. This
resource depletion is further compounded by anxiety related to anticipated discrim-
ination in the workplace (e.g., Scott et al. 2011).
In their meta-analytic synthesis of international studies, Blais et al. (2018)
reported that 12.3% of LGBTQI+ applicants, on average, have indicated that they
were encouraged not to apply or were removed from the hiring process altogether.
Further, indicating association with a trans group or organization dramatically
reduces the chances that one receives a callback from an employing organization
(Bardales 2013). Although the attributes that would identify one as LGBTQI+ are
often invisible or undetectable, discrimination has occurred during job interviews
with candidates not receiving job offers due to being their authentic self, e.g., gay
male candidate behaving in an effeminate manner or trans candidate not perfectly
“passing” as their preferred gender (e.g., Budge et al. 2010). Additionally, for trans
applicants, unfortunately, it can be a “damned if you do, damned if you don’t”
scenario regarding disclosing gender history in a job application. If one does not
disclose and is later determined different, the trans individual can be judged by the
employer as lying (Budge et al. 2010). Yet, if one does disclose, the employing
organization may question the applicant’s credibility, mental health, and professional
fitness (MacDonnell and Grigorovich 2012). Hence, trans applicants are likely to be
more concerned about how they will be perceived (Waite 2012). These additional
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 485

concerns have negative implications for how confidently trans individuals present
themselves and may further induce anxiety and fear (Pepper and Lorah 2008). To be
sure, LGBTQI+ applicants’ experiences during the recruitment and selection process
are largely dependent on the national and/or local jurisdiction laws of the applicant.
LGBTQI+ applicants tend to face greater discrimination in countries considered less
liberal (e.g., Greece) than in those considered more liberal (e.g., Belgium; Steffens
et al. 2016).
Studies also have shown that anticipation of stigma and ultimately discrimination
inhibits LGBTQI+ individuals in recognizing and pursuing potential job and career
opportunities (e.g., Fassinger 1996). As a result, some LGBTQI+ employees tend to
remain employed with longer tenures in organizations where they feel protected
from discrimination and/or ghettoize themselves by working in “gay”borhoods
and/or in occupations in which they can be their authentic selves with minimal
risk of harm or discrimination. Hence, LGBTQI+ employees often sacrifice career
promotion and growth opportunities, fit with their qualifications and abilities, and
increased wages (Ragins 2004; Ragins and Cornwell 2001). Evidence has shown the
consequences that LGBTQI+ individuals can face by not pursuing potential career
advancement in order to avoid discrimination: for example, LGBTQI+ individuals
have received lower salaries than heterosexual employees (Ng et al. 2012), and trans
individuals have accepted lower-skilled and lower-paid job opportunities (Gagné
et al. 1997) as a result of anticipated stigma.
Due to the prevalence of LGBTQI+ identities being stigmatized both in the media
and real life, the anticipation of such events are likely salient and stressful to
LGBTQI+ individuals, in turn impacting their confidence, mental health, and per-
formance. Across international samples, 42.4% of LGBTQI+ employees reported
being victims of verbal harassment; 38.9% indicated having been asked inappropri-
ate question(s) about their identity, while 25.4%, on average, stated they were the
recipient of rumors that questioned their abilities and reputation in the workplace
(Blais et al. 2018). Transgender employees may face even greater risk from discrim-
ination and stress because trans people are three times more likely to lose their jobs
in comparison with their LGB counterparts (Sears and Mallory 2011). For those who
belong to other minority groups in addition to LGBTQI+ categories, their risk of
discrimination can dramatically increase, as result of “double jeopardy” or belonging
to multiple marginalized groups who may additively or multiplicatively experience
harm (Berdahl and Moore 2006).
Another challenge of LGBTQI+ employees is that of underrepresentation; spe-
cifically, that LGBTQI+ identified individuals are underrepresented in organizational
literature and are unlikely to be reflected in middle management or at the top ranks of
the organization. Hence, there tends to be no recognition or anyone to look up to as
visible representation to junior LGBTQI+ that progression is possible. For example,
only 17% of FTSE 100 companies’ websites specifically provide discussion related
to trans employees’ issues (Beauregard et al. 2018). Signal and attraction-selection-
attrition theories suggest potential trans applicants may not be attracted to organiza-
tions who do not speak to the trans community, in turn making it more difficult for
organizations to acquire more trans leaders (Schneider 1987; Rynes 1991). Although
486 J. Moser et al.

in the minority, there are examples like Tim Cook, CEO of Apple, and Martine
Rothblatt, CEO of United Therapeutics Corporation, who are breaking barriers and
providing leadership examples required to promote LGBTQI+ advancement.
Finally, transitioning to one’s identified gender is a long and difficult process for
trans individuals, both physically and mentally (Jones 2013). The mind and body
requirements for change to occur can take medical attention, e.g., medical, surgical,
and cosmetic procedures and therapies, and these transitioning individuals often
experience pain and discomfort due to these operations and procedures. As trans-
itioning takes time, trans employees may appear or present differently depending on
their stage of transition. Some choose not to go through the lengthy and often painful
process yet may desire some medical or cosmetic change to better fit their identified
gender. For example, some may choose to dress in ways that confirm their identity,
morph their body so that they present as their identified gender (e.g., binding breasts,
tucking genitalia), and/or dress to appear gender neutral or androgynous (see
Richards et al. 2016). Even if trans individuals make an effort to “pass” to the public
as their sex identity, they may never completely “pass” as it can be difficult to fully
change genetics. Trans employees have suggested that this period is extremely
stressful and one where they are very vulnerable (e.g., forced to use employer
restrooms or to follow dress codes that do not fit their identity), with some reporting
experiences of being bullied, harassed, diminished, rejected, and discriminated
(Jones 2013; Marvell et al. 2017).
During and after the transitioning process, trans employees may be referred to as
the wrong pronoun by the cisgender public and workplace colleagues, leaving trans
employees feeling disrespected (Bender-Baird 2011; Brewster et al. 2014).
Depending on the legal protection provided, trans employees may lose their jobs
due to their employer citing reasons related to the trans worker failing to meet the
required competences; however, such terminations are usually linked to prejudiced
organizational cultures (Budge et al. 2010; Gut et al. 2018). Although trans
employees generally feel better about themselves after transitioning, performance
evaluations can change particularly for MtF trans employees, as now they begin to
experience the inequalities and biases that women have faced for centuries (Schilt
and Connell 2007; Yavorsky 2012).

The Risk of Tokenism

When organizations actually “walk the talk,” LGBTQI+-related inclusive practices

and policies can minimize perceived discrimination by employees, in turn increasing
the number of people who choose to disclose their LGBTQI+ identities. Policy
related to significant others being welcome to company social events has been found
to be the most influential initiative of all policies and practices tested in a quantitative
study by Ragins and Cornwell (2001). Yet, when implementing and managing
practices and policies, organizations must show to all stakeholders that they have a
sincere interest in the advancement and well-being of their minority employees and
are making a genuine effort. Organizations must try and do this without embracing
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 487

surface-level symbolism which, while giving the appearance of being inclusive,

achieves only superficial outcomes rather than real change. In this way, LGBTQI+
stakeholders and related initiatives are used as tokens to generate public goodwill
and manage organizational branding and image. For example, while employers
distributing LGBTQI+ “rainbow” lanyards to employees who wish to demonstrate
allyship with the LGBTQI+ community can help to amplify and normalize such
support, it can also have the unintended consequence of ambiguating the signal value
of the lanyard. Some employees who wear “rainbow” lanyards do not embody
legitimate allyship behaviors, and it can confuse LGBTQI+ employees in identifying
whom to approach in the workplace for support and resources (Calvard et al. 2020).
Such initiatives, particularly if token gestures, can falsely promote stakeholder
impressions that homophobia and transphobia have been erased from the workplace
and foster a false sense of security. Yet, in reality, some LGBTQI+ employees in
these contexts may remain fearful due to the presence of stigma and bias (Calvard
et al. 2020).
If employer efforts make employees feel tokenized, research has suggested that
minorities might suffer from negative consequences due to heightened visibility and
pressures to perform certain tasks (e.g., King et al. 2010). In implementing their
inclusive initiatives, organizations often can treat their LGBTQI+ members as
“model minorities,” basing role, task, and other assignments on stereotypes of the
group. When these initiatives emerge and require staff to implement them, managers
tend to rely on their default response and approach minority employees in their teams
to take on these roles. This can be exhausting for employees who may feel over-
worked with the additional duties and find it challenging to complete their assigned
job tasks and maintain work-life balance (Calvard et al. 2020). Consistently
assigning minority employees to these diversity and inclusion roles also reduces
the opportunity for majority employees to champion and lead inclusive initiatives.
Additionally, managers can assign other work and nonwork-related duties (e.g.,
planning office socials) based on positive stereotypes (e.g., gay men are stylish),
yet this misguided approach can lead employees feeling frustrated, improperly
utilized, and not genuinely celebrated.

The Question of Disclosure

Although disclosure tends to be greater in organizations that have policies that forbid
discrimination and encourage inclusivity, identity disclosure is a very personal
decision and dependent on the person and their situation (Ragins and Cornwell
2001). Following invisible stigma disclosure (Ragins 2008) and cross-domain iden-
tity transition (Ladge et al. 2012) theories, LGBTQI+ employees, who have
disclosed their stigmatized identity in both work and nonwork domains, have
complete identity integration and may be best suited to take full advantage of their
organization’s inclusive initiatives and workplace relationships, which facilitate
improved personal and work-related outcomes (e.g., Law et al. 2011). However,
these outcomes likely are enhanced when employees, working with their respective
488 J. Moser et al.

human resources department and management, can completely control their disclo-
sure narrative (Bender-Baird 2011). Although the decision to disclose is dependent
on supportive contexts, individual differences, and perceived disclosure consequences
(Ragins 2008), disclosure is not an all-or-none phenomenon for LGBTQI+ employees
(Ragins and Cornwell 2001). Ragins and Cornwell (2001) reported that 11.7% did not
disclose their sexual orientation identity at work; 61.6% disclosed to some extent,
while the remainder indicated complete disclosure. Trans employees’ disclosure rate at
work is lower, with evidence from one study suggesting that only 35% disclose their
trans identity (Maguen et al. 2007).
Even in workplace contexts where diversity is celebrated, some LGBTQI+
employees choose not to disclose. This could stem from LGBTQI+ employees’
individual differences, their desire to maintain a specific workplace image, and/or
trying to avoid biased evaluations from others in the workplace (e.g., students
finding straight instructors more credible than gay instructors; Russ et al. 2002).
Some may decide to create a façade to successfully conceal their LGBTQI+ identity
to meet the above objectives; however, this has the potential to elicit personal
burnout and other negative outcomes (Newheiser and Barreto 2014; Ragins 2008).
Further, some trans individuals have the ability to “pass” in public and thus “go
stealth” in their workplace as their affirmed gender, preferring instead to subvert the
stigma and challenges that are associated with being openly trans (Budge et al.
2010).
Therefore, even if organizations are being genuine and proactive, they must
realize that they cannot force their inclusive initiatives on unwilling participants.
Employees who do not want to disclose their LGBTQI+ identity and sense that they
have no choice with organizational practices and policies may have a negative
emotional response, disidentify, and withdraw from work (e.g., Booth et al. 2020;
Shantz and Booth 2014). They may not feel understood by the organization because
initiatives are not self-verifying and have the potential to jeopardize their desired
state of identity (Booth et al. 2020). These employees could perceive such practices
as an invasion of privacy, particularly if they are inundated and constantly reminded
of the initiatives. Although these practices are intended to be inclusive, LGBTQI+
employees who do not want to lose their control over their disclosure decision may
perceive such initiatives as mechanisms to be “outed” (Budge et al. 2010).

Moving Toward Inclusion

In spite of these challenges, we have identified three ways organizations can begin
better supporting their LGBTQI+ employees.

Signals and Systems

A meaningful way for organizations to be more inclusive of LGBTQI+ employees is
to deploy signals and systems that make it easy for employees to embody their
LGBTQI+ identity at work, should they choose to do so (Clair et al. 2005). In the
proceeding section, we differentiate signals from systems, defining the former as any
stimuli that provides a visual cue that LGBTQI+ identities are welcome in an
organizational context and the latter as processes that facilitate the authentic
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 489

inclusion of LGBTQI+ identities with as little emotional labor needed from the
individual as possible. In line with Follmer et al. (2019), we propose the simulta-
neous deployment of signals and systemic processes to be an imperative part of
destigmatizing LGBTQI+ identities within the workplace.

Signals
As stated, there are a number of signals organizations can use to communicate the
acceptance of LGBTQI+ employees, beginning with the creation of a job posting
through an employee’s departure from the organization. One way to signal inclusion
is the utilization of gender-neutral language in recruitment materials. Gender-neutral
language speaks to the use of both gendered pronouns and also gender-coded words.
It has long been accepted that the language used in job postings has a cascading
effect on the types of people who are drawn to an organization and, in turn, the extent
to which that organization’s culture is welcoming to others (Bem and Bem 1973; cf.,
Eagly and Karau 1991; Schmader et al. 2007). Indeed, an experimental study by
Gaucher et al. (2011) found that crafting job postings with “masculine-coded” words –
such as “competitive,” “headstrong,” “outspoken” – led women to find such postings
less appealing. It would behoove organizations to apply these binary-gender learn-
ings to ensure adverts are as accessible as possible to potential employees outside the
gender binary as well. One action point for organizations is to ensure job postings
utilize gender-neutral descriptors (e.g., the singular “they” or “this person,” rather
than “he” or “she”) when describing desirable applicants in job adverts. To further
optimize performance in this area, organizations can utilize software to screen
potential job postings and flag gendered language, such as Applied and Gender
Decoder.
Workplace policies can also be used to signal inclusion of nonnormative gender
expression. Many corporate dress code policies have, historically, dictated different
rules for men and women. In 2010, the Swiss bank UBS notably received much
criticism upon its 44-page staff dress code being made public, in which women were
instructed how to apply makeup, which perfumes to wear, and even the color of their
underwear, while men were told to keep their beards neat and were permitted to wear
only a black suit with a red tie (BBC 2011). However, as noted by the Society for
Human Resource Management, dress codes are often based on stereotypical gender
presentations; it’s not unheard of for women to be strongly encouraged to wear a full-
face makeup, while it would be frowned upon for a man to arrive in the same way
(Wilkie 2019). Such reductive policies often disproportionately impact LGBTQI+
people, as queer people are more likely to embody nonnormative or gender-fluid
gender expression (Sawyer and Thoroughgood 2017). If organizations feel appear-
ance guidelines to be necessary, they should make them applicable to all employees
(e.g., ripped jeans are not permissible at work), rather than stratifying guidelines
according to gender, as to allow all employees to express themselves authentically.
Organizations can also use formal benefit policies to signal their support for
nontraditional familial structures, specifically as pertains to partner benefits and
care leave. Though same-sex marriage is becoming more commonplace throughout
the West, enabling same-sex partners to enjoy the same benefits afforded to
490 J. Moser et al.

heterosexual couples (e.g., healthcare, tax breaks, etc.), there remain many places
where same-sex relationships are held on unequal footing. As such, organizations
should proactively incorporate same-sex partner benefits to whatever extent their
operating country laws allow them to do so, including allowances for formal
marriages not being possible (e.g., acknowledging common law partnerships).
Healthcare benefits should also cover trans-specific healthcare needs, such as hor-
mones or gender-affirming surgeries such as voluntary mastectomies (“top sur-
gery”). In addition to marital/partner benefits, same-sex couples who choose to
have children are also liable to face challenges accessing parental leave. A study
of same-sex parental leave policies in 34 OECD countries found that same-sex male
couples were at the greatest deficit compared to their mixed-sex counterparts, with
only 4 countries providing equal leave, as compared to the 19 countries that offer
equal leave to same-sex female couples (Wong et al. 2019). Where possible,
organizations should supplement these national leave policies such that same-sex
employees receive the same leave entitlements as heterosexual employees.
Another way organizations can signal acceptance of LGBTQI+ individuals is to
encourage all employees to include their pronouns in email signatures. As elaborated
by the UK-based LGBT+ advocacy organization Stonewall, requesting that all
employees specify their pronouns may help trans/nonbinary/gender nonconforming
employees feel less othered in their experience of having to clarify theirs. Having
pronouns included in a statutory setting such as an email signature further provides
others with a point of reference, reducing the onus on LGBT+ employees to have to
continually “come out” with respect to their gender identity. It’s important, however,
for organizations to encourage rather than require pronoun sharing, as making it
mandatory may make employees feel pressured to “out” themselves before they’re
ready or may otherwise contribute to a hostile working experience for some indi-
viduals (McDonald 2020).
In addition to the aforementioned language-based strategies for signaling inclusion
to LGBTQI+ employees, organizations should also consider utilizing visual signals of
LGBTQI+ inclusion. Another way this can be achieved is through the acknowledg-
ment of commemorative days significant to the LGBTQI+ community, including
Pride Month, National Coming Out Day, and Trans Awareness Week. Acknowledg-
ment can take the form of posters, informational articles on company intranet sites, or
written statements. Finally, organizations can encourage employees to personalize
their workspaces, where personalization is defined as “the display and arrangement of
artifacts and objects according to personal choices and desires” (Elsbach and Pratt
2007: 198). Research by Elsbach (2003, 2004); Gosling et al. (2002); and Wells
(2000) have documented that personalizing workspaces facilitates feelings of identity
affirmation and distinctiveness, particularly in highly depersonalized environments
such as call centers. Wells (2000) further demonstrated that these positive feelings
contribute toward lower levels of turnover and higher overall morale.

Systems
Though signals are a crucial first step to promoting the inclusion of LGBTQI+
identities in the workplace, it’s equally imperative that these signals are met with
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 491

systemic processes within an organization that turn the promise of inclusion into a
reality. One systemic change organizations can make to support LGBTQI+
employees is the equipment of all workspaces with gender-neutral bathrooms. The
topic of bathroom usage has come under much public scrutiny in recent years,
perhaps most famously within the context of North Carolina’s Public Facilities
Privacy and Security Act, or House Bill 2 (HB2). Passed in 2016, a portion of
HB2 required that citizens only use restrooms that aligned with the sex listed on their
birth certificate (Lichtblau and Faussett 2016). HB2 and similar laws are problematic
not only for transgender individuals but also for cisgender individuals who present in
a way that is atypical of their assigned sex. Explicitly identifying certain restrooms as
all gender or gender neutral alleviates concerns that one might find themselves in
harm’s way for doing gender “incorrectly” and reduces the labor of trans/gender
nonconforming employees to seek out safe accommodation.
Another systemic change organizations can employ to support their LGBTQI+
employees is to include fields for legal and preferred names, pronouns, and gender-
neutral honorifics (e.g., Mx., M.) on hiring documents and other intraorganizational
forms, such as event bookings or benefit enrollment forms. It is often an onerous task
for trans and gender nonconforming individuals to have to consistently out them-
selves and educate others as to how they would like to be addressed. Further, given
that changes are often implemented on an ad hoc basis (e.g., on the email system, but
not the payroll system), it can take several rounds of self-advocating before their
names, honorifics, and pronouns have been comprehensively updated. As a result,
organizations should endeavor to provide spaces for this information to be collected
and processed all at once upon hire, to minimize the extra labor required from the
employee.
Finally, it’s important that organizations develop processes that acknowledge and
accommodate employees who transition during the course of their employment. For
example, an employee may identify as male at the time of hire and in turn select male
honorifics/pronouns on all formal paperwork. However, she may later realize she is a
woman. As opposed to waiting for the employee to approach HR and update her
identifying information, a systemic approach to transitioning would be to allow
employees to access and update their HR systems data at any time. Should this not be
technologically feasible, organizations should endeavor to conduct HR system data
refreshes at different points throughout the year. Proactively seeking out this infor-
mation signals to employees that their organization recognizes that identities might
evolve over time and also alleviates the stress of an employee having to broach the
subject with HR themselves.

Employee Resource Groups

The second way organizations can promote the inclusion of their LGBTQI+
employees is through the creation of employee resource groups (ERGs). ERGs
have been a feature in organizations since the 1970s, when a group of Xerox
employees formed the Black Employee Caucus in response to race riots in upstate
492 J. Moser et al.

New York (Briscoe and Safford 2015). Over time, such groups have taken on
additional names, such as affinity groups, employee networks, or employee forums.
ERGs are defined as “groups of employees in an organisation formed to act as a
resource for both members and the organisation” (Kaplan et al. 2009, p. 1). Group
membership is voluntary and is generally predicated on a demographic (e.g., gender
or race), life stage (e.g., carers, early careers), or function (e.g., support staff, sales
teams).
ERGs offer numerous benefits to both employees and organizations. One such
benefit is the opportunity to develop non-role-related ties at work. Though, as has
been noted above, the LGBTQI+ umbrella contains a multitude of experiences,
ERGs that are built around a shared experience of “otherness” help to foster a
sense of “in the same boat consciousness,” which is a key facet to workplace
socialization, driving outcomes such as reduced turnover and increased commitment
and positive affect toward the organization (Van Maanen and Schein 1979). Empir-
ical work by Colgan and McKearny (2012) found that LGBTQI+ ERGs enable
employees to develop interorganizational networks of support for things like train-
ing, locating resources, networking, and sharing challenges. Indeed, ERGs have the
added benefit of providing ties outside of one’s team, meaning that these ties are
likely to sustain regardless of where an individual moves within an organization,
offering more durability than team or role-based ties (Moser and Ashforth 2020).
We propose ERGs are linked to activism by way of providing a mechanism to
cultivate employee voice. Employee voice is defined as “nonrequired behaviour that
emphasizes expression of constructive challenge with an intent to improve rather
than merely criticize” (Van Dyne and LePine 1998, p. 109). As mentioned earlier,
ERGs are generally predicated on underserved, undervoiced group membership
(e.g., racial/ethnic minority, specific functions, etc.); as such, these groups are
well-poised to generate conversations around what can be improved in the organi-
zation for the benefit of these identities. To this point, an empirical study by Briscoe
and Safford (2008) demonstrated how the presence and persistence of LGBTQI+
employee groups increased firms’ susceptibility to adopting same-sex partner benefit
policies at Fortune 500 organizations.
In discussing the benefits of ERGs, however, we would be remiss not to also
mention their susceptibility to overuse, or “scope creep.” While ERGs have great
capacity to empower employees, they are often called upon in times of crisis to
perform unpaid labor for their organizations (Morris 2020). Indeed, in some ways,
their very existence constitutes an act of service from employees. As diversity and
inclusion has become an increasingly salient pillar of an organization’s CSR profile,
having ERGs that serve various communities has evolved from being a “nice to
have” to being an important signal of an organization’s commitment to equity,
diversity, and inclusion (Welbourne et al. 2017). And yet, despite their importance,
ERGs are rarely given sufficient resources from organizations to facilitate their
activities. Resource deficiency often manifests itself financially, such that groups
aren’t given enough funding to host events or compensate external speakers, but also
takes the form of insufficient labor to carry out their activities. Groups are typically
run by volunteers who take on the mission of the ERG in addition to a full-time job.
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 493

Despite such positions being considered little more than an extracurricular, group
leads and members are often tasked with diversity and inclusion tasks that central
organizational teams like HR don’t feel qualified to carry out on their own, such as
drafting statements denouncing or supporting current events or creating more inclu-
sive policy language (Tiku 2020). As is the case with any organizational citizenship
behavior, such tasks necessitate employees’ withdrawal from other, potentially more
lucrative extra-role behaviors, in turn reducing their ability to access rewards such as
pay rises or promotions (Bergeron 2007).
In order to best equip ERGs to elevate rather than burden employees, organiza-
tions should embed groups into the fabric of their organizational structures instead of
framing them as an extracurricular. In other words, ERGs need to be legitimized by
organizational leadership. One way of conferring legitimacy is to ensure a member
of the C-suite is appointed as a champion for a given ERG (Bethea 2020). Ideally,
this person should be an out-group member (e.g., not a member of the ERG). Having
an out-group member champion, an ERG signals to other out-group members that
group-related issues are matters of importance to all members of an organization,
rather than solely members of the community. Another way of conferring legitimacy
to ERGs is to allow group leaders and committee members to allocate a percentage
of their job role time to ERG-related commitments (Bethea 2020). Allowing for this
formal allocation of time implies that these activities are considered a central priority
of the organization, rather than something to be squeezed in when possible. This
delineation should be made in formal documents, such as contracts, but should also
be reflected in any timekeeping tools utilized by the organization, such as timesheets.
Finally, legitimacy can also be imbued through financial means, such as, for exam-
ple, offering a financial incentive such as a bonus or an overall salary increase in
exchange for labor provided to ERGs (Starling 2020).
In sum, ERGs are an effective mechanism for connecting LGBTQI+ employees
and providing a mechanism for employee voice. However, for employees to derive
the intended benefits from ERGs, they must be allowed to exist solely as groups by
and for employees – rather than a body to be called on by leaders to perform work
that would otherwise be handled by a paid external consultant.

Collective Engagement

Perhaps the most important part of authentically including LGBTQI+ employees at

work is to engage in dialogue about what that looks like for the employees at that
organization specifically. Though senior leaders may want to demonstrate their
support for the community by marching in the local Pride parade, for example,
LGBTQI+ employees may not find resonance in doing so. To go against their wishes
– even when it’s meant to demonstrate support – can connote a form of exploitation,
whereby it is more important to appear supportive than it is to actually engage with
one’s employees.
Cisgender and heterosexual friends and work colleagues may ask LGBTQI+
individuals to educate them about transphobia/homophobia and enquire “what do
494 J. Moser et al.

you think of these phobias” or “what can I do to help?” This is somewhat akin to the
experiences of racial minorities in their efforts to eradicate racial inequality and
police brutality (Wilson 2020). These majority individuals are not being mindful of
the potential for how the marginalized person’s explanation can generate negative
emotions (e.g., pain or fear) from conjuring previous and current negative interac-
tions that the marginalized person has witnessed or personally experienced inside
and outside of the workplace. Additionally, from hearing these stories from the
marginalized, majority individuals may not be prepared for the negative emotions
that they may feel, as they may become more aware of their ignorance of the
minority experience, may attribute blame to themselves as a potential contributor,
and/or may recognize their lack of helping the marginalized (Wilson 2020). It is
unfair to expect the marginalized to educate and to determine a way forward for
majority individuals “to help” or “make change.” The onus should not be on the
marginalized as this can be cognitively and emotionally depleting, causing negative
consequences. Responsibility lies within cisgender and heterosexual individuals to
educate themselves, as well as determine ways in which they can use their privilege
and majority status to dismantle transphobia and homophobia. These points do not
mean that organizations should favor the voice of the majority over those of the
marginalized employees on how initiatives are run and organized. For programs to
be effective and widely utilized, it is imperative that there is genuine buy-in,
communication, involvement, and leadership from these marginalized groups. How-
ever, the marginalized should not be expected to always do the heavy lifting in
designing, enforcing, and informing inclusive initiatives. These activities should be a
collaboration, espoused throughout the organization with the majority’s involve-
ment. The access to greater resources which is enjoyed by the majority will assist in
sustaining inclusive initiatives and help to bring about the widespread organizational
change required.

Conclusion

As the preceding sections have shown, LGBTQI+ workers often continue to face
barriers to inclusion in the workplace. The conclusion to this chapter focuses on
challenges remaining for employers in creating inclusive policies and practices in
countries with LGBTQI+-unfriendly legislation and social norms and for transgen-
der employees undergoing gender transition. We come to a close by noting how
recent sociopolitical developments in the West have created newly regressive envi-
ronments in which LGBTQI+ individuals are under increased threat, making
employer support more important than ever.
An ongoing challenge for multinational organizations is how to reconcile their
LGBTQI+-inclusive policies and practices from headquarters with local legal frame-
works in host countries that are unsympathetic to LGBTQI+ rights. The delicate
balancing act between localizing human resource management (HRM) practices and
global standardization becomes especially difficult in legal environments that either
make little provision for LGBTQI+ equality or criminalize same-sex relationships
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 495

outright. For example, Luiz and Spencer’s (2019) research found that multinationals
experience difficulty in aligning their corporate values and HRM policies regarding
support for LGBTQI+ employees with legislative requirements and local institutions
in the African nations where they operate. Protecting LGBTQI+ employees from
discriminatory selection, promotion, and dismissal practices or from harassment and
bullying can be an arduous task when there is no legal basis for these protections or
their enforcement. In countries where engaging in same-sex relationships can lead to
prosecution, organizations may not be able to maintain safe working conditions for
LGBTQI+ employees.
Research by Boerties (2012) on LGBTQI+-friendly multinationals sheds light on
how these organizations tackle such problems. When there are challenges to policy
enforcement due to weak or nonexistent antidiscrimination legislation in host coun-
tries, multinationals often implement “soft” measures such as investment in
LGBTQI+ inclusion and awareness programs, training, mentoring, and diversity
standards for recruitment. The purpose of these is to try to ensure LGBTQI+ equality
in daily operations and to gradually affect attitude change among the local work-
force. As Trau et al. (2018) argue, while local communities’ legal and socio-
normative features influence organizations’ LGBTQI+ policies, this process is
recursive in that communities’ regulative and socio-normative processes are also
influenced in turn by organizations’ approach in relation to the stigmatization of
LGBTQI+ individuals within those communities. Winning local hearts and minds
over to LGBTQI+ inclusion may therefore be possible via the sustained implemen-
tation of culturally sensitive compromises to LGBTQI+ equality by multinational
employers.
In countries with serious legal impediments to LGBTQI+ equality, however,
Boerties finds that multinationals are reluctant to appear as though they are imposing
their own values in an imperialistic fashion. In nations such as Nigeria or Saudi
Arabia, therefore, multinationals do not seek to negotiate for more favorable work-
place conditions for LGBTQI+ employees, perceiving the gap between their own
corporate values and the conservative social mores and local legislative conditions to
be unbridgeable. In these environments, multinational firms choose not to implement
LGBTQI+ equality policies because they cannot be upheld by local legislation. This
raises issues for LGBTQI+ expatriate employees. As McPhail (2017) notes, a greater
proportion of LGBTQI+ employees are likely to be found in senior management
positions relative to their straight and cisgender counterparts, and thus they represent
a significant number of the top talent eligible for international assignments. How-
ever, assignments in particular countries would represent a risk to LGBTQI+
individuals’ health and safety, and employers must therefore grapple with how to
protect their workers. Some multinationals may choose to offer alternative country
assignments or provide extensive preparation for LGBTQI+ expatriates along with
emergency support measures as required including extraction, legal assistance, or
confidential advice; others, such as Accenture and IBM, have made available virtual
international assignments in which the LGBTQI+ employee resides in their own
country of choice and exposure to local legal conditions that may endanger their
safety is therefore minimized (Boerties 2012).
496 J. Moser et al.

Another challenge remaining for organizations is the question of how best to

support transgender employees who may be transitioning in the workplace from the
expression of one gender identity to another. This process is widely acknowledged as
having the potential to be highly stressful for transgender employees for a variety of
reasons. Interventions such as hormone therapy, surgery, and cosmetic procedures
like laser hair removal can produce anything from physical discomfort to potentially
serious health complications (Beauregard et al. 2020). During and post-transition,
transgender individuals adjust gendered speech, nonverbal communication, and
behavior patterns, causing others in the workplace to see them differently and change
their own behavior toward them (Schilt and Connell 2007). During this period,
transgender employees are particularly vulnerable to workplace harassment and
bullying and, in turn, anxiety and depression (Marvell et al. 2017; Sawyer and
Thoroughgood 2017).
Workplace inclusion can therefore be seen as vitally important for transitioning
employees. Many transgender employees have reported higher levels of job satis-
faction after transitioning and described feeling more comfortable at work in their
new gender identity presentation (Drydakis 2016). However, there is considerable
evidence to suggest that many transgender employees lose their jobs post-transition
and that while dismissal is construed as being performance-related, employer dis-
comfort and prejudice are likely to underlie these decisions (Gut et al. 2018). While
human resources should be the first point of contact for transgender employees to
obtain support for their transition journey, research suggests that organizations are
often ill-equipped to respond to these workers’ needs for inclusion, lacking knowl-
edge and training on the issues they face at work (Beauregard et al. 2020).
Indeed, as the political environment continues to be volatile throughout the Western
world, employer support for LGBTQI+ inclusion becomes increasingly crucial.
Resurgent populism among right-wing governments has raised concerns for hard-
won LGBTQI+ rights. Despite having decriminalized same-sex relationships in 1932,
decades before most European nations, nearly one third of towns and regions in
Poland have passed (nonbinding) resolutions that declare them free of “LGBT ideol-
ogy” (Ash 2020). While campaigning for reelection, President Andrzej Duda referred
to the promotion of rights for the LGBTQI+ community as “even more destructive”
than communism; the archbishop of Krakow, influential in a predominantly Catholic
nation, has spoken in warning tones about a neo-Marxist “rainbow plague” (Ash
2020). Such prominent antipathy toward LGBTQI+ equality clearly has negative
implications for the inclusion of LGBTQI+ individuals in Polish organizations,
normalizing prejudice and denigrating those who advocate for this community.
Author J. K. Rowling has further continued to use social media to express her view
that transgender women are not women and should not be allowed access to women-
only spaces such as changing rooms and bathrooms (Lampen 2020). Facing criticism
from many for this trans-exclusive perspective, Rowling published a 3,690-word blog
post contending that although she broadly supports transgender individuals, transgen-
der women remain, biologically, men and thus pose a threat of sexual violence to
cisgender women upon whom they might prey if permitted entry to “safe spaces” for
women. The media attention garnered by this series of events has, according to
24 Challenges and Opportunities for LGBTQI+ Inclusion at Work 497

transgender women participating in a mental health conference panel session chaired

by one of the authors of this chapter (personal communication, October 12, 2020),
increased their direct experience of verbal harassment and abuse by strangers in public
and online. Emboldened by Rowling’s initial statements and continued arguments, US
Senator James Lankford quoted her blog post while blocking senate consideration of
the Equality Act, a bill that would have entitled LGBTQI+ individuals to civil rights
protections in the United States (Fitzsimons 2020).
In this type of sociopolitical climate, employer promotion of LGBTQI+ inclusion
is critical. When public attitudes shift to intolerance and in some cases outright
homophobia or transphobia, the workplace may be one of the few (or only) bastions
of support that LGBTQI+ employees experience. Modelling an environment where
diversity in sexuality and gender identity expression is not simply tolerated but
respected and valued shows LGBTQI+ employees and their co-workers a viable way
forward in what seem like increasingly troubled times. Efforts toward organizational
inclusion for LGBTQI+ employees thus go beyond improving workplace relation-
ships and productivity; it can establish hope for a better future.

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Performance Management and Wellbeing
at the Workplace 25
Monica Franco-Santos, Dan Stull, and Mike Bourne

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 504
What Do We Mean by “Performance Management Systems” and “Wellbeing”? . . . . . . . . . . . . . 505
Performance Management Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 505
Wellbeing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 505
Different Types of Performance Management Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 506
Directive Performance Management Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 507
Enabling Performance Management Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 511
Performance Management and Wellbeing Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 512
Fostering Employee Wellbeing: A Guiding Framework for Managers . . . . . . . . . . . . . . . . . . . . . . . . 515
The Role of Organizational Goals in Performance Management Systems . . . . . . . . . . . . . . . . . 515
Organizational Goals and Performance Management Systems Types . . . . . . . . . . . . . . . . . . . . . . 518
Performance Management Systems for Wellbeing and Performance . . . . . . . . . . . . . . . . . . . . . . 520
Concluding Remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 522

Abstract
Performance management systems can be a source of stress and anxiety, and yet
they can also provide clarity and focus, which are both factors that have positive
effects on wellbeing at work. Employee wellbeing is essential as it has been
shown to enhance organizational performance and employees’ quality of life.
These paradoxical results represent a challenge for organizations when designing
performance management systems. In this chapter, we examine current research
on the relationship between performance management practices and employee
wellbeing and formulate a conceptual framework elucidating the conditions
under which different wellbeing results are likely to occur. The purpose of our
work is to help organizations design performance management mechanisms that

M. Franco-Santos (*) · D. Stull · M. Bourne

Cranfield School of Management, Bedford, UK
e-mail: monica.franco@cranfield.ac.uk; Daniel.Stull@cranfield.ac.uk; m.bourne@cranfield.ac.uk

© Springer Nature Switzerland AG 2022 503

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_42
504 M. Franco-Santos et al.

account for and foster employees’ wellbeing as well as raise awareness regarding
the situations that can deteriorate it. We conclude by highlighting the importance
of managerial philosophies and organizational goals definitions, recommending
the adoption of a enabling or a hybrid set of performance management mecha-
nisms to better accommodate the complex nature of wellbeing and other organi-
zational goals.

Keywords
Performance management systems · Performance measurement · Governance ·
Wellbeing · Management control

Introduction

How organizations manage their performance has profound effects on the

wellbeing of their employees (Salas-Vallina et al. 2020). Some organizations
adopt performance management practices that improve people’s performance
without posing a threat to their wellbeing. Others manage performance in a way
that may enhance performance, but they do so by neglecting or weakening
people’s emotional and physical wellbeing (Franco-Santos and Doherty 2017).
The management literature often refers to the former positive relationship between
performance management and wellbeing as a win-win or mutual gain relationship,
while describing the latter as a win-lose relationship (Peccei and Van der Voorde
2019). In general, the detrimental effect of managerial practices on wellbeing has
received little attention in organizations (Tweedie et al. 2019). This is likely to be
due to factors such as a pressing shareholder value agenda, prioritizing the
financial interests of shareholders over those of other stakeholders and organiza-
tions being more interested in knowing what people do than how they feel (Guest
2017). From a moral, ethical, and financial perspective, this lack of attention is no
longer tenable (Tweedie et al. 2019). Especially, when empirical evidence in
economics shows that wellbeing influences long-term productivity (Oswald et al.
2015), and macro sociology research suggests that wellbeing interacts with the
social structure of the communities in which organizations operate (Ouchi and
Johnson 1978).
This chapter offers a review of the extant literature investigating the links between
performance management systems and wellbeing. We aim to extract key insights and
present a framework that can guide organizations in their design of performance
management systems that promote mutual gains. The chapter is structured as
follows: We first describe what we mean by performance management systems
and employee wellbeing. We then explain what different types of performance
management systems look like, paying special attention to their underlying rationale,
assumptions, and core components. Next, we review the academic research exam-
ining how (and why) different performance management systems influence
25 Performance Management and Wellbeing at the Workplace 505

employee wellbeing. We conclude by discussing how organizations can design

performance management systems that foster healthy workplaces.

What Do We Mean by “Performance Management Systems”

and “Wellbeing”?

Performance Management Systems

We define performance management systems as the network of control mechanisms

present in an organization to facilitate the delivery of its goals by influencing or
guiding people’s behavior (Ouchi and Johnson 1978; Flamholtz et al. 1985; Ferreira
and Otley 2009). We view organizations as a coalition of individuals (often referred
to as stakeholders) who pursue a set of intended goals or objectives (Cyert and
March 1963). The degree of performance (or success) an organization achieves is
understood in terms of how well its intended goals are agreed, shared, and delivered.
In the attainment of organizational goals, control mechanisms play a crucial role
(Cardinal et al. 2017). The term “control mechanisms” is here used in a broad sense
to include the processes or practices that increase the probability of people (individ-
uals and groups) behaving in ways that facilitate the delivery of organizational goals.
In other words, that help an organization to perform as expected (satisfying the needs
and wants of its stakeholders). For instance, control mechanisms help key stake-
holders arrive at a consensus about the set of goals that need to be prioritized; they
facilitate a shared understanding of those goals; and they translate goals into
measures to assist in their delivery.
An organization-wide performance management system is a complex system,
comprising various interrelated sub-systems of controls (Merchant and Otley 2020).
These systems may differ in terms of their specific form and usage across the various
parts and hierarchical levels of an organization. These complex systems can have
features that are rationally and centrally designed, but they are also subject to
emergent processes that make them be in continuous evolution. To be effective,
previous research has found that the overall design philosophy of a performance
management system needs to fit the nature of the goals the organization pursues and
the wider context in which the organization operates (Otley 2016). To foster
employee wellbeing, it is also important that the system meets the behavioral and
identity needs of the people whose skills, knowledge, and motivations are more
likely to help deliver organizational goals (Franco-Santos et al. 2017).

Wellbeing

The meaning of wellbeing is highly contested. Some argue that it is an “elastic

concept” because it means different things to different people (Danna and Griffin
1999). The concept involves “being” and “well,” which means, colloquially speak-
ing, “feeling good.” In general, most scholars agree that wellbeing refers to people’s
506 M. Franco-Santos et al.

feelings about their everyday life (Warr 1978). In research terms, a common view is
emerging suggesting that wellbeing comprises three separate but related compo-
nents: cognitive evaluations about one’s life (e.g., satisfaction with life), positive
affective states (e.g., happiness), and negative affective states (e.g., stress) (Diener
et al. 2018). In particular, management research focuses on work-related wellbeing,
understood as “the overall quality of an employee’s experience and functioning at
work” (Grant et al. 2007, p. 52). Due to the multidimensional nature of wellbeing, its
operationalization is not always consistent across studies; although, most researchers
concur with the notion that employee wellbeing can only be subjectively assessed
and involves the presence of positive emotions about life at work (e.g., happiness,
meaning, satisfaction, good relationships) as well as the absence of negative ones
(e.g., depression, stress, burnout, or anxiety). Management practices influence how
people feel at work (Guest 2017). Notably, performance management systems play a
crucial role in people’s working life. Although, the wellbeing effects of these
systems are highly dependent on the type of performance management system
adopted; that is, their specific design features and how these features are used or
enacted (Franco-Santos and Doherty 2017).

Different Types of Performance Management Systems

Performance management systems have a cybernetic or “steermanship” nature

(Flamholtz et al. 1985), which implies that they are purpose-driven and developed
by people and for people to use. They are “tools” designed with a purpose in mind,
which may or may not be used as designers expect. For example, in a hospital, a
“waiting time measure” may have been designed to better understand the healthcare
delivery process and learn how to improve it. Yet, over time, the measure starts to be
used by some managers as a performance indicator with which to “hammer” staff for
not meeting their, all of a sudden, “accountable” results. As explained earlier, the
overall purpose of a performance management system is to facilitate the delivery of
organizational goals. The delivery of organizational goals can be considered a
problem. Leaders at all levels need to deal with this problem. The way the problem
is framed is determined by the assumptions and rationale the people dealing with the
problem have. These assumptions and ideas are not only crucial in the process of
framing the problem. They are also essential in the process of creating a potential
solution to the problem. How leaders frame their performance problem has conse-
quences for the mechanisms they select to address such problem.
A performance management system comprises the control mechanisms designed
and used in organizations to address the performance problem leaders believe their
organization has. If we understand organizations as a coalition of individuals, and
individuals are characterized by the diverse assumptions and ideologies they hold;
then, we are likely to find different framings of the performance problem leaders face
as well as different types of performance management systems. For ease of under-
standing, we focus our attention on describing ideal types of these systems. This
approach helps us illustrate that the two poles designers may adopt. As Ouchi and
25 Performance Management and Wellbeing at the Workplace 507

Johnson (1978) suggest, an ideal-type approach is a useful tool for explaining

complex phenomena, in which the whole is more than its parts. We describe these
systems adapting a well-known framework specified by Flamholtz et al. (1985),
building on a broad and diverse social science literature. Flamholtz et al.’s (1985)
original work simplifies the complexity associated with performance management
systems by concentrating on “core controls” (i.e., those that are formally designed to
increase the probability of people behaving in ways that facilitate the delivery of
goals).
Their framework acknowledges that these core controls are embedded in a wider
“control context” shaped by the organizational structure, culture and its external
environment, which indirectly influence individual and group behavior. To this
framework, we add that the control context is also a product of the history of the
organization. This control context not only influences individuals and groups. It also
affects the design, evolution, and usage of control mechanisms and their relation-
ships (Otley and Franco-Santos 2020). Flamholtz et al. (1985) highlight that the core
control mechanisms are those developed to “plan” for performance, “measure”
performance, “review” performance, and “reward” performance. Subsequent
research identified a set of additional control mechanisms, which are “selection”
and “leadership” (Abernethy et al. 2010, 2015). These controls can take various
forms. We categorize them under the labels of directive and enabling performance
management systems (Franco-Santos and Otley 2018). In the overall design, core
controls follow a sequence which is often time-bound. Both types of controls can
operate at the organization, group, and individual level.

Directive Performance Management Systems

As suggested earlier, performance management systems exist to address the perfor-

mance problem an organization faces. In some organizations, the performance
problem is framed as an “alignment” problem (Franco-Santos and Otley 2018).
The dominant logic or rationale in these organizations suggests that performance
is more likely when individual and organizational goals are aligned. Alignment,
however, is problematic because people tend to behave opportunistically, prioritizing
their interests at the expense of organizational goals. This way of framing the
performance problem is known to be underpinned by an instrumental rationality
largely informed by economics knowledge and, in particular, the assumptions and
predictions of principal-agency research (Davis et al. 1997). First, this framing
assumes that shareholders (or owners) are the organization’s dominant coalition.
They delegate the running of the organization to managers or “agents” who act on
their behalf. Thus, shareholders’ financial goals must be prioritized, ensuring there is
little uncertainty about the expected results and the means to achieve them. Another
assumption is that information is asymmetric (i.e., performance knowledge is imper-
fect, but managers have more and better information than shareholders). Further, it
presupposes that managers are risk-averse, effort-averse and motivated by self-
interest.
508 M. Franco-Santos et al.

These assumed conditions create the basis for the goal-misalignment problem.
This problem is thought to be resolved with the use of directive controls; in
particular, monitoring and incentives (Eisenhardt 1989). Without controls, the think-
ing goes, shareholders’ goals will suffer because employees will make decisions and
work on tasks that advance their agendas, disregarding shareholder’s needs. With
monitoring practices, shareholders can obtain additional information to be able to
assess the extent to which managers are making decisions and taking actions that
benefit the organization from the perspective of its shareholders/owners. With
monetary incentives, shareholders can attract and retain the individuals that are
more likely to help them achieve their goals as well as motivate them to focus
their attention on the behaviors that are more likely to lead to the expected financial
results. Both mechanisms tend to bring with them additional secondary or indirect
effects. Among other things, they may constraint autonomy, promote internal com-
petition, condition learning, and discourage innovative behaviors (Franco-Santos
and Otley 2018). Yet, these potential side-effects are considered by many as neces-
sary evils. Deeds that may be harmful but less important than the positive effects
these mechanisms create for the organization as a whole.
In practice, the organizations focused on goal-alignment tend to describe their
monitoring and incentive practices as the core elements of their performance man-
agement system.
Monitoring is formally implemented through the use of three key managerial
practices: performance planning, measurement, and reviews. Performance planning
comprises the decisions and actions for selecting and agreeing on the definition of
the goal or goals that need delivery (e.g., profit-maximization). Performance mea-
surement involves the operationalization of goals, the selection of metrics or Key
Performance Indicators (KPIs) that help shareholders and leaders understand the
extent to which goals are being achieved, and the setting of performance targets
signalling the level of achievement expected. Performance reviews include the
analysis and evaluation of goal-related information at the individual, team, and
organizational level. Indirectly, monitoring can also be exercised through leaders
who follow an “initiating structure” or “command-and-control” approach character-
ized by a central focus on structuring the work environment by implementing
uniform procedures and clear roles and responsibilities with limited employee
participation (Abernethy et al. 2010).
Organizations often implement incentives by using bonuses and other
performance-related rewards (e.g., commissions, shares-schemes) linked to the
complete or partial attainment of goals as a way to extrinsically motivate alignment.
Apart from their motivation effect, these incentives also have a sorting effect. They
activate and attract people who have a preference for them. Previous research has
highlighted that to be effective in the delivery of organizational goals, control
mechanisms need to be tightly coupled. In other words, they are linked and depen-
dent upon each other. For instance, bonus schemes to work well require to be
connected to relevant goals, valid metrics, reasonable targets, and objective perfor-
mance appraisals (Otley 2016). In Table 1, we explain in greater detail what these
directive performance management system looks like. In current times, this is the
25 Performance Management and Wellbeing at the Workplace 509

Table 1 Classification of performance management systems

Directive performance Enabling performance
management system management system
Control problem • Alignment • Uncertainty
Management • Transactional (Control/ • Relational (Learning/
philosophy monitoring oriented) involvement oriented)
Assumptions Agency-theory assumptions: Stewardship theory assumptions
• Organizational goals defined by about:
shareholders (owners): wealth- • Organizational goals defined by
maximization multiple stakeholders: wealth and
non-wealth-related satisfaction
• Employees’ behaviors (self- • Employees’ behavior
interest, extrinsically motivated) (pro-organizational, intrinsically
motivated)
• Information asymmetry • Information is imperfect
• Uncertainty is not perceived as • Employees’ self-interest is not
a problem perceived as a problem
Control mechanisms
Plan for • Success (performance) is • Success is signalled by the
performance defined using specific delivery of a mission
organizational, team, and
individual goals
• These goals tend to be financial The organization has a purpose
and have a short-term orientation (or a cause)
• The mission may comprise
vague end goals with a long-term
orientation
• Senior leaders set • The mission aims to capture the
organizational goals, and these are main needs and wants of key
then cascaded them down to the stakeholders. Through continuous
individual level communication, it is embedded/
internalized throughout the
organization
• Specific strategies and projects • Priorities are discussed and
are devised to reach the set goals agreed among the different
stakeholders (including employees)
through active discussions and
dialogues
• Strategies and projects may be
ill-defined and long-term in nature
Measuring • Metrics are created and • Where applicable metrics are
performance quantitative data is gathered and developed, agreed with relevant
(Knowledge) analyzed to help monitor the stakeholders, and used to guide
delivery of organizational, team, action. Together with quantitative
and individual goals data qualitative data is also
gathered and analyzed
• Targets are used to distinguish • The role of performance-related
“good” from “poor” performance at data is to encourage understanding,
all levels learning, and improvement
(continued)
510 M. Franco-Santos et al.

Table 1 (continued)
Directive performance Enabling performance
management system management system
• Aspirational targets may be
adopted but they are only used as
guidance for learning
Reviewing • Measured performance is • Performance-related data is
performance periodically reviewed and reviewed (mostly at the group level
evaluated against targeted as the work of individuals is highly
performance (at least once a year) interrelated)
to better understand the extent to
which goals have been achieved
• Performance appraisals are used • Individuals exercise self-
to assess individual measured management of their performance
performance and provide feedback
• Individuals’ work and situation
are reviewed by knowledgeable
individuals for developmental and
learning purposes
Rewarding • The main focus is on extrinsic • Extrinsic rewards (salary) meet
performance rewards linked to measured basic needs
performance results (e.g., part of
the overall pay is at risk using
incentive schemes)
• Intrinsic rewards are fostered
(sense of autonomy, sense of
community, sense of development,
sense of meaningfulness)
Employing for • Selection is mainly based on • Recruitment is mainly based on
performance past achievements individual potential, attitudes, and
(selection and motivation
probation) • Employees’ probation period is • Probation is based on internal
often short and based on and external peer-reviews of the
measurable performance criteria individual contributions and
potential to contribute further
• Tight control of who joins the
organization and on who stays after
the probation period
Coordinating/ • ”Command and control” • Shared leadership
leading leadership approach
performance • Leaders pay close attention to • Leaders pay attention to what is
the results of performance meaningful for the organization
measures and operate accordingly and for staff (even if what is
meaningful cannot be measured)
• Typical leaders’ beliefs: “you • Typical leaders’ beliefs: “What
can’t manage what you can’t counts cannot always be counted,”
measure,” “pay is the best “money motivates, but excellent
motivator for people to perform” performance needs an intrinsic
drive”
(continued)
25 Performance Management and Wellbeing at the Workplace 511

Table 1 (continued)
Directive performance Enabling performance
management system management system
What are top • On monitoring performance • On learning and performance
managers focused improvement
on? • On incentivizing performance • On providing an enabling
context for aligned individuals to
conserve their motivation

type of performance management system most organizations adopt and endorse;

however, not all organizations do so. Some adopt enabling control mechanisms
informed by a different way of defining their performance problem.

Enabling Performance Management Systems

Given their history, logic, or circumstances, some organizations (their leaders and
key stakeholders) may frame their performance problem differently. Rather than
perceiving the problem in terms of goal-misalignment, they may frame it as a
problem that emerges due to the perceived uncertainty and changing environment,
limiting the extent to which people’s actions will be effective (Franco-Santos and
Otley 2018). Underpinned by an involvement rationality, this problem framing
operates with a different set of assumptions (Davis et al. 1997). For instance, the
dominant coalition is thought to be comprised by multiple stakeholders (e.g.,
owners, customers, employees, regulators, society, environment) with a multiplicity
of interests some of which are complex (e.g., wellbeing or environmental sustain-
ability) and conflicting.
People’s decisions and behaviors are presupposed to be genuinely aligned to the
interest of the organization; that is, people tend to behave as “stewards” who are
internally motivated to satisfy the various needs of stakeholders. Managers are also
thought to operate in a complex environment characterized by continuous change
and imperfect information. Under these conditions, organizations face an uncertainty
problem that will affect their performance. The complex nature of their goals and the
environment they operate in create a situation in which the consequences of mana-
gerial action may be unknown, and the connections between actions and results may
be inexact. Consequently, the delivery of organizational goals may be constrained.
From this perspective, stewardship researchers (Davis et al. 1997) identify and
suggest the adoption of empowering or enabling control mechanisms to help orga-
nizations navigate complexity and manage their performance.
Enabling controls are focused on encouraging managers to learn how to deal and
cope with uncertainty and on conserving their motivation to act in a
pro-organizational manner. Given the uncertain situation managers are thought to
be in, the use of monitoring or financial incentives is considered to be pointless as the
multiplicity and complex nature of organizational goals are technically not suited to
512 M. Franco-Santos et al.

this type of controls. Organizations following this performance framing are likely to
define their intended goals in broad terms and identified them through consultations
with key stakeholders (Davis et al. 1997). They gather data about the extent to which
they are advancing their stakeholders’ goals through quantitative (e.g., metrics
without performance targets), but also qualitative means (e.g., informal conversa-
tions). They review their performance-related information to encourage learning and
development rather than monitoring; and use intrinsic reward mechanisms that
encourage self-efficacy and self-determination (sense of autonomy, sense of mean-
ingfulness, sense of development, and sense of community). They select individuals
based on values, attitudes, and potential, using longer probation periods and foster-
ing a shared leadership approach. Table 1 summarizes what this enabling system
looks like in practice.
To improve the clarity and comprehension of these complex systems, we have
described the two ideal types of performance management systems as independent.
Meaning that the choice of directive controls implies that enabling controls are not
considered. However, in their intended designs, organizations may emphasize one of
these ideal types, for example, a directive type, while adopting in specific circum-
stances control practices more suited to an enabling system.
Alternatively, formally designed mechanisms may be enacted in ways that do not
follow their intended purpose. For example, a directive system comprising clear
output measures and targets designed with a corporate intention to be used as
monitoring devices may be overlooked or completely ignored at the local level by
managers who question their utility and instead chose enabling mechanisms to
ensure their unit performs. These situations are more likely to be the norm than the
exception due to the dynamic and path-dependence nature of these systems (Mer-
chant and Otley 2020). After describing these two ideal types of performance
management systems, we now provide a brief review of the role they play in
enhancing or weakening employee wellbeing. Our intention here is to illustrate
key insights from extant research rather than to provide a comprehensive literature
review.

Performance Management and Wellbeing Research

Ouchi and Johnson (1978) were among the first scholars to investigate the relation-
ship between the use of control mechanisms and employees’ wellbeing in American
corporations. In their work, they identified two ideal types of organizational control
systems. Those used in “type A” and “type Z” organizations. Although their research
was conducted more than 40 years ago, their control types resemble the fundamental
characteristics of the different performance management systems described above as
directive and enabling. They find two very distinct management philosophies or
rationalities in “type A” and “type Z” companies. They labelled them as control-
oriented and learning or involvement-oriented, respectively. Ouchi and Johnson’s
(1978) interpretation of management philosophies resonates with the management
rationalities described by Davis et al. (1997) as the ones underpinning agency theory
25 Performance Management and Wellbeing at the Workplace 513

and stewardship theory premises and predictions. Ouchi and Johnson (1978) argued
that insofar as controls satisfy the relational needs of employees, they affect their
emotional wellbeing. In their research, they found greater sense of autonomy among
the employees working for “type A” organizations and greater emotional wellbeing
among employees in “type Z” organizations. After the publication of Ouchi and
Johnson’s (1978) research, the management literature seemed to primarily focus on
investigating how specific control mechanisms or sub-systems, rather than the
overall system, affected wellbeing.
Within management research, Human Resource Management (HRM) scholars
have been the most active at investigating how control mechanisms such as perfor-
mance appraisals relate to employee wellbeing. Within the HRM field, two distinct
streams of literature examine these phenomena: Mainstream HRM and Critical
HRM (Tweedie et al. 2019). Mainstream HRM research tends to adopt an instru-
mental logic with a focus on employee performance and wellbeing to the extent that
they are considered to mediate the relationship between performance appraisals and
organizational financial results. Over the years, this research has found that
employees’ work experiences associated with appraisal processes are affected by
factors such as perceptions of justice, leader’s support, or the provision of feedback
with a development orientation (e.g., Schleicher et al. 2018). Recommendations for
addressing these factors have been put forward as means to enhance individual
performance (believed to be aggregable into firm performance), rather than a gen-
uine interest in employee wellbeing (Tweedie et al. 2019).
Critical HRM (CHRM) incorporates research adopting a critical stand and
directly focuses on wellbeing as an “end-goal” that must be pursued in its own
right. CHRM research emphasizes that it does not endorse a managerial philos-
ophy that assumes people are opportunistic and performance management is
instrumental for both strategic alignment and financial success. When describing
CHRM research, Tweedie et al. (2019) include the work of labor process theo-
rists, Foucauldian debates and “conflicting rationalities” studies. They argue that
labor process theorists understand performance appraisals as a “control mecha-
nism that enables managers to maintain domination over workers” (Tweedie et al.
2019, p. 81). From this perspective, control mechanisms are seen as a disciplinary
device that limits employee autonomy and acts as a subtle ideological instrument,
promoting efficiency, competition, surveillance, and materialistic values (Barlow
1989; Newton and Findlay 1996). Foucauldian-based performance management
debates emphasize managers’ power over employees and questions the extent to
which performance management can ever act as “an aid to subjective wellbeing”
(Townley 1993, p. 235). A third strand of CHRM research, they contend, draws
from sociology and philosophy research and finds that performance management
tools, when used as surveillance or monitoring mechanisms, can be harmful
(Townley et al. 2003). Overall, Tweedie et al. (2019) contribute to the Main-
stream HRM-CHRM research by building on recognition theory research and
encouraging new work that looks into how performance management may neg-
atively affect wellbeing by influencing individual identities and relations with
self and others.
514 M. Franco-Santos et al.

Following Ouchi and Johnson (1978) holistic approach, recent research has gone
back to analyze how different types of performance management systems influence
wellbeing, considering multiple sub-systems and not only appraisals. For instance,
research conducted in UK universities found that most universities adopted hybrid
performance management systems that included directive and enabling (or collegial)
control mechanisms (Franco-Santos and Doherty 2017; Franco-Santos et al. 2017).
In general, enabling controls were positively related to the wellbeing of all university
staff regardless of their role and job position. The presence of directive controls was
positively related to the wellbeing of leaders (regardless of their academic or
non-academic role) and non-leaders in professional service roles. Yet, directive
controls negatively affected staff in academic roles both in terms of their vitality
and stress (Franco-Santos et al. 2017).
Decramer et al. (2015) investigated the impact of performance management
systems on nurses working in a Flemish hospital. They found that the planning
and evaluation of strategy- aligned goals yield higher affective commitment, but
lower job satisfaction. The authors speculated suggesting that these findings could
have been due to the fact that the use of performance management systems enhanced
perceptions of workload imbalance and intensification with damaging effects for
nurses’ wellbeing. The work of Van Thielen et al. (2018) examined the role of
performance management systems in fostering the wellbeing of police officers in
Belgium. Their data demonstrated that the combination of performance planning
(clarity of expectations without targets) and performance evaluation (discussions
about progress and results) was positively related to performance management
satisfaction, which in turn was negatively related to strain and positively to job
satisfaction. In their research, Van Thielen et al. (2018) and Decramer et al. (2015) do
not explicitly distinguish between directive and enabling performance management
systems. They describe what could be considered a directive system oriented to
make the police service or hospitals more efficient and effective. However, in the
empirical part of their studies, the way they measure performance management
system characteristics seems to integrate both directive and enabling elements
(e.g., lack of targets, and focus on performance-related discussions without any
mentioning of potential monetary or disciplinary consequences). This may suggest
the systems studied could have been directive in their original design, but the
researchers paid attention to the potential enabling aspects in which these systems
were used, researching, without intending to, what we here consider “hybrid”
systems. This interpretation may explain their various findings.
In sum, the evidence reviewed suggests that the effect performance management
has on wellbeing is dependent on the type of performance management system
designed, the way it is used, the nature of job roles, and job positions. Control
mechanisms that are perceived to threaten autonomy, collaboration and professional
knowledge seem to emotionally affect some individuals (not all). People in highly
vocational professions (e.g., teaching, research, nursing, policing), who could be
considered “stewards,” seem to be more seriously and negatively affected by this
type of control mechanisms. This may be so because directive mechanisms are
perceived as a threat and affect their sense of identity. Controls that are perceived
25 Performance Management and Wellbeing at the Workplace 515

to be enabling, supportive and humane as well as useful in the provision of clarity of

direction and learning seem to enhance employee wellbeing in general.
Building on these evidence-based insights, we now describe a conceptual framework.
This framework is meant to be a “thinking tool” to guide managerial decisions about the
design of performance management systems that aims to foster rather than hinder
wellbeing. Our point of departure is anchored on two basic premises: First, we argue
that employee wellbeing is a key requirement for any organization that must be satisfied
because it is morally and ethically desirable. Second, we argue that it is important
organizations take into account the elements included in the ideal types of performance
management systems, but according to the nature of their goals and idiosyncrasies they
attempt to craft a hybrid system. In that sense, we reject the idea that “one-size fits all”
when dealing with performance management systems due to their complexity and the
dynamism of factors beyond the organization (e.g., economic, social, and political
circumstances) (Franco-Santos and Otley 2018; Merchant and Otley 2020).

Fostering Employee Wellbeing: A Guiding Framework

for Managers

Any organization that wishes to be considered ethically and morally sound should
aspire to be a healthy workplace (World Health Organization 2020). Healthy work-
places are those providing a context in which employees feel they are doing
meaningful work; they are learning and advancing in their careers; they have a
certain amount of autonomy; they know what is expected from them; and they are
supported by leaders and colleagues (Kelloway and Day 2005; Day et al. 2014).
Management research has shown people-related practices associated with the deliv-
ery of organizational goals have a significant effect on such context, so how leaders
design and use these practices directly affects how people experience their life at
work (Van De Voorde et al. 2012; Peccei and Van der Voorde 2019). In the past,
organizations have paid little attention to employee wellbeing as an expected “end”
objective; even though, it should be considered a moral duty to do so (Guest 2017;
Tweedie et al. 2019). Based on previous knowledge looking at performance man-
agement, we now offer a framework that can help organizations engender mutual
gains, systems that aim to facilitate wellbeing and performance. To do so, we first
need to explain in greater detail the nature of organizational goals and people’s
motivational characteristics play in deciding what type of performance management
system (directive, enabling, or hybrid) is going to be more appropriate in terms of
delivering both wellbeing and performance.

The Role of Organizational Goals in Performance Management

Systems

As clarified earlier, the overall purpose of performance management systems is to

facilitate the agreement and shared understanding of organizational goals. Goals or
516 M. Franco-Santos et al.

objectives depict intentions (Latham and Locke 1990). Typically, organizational

leaders and their stakeholders agree to focus on a reduced list of goals, which are
used to clarify direction, focus attention and guide individual and group efforts
(Cyert and March 1963; Obloj and Sengul 2020).
Organizational goals differ in terms of their scope, measurability, aggregability,
replicability, and temporality. Goal scope or dimensionality refers to how performance
is defined. Organizational goals can be defined in terms of a unique performance
dimension (e.g., financial) or diverse dimensions (e.g., financial and non-financial). A
focus on a unique performance dimension tends to assume that success is determined
by the interests of a single stakeholder that is shareholders (this is why this dimension
tends to be financial), and that maximization is the overall aim as “it is logically
impossible to maximize in more than one dimension at the same time” (Jensen 2002,
p. 238). For example, an organization solely focusing on shareholder’s financial
returns may focus on maximizing that “end” considering other stakeholders’ interests
(e.g., employee engagement, customer satisfaction) as “means” that can be traded-off
as substitutable parts, rather than the necessary parts of a whole. Defining performance
in terms of diverse dimensions all of which are equally valuable and necessary (e.g.,
cost-efficiency, quality of service, and wellbeing) implies that the means-end logic
may be unhelpful as the ends cannot be treated as if they were exchangeable. In that
case, a part-whole logic focused on understanding interconnections to be able to
balance or harmonize the attention and actions needed for delivering the different
dimensions appear more appropriate (Rocha and Ghoshal 2006).
Goal measurability refers to the extent to which goals can be measured with valid
and reliable indicators. Some goals can be easily measured (e.g., profit), others will
always have imperfect measures (e.g., innovation, customer service). For example, a
health care provider may be focused on delivering excellence in quality of care and
measures this particular goal with key indicators such as waiting times and patient
satisfaction. These two indicators capture some aspects of the quality goal, but many
other aspects related to quality itself are left unmeasured leading to an imperfect
measure of the quality of care goal. Measurement imperfection can be due to various
factors such as the multidimensionality or the dynamic nature of the goal (Meyer and
Gupta 1994; Dahler-Larsen 2014).
Goal aggregability relates to the extent to which goals have a multilevel nature
that enables them to be cascaded down within the organization. Goal aggregability is
commonly taken for granted. This is why most organizations do not even question
whether an organizational goal can be cascaded down to the division, department,
team, and individual level. The assumption is that if a goal can be measured, it can
also be cascaded. However, some goals can only be delivered at higher-order levels
as their delivery emerges from the interactions of units or individuals at lower levels.
That is, some goals reflect a “whole” that is more than the sum of its parts. For
instance, excellent customer experience in an organization may be the result of
multiple interdependent factors that occur beyond a particular department or team
so it may be that assessing this goal at each level of the organization does not make
much sense due to its costing, wasted effort, and potential unintended consequences
(Franco-Santos and Otley 2018).
25 Performance Management and Wellbeing at the Workplace 517

Goals replicability refers to how much knowledge does the organization possess
about the process that leads to the goal being delivered so it can be predicted, and its
attainment replicated overtime. In other words, this characteristic relates to the level
of uncertainty between potential paths and their desired outcomes. It could be that
multiple independent paths lead to an expected goal. If these paths have similar
known chances of success, then leaders can identify the most effective path and
ensure that this path can be replicated regardless of time and context. For instance,
many organizations believe that profit maximization is likely to be delivered through
engaged employees, who enable operational excellence that leads to customer
satisfaction and eventually to higher profits (Kaplan and Norton 2000). However,
there may be goals which delivery is difficult to predict as paths are interrelated, may
suffer changes overtime or generate uncertain consequences that are highly depen-
dent on contextual factors. For example, an organization such as the Red Cross,
which is focused on “protecting life and health and to ensure respect for the human
being” may have more difficulties replicating and monitoring the process that
facilitates the delivery of their goals. Regularly, they may need to experiment and
innovate with new paths based on the situational factors they face.
Finally, goal temporality considers whether the goal needs to be delivered in a
short or long period of time. Most organizations have a time orientation already
associated with the delivery of their goals. A short-term orientation often refers to
one year or less. A medium-term orientation would be 2–3 years. A long-term
orientation for a goal would be more than 3 years. Table 2 summarizes the different
characteristics of organizational goals. We posit that the more a set of goals encom-
passes multiple dimensions of performance with low measurability, aggregability,
and replicability, the higher their degree of complexity will be. In the interest of
clarity, we have described these goal characteristics as being dichotomous and

Table 2 The nature of organizational goals

Dimensions Low goal complexity High goal complexity
Scope Single dimension (it can be Multiple dimensions of equal value
maximized). (they need to be balanced as some
goals may be conflicting but have
equal priority).
Measurability Goals can be measured with valid and Goals can only be measured with
reliable metrics. metrics that have low validity and
reliability.
Aggregability The whole is the sum of individual The whole is more (or less) than
parts. Goals can be cascaded down the individual parts. There are limits to
organization (from organizational to cascading goals down to the
teams, to individuals). individual level.
Replicability The goal delivery process is known There is little knowledge about the
(or assumed to be known) to those overall goal delivery process; it is
setting the goal; it can be replicated. A difficult to replicate the process.
predictive model can be formulated. Developing a predictive model is
unlikely.
Temporality Short-term oriented. Long-term oriented.
518 M. Franco-Santos et al.

independent. For empirical research, it is more appropriate to consider them as

continuous and interrelated. It is important to highlight here that these characteristics
focus on the nature or content of the goal rather than its context. Although, it is worth
noting that how context, especially extreme contexts such as a pandemic or a
financial crisis, interacts with the nature of organizational goals can significantly
affect it. For instance, a highly predictable financial goal may turn out to be
unpredictable due to an economic crisis. This change will increase the complex
nature of the goal.
An understanding of the nature of goals is central not only for its interest, but for
the implications it has for the design of performance management systems as well as
their consequences on employee wellbeing. The way goals are portrayed reflecting
the values and beliefs of the people who select them and are more likely to accept
them (Seijts and Latham 2012). The nature of goals has serious implications for the
means required to facilitate their delivery (Locke and Latham 2002). The level of
goal complexity and time orientation is associated with people’s information pro-
cessing and motivation characteristics (Schroder et al. 1967; Campbell 1988), which
in turn influence the choice of control mechanisms that would increase the likelihood
of obtaining mutual gains in terms of performance and wellbeing. Based on these
premises and the literature reviewed here so far, the following framework can be
derived.

Organizational Goals and Performance Management Systems Types

Distinguishing between high complex and low complex organizational goals and
their time orientation seems potentially fruitful as a way to illustrate how different
types of performance management systems affect performance and wellbeing. As
mentioned earlier, the design of a performance management system is triggered by
the performance problem organizations (their leaders and key stakeholders) believe
they have. The way the performance problem is framed is informed or anchored in
the management rationality dominating the organization. Organizations where an
instrumental rationality or logic dominates will tend to frame the performance
problem as a goal-misalignment problem and define organizational performance in
terms of organizational goals that are mainly financial, measurable, aggregable,
replicable, and short-term oriented. It is important to note that leaders may not be
fully cognizant of their problem framing or managerial rationality. They may have
internalized it without questioning it through their education or previews work
experiences (Ghoshal and Moran 1996). Yet they imply it in their daily interactions
with others. For example, comments such as “alignment in this organization is
elusive” or “we need to ensure strategic alignment” epitomize an alignment framing.
In many organizations, this particular framing is taken for granted or understood as a
given (Ghoshal and Moran 1996).
In Fig. 1, these low complex and short-time oriented goals will be positioned in
quadrant III. Underpinned by a dominant instrumental rationality, we are likely to
find control mechanisms which resemble a directive performance management type
25 Performance Management and Wellbeing at the Workplace 519

Fig. 1 Performance
Management Systems and
wellbeing framework

(for reference see Table 1). The overall purpose of these controls will be to monitor
and incentivize alignment. These organizations will tend to attract, motivate, retain,
and manage the performance of individuals that already behave as “agents” as
presumed by agency theorists (Eisenhardt 1989) or eventually will behave like
“agents” as time goes by (Ghoshal and Moran 1996). Examples of these extreme
organizations are places such as Enron or Well-Fargo. Both of these organizations
enjoyed great financial success for years following an extreme version of instru-
mental rationality and adopting highly directive performance management systems.
Their success was, however, affected by shifts in the economic environment which
uncertainty drastically undermined the predictability and validity of the measures
used to assess their goals. Leaders should have responded to this situation by
reframing their performance problem towards a hybrid one which incorporated
uncertainty and alignment. They did not change course. As a result, unintended
perverse consequences emerged (e.g., unethical behaviors such as gaming, data, or
manipulation) as others have explained elsewhere (Boje et al. 2006; Witman 2018).
Organizations where a relational or involvement rationality dominate will tend to
frame the performance problem as an uncertainty-related problem. That is, a “wicked”
problem that requires constant work and continuous learning (Rittel and Webber
1973). In these organizations, performance is likely to be defined in terms of organi-
zational goals that are multidimensional, difficult to measure and aggregate, with
reduced replicability and long-term oriented. In Fig. 1, these goals will be positioned
in quadrant I. Accordingly, organizations operating under this dominant relational
logic are more likely to design stewardship-based or enabling performance manage-
ment mechanisms. These mechanisms will be focused on creating a context in which
people can learn and maintain their internal drives to be able to cope with the
520 M. Franco-Santos et al.

uncertainty and risk associated with organizational goals. These organizations will aim
to attract, motivate, and retain “stewards” (Davis et al. 1997), rather than “agents.”
An example of an organization in quadrant I could be the idealized view of what a
university is (or ought to be) (as faculty members, we cannot help but wonder where
this idealized view has gone, how, and most importantly why, most of our current
universities are very distant from this idealized view). As traditionally defined, a
university is a place where scholars are focused on delivering excellence in educa-
tion and research that benefits the economy, culture, and the environment (Ortega y
Gasset 1946). For example, places such as The University of Cambridge (2020) still
has a mission which resembles this purpose: “to contribute to society through the
pursuit of education, learning and research at the highest international levels of
excellence.” For many centuries, the control mechanisms associated with an
enabling performance management type operated in English universities; however,
for the last 30 years, scholars in diverse disciplines have begun to notice how the
relational (and collegial) rationality is being eroded and a “neo-liberal” logic, which
resembles the ideas of an instrumental rationality and the premises and predictions of
principal-agency theory, is shaping the control mechanisms adopted by universities
and consequently faculty behavior and motivations (Kalfa et al. 2018).
Organizations operating in quadrant I and III are likely to be extremes or ideal types.
However, in present times, we expect most organizations to be positioned in quadrants II
or IV with hybrid systems as they experience conflicting rationales, which result in
organizational goals that have a mixed nature. It is also plausible that organizations (as a
whole or some of their parts) dynamically move from quadrant to quadrant as the
conditions in their environments change. To date, there has been little research looking
at hybrid performance management systems (Franco-Santos and Otley 2018). Little
empirical knowledge exists describing what these hybrid systems look like and the
extent to which they facilitate the delivery of performance and wellbeing.
Hybridity is not a new phenomenon. It has been previously investigated in other
management literatures (O’Reilly III and Tushman 2013; Dalpiaz et al. 2016; Luger
et al. 2018). Without enough empirical data on this matter, we can only tentatively
outline a few ideas that seem to converge from these diverse literatures to help us
visualize what a hybrid performance management system looks like. For instance, it is
reasonable to expect that organizations facing a hybrid framing will follow either a
structural approach with dual systems in different contexts, for example, sales depart-
ment adopting a directive-type system while the research and development department
adopting a more enabling-type system; a time-based approach with the organization
stressing different control mechanisms overtime based on their different priorities; or a
contextual approach with the organization developing “requisite variety” (Ashby
1958) or a repertoire of responses and behavioral capabilities that allows it to integrate
directive and enabling mechanisms in a seamless manner without resistance.

Performance Management Systems for Wellbeing and Performance

If we understand wellbeing as a constrain or necessary condition that every organi-

zation needs to contemplate (Guest 2017), the type of controls adopted need to fit the
25 Performance Management and Wellbeing at the Workplace 521

nature of that organizational goal. Interestingly, this positioning of wellbeing as a

key goal that reflects the needs of employees and society at large already implies the
humanistic values that underpin an involvement management rationality. Based on
previous research, we already know that wellbeing is a contested concept, indicating
that its complex nature allows for its definition to vary depending on the beliefs and
values of the people defining it and responsible for its delivery. Interpreting
wellbeing as “the overall quality of an employee’s experience and functioning at
work” (Grant et al. 2007, p. 52) suggests that wellbeing is a multidimensional
concept that is difficult to measure validly and reliably; it is not aggregable or easily
predictable; and it is long-term oriented. This definition positions the delivery of
wellbeing as a “wicked” problem. A problem requires flexibility, high involvement,
and continuous adaptation. It goes without saying that we expect every employee to
be genuinely aligned with or interested in this particular organizational goal.
Based on this characterization and following the ideas discussed so far, the most
appropriate means to enhance wellbeing seem to be the adoption of enabling or
hybrid control mechanisms (quadrants I, IV, and II). The least desirable approach
will be to design a pure directive performance management system (quadrant III).
Although, we should not discount the possibility that a system in quadrant III creates
the conditions for wellbeing to emerge as an unintended consequence – a byproduct
which was not the ultimate aim of its designers (see, for example, the work of
Kelloway and Day 2005; Day et al. 2014). Enabling mechanisms are associated with
work contexts in which people feel they have autonomy, a sense of meaningfulness,
a sense of development and growth, and a supportive community of colleagues and
superiors. Due to the high complexity nature of wellbeing, organizations in “quad-
rant I” will muddle or navigate through its delivery as individual and environmental
factors will always influence this particular goal. Their overall purpose will be the
continuous improvement of wellbeing at all levels rather than its “maximization.” It
is unlikely that we find organizations with 100% of their people professing high
wellbeing and, if we do, chances are gaming, lying, data manipulation, or other
factors indicating bigger problems are at play (Franco-Santos and Otley 2018).
Furthermore, in organizations adopting enabling performance management systems
(quadrant I), having a particular target will be meaningless.
This is because knowing an organization is purposefully seeking to achieve, for
example, 65% of their people in a high wellbeing category means that this organi-
zation is fine with having 35% of their staff under a low wellbeing category, which is
morally and ethically questionable. Nevertheless, we may see organizations in
quadrants II and IV with more flexible arrangements as they aim for wellbeing
together with other indicators of performance such as profit or quality.

Concluding Remarks

In this chapter, we have explained how different types of performance management

systems can create stress and anxiety, as well as positive effects on wellbeing at
work. Organizations need to pay attention to how people feel at work and to how
managerial practices affect them, not just because it is financially beneficial, but
522 M. Franco-Santos et al.

because it is morally and ethical to do so. To inform leaders’ approach to the design
and use of performance management systems, we offer a framework or “thinking
tool” which aims to facilitate their decision making. Following this framework,
leaders need to be aware of the management rationality influencing the way in
which they frame their performance problem, define organizational goals and the
means they select to facilitate their delivery. To address people’s wellbeing needs,
the use of enabling performance management mechanisms is highly recommended.
Although if wellbeing needs to be balanced with financial performance, a hybrid
performance management system might be more desirable. A directive performance
management approach can have harmful effects on wellbeing, especially of people
exerting pure “stewardship” behaviors often associated with vocational professions.
A directive system can, however, enhance the wellbeing of individuals exerting pure
“agent” type behaviors even though it may do it as an unintended (positive)
consequence rather than as an intended objective of the performance management
system.

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 Part IV
Employment Practices for Occupational Health
and Disability
The Aging Workforce
26
Elliroma Gardiner and Mego Kuan-Lun Chen

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528
Who Is an Aging Worker? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 529
How Aging Impacts Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 530
Physiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 530
Cognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531
Psychosocial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 532
Occupational Health and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 532
Challenges for Aging Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
Agism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
Shift in Social Identities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 534
Gender Norms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 535
Organizational Responses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 536
Age-Friendly Climate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 536
Flexible Work Arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537
Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 538
Job Crafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 539
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 540
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 540

Abstract
By 2050, one in six people in the world, and one in four people in developed
countries, will be over 65 years in age. The increasing proportion of older

E. Gardiner (*)
School of Management, QUT Business School, Queensland University of Technology, Brisbane,
QLD, Australia
e-mail: [email protected]
M. K.-L. Chen
School of Management, QUT Business School, Brisbane, QLD, Australia

© Springer Nature Switzerland AG 2022 527

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_22
528 E. Gardiner and M. K.-L. Chen

individuals is resulting in significant fiscal, healthcare, and social welfare chal-

lenges. Governments around the globe see prolonging the working lives of aging
workers as a key strategy to delaying the widespread negative impacts of an aging
workforce. Although the workforce participation of aging workers is now at its
peak, many workers across the globe are choosing to retire well below the normal
government-issued pension age. In some countries at least (such as France, Italy,
and Norway), premature exit from the workforce is the norm rather than the
exception. This chapter aims to provide insights into the working life of aging
workers, with the view to investigate how aging impacts the individual worker’s
psychological health and wellbeing as well as performance and engagement at
work. The chapter also aims to evaluate organizational initiatives and identify
what organizations can do to better support aging workers.

Keywords
Aging worker · Older worker · Flexible work · Agism · Age discrimination

Introduction

According to the United Nations (2019), individuals aged 65 years and over have
outnumbered children under 5 years of age since 2018. The number of persons aged
80 years and above is projected to grow from 143 million in 2019 to 426 million in
2050. The disproportionate number of older person (aged 65 years and above) to
working age persons (aged between 20 and 64 years) has resulted in significant
fiscal, healthcare, and social welfare challenges (Rouzet et al. 2019). As the number
of older adults needing care increases, health and social services industries
are likely to be hit the hardest due to long-term labor shortages and rising
healthcare demands, especially for hospital and general practitioner services (Ide
et al. 2017).
Workforce participation of aging workers is now at its peak, with more individ-
uals continuing to work after the conventional retirement age and re-entering the
employment market after retiring temporarily (Giandrea et al. 2009). From 2010 to
2019, the workforce participation rate of individuals aged 55–64 years grew from
60% to 68% in the UK, 37–57% in Italy, and 69–78% in Japan (OECD 2020a).
Despite the increased participation of aging workers globally, data released by the
OECD indicates that in several countries, such as Belgium, France, Germany, Italy,
Iceland, Ireland, Luxemburg, Netherlands, Norway, Spain, and the Slovak Republic,
the average effective age of retirement is still well below the normal pension age
(OECD 2020b). For instance, the average exit of males in Italy is 4.4 years lower
than the official retirement age (OECD 2020b). This data indicates that in many
countries, early exit is the norm rather than exception. Further prolonging the
working lives of aging workers and encouraging workforce re-entry of retired
workers are key strategies to delaying the negative impacts of an aging population
(Tremblay and Genin 2009).
26 The Aging Workforce 529

Organizations play an important role in shaping the experiences of aging workers.

While individual factors, such as cognitive skills, health status, and financial needs
are important preconditions that enable and motivate aging workers to keep working,
having an inclusive work environment that accommodates their needs is just as
important to encourage continuous workforce participation (Nagarajan et al. 2019).
Supportive organizational practices and policies communicate the employer’s
unwavering commitment to create an inclusive, age-friendly environment and
acknowledgment of aging workers’ unique values, which in turn elicit intention to
stay among aging workers (Bentley et al. 2019). While more employers are taking
proactive measures to ensure aging workers are not inadvertently disadvantaged by
organizational logistics and policies (Turek et al. 2019), many are yet to ameliorate
policies that are no longer conducive to the current aging workforce (Moen et al.
2017).
This chapter aims to provide insights into the working life of aging workers, with
the view to investigate how aging impacts the experiences of aging workers. The
chapter also aims to identify and evaluate initiatives that organizations can imple-
ment to better support aging workers. The chapter is structured as follows. A
discussion of who is an older worker will be provided first followed by a description
of how the aging process impacts workers. Challenges faced by aging workers with
respect to agism, threats to social identity and gender norms will then be explored.
Lastly, organizational measures to support aging workers will be described and
evaluated.

Who Is an Aging Worker?

One of the challenges in understanding how to best support and manage an aging
workforce is the lack of a universal definition as to who qualifies as an “aging,”
“older,” or “mature” worker. The first issue is with respect to the age of the worker.
Although one might think that using an objective metric such as chronological age
would facilitate the categorization of workers, this is not the case. Many different
cut-offs are used. In Australia, an older worker used to be anyone aged 45 years and
over (ABS 2005); however, the limit has been increased to be more in line with the
United States at 55 years and over (ABS 2010).
Scholars tend to use a wider variety of age cut-offs, ranging from as low as
40 years (Ng and Feldman 2008) to as high as 65+ years (Fleming et al. 2007).
Inconsistencies aside, chronological age also does not consider relevant contextual
factors, such as the nature of the job or industry. In the case of Virgin Blue Airlines
Pty Ltd v Stewart (2007), eight women were successful in their direct age discrim-
ination claim on the basis that the airlines’ selection process disproportionately
favored candidates who were aged 35 and younger. This demonstrates that in
some industries, even chronologically young workers can be seen to be “too old.”
Alternatives to chronological age such as lifespan age, which reflects the life stage
and unique personal circumstances of an individual, and organizational age, which
refers to career stage or age norms within an organization, have been proposed
530 E. Gardiner and M. K.-L. Chen

(Lange et al. 2006). However, each of these options has been shown to introduce
alternative conceptual issues (Peeters et al. 2008); hence, chronological age is still
the most widely used measure for identifying aging workers (i.e., Chen and Gardiner
2019).
The second issue in accurately characterizing who is an aging worker is the
assumption that this category of worker is homogenous (Krekula and Vickerstaff
2020). Descriptions of aging workers largely strip away any sense of their gender,
class, bibliographies, or social context (Krekula and Vickerstaff 2017). Ignoring
heterogeneity among aging workers means that we underestimate how the presence
or lack of career responsibilities, financial security, physical and psychological
health, social support, and interests impact their experiences and participation
decisions. The reality is that many complex factors influence a worker’s decision
to remain or exit the workforce, with several of these factors largely out of the
individual’s control (Gahan et al. 2017).

How Aging Impacts Workers

The definitional issues in what constitutes an aging workforce highlight that while
some standard or objective measure and description of an older worker is required
from a scholarly point of view, how individuals age and experience aging in real life
varies greatly. Aging is associated with a general decline in physical and cognitive
functioning (Peng and Chan 2019, p. 162). Definitions such as these, however, have
been heavily criticized by some scholars as detrimentally focusing attention on the
negative aspects of aging, such as mortality, morbidity, and disability (Peel et al.
2004), and away from investigating positive, successful, active, and healthy aging
(Bousquet et al. 2015).
The most well-known, albeit slightly contentious, definition of successful aging is
by Rowe and Kahn (2015), who describe successful aging as consisting of three
principles, namely, low risk of disease and disease-related disability; maintenance of
high mental and physical function; and continued engagement with life, which
includes relations with others and productive activity, either paid or volunteered
(p. 593). Opponents of biologically focused definitions of aging argue that health is a
multidimensional construct that captures not just what is happening physiologically,
but also the social, environmental, and spiritual experiences of an individual
(McCann Mortimer et al. 2008). Failure to take these aspects of aging into account
reinforces the homogenous view of older workers (Peel et al. 2004). The focus of this
section of the chapter is to describe the health and performance impacts of aging on
workers.

Physiology

Aging is closely associated with physical decline. Physiologically, aging reduces

bone density, muscle strength, and aerobic capacity (Robroek et al. 2013). The loss
26 The Aging Workforce 531

of calcium in aging bones makes them more porous, and fragile, increasing suscep-
tibility to osteoporosis (Noone et al. 2014). Muscle strength peaks at age 20 and then
reduces by 10% per decade until 60 (Mazzeo 2000). Similarly, deleterious effects of
aging on endurance and aerobatic capacity can be seen after age 25, with decline
even more prominent after age 40 (Kenny et al. 2016). Aging also makes individuals
less resistant to extreme temperatures, with older individuals experiencing greater
difficulties in regulating and adjusting to temperature differences (EU-OSHA 2016).
These age-related physiological changes, particularly reduced energy and strength,
are likely to impact performance in roles that have a large physical component
(Varianou-Mikellidou et al. 2019).
In terms of sensory systems, age-related anatomical changes to the eyeball can
reduce the quality of sensory inputs to visual processing, which in turn can reduce
visual acuity (Willis et al. 2013). Visual impairment is the primary cause of
age-related disability (Whillans and Nazroo 2018). Indeed, deterioration of spatial
vision, vision motion perception, and balance control have been linked to a higher
incidence of falling (Saftari and Kwon 2018). Hearing loss is also often associated
with aging, with approximately 23% of individuals between 65 and 75, and 40% of
individuals older than 75 experiencing some form of hearing difficulty (Seidman
et al. 2002). Workers with previous exposure to high levels of noise (i.e., >85 dBA)
are likely to be further at risk (Prince et al. 2003). Reduced hearing capacity may
negatively impact the ease of which older workers can understand instructions as
well as their awareness of hazards, particularly in noisy environments (EU-OSHA
2016).

Cognition

The aging process has been linked to decreases in speed and precision of cognitive
perceptual processes; however, aging has also been associated with increased lan-
guage control and complex problem-solving ability (Ilmarinen 2001). Mental pro-
cesses are at their highest when individuals are in their 30s and 40s, with only slight
decrements in the 50s and 60s (Noone et al. 2014). Mental growth, verbal command,
ability to reason, and wisdom have been shown to strengthen with age (Baltes and
Finkelstein 2011). There is some research to suggest that the speed of learning
reduces with age; however, the actual learning process appears to be independent
of age (Ilmarinen 2001). Generally, for most occupations, cognitive decline is
likely to have limited impacts on job performance (EU-OSHA 2016; Noone et al.
2014).
Some of the cognitive decline associated with aging can be buffered by previ-
ously acquired skills and knowledge of the task as well as high levels of motivation
(Ilmarinen 2001). It is thought that positive job experiences, which maintain or
improve cognitive functioning, rather than job performance directly provide some
explanation for why job performance does not diminish with age (Spirduso 1995). It
is also interesting to note that declines in physical functioning do not necessarily
negate or reduce cognitive improvements (Ilmarinen 2001).
532 E. Gardiner and M. K.-L. Chen

Psychosocial

The psychosocial health of older adults reflects the quality and size of their social
network and support, social interaction, community participation, social function-
ing, and intergenerational activities (Seah et al. 2019, p. 37). The social health of
older individuals is enhanced with the presence of social support, education, and
literacy as well as freedom from abuse and absence of violence (WHO 2002).
Increased levels of social support in both work and non-work contexts have been
found to positively predict the well-being of older workers (Cheung and Wu 2012),
with research on Australian workers aged 60–79 revealing that older age, men, and
part-time workers have higher levels of mental health and wellbeing (Forbes et al.
2015).
In addition, poor psychosocial work environments are more detrimental for older
compared to younger workers and are associated with early retirement for males
(Thorsen et al. 2012). Psychosocial working conditions have been shown in the
literature to impact the health of prime-age workers, with poor psychosocial working
conditions linked to frailty in older workers (Kalousova and de Leon 2015). Other
psychosocial factors (e.g., workload) have also been shown to differentially impact
older and younger workers, with older workers having a higher need for recovery
after work than younger workers (Kiss et al. 2008). Research by Ilmarinen et al.
(2005) with a large nationally representative sample of workers from Finland
showed that the mental requirements of the job and work environment were key
predictors of work ability for older workers. So, while the psychosocial health of
older workers is not necessarily affected by aging, it does appear that older workers
are more susceptible than younger workers to poor organizational-based psychoso-
cial factors.

Occupational Health and Safety

Considering the impact of aging on physiological and cognitive functioning, as well

as the social experiences of older workers, many scholars and policy makers have
been interested in determining whether older workers pose a higher occupational
health and safety risk to themselves and others. Research suggests that in comparison
with younger workers, older workers experience greater health problems and longer
absences from work due to ill health (Niedhammer et al. 2019). Younger workers
have been found to be more prone to accidents than their older colleagues (Volberg
et al. 2017); however, older workers experience more severe injuries than their
younger counterparts (Bande and López-Mourelo 2015). Figures from the United
States indicate much higher fatality rates for older workers. For instance, after
analyzing data from the Jefferson County Coroner/Medical Examiner Office,
McGwin et al. (2002) found that workers aged over 55 years had a fourfold risk of
fatality in comparison with younger workers. Another US study found the rate for
workers aged over 65 years to be three times that of younger workers (Rogers and
Wiatrowksi 2005).
26 The Aging Workforce 533

The results of a systematic review investigating the health and safety risks of
workers aged 60+ found very little direct evidence of higher health and safety risks
for workers aged 60+. Some specific age-related impairments, such as hearing loss,
were related to some increases in accident risk. However, overall, workers over
60 were found to experience fewer, but more serious, injuries, and accidents. The
study found some support for compensatory strategies and experience to further
support safety at work (Farrow and Reynolds 2012).
These results from the systematic review have been replicated and expanded in a
recent meta-analysis by Peng and Chan (2019). Peng and Chan (2019) conducted an
extensive review of three decades of research on age-related occupational accident
risks to identify whether aging poses a greater health and safety risk for older
workers. The results of their meta-analysis showed that while older workers were
more vulnerable than younger workers, experiencing twice as many severe and/or
fatal accidents, their chances of experiencing non-fatal accidents were slightly lower.
The type of work, as well as how accidents were measured appeared to moderate the
relationship between age and accident rates. Older workers in physically demanding
occupations (e.g., manufacturing and construction) were more vulnerable, and older
workers also reported higher incidence of slip and fall accidents in comparison to
younger workers.
Another important study which sheds light on how aging impacts occupation
health and safety was conducted by Varianou-Mikellidou et al. (2019). The focus of
their research was to identify and put forward recommendations for how to best
manage occupational health and safety risks in relation to aging workers. After an
extensive review of the literature on age-related physiological and psychological
changes and the impact of these changes on work, the authors concluded that
occupational health and safety management systems should identify and accept
age-related changes as potential hazards. More specifically, they suggest a focus
on work ability (EU-OSHA n.d.) and performance of age-sensitive risk assessments
to assist in creating a more holistic approach to occupational health and safety
management.

Challenges for Aging Workers

In addition to the individual-level physical, cognitive, and psychosocial challenges

associated with the aging process, aging workers also experience significant chal-
lenges due to often ill-informed perceptions of others towards aging. This section of
the chapter explores three key challenges faced by aging workers, namely, agism,
shifting social identities, and gender norms.

Agism

Despite the introduction of anti-discrimination laws and increased recognition of

aging workers’ value (North 2019), agism is pervasive and continues to create
534 E. Gardiner and M. K.-L. Chen

barriers that prevent aging workers from maintaining and attaining meaningful work
(Stypinska and Turek 2017), which in turn leads to involuntary early exits (Gonzales
et al. 2018). Stereotypes, whether positive or negative, can create an overgeneralized
and homogenous image of a particular social group or category, and influence
people’s intended and actual behaviors in ways that are consistent with those
stereotypes. Aging workers are perceived as more reliable, committed, and as having
better social and interpersonal skills; however, pervasive negative stereotypes about
older people, such as reduced cognitive and physical capacity, resistance to learning,
lack of flexibility, and low technology literacy, can disadvantage aging workers
significantly in the employment market (Harris et al. 2018).
Previous studies show that irrespective of the requirements of the job and the
aging workers’ education, work experiences, and competencies, aging workers are
perceived as less suitable candidates and are less likely to be shortlisted for inter-
views than younger workers (Richardson et al. 2013). Not surprisingly, agism is
more prevalent in industry sectors and professions that are fast-paced, technology-
driven, and more physically demanding (Stypinska and Turek 2017). Information
technology (IT), banking, and the hospitality industries have smaller proportions of
aging workers than education, public administration, and utilities (Adler and Hilber
2009). Industries that traditionally rely on esthetic labor, that is the materialization of
employee’s esthetic capacities and attributes for customer consumption to promote
and sell their services, such as retail and hospitality, are more discriminatory towards
aging workers (Witz et al. 2003).
In addition to barriers to the employment market, once employed, aging workers
receive less training opportunities than younger workers, especially for those aged
over 50 (Canduela et al. 2012). Being resistant to change, less capable of learning
and having shorter tenure are common stereotypes that lead employers to believe
that their investment in aging workers is of little value (Williams Van Rooij 2012).
Without a doubt, employers’ perceptions of aging workers influence employment,
training, and promotion decisions for aging workers (Van Dalen et al. 2010); however,
attitudes of fellow workers and their influence on the daily experience of aging workers
should not be overlooked (Finkelstein et al. 2013). Stereotypical beliefs can influence
fellow workers’ intention to support fair and equitable personnel policies and decisions
as well as their willingness to work with aging workers (Chiu et al. 2001). Support from
supervisors and co-workers reduces the prevalence of age discrimination and helps
aging workers to manage aging anxiety, which has been linked to reduced job satisfac-
tion, commitment, and engagement (Macdonald and Levy 2016).

Shift in Social Identities

Another challenge that aging workers may face is bearing the consequences of
negative stereotypes on self-evaluation, well-being, job performance, and even with-
drawal intentions (Finkelstein et al. 2013). Age is a common proxy for categorizing
oneself and others into social groups (Desmette and Gaillard 2008). As people get
26 The Aging Workforce 535

older, Age identify shifts as people get older. The degree to which one embodies age
stereotypes determines how one reacts to ageing, as manifested by self-perceptions,
cognitive and physical functioning, and health status. (Levy 2009).
Aging workers who held more negative perceptions of aging exhibited lower
levels of occupational self-efficacy and reduced beliefs in their ability to perform
work (Chiesa et al. 2016). Also, in the studies with workers aged between 45 and
59 years, self-identification as “older worker” was found to be associated with early
retirement intentions (Desmette and Gaillard 2008).
The threat of confirming or being reduced to the negative stereotypes of their social
groups in a given situation, known as stereotype threat (Steele and Aronson 1995), has
been shown to affect older adults’ memory and cognitive performance in laboratory
settings (Lamont et al. 2015). A field study with aging workers found that the experience
of stereotype threat at work is associated with lower job satisfaction, reduced organiza-
tional commitment, and poor mental health, which in turn leads to a higher intention to
leave (von Hippel et al. 2013). It is worth noting that stereotypes only affect those who
identify themselves with a particular social group and are cognizant of the stereotypes
attached with their social group (Steele and Aronson 1995).

Gender Norms

Workforce participation of female aging workers is on the rise. More women are
moving to a “bridge job,” which is a temporary position between full-time work and
retirement, before leaving the labor force permanently (Cahill et al. 2011). Higher
divorce rates, lower lifetime earnings due to persistent gender pay gap, and less
retirement savings due to more career breaks are likely reasons that contribute to
increased workforce participation before and after retirement (Gahan et al. 2017).
However, female aging workers face more barriers than their male counterparts. As
studies repeatedly show, older women have longer unemployment duration and lower
call-back rates for job interviews (Carlsson and Eriksson 2019; Neumark et al. 2019).
Also, female aging workers concurrently experience agism with gender inequality-
sometimes known as “double jeopardy” or “gendered agism”—which further hampers
their opportunities in the employment market (Itzin and Newman 1995).
Female workers face different forms of agism throughout their career trajectories.
In their 20s and 30s, female workers are perceived as a flight risk with higher
marriage and childbearing probabilities. However, once they reach their 40s, female
workers are at risk of being seen as “too-old” by male colleagues, especially for
those working in the service sector (Jyrkinen and McKie 2012). Female aging
workers may also feel pressured to look a certain way to be taken seriously for
professional positions and to minimize the impacts on their career prospects
(Jyrkinen and McKie 2012). It is worth noting that aging can be empowering.
Interviews with 54- to 62-year-old women in senior professional or managerial
positions demonstrates that aging can help women build professional authority and
credibility as well as liberate them from expectations that are driven by gender and
sexual ideologies (Isopahkala-Bouret 2017).
536 E. Gardiner and M. K.-L. Chen

Organizational Responses

This section highlights organizational strategies for promoting successful aging in

the workplace as proposed by organizational psychology and gerontology
researchers. Theoretical and empirical evidence on the effects of supportive organi-
zational age culture and age climate, flexible work arrangements, training, and job
crafting on the aging workplace are explored.

Age-Friendly Climate

Organizational culture refers to the shared values, norms, and beliefs within the
organization (Schein 1990), whereas organizational climate is the shared perceptions
of organizational policies, practices, and protocols (van Dam et al. 2017). Supportive
age culture and age culture and age climate reduces the occurrence of age discrim-
ination and are perceived as a catalyst to realize the benefits of an aging workforce
(Appannah and Biggs 2015). Attitudes of top management towards workers of
different age groups form the basis of age culture, which in turn affects how aging
workers are perceived and treated in the workplace (Hertel and Zacher 2018).
Supportive age culture alleviates concerns of age-based discrimination (Loretto
and White 2006) and communicates that the organization is supportive of aging
workers. This fosters a sense of belongingness and loyalty on the part of aging
workers (Kanfer and Ackerman 2004).
Supportive age climate is also beneficial to an aging workplace with a diverse age
profile. Although age diversity is advantageous to organizations that thrive on
employees’ creativity and problem-solving skills (Backes-Gellner and Veen 2013),
age diversity has also been associated with increased prejudice and stereotyping
(Schneid et al. 2016). As age heterogeneity increases, so does the salience of age
differences. This prompts identification and categorization of self and others into age
groups, leading to a heightened perception of age discrimination (Kunze et al. 2011).
A cross-organizational study with 128 companies found that increased age diversity
is associated with perceptions of an age discrimination climate, which in turn leads to
a reduction in affective commitment and firm performance (Kunze et al. 2011).
Organization with age-inclusive human resources (HR) policies and
age-awareness training are found to have more supportive age culture and age
climate. HR policies set the strategies for workforce management and communi-
cate the culture and climate that the organization seeks to foster (Eppler-Hattab
et al. 2020). In their cross-organizational study with 147 companies, Kunze et al.
(2013) found that organizations with age-inclusive HR policies and managers who
have lower levels of negative age stereotypes are less affected by the harmful
consequences of age diversity on organizational performance through reduced
perception of age discrimination climate. Similarly, Boehm et al. (2014) found
that organizations with inclusive HR practices which provided workers of all ages
equal access to training and career mobility opportunities had a more positve age-
diversity climate, better firm performance, and lower turnover. It should be noted
26 The Aging Workforce 537

that age-inclusive HR policies are different from age-specific or age-aware HR

policies, which are geared towards aging workers. HR policies aimed at aging
workers are unwelcomed as they reinforce the negative stereotypes that aging
workers belong to a vulnerable social group that requires care and special attention
(Hennekam and Herrbach 2015).
Numerous researchers have recommended age-awareness training that challenge
age stereotypes, educate about the influence of stereotypes on management decisions
and organizational performance, and provide practical recommendations for man-
aging an aging workforce (Kunze et al. 2013). Attitudes of management and
employees can influence the recruitment, management, and development decisions
for aging workers (Appannah and Biggs 2015). Ongoing commitment and support
from management is imperative to the success of age-inclusive policies (Mid-
tsundstad 2011). Managers need to be cognizant of the age stereotypes and biases
they hold and take proactive measures to mitigate its influences on their decisions
(Bal et al. 2011). Evidence from a 6-year field study showed that age-awareness
training can decrease age stereotypes, reduce the occurrences of age-related team
conflicts, and improve innovation performance (Wegge et al. 2012). However, an
earlier study that evaluated the effectiveness of an age awareness workshop showed
that while training improved knowledge of aging and the importance of using
politically correct language, it did not result in a change in attitudes towards older
adults (Stuart-Hamilton and Mahoney 2003). Further systematic investigation to
identify effective age-awareness training methodology and approach is warranted.

Flexible Work Arrangements

Flexible work arrangement (FWA) provides employees the flexibility to alter their
work hours, patterns, and location (Allen et al. 2013). Flexible work schedules,
compressed work week, job sharing, telecommuting, and phased retirement are
commonly practiced FWA to attract and retain aging workers (Moen et al. 2017).
FWA is theorized to reduce occupational stress and improve work-life balance, job
satisfaction, and the overall workplace experience of aging workers (Dropkin et al.
2016).
Given the physiological decrements associated with aging, the ability to exercise
discretion over when and where to work according to their needs (e.g., changing
sleep patterns or physical fitness) can be appealing to aging workers (Atkinson and
Sandiford 2016). FWA enables aging workers to optimize their use of resources to
compensate for age-related vulnerabilities (Kanfer and Ackerman 2004) and sustain
work performance (Bal and De Lange 2015). Maintenance HR practices, such as
flexible work arrangements, which are designed to help employees maintain their
current level of functioning, are associated with increased affective commitment and
job satisfaction among aging workers (Kooij et al. 2010). Job flexibility helps aging
workers to continue working while attending to social and family commitments,
which with age, become more important priorities than career goals (Thrasher et al.
2016).
538 E. Gardiner and M. K.-L. Chen

Few empirical studies have been conducted to examine the benefits of FWA to an
aging workforce, and what has been found is mixed. A large-scale qualitative study
with HR managers from 736 firms (Stirpe et al. 2018) found that FWA did not have
noticeable effects on employee retention among aging workers. In fact, when the
organizations also provided HR practices designed to upskill, motivate, and engage
employees, employee retention among aging workers declined (Stirpe et al. 2018).
Other studies echoed similar results, indicating that FWAs have limited effects on
aging workers’ intention to remain or intention to continue working (Armstrong-
Stassen and Ursel 2009; Van Solinge and Henkens 2014). More recent studies have
found support for the positive effects of FWA on aging workforce. For example, the
study by Moen et al. (2016) examined whether added flexibility to when and where
the work is completed, greater supervisory support for personal lives, and removal of
low-valued work affect the retirement expectations of IT professionals and managers
aged 50–64 years in a large Fortune 500 company. The study, which randomly
assigned work units to either the experimental group or control group, found that
participants in the experimental group expected to retire later than those in the
control group 5 years after the baseline. A more recent study found that aging
workers (60–65 years) with chronic health conditions were less likely to perceive
their health conditions as limiting to work performance when their organization
offered flexible work hours and had high levels of psychological safety climate, that
is, an organization climate where employees are not fearful of taking interpersonal
risks and of the reprehension that may follow if mistakes are made (Vanajan et al.
2020).

Training

Training is imperative to support aging workers to sustain healthy and longer

working lives as it helps them to acquire essential knowledge and competencies
for their role and improves their employability in the labor market. Aging workers,
however, receive far less training and development opportunities in comparison to
their younger colleagues (Karpinska et al. 2015) due to the assumptions that aging
workers have lower learning ability and are likely to leave (or retire) sooner
(Hennekam and Herrbach 2015). When aging workers are not provided with ade-
quate training, they face skill obsolescence. Skill obsolescence occurs when job
skills and knowledge become outdated, underdeveloped, or decline in productive
value, leading to increased risk of unemployment and poorer employment prospects,
which in turn decrease the motivation to remain engaged in the workforce, including
opting to retire early (Brooke and Taylor 2005).
The benefits of training have been recognized by workers and organizations alike.
There is evidence showing that when organizations invest in staff development,
workers feel valued and appreciated (Kooij et al. 2010). This can elicit a sense of
obligation on the part of workers to repay the organization with commitment and
productivity (Armstrong-Stassen and Ursel 2009). Access to training opportunities
has been associated with increased job satisfaction (Leppel et al. 2012), reduced
26 The Aging Workforce 539

turnover intention (Herrbach et al. 2009), and lower retirement intention (Berg et al.
2017) for aging workers.
For training programs to be successful, they should be tailored to the learning
styles and developmental needs of the aging workers, which can vary significantly
between individuals. It is suggested that ageing workers benefit more from informal,
flexible, on-the-job training than from rigid seminars or training circles (Zwick
2015). Aging workers may react negatively towards traditional training method,
which tend to focus on school-related skills and abilities, such as memorization and
reaction speed, as speed and precision of retrieving information declines with age
(Kanfer and Ackerman 2004).

Job Crafting

Job crafting refers to the process where individuals exercise personal agencies to
change the physical and cognitive boundaries of job tasks, work relationships, and
the meaning of the job (Wrzesniewski and Dutton 2001). The original framework by
Wrzesniewski and Dutton (2001) theorized that there are three forms of job crafting–
task, cognitive, and relationship crafting. Task crafting describes changing the type,
scope, and number of tasks that one performs. Cognitive crafting comprises altering
one’s perceptions and cognitive representation of their work. Relationship crafting
refers to exercising discretion over the type and frequency of social interactions on
the job. Tims and Bakker (2010) further conceptualized job crafting based on the job
demands-resources (JD-R) model. They described job crafting as a self-initiated
behavior that seeks to improve the alignment between work environment with
individual abilities and goals through altering structural and social job resources
and challenging and hindering job demands (Moghimi et al. 2015).
Job crafting, which is an individualized, bottom-up approach initiated by
employees, is suggested to be a more effective strategy than job design, which
utilizes a traditional top-down, management-driven approach, for optimizing
person-job fit among aging workers (Kooij et al. 2015). Person-job fit is the degree
of fit between one’s work-related knowledge, skills, abilities, and needs and what is
required and provided by a person’s job (Edwards 1991). Over time, age-related
changes in personal attributes can worsen person-job fit. Aging workers may become
less capable of performing work tasks at the same intensity (e.g., long working
hours) and may place greater emphasis on priorities outside of work, such as health
and family commitments (Wong and Tetrick 2017). Organizations need to modify
the job requirements to adapt to the evolving needs of their aging workforce to
prevent poor person-job fit (Lichtenthaler and Fischbach 2016).
Aging, however, does not result in a uniform decline in work ability or work
motivation. With different career and life trajectories, individual differences in work-
related attitudes and abilities tend to increase with age (Kooij et al. 2015). Individual
work motivation profiles also develop and mature overtime, which may prompt
aging workers to engage in personalized task-specific regulation (Stamov-Roßnagel
and Hertel 2010). Personalized task-specific regulation includes increasing one’s
540 E. Gardiner and M. K.-L. Chen

motivation and effort in certain tasks to compensate for declines in other areas to
maintain one’s positive emotional state, well-being, and job performance. While job
crafting could be used to minimize the growing disparities between ability, motiva-
tion, and job requirements as workers’ age, modifying working conditions to
accommodate the needs of heterogeneous aging workers, while also maintaining
work performance could be challenging for organizations (Kooij et al. 2015; Wong
and Tetrick 2017).
Few empirical studies have investigated the effects of job crafting on an aging
workforce since job crafting was initially conceptualized by Wrzesniewski and
Dutton (2001) to the more recent work by Kooij et al. (2015). Lichtenthaler and
Fischbach (2016) conducted one of the first studies that explored the effects of job
crafting on aging workers’ motivation to continue working beyond retirement age.
They found that participants who actively engaged in job crafting through the
increasing structural (e.g., accessing training) and social (e.g., receiving collegial
support) job resources, challenging job demands (e.g., seeking interesting job
assignments), and reducing hindering job demands (e.g., making fewer decisions
at work) had higher levels of comprehensibility and manageability of their work.
They also found their job more meaningful and were less likely to experience
burnout. These, in turn, increased the motivation of aging workers to remain
working and delay retirement. Another study in Germany with aging workers in
the private sectors found further evidence that job crafting creates more work
meaningfulness, which is the key to satisfying and sustainable career for aging
workers (Nagy et al. 2019).

Conclusion

This chapter aimed to provide insight into the experiences of aging workers–
understanding who an aging worker is, the barriers and challenges experienced by
them, and what can be done to better support the workforce participation of aging
workers. Although the aging process does impact workers, the often-reported neg-
ative experiences of aging workers with respect to obtaining and maintaining work
stems from the perceptions and behaviors of others, such as colleagues and super-
visors. The efforts of government to prolong the working lives of aging workers are
severely undermined by the perpetuation of negative stereotypes and perceptions of
aging workers. Aging workers have great deal to offer society and organizations, and
organizations can play an important role in supporting and encouraging individuals
to work at least up to, if not past retirement age.

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Occupational Health Services
and Prevention of Work-Related 27
Musculoskeletal Problems

Deborah Roy

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 548
Musculoskeletal Disorders and the Rise in Occupational Health Management . . . . . . . . . . . . . . . 549
Prevalence of Musculoskeletal Disorders (MSDs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 550
MSDs Among Workers in Health and Social Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 552
Can Musculoskeletal Disorders Among Health and Social Care
Professionals Be Reduced? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 554
Musculoskeletal Disorder in the World of Construction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 556
Preventing Musculoskeletal Disorders in the Construction Industry . . . . . . . . . . . . . . . . . . . . . . . . . . . 557
The Risks of Musculoskeletal Disorders Posed by Sedentary Professions . . . . . . . . . . . . . . . . . . . . 559
The Benefits of Getting Up and Taking a Break from Your Desk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 560
Psychological and Social Factors and MSDs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 561
What Does the Effective Risk Management of MSDs Look Like? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 562
Getting People with Injuries Back to Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 564
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 564
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565

Abstract
Occupational health services, and effective health and safety training, are crucial
in any organization to prevent work-related musculoskeletal disorders
(WRMSDs). Jobs that require the worker to hold the same working posture or
position for prolonged periods, to apply extreme force, to engage in heavy lifting,
and to regularly experience physical fatigue elicit important physical work risk
factors for MSDs in most professions. This problem is a global threat to healthy
ageing, but also WRMSDs cost the British National Health Service (NHS)
billions of pounds each year. To mitigate injuries and prevent them from happen-
ing altogether, it is crucial that organizations prioritize MSD prevention and risk

D. Roy (*)
School of Psychology, University of Bath, Bath, UK
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 547

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_23
548 D. Roy

assessment and embed occupational health into their very philosophy and culture.
Awareness should be raised about not just the physical risks, but also psychoso-
cial risks of MSDs, and all of this should be taking place at a time when the
working population is ageing. This chapter covers the scale of the problem of
WRMSDs and the latest research undertaken in a number of specific work
environments that experience high levels of WRMSDs, such as health and social
care, construction work, and sedentary occupations. Other objectives are to bring
to light the latest developments in ergonomic and human factors research that use
biomechanical assessments and movement sensor equipment within laboratories
and in situ, to identify important thresholds, and to limit injury during physically
demanding activities. At various junctions, it speaks to issues around ageing,
concluding by reviewing the important occupational health management inter-
ventions that may help.

Keywords
Work-related musculoskeletal disorders · Construction · Health and social care
workers · Sedentary occupations · Office work · Ergonomics · Human factors ·
Public health · Occupational health · Ageing · Healthy lifestyles

Introduction

In wealthy countries, musculoskeletal disorders (MSDs) are common attributes of a

loss to national productivity and premature retirements (Schofield et al. 2012).
MSDs, particularly disorders of the back, and upper and lower limbs, are some of
the commonest causes of occupational ill health in the UK (Health and Safety
Executive 2020a, b, c) and other European countries such as Spain ( Hernández
Martín et al. 2019). In the UK alone, during 2018/2019, almost seven million
working days were lost due to work-related musculoskeletal disorders (Labour
Force Survey 2018/2019). MSDs are prevalent in all sectors, but it is in the
construction industry, and among health and social care professions, that signifi-
cantly higher than average rates are to be found, and sedentary occupations are also
contributing significantly to these figures (Dianat et al. 2015). Outside of work, there
are contributory actors, such as taking part in sport or home activities. But also levels
of fitness, and health and psychosocial factors such as financial worries, lack of
control at work, stress, and depression, are also implicated. An MSD can conse-
quently be the direct result of the work someone is employed to do, or may be a
preexisting condition that becomes subsequently aggravated by further exposure to
risky working practices. Stress can also increase severity of perceived and actual
pain and discomfort. And, while the exact mechanisms are still not fully understood,
stress is thought to alter our perceptions in terms of our ability to cope, as well as
intensifying muscle tension (Sobeih et al. 2009). Stress may cause people to engage
in unhealthy behaviors such as excessive drinking or smoking, and could suppress
the immune system and induce inflammation mechanisms (Lunt et al. 2007).
27 Occupational Health Services and Prevention of Work-Related. . . 549

Because multiple risk factors are involved, a holistic approach to managing muscu-
loskeletal health is needed, and should be prioritized by all organizations in an effort
to engender good overall health and well-being in their workforce. But importantly it
could also enable workers to continue to work as they progress into older age (DWP
2014). Healthy older workers who do not have MSDs can work well into their 60s,
so a focus on preventing work-related conditions can extend working lives. The
reality is of course that some employers adhere to the law and abide by regulations
around health and safety but fail to embrace a holistic approach, and small busi-
nesses may lack the resources to provide comprehensive occupational health support
for their workers, resulting in some employees having to reluctantly give up work
prematurely (DWP 2014).
According to the Office for National Statistics (2018) most sickness absences in
the last 20 years were attributed to MSDs. An injury can occur when the load on the
body exceeds its capacity to handle it and this can happen during heavy lifting,
pushing, and pulling (which can cause lower back pain) and also from poor posture,
obesity, and ageing (Bevan 2015). The most frequently cited risk factors for work-
related MSDs include working at a fast rate, repetitive motion patterns, frequent
bending and twisting, exposure to the cold, and insufficient recovery time. Older
workers in particular, who engage in strenuous physical work, require longer
recovery times (Kiss et al. 2008). Increasing physical exercise can have a notable
effect on the health and well-being of older workers as well as younger employees
(Rhodes et al. 2017) and many misconceptions exist about being older (Bohle et al.
2010), as there is a great deal of variation within as well as between age groups when
it comes to physical ageing. Unfortunately, those who have already acquired
WRMSDs will experience age-specific challenges, but those who remain injury
and MSD free into older age, with the right support, could enjoy many years of
employment in later life (Ilmarinen 2012).
The human body is an amazing piece of biomechanical engineering, but being
exposed to heavy physical work and pressure from employers to meet activity targets
are not the only health and safety concerns. Another serious issue is the rise in
sedentary professions, meaning workers are often sitting for long periods at work-
stations using computer keyboards, which can result in discomfort, MSDs, stress,
and fatigue. Sitting all day is a hazard in and of itself, as it has already been
established that obesity, and in the USA a lack of exercise, is related to painful
musculoskeletal conditions such as arthritis (Hootman et al. 2011). Targeted research
remains vital to understand how MSDs may be prevented wherever possible, and to
determine the levels of stress that go on to exacerbate MSDs in the workplace.

Musculoskeletal Disorders and the Rise in Occupational Health

Management

Industrialization is a term used to describe a specific period of economic and social

change, during which many countries moved from an economy reliant upon farming
to large-scale manufacturing. Little thought during that time was given to if, and
550 D. Roy

how, working conditions would impact workers’ health, and because of this, the
“Industrial Revolution” era saw some of the worst occupational diseases reported,
and perhaps one of the earliest cases of a skeletal disorder was “phossy jaw” where
the jaw bone dies (necrosis) from prolonged exposure to white phosphorus, some-
thing commonly used at that time in the manufacturing of matches in the nineteenth
and twentieth centuries, and it was not until 1910 that legislation was introduced that
prohibited the use of white phosphorus in British match factories (Marx 2008).
A number of years later, the continued concerns about the health of machine and
factory workers resulted in the Health and Safety at Work Act (1974) being passed in
GB. This piece of law was designed to ensure that employers provided employees
with a work environment free from hazards, including exposure to toxic chemicals,
excessive noise levels, mechanical dangers, heat or cold stress, and unsanitary
conditions. The Health and Safety at Work Act of 1974 forms the basis of current
health and safety regulatory frameworks in GB. The Act places responsibility on
both the employer and employee to ensure the health, safety, and well-being of
individuals across all workplaces, and members of the public who could be affected
by work activities. In Northern Ireland, the Health and Safety at Work Order (1978)
provides legislation setting out a similar set of responsibilities in respect to the health
and safety for employers. The creation of the UK’s first Health and Safety Executive
(HSE) followed (and HSE NI), which not only continues to regulate and reinforce
UK legislation but has also influenced health and safety laws across Europe and
beyond (StaySafe 2019). Consequently, a raft of health, safety, and welfare legisla-
tion is in place to educate and hold employers accountable for providing a safe
workplace, effectively assessing risk, and preventing problems from occurring,
where possible.
Changes in the workplace in GB as a result of the Health and Safety at Work Act
meant a substantial 73% reduction in the number of workplace fatalities between
1974 and 2007, and nonfatal injuries also fell by 70% (StaySafe 2019). Construction,
manufacturing, and farming continue as professions with high risk to life and limb,
but today, the sedentary nature of many jobs has become another major risk factor,
particularly for work-related upper limb disorders (WRULDs).

Prevalence of Musculoskeletal Disorders (MSDs)

As many as 100 million European citizens are believed to be suffering from chronic
musculoskeletal pain and musculoskeletal disorders (MSDs), and 40 million of these
workers attribute their MSDs directly to their work (Bevan 2015). In England, MSDs
account for 30% of GP consultations (NHS England 2017) and for over 25% of all
surgical interventions in the NHS, and this is set to rise significantly over the next
10 years (Arthritis Research UK 2014). This is costing the NHS £4.76 billion each
year (NIHR Horizon Scanning Centre 2013). MSDs are also related to a large
number of other diseases, including diabetes, depression, and obesity (Arthritis
Research UK 2014).
27 Occupational Health Services and Prevention of Work-Related. . . 551

There are approximately 9.6 million adults and 12,000 children suffering from
around 200 musculoskeletal conditions in the UK (NHS England 2017). Osteoar-
thritis and lower back pain are major contributors to musculoskeletal injury in those
over 50 years of age and, along with rheumatoid arthritis, psoriatic arthritis, and
gout, are some of the commonest musculoskeletal conditions globally (Lewis et al.
2019). Significant epidemiological evidence from the USA revealed a link between
obesity and deterioration of joints (Felson et al. 1988). And yet, becoming more
active and taking regular exercise, as recommended by Arthritis Research
UK/Versus Arthritis (2014), can be the best way to improve musculoskeletal health.
The problem of a lack in activity is serious, as only one-third of adults in the UK
engage weekly in moderate physical activity for half an hour. In a large Canadian
study, those who lived with or had osteoarthritis (OA) could subsequently break
bones because of their condition and, along with rheumatoid arthritis (RA) sufferers,
may not live as long as peers of the same age and gender (Widdifield et al. 2015).
The three primary risk factors that cause 39 MSDs in the USA are high force,
awkward posture, and long duration or high frequency (Coble 2015). Secondary risk
factors that contribute to developing an MSD include soft-tissue compression, low
temperature, vibration, impact stress, and glove issues. But across Europe, according
to Bevan (2015), it is not only rapid pace of work and heavy loads which are
important risk factors, but also psychosocial and organizational factors, such as
monotony, low job satisfaction, lack of autonomy and control, and a lack of social
support that create stress which can exacerbate MSDs (Bevan 2015).
The skilled trades, such as heavy machine operations, building, and plant oper-
ations, are occupations that experience significantly higher rates of MSDs compared
to all others (Health and Safety Executive 2013a, b). However, in the UK health and
social care, services and office-based jobs also have high rates of MSDs, along with
poor mental health (James and Walters 1999). According to Carter et al. (2013) in the
UK, lower grade office workers are more likely to experience job insecurity and
work overload, leading to mental health problems and other health conditions.
Similar experiences are found in public sector workers across a number of
European states, which historically had experienced better working conditions and
are now experiencing longer working hours, resulting in higher workloads and
increased job stress levels. This deterioration in working conditions coincided with
the onset of the economic crisis in 2008 (EFILWC 2013).
The UK Labour Force Survey (LFS 2018/2019) found that 498,000 workers
suffered from work-related musculoskeletal disorders (new or long-standing), 40%
of which were in the lower back, 41% were in the upper limbs or neck, and 19% were
in the lower limbs. While men and women over the age of 45 self-report more
WRMSDs than the younger groups, the prevalence rates are highest among males
over 55 years old (2250 cases per 100,000 workers) and females over 55 years old
(2100 cases per 100,000 females), respectively (HSE, Annual Statistics, 2019). These
rates are worrying, given that across Europe, the workforce is also ageing (Walker and
Maltby 2012). More people are having to work beyond normal retirement age,
because governments have increased the retirement age due to concerns that there
will be insufficient money later to meet pension obligations and care for those with
552 D. Roy

chronic disease (Bevan 2015). That being said, prevention of MSDs in younger
adulthood or middle age could do much to reduce these rates of MSDs in older adults.

MSDs Among Workers in Health and Social Care

European healthcare sector employees experience high numbers of work-related

injuries, and high incidence rates are consistent with those found in the USA
(Okuyucu et al. 2019). The nursing profession is ranked in the top ten professions
at great risk of low back pain, and this risk of lower back pain exists across all
nations, something a systematic review of 19 years of research of African nurses
found. Although incidences of lower back pain were lower among African nurses
when compared to the Western and Asian workforce, prevalence of low back pain
was nevertheless considerable (Kasa et al. 2019). Nursing in the community brings
with it specific risks, as nurses and care workers may not have access to the same
equipment that is available in hospital settings and have a tendency to “struggle on.”
They may have to kneel for prolonged periods and lift patients who are becoming
increasingly obese (VanHoy and Laidlow 2009). This brings challenges for many
nations as obesity is now a global epidemic (Jaacks et al. 2019). The degree of pain
and discomfort from MSDs is also exacerbated by the levels of presenteeism that
exist in health care, something that is particularly prevalent among nurses in the
USA (Allen et al. 2018) as well as the UK (Kinman 2019). Presenteeism is where
staffs continue to work, even though they are in pain or unwell and are less
productive as a consequence.
It would be wrong to assume that MSD problems in health care are restricted to
the nursing profession. In fact, a US-wide study found that 76% of radiation
therapists experience MSDs, most commonly in the lumbar back and neck and
shoulders, at rates similar to those found among nurses (Hanania et al. 2020). This
study also identified additional risk factors which included smoking, being female,
and being obese (Hanania et al. 2019). Among the UK medical profession, a
literature review revealed that the risk of MSDs varies according to specialty, but
surgeons are at particular risk of MSDs because they have to hold positions for
prolonged periods (Vijendren et al. 2015).
Compared to 15 years ago, there are now 1.4 million more older workers aged
50 years and over in the UK (Cridland 2017) and the health and social care
workforce is also ageing along with the rest of the working population. This reflects
a global trend in ageing, and it is anticipated that by 2050, two billion people will be
60 and over worldwide (WHO 2017). It is known that pain is more acute for older
physiotherapists with MSDs, and musculoskeletal pain or injury and high workloads
are driving physiotherapists to seek work outside of the British healthcare system
(King et al. 2013), and this is also happening in other countries such as the USA
(Vieira et al. 2016). Midwives are another professional group at particular risk of
MSDs, and they are also an ageing workforce, because it was found in 2016 that
one-third of NHS midwives were over 50, and while midwives and nurses do not
necessarily leave their profession because of injuries, they nevertheless experience
27 Occupational Health Services and Prevention of Work-Related. . . 553

very high levels of MSDs in the low back, neck, and shoulders (Okuyucu et al.
2019).
Older workers are not the only age group at particular risk of MSDs. According to
Nyateka et al. (2012), young midwives and young construction workers are age
groups at risk due to lack of experience, and beliefs held that they are resilient and
have the capacity to withstand exposures to high physical load (Nyateka et al. 2019).
Among the midwifery profession risk factors include low job satisfaction, work
stress, and being younger because the lower the experience, the higher the risk of
MSDs and of developing lower back symptoms. These outcomes are found in the
UK, as well as many other European countries (Nyateka et al. 2012; Nowotny-
Czupryna et al. 2012). Midwives have to perform heavy lifting and hold awkward
postures for long periods of time. Also psychosocial factors at work (e.g., too much
overtime, high mental pressure, inadequate work support, and inadequate work
discussion) are potential antecedents for the development of MSDs, as well as
workplace factors. A study which simulated attendance at childbirth and employed
ergonomic measurements using OWAS found that midwives have to work while
holding unnatural body alignments and experience spinal pain. And, while it was
hard to identify spinal overloads, they found that the most frequently occurring
incidences of spinal overload affect lumbar and cervical regions altogether, in both
junior and senior midwives (Nowotny-Czupryna et al. 2012).
Another factor to consider is that MSDs frequently do not occur in isolation, as
many who suffer from MSDs will also have other health problems or comorbidities
evidenced by a number of studies. For example, a study in a Switzerland hospital
found that work- and stress-related musculoskeletal disorders among health pro-
fessionals were associated with physical workload, psychological stress, and sleep
disorders, with sleep disorders primarily being the result of stress (Hämmig 2020).
Also, Zhang et al. (2020) found a 14.5% prevalence of a comorbidity between the
depression and MSDs among community nurses in the USA, with a significant
association found between work-family conflicts and shift length and patterns.
Context is also a factor, as found by a large study in Taiwan, which used a
nationwide population-based database and investigated new-onset spine disorder
associations among physical, occupational, and pharmacy healthcare professionals
working in different workplaces. Physiotherapists working in clinics were twice as
likely to be at risk of developing spine-related MSDs relative to OTs and pharma-
cists, and preventative measures were recommended (Liao et al. 2016).
del Campo et al. (2017) conducted a case–control study on female healthcare
workers. Incidents of MSDs were higher in those with preexisting anxiety or
depression compared to those who did not have these conditions. The degree of
patient contact was also a risk factor, along with morning shift work.
When it comes to primary care nurses, an investigation among Portuguese nurses
of self-reported symptoms of WRMSDs (mainly discomfort and pain) found that
causes included not taking proper precautions, not taking breaks, and holding and
repeating extreme postures for prolonged periods. These behaviors, particularly in a
stressful environment, can accentuate mechanical loading of muscles and cause
MSDs (Ribeiro et al. 2016). It is clear that occupational prevention programs,
554 D. Roy

which include raising awareness of the need to take proper breaks, could go some
way to mitigate these occurrences.
In another study of 2000 Danish hospital healthcare workers, researchers inves-
tigated the risk factors for back injury during patient transfer (Andersen et al. 2019).
They found that a lack of necessary assistance devices was a common phenomenon
during back injury events, with the top four devices not available being sliding sheets
(30%), intelligent beds (19%), walking aids (18%), and ceiling lifts (13%) (Andersen
et al. 2019). Poor collaboration and lack of support from colleagues were also
identified as psychosocial risk factors, which can increase the risk for back injury.
In this instance, providing the necessary lifting equipment, reducing the number of
daily patient transfers that take place, and encouraging better cooperation between
colleagues can reduce the physical burden, and stop back injuries, or at least
reduce them.
It is becoming increasingly common to find links between MSDs and mental
health problems. Mirzaee et al. (2015) found a significant correlation between
mental workload and fatigue in the healthcare personnel. Mental “workload” has
become a common concept in ergonomics and human factors, because it represents a
topic of increasing importance (Sveinsdottir et al. 2006).

Can Musculoskeletal Disorders Among Health and Social Care

Professionals Be Reduced?

The British Medical Association (BMA 2016) recommends that employers need to
consider how reasonable adjustments can be made to accommodate different worker
requirements, particularly where there are heavy physical demands and long hours.
Such adjustments should be accompanied by ergonomic education, as it is important
to raise employee understanding and awareness, in order to reduce the risk of MSDs
wherever possible. Good intentions can however result in a broad-brush approach
being taken to health and safety advice around MSDs, and it could prove beneficial if
a tailored approach is taken and specific factors are targeted, such as age-related
adjustments. Given that younger workers may have misconceptions about what their
bodies can withstand, education that is tailored to this age group is needed to raise
awareness about their bodies’ capacity. A study of activities within the nursing
profession investigated how Iranian nurses could best benefit from an education
program targeting the prevention of lower back pain (Sharafkhani et al. 2015). A
randomized control trial (RCC) took place targeting MSD and health belief factors.
Focusing on held beliefs and perceptions about their health and risks of lower back
pain was more effective than standard health and safety training. These findings
provide support for the benefits of using a more tailored approach rather than relying
on typical education strategies.
What may resonate more with younger workers are ergonomic and human factors
research findings, which can more accurately assess and pinpoint limits within our
bodies when it comes to the amount of pressure it can take and physical load. This
research has continued to grow since 1991, when the early work of Kivi and Mattila
27 Occupational Health Services and Prevention of Work-Related. . . 555

(1991) recognized the need for a scientific assessment and analysis of jobs, where
workload was high, and where workers held awkward positions for prolonged
periods. They created the OWAS (Oak Working Posture Analysing System) to
observe and analyze posture. They found that it was possible to more effectively
detect MSD risks when they are used to complement other interventions (Kivi and
Mattila 1991). Another study conducted across eight hospitals in Italy employed the
disabilities of the arm, shoulder, and hand (DASH) questionnaire and evaluated the
association between personal and job characteristics and the risk of upper limb work-
related musculoskeletal disorders (WMSDs) among operating room nurses (Clari
et al. 2016). The prevalence of upper limb WMSDs was 46%. The findings led to
recommendations to urgently implement ergonomic interventions alongside job
rotation, given that the exposure to risk was elevated DASH scores for female
scrub nurses.
As mentioned earlier, lower back pain remains a significant problem facing
nurses and other healthcare professionals (Kasa et al. 2019). But much can be
done to reduce the incidence of lower back disorder. In a systematic review of
controlled intervention studies, technical aids for patient handling that could prevent
musculoskeletal complaints in health care were assessed, and it revealed that inter-
ventions using technical patient handling aids can prevent many musculoskeletal
complaints (Hegewald et al. 2018). Given the considerable amount of physical effort
that is required when patients are being transferred sideways, or laterally from a bed
for example, the tilted table technique provides clear ergonomic benefits as it can
completely replace the physical efforts that have to be exerted by the pushing nurse,
along with different friction-reducing devices (FRD). However, time is often not on
the side of the healthcare worker, and while muscle activation in the pulling nurse
can be significantly decreased, making the transfer using devices can take about 7 s
longer (Hegewald et al. 2018). Work pressure is consequently a risk factor and needs
to be prioritized because performing a transfer of a patient using ergonomic inter-
ventions can make a real and positive impact on nurses’ well-being and efficiency
(Al-Qaisi et al. 2020).
Healthcare workers who are also on their feet all day suffer from foot pain, and
this is particularly high among older nurses, having spent many thousands of hours
on their feet in the course of their career. Such pain is exacerbated by being
overweight (Clari et al. 2016). Despite foot pain being a common problem among
workers who spend many hours on their feet, very little has been published about
foot pain until recently. Stolt et al. (2020) developed a Foot Health Promotion
Programme (FHPP) in Finland, which improved knowledge to encourage better
self-care among nurses. The lack of research published on foot pain among
healthcare workers is a serious gap in the literature and should be addressed.
Staff engagement and empowering to problem solve can yield valuable insights
as Richardson et al. (2019) found, when developing occupational health policies
with nurses and physiotherapists. The staffs recommended orthopedic assessments
along with changes to the workplace, as they believed that this could help foster a
culture of safety. Other examples of good practice include the Royal College of
Nursing (UK) “Go Home Healthy Campaign” (2018), which encourages employers
556 D. Roy

to protect their employees and offers advice and useful resources. The initiative also
encourages nurses to take more personal responsibility for adhering to health and
safety regulations. In any preventative strategy, it is crucial that support is available
to prevent injury when moving patients, and the availability and use of aids are
increasingly important according to a review of over 350 studies about the topic,
which revealed that significant physical hazards and risks are associated with
handling patients, as they are becoming increasingly overweight and obese (Choi
and Brings 2015). The recommended solutions include lifting/transfer equipment
and devices, ergonomic assessments and controls, no-lift polices, and training and
education. What could be of additional benefit to staff is more research that uses
rigorous methodology to find the safest way to handle this growing patient popula-
tion. Ergonomic solutions to lower back pain among healthcare workers come in the
form of wearing lumbosacral supports, such as a brace, as they can significantly
reduce the range of motion in the lumbar spine and reduce back and neck pain
(Hagiwara et al. 2017).
Going forward, it is clear that midwives, physical therapists, nurses, radiation
therapists, and surgeons are all healthcare professionals that are at particular risk of
MSDs (Cridland 2017; Hanania et al. 2020; Kasa et al. 2019; King et al. 2013;
Kinman 2019; Okuyucu 2019; VanHoy and Laidlow 2009; Vijendren et al. 2015;
Walker and Maltby 2012), because an intrinsic part of their roles requires them to lift
or hold patients while in awkward positions for long periods of time. Training and
awareness along with lifting equipment and support devices can help prevent injury,
but also managers at all levels of a healthcare organization should be made aware of
the potential risks of MSDs, both psychosocial and physical, and should ensure that
education and awareness training is provided to their staff. This is because they
should acknowledge that they are one of a number of people in the organization who
hold the ring when it comes to protecting staff from MSDs. A particular focus on
younger age groups could increase probabilities that staffs will remain injury free
and enjoy long, healthy careers. Any education programs should also emphasize the
importance of maintaining a healthy lifestyle, given the relationship between obesity
and deterioration of joints, which strengthens with age (Bevan 2015; Felson 1988).

Musculoskeletal Disorder in the World of Construction

Construction workers are a diverse professional group who are frequently exposed to
lifting, operation of heavy, vibrating machinery, and kneeing or squatting in awk-
ward positions for long periods of time. Because of these high occupational MSD
risks, construction workers acquire MSDs faster than other occupational workers
(Punchihewa and Gyi 2009). An analysis of the UK Labour Force Survey data over
the period of 2009–2010 and 2011–2012 illustrated that manual handling, carrying,
and lifting are some of the leading causal factors in the development of WRMSDs,
particularly back pain (Health and Safety Executive 2013a, b; Kivi and Mattila
1991). Construction is a particularly precarious profession, and according to annual
average rates for 2015/2016 to 2019/2020, the rate of fatal injury in GB in
27 Occupational Health Services and Prevention of Work-Related. . . 557

construction was about four times as high as the average rate across all industries
(except agriculture) (HSE 2020a, b, c). Hazards are everywhere, and risk increases,
in part, to tradespeople having to work long hours, and the danger is higher among
those who lack the skills necessary to perform the roles asked of them. This can
invariably lead to additional problem of occupational stress, as construction workers
have been known to report both high levels of stress and muscular skeletal pain
(Chakraborty et al. 2018). A common condition experienced among builders is the
hand–arm vibration syndrome (HAVS) previously referred to as “vibration white
finger.” This disorder is caused by using tools with vibrating hand controls, such as
pneumatic drills, asphalt breakers, sanders, and angle grinders (Gibb et al. 2015).
While principal contractors must provide personal protective equipment and
address any potential hazards by putting safeguards in place, etc. many workers
acquire MSDs and will leave construction work because of injury or ill health. In
addition to having to adhere to extensive health and safety laws, occupational health
and safety managers working in construction also have to withstand the culture of
the construction industry itself, where it is common for workers to lead an almost
nomadic lifestyle, moving around from contract to contract. As a consequence,
despite best efforts, time pressure and short-term contracts may result in workers
failing to partake in all of the necessary training made available to them.
Younger workers are at particular risk in the construction industry. According to
the HSE, the injury rate is three times higher among those who have been in their
current job for less than 6 months compared with those with more experience (HSE
2011). The young apprentice program provides an opportunity to those who seek a
qualification in construction work. This is a timely opportunity for education and
awareness to be instilled among the young, but it could also be equally valuable if
extended to older workers who may have missed out first time around (Nyateka et al.
2012).

Preventing Musculoskeletal Disorders in the Construction

Industry

As with all places of work, adherence to health and safety law and availability of
proper assessment and training are crucial for anyone who contracts for construction
work. Anyone commissioning construction work in GB, for example, must meet the
obligations set down in the HSE (Construction Design and Management Regulations
(CDM) 2015). Good practice is for contractors to demonstrate that they have
satisfactorily assessed their health and safety management. Welfare facilities should
also be provided to workers in GB during any construction work (HSE 2010).
One of the challenges for the construction industry as well as other professions is
an ageing workforce. While the abolishment of the mandatory retirement age in the
UK (Gov UK 2011) provided an opportunity for those who wish to, to extend their
working lives, for those who already suffer from ill health and MSDs, working
longer may not be an option. Because the State Pension Age has been raised to 66–
68 years, many workers in their late 50s or early 60s will now have to continue to
558 D. Roy

work, despite existing MSDs and the risk of further conditions such as RA and
OA. Approximately 28% of workers in the construction industry are 50 years old
and over in the UK. To ensure that workers can age well, advice from those in
supervisory positions should include a reinforcement of the message that working
lives can be extended as long as workers do not succumb to MSDs caused by poor
posture, work pressure, lack of access to awareness training, or hazards such as
inadequate guardrails. General healthy lifestyle advice would also be appropriate
given that the older workers over time are also particularly vulnerable to the risk of
heart disease (Nuñez 2010).
In construction as in other professions, WRMSDs can be reduced or even
prevented, and this can extend working lives. Increasing postural awareness
among masonry workers through education and experience in ergonomic safety
means that they are more likely to remain in the workforce for much longer and
do not leave the trade prematurely (Hess et al. 2020; HSE 2010; Welch 2009). This
evidence gives weight to the argument that early intervention in the form of
ergonomic education and training should be reinforced during apprentice training
in all trades.
What is also being developed by Malaysian engineers are ways to detect risk
using biomechanical assessments and the use of wearable protective equipment,
such as exoskeletons that provide support during twisting and turning movements
(torque assistance) and can reduce muscular activity by 36% during repetitive lower
limb movement (RLLM) (Sado et al. 2019). Furthermore, human factors researchers
in Scotland and the USA have employed wearable sensors to perform postural
ergonomic risk assessments of carpentry tasks such as laying timber floors, a task
that is repetitive, and also for jobs requiring nonstatic postures (Akanmu et al. 2020;
Valero et al. 2016). Ergonomic assessments can also use the rapid upper limb
assessment (RULA) scoring system to assess the extent to which any posture is
creating internal and external stresses on any joint in the body. This can highlight
limits to repetitive movements, which can lead to accumulative microtrauma and
chronic MSDs (Kulkarni and Devalkar 2019; Menychtas et al. 2020). Worker
engagement within the construction industry yields similar benefits to those found
with healthcare workers and has been found to be effective in preventing and
reducing the prevalence of MSDs in a number of industries globally, something
referred to as “participatory ergonomics” (Hignett et al. 2005).
Kurien et al. (2018) are another group of researchers who introduced innovative
approaches to preventing MSDs by taking construction workers off-site and
remotely linking them, and their motions, to a robotic construction worker (RCW).
A number of possible construction scenarios were created and their movements
captured by a 3D body and hand position tracking system. Using similar sensory
equipment, Yan et al. (2017) were also able to show how monitoring the postures of
workers fitting concrete buildings with reinforcing steel in Hong Kong could be
altered, once their trunk inclination angle and holding times began to exceed
acceptable thresholds. Further innovative studies have successfully demonstrated
that using a wearable insole pressure system during construction work can success-
fully identify risk factors for developing WMSDs from awkward working postures
27 Occupational Health Services and Prevention of Work-Related. . . 559

(Antwi-Afari et al. 2018). All in all, early intervention health and safety training will
greatly benefit the construction industry, particularly those workers just starting off.
Engaging workers by allowing them to see when and how their body is reaching
unacceptable thresholds can educate them in ergonomic safety and could be part of
interventions that may extend the working lives of older construction workers (Gibb
et al. 2015). There is no shortage of health and safety regulations to support the
construction industry, but successful adherence will be predicated upon a commit-
ment to occupational health and safety at every level of management and on the
resources an organization is able, and willing, to invest.
Going forward, as mentioned earlier, convincing, innovative scientific research
evidence from Malaysia, France, China, India, and the USA is growing and can
increase both younger and older workers’ understanding about what is safe for them
in terms of heavy lifting and repetitive movements (Akanmu et al. 2020; Kulkarni
and Devalkar 2019; Menychtas et al. 2020; Sado et al. 2015; Valero et al. 2016).
Ergonomic research evidence could be enhanced further if the technology is devel-
oped that can measure the posture of a worker, while that worker is moving and
lifting, to reduce MSDs of the lower back (Greenland et al. 2011).

The Risks of Musculoskeletal Disorders Posed by Sedentary

Professions

Being seated all day and not taking regular breaks can be an occupational hazard in
and of itself. Computer and keyboard work requires repetitive movements, using the
hands and wrists, and people often sit badly in awkward positions. This can lead to
increasing discomfort in the lower back, hips, thigh, and buttock areas, and exposure
to these working conditions can additionally affect our thinking capacity (Baker
et al. 2018).
Other health hazards exist for sedentary workers who remain inactive during the
working day, such as risk of developing diabetes mellitus and osteoarthritis (OA) in
selected joints, with the most commonly affected joints being in the hands and
shoulders (Kaka et al. 2019).
One large investigation in Turkey found that just over half of office workers who
did not regularly exercise were the ones who most frequently complained of pain in
the lower back, neck, and back as a result of not taking breaks, while sitting on a
chair that supported only the lumbar area and the arms. Other features of their work
included having the computer mouse at a distance from the keyboard, having their
head inclined at 45 when working, working holding both forearms above the level
of the desk, and being in a moderate or extremely stressful workplace (Celik et al.
2018). Brazilian researchers found that features of a workstation, specifically the
chair height and arm and back rest, are also associated with poor posture in the upper
limbs and contribute to musculoskeletal pain in computer office workers (Rodrigues
et al. 2017). A cohort study in Denmark discovered an increased risk of carpal tunnel
syndrome (CTS), which creates pain and numbness in the fingers from high levels of
wrist movement (Lund et al. 2019).
560 D. Roy

The musculoskeletal problems associated with sedentary work are, of course, not
exclusive to office workers, as truck drivers, taxi drivers, and bus drivers also spend
many long hours sitting in less than optimum positions and may have little lumbar
support. Pradeepkumar et al. (2020) reported that just over half of their study
population of Indian bus drivers experienced WRMSDs. Many incidences of
MSDs could be reduced, however, by training and education in vehicle ergonomics
(proper posture, making seat adjustments, and in-vehicle control adjustments). As a
result of their findings, Pradeepkumar et al. (2020) raised concerns that rates of
MSDs among middle-aged drivers would continue to increase without ergonomic
education and health promotion advice to encourage a reduction in tobacco/alcohol
use, healthier eating, and uptake of physical exercise for a couple of hours per week.
Because of the lack of research conducted in this area, Hoe et al. (2018)
performed a Cochrane review to assess the extent to which physical, cognitive,
and organizational ergonomic interventions, or combinations of those interventions,
could be utilized to prevent MSDs among office workers. They found inconsistent
evidence about whether or not physical ergonomic interventions had positive effects
or if an arm support or an alternative mouse could reduce the incidence of neck or
shoulder MSDs. The use of supplementary breaks also yielded low-quality evidence
of an effect on upper limb discomfort. One conclusion drawn from this research is
that further high-quality studies are needed to determine the effectiveness of these
ergonomic interventions among office workers (Baker et al. 2018; Hoe et al. 2018).
A further evaluation of evidence following a systematic review by researchers in
Thailand supported the effectiveness of breaks on reducing low back pain, discomfort,
and work productivity in office workers, but highlighted that quality evidence is
limited about any effective ergonomic interventions that could reduce MSDs among
sedentary professions (Waongenngarm et al. 2018). Nevertheless, the researchers were
able to report that taking breaks had no detrimental effect on work productivity and
active breaks with postural change may be effective in reducing lower back pain in
workers and can prevent discomfort in healthy subjects (Waongenngarm et al. 2018).

The Benefits of Getting Up and Taking a Break from Your Desk

A recent meta-analysis using data collected from one million participants established
that if people took 1 h of moderate exercise each day, it could eliminate any
increased risk of death related to sitting 8 h per day (Ekelund et al. 2016). It is
apparent that there is a paucity of intervention research when it comes to measuring
any harmful impacts on our bodies from prolonged sitting and keyboard use for
office work. However, research is continuing to evolve, and it has been shown that
there is value in the regular monitoring of work environment activity to measure time
spent sitting and number of sedentary breaks taken. Simply by taking the time to
perform these monitoring tasks can reduce sedentary behavior, increase standing
time, and reduce lower back pain (Ekelund et al. 2016; Foley et al. 2016).
Evidence is also available that if office workers with neck, shoulder, and lower
back pain took regular exercise, they reported significantly lower pain scores for
their neck, right shoulder, left shoulder, and lower back, compared to those who did
27 Occupational Health Services and Prevention of Work-Related. . . 561

not take exercise (Shariat et al. 2018). This suggests that interventions to reduce
MSDs among those in sedentary jobs should not solely rely on ergonomic modifi-
cations, rather occupational health therapists should also incorporate exercise in their
treatment programs (Shariat et al. 2018). From the literature available, it is clear that
taking breaks and regular exercise can be beneficial to anyone working in a role
which requires sitting for prolonged periods, whether it be driving a lorry or
operating a computer (Ekelund et al. 2016; Foley et al. 2016; Waongenngarm
et al. 2018). This could help mitigate the risk of developing MSDs in the upper
body and also improve their cardiovascular health. For those responsible for health
and safety in office environments, relevant guidance for those working with visual
display units (VDUs) can be found on the HSE website (HSE 2013a, b).
It would appear that there is plenty of scope to develop the body of research
addressing MSDs and sedentary work and develop ergonomic education programs.
Promising research comes from a study in Switzerland of the ergonomic properties of
office chairs and different sitting positions taken, to determine how pressure is
distributed on the seat pan and the backrest. What makes this research important is
that the seat has to bear our total body weight and the length, width, height, or contours
of our seat can therefore make a significant difference in our levels of comfort (Zemp
et al. 2016). The seat pan is particularly important, but in order to conduct comparison
research with different chairs, chair-specific sensor mat calibration is needed. This will
make assessing pressure distribution of different office chairs possible. It is crucial that
chair-specific sensor mat calibration is used when assessing motion using electromy-
ography magnet resonance imaging (Zemp et al. 2016). We still have much to learn
about the optimal office chair properties (surface, cushion properties, geometry, etc.) to
track motion, measure subjective comfort/discomfort ratings, etc., and therefore a
chair-specific calibration is essential for research particularly with regard to the seat
pan. Furthermore, any evaluation of the different seat pan and backrest pressure
parameters will support researchers as they design appropriate pressure distribution
limitations for future studies (Zemp et al. 2016).
Going forward, the overall conclusion from giving consideration to available
research on MSDs and sedentary professions is that evidence posits that the effects
of a sedentary lifestyle and desk-based jobs can certainly be partially mitigated by a
small amount of activity every day (Ekelund et al. 2016; Foley et al. 2016; Zemp
et al. 2016) along with ergonomic chairs suited to specific needs (Office for National
Statistics 2019). Some of the quality of research undertaken may hamper the
development of organizational interventions to reduce the incidence of neck or
shoulder MSDs in office environments, and more studies, using robust research
methods, could help determine the effectiveness of any potential interventions to
prevent MSDs among office workers.

Psychological and Social Factors and MSDs

A lack of integrated MSD risk management procedures has been identified as a

barrier to more effective workplace practices, and despite evidence existing that
work-related psychosocial hazards are harmful and can interact with MSD risks,
562 D. Roy

according to Australian researchers, this evidence often does not find its way into
current health and safety risk management activities (Macdonald and Oakman
2015). And yet, preexisting conditions and being in constant pain from osteoarthritis
can lead to depression and anxiety, which can intensify the pain (Macdonald and
Oakman 2015). The extent to which working environments are contributing to stress
can be assessed using a number of assessment tools readily available, which can help
to identify mental health issues and situational factors. Such tools include question-
naires such as the Karasek’s Job Content Questionnaire (Karasek 1979, 1985) and
the model of effort-reward imbalance (Siegrist et al. 2004).
On a number of occasions during this chapter, reference has been made to how
stress and lack of breaks from workstations and other work-related psychosocial
hazards, such as low autonomy, can have additive or even interactive effect on MSDs
(Carter et al. 2013; Celik et al. 2018; Chakraborty et al. 2018; Nowotny-Czupryna
et al. 2012; Nyateka et al. 2012; Zhang et al. 2020; HSE 2020a, b, c). And yet the
impact of psychosocial factors is not widely considered (stress, lack of job satisfac-
tion, depression, lack of autonomy, poor work–life balances, etc.) because their
relationship to MSDs is less understood by those responsible for workplace MSD
risk management (Macdonald and Oakman 2015). Physical risks or hazards remain
the chief concern for many managers, especially in physically demanding jobs such
as construction. In addition, this could be an autocratic organizational culture where
staff consultation and engagement may rarely, if ever, take place, and yet it can yield
benefits as it can improve staff attitudes towards managing risks and empower them
to be active players in developing preventative strategies (Hignett et al. 2005;
Sharafkhani 2015; Stolt et al. 2020). It is often the case that attitudes of the staffs
themselves require an intervention, if we take presenteeism among healthcare
workers as one example (Kinman 2019), and also older workers may be reluctant
to admit to experiencing musculoskeletal pain for fear of being stigmatized.
While there is much variation within and between age groups when it comes to
physical strength and how well we physically age, factors that pertain to ageing are
relevant to all the professional groups discussed thus far. Contrary to the beliefs of
many, the dominant finding in the research literature is that healthy older people with
current skills perform as well at work as their younger counterparts, and those over
60 are in fact often better equipped to deal with stressful working environments and
pose no greater safety risks. This comes largely to the protective personal properties
of expertise, experience, and education (BMA 2016). That being said, there are some
inevitabilities when it comes to ageing as the research shows that rates of MSDs are
highest among men and women over 55 years old, and in certain professions as
health and social care, MSD conditions are more painful in older workers (Clari et al.
2016; King et al. 2013).

What Does the Effective Risk Management of MSDs Look Like?

Age positive policies should be part and parcel of any good health and safety risk
management plans and should include assessments specific to particular job roles;
age should be taken into account and any other potential vulnerabilities, to ensure
27 Occupational Health Services and Prevention of Work-Related. . . 563

that the work environment and job performance can be carried out safely (Bohle
et al. 2010; Ilmarinen 2012; Kiss et al. 2008; Nicholson et al. 2016; Oakman et al.
2016). A holistic approach to assessing and managing treatment for musculoskeletal
conditions is necessary, requiring the input of multidisciplinary health professionals,
including general practitioners, dieticians, physical therapists, and fitness specialists.
Good occupational health and work safety practices should be underpinned by
commitment from those in the highest levels of management in any organization.
One principal change in any organizational culture that could engender a prevention
culture could be to expel the notion that one person, working in a remote part of the
building, has the sole responsibility for health and safety. Canadian research has
shown that occurrence of WRMSDs is higher when supervisors are not open to their
staffs speaking up when they are concerned about occupational hazards (Tucker and
Turner 2014). What makes sense then is for people supervising or having responsi-
bility for a group of employees to be suitably supported and qualified and made
aware of both physical and psychosocial risks that may exist in their workplace, and
importantly understand age-specific risk factors. There is value in empowering
workers to be active participants in any initiatives that identify and offer solutions
to physical and psychosocial risks (Richardson et al. 2019; Stolt et al. 2020).
Training is crucial in both awareness of risk and education that engenders positive
attitudes to reporting early indications of MSDs, thus allowing early preventative
measures to be implemented (Lunt et al. 2007).
Occupational health has an important health promotion role; it is not simply a
matter of assessing and managing MSDs, and this chapter has provided evidence that
the risk of MSDs can be reduced among all age groups, through regular exercise,
tackling obesity, eating more healthily, and giving up unhealthy behaviors such as
smoking and maintaining good psychological health (Bevan 2015; Eklund et al.
2016; Felson et al. 1988; Ilmarinen 2012; Pradeepkumar et al. 2020). But again, it
should not fall to one person to carry the responsibility for workers in any
organization.
Given that older people who suffer from MSDs and arthritis are less active, and
therefore may be more prone to functional decline and increased mortality, older
workers in particular should be encouraged to engage in regular physical exercise
such as walking or dancing. The benefits are clear as exercise has been shown to
improve skeletal muscle performance in healthy 60-year-olds and above (Beaudart
et al. 2017; Ilmarinen 2012; Lundberg and Nader 2008). Added to this, diets high in
fruits and vegetables can improve muscle mass in older adults (Dawson-Hughes
et al. 2008).
A push for further investment in ergonomic research, particularly in relation to
sedentary professions, will further support a preventative approach to tackling MSDs
in the workplace. Given the high risk of MSDs in the health and social care and the
construction industry, advances in technology are welcomed that can more accu-
rately pinpoint where and how muscular skeletal diseases progress and inform
tailored, holistic interventions across all professions at particular risk of MSDs
(Antwi-Afari et al. 2018; Kurien et al. 2018; Lewis et al. 2019; Stolt et al. 2020).
Given the economic cost of a high prevalence of MSDs, it is not only important to
prevent MSDs to help the economy, but it will also give older people the opportunity
564 D. Roy

to enjoy longer working lives, and thus financial as well as physical and psycholog-
ical health benefits (Bevan 2015; Cooper et al. 2010; Lunt et al. 2007; Vos et al.
2008).

Getting People with Injuries Back to Work

At the beginning of this chapter, it was revealed that in GB during 2018–2019,

almost seven million working days were lost due to work-related musculoskeletal
disorders (LFS 2018/2019). Support for workers to return to their jobs can reduce the
financial burden on the economy and minimize sickness absence (Kiss et al. 2008;
Vargas-Prada et al. 2016). One example of an initiative, which can support workers
to return to work faster, is a first-contact practitioner model of care called the
Musculoskeletal (MSK) Core Capabilities Framework, created to guide employers
on the development of MSD support services (Health Education England and NHS
England 2018). This provides training guidelines on good practice for multi-
professional teams working in many settings, including early diagnosis. This is a
valuable resource, given that a systematic review conducted by Australian
researchers revealed that early intervention in the first 2 weeks of sickness absence
with injured workers can reduce lost workdays (Nicholas et al. 2019).

Conclusion

Musculoskeletal problems are one of the four most common reasons for people
taking sick leave in the UK (Office for National Statistics 2018), and a large study in
Finland revealed that the rates were higher among those of lower occupational class
(Pekkala et al. 2018). And yet many musculoskeletal problems and disorders can be
reduced and even prevented through a number of practices, which should be
promoted and supported by organizational leaders. Managers should foster a health
and safety culture, thereby ensuring that occupational health responsibilities are a
core component of the job roles of supervisors at every level of an organization. As
reported earlier, psychosocial hazards such as low autonomy, mental health prob-
lems, and low organizational support should be considered along with physical risks,
and workers themselves need to take personal responsibility for acquiring knowl-
edge and calling it out when they are concerned about their working conditions. By
being more proactive, they will be able to enjoy the benefits a more healthy working
practice could bring to their personal lives. Other important elements are having a
robust monitoring and reporting system in place and encouraging staffs to be
actively engaged in initiatives that find solutions to inform good health and safety
policies. According to the World Health Organization, MSDs pose a real risk to
healthy ageing right across the world (Briggs et al. 2016). Our behaviors and
attitudes in the workplace will consequently have an important bearing on the extent
to which we become older but healthy adults, absent of musculoskeletal pain or
27 Occupational Health Services and Prevention of Work-Related. . . 565

disorders. Ensuring that the right people take the right attitude towards occupational
health and safety, in all work environments, will certainly be a good start.

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Common Mental Health Problems
28
Abasiama Etuknwa and Mariya Mathai

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574
Common Mental Health Problems (CMPs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576
Symptoms Associated with Common Mental Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576
Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576
Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 577
Stress and Related Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 578
Work and Common Mental Problems (CMPs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 578
Impact of Common Mental Health Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 579
Management of CMPs in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 581
Overview of Successful Management of CMPs in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . 582
Overview of Workplace Management of CMP Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 586
Summary of Up-to-Date Findings on Workplace Management of CMPs . . . . . . . . . . . . . . . . . . . . . 589
Gaps in Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 590
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 590
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591

Abstract
Common mental health problems (CMPs) have been recognized as one of the
most common causes of sickness absence in developed countries. Despite the
effectiveness of interventions or workplace strategies for people sick-listed with
CMP, the incidence of work disability due to CMP, days lost to work as a result,
and the cost to the economy have shown little or no significant decrease over the
years. At the same time, some studies suggest that preventive workplace-based
interventions are effective in reducing the prevalence of CMPs. Other studies

A. Etuknwa (*)
Allied Professions, Sport and Exercise, University of Huddersfield, Huddersfield, UK
e-mail: [email protected]
M. Mathai
Norwich Business School, Norwich Research Park, University of East Anglia, Norwich, UK

© Springer Nature Switzerland AG 2022 573

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_24
574 A. Etuknwa and M. Mathai

imply that the failure to take account of the personal and social factors of sick-
listed employees when managing or implementing workplace strategies may be
contributing to the insignificant reductions in CMPs. However, a summary of up-
to-date reviews identifies two main findings for effective workplace management
of CMPs:

1. Proactive interventions taking account of employee’s personal and social

factors are likely to impact health outcomes or work functionality for people
sick-listed with CMPs leading to return to work after a period of absence.
2. Employment outcomes such as job retention for these sick-listed individuals
hinge on organizational factors. Hence, one’s ability to remain at work despite
ill health due to CMPs is contingent on management practices within the
workplace. This book chapter, therefore, aims to highlight the main types
and causes of CMPs and their broader impacts. It also aims to identify best
CMP management strategies in the workplace to date based on intervention
studies and guidelines and other areas for future research that might be useful
in reducing sickness absence rates due to CMPs.

Keywords
Common mental disorders · Mental health · Occupational health · Management ·
Employment practices · Sickness absence · Return to work · Workplace
interventions · Best-practices

Introduction

Work disability caused by common mental health problems (CMPs) has shown a
significant increase over the years and is now recognized as the leading cause of
sickness absence and long-term disability in developed countries (Corbière et al.
2019; Harvey et al. 2017). The prevalence of CMPs has become a major research
focus, especially as the economic cost of sickness absence is yearly growing (Hill
2015). In 2015/2016, work-related stress, depression, and anxiety accounted for a
total of 488,000 reported new cases in the United Kingdom, a prevalence rate of
1510 per 100,000 workers with 11.7 million working days lost (Health and Safety
Executive (HSE) 2016). Consequently 2018/2019 accounted for 602,000 reported
new or long-standing cases with 12.8 million working days lost (Health and Safety
Executive 2019) which is evidential of the significant increase in mental health
issues in the country (see Fig. 1). Thus, there is a burden on employers and
government to have a better understanding of the complexities of CMPs and how
to effectively manage it to, in turn, impact on the growing sickness absence rate.
Ensuring the health, safety, and well-being of employees in most developing and
developed countries is the responsibility of the employer (Akomah et al. 2010; Chu
and Dwyer 2002; E.U. 1989). Hence, requiring employers to implement effective
workplace strategies to support employees sick-listed with CMPs is not misplaced.
28 Common Mental Health Problems 575

Fig. 1 Work-related stress, depression or anxiety per 100,000 workers: new and long standing
(Health and Safety Executive 2019)

A wide range of practical strategies and interventions have been researched to

address the burden of CMPs. However, the need for more proactive strategies instead
of reactive strategies is required: proactive interventions, taking account of personal
and organizational factors (Thisted et al. 2017). While the effectiveness of a varied
number of these interventions on addressing CMPs has been ascertained (Lammerts
et al. 2016; Nigatu et al. 2016), the insignificant decline in reported cases of CMPs,
both new and long-standing cases, may suggest the need for more sustainable-
focused approaches. However, it is still unclear what specific areas need to be
addressed to effectively manage CMPs in the workplace. It is possible that while
treatment approaches may be useful in helping sick-listed workers attain some level
of recovery and work functionality, attaining a level of recovery that facilitates job
retention is dependent on workplace management practices. This assumption is as a
result of evidence showing that more sick-listed workers are likely to remain at work
despite ill health (presenteeism) due to factors relating to the burden of their financial
responsibilities (Kinman 2019; Lammerts et al. 2016). Therefore, the issue of
presenteeism magnifies the responsibility of employers in providing adequate work-
place measures to prevent a relapse. Hence, this chapter’s goal in examining the
varied types of workplace interventions and best practices available to sick-listed
workers will aid in identifying critical components that are useful for effective
management and prevention of CMPs. However, according to Cancelliere et al.
(2016) and Alavi and Oxley (2013), achieving more lasting outcomes for people
sick-listed with CMPs may not be solely dependent on just the effectiveness of an
intervention but may be a consequent of an interplay of many factors. Hence this
chapter’s goal is to also examine studies that take account of the effects of a wide
range of factors on CMPs’ outcome.
This chapter begins with a brief description of the most commonly reported
mental health problems and their symptoms in developed countries. Although
some of these mental health problems are physically recognizable in patterns of
behaviors or social relationships, others are hidden and unrecognizable and just as
serious (Street 2005). In this chapter, we also pay specific attention to work-related
CMPs and their impacts, as well as an overview of relevant evidence-based
approaches and guidelines to manage CMPs in the workplace effectively.
576 A. Etuknwa and M. Mathai

Common Mental Health Problems (CMPs)

In most developed countries, common mental health problems (CMPs) are now the
leading cause of sickness absence and long-term incapacity (Harvey et al. 2017).
According to Seymour (2010), CMPs are widespread in the general population and a
predominant health problem of working-age adults. The most commonly reported
forms in the workforce which are usually treatable and preventable in some cases
include depression, anxiety, and other stress-related conditions (Harvey et al. 2017;
Joyce et al. 2016; Pomaki et al. 2012; Seymour 2010). According to the World
Health Organization (2004), depression was ranked as the leading cause of disability,
and its incidence was not gender specific. However, in recent times, a review
conducted by Seymour (2010) in Great Britain indicates that the incidence of both
depression and anxiety is higher among women and in people aged 45–54 years,
with a notable upward trend in their rates over the last decade. While arguments on
the gender specificity of the incidence of these mental health issues may not be fully
confirmed, its impact is evident. However, the widespread incidence of CMPs in the
workforce warrants the need for effective workplace strategies to successfully
manage and support sick-listed individuals return to work and remain at work.

Symptoms Associated with Common Mental Problems

People with common mental health problems have significant challenges with their
thinking, mood, or behaviors; however, symptoms vary across different diagnoses
(Melrose 2018). The association of mental health problems with experiencing brief
stress and sadness is misplaced, especially as mental problems cause significant
distress and impair function, making it difficult for sick-listed individuals to cope
with the demands of everyday life, whereas normal stress and sadness do not
(Melrose 2018). As such, while people who are stressed or sad can still manage to
go about their daily living and work obligations, people with more serious mental
health problems are unable to manage daily activities effectively. According to
findings presented in a 2008 review commissioned by the Health Work and
Wellbeing Programme, symptoms associated with mental health problems (e.g.,
sleep problems, fatigue, irritability, and worry) affect one-sixth of the working-age
population of Great Britain at any time which can impair an individual’s work
functioning (Lelliott et al. 2008). However, more symptoms are associated with
specific forms of mental problems, and understanding how and under what circum-
stances these symptoms manifest might be useful to workplace leaders in the timely
and effective management of cases.

Depression

Depression is a mood disorder where people feel sad even when things are going
well (Melrose 2018). According to the NHS (2019), there are different types of
28 Common Mental Health Problems 577

depression and the symptoms can be complex, widely vary across people, persist for
weeks or months, and are bad enough to interfere with work, social, and family life.
Symptoms of depression can be grouped in three main categories: psychological,
physical, and social (NHS 2019).
Psychological symptoms of depression could include continuous low mood,
feeling hopeless and helpless, low self-esteem, feeling tearful, feeling guilt-ridden,
feeling irritable and intolerant of others, having no interest in things, difficulty in
making decisions, feeling worried, having harmful thoughts, etc.
Physical symptoms of depression could include moving or speaking more slowly
than usual, changes in appetite or weight loss, constipation, unexplained aches and
pains, lack of energy, disturbed sleep, etc.
Social symptoms of depression could include avoiding contact with friends and
taking part in fewer social activities, neglecting hobbies and interests, having
difficulties in the home, work, or family life, etc.
It is important to note that these symptoms are not exhaustive of the full range of
symptoms. Additionally, the onset of depression in some cases is gradual and can be
difficult to detect (Becker et al. 1985).

Anxiety

According to Melrose (2018), anxiety disorders are marked by pathological or

extreme anxiety or dread. Anxiety often manifests itself in situations when people
are worried, tense, or afraid, particularly about things that are about to happen or will
happen in the future (Mind for Better Mental Health 2017). Some authors argue that
people with intellectual disabilities are more likely to struggle with anxiety due to
slightly different brain structures, limited expressive language abilities, and diffi-
culty understanding social situations perceived as unpredictable and scary (Cooray
and Bakala 2005). However, there is limited research in supporting this assertion.
Experience of anxiety feels different for everyone and varies based on the level of
threat perceived (Mind for Better Mental Health 2017; Huddy et al. 2005); it could
be a thought, feeling, or a physical sensation. Some of these symptoms include the
following:

1. Physical symptoms: a churning feeling in the stomach, feeling dizzy, pins and
needles, restlessness, aches and pains, faster breathing, irregular heartbeat, sweat-
ing or hot flushes, teeth grinding, nausea, panic attacks, difficulty swallowing,
trembling, etc. (Melrose 2018; Mind for Better Mental Health 2017).
2. Behavioural symptoms: increased agitation, crying, repeating comments about
feeling afraid, withdrawing, regressing toward more childlike behavior, clinging,
and freezing (Melrose 2018).
3. Psychological symptoms: feeling tense, nervousness or inability to relax, having
a sense of dread, feeling like the world is speeding up or slowing down, feeling
unable to stop worrying or that bad things will happen if one stopped worrying,
worrying about anxiety itself, wanting lots of reassurance from people or
578 A. Etuknwa and M. Mathai

worrying that people are upset or angry with one, worrying about losing touch
with reality, rumination, depersonalization, derealization, and worrying a lot
about things that might happen in the future (Melrose 2018; NICE 2011).

Stress and Related Disorders

Stress is the body’s reaction to feeling threatened or under pressure (NHS 2020).
However, experiences of stress can either be acute (brief), episodic acute (frequent
due to daily exposure to pressure), or chronic (long term) (Freshwater 2018). Feeling
under pressure is something everyone feels at some point as a result of exposure to
different stressful situations at work or home. Colligan and Higgins (2006) defined
stress in the workplace as the change in one’s mental or physical state in response to
workplaces that pose an appraised challenge or threat to employees. Based on this
definition, experiences of stress in the workplace are of an acute episodic category;
however, where it is not properly treated and managed, it could progress into chronic
stress.
Other forms of stress-related disorders include posttraumatic stress disorder
(PTSD). PTSD is a disorder in which an overwhelming traumatic event is
reexperienced (Melrose 2018). According to Zatzick et al. (1997), it is not uncom-
mon for people with PTSD to lose their jobs either because of reexperiencing
symptoms or as a result of their inability to cope with reminders of the traumatic
event they encounter while at work.
Symptoms also vary according to the different types of stress disorders.
Symptoms associated with stress include feeling overwhelmed, having racing
thoughts or difficulty concentrating, being irritable, feeling constantly worried,
anxious or scared, feeling a lack of self-confidence, having trouble sleeping or
feeling tired all the time, avoiding things or people that are problems, eating more
or less than usual, drinking or smoking more than usual, etc. (NHS 2020).
Symptoms associated with PTSD include fear, helplessness, avoidance of stimuli
associated with the trauma, nightmares, insomnia, flashbacks, mistrust, intense
psychological distress, and self-medication with abuse of a substance (Melrose
2018).

Work and Common Mental Problems (CMPs)

While the most commonly reported cases of CMPs are related to issues at work, the
same pressure and demands experienced at work can also be experienced outside
work, thus significantly reducing the ability of individuals to work (HSENI 2019).
According to Shift (2007), non-work-related mental health problems are often a
reaction to difficult life events or experiences. Hence, while proper management
strategies may be in place at work for CMPs, it may be counterproductive as these
non-work experiences or events are ongoing and uncontrollable by the workplace.
On the contrary, work-related issues causing or aggravating CMPs are controllable
and more likely to be effectively managed.
28 Common Mental Health Problems 579

Fig. 2 Causes of work-related common mental problems in Great Britain (Health and Safety
Executive 2019)

According to Health and Safety Executive’s (2019) recent report, work-related

CMPs are often caused by issues relating to workload, lack of support, violence,
threats or bullying, organizational changes and other factors (see Fig. 2), aligning
with previous suggestions from some researchers on long work hours, work over-
load, lack of control over work, lack of participation in decision-making, poor social
support, and unclear management and work role with some correlation with poor
management being notable work factors associated with CMPs (Seymour 2010).
How work impacts negatively on an individual, therefore, appears to be multiface-
ted. According to Sanderson and Andrews (2006), the changing nature of work itself
increases the risk of mental issues. For example, studies have shown that working a
seasonal, casual, fixed-term, temporary, or subsidized job with no benefits is asso-
ciated with significantly worse mental health (Etuknwa et al. 2019; Sanderson and
Andrews 2006). Hence, when components of the job impacting negatively on health
are adequately assessed and adjusted for sick-listed employees, taking account of
their symptoms, the risk to health may be substantially reduced.

Impact of Common Mental Health Problems

The impact of CMPs in the workplace has serious consequences not only for the
sick-listed individuals but also for the productivity of the organization (World Health
Organisation (WHO) 2000).
580 A. Etuknwa and M. Mathai

According to Dietrich et al. (2012), impacts of CMPs on sick-listed individuals

are both personal and economic. As cited by Dietrich et al. (2012), part of the closing
remark of UN Secretary-General Ban Ki-moon stressed the paramount importance
of one’s ability to contribute to society. Hence, the mental status of employees
determines their performance at work, the rate of sickness occurrence, absenteeism,
and staff turnover (World Health Organisation (WHO) 2000). In the event that these
employees are absent from work for an extended period, it increases the likelihood of
long-term disability, which impacts negatively on their income (Henderson et al.
2005). Consequently, research over the years has consistently shown that individuals
with mental health issues are subject to stigma – unfair and unfavorable treatment of
people due to their mental health conditions (Sharac et al. 2010). According to
Sharac et al. (2010), unfair treatment of individuals sick-listed with mental health
issues exists in a variety of settings to include housing, employment, and healthcare,
which is likely to influence access to essential services and aggravate already
existing conditions. The link between being diagnosed with CMPs and difficulty
in gaining employment has been researched for many years, and findings show that
while employers often express the willingness to recruit people with CMPs (Herzig
and Thole 1998; Bieliauskas and Wolfe 1960; Landy and Griffith 1958), only a few
employers follow through in actuality (Manning and White 1995). This position may
explain why employees are often not willing to disclose their mental health history to
employers to increase their chances of securing a job, on one hand, which in turn
increases the prevalence of CMPs among the working-age population (Roberts and
Macan 2006). This implication is supported by findings from Sharac et al.’s (2010)
study, which showed that disclosure of mental health history has a detrimental
impact on success in gaining employment. Conversely, there is evidence also
showing that people who have gained employment are afraid of disclosing their
mental health problems to their employers due to the perceived risk of jeopardizing
their career (Mind 2011). These reservations by employees are not misplaced as
evidence shows that compared to people sick-listed with physical conditions,
employees sick-listed with CMPs or are returning to work after a period of absence
due to CMPs are more likely to be closely monitored, demoted, or questioned more
severely (Baldwin and Marcus 2006). Hence, these worker’s fear that their compe-
tence would be called to question if employers were privy to their mental health
status.
In the United Kingdom, the mental healthcare sector has in recent times been
under tremendous financial pressures which have led to large-scale cost reduction
programs shown to impact negatively on the quality of care provided for patients
(Jacobs 2017). Nevertheless, a considerable dearth of evidence suggests that regard-
less of these financial pressures, people sick-listed with CMPs are less likely to seek
help or would minimize their contact with care services in an attempt to avoid being
labelled as “mentally ill” (Corrigan 2004). Therefore, as long as societal pressures as
a result of poor perceptions of mental health issue persist, reducing the prevalence of
CMPs and cost incurred as a result may prove challenging.
CMPs are associated with large direct costs not only for individuals but also for
society and the economy (Mental Health Foundation 2016). Studies that have
28 Common Mental Health Problems 581

compared the expenses associated with varying chronic conditions have shown that
CMPs are among the costliest to employers (Wang et al. 2008). According to
Langlieb and Kahn (2005), employers are a fundamental component of the
healthcare system and are also increasingly contributing to policymaking decisions
through the provision of relevant information and healthcare services or benefits to
employees and their families in some cases. In 2011, it was estimated that it cost UK
employers approximately £2.4 billion per year to replace staff lost due to CMPs
(Mental Health Foundation 2015). However, this estimated cost increased to £5.4
billion in 2015, suggesting an insignificant reduction in the prevalence of CMPs
despite evidence showing the effectiveness of some clinical interventions (Mental
Health Foundation 2016). Consequently, based on a 2007 report published by The
King’s Fund, mental health-related social and informal care costs in England were
estimated at £22.5 billion a year; however, costs were projected to increase to £32.6
billion by 2030 (McCorne et al. 2008). With the economic costs of this scale, it is
vital to understand more effective means to manage and prevent CMPs, and the
burden of this responsibility rests on employers.

Management of CMPs in the Workplace

Whether mental health issues are caused by or aggravated by work, employers have
a legal duty of care to manage and prevent ill health in the workplace effectively
(Health and Safety Executive 2017). Considering the mental healthcare sector in the
United Kingdom in recent times has been under tremendous financial pressures
(Jacobs 2017), for some employees, workplace interventions or management strat-
egies may be the only form of treatment or rehabilitation they receive for ill health,
hence a need to evaluate the quality and adequacy of these workplace CMP
management strategies for lasting outcomes. According to Seymour (2010), a
practical approach to the management of ill health such as CMPs in the workplace
is likely to avert the related problems and costs often associated with absenteeism,
presenteeism, or staff turnover.
While there is a strong evidence base on the efficacy and effectiveness of clinical
interventions such as cognitive behavioral therapy (CBT) in treating CMPs (Hof-
mann et al. 2012; Warmerdam et al. 2010), returning to work after these treatments
could either make or break the recovery process for sick-listed individuals, espe-
cially in working environments devoid of effective management strategies. Con-
versely, studies also show that due to personal or circumstantial factors, sick-listed
workers are more likely to remain at work despite ill health, contributing to the high
rate of presenteeism at the workplace, which contributes the risk of work to ill health
in environments with poor CMP management structures (Kinman 2019). This
increasing prevalence of presenteeism in the workplace questions the quality and
effectiveness of up-to-date interventions or management strategies provided at the
workplace to manage CMPs.
In a bid to control business cost, many employers appear to be more focused on
the cost of illness and related expenditures of disability and lost productivity time
582 A. Etuknwa and M. Mathai

(Langlieb and Kahn 2005). Hence, it is possible that by so doing, the quality and
effectiveness of management strategies may be compromised to save cost. However,
as long key factors are not taken into account during the implementation of these
interventions, sustainable outcomes are not likely to be attained, and neither will cost
of ill health reduce (Alavi and Oxley 2013). Therefore, understanding how CMPs
can be effectively managed in the workplace is crucial.
Some systematic reviews carried out to evaluate the quality, content, and effec-
tiveness of intervention strategies and guidelines (Cullen et al. 2018; Joyce et al.
2016; Pomaki et al. 2012; Seymour 2010) will hence be examined to ascertain the
most effective workplace practices in managing CMPs.

Overview of Successful Management of CMPs in the Workplace

Tsutsumi et al. (2009)

Although evidence on the effects of a workplace participatory intervention on out-
comes, promoting good mental health and organizational productivity, appeared to
be promising, its effectiveness in a real workplace setting had not been investigated
in a randomized control trial (RCT). Hence, Tsutsumi et al. (2009) conducted this
RCT to explore the proposed effects of workplace participatory interventions on
outcomes among blue-collar workers. The team-based, problem-solving interven-
tion was based on active employee involvement, shared work-related goals, and
action planning to improve working environments to reduce risk to mental health.
The intervention was process-oriented and focused on identifying and resolving
problems in existing practice and improving the environment and job redesign rather
than a behavioral change in symptoms of ill health. Findings showed that to initiate
and facilitate the intervention strategies successfully, key persons (leaders in charge
of implementing participatory intervention) were adequately trained. Workers who
participated in this intervention were able to improve their working environment by
hazard identification, risk evaluation, group discussions on workplace improve-
ments, and actual planning to realize set goals. The results indicated that workplace
participatory intervention was effective in preventing deterioration of mental health
which in turn impacted positively on productivity.

Seymour (2010)
Seymour conducted a review of the literature between 1980 and 2008 for effective
management of CMPs in the working-age population with outcomes being retention
at work and return to work after sick leave. While evidence suggests the effective-
ness of psychological therapies such as cognitive behavioural methods that focus on
reducing symptoms in the treatment of anxiety and depression, on their own, they do
not improve employment outcomes such as retention at work or a return to work
after a period of absence. Hence effective management of CMPs within the work-
place is facilitated by organizational factors in the form of provision of adequate
adjustments and flexible working options. Additionally, the significance of the line
28 Common Mental Health Problems 583

manager’s role in effectively managing CMPS and the need for relevant training to
enable them to do this was particularly identified as a key finding of the review. As a
follow-up from this finding, a pilot program was conducted in Australia aiming to
build the knowledge, confidence, and skills of managers in supporting people with
CMPs at work. At the end of the program, impact assessment showed that manager’s
knowledge about CMPs and proper management rose significantly, and their atti-
tudes toward sick-listed individuals changed positively; and their confidence to
provide support and take actions for these groups of employees improved. Findings
consistent with included studies in these reviews showed that for people remaining at
work or successfully returning to work after a period of absence due to CMPs is not a
function of being entirely free of symptoms, hence the need for less emphasis to be
placed on employees being symptom-free before returning to work.

Pomaki et al. (2012)

Pomaki et al.’s (2012) review of literature from 2007 to 2009 was aimed at
summarizing the evidence on workplace-based prevention of CMPs with primary
outcomes being work disability outcomes (retention at work, sickness absence, and
return to work), quality of life, and economic costs. While findings showed that
facilitation of treatment and psychological interventions, primarily cognitive behav-
ioral therapy, improved work functioning, quality of life, and economic outcomes,
interventions had no effects on work disability outcomes. Work disability outcomes
were found to be facilitated by a workplace disability management system. This
intervention involved mailing information packages on available modified working
options and benefits to people sick-listed with CMPs. Findings also showed that
workplaces working in collaboration with healthcare services reported greater effec-
tiveness in improving all of the outcomes. Pomaki et al.’s (2012) review, therefore,
draws on two main conclusions: (1) workplace-based interventions show promise
for preventing work-related CMPs, and (2) non-workplace-based interventions such
as clinical-based treatments divorced from the workplace do not typically result in
improvements in work functioning and return to work outcomes.

Dietrich et al. (2012)

Dietrich et al. (2012) conducted a systematic review of the literature published from
2001 to 2009 on preventive strategies for individuals with depression. Their study
found that workplace intervention strategies, explicitly targeting depression, were
still yet to be fully developed. Only one prevention intervention targeting depression
in the workplace was identified in the literature search. Evaluation of the program
showed that providing a diagnosis of depression along with psychoeducation sig-
nificantly improved symptom severity and remission rates. However, younger per-
sons (below 40 years), particularly women, did not benefit from the program
considering the prevalence of depression is more commonly reported among
women compared to men. Hence, Dietrich and colleagues called for more
evidence-based interventions in the workplace, targeting depression and particularly
tailored to target higher-risk groups.
584 A. Etuknwa and M. Mathai

Joyce et al. (2016)

A systematic review of literature from 2001 to 2012 was conducted to examine the
effectiveness of workplace mental health interventions on symptom reduction and
occupational outcomes. Three main intervention types were identified: primary
(increased employee control, physical activity, and workplace health promotion
services), secondary (workplace screening, counselling, stress management pro-
grams, and psychological debriefing), and tertiary (CBT, exposure therapy, and
medication). Their findings showed that interventions with a specific focus on
work such as exposure therapy and CBT-based and problem-focused return to
work programs had a strong evidence base for improving both symptoms and a
moderate evidence base for improving occupational outcomes for people sick-listed
with depression and anxiety. The effects of these interventions on work-related
aspects such as absenteeism and presenteeism were not explored in the majority of
the included studies. Overall, Joyce et al. (2016) conclude that effective prevention
of CMPs in the workplace might not be as a result of a single intervention approach
but by implementing multiple intervention approaches simultaneously.

Carolan et al. (2017)

The aim of this review was (1) to evaluate the effectiveness of occupational digital
mental health interventions in enhancing employee psychological well-being and
increasing work effectiveness and (2) to identify features of the intervention
associated with the highest rate of engagement and adherence. Twenty-one ran-
domized controlled trials (RCT) originating from seven countries (United States,
Germany, the Netherlands, the United Kingdom, Japan, Australia, and Sweden)
and published from January 2000 to May 2016 were identified and included in the
review. Included RCTs compared a web-based psychological intervention deliv-
ered in the workplace with waitlist control, active control, or usual care. Over half
of the interventions were based on cognitive or cognitive behavioral therapy, with
three based on stress and coping, two based on mindfulness, and one each based on
social cognitive theory, problem-solving training, positive psychology, and accep-
tance and commitment therapy. Results indicated that occupational digital mental
health interventions had a statistically significant effect on both psychological
well-being and work effectiveness. However, no statistically significant differences
were observed in outcomes between studies using CBT approaches compared to
other psychological strategies adopted. Findings from this review also revealed
that interventions that offered guidance were delivered over a short period (6 to
7 weeks), utilized secondary modalities for delivering interventions, and engaged
users through emails and text messages, and used persuasive technology (self-
monitoring and tailoring) achieved the most significant engagement and adherence.
Despite the positive effects of a digital mental health intervention in the workplace
on evaluated outcomes, Carolan et al. (2017) suggest the need to conduct further
research to understand better the likely challenges and benefits of delivering this
intervention in a workplace setting.
28 Common Mental Health Problems 585

Cullen et al. (2018)

A systematic review of the literature between 1990 and 2015 was conducted by
Cullen et al. (2018) to synthesize evidence on the effectiveness of workplace-based
return to work interventions and work disability management interventions that
assist workers sick-listed with both physical and mental health conditions. Evidence
was synthesized across three main intervention domains: health-focused, service
coordination, and work modification interventions. Strong evidence showed that
return to work due to mental health conditions was significantly facilitated by multi-
domain interventions incorporating at least two of the three domains. There was also
strong evidence showing that CBT interventions in the absence of workplace
modifications or service coordination components are ineffective in helping people
with mental issues return to work.

Gayed et al. (2018)

This systematic review and meta-analysis was conducted as a result of the recogni-
tion of the role of managers in negatively impacting the mental health and well-being
of employees and the growing need to train these managers on how to reduce work-
related mental health risk factors. Ten controlled trials on workplace interventions
for managers with an emphasis on the mental health of employees conducted in four
countries (Canada, Japan, Australia, and the United Kingdom) were identified and
included in the review. The review aimed to assess the overall efficacy of workplace
mental health education delivered to managers that targeted their employees’ mental
well-being. Results from the meta-analysis indicated that managers benefitted from
specialized and evidence-based interventions targeted at promoting their understand-
ing of mental health problems experienced by employees. The mental health training
notably appeared to increase not only their understanding of mental issues but also
their role and responsibility when it comes to the mental health of their employees,
their attitude toward mental health at work, and their behavior in addressing mental
health issues in general. While a few included studies which assessed the impact of
training managers on employee outcome showed some positive effects on sickness
absence rate and disability, there was a general lack of high-quality studies evaluat-
ing employee outcomes. Hence, Gayed et al.’s (2018) studies were therefore unable
to reach firm conclusions concerning overall effects.

Wan Mohd Yunus et al. (2018)

A systematic review of RCTs was conducted to investigate the effects of universal
and targeted workplace interventions on levels of depression. Twenty-two studies
conducted in ten countries (the Netherlands, Thailand, Germany, the United States,
Japan, the United Kingdom, Sweden, Hong Kong, Australia, and Finland) between
1987 and 2015 were included. Of the 22 studies included, 14 studies used a targeted
approach (offered to specific employees with higher levels of depression), while
8 used a universal approach (offered to all employees). Two main intervention
approaches were identified in the included studies: cognitive behavioral therapy
(CBT) and interventions combining different therapeutic approaches. While CBT
586 A. Etuknwa and M. Mathai

was the most frequently used intervention approach in the workplace, however,
findings indicated that interventions that combined more than one therapeutic
approach showed more promising results compared to CBT alone. Particularly,
interventions combining CBT and coping flexibility and delivered in a group format
recorded the highest effect size and showed low attrition, respectively. This finding
suggests that people sick-listed with depression are more likely to engage and benefit
from intervention strategies that involve group participation (universal intervention)
rather than singling them out (targeted intervention). These combined interventions
were shown to be effective in reducing levels of depression among employees at the
workplace. However, Wan Mohd Yunus et al. advise on the need to carefully think
through the mode of delivery, as well as the suitability of implementing combined
interventions and its fit with the target work population.

Etuknwa et al. (2019)

While several studies and systematic reviews have been conducted on the effective-
ness of a wide range of interventions, the prevalence of CMPs persists, which raises
uncertainties regarding the effectiveness of interventions in sustaining outcomes.
Some authors suggest that when an employee’s personal and social factors are taken
into account, more sustainable outcomes may be achieved. It was for this reason that
Etuknwa et al. (2019) conducted a review of 79 literature published from 1989 to
2017 to assess the impact of personal and social factors on sustainable return to work
(RTW) after ill health due to mental health disorders alongside musculoskeletal
disorders. Personal and social factors identified in the included studies reporting
sustainable RTW outcomes were support from leaders and co-workers, job crafting
practices, age, gender, work attitude, self-efficacy, education, economic status/
income, length of sickness absence, and job contract/security. The most consistent
evidence for achieving sustainable RTW for common mental health disorders was
support from leaders and co-workers, having a positive work attitude and high self-
efficacy, being of a younger age, and being of a higher educational level. Findings
from this review demonstrate the role of a variety of personal and social factors play
in impacting either positive or negative outcomes. It also highlighted the interrela-
tionship between an individual’s personal factors and their social environment in
impacting positive RTW outcomes and the need to research further the nature of the
interaction between these factors in more detail in ways that would benefit employers
in more effective implementation of RTW strategies.

Overview of Workplace Management of CMP Guidelines

Based on the scale and impact of work-related CMPs in developed countries, a

variety of guidelines on how to effectively prevent, detect, and manage CMPs have
been developed for and are easily accessible to workplaces. Even though current
trend with the advent of guidelines and adoption of best practice strategies at
workplaces may suggest that employers are beginning to act more proactively on
mental health issues, employees still feel like they are not adequately supported
(Chartered Institute of Personnel and Development 2018). The insignificant
28 Common Mental Health Problems 587

reductions in the prevalence of CMPs may suggest that the adoption of recommen-
dations provided in these documents may not necessarily be translating to effective
implementation. Hence, it is important to understand the content, quality, and
applicability of these guidelines and their overarching impact. According to
LaMontagne et al. (2014), guidelines should be based on sound principles or
theories, and their feasibility and effectiveness need to be demonstrated in imple-
mentation and effectiveness studies. In other words, guidelines should be informed
by evidence-based studies, and implementation should be practical. It is, therefore,
unclear if current workplace guidelines on effective management of CMPs in the
workplace have been developed as suggested by LaMontagne and his colleagues and
how that contributes to workplace disability outcomes. Additionally, there is also the
persistent issue of how workplace health intervention policies and practice are
considered more individual-directed and devoid of integrated approaches, which
may be viewed as a contributing factor to poor implementation (LaMontagne et al.
2014). A review of guidelines across developed countries has been conducted and
will be briefly summarized below.

Joosen et al. (2015)

The aim of Joosen et al.’s (2015) review was to identify occupational health
guidelines focusing on the management of mental disorders and stress-related
symptoms from different countries worldwide and to describe them, compare the
content, and assess their developmental and reporting quality. A systematic search of
relevant guidelines was conducted, and 14 guidelines developed from 2000 to 2011
in 5 countries (Japan, Finland, Republic of Korea, the United Kingdom, and the
Netherlands) were considered eligible and included in the final review. Results
showed that only 4 of the 14 guidelines were of high-reporting quality. The best
described component across all the guidelines was the scope and purpose. As such,
some guidelines were lacking in clarity around stakeholder involvement, the rigor of
development, and applicability.
Consequently, the majority of the guidelines missed clearly formulated vital
recommendations. Furthermore, most of the guidelines inadequately reported on
editorial independence, barriers, and facilitators for implementation and the pro-
cedures used to gather and synthesize evidence. Joosen et al.’s (2015) review also
identified the difficulty in accessing available guidelines during the search for
guidelines stage. Joosen et al. suggest the need for guideline developers, implemen-
ters, and researchers to learn from each other and make guidelines accessible via
international databases. To address issues around the quality, applicability, and
implementation of guidelines, Joosen et al. (2015) suggest the need for guideline
committees to be transparent in publishing the background study and their literature
study and clearly describe how they derived recommendations from the available
evidence.

Dewa et al. (2016)

A systematic review of best practice guidelines was conducted to address two
questions: (1) What is the quality of the development and recommendations of
these guidelines? (2) What are the areas of agreement and discrepancy among the
588 A. Etuknwa and M. Mathai

identified guidelines related to return to work (RTW) from mental illness-related

disability leave? Out of 58 unique documents identified for screening, three guide-
lines developed in Canada, the United Kingdom, and Australia were included in the
final review. Included guidelines scored low on quality as a result of a lack of
transparency on the evidence base linked to recommendations and how the evidence
could be applied in practice. There were no discrepancies among the included
guidelines, and all agreed on the need for (1) a well-described organizational policy
and procedure for the role and responsibility of all stakeholders, (2) a disability leave
plan, and (3) a need for a coordinated RTW plan that includes work accommoda-
tions. Additionally, one guideline highlighted the importance of supervisor training
and mental health literacy training for all staff. Common across included guidelines
was the recognition of the role of a variety of stakeholders in aiding successful RTW.
The importance of managers working in collaboration with the sick-listed worker to
develop appropriate work accommodations and the need for the workplace to
support these employees by providing easy access to treatment services was also
highlighted. While these guidelines emphasize different aspects of RTW, Dewa et al.
(2016) suggests that taking account of all elements could be considered comple-
mentary and together provide relevant components of managing mental illness-
related disability in the workplace.

Memish et al. (2017)

Memish et al. (2017) conducted a review of 20 guidelines developed for or easily
accessible to workplaces in Canada, Australia, the United Kingdom, Ireland, and
Europe on how employers can detect, prevent, and manage mental health problems
in the workplace. The review aimed to assess both the quality and content of these
guidelines. Evidence showed that the most effective way to prevent, manage, and
protect employee’s mental health problems is via interventions designed to target
both individual, employee level, and organizational level factors (e.g., leadership
styles, workplace climate, or culture). Hence, Memish et al. (2017) suggest that
future guidelines should take account of organizational factors to ensure recommen-
dations are comprehensive and concordant with a best practice, integrated approach.
The content and quality of guidelines varied significantly, with low scores often as a
result of a focus on detection and treatment of mental health problems in the
workplace, rather than on protection and prevention. Guidelines which have pre-
ventive content were found to be lacking in practical tools and advice on implemen-
tation. Development processes of guidelines were also found to be lacking in rigor
and input from sick-listed stakeholders.

Nexø et al. (2018)

Seventeen workplace guidelines developed between 2000 and 2016 and aimed at
preventing, detecting, and managing work-related mental health problems in
Australia, Canada, Denmark, England, New Zealand, and Sweden were reviewed
for quality and content. The review identified three key recommended preventive
approaches (primary, secondary, and tertiary) mostly focusing on the role of
employers. However, the quality of the guidelines varied considerably, even though
in some cases the quality of the scope and purpose and the clarity of presentation
28 Common Mental Health Problems 589

were high. The quality of stakeholder involvement, rigor in development, and

applicability was poor. Guidelines were found to be developed without the backings
of evidence-based studies. Therefore, Nexø et al. (2018) conclude that workplaces
need better quality guidelines with sufficient rigor and evidence from effectiveness
studies to prevent, detect, and manage work-related CMPs properly.

Summary of Up-to-Date Findings on Workplace Management

of CMPs

An overview of up-to-date evidence has identified consistent evidence on the

effectiveness of crucial workplace interventions on two main outcomes: health and
employment/disability outcomes. As health outcomes have to do with improving
symptoms and work functioning, employment/disability outcomes in these studies
included job retention, sickness absence, return to work, and productivity.
On the one hand, while cognitive behavioral therapy (CBT) was identified as the
most widely used intervention for people sick-listed with CMPs, its effects were only
found on health outcomes. However, interventions combining more than one ther-
apeutic approach compared to CBT alone were found to show more promising
effects on symptoms. Conversely, to achieve employment outcomes, it is suggested
that CBT be adopted with other intervention approaches not only focusing on health.
More specifically, evidence suggests that CBT implemented in the absence of work
modifications is bound to be ineffective in achieving employment outcomes.
On the other hand, employment/disability outcomes across reviewed studies
appeared to be consistently facilitated by the workplace disability management
system. Employees sick-listed with CMPs were found to benefit from interventions
that were problem-focused, participatory (group-based), and incorporating work
factors such as the provision of adequate job redesign and work accommodation/
flexible working options, training of line managers, a supportive line manager and
co-workers, benefits, an ethical workplace culture, and working in collaboration with
healthcare services. However, implementing preventive strategies without taking
account of personal and social factors surrounding sick-listed employees is likely to
impede the attainment of sustainable outcomes. Hence, the importance of taking into
account key factors such as employee’s age, level of education, or length of absence
when agreeing on appropriate strategies to aid in understanding employee’s likeli-
hood of relapse, ability to understand and adhere to intervention procedures, and
likely challenges to transitioning back to work, respectively.
The role of managers regarding their competence, their attitude toward sick-listed
workers, and their behavior in addressing mental health issues were identified as key
to the effective management of CMPs in the workplace. Hence along with adequate
training, managers working in collaboration with a wide range of support services to
include healthcare appear to provide them with the needed support to make informed
decisions regarding appropriate interventions tailored to sick-listed employees. This
finding is consistent with Corbière et al.’s (2019) recent study on stakeholders’ role
and actions in the return-to-work process of workers on sick leave due to common
mental disorders. Therefore, it is clear that effective workplace management of
590 A. Etuknwa and M. Mathai

CMPs involves multiple disciplines and stakeholders, and the effect depends on the
interplay between workplace and social and personal factors. Additionally, multiple
studies have shown that effective prevention of CMPs in the workplace might not be
a result of a single intervention approach; hence it might benefit employers to
consider multiple intervention approaches simultaneously.
There is a general lack of good quality guidelines informing effective management
and prevention of CMPs in workplaces. While the scope and purpose of review
guidelines were considered of high quality, key contents of the guidelines considered
of low quality were consistent across all guidelines. These contents include a general
lack in issues relating to rigor in development, clarity on the role and competency of all
stakeholders, ease of applicability and implementation, and input from sick-listed
employees. More importantly, guidelines were generally found to be lacking the
evidence base linked to the recommendations. Hence, there is a possibility that the
poor-quality nature of guidelines adopted by employers may be playing a significant
role in the insignificant reductions of CMPs in the workplace. When stakeholders who
manage the implementation of preventive strategies such as work accommodations are
unclear on the practical tools to adopt and do not work in collaboration with sick-listed
workers to clarify their limitations, ineffective work strategies resulting in aggravating
ill health is perhaps unavoidable. Additionally, recommendations informed by research
must clearly state practical procedures and tools on what was done and how and under
what circumstances strategies work to guide effective implementation better.
An overview of these guidelines, therefore, stresses the importance of better-
quality guidelines to guide employers on how to manage and prevent CMPs in the
workplace effectively. As highlighted in the interventions, the need to train managers
or stakeholders who oversee the implementation of preventive work strategies is also
identified as a key factor in the guidelines, showing its importance. Therefore, it
implies that effective management and prevention of CMPs at the workplace is
facilitated to a great extent by competent and supportive managers.

Gaps in Evidence

The evidence base on the effectiveness of interventions on health outcomes, partic-

ularly for people with depression, is still lacking. However, employees sick-listed
with depression in examined studies in this chapter appeared to benefit more from
CBT interventions administered together with coping flexibility delivered in group
form. Based on the limited evidence drawing the link between these intervention
approaches and improved health outcomes for people with depression, a need for
further research in this area is essential.

Conclusion

In this chapter, we have discussed the most commonly reported common mental
health problems, their symptoms, and their impacts. These disorders are recognized
as a major public health problem (Goldberg and Gater 1996) and a leading cause of
28 Common Mental Health Problems 591

sickness absence and long-term disability in developed countries (Corbière et al.

2019; Harvey et al. 2017). The World Health Organization has indicated an increase
in the prevalence of these disorders in recent years, affecting (respectively) 4.4% and
3.6% of the world’s population (World Health Organisation 2017). Goetzel et al.
(2018) argue that since most of life is spent in working years, the workplace is an
ideal setting for public health-informed initiatives that promote mental and behav-
ioral health and prevent illness. As such, we have summarized the effective work-
place strategies on managing CMPs and highlighted essential contents to improve
guidelines to better inform employers on effective management of CMPs for more
significant reductions in the prevalence of CMPs. Hence, it is anticipated that this
will aid businesses in saving substantial resources, decreasing presenteeism, increas-
ing productivity, encouraging job retention while reducing healthcare costs, and
improving the mental health of their employees.
While CMPs are complex and differ in symptoms, depending on the severity,
there is sufficient evidence suggesting that taking account of personal and social
factors of workers during the implementation of proactive interventions incorporat-
ing work factors is likely to yield favorable outcomes – outcomes such as the
elimination of the risk of work to ill health to a reasonably practicable level, which
in turn reduces lost working days. Because poorly managed intervention processes
have been shown to have a high likelihood of aggravating ill health and negatively
impacting employment or disability outcomes, the need to train workplace actors
(line managers, supervisors, etc.) who manage these implementation processes
cannot be overemphasized. Furthermore, a workplace that fosters supportive inter-
actions between leaders, co-workers, and sick-listed workers is likely to enhance
work attitudes and self-efficacy, thus impacting on sustainable outcomes. According
to Etuknwa et al. (2019), promoting a workplace culture of support is essential to
making people sick-listed with CMPs feel valued, worthy, and not necessarily
blamed for mental condition.

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Burnout
29
Michael P. Leiter

Contents
Introduction and Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 598
Person-Oriented Approaches to Burnout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 598
Worklife Profiles Based on the MBI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600
Areas of Worklife . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 602
A Change Model for Burnout Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 605
Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 606
Individual Versus Organizational Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 607
Changing the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 608
Improving Social Encounters to Alleviate Burnout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 609
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 610
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611

Abstract
Job burnout combines exhaustion, cynicism, and inefficacy into a syndrome that
functions as an occupational condition undermining the quality of worklife.
Burnout has negative implications for mental and physical well-being without
being a disease in itself. Instead, burnout reflects a breakdown in the relationships
that people maintain with their workplaces. Although burnout has been the focus
of academic research and management consulting for nearly half a century, little
progress has been made on defining effective interventions. Much of the research
and advice pertaining to alleviating and preventing burnout focus on individual
action, largely ignoring the predominant role of management practices, work
demands, resource shortages, and strained personal relationships that research has
consistently associated with the syndrome. Given the wide range of workplace

M. P. Leiter (*)
Deakin University, Geelong, Australia
Acadia University, Wolfville, NS, Canada
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 597

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_25
598 M. P. Leiter

processes and conditions that have been associated with burnout, there is a
potential for a wide range of strategies worth exploring to test ways of alleviating
the three dimensions of the burnout syndrome. Improving the quality of social
encounters at work is one approach considered here.

Keywords
Burnout · Work engagement · Areas of worklife · Workplace civility ·
Organizational intervention

Introduction and Definitions

Burnout reflects a breakdown in employees’ relationships with their workplace that

is characterized by ongoing exhaustion, cynicism, and inefficacy.
The World Health Organization (WHO) in the course of developing the 11th
edition of the International Classification of Diseases (ICD-11) made a definitive
statement that burnout is not a disease. The combination of exhaustion with cynicism
and inefficacy did not in itself warrant the classification as a disease. Instead, burnout
functions as an “occupational condition,” parallel to chronic unemployment that is
associated with a variety of mental and physical illnesses (https://www.who.int/
mental_health/evidence/burn-out/en/). So, while not a disease in and of itself,
burnout signals vulnerabilities to developing diseases.
However, referring to burnout as an occupational condition fails to capture the
full scope of the condition, its insidious impact on career trajectories (Maslach et al.
2001), and its capacity to persist for years (Leiter et al. 2013; Toppinen-Tanner et al.
2002). If not a health condition, burnout has qualities of a major life crisis focused on
a primary life domain. Work defines significant relationships in which people
connect with organizations. The relationship may be brief or last a lifetime. The
relationship could encompass a full range of personal motives, aspirations, abilities,
and values. Or it could be a transactional opportunity to trade labor for money. In this
more transactional mode, persistently excessive demands or resource shortfalls
would likely prompt exit as people seek better rates of exchange for their labor.
They may resign themselves to remaining in problematic jobs during poor labor
markets, prompting them to reconsider their options. When work encompasses much
more in terms of values and commitments, decisions to exit become more fraught,
resulting in more people remaining in place despite difficulties in maintaining
sufficient energy, involvement, and efficacy in the course of doing their jobs.

Person-Oriented Approaches to Burnout

In their writings on person-oriented approaches, Bergman and Magnusson (1997)

emphasized both theoretical and analytical aspects of the perspective. A central
theory notion was that a key task for psychology was developing comprehensive
29 Burnout 599

and integrated models of people. That is, people comprise a multitude of elements
and processes, but these components do not simply exist parallel to one another, but
they form interactive systems. From that basis, unwrapping the components has a
useful but ultimately limited capacity to further understanding. A holistic consider-
ation of entities adds some valuable depth. When considering people individually or
in groups, distinct patterns of elements emerge. That is, people do not combine
components in the same manner, but the combinations in practice can be distilled
into a finite set of patterns.
The analytic aspect of personal-oriented approaches rests upon statistical pro-
cedures of pattern identification, specifically cluster analysis and latent profile
analysis (LPA). These techniques use iterative processes to sort through a large set
of individual records on key variables to determine ways in which they combine with
one another. In practice, cluster analysis tends toward solutions in which the various
profiles are of similar size; LPA has less of a tendency in this way.
A critical decision within a person-oriented analysis is determining the number of
profiles. The procedure involves running a series of analyses that specify 4, 5, 6, or
whatever number of profiles. LPA uses an iterative process, the results of which
provide indicators of model fit, none of which are considered definitive on its own.
In combination they can inform decisions on selecting the number of profiles to
pursue. The indicators include the Akaike information criterion (AIC), the Bayesian
information criterion (BIC), and the Lo-Mendell Rubin adjusted likelihood ratio. For
AIC and BIC, smaller values indicate a better fit (Williams and Kibowski 2016); for
Lo-Mendell and the bootstrapped likelihood ratio test, a significant value indicates a
better fit than provided by a model with one less profile (Nylund et al. 2007). Entropy
indicates the probability of accurate assignment of cases to a profile. In addition to
these statistical indicators that at times may be inconclusive, one examines the extent
to which the resulting profiles make sense in light of the theoretical underpinnings of
the approach. Finally, profile solutions with very small numbers of participants in
any of the profiles are not viable.
Profiles offer benefits relative to median or quartile splits, an alternative method
of turning continuous scores into categories. Splits receive criticisms first for
impoverishing the available information. For example, the exhaustion scale of the
MBI General Scale (MBI-GS) has 5 items rated on a 7-point (0 to 6) scale, yielding a
range of scores from 0 to 30 with each increment indicating a bit more exhaustion.
Analyses that divide these scores into high/medium/low, based on the 33% and 67%
points in a normative frequency scale, reduce a 30-point scale to a 3-point scale. That
impoverishment of the data reduces the potential degree of subtlety in any analysis
based on the categorization. This reduction in the data brings the benefit of labelling
a third of respondents has high burnout. That trade-off is of dubious value in that
(1) exhaustion is not the same as burnout and (2) there has been no validation of the
implicit proposition that any qualitative changes in burnout-relevant experiences or
covariants occur at this arbitrary 67% cutoff. This last point pertains to the second
criticism leveled at splits: they equate the difference between a respondent who
scored just above and one who scored just below the cutoff with a difference
between two people who scored on opposite extremes of the categories. The practice
600 M. P. Leiter

of slotting responses into high/medium/low has found favor in some professional

journals but have little currency in forums that value statistical analysis.
Profile analysis adds a level of sophistication to the analysis that reduces the
relevance of these shortcomings of unidimensional splits. Its capacity to identify
subgroups with distinct patterns on multiple indicators increases confidence that
distinctions have a deeper foundation than simply being a little higher or a little
lower on a given measure. This confidence increases when the measures thereby
combined define a syndrome in which the elements relate to one another in a
meaningful way. The results of a profile analysis are more interesting and more
useful when the defining elements do not highly correlate with one another. Three
highly correlated elements are likely to move in lockstep. Perhaps the elements are
reflections of a single underlying construct, or they are all determined by identical
situational conditions. When the defining measures are highly correlated, the
resulting profiles tend to be high on all three, low on all three, and few variations
in between of theoretical or practical interest. In contrast, defining elements that have
moderate and uneven correlations with one another create more opportunities for
more interesting and useful profiles. That is, if the profiles simply reflect high,
medium, and low scores on the defining elements, the profiles would correlate
with other measures of precursors or outcomes in the same way as would the
elements themselves. Lower correlations among elements increase the possibilities
for interesting profiles because a given score on one element does not inevitably
imply a similar score on other elements.

Worklife Profiles Based on the MBI

The Maslach Burnout Inventory (MBI) generally shows moderately high correla-
tions of exhaustion with cynicism (emotional exhaustion with depersonalization on
the original Human Services Scale) with low to moderate correlations of these
elements with professional efficacy (personal accomplishment on the original
Human Services Scale) (Maslach et al. 2001). Person-oriented analyses using latent
profile analysis (LPA) has identified various profiles (e.g., Mäkikangas et al. 2020).
One study has used cluster analysis based on the Oldenburg burnout scale combined
with the Utrecht work engagement scale (Timms et al. 2012).
These analyses have confirmed the two contrasting profiles: negative scores on all
three elements (e.g., burnout) and positive scores on all three elements (e.g.,
engagement). They have found intermediate profiles in which the elements do not
move together. Leiter and Maslach (2016) found five profiles in their analyses of two
samples. In addition to burnout and engagement, the analysis identified profiles with
negative scores on only one of the three elements in combination with positive or
moderate scores on the other two elements. These three profiles were labelled
ineffective (negative only on efficacy), overextended (negative only on exhaustion),
and disengaged (negative only on cynicism).
The graph, MBI profiles, shows the average scores for each profile on the MBI
elements derived from combined surveys of Australian employees in various
29 Burnout 601

industries (primarily healthcare, police, financial services, and consulting; N ¼ 989).

Engaged has below average levels of exhaustion and cynicism. In fact, it is the only
profile in this sample with below average levels on those elements. It also has above
average levels of efficacy. In contrast, burnout shows the opposite: very high levels
of exhaustion and cynicism with below average levels of efficacy.
The ineffective profile has average levels of exhaustion and cynicism combined
with low levels of efficacy. The profile reflects more a sense of dullness than distress.
In this profile people on average experience exhaustion and cynicism occasionally as
do people in general, but they rarely feel confirmed in their efficacy or their impact.
In the ineffective profile, people are missing qualities of being engaged with their
work, but their state is much less distressed than in the other non-engaged profiles.
Overextended is noteworthy for high exhaustion with moderate levels of cyni-
cism. Efficacy is in the positive range, at a similar level as for engaged. This profile
conveys an image of people working too long or too hard without sufficient
opportunities for rest and recovery. Their high sense of efficacy may be part of
what keeps them going. It conveys that they believe in themselves as important
contributors to their colleagues or their service recipients.
The disengaged profile has high levels of cynicism with moderate levels of
exhaustion and moderately low efficacy in this sample. This profile conveys a
more distant and discouraged relationship with work.
The burnout profile has the worst of all three elements: the most negative scores
on exhaustion, cynicism, and efficacy. People in this profile has the longest way to go
to return to an average level of experience. And they lack any positive elements on
which to build.

Note: N ¼ 989
602 M. P. Leiter

A normative database for the Maslach Burnout Inventory General Scale

(MBI-GS) including 45,000 entries from a variety of occupations but mostly within
healthcare has engaged as the most prevalent profile at 36%. The other four profiles
have roughly equal prevalence ranging from 14% for burnout to 18% for over-
extended. This distribution underscores the importance of a clear definition of
burnout in reporting surveys. Articles that report very high rates of burnout for
healthcare professionals use generous criteria, such as scoring in the most negative
33% on any of the three subscales.

Note: N ¼ 45,293

Areas of Worklife

The areas of worklife model (Leiter and Maslach 2004, 2011; Maslach and Leiter
1997) brought together research linking the three aspects of burnout to matches and
mismatches in six areas. Workload refers to the extent to which employees find the
amount, complexity, and quality of demands manageable. Control concerns
employees’ participation in decision-making and their exercise of autonomy in
their work. Reward captures recognition, while community concerns the availability
of supportive social encounters at work. Fairness assesses distributive and proce-
dural justices. Values addresses the extent to which employees believe that their
values and the organizational values coincide. The model follows a person/job fit
framework by conceding that people may vary considerably in their preferred mode
of work. For example, some people may be much more concerned with value
congruence with their employers, while others may have a more transactional view
29 Burnout 603

of their employment relationship. Similarly, opportunities or crises within a work-

place may make one area of worklife more salient for all employees at times.
The areas of worklife model (Leiter and Maslach 2004) depicts the six areas to
maintain a consistent balance with the three aspects of burnout. Rather than a
unidirectional causal model, influence works broadly. For example, the model pro-
poses that unmanageable workload contributes to exhaustion while exhaustion
reduces the range of work demands that people find manageable. Value conflicts
with employers may prompt cynicism, while cynicism increases employees’ skep-
ticism about the sincerity of employers’ values. Meta-analyses have confirmed that
the policies and practices that define the management environment have distinct
relationships with the three aspects of burnout with both exhaustion and deperson-
alization consistently negatively related to commitment, reflecting the withdrawal
aspect of cynicism or depersonalization (Lee and Ashforth 1996). It follows that
changes in employees’ experience of exhaustion, cynicism, and efficacy would align
with changes in employees’ evaluation of their management environment.
The figure, worklife areas across profiles, displays scores on the 6 areas of worklife
for each of the 5 worklife profiles compiled from surveys of 234 employees partici-
pating in surveys of healthcare and law enforcement personnel in Australia. On the
two extremes, engaged is associated with positive evaluations of all six areas of
worklife, while burnout is associated with negative scores on all six areas. Ineffective
has values close to the midline for five of the areas of worklife but has positive
evaluation of manageable workload. People in the ineffective profile are not enthusi-
astically positive about areas of worklife, but they do not appear distressed either.
They appear to find their workload as manageable as those in the engaged profile.

Note: N ¼ 234
604 M. P. Leiter

In contrast, the overextended profile is associated with negative ratings of work-

load, consistent with their defining features of exhaustion. The only other area of
worklife that is notably lower than the norm is fairness, which may pertain to
workload allocation. Disengaged has an opposite pattern. Workload is rated at the
average level while the other five areas of worklife receive negative ratings. These
distinct ratings on the six areas of worklife demonstrate a potential value of a person-
oriented approach. The contrasts across the profiles do not mirror correlational
analyses of a steadily more negative view of worklife with more negative scores
on the MBI subscales. Instead, the profiles emphasize different concerns for people
in the various profiles.
The analysis also has implications for taking action to alleviate. Clearly, the
burnout profile calls for definitive action that may not be well received in the first
instance. That is, people in the burnout profile are exhausted, reducing their incli-
nation to try anything new. Cynicism reflects a lack of confidence in the employing
organization or in other people, as reflected in the MBI item, “I just want to do my
work and not be bothered.” The low level of efficacy presents another barrier in that
people have lost confidence in their own capacity to have an impact through their
work. One the full burnout syndrome has established itself in people; alleviating it
requires an intense and ongoing course of action to have any impact.
Moving people in the other profiles toward the engaged profile does not require as
great a commitment. The people in the ineffective profile are not in a deficit position
on any of the areas of worklife. Their position is as good as one could hope for on
manageable workload. They are not looking for actions to alleviate distress. They
may not feel distressed at all. But there may be potential for actions that work with
them to develop a better alignment of the other areas of worklife with these
employees’ aspirations and values for their work.
The overextended profile provides an informative contrast with the burnout
profile in that those in the overextended profile have one overriding concern:
unmanageable workload. They rate workload every bit as negatively as do people
in the burnout profile. But workload is pretty much the only issue for those in the
overextended profile. They do experience distress associated with high levels of
exhaustion. The assistance they seek is focused: they would appreciate help in
addressing unmanageable workload. Their neutrality to positive scores on cynicism
and efficacy indicates exceptional strengths in their approach to work. They believe
in the value of the work that they do, and they have confidence in their capacity to
make a meaningful, competent, and valuable contribution. Rather than the broad
range of actions needed to reach and to help people experiencing the full burnout
syndrome, people in the overextended profile are only open to action that is clearly
designed to help make their work demands more manageable. They are too
exhausted to give serious consideration to anything else that someone may want to
offer. Offering additional elements would not only be a poor use of limited resources;
doing so would likely be met with resistance from those it was intended to help.
Essentially, a more accurate, multifaceted assessment of the issues confronting
people at work and what they experience in that setting helps to direct action more
effectively.
29 Burnout 605

A Change Model for Burnout Interventions

Preventing or alleviating the defining qualities of job burnout remains challenging

despite decades of research on the syndrome. Articles exploring the correlates of
exhaustion, cynicism, and inefficacy often conclude with considering the potential
applications of the findings and a call for high-quality intervention studies. Unfor-
tunately, those intervention studies remain rare. Part of the problem is that interven-
tion research is expensive and takes a long time. A second problem is that field
research in work settings requires the cooperation of people within the potential
research settings. Their top priority is pursuing their mission of creating products or
serving their clientele. To devote time and resources to test a new approach, they
would like to feel confident that it will have a beneficial impact. At the outset of an
evaluation research project, it is not possible to provide assurance about the
approach’s impact: that is what the research is intended to evaluate.
Compounding these issues is a general inclination toward individual interven-
tions rather than organizational action. Training individuals to cope more effectively
with stress experiences is much simpler than changing the conditions under which
people work. Changing work processes requires the cooperation of people in various
roles at the participating organization. It takes a long time to define the hoped-for
changes, to build the necessary consensus, and to arrange the essential logistics
necessary for the project to go forward. Organizational intervention projects encoun-
ter various barriers to following the gold standard of randomized control trials (RCT)
in their design and implementation.
First, the double-blind quality runs counter to the need for active involvement of
participants in organizational interventions. It is difficult to change the nature of how
people work without them noticing what exactly they are doing differently. The
active involvement of participants in designing the intervention may be a critical
success factor in the project. Organizational leaders with whom researchers work
usually want a promising intervention to be tested on workgroups in need of such an
intervention. It is difficult to randomly select workgroups with whom to work.
Although people often complain of organizational silos with little communication
across departments, there are countervailing patterns of communication throughout
organizations, such that it is difficult to keep control units unaware of what is
occurring in the test units. The active involvement of participants in the design
and implementation of organizational interventions results in a lack of standardiza-
tion. No two units are implementing the program in exactly the same way. The
practical implementation of organizational interventions departs in important ways
from the RCT ideal.
Evaluating the impact of interventions calls for innovative strategies to overcome
subjective perspectives and to identify active mechanisms contributing to change
(Nielsen et al. 2008). McKinley et al. (2017) noted the challenges in conducting
meta-analysis of intervention studies using workshop formats, in that they could find
little or no consistency across studies in the content of such interventions. They
attributed this variation to weak theoretical frameworks, leaving much of the inter-
vention design to be responsive to local issues. This approach makes sense for
606 M. P. Leiter

developing sustainable intervention; however it presents challenges to identifying

the critical elements of an intervention.

Interventions

However, work on organizational interventions in recent years has identified qual-

ities of workplace interventions that function as harbingers of success. These
qualities are compatible with Kotter’s (1996) perspectives on the design and imple-
mentation of change initiatives (also see Lowe 2008; NIOSH 2008; and Peersman
et al. 1998). Leiter and Maslach (2014) summarized five central points from these
perspectives on planned organizational change.

• Urgency: Successful change initiatives have a sense of addressing issues of

critical importance to participants. They have a goal that describes the preferred
end state and how it differs from the current state. Reducing burnout presents
serious challenges due to its stability over long periods.
• Targeted and strategic: Successful change initiatives focus on the key leverage
points for effecting change. A large body of research identifying the primary
antecedents of job burnout provides direction for focusing interventions. Suc-
cessful change initiatives identify strategies that encompass a variety of specific
tactics, any or all of which have a potential to make a difference. A clear focus on
an identified target has been recognized as a success factor for organizational
interventions that are subject to “mission creep” (a term that refers to the
expansion of project objectives beyond the original goal, or mission, of the
program design; DeJoy et al. 2010).
• Collaborative: Employee participation throughout the intervention process
improves chances of success. People do not take kindly to being told what to
do. Successful change initiatives begin with, and maintain throughout, a dialogue
characterized by close listening, continuous learning, and ongoing adaptation of
implementation. This point was emphasized by Halbesleben et al. (2006) and also
by Dejoy et al. (2010).
• Sustained. Addressing burnout requires an ongoing commitment. Burnout is an
enduring condition closely linked with the structure of the work environment.
Long-term success requires sustained efforts to maintain gains. Without such
effort, the original baseline conditions may become reestablished. The interven-
tions reviewed earlier generally lasted for many months of individual or group
sessions (e.g., Salmela-Aro et al. 2004; Mommersteeg et al. 2006).
• Evaluated. Successful change initiatives measure progress. Assessment provides
a vital flow of information to guide implementation. The adage that “one attends
to what is measured” fits well for intervention programs. Clear measurement of
primary constructs is essential both to diagnose the situation and to determine if
action has had the desired impact (Moulding et al. 1999).
29 Burnout 607

Individual Versus Organizational Interventions

Deciding to take action to alleviate or to prevent job burnout leads to additional

decisions about what to target for change and the methods for bringing about change.
As noted, much of the somewhat scant intervention research emphasizes improving
individual employees’ capacity to cope with the workplace as it is rather than to
change the way that the work is being done. In their review of intervention research,
Awa et al. (2010) noted that individual focused interventions have been devoted
primarily to building resilience, often through various relaxation techniques. The
most broadly called-upon approach in recent years was mindfulness. The general
expectation was that teaching people to focus their minds in a context encouraging
serenity would both have a calming effect at the moment and encouraging a state of
mind that would enable people to cope more effectively with demanding situations
they encounter in their day-to-day lives. Changing the conditions under which
people work goes beyond the scope of these studies. An example of an individual
training approach from Ghannam et al. (2020) was focused on medical residents. It
provided a 1-day training session that defined the concept of stress, reviewed ways of
detecting job stressors and stress outcomes, led participants through method to
implement relaxation techniques (including sleep hygiene and breathing exercises),
reviewed strategies for cognitive restructuring, and taught techniques for improving
time management. The primary focus of these elements was to build participants’
resilience, extending their capacity to tolerate the level of demand that were consid-
ered problematic. That is, the current level of demand was accepted as unchangeable.
Another study (Hofer et al. 2018) provided participants with a self-help book based
on principles from acceptance and commitment therapy (ACT) without any refer-
ence to participants’ work context. Compared to a waiting list control group that had
not yet received the book, the treatment group showed fewer indications of burnout
at posttest.
An evaluation of a mindfulness, acceptance, and value intervention (MAV) for
burnout, using a randomized control trial format, employed a person-centered
analysis to determine the extent to which people changed in the test groups. A latent
profile analysis found evidence of a profile characterized by diminishing exhaustion
combined with increasing skills and practice of mindfulness techniques (Kinnunen
et al. 2020). That pattern presaged participants retaining the benefits to well-being at
assessments at follow-up intervals of 4 and 8 months after the intervention. In
contrast, those who did not combine skill acquisition with decreased exhaustion
were unlikely to show subsequent benefits. The authors proposed that additional
follow-up training sessions may be necessary when the initial uptake is not evident at
the assessment immediately following the training.
Another approach includes activities that focus additionally on the physical
experiences of stress. A combination of Hatha yoga and mindfulness exercises
was found to be helpful in reducing various stress indicators, including exhaustion
on the MBI (Sallon et al. 2017).
608 M. P. Leiter

The objectives of these studies were not to change participants’ relationship with
their work or their work setting. Instead, the objective was to increase participants’
capacities to manage stress when they encountered strained situations.

Changing the Workplace

Interventions designed to change the workplace are rarer but do occur. For
example, Halbesleben et al. (2006) applied an action research model to the
question of reducing burnout. The format led employees and managers through
a process of group problem solving to address issues that employees raised about
their work lives. The process led to a reduction of both exhaustion and cynicism
reported by participants. An important quality of this study was that the focus was
not on the mental or physical health of employees but on the way that the work
was implemented at the workplace. This put the focus on the managerial domain.
That is, managers did not need to develop a new set of quasi-therapeutic skills to
address psychological problems among their employees. Instead, they drew upon
their managerial expertise to solve problems in how the workplace functioned. In
terms of the research format, the method departed from the RCT framework in
that (1) everyone was fully aware of who was in the treatment group and (2) no
two groups would identify exactly the same problems or devise exactly the same
responses to those problems. Instead, the dynamics of a shared, collaborative
process was at the core of the intervention. A study by Berg et al. (2008) in
Swedish hospitals found a decrease in exhaustion among nurses when the hos-
pital implemented an individualized patient care model. This change gave a
broader participation in the decisions that were at the heart of ongoing inpatient
treatment. In doing so, the model changed participant’s day-to-day patterns
of work.
Other studies have actively emphasized individual participation in intervention
design, such as Hätinen et al. (2007) that found that individually designed rehabil-
itation plans were more effective at reducing exhaustion than were individual
therapy sessions. Others have argued that participation in problem identification,
planning, design, and implementation of action plans is an essential part of the
mechanisms to bring about change in the relationships people maintain with their
workplaces (Le Blanc and Schaufeli 2008).
The pivotal points in the relationships people develop with their workplaces are
their encounters with other people. Encounters with supervisors as well as the day-
to-day interactions with colleagues play an important role in defining the primary
parameters of the workplace culture. An informative metric for evaluating the
quality of these encounters is the ratio of civility to incivility in the behavior received
from supervisors and coworkers as well as that instigated toward others. The Social
Encounters Scale (Leiter 2019a) is an assessment tool that assesses civility and
incivility from each of these sources on a consistent rating scheme that ranges
from 0 (never) to 6 (every day). Fortunately, for most people (but not everyone)
civility occurs more often than incivility.
29 Burnout 609

Improving Social Encounters to Alleviate Burnout

The connection of social dynamics with the worklife profiles suggests that improv-
ing the balance of civility to incivility among members of work groups has a
potential for alleviating or preventing the defining elements of burnout. One format
for improving civility has been the CREW (civility, respect, and engagement with
work) process developed by the Veterans Health Administration in the USA,
Osatuke et al. (2009). Through a series of facilitated sessions, members of intact
workgroups reflected on the quality of their social encounters, with an emphasis on
the qualities of civility and incivility that were conveyed and received. They
developed the format having confirmed that the level of civility and incivility
differed considerably across units, consistent with levels of exhaustion, cynicism,
and inefficacy. In the first instance, the VHA analysis demonstrated that the CREW
process was effective at increasing the level of civility on the participating units in
contrast to control groups that remained constant on the civility measure over the
study interval (Osatuke et al. 2009).
The CREW intervention encompasses the six qualities of change that we propose
as necessary for effective interventions. Detailed descriptions of the CREW process
are available in Leiter et al. (2012), Leiter et al. (2011, 2012), and Osatuke et al.
(2009), but here we will focus just on how CREW is a good example of the new
change model for burnout interventions.
First, CREW responds to urgency in that workgroups and organizational leaders
are often in a state of crises when workgroup social dynamics become dominated by
incivility or abusive interactions. As is often the case with field applications of
interventions, they were tested with workgroups that expressed an urgent need for
action. Participation in the process was not randomly assigned but distributed in
response to expressed need.
Second, CREW is goal-oriented. Osatuke et al. (2009) emphasize the importance
of working toward constructive goals. The primary focus is increasing the frequency
of civil exchanges. The approach minimizes passive goals, such as the reduction or
elimination of bullying or incivility. A passive goal of eliminating incivility fails to
address the constructive behaviors that would replace incivility within the ongoing
interactions among the employees. Social encounters are an essential aspect of
providing healthcare to patients, so the objective must go beyond eliminating bad
behavior to define what needs to replace that behavior in a constructive manner.
CREW is targeted on social dynamics that are responsive to action. Changes in
social dynamics are expected to be consequential for employees’ experiences of the
defining qualities of job burnout.
The potential for change is more evidenced in CREW’s collaborative format.
The sessions begin by reviewing the results of a survey of the levels of civility and
incivility that participants have experienced. The objective of this initial discussion
is to determine the starting point for the group. On the basis of this conversation, the
group is prepared to set goals that are meaningful to the participants. Rather than
provide workgroups with a preset code of conduct or a set of etiquette rules, the
process asks participants how they define respect and disrespect in their group. This
610 M. P. Leiter

approach allows a collaborative approach to setting goals that acknowledges the

wide diversity in social cultures among workgroups. That is, some groups tend
toward concise, task-oriented interactions that fit the fast pace of their work and
communications. Other settings tend toward more thorough, thoughtful interactions
that fit the slower pace and greater depth of their processes. By encouraging
participants to define their objectives, the process increases the potential for deeper
commitment to those goals.
CREW’s strategic quality is evident within the overall design of the process as
well as in the specifics of the exercises and topics contained within the CREW toolkit
that facilitators use to guide the structure of sessions. The structured exercises that
guide CREW’s facilitators are designed to encourage participants to explore ways of
interacting with one another. The exercises cover a range of situations, such as
expressing appreciation, resolving conflict, or challenging a coworker who has
behaved uncivilly during a shared interaction with a service recipient.
CREW is sustained over a 6-month implementation. The process’s emphasis on
collaboration in implementation and goal setting is intended to increase participants’
commitment to a more civil, respectful workplace. Going forward from the 6 months
of sessions, workgroups are largely on their own. For the gains to be sustained over
time, the participating workgroups need to experience the benefits of respect and
civility. The intention is that both receiving and giving civility will become self-
sustaining reciprocally. Assessments of CREW implementations have confirmed
these gains at a 1-year follow-up.
The evaluation quality of CREW gives it a more credible place within organi-
zational priorities. The evaluations of the process include surveys that capture the
relative frequency of civility and incivility in social encounters. It helps to supple-
ment these data with interviews and/or workgroup discussions reflecting on the
experience of implementing the process as well as the challenges people have
found in sustaining the gains over time. Institutional data on absences, turnover,
and complaints provide another reference point for evaluating the impact of the
process.
A more recently developed workgroup civility approach is SCORE (strengthen-
ing a culture of respect and engagement). Preliminary assessments of the approach
have encouraging results on improving civility and developing work settings more
conducive to work engagement (Leiter 2018). The approach differs from CREW in
having only five sessions in contrast to CREW’s 20+ sessions. SCORE uses profes-
sional facilitators rather than developing and mentoring volunteer facilitators
through a train the trainer format. Also, SCORE is highly structured in terms of
the agenda for the five sessions, while CREW uses a less directive approach. Further
studies are assessing the impact of SCORE in controlled research formats.

Conclusion

Burnout, as an indicator of workplace stress, reflects the social context in which it

occurs, making it more of a relationship problem than an individual failing. Despite
the importance of context in the development of burnout, much of the advice and
29 Burnout 611

research on intervention has focused on toughening the employee rather than

improving the workplace. This work reflects an implicit assumption that if only
people were tough enough, they could endure any amount of poor management,
injustices, and abuse without emotional or physical consequences. So, resilience and
mindfulness have been the target of intervention rather than management practices or
social dynamics.
The importance of social context has been especially evident during the COVID
pandemic of 2020 that has disrupted relationships with work globally. The disruption
has occurred in diverse ways, intensifying the work and risks of healthcare providers
while sending entertainers and restaurant workers into unemployment. For some the
dominant pressures toward exhaustion arise from intense work demands
(ClinicalTrials.gov 2020). For others, cynicism and hopelessness in response to
inadequate workplace or government action dominates (Leiter 2019b). The need to
abruptly change work methods or change specialty in response to shutdowns or
treatment requirements challenged efficacy in many instances (König et al. 2020).
Increases in levels of exhaustion and cynicism under these circumstances seem much
more a function of the situation than of people having insufficient resilience.
Beyond the intensity of the pandemic times, the nature of work has intensified
without consideration for the capacity of people to sustain their level of participation.
The increased centralization of wealth and the competition for elite positions in
finance, medicine, law, and other lucrative fields have created structures that drive
people to work very long hours at an intense pace to maintain their position in
whatever race is occurring (Markovits 2019). On the other end of the income
distribution, people work long, uncertain, and fragmented hours to maintain a
home and provide for basic needs (McCallum 2020). From broad social trends to
social encounters while passing in the hallway, the design and process of contem-
porary work define conditions contributing to burnout.

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Workplace Fatigue: The Impact of the Drive
30
Darren Wishart and Daniell Barrett

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 616
What Is Fatigue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 617
Causes of Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 618
The Neurobiology of Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 618
Time on Task and Cognitive Load . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619
Environmental Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619
Time Without Sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 620
Measuring Fatigue at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 620
Fitness for Duty Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 621
Continuous Operator Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 622
Performance-Based Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 623
Fatigue in the Work-Driving Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 623
Monitoring Driver Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 626
Organizational Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 627
Managing Driver Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 627
The Swiss Cheese Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 628
Threat and Error Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 628
Biomathematical Models of Fatigue Risk Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 629
Safety Error Trajectory Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 629
Adapted Safety Error Trajectory Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 629
Future Directions and Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 633
Conclusions and Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 634
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 634

Abstract
Fatigue for many people has become an everyday occurrence, particularly due to
the demands associated with work hours, lifestyle, work family balance, travel,

D. Wishart (*) · D. Barrett

Griffith University, Mt Gravatt Campus, Mount Gravatt, QLD, Australia
e-mail: d.wishart@griffith.edu.au; daniell.barrett@griffith.edu.au

© Springer Nature Switzerland AG 2022 615

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_26
616 D. Wishart and D. Barrett

and commuting. Within a workplace, hazards such as fatigue require particular

consideration and risk mitigation strategies to ensure a safe workplace. One area
requiring increased attention within the work environment is fatigue within the
work-driving context. Many people as part of their workday drive for work, and
this activity has been identified as a high-risk work activity due to the significant
injuries and fatalities attributed to work crashes. The demands associated with
work and business and the geographical size of Australia can result in increasing
amounts of time spent behind the wheel. Fatigue is a contributing factor to
workplace crashes. Fatigue is a product of both physiological and environmental
properties and has a significant impact on an individual’s driving ability resulting
from decreased psychological functioning, delayed reaction time, poor decision-
making, and reduced attentiveness. Transport industry safety management sys-
tems operate implementing a variety of strategies aimed at reducing the risk of
fatigue-related incidents. However, the risk management, monitoring, and pre-
vention of fatigue in the work-driving setting offers unique challenges. This
chapter provides an overview of previous fatigue risk management and research
and some of the unique challenges associated with the measurement of fatigue.
An adapted version of Dawson and McCulloch (Sleep Med Rev 9:365–380.
https://doi.org/10.1016/j.smrv.2005.03.002, 2005) Safety Error Trajectory
Framework is provided along with the implications to organizational culture
and work-driving safety across multiple organizational levels. This chapter con-
cludes by suggesting a number of future directions for research and industry
aiming to reduce the impact and frequency of fatigue crashes within the work
environment.

Keywords
Fatigue · Sleepiness · Safety · Safety management systems · Driver incidents ·
Measurement

Introduction

In an ever changing and competitive world of business, work, and careers, people are
under pressure to do the job faster, more efficiently, get ahead in a job or career, and
optimize market share and consequently are likely to work longer hours for career
progression. In addition to the long hours associated with work, is the need to
undertake activities to live a healthy and balanced lifestyle along with the challenges
of family demands, travel for work, and daily commuting. For many people, it
appears that there never seems to be enough hours in the day and fatigue can be
all too commonplace. People in today’s society when asked “How are things are
going?” often reply with responses attesting to being extremely busy, closely
followed up with comments about finishing each day extremely tired or worn out.
Fatigue, particularly as a result of increasing life demands, has unfortunately become
a daily occurrence. Travel and in particular driving for work also are a daily activity
30 Workplace Fatigue: The Impact of the Drive 617

for many people either spending long periods of time in the commute to and from
work or driving significant distances as part of their job. This chapter discusses
fatigue, particularly within the work environment, and outlines the different types of
fatigue along with factors associated with fatigue. This chapter discusses the impli-
cations of fatigue within the work environment and in particular within the capacity
of work-related driving and the implications associated with driving safely. It will
conclude by highlighting the current strategies and interventions to address the issue
of fatigue within the work-driving context, the applicability of these strategies for
managing fatigue in other areas of the workplace and their limitations, and sugges-
tions for future research directions.

What Is Fatigue?

The literature around fatigue, workplace fatigue, and driver fatigue often employs
different definitions for fatigue and often conflates fatigue with sleepiness. This is
further complicated when the antecedents and consequences of fatigue and sleepi-
ness are discussed. Traditionally, sleepiness is simply the tendency for an individual
to fall asleep (Lerman et al. 2012). In this manner, sleepiness can be defined as a
physiological state, akin to hunger or thirst, where an individual desires sleep
(Mullins et al. 2014). Comparatively, fatigue can be defined as a body’s response
to reduced sleep or continued physical exertion (Lerman et al. 2012). However,
fatigue does not exclusively come in physical forms with physical exhaustion or
muscular fatigue (Lerman et al. 2012; Mullins et al. 2014; Shen et al. 2006); it can
also come in the form of psychological and emotional exhaustion (Mullins et al.
2014). The exhaustion associated with fatigue has also been described as a lack of
energy or tiredness that leads to decreased physical or psychological functioning
(Shen et al. 2006). This inclusion of tiredness in this definition of fatigue places
sleepiness within the bounds of fatigue.
Fatigue and sleepiness have a variety of contributory factors. For instance,
biological processes such as circadian rhythms and their variability regulate the
human sleep cycles (Lerman et al. 2012), and the homeostatic process balances time
awake and time asleep (Satterfield and Van Dongen 2013). Researchers have also
described that some of the antecedents of fatigue include time on task and an
individual’s cognitive load (Mullins et al. 2014). Research has demonstrated that
prolonged cognitive load in the form of a series of strenuous mental tasks signifi-
cantly increased subjective rating of fatigue and decreased parasympathetic nervous
system activity, indicating the body leaves the resting state when experiencing
fatigue (Mizuno et al. 2011). Research also indicates that time on task impacts
sleepiness with increased length of time spent in a simulated driving activity leading
to subjective sleepiness gradually increasing (Ting et al. 2008). Finally, there are a
variety of sleep disorders such as sleep apnea, insomnia, and narcolepsy, which have
the capacity to contribute to fatigue and tiredness (Lerman et al. 2012). This is not a
comprehensive list of the antecedents for fatigue and sleepiness, and indeed, many of
these antecedents encompass both fatigue and sleepiness.
618 D. Wishart and D. Barrett

There are also a variety of consequences from individuals experiencing fatigue

and sleepiness that will be discussed at length in this chapter. For example, individ-
uals experiencing fatigue display hampered muscle activity and reduced cognitive
function due to fatigue that is the result of extended periods of activity (Abd-Elfattah
et al. 2015; Lerman et al. 2012). Similarly, individuals experiencing sleepiness
display a decreased ability to pay attention to detail, slower reaction time, and
impaired judgment when making decisions (Lerman et al. 2012). Such consequences
and how they apply to the driving context will be discussed at length in this chapter.
With the variety of definitions of fatigue and sleepiness, it would take a full literature
review to clarify their meaning, their independent antecedents, and their unique
consequences. That is not the purpose of this chapter. As such, this chapter will
define sleepiness as the tendency to fall asleep, and fatigue as the broader experience
of psychological and physical exhaustion; in this way, fatigue would be inclusive of
sleepiness.

Causes of Fatigue

The Neurobiology of Fatigue

At a biological level, sleepiness is the result of two primary processes: The circadian
rhythm and the homeostatic process (Satterfield and Van Dongen 2013). The circa-
dian rhythm is the biological clock governed by the hypothalamus and causes a daily
cycle of sleepiness. While this cycle is not completely dependent on light, it is
heavily impacted by the light that enters the eyes (Sack et al. 2007). Broadly, the
circadian rhythm is the process that causes a person’s feelings of sleepiness at night
and alertness during the day (Satterfield and Van Dongen 2013) along with feelings
of a slight increase in sleepiness in midafternoon (Sack et al. 2007). Research
demonstrates that an increase in workplace fatigue-related incidents coincides with
circadian rhythm peak times of sleepiness (Lerman et al. 2012). For example, a
study, using a sample of engineer shift workers, found that workplace injuries were
more likely to occur during the night shift compared to the day shift (Smith et al.
1994). Furthermore, a study on French Firefighters demonstrated that they experi-
enced the greatest amount of work-related injuries around 2400–0400 h (Riedel et al.
2011) which once again coincides with low points in circadian rhythms.
The homeostatic process acts in a different manner to the circadian rhythm
(Satterfield and Van Dongen 2013). Rather than causing sleepiness due to the
amount of light entering the eyes, it seeks to balance the amount of sleep and
wakefulness directly. It increases pressure for an individual to sleep (by making a
person feel sleepy), with the increase in time being awake, and removes this pressure
with the increase in time spent asleep (Satterfield and Van Dongen 2013; Van
Dongen and Dinges 2000). That is, the longer an individual is awake, the more
they feel like they need to sleep no matter what time of the day it is. The homeostatic
process and the circadian rhythm are both complex processes that interact with one
another in a nonlinear manner, and it is not currently possible to estimate the relative
30 Workplace Fatigue: The Impact of the Drive 619

impact the two processes have on sleepiness (Van Dongen and Dinges 2000).
However, these two neurobiological processes have direct relevance for organiza-
tional policy and in particular workplace driving. Employee shift and work
timetabling should not only consider the particular times of the day associated
with circadian rhythms, but also should consider previous sleep patterns and quality
of sleep experienced by employees in days and times prior to and during work tasks
and shifts.

Time on Task and Cognitive Load

In addition to the time of day and humans’ innate biological response, there are
several environmental factors that can contribute to sleepiness and fatigue. One such
contributing factor is the cognitive load of prolonged time spent on a singular task.
An example a study using a driving simulator found that time on task (and time of
day) impacted self-reported levels of sleepiness as participants performed six 1-h
sessions in a simulator (Åkerstedt et al. 2009). In addition to subjective sleepiness,
the results also demonstrated other physical measures linked to unsafe driving such
as lane variability and blink duration which were negatively impacted with increased
time on task in the simulator (Åkerstedt et al. 2009). Time on task not only impacts
physiological and subjective sleepiness, it also impacts individual’s cognitive per-
formance. For instance, research on standardized testing in school and university
settings has shown that with each hour later in the day that a test occurs, average
performance on tests decreases slightly (Ackerman and Kanfer 2009; Sievertsen
et al. 2016). However, with small breaks of 20–30 min, test scores can increase
(Sievertsen et al. 2016). Furthermore, research performed with computer-based
attention maintenance tasks found that sustained cognitive effort resulted in deficits
in individual’s executive attentional abilities (Mizuno et al. 2011). These results
therefore demonstrate that within a work setting, sustained attention can have a
profound impact on an individual’s level of cognitive fatigue and their ability to
function at a high level. Consequently, not only does time on task and cognitive load
impact upon work performance, but they also have serious safety implications
associated with work-driving tasks.

Environmental Issues

There are a range of factors associated with the physical environment that can also
impact an individual’s level of fatigue. For example, internal lighting provides a
clear example of an environmental factor that could influence fatigue due to the
influence that natural light has with circadian rhythms. Previous research has shown
that the inclusion of bright lights (1000 lux compared to 100 lux) during artificial
night shifts prevented the reduction in alertness and improved individuals’ perfor-
mance on cognitive tests (Campbell and Dawson 1990). Part of the process of
nocturnal work and the exposure to artificial light during that shift (i.e., nurses
620 D. Wishart and D. Barrett

working a night shift) is the returning to a normal sleep cycle. This transition from
night shift to a normal day/night sleep cycle forces changes to the circadian cycle.
Continued disruptions to these normal cycles can be associated with health issues
(Scheer et al. 2009) including diabetes (Knutson 2006) and hypertension
(Gangwisch et al. 2006). More recent research indicates that filtering out part of
the light spectrum (light below 480 nm) during night shifts can prevent the severe
impact on the circadian rhythm and result in improved alertness the next morning
(Rahman et al. 2011). While this may provide some benefit to workers associated
with shift work, it remains unclear as to the direct benefit that this may offer drivers.
In addition, workers’ ability and safety associated with driving home after such night
shifts may still be compromised. Research also suggests that temperature is also a
factor that can influence individual experiences of fatigue. Higher temperatures tend
to produce reduced rates of performance on cognitive tasks and vigilance tasks
(Lerman et al. 2012). Temperatures at the lower end of the comfort spectrum
(20C/68F) are recommended for indoor workplaces to avoid drowsiness (Lerman
et al. 2012). While it is evident that light and temperature can affect fatigue, which
has implications for workplace design to reduce the impact of fatigue, other factors
associated with fatigue are also important.

Time Without Sleep

A major factor associated with workplace fatigue is simply the lack of sleep or the
lack of quality sleep. Time without sleep can be separated into chronic lack of sleep
and acute lack of sleep (Shen et al. 2006; Winwood et al. 2005). Acute lack of sleep
is the occurrence of a bad night’s sleep during the previous 24-hour period, whereas
chronic lack of sleep occurs when a person experiences some form of persistence or
ongoing instances of a reduced amount of sleep. Generally, adults require 7–9 h of
sleep in each 24-hour period to remain healthy (Hirshkowitz et al. 2015). However,
sleep quality has also been identified as being extremely important in its relation to
fatigue (Nicassio et al. 2002), with continuous uninterrupted sleep being the most
beneficial in staving off sleepiness. There are a variety of potential causes for a
persistence of reduced sleep including chronic diseases, medication, or environmen-
tal factors (Colten and Altevogt 2006), many of which are common within work-
driving settings.

Measuring Fatigue at Work

There are a variety of challenges associated with definitively measuring fatigue, and
consequently, many organizations adopt a risk management approach to addressing
the risks and safety implications associated with fatigue. For example, within the
transport sector in Australia, there exist established limitations regarding the number
of hours a vehicle can be driven for work in a 24-h period. Consequently, risk
30 Workplace Fatigue: The Impact of the Drive 621

management and mitigation strategies are commonly implemented throughout typ-

ical high-risk work sectors such as mining, gas, and utility sectors. In contrast, other
work sectors may have more flexible arrangements due to perceptions of less risk or
challenges with resourcing demands. For example, health professionals or first
responders often must work despite fatigue. For instance, due to particular
unscheduled job demand or an extreme incident occurring toward the end of a
shift, such workers may be required to respond and, as a result, work a shift longer
than 12 h. When such shifts occur in a health care context, it can lead to a variety of
negative outcomes for the workers’ on-the-job performance (Rogers et al. 2004),
with shift work in general leading to an experience of burnout (Wisetborisut et al.
2014).
The risk management process not only includes mandating shift length or time
between shifts to ensure employees have the opportunity for sleep, but also moni-
toring fatigue to determine if workers have adequately rested. There are a variety of
methods available for measuring or monitoring fatigue, with the manner in which
fatigue is monitored often being a product of the context of the work. Within a work
setting, accurately measuring fatigue is highly important to maintain safety for the
entire workplace. There are several challenges associated with fatigue measurement
with the cost and availability of technology along with the task being performed and
what is actually being measured. In addition to ensuring safety within a workplace,
not only do fatigue risk monitoring and management strategies need to be scientif-
ically accurate, but they also need to be accepted as valid, if required to be used as
evidence in cases where fatigue may have contributed to an incident (Dawson et al.
2014). Fatigue measurement and monitoring methods can broadly be defined as
fitness for duty tests, continuous operator monitoring, or performance-based
monitoring.

Fitness for Duty Tests

Fitness for duty tests is undertaken as assessments that occur prior to an employee
having the opportunity, or being permitted, to perform the task that is part of their
work. Often these assessments employ technology as a test of reaction time or
general cognitive performance on a brief task which are used as proxy measures
for fatigue (Dawson et al. 2014). These methods suggest that if an employee
performs above a preset standard, then they are deemed to not be fatigued and
therefore fit for work. However, a limitation associated with this type of fatigue
measurement is that there is little evidence that these fitnesses for duty tests are
predictive of fatigue that is experienced across the course of a work shift. Therefore,
in regard to fatigue, it is actually only a measure of an employee’s level of fatigue at
the beginning of their shift in contrast to a measure predicting fatigue that may be
experienced at some stage after that time (Dawson et al. 2014). Furthermore, in
regard to fatigue that may occur during the course of a shift, research suggests that
there is little consensus as to the frequency with which these tests should be
administered across a shift (Dawson et al. 2014).
622 D. Wishart and D. Barrett

The psychomotor vigilance task (PVT) is heralded as the golden standard for
measuring fatigue in this manner (Dawson et al. 2014). The PVT is a reaction time
test and involves a participant waiting for an expected stimulus (a small bright light
on a computer screen) and immediately pressing a button in response to it appearing
(Dinges and Powell 1985). The assessment usually lasts 10 min with intervals
between the appearance of the stimulus varying between 2–10 s (Dinges and Powell
1985). This measures an individual’s reaction time to the stimulus, and their ability
to maintain attention to the simple task (Matthews et al. 2017). In the context of
measuring driver fatigue, reductions in driver performance are associated with
reductions in performance on the PVT. A simulated driving exercise and PVT
assessment repeatedly occurring across a 24-h period with increasing time awake
at each assessment found that both driving performance and PVT performance
degraded with the lack of sleep (Baulk et al. 2008). However, the authors of this
research highlight that reduction in driving performance as a result of time awake
was highly variable between participants, but the reduction performance in the PVT
as a result of time awake was comparably very stable and did not vary. They describe
how this indicates that PVT reaction time is not a sufficient measure of fatigue and
should be used in assessments accompanied by other tests (Baulk et al. 2008).

Continuous Operator Monitoring

These assessments measure an individual’s fatigue during work. This is done by

measuring proxy physiological indicators of fatigue. Unlike fitness for duty tests,
these methods can be very costly (Dawson et al. 2014). This is due not only to the
purchase price of the technology used, but also due to the fact that that every
employee on shift would require this technology to accompany them while they
are on shift. Common forms of this technology include measures of eye movements
or blink frequency, where others measure brainwaves through EEG, or galvanic skin
resistance (Dawson et al. 2014). Such techniques of continuously measuring fatigue
can not only be costly, but they could also potentially hinder individual work
performance with their physical presence in the workplace. Within the heavy vehicle
transport sector, recent developments in the technology space have resulted in
technology being trialed that continuously monitors drivers via in-cabin cameras
and infrared technology. The purpose of this being to monitor in real-time drivers
using facial, eye, and head movements, in addition to other aspects associated with
vehicle movements, as indicators of fatigue (Wishart 2020). The technology utilizes
a series of algorithms to, in real time, process information and determine if an event
should be defined as an indicator of fatigue. From there, a notification can be sent to a
designated fleet or transport operator, and a series of alarms and alerts within the
vehicle cabin can be triggered, alerting the driver and preventing the fatigue from
resulting in a road incident. While this technology appears to offer some safety-
related benefits through real-time event notification and preventing a fatigue crash, it
does not prevent the instance of fatigue events occurring nor predict the possibility of
fatigue prior to the driving task.
30 Workplace Fatigue: The Impact of the Drive 623

Performance-Based Monitoring

Performance-based monitoring while not directly measuring fatigue offers some

opportunity as a pseudomeasure of fatigue by measuring the continuous perfor-
mance of an individual. It is believed that measuring an individual’s performance can
provide information as to if the individual is experiencing fatigue (Dawson et al.
2014). For instance, if an individual’s work performance is decreasing or in the case
of a driver, they are making fewer within-lane corrections, or the vehicle is failing to
stay within the designated lane, then this could indicate that the person is fatigued
(Dawson et al. 2014). It is important to note that performance-based monitoring
requires fatigue to have already impacted an individual’s performance, and conse-
quently such an approach could have substantial safety implications whereby a
fatigued person’s reduced performance, if not noticed immediately, could result in
a serious workplace incident. Therefore, in performance-based monitoring, if used as
a fatigue prevention strategy, it is important to find the correct balance whereby
quality of performance has been impacted to an extent that it would indicate fatigue,
but where it would not yet be impacting upon safety.

Fatigue in the Work-Driving Context

Driving for work has been established as one of the riskiest activities that a person
can do in the performance of their job, due to the overrepresentation of work-related
crashes and injuries that occur while driving for work purposes (Haworth et al. 2000;
Mitchell et al. 2012; WHO 2004; Wishart 2015; Wishart et al. 2011). According to
Safe Work Australia (2017) in Australia during the 14 years from 2003 to 2016,
approximately two-thirds of all workplace fatalities involved vehicles indicating that
vehicles are the highest mechanism of injury to Australian worker fatalities.
Experiencing fatigue vastly increases the likelihood of a workplace incident occur-
ring, and 30% of serious workplace injuries are fatigue related (Australian Transport
Council 2011). Given the prevalence of fatigue-related workplace injuries and the
overrepresentation of work-driving crashes in worker fatalities, work-driving fatigue
is believed to be one of the most important factors contributing to all road crashes
(Haworth et al. 2000). Furthermore, due to the vastness of countries like Australia,
many people drive long distances either for holidays, pleasure, or commuting and
traveling for work. Consequently, fatigue is a particularly pertinent issue in the
driving community as a result of long-distance travel, monotony, and exposure
factors. Other factors that contribute to fatigue within the work-driving environment
include work pressure, shift work, personal circumstances, health and well-being,
inadequate amount or quality of sleep, sustained mental or physical effort, disruption
of circadian rhythms (the daily cycle of waking and sleeping), inadequate rest
breaks, and environmental stresses (heat and noise; Lerman et al. 2012).
To provide further context of the issue of fatigue while driving, approximately
20–30% of fatalities and serious injuries resulting in road incidents can be attributed
to sleepiness (Australian Transport Council 2011). With the frequency of
624 D. Wishart and D. Barrett

fatigue-related crashes, organizational and road safety stakeholders highlight the

importance of addressing the problem of fatigue in the workplace-driving context.
However, one of the major challenges associated with fatigue-related crashes, and
subsequently their prevention, is the difficulty in determining if fatigue played a role
in a road incident. Consequently, it is likely that fatigue-related crash statistics, while
alarming, are potentially grossly underreported. For example, estimations of fatigue-
related crashes vary across Australian states, due to different methods of measure-
ment and assessment that currently exist (Dawson et al. 2018). Whether or not
fatigue is recorded as a contributory factor can often depend upon the outcomes
from an investigation utilizing subjective assessments or after-the-fact determina-
tions whereby other potential factors are ruled out, leaving fatigue as the only other
potential contributing factor (Dawson et al. 2018). Therefore, the frequency of
fatigue as a contributing factor in crashes can vary substantially depending upon
the method used (Dawson et al. 2018).
Research conducted in the United States also provides compelling evidence as to
detrimental effects of fatigue on driving safety. The National Highway Traffic Safety
Administration’s National Motor Vehicle Crash Causation Survey consisting of a
representative sample of police-reported road incidents reported that when an indi-
vidual had 4 h, or less, of sleep, the next day they were 11.5 times more likely to be
involved in a road incident, compared to an individual who had at least 7 h of sleep
(AAA Foundation for Traffic Safety 2016). The results also indicated that the
likelihood of crash involvement due to fatigue decreases with each extra hour of
sleep that drivers were able to get the previous night (AAA Foundation for Traffic
Safety 2016). Further evidence attesting to the impact of fatigue upon the safe
driving context can also be demonstrated by the danger associated with traveling
in a vehicle with eyes even closing for a short time. For example, a driver traveling in
a vehicle at 100 km/h will cover a distance of 111 meters, more than the length of a
standard football field, if they happen to not look at the road or close their eyes for a
period of 4 s.
Another Australian research has highlighted the effects of fatigue by demonstrat-
ing that a person who has been awake for 17–19 h has performance capabilities
similar to being impaired by alcohol to a blood alcohol content equivalent to 0.05%,
the legal limit in Australia for most drivers (Dawson and Reid 1997; Williamson and
Feyer 2000). This research provides an indication of the alarming evidence associ-
ated with the impact of fatigue. For instance, unlike alcohol impairment whereby
there is an easily administered breath test reading that can determine the level of
blood alcohol in a person’s system, there currently is no such measurement indicator
for fatigue.
Within the driving environment, lane variability and lane drifting can also be a
fatigue-related factor that can result in head-on collisions or runoff road-type
crashes. Lane drift incidents have the propensity to increase gradually with the
increased number of hours that the driver has spent awake. A simulated driving
study found that after approximately 3, 8, 18, and 24 h awake, incidents of lane
drifting increased at each increment, with a large spike in lane drift incidents
occurring after 24+ hours (Baulk et al. 2006). Fatigue and lane drift can also be
30 Workplace Fatigue: The Impact of the Drive 625

influenced by the monotony of the task that is being performed. Research has
demonstrated that when performing a monotonous driving activity that lasted 1 h,
driver’s number of out-of-lane variations significantly increased in the second half
compared to the first half (Trumbo et al. 2017). This demonstrates how passive
fatigue can cause increased lane drifting. Increased lane variability occurs as fatigued
drivers perform fewer microlane corrections, and more macrolane corrections (Daw-
son et al. 2014), as they are slower to respond to the gradual and constant drift that
occurs when traveling within lanes.
Another key factor in the driving setting relative to fatigue is reaction time.
Reaction time is a valuable proxy measure for driver performance as it is directly
relevant to a driver’s ability to quickly and thus effectively respond to a changing
environment. Reaction time, as measured by psychomotor vigilance task (PVT), is
known to increase gradually with increased number of hours awake, with a large
spike in reaction time after 24+ hours of wakefulness (Baulk et al. 2006). Increased
levels of passive fatigue also influence reaction time. A study, examining reaction
time of drivers traveling along a simulated highway, found that reaction time
increased with the length of time the participants were driving. The road was
designed to be as realistic as possible, but to be likened to a monotonous drive
with few curves, flat landscape, and low traffic (Ting et al. 2008) suggesting that
fatigue may have an adverse effect on reaction time.
The complexities of the impact of fatigue on crashes and work-driving safety are
further muddied by differences not only in research and definitions associated with
fatigue and sleepiness, but also separating the various forms of fatigue. This is
important as different forms of fatigue have different causal factors, and thus require
different intervention strategies (May and Baldwin 2009). As discussed previously,
task-related fatigue can be distinguished from sleepiness, or sleep-related fatigue
(Lerman et al. 2012; May and Baldwin 2009). In the context of driving, task-related
fatigue can be further separated into passive fatigue and active fatigue. Passive
fatigue is caused by an individual performing a monotonous drive, an extended
drive, or when they experience cognitive underload. Active fatigue is caused by an
individual performing a secondary task, driving through high-density traffic, or
when they experience increased cognitive load (May and Baldwin 2009).
Although it may seem counterintuitive, there is evidence that performing second-
ary tasks may be beneficial for driver experiencing passive fatigue. When drivers
were performing a secondary task in the form of a song-naming game, this prevented
the decrease in performance associated with performing a monotonous simulated
driving scenario. This is explained as despite music potentially acting as a distractor,
and it was beneficial in instances of cognitive underload (monotonous driving). This
increase in allocation of cognitive resources to the environment reduced the impact
of fatigue (Trumbo et al. 2017).
Separate from the concept of passive and active fatigue, a driver is more likely to
experience general fatigue when that driver: has spent an extended amount of time
behind the wheel, is experiencing an elevated mental load, or are driving at certain
times of the day (Åkerstedt et al. 2009; Borghini et al. 2014; Trumbo et al. 2017).
Employees of the transport industry are likely to experience all of these antecedents.
626 D. Wishart and D. Barrett

The most ubiquitous likely being spending long periods of time behind the wheel.
This is also a key example of passive fatigue. The impact of extended periods of
driving can be felt by drivers very quickly. Individuals performing a simulated
monotonous driving task began experiencing reduced performance after only
30 min in the simulator (Trumbo et al. 2017). This exemplifies the problem of the
increased time on task as a contributor to the experience of fatigue. The time of day
also has a significant impact on the driver’s level of fatigue. Not only does the driver
experience a circadian low resulting in a general feeling of sleepiness, but they also
would potentially be experiencing a homeostatic pressure to sleep if they spent an
extended part of that day awake (Åkerstedt et al. 2009). Together, these neurobio-
logical pressures cause a high level of fatigue, and thus a potential for road incidents,
for drivers that work at night.

Monitoring Driver Fatigue

Organizations in attempting to address the substantial risks associated with the

monitoring and management of fatigue are looking toward the utilization of a variety
of technology-related risk mitigation interventions. The use of technology is grow-
ing in popularity, particularly in the heavy vehicle transport and logistics industry
wherein transport operations require long-haul activities. For a full review of driver
fatigue measurements, see May and Baldwin (2009), Sikander and Anwar (2019).
Some of the continuous operator monitoring and performance-based monitoring
methods are as follows:

• Continuous EEG measurement through electrodes placed on the scalp can signal
the transition between wakefulness and sleep.
• Eye closure measurements determine the length of time that eyelids cover more
than 80% of the eye. Poorer scores have been associated with higher ratings of
sleepiness and longer reaction time.
• Head-nodding measurements are performed by technology that focusses on the
driver’s head and monitors its position, providing a buzz if the head moves into a
position similar to the driver falling asleep.
• Lane departure warning systems employ an external camera to monitor the road
ahead of the vehicle and can notify the driver when they move outside of the lane
bounds.
• Collision avoidance systems in the form of sensors around the outside of the
vehicle can notify the driver if they are close to touching obstacles or other
vehicles behind or to the side of their vehicle.
• A deadman switch can be installed in a vehicle as a button or switch that the drive
must continuously press, and if they do not (presumably due to falling asleep),
then an alarm is sounded.
• Roadway designs through rumble strips can ensure that noise and vibrations are
provided to any driver that veers outside of the normally traveled lanes.
30 Workplace Fatigue: The Impact of the Drive 627

However, while this is encouraging as a means of risk mitigation, challenges still

exist associated with the identification of a fatigue-related event whereby the driver
and subsequently vehicle are not in the close proximity of assistance or even a safe
place to immediately pullover. In addition, it is alarming that instances of the use of
such technology provide some evidence attesting to how prevalent instances of
fatigue are within the work-driving setting. Furthermore, while such technology is
available, it is currently not mandatory and still requires further development to
increase reliability.

Organizational Culture

Organizational culture is also a very important aspect for any organization to

implement any controls in fatigue safety management. In an Australian organiza-
tional setting, a poor organizational safety culture was a large predictor of fatigue-
related behavior and fatigue-related near misses occurring (Strahan et al. 2008).
Employees’ experience of stress was also a predictor, albeit smaller in strength, of
fatigue-related incidents (Strahan et al. 2008). Organizational safety culture was
measured by a safety climate scale that included items around communication to
workers, individuals being able to express their views, enough employees being
available, training, and more, and fatigue-related behavior included driving when not
had enough sleep, driving for extended periods of time, driving while fatigued, and
driving longer than 2 h without breaks (Strahan et al. 2008). Further research into the
behavior of Australian train drivers shows that beliefs such as feeling that they were
unable to be relieved midshift prevented them from requesting to stop driving during
a shift, no matter the severity of their tiredness (Rainbird et al. 2010). In this setting,
there was a fear of letting the other drivers down (Rainbird et al. 2010). This is
transferable to long-haul drivers and a potential for a mentality that they “have to”
continue driving to make their delivery within certain time parameters. Interventions
into organizational culture would likely be best suited to being targeted toward
management level within the transport industry. Research from Turkey highlighted
that when management was perceived to care about safety, there was a negative
correlation with safety-related violations (Öz et al. 2013).

Managing Driver Fatigue

Measurement of fatigue is a key aspect in any intervention designed to improve

worker or driver safety. However, it is not the first step in mitigating the impact of
fatigue. For an organization to maximize the safety of its drivers, it must ensure that
fatigue is measured, reported on, and managed in a proactive manner. Furthermore,
the strategies and processes that are implemented to manage fatigue must be
applicable to the transport context and the unique organizational context. For the
transport industry to be a high reliability industry, it must successfully manage
fatigue-related safety issues by not only retroactively addressing issues, but also
628 D. Wishart and D. Barrett

proactively implementing safety systems of hazard identification and mitigation

(Gander et al. 2011). In such a maximally safe system, the occurrence of an error
would be seen as a failure at multiple levels of hazard identification and mitigation,
and an error has a trackable trajectory through these failures (Gander et al. 2011;
Reason et al. 2006). However, one of the challenges with fatigue-related errors is
associated with the real-time measurement and monitoring of fatigue and the inter-
vention prior to the actual fatigue event occurring. Recent strides in the realm of
continuous measurement of fatigue for road users have made substantial progress in
overcoming this challenge. Furthermore, even when organizations have fatigue-
related measurements and strategies to prevent the occurrence of fatigue-related
events, there are many factors outside of the organization’s control which can impact
whether an incident occurs. Even with continuous measurement of fatigue, fatigue
can still be undetected until the actual error event occurs, which can often be too late
when considering the context of an individual operating a vehicle. A number of
models developed across safety and other industries may provide applicable frame-
works to explain and manage fatigue within the work-driving sector, and a brief
overview is provided below.

The Swiss Cheese Model

The Swiss Cheese Model is a model of general safety incident prevention and
investigation. The basis of the model is that for a safety incident to occur, breaches
of multiple safety defenses occur (Li and Guldenmund 2018; Reason et al. 2006). A
key tenet of the Swiss Cheese Model is that any one breach is not itself a significant
failure, or even breaches at multiple levels. Rather, a series of failures occur
simultaneously and in an interrelated manner, which allows for a hazard to pass
through successive layers of defenses to cause an incident (Reason et al. 2006). The
levels at which controls can be put in place and failures can subsequently occur
include organizational factors, local workplace factors, unsafe acts, and defenses
(Reason et al. 2006).

Threat and Error Management

The Threat and Error Management system originated in the aviation industry but has
applicability in a general safety management setting (Brennan et al. 2020; Helmreich
2000). The model separates threats and errors as two distinct and intersecting
avenues that safety incidents can occur through. Threat can either be latent, with
organizational culture or professional policies, or they can be immediate with
environmental, individual, or team factors (Helmreich 2000). Errors, when they
occur, follow an immediate error management process starting with the error being
recognized, and the management of the error state occurring, which can either lead to
a negative outcome or the mitigation of the negative outcome (Brennan et al. 2020;
Helmreich 2000). The latent and immediate threats can influence the error
30 Workplace Fatigue: The Impact of the Drive 629

management process, with individual and organizational factors influencing whether

the error is being recognized and how the error state is managed. Despite both the
Swiss Cheese Model and Threat and Error Management Model not being explicitly
modeled in response to fatigue management, as general models, they are highly
applicable to fatigue risk-based management.

Biomathematical Models of Fatigue Risk Management

Biomathematical models of fatigue employ quantitative methods to predict the level

of fatigue that employees experience in association with different working patterns
(Dawson et al. 2011). Broadly, such quantitative methods aim to create models of the
levels of fatigue that are associated with different shift patterns (James et al. 2018).
From there, predictions can be made about the level of fatigue that employees are
likely to experience under specific conditions. This should subsequently inform
organizational decision-making around shift and work patterns in light of the
fatigue-based risk. Example biomathematical models include models where the
amount of sleep that individuals obtain is measured or their level of opportunity
for sleep is measured based on shift scheduling. In either instance, minimum
benchmarks are required for an individual to be deemed fit for work (Dawson
et al. 2011). Furthermore, biomathematical models have the potential of informing
the amount of sleep required for safe operation within a specific role to be achieved.

Safety Error Trajectory Framework

The Safety Error Trajectory Framework created a safety management system focus
on modeling the levels of fatigue safety (Dawson et al. 2012; Dawson and
McCulloch 2005). This model recognizes the value of past models such as the
Swiss Cheese Model and the Threat and Error Management Model while applying
it to a fatigue context with the incorporation of the biomathematical models. The
model has five levels as follows: opportunity for sleep, actual sleep obtained,
symptoms of fatigue, errors related to fatigue, and the fatigue-related error. Each
of the levels preceding the fatigue-related error describes both where safety failures
can occur, or where safety controls can be implemented.

Adapted Safety Error Trajectory Framework

The below model (see Fig. 1) is an adaptation of the safety error trajectory frame-
work applicable to work driving. The safety error trajectory framework is an
excellent marriage of the focus on sleep and the multilevel safety management
models that came before. This adapted version expands on this further and incorpo-
rates organizational demands directly into the framework. This allows for an explicit
recognition of the significance that the type, importance, and salience that the
630 D. Wishart and D. Barrett

Fig. 1 An adapted version of the safety error trajectory framework with the addition of organiza-
tional demands/reasonable organizational demands

organizational demands themselves can have on an employee’s experience of

fatigue. Similar to the original framework, each level highlighted below can be
understood in regard to both how failures can occur and how controls can be
implemented. However, a further expansion in the adapted version below is the
discussion of how organizational culture can have a significant impact on both the
presence of safety failures and the ability for controls to be implemented.
Errors or failures can occur at each level as follows:

• Level 1: This level includes the opportunity that has been afforded to an individ-
ual driver to actually sleep. Fundamentally, this is a probabilistic assumption as it
is not certain that an individual would acquire or be perfectly able to acquire
adequate sleep when given a certain period of inter-work time. As such, it is
important to note that the average amount of sleep that an individual obtains is
relevant here (Dawson and McCulloch 2005).
• Level 2: This level simply includes the amount of actual sleep that was obtained
by the individual. As discussed already in this chapter, the amount of sleep
obtained, not only in the past 24-h period, but also in the longer 48-h period, is
relevant for immediate experienced fatigue for drivers (Dawson and McCulloch
2005).
• Level 3: This level is an expansion of the original safety error trajectory frame-
work and includes demands that are directly placed on the employees, and the
degree to which these are likely to invoke fatigue within the individual. Of
relevance here is the types of demands and their presentation to the employees.
For instance, the demands could include an individual performing a repetitive and
30 Workplace Fatigue: The Impact of the Drive 631

monotonous task at night, such as long-haul driving along straight and flat roads
is more likely to experience fatigue (Ting et al. 2008; Trumbo et al. 2017).
Alternatively, higher intensity and more cognitively demanding work can pro-
duce active fatigue within a driver (May and Baldwin 2009).
• Level 4: Signs and symptoms of fatigue that the individual displays in their
behavior or cognitive state can indicate their level of fatigue (Dawson et al.
2011). Clear examples of such behavioral indicators include the increased blink
frequency and duration.
• Level 5: The occurrence of fatigue-related errors. This is the closest step to a
safety incident occurring and may have not occurred simply because of other
safety barriers, or because the error was not large enough to result in an incident.
For instance, a microsleep and the associated lane drift while driving would be the
occurrence of a fatigue-related error; however, it would not necessarily result in a
road incident (Dawson et al. 2011).
• Level 6: Occurrence of fatigue-related incidents such as a driver being involved in
a road incident due to their fatigue.

Controls can be in place at each level as follows:

• Level 1: Organizational controls at this level include ensuring that employees are
provided with opportunity to have enough sleep (Dawson and McCulloch 2005).
An example of this would be having a mandatory minimum number of hours
between shifts for long-haul workers to ensure that they have had the opportunity
to sleep. A further example on long haul is the provision of adequate and suitable
areas to sleep.
• Level 2: Organizational controls at this level go beyond ensuring that employees
are provided with enough time to sleep, to actually ensuring that they obtain that
sleep. This is mostly the responsibility of the individual themselves, as they need
to obtain an adequate amount of sleep to function at their maximum capacity. To
determine if individuals have had sufficient sleep, prior sleep/wake models can be
employed (Dawson and McCulloch 2005). However, while sleep hours may
provide an indication although organizations primarily record the number of
hours at rest, further directions could be explored regarding sleep quality.
• Level 3: Organizational controls at this level include ensuring that demands
themselves are manageable and realistic, for instance, regulating that workers
must have a break after a certain period of time. Furthermore, it would not be
conducive to a safe work environment for workers to be presented with demands
that require them to work through their breaks, to work overtime, or for them to
continue to work even when they feel tired. Managing demands as they are
presented to an individual to ensure that drivers delivering products along a
timeline have a realistic set of demands set before them can assist as an organi-
zational control.
• Level 4: Measurement is a key component to mitigating the impact of fatigue, and
this applies primarily at this level and the next. Level 4 is where the organization
has the opportunity to assess an individual’s level of fatigue by measuring the
632 D. Wishart and D. Barrett

behavioral indicators of fatigue. This is where technology such as eye closure

measures, head-nodding measurement, and self-report measures of fatigue would
be found (Dawson and McCulloch 2005). Although it is not necessary for these
fatigue assessments to take place within the vehicle, many of these measures
currently are in the form of continuous operator monitoring such as eye move-
ments as an addition to fitness for duty assessments.
• Level 5: Organizational controls at this level also would include directly moni-
toring of individuals and the vehicle to measure when close calls occur. Measure-
ments currently utilized within a vehicle are in the form of performance-based
monitoring, as it is the fatigue-related behaviors that are occurring at this level.
Strategies here can expand beyond simply measuring the level of fatigue and
intervening when fatigue is found and could attempt to fatigue proof a system that
an individual operates within (Dawson and McCulloch 2005), for instance,
automatic warning systems. In comparison to level 4, where the degree to
which an individual is experiencing fatigue is measured (e.g., eye closure or
head-nodding), level 5 would aim to measure the actual errors that result from that
fatigue (e.g., lane drift). It must be noted such errors may not necessarily result in
an incident when they are measured.
• Level 6: When fatigue-related events do occur, an organization has an opportunity
to investigate the circumstances around the event to determine where the failures
occurred in the barriers leading up to that incident. This is for the purpose of
continual improvement in the fatigue management system within the
organization.

Organizational culture also directly pertains to the safety error trajectory frame-
work that is described above at each of the levels as follows:

• Level 1: A negative organizational culture at this level could manifest in how

employees and managers treat the minimum time between shifts. For instance, in
a health setting, nurses frequently work shifts up to 13–15 h long while working
consecutive days (Trinkoff et al. 2006). This may arise from an industry culture in
health care delivery that may be focused on patient care, at the expense of health
care professional well-being.
• Level 2: At this level, an organizational culture exists in the descriptive and
injunctive norms that employees perceive around the amount of sleep that is to be
obtained between shifts. Despite explicit organizational policy positions on sleep
that is to be obtained, employees might not pay much attention to such rules, and
instead rely on their perceptions of what is acceptable behavior, in regard to
amount of sleep to be obtained, based on observing the behaviors of others.
• Level 3: At this level, an organizational culture may implicitly have demands that
extend beyond the explicit deadlines. For instance, it may be procedure that a
long-haul drive must take a break after a certain amount of time on the road;
however, doing so may create a delay in delivery that would not be deemed
acceptable for one reason or another.
30 Workplace Fatigue: The Impact of the Drive 633

• Level 4: At this level, an organization culture may not embrace a true safety
culture where employees recognize and understand the significance of fatigue.
For instance, an organization can build a safety culture by communicating the
priority of driver safety over delivery times through ensuring that all drivers are
aware how it is acceptable for them to arrive at their destination late if they need to
take a fatigue-related break.
• Level 5: At this level, an organizational culture can be accepting of errors made
by employees. This would encourage a culture where employees feel safe in
coming forward with the errors they have made, and not being afraid of punish-
ment, which would encourage them to hide fatigue-related errors, potentially
leading to an increased likelihood of a fatigue-related incident.
• Level 6: At the final stage, once an incident has already occurred, there is a
multitude of ways that an organization can approach the investigation process. If
an organization has learning culture where safety ideals are truly attempted to be
met, then that would have the potential of reducing future incidents with lessons
learned. A negative culture around incidents might be purely a liability approach,
where the organization strives to do enough where they would not be financially
responsible for any incident, if one does occur.

Future Directions and Opportunities

In attempting to address the fatigue issue particularly within the work-driving

context, numerous models and risk management frameworks are utilized in con-
junction with much laboratory-based research to better understand fatigue and the
impact of fatigue on human performance. While fatigue monitoring and manage-
ment frameworks have improved in recent years, further opportunities and research
are required to facilitate continuous improvement and proactive predictability of
fatigue events. For instance, the authors are currently involved in conducting pilot
research within the heavy vehicle industry sector to investigate real-time driver
monitoring technology across numerous transport operations and the impact the
technology has upon fatigue prevention, driver behavior and management, and
organizational safety culture. Despite the technology providing real-time indications
of fatigue, monitored drivers still show signs of fatigue-related incidents or near
misses. Future research and technology directions can hopefully advance to develop
reliable mechanisms to determine fatigue well in advance of even these indicators
prior to embarking upon a trip.
In addition, fatigue-related crashes are potentially underreported. To further
advance the determination of fatigue-related events, postincident investigations
and evaluations into the manner in which fatigue may have interacted with other
potential contributing factors need to be improved.
Organizational safety systems and frameworks need to not only provide adequate
structure to mitigate risk and manage fatigue but also ensure that they are easily
administered and industry friendly in application. Consequently, future research and
fatigue framework development within the heavy vehicle sector will require
634 D. Wishart and D. Barrett

extensive industry consultation and collaboration to ensure that driving fatigue is

addressed in a manner that is workable in a competitive business environment along
with ensuring other hazards are not introduced into the system.
Finally, while this chapter has focused on fatigue within the workplace-driving
setting, there are fatigue and risk management implications associated within other
work settings, and any advances in managing and mitigating risk within the work-
driving setting may also provide opportunities to further inform general workplace
fatigue.

Conclusions and Summary

Fatigue is an issue impacting upon the health and well-being of workers across many
work environments, including the work driving setting where fatigue is a major
contributor to unsafe driving and crashes. This chapter has discussed fatigue and
some of the many challenges associated with measuring, monitoring, and managing
fatigue. While much of the focus on managing and monitoring fatigue within the
work driving setting is upon the driver, organizational safety systems, risk manage-
ment in conjunction with fostering, and supporting a positive organizational safety
culture are paramount to better understanding and addressing the complexities of
work driving fatigue. Furthermore, work driving fatigue management systems and
processes, to have any success, need to be practical, lack complexity, and improve
safety while managing the demands of business.

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Disruption in the Workplace
Vocational Rehabilitation in the New World
31
Elizabeth Kendall and Vanette McLennan

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 640
What Is Vocational Rehabilitation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 642
The Timing of Vocational Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 645
The Role of a Collaborative Organizational Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 646
The Future of Vocational Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649
Managing Variable and Unpredictable Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649
Personalized Participatory and Customizable Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651
Alternative Business Models . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 652
Technology-Enabled Vocational Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 653
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 655
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 656

Abstract
Despite considerable global focus on the right to work, employment rates for
people with disability have failed to improve over the last decade. People with
disability continue to encounter discrimination, stigmatization, and accessibility
issues in securing and maintaining employment. Returning to work after an
illness or injury is more likely than ever before, but the evidence to support
vocational rehabilitation is limited. The rapid adoption of advanced personalized
technologies automation and artificial intelligence along with globalization and
evolving business models present new opportunities for the inclusion of people
with disabilities in the workplace. However, parallel to these potential gains are
major challenges in promoting equality, well-being, and disability prevention in a
24/7 economy where the boundaries between work and life have become increas-
ingly blurred. Vocational rehabilitation offers a vehicle for managing these

E. Kendall (*) · V. McLennan

The Hopkins Centre Menzies Health Institute Qld, Griffith University, Brisbane, QLD, Australia
e-mail: e.kendall@griffith.edu.au; v.mclennan@griffith.edu.au

© Springer Nature Switzerland AG 2022 639

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_28
640 E. Kendall and V. McLennan

challenges and trends in ways that will enhance experiences for all workers in the
future. This chapter examines the trends that have influenced vocational rehabil-
itation in the past and into the future.

Keywords
Vocational rehabilitation · Disability · Workplace · Employment · Return to work

Introduction

According to the World Health Organization, at least 15% of the population has a
diagnosed disability (WHO 2011) representing 1.2 billion people in 2020.
Depending on the way in which disability is defined and recorded in different
countries, population prevalence can range from 10 to 40%. In Australia one in
five people (20%) has a disability (Australian Bureau of Statistics 2016). However,
another 20% have long-term disabling conditions that may not be labeled as a
disability (Australian Bureau of Statistics 2016). Thus, up to 40% of the population
may experience disability at any point in time suggesting that most households will
have been affected by disability.
Article 27 of the Convention on the Rights of Persons with Disabilities affords
people with disability “the right to the opportunity to gain a living by work freely
chosen or accepted in a labor market and a work environment that is open, inclusive
and accessible to persons with disabilities.” Further, one of the 2030 Sustainable
Development Goals (SDGs) set by the United Nations is to “promote sustained,
inclusive and sustainable economic growth, full and productive employment and
decent work for all.” The SDGs make specific reference to disability and aspire
strongly to a “leave no one behind” agenda (Abualghaib et al. 2019). Access to
income from employment is a fundamental marker of social inclusion and partici-
pation in society (Lin et al. 2019) but also enables participation in many other
activities and contributes to a positive evaluation of oneself. As a result, there is
now global consensus that people with disabilities should receive assistance to
remain in or (re-)enter work (Ma et al. 2020).
Despite this trend toward human rights, the ability to work without discrimination
is often denied to people with disability (McEwin 2017). Around the world people
with disability continue to be underrepresented in the workplace with unemployment
rates of up to 80–90% in developing countries and 50–70% in developed countries
(UN World Bank). Labor force participation rates for people with disability in
Australia are low (53% of working-age people with disability compared with 83%
without disability (AIHW 2019)), and these rates have changed very little over the
past two decades meaning that few employers will have experienced the benefits of
employing disabled workers.
Unfortunately, discrimination remains extremely common in the workforce. Global
statistics consistently show that people with disability are employed at significantly
lower rates than the general population (OECD 2010). Research has shown that
31 Disruption in the Workplace 641

employers often hold pessimistic views about the work capabilities of people with
disabilities (Bonaccio et al. 2020). In Australia, but also in other countries, the largest
proportion of discrimination cases reported to statutory agencies concern disability
and particularly employment discrimination (Darcy et al. 2016). Discrimination
complaints are most common for people with mental health concerns or stigmatized
health conditions, such as HIV. Compared to employees without disabilities, those
with disabilities also report less job security and flexibility; more negative treatment by
management; and lower levels of job satisfaction (Schur et al. 2017).
When injury, illness and disability are not well accommodated or supported at
work, workers are likely to be physically present but unable to perform their duties
(presenteeism) with detrimental consequences for all stakeholders. Presenteeism has
been described as a hidden cost of workplace injury and disability that could be as
high as 60% of the total cost (Ammendolia et al. 2016). Further, presenteeism among
nursing and healthcare professionals has been associated with an elevated risk of
being in receipt of a disability pension in the future even after adjusting for gender,
sociodemographic variables, physical and psychosocial working conditions, and
self-rated health (Gustafsson et al. 2019). Thus, the cost and impact of this situation
are magnified and felt by the entire society.
Some researchers have described the disabled population as one of the largest
underutilized labor pools (Kruse et al. 2010). Buys et al. (2015) commented on a
notable shift in government attitude from viewing those with disabilities as a
marginalized welfare group to a solution for important labor shortages. However,
attracting qualified applicants with disabilities continues to be a challenge for
employers (Bonaccio et al. 2020). Bruyère et al. (2005) concluded that recruitment
and application processes actively discourage people with disabilities due to the lack
of accessibility. People with disabilities or illnesses are also likely to conceal their
condition for fear of discrimination which then obscures the need for employers to
implement new processes.
The difference in employment rates between disabled and non-disabled people is
an important indicator of disability equality (Geiger et al. 2017). Although there is a
large amount of disability data available, definitions and indicators vary widely
resulting in diverse estimates of prevalence. As Geiger et al. (2017) concluded,
there are many defensible ways of measuring disability, but each produces different
reported levels of disability accounting for different statistics across the world and
across different studies. This effect was demonstrated in a New Zealand study of
2807 randomly selected citizens conducted by Bourke et al. (2020). These
researchers simultaneously applied four different methods of disability measurement
and identified prevalence rates ranging from 9.1% to 27.7%. Abualghaib et al.
(2019) concluded that employment initiatives are hindered by the absence of reliable
disability data particularly given that accurately measuring progress towards targets
is the only way of bringing attention to gaps and inequities. There is clearly a need
for investment in consistent disability measures that allow comparisons across
multiple boundaries and intervals.
There is evidence to suggest that employers can benefit greatly from the employ-
ment of people with disabilities as well as the rapid rehabilitation of those who
642 E. Kendall and V. McLennan

become disabled during their employment (Hartnett et al. 2011). Some of the
identified benefits for employers include a more diverse and creative workplace
culture, increased morale and enthusiasm among employees, enhanced productivity
(and profitability), and a supportive flexible environment that benefits all employees
(Lindsay et al. 2018). This return on investment has been demonstrated in multiple
studies that have shown exemplary performance by disabled employees when the
right accommodations have been put in place (Silvia et al. 2020; Sinden and Martin
Ginis 2012) as well as flow on benefits for workers without disability (Schur et al.
2014). Unfortunately, disability employment initiatives aimed at employers often
take a social justice angle, encouraging them to be willing to consider employees
with disabilities for the greater good of society. This approach can be effective but
also underemphasizes the benefits that can accrue to employers who actively pro-
mote accessibility and inclusion as fundamental values underpinning their work-
place culture. Vocational rehabilitation is a practice that has become increasingly
embedded in workplaces and offers a vehicle through which employers can experi-
ence the value of employees with disability.

What Is Vocational Rehabilitation?

Whether or not someone has a work disability depends on the match between
physical or mental status and the requirements of a particular job or work environ-
ment at a particular point in time. Thus, work disability is not a static concept and
may change across time, workplaces, and tasks (Maestas et al. 2019). Vocational
rehabilitation has been specifically designed to address work disability. It is a
combination of interventions or an overarching approach designed to assist someone
with a disability to remain at work, return to the workplace, or enter employment for
the first time.
In reality, vocational rehabilitation is not well defined or integrated and is
represented by a collection of services, actions and funding incentives tailored to
particular situations. There is a lack of clarity about what practices constitute
vocational rehabilitation and in the field, practice incorporates an extremely broad
set of activities. For instance, Gensby et al. (2014) examined multiple vocational
programs and identified an extensive list of activities including early contact with
injured or disabled employees, vocational assessments including job analysis and
counseling, workplace accommodations (including modified and/or tailored work
environments, schedules or duties, transitional work opportunities, alternative place-
ments, revision of workplace roles, redefinitions of tasks and delegation of respon-
sibilities, job replacement, and job sharing), return-to-work coordination or case
management, clinical interventions for psychological or physical abilities (e.g.,
therapy, exercise, ergonomics, motivational training), and ongoing monitoring.
Gensby and colleagues (2014) concluded that vocational rehabilitation also
consisted of broader activities such as the education and engagement of all stake-
holders, development of policies, and implementation of prevention strategies. In the
last few decades, a movement has emerged focusing on bringing injury prevention,
31 Disruption in the Workplace 643

return-to-work, and disability employment programs under an overarching frame-

work, often referred to as disability management (Shrey et al. 2006). This promising
development has reoriented many elements of vocational rehabilitation (Buys et al.
2015) by emphasizing the central role of the employer and workplace culture. In
reality, however, the delivery of vocational rehabilitation still varies considerably, by
necessity and in response to factors such as caseload, the target population, the
industries in which services are delivered, the circumstances of individual workers,
and the type of funding or regulatory scheme.
Despite such diversity, researchers who reviewed a large number of vocational
rehabilitation programs found that variation was usually within 12% of a nominated
benchmark (Holmes et al. 2020). The most frequently provided services were
vocational assessment, work preparation, and return-to-work accommodations.
One of the most comprehensive reviews of vocational rehabilitation (Waddell
et al. 2013), commissioned by the UK government, examined 450 scientific studies
and concluded that there was strong evidence for the combination of work-focused
clinical interventions designed to improve work-related skills of the individual and
accommodating workplaces designed to ensure the working environment maximizes
positive outcomes. Van der Klink et al. (2016) came to a similar conclusion and
noted the important distinction between (i) being physically and mentally able to
perform at work, (ii) having opportunities to perform, and (iii) being facilitated and
allowed to perform by the workplace. Vocational rehabilitation focuses on bringing
together these three concepts in a meaningful way by matching individual-focused
interventions with workplace-based interventions and broader social interventions to
deliver employment success.
One of the mainstays of vocational rehabilitation is tailored workplace accom-
modations, despite some criticism about the lack of theoretical basis or sound
evaluation for this process (Doyle and McDowall 2019). Accommodations are the
modifications and supports required by workers with permanent disabilities or
temporary incapacities to improve their access to work, enable job performance
and support job maintenence. These accommodations usually involve changes in
work tasks, duration, intensity, or timing of activities. These accommodations are
relatively easy to organize, particularly in large organizations where workers and
tasks can be rotated or substituted. Although accommodations are more challenging
in small business environments, a more significant challenge involves the need for
modifications to the physical workplace to improve access or support performance.
Retrofitting spaces to introduce accessibility is difficult and costly for employers, so
responses are often piecemeal and inadequate to meet the needs of disabled
employees. When assistive equipment is integrated into a workplace, it is usually
based on the application of standardized modifications that might work for the
greatest number of individuals but may not address the specific needs of individual
workers allowing them to be competitive and productive at work. Universal archi-
tectural design for workplaces is an important aspiration for the future, particularly
for large public employers. Similarly, personalizing assistive equipment and allo-
wing customizable modifications are an important focus for the future of vocational
rehabilitation.
644 E. Kendall and V. McLennan

The lack of evidence about accommodations in the workplace stems from the
nature of evaluation studies in this field. The main focus of evaluations has been on
musculoskeletal disorders in employees of large organizations (Kristman et al.
2016). Researchers have concluded that strong evidence supports the effectiveness
of vocational rehabilitation interventions for musculoskeletal conditions particularly
low back pain (Waddell et al. 2013). However, little is known about the effectiveness
of interventions in different populations (Alexander and Cooper 2019). Some
populations are very poorly researched in relation to employment, resulting in
inadequate evidence to inform future program design. For example, the review
conducted by Ma et al. (2020) highlighted a paucity of research focused on inter-
ventions to support vocational outcomes for adults with childhood-onset disabilities.
Although job placement assistance, on-the-job training, on-the-job supports,
counseling, and guidance predicted successful employment outcomes, this popula-
tion is clearly an area for consideration in future. The review by Sweetland et al.
(2012) found a lack of large quantitative studies in the area of employment and
multiple sclerosis. They recommended further research before any conclusions could
be drawn about the effectiveness of particular interventions to support work reten-
tion or return to work for this population. Similarly, in a review of stroke programs,
Baldwin and Brusco (2011) found a lack of high-quality trials to draw any conclu-
sions about the effectiveness of vocational rehabilitation. In cancer populations,
Tamminga et al. (2010) concluded that it was not possible to determine the effec-
tiveness of vocational rehabilitation due to the large differences in the content of
interventions, samples, and study designs. Even in the area of spinal cord injury, a
review by Roels et al. (2016) identified a profound lack of high-level evidence
focusing on interventions to improve employment.
For more commonly researched disability groups, vocational rehabilitation pro-
grams are often radically different leading to inconclusive research. As a result,
evidence to support vocational rehabilitation is mixed. For instance, even within the
area of musculoskeletal injuries, a Cochrane review showed no high-quality evi-
dence to support or refute its efficacy for enhancing return to work in workers with
traumatic upper limb injuries (Hou et al. 2017). A comparison of nine vocational
rehabilitation programs for people with hearing difficulties (Gussenhoven et al.
2013) identified vast differences in procedure, duration, setting, and content. The
only common elements where conclusions could be made were basic tasks, such as
education, the provision of hearing aids and other assistive devices, training in
coping strategies and communication, and information about workplace accommo-
dations for employers.
Lund and Cmar (2019) sought to understand the differential impacts of vocational
rehabilitation for people with visual impairments. Their review indicated that good
outcomes were less likely for those with lower levels of education or who were
already in receipt of social security income. Similarly, Etuknwa et al. (2019)
confirmed that younger age and higher education levels were associated with better
outcomes for people with musculoskeletal disorders and mental disorders who
participated in vocational rehabilitation. In a review of stroke rehabilitation, Wei
et al. (2016) found inconsistent evidence for vocational rehabilitation but noted that
31 Disruption in the Workplace 645

improvements in fatigue and cognitive function were related to successful return-to-

work outcomes. Thus, the success of vocational rehabilitation may be evident for
particular employees but also predicated on the extent to which it can address work-
related challenges experienced by injured and disabled workers.
Researchers have unanimously commented on the complications created by
inconsistent measurement of employment outcomes, including a lack of standard-
ized terminology or definitions and the vast differences in the way programs are
delivered. As Alexander and Cooper (2019) concluded in their review of vocational
rehabilitation, studies lacked detail about components of programs’ timing, duration,
and delivery mechanisms limiting reproducibility. Most studies defined employment
status dichotomously (i.e., successful versus not successful), whereas other studies
used more detailed categories of employment outcomes (i.e., full-time, part-time,
employment relative to pre-injury employment, and level of income), and others
have included homemaking and full-time studies as employment outcomes, making
comparisons difficult or impossible. There are multiple ways of conceptualizing
employment outcomes, and each will lead to different conclusions. Comparison
groups are difficult to achieve in this area as withholding vocational support from
people who have been injured or disabled would be considered unethical in most
circumstances. Natural control groups are unhelpful as workers who do not access
vocational rehabilitation of any kind are typically those who do not require or want
assistance. Not surprisingly, in the review by Baldwin and Brusco (2011), employ-
ment rates varied from 12% to 49% across the included studies, and it was difficult to
conclude the extent to which any change can be attributed to the intervention. This
heterogeneity and variability in study designs limit the development of evidence and
clarity about effectiveness.

The Timing of Vocational Rehabilitation

The concept of early intervention is central to vocational rehabilitation, yet imple-

mentation in practice has been rare, especially in cases of significant injuries and
disabilities. Waddell et al. (2013) recommended early delivery of simple
low-intensity low-cost interventions that could facilitate rapid (re)engagement with
the workplace. Progressively more intensive and structured interventions should
then be provided for those who need additional help to access and/or maintain work.
For young people with disabilities, early intervention will mean stronger transi-
tion programs and school engagement. For people who are injured or become ill at
work, it will mean embedding early indications of injury into the workplace to
promote early treatment or prevention and maintain a strong employer-employee
bond (Bloom et al. 2019; Murphy and O’Hare 2011). Wei et al. (2016) recommended
that inpatient stroke rehabilitation programs should focus more on preparation for
return to employment particularly for younger people. Similar conclusions have
been made in relation to early onset dementia (McCulloch et al. 2016). In the area of
brain injury, some researchers have commented on the lack of vocational rehabili-
tation during hospital treatment (O’Keefe et al. 2019). They concluded that work
646 E. Kendall and V. McLennan

skills could be improved during hospital rehabilitation even though some aspects of
vocational rehabilitation might not be feasible. Early commencement of vocational
rehabilitation has only recently gained momentum through emerging evidence of its
effectiveness (Hilton et al. 2017; Middleton et al. 2015). This approach capitalizes
on people’s early hopes and motivations for a return to “normal” life and ensures that
the possibilities of (re)entering work or study are communicated early which can also
enhance motivation and treatment adherence in other aspects of rehabilitation (Fadyl
and McPherson 2010). Finding ways to engage earlier will be a key focus of future
vocational rehabilitation in maximizing the likelihood of successful and sustainable
employment outcomes.
Sustained support over time is also an important yet overlooked element of
vocational rehabilitation. Gray et al. (2019) confirmed that clear return-to-work
plans and ongoing support in the workplace were particularly important to sustained
employment outcomes for injured workers. The lack of long-term vocational support
was particularly evident in the study conducted by Jetha et al. (2019). In reviewing
19 studies of interventions designed to promote workforce participation of people
with disabilities, Jetha and colleagues identified a clear focus on preparation for
employment and transition into work. However, no interventions focused on sus-
taining employment or advancing the careers of these workers. Similarly, in a review
of workplace supports for people with intellectual disability, Carlson et al. (2020)
confirmed that programs focused mostly on performance support and maintenance
of employment. Some programs focused on supports for social integration in the
workplace, but no programs focused on career advancement. Boelhouwer et al.
(2020) concluded from their review of cancer survivors that no data were available
beyond the first 2 years after cancer treatment. However, physical or cognitive
complaints and fatigue occurring later in the course of treatment were negatively
associated with work ability suggesting that an impact on employment may be
observed in the long term. The absence of longitudinal studies that track outcomes
over a longer period of time prevents reliable conclusions.

The Role of a Collaborative Organizational Culture

The shift toward disability management in the last few decades has emphasized the
importance of the organizational context and the role of employers in creating a
supportive environment for workers with disabilities. An interesting illustration of
this shift is shown by Main and Shaw (2016) who compared the content of a 2005
conference on disability and employment with the 2015 version of the same confer-
ence. In 2005, key themes were clinical in focus with only a few items focusing on
the broader working environment. Topics included early risk prediction; psychoso-
cial, behavioral and cognitive interventions and physical treatments to improve
work performance; the challenges associated with implementing evidence; outcome
evaluation in the workplace; and engaging multiple stakeholders in the process.
In contrast, the 2015 conference emphasized organizational and social factors,
employer roles and responsibilities, nonclinical approaches, and maintenance of
31 Disruption in the Workplace 647

employment. The conference members agreed that future research should strive for
(a) broader inclusion of workers and workplaces in decision-making, (b) attention to
multilevel influences in the workplace, (c) a focus on social as well as physical
aspects of work, (d) earlier employer collaboration, (e) more attention to implemen-
tation, and (f) a broader assessment of possible outcome domains. Although reviews
of vocational rehabilitation practice have continued to reveal a focus on the worker
rather than on the workplace environment (Pieper et al. 2019), it is now accepted that
work-focused clinical interventions and accommodating workplaces are
interdependent and both necessary but not sufficient alone (Waddell et al. 2013).
Kristman et al. (2016) found that employers generally understood their focus to
be on defining roles and responsibilities, standardizing management tools and pro-
cedures, responding to injured workers in prompt and proactive ways, and attending
to the individualized needs of workers through accommodations. These responses
are enacted primarily through supervisors, so it is not surprising that the role of
supervisors in successful employment outcomes has been clearly demonstrated.
Etuknwa et al. (2019) found consistent evidence for support from supervisors and
coworkers for workers with both musculoskeletal and mental disorders. These
researchers used a relatively stringent definition of return to work (i.e., stable full-
or part-time employment to either the original or a modified job for a period of at
least 3 months without sickness, absence, or re-occurrence of inability to work).
Similarly, Jetha et al. (2018) found that positive supervisor reactions to injury were
significantly associated with return to work both at the time of a workers’ compen-
sation claim acceptance and 6 months later. In another study, peer support and peer
mentoring increased work participation for persons with intellectual disabilities,
neurological/cognitive disabilities, and autism spectrum disorder (Smith et al.
2017). Thus, the importance of ongoing positive supervisor and peer processes at
work can generate sustainable outcomes. Most researchers have concluded that
promoting positive supervisor and peer reactions toward injured and disabled
workers is an important vocational rehabilitation strategy.
In trying to understand the predictors of respectful interactions, Lappalainen et al.
(2019) found that 77% of supervisors had experienced the process of managing an
employee with disability and these supervisors had benefited from explicit company
policy training in disability management and a functional collaboration with occu-
pational health and safety professionals. When these factors were present, supervi-
sors reported increased willingness to address work-related issues cooperatively with
injured and disabled employees. Wagner and colleagues (2018) found that
employees in multiple countries were familiar with some type of disability manage-
ment initiative in their workplaces. As Liukko and Kuuva (2017) noted, disability in
the workplace is no longer seen as a medical or individual problem but as a societal
and organizational challenge to be solved through coordinated action from a range of
stakeholders.
For many decades, researchers have emphasized the importance of the way in
which stakeholders communicate and collaborate to achieve work outcomes for
people with a disability. However, cooperation among stakeholders who are
involved in the process has been labeled as one of the main challenges to a more
648 E. Kendall and V. McLennan

inclusive and accepting workplace. In support of this conclusion, an Australian study

of workers’ compensation systems (Kilgour et al. 2015) confirmed that health pro-
fessionals are influential in the recovery process but are not always helpful perhaps
because their focus is not on employment. They noted that interactions between
health professionals and insurers can significantly affect injured workers’ engage-
ment in rehabilitation. When examining the relationships between insurers and
injured workers, Kilgour et al. (2015) found that most interactions were negative,
sometimes even causing secondary injury. In one study, injured workers who had
chronic whiplash (Peolsson et al. 2020) described the process of returning to work
following their injury as a series of setbacks dominated by bureaucracy and being
misunderstood by healthcare professionals. Respectful understanding and support-
ive communication and efficient services were rarely reported by injured workers
possibly because these interactions all occurred within a broader adversarial context
rather than within a supportive workplace culture where they felt valued.
Kristman and colleagues (2016) tried to identify the way in which different
models of employee management determined practices and responses by employers.
They observed that organizations tended to operate from one or a combination of
frameworks that set the tone of their organizational culture and informed decision-
making. Approaches could be based on (1) biomedical models of disability where
responsibility rested on health professionals and individuals themselves; (2) financial
management models focused on cost-containment monitoring of statistical trends
and short-term profit margins; (3) personnel management models that focus on
adherence with regulatory guidelines; and (4) organizational development models
where the organization views itself as an ecology of interdependent relationships
where actions taken toward injured or disabled workers are emblematic of an overall
culture of diversity wellness inclusion that benefits all parties.
Several other researchers have focused on how explicit statements about the
organizational culture can influence workplace health, productivity and disability
employment (Buys et al. 2017). Supportive organizational cultures were those where
there was consistency between the organization’s espoused beliefs about the value of
injured and disabled employees and the activities that demonstrated this value
directly to the workers. When the experiences of workers with disability differed
from the expressed values of the employers, employees quickly identified discrep-
ancies. A negative workplace culture impeded vocational rehabilitation, whereas a
positive organizational culture was based on a genuine interest in the well-being of
injured or disabled workers as well as the entire workforce. Organizations demon-
strated this interest through regular clear communication and supportive interactions
between supervisors, coworkers, and injured workers. They also provided prompt
processing of claims and medical costs and a focus on injury prevention and the
general wellness of all staff members.
The organizational acceptability of disability or the stigma associated with
disclosure may also impact on the extent to which workers divulge information
that could inform accommodations. For this reason, Santuzzi and Waltz (2016)
argued that employers should overtly communicate the nature of the workplace
and set the tone of disability acceptance. In contrast, the absence of proactive
31 Disruption in the Workplace 649

disability strategies might encourage workers to avoid requesting accommodations.

Ironically, at the same time as generating the potential for discrimination and stigma,
a diagnosis of a disability provides legal protection to employees through legislation
that requires accommodations for these employees (Doyle and McDowall 2019).
These findings show that corporate social responsibility might be one of the few
ways in which global employment goals for people with disabilities can become
reality (Kwan 2020). The rise of corporate social responsibility over the last few
decades should naturally emphasize inclusive employment practices. However, as
Kwan (2020) noted, equal opportunity for people with disabilities is rarely men-
tioned in this field, with the emphasis still being on minimum legal requirements.

The Future of Vocational Rehabilitation

Global trends such as the aging workforce, technological disruption, and increasing
number of work-related legislative frameworks have altered the nature of work over
the last few decades. However, the COVID-19 pandemic has radically changed the
way we think about employment and job security. It has escalated the rate of change
beyond anything imaginable, altering the workplace itself and how employees
interact with each other on a daily basis. It has also changed the way we think
about important social systems, such as unemployment benefits, workers’ compen-
sation, insurance, and disability payments (Ståhl and MacEachen 2020).
Trends that will become reality for workplaces over the next few years include the
emergence of variable and unpredictable health conditions and disabilities that had
not previously been considered from a workplace perspective; a highly participatory,
personalized, and customizable approach to employment; the rise of alternative self-
directed business models; and the application of advanced technology in the work-
place. The next few years may represent a crucial turning point for vocational
rehabilitation as it responds to these major challenges. These challenges will neces-
sitate changes in the way vocational rehabilitation is designed and delivered to
ensure it is well prepared for this future.

Managing Variable and Unpredictable Conditions

The growth of chronic physical and mental health conditions will bring a range of
new conditions into focus for vocational rehabilitation. Increased life expectancy
and mandatory extensions of retirement age are leading to growing numbers of
workers with disabilities and chronic health conditions remaining in the workforce.
This situation increases the risk of workplace injuries and threats to productivity
created by the deteriorating health of aging workers. Complicating this picture is the
fact that age is a significant predictor of employment outcomes irrespective of
disability type or the nature of the injury sustained by workers. For instance, in an
Israeli study (Savitsky et al. 2020), older workers (aged over 55 years) had an 11fold
increased probability of not returning to work compared to other injured workers.
650 E. Kendall and V. McLennan

Further, the efficacy of return-to-work interventions for aging workers is mixed,

creating even greater disadvantage for these workers. These conditions are often
characterized by ambiguous, fluctuating, and hidden symptoms that will impact on
work capability and work identity in unexpected ways. They are not likely to be
managed well in the workplace (Holland and Clayton 2020). Workers with some of
these conditions might not be aware of their own impairment, or it might not become
obvious until circumstances in the workplace change (Santuzzi and Waltz 2016).
Work disability might emerge over time as a result of a slow progression as new
workplace practices or job demands are implemented or as definitions of disability
change. Diagnostic delays or even the absence of a clear diagnosis will make it
challenging to engage employers and coworkers in collaborative work accommoda-
tions and task modifications.
There is currently only minimal assistance for workers with these conditions to
retain or regain employment as clearly articulated by Hoving et al. (2013) in relation to
arthritis. Waddell et al. (2013) noted that cardiac rehabilitation programs were highly
clinical and disease-focused with little emphasis on employment. However, the value
of returning to work following a cardiac event has been well documented (Kennedy
et al. 2007). Similarly, the value of returning to work following a diagnosis of (and
treatment for) cancer is widely known, with most cancer survivors regarding work as a
vital aspect of re-establishing their lives (Wells et al. 2013). Cancer rehabilitation
programs also tend to overlook vocational goals (de Boer et al. 2009). The workforce
prevalence of other complex conditions such as early-onset dementia and other
age-related neurological conditions will generate significant challenges for vocational
rehabilitation, particularly as people with these conditions are known to not receive
reasonable adjustments in the workplace (McCulloch et al. 2016).
Other areas where an increasing need for vocational rehabilitation may emerge in
the future include climate-related conditions, such as population-induced respiratory
disease and mosquito-borne infections. Climate disease has been prioritized by the
World Health Organization (2019) as a major challenge for the future, and this
challenge will be seen in the workplace. Mental health conditions including those
associated with conflict-related trauma, the impacts of drug and alcohol use (e.g.,
fetal alcohol spectrum disorder, alcohol-related brain damage), and the conse-
quences of domestic violence, are rising rapidly and will impact on workplaces.
As the prevalence of mental health conditions in the general population grows, the
need to manage the well-being of entire workforces will become more urgent. This
year has also revealed the vulnerability of our workforces to large-scale disasters and
pandemics. The long-term consequences of COVID-19 is yet to be fully understood,
but evidence from previous pandemics suggests that a wave of disability may be
experienced in coming years (Helgertz and Bengtsson 2019). COVID-19 has also
raised awareness about the importance of particular workforces in the maintenance
of our communities during times of disaster (e.g., the healthcare workforce, emer-
gency services and first responders). There is clearly a role for vocational rehabili-
tation in ensuring the sustainability and “surge capacity” of these workforces.
It is not clear yet how equipped vocational rehabilitation is to address these
challenges in the future. Employers and providers of vocational rehabilitation will
31 Disruption in the Workplace 651

need to develop proficiency in supporting workers who have a range of complex and
variable conditions which will emphasize the importance of underlying principles
rather than disability-specific content knowledge. As Santuzzi and Waltz (2016)
rightly pointed out, however, disability in the workplace is already a fluid concept, so
this is an opportunity for vocational rehabilitation to expand its boundaries.

Personalized Participatory and Customizable Rehabilitation

A recent review of systematic reviews revealed that vocational rehabilitation is most

successful when based on personalized interventions designed to address the unique
interaction between workers and their specific workplaces (Pieper et al. 2019). Jetha
et al. (2019) found evidence to support the positive impact of personalized or tailored
supports on preparation and entry into competitive employment for young adults
with chronic physical and mental health conditions. However, there was insufficient
evidence for the effect of supported employment on other work outcomes (e.g.,
income, hours worked, or job tenure). Similarly, Smith et al. (2017) found that
people with neurological disabilities benefitted from personalized one-on-one
(as opposed to group) intervention. Interventions that were more customized to the
client’s needs seemed to be the most effective. Although most disability groups
benefited from customized work accommodations, the evidence for effectiveness
was weaker presumably due to the challenges with controlled trials.
The review by Pieper et al. (2019) also showed that multicomponent programs
based on a participatory approach that engages employees, employers, and manage-
ment structures are more effective than single interventions. Participatory
approaches based on end-user engagement in design have become more common
in all settings and are particularly important in the disability sector where co-design
has become an important feature of most programs. Co-design assumes that workers
are best placed to identify acceptable solutions for their circumstances, therefore
increasing the likelihood of sustainability and effectiveness (Asensio-Cuesta et al.
2019). It also assumes a level of capacity to make decisions for the good of all
stakeholders. Brongers et al. (2020) referred to this as a strength-based approach to
disability employment. This approach is based on six core principles: (1) the belief
that injured and disabled workers can recover, reclaim or transform their lives; (2) a
focus on workers’ strengths rather than deficits; (3) a focus on the availability and
mobilization of community resources to support employment; (4) the belief that
workers should be the directors of their own processes; (5) emphasis on workers’
relationships with key stakeholders such as their employers; and (6) recognition that
the process of employment occurs in the community as much as in the workplace.
This contextualized, self-determined and co-designed process resonates with many
other developments in the disability field and offers a role for vocational
rehabilitation.
Self-managed solutions make intuitive sense in vocational rehabilitation as the
process builds on the natural desire of people to have self-determination. For
instance Wells et al. (2013) found that workers recovering from cancer adopted a
652 E. Kendall and V. McLennan

range of self-managed strategies with varied success to facilitate their return to work,
namely, (1) communication and negotiation with employers, (2) acknowledging and
accepting their own changed capabilities, (3) managing symptoms and rebuilding confi-
dence, and (4) “working smarter.” In this regard, an interesting finding from the recent
review conducted by Etuknwa et al. (2019) was that “job crafting” appeared to be a
successful predictor of sustainable return to work. Although insufficient evidence was
available to draw confident conclusions about this process, job crafting might offer an
interesting model of participatory, customized and personalized workplaces for the future.
Job crafting involves a worker initiating and overseeing the customization of their
workplace role and tasks to suit their individual work functioning needs. This process
has been shown to be a positive factor in worker engagement and retention after returning
to work (Nielsen 2020) and in the prevention of staff burnout (Demerouti 2015). It
closely parallels the process of accommodations used in vocational rehabilitation.
Wells and her colleagues (2013) took the personalization and self-management
argument one step further noting that “return to work” may be a simplistic way of
thinking about outcomes. They observed that the benefits of work are idiosyncratic and
time dependent. Santuzzi and Waltz (2016) cautioned that workers will all have different
disability identities even if they have the same disabling condition and level of impair-
ment, and this identity will impact on the way in which disability interacts with the
workplace. Wells et al. recommended a more nuanced approach to vocational rehabil-
itation that acknowledges workers’ sense of identity, the meaning and significance of
work, and individual circumstances over time. Van der Klink et al. also commented on
the complex interaction between the desire for self-determination and necessary depen-
dence on structural conditions that can hinder or facilitate capability. Employment
initiatives must negotiate these complex tensions, modify the strategies in response to
changing circumstances, and balance the interests of all stakeholders through the
multiple vocational transitions that will occur over time (Studer et al. 2017). This
approach implies a different model of vocational rehabilitation that could and perhaps
should be a natural expectation of any worker and a viable business strategy for
employers who wish to maintain productivity and longevity for their workers.

Alternative Business Models

Much of what is known about vocational rehabilitation has been learned in large
organizations. However future trends suggest that people with disabilities will find
themselves in a range of different employment situations including small businesses
or self-employment. In reviewing business structures that may create opportunities
or hindrances for people with disabilities, Ekberg and colleagues (2016) identified
the rise of temporary and contingent employment, virtual or remote work, and lone
workers, particularly through the current “gig economy,” characterized by on-
demand independent contracting, self-employment, entrepreneurship, and sporadic
employment in small businesses. These alternative business structures offer oppor-
tunities for people with disabilities to obtain employment without the usual barriers
associated with physically inaccessible buildings, limited transport systems, and
inadequate access to equipment.
31 Disruption in the Workplace 653

Self-employment arrangements allow people with disabilities to work in more

flexible self-determined ways which suit their own abilities and in their own familiar
and accessible setting that is easily adapted to suit changing needs over time (Maritz
and Laferriere 2016). Self-employment can also highlight the talents and individu-
ality of workers who have disability rather than the comparisons with others that
inevitably occur in competitive employment settings (Griffin et al. 2014). When
people with disability are adequately supported and prepared for self-employment, it
has positive effects even from the early stage of start-up activities on self-esteem,
self-efficacy, and psychosocial well-being (Martin and Honig 2019). However, self-
employment is not without its critics, based on the need for substantial training and
support in enterprising and business skills to increase the likelihood of sustained
success (Ashley and Graff 2017; Castillo and Fischer 2019). Vocational rehabilita-
tion providers have traditionally been reluctant to support self-employment goals
based on the common perception of self-employment as being riskier than conven-
tional employment and less likely to meet corporate key performance indicators in
the short-term (Maritz and Laferriere 2016). Not surprisingly, there is a lack of
knowledge and skills among vocational rehabilitation professionals about how best
to support clients in self-employment endeavors (Kendall et al. 2006).
The rise of self-employment and entrepreneurship models for people with dis-
abilities has generated several fundamental criticisms among disability scholars. A
major criticism concerns the fact that if workers in these situations are injured or
become unwell, they are afforded little protection or security. In small businesses, the
capacity to manage illness absences, provide accommodations, support early return
to work, provide training, support disabled workers, or implement sustained health
promotion programs to prevent injury is limited. Under the rubric of self-
employment, very little assistance is available to people with disabilities who
continue to experience precariousness (Dewhurst 2017). Models based on lone
employment also allow employees with disabilities to be relegated to jobs that
lack coworker interaction which can further marginalize these workers and alienate
them from the valuable sources of support (Schur et al. 2017). A more fundamental
criticism is that this agenda perpetuates a “triumph over tragedy” argument (Lin et al.
2019) that undermines the need for workplaces to accommodate disability and places
responsibility on the worker to be enterprising. Irrespective of these criticisms,
entrepreneurship has become a benchmark, and people with disabilities are increas-
ingly defining themselves as entrepreneurs rather than employees. Vocational reha-
bilitation will need to adapt to these changing models of employment opportunities
enabling self-determined economic and vocational participation through empower-
ment and linkage to real-world employability and enterprising upskilling.

Technology-Enabled Vocational Rehabilitation

Most workplaces are currently undergoing some form of “modernization” that

involves digital disruption of routine processes and practices. As Scotch and
McConnel (2017) hypothesized, this change is likely to accelerate over the next
few years with computerization of most processes, 3D printing of bespoke products,
654 E. Kendall and V. McLennan

advanced telecommunications, and, eventually, seamless brain-computer interfaces.

Technology brings the possibility for people with disabilities to achieve equality and
independence in society. It has become an essential and ubiquitous aspect of life for
most people, but for people with disability, it holds the promise of true inclusion. It has
the potential to change the way in which people with disabilities are viewed in the
workplace because, if used judiciously, it can eliminate disability-related challenges.
The Australian Disability Discrimination Commissioner (McEwin 2017)
commented recently that technology could be a great equalizer in ensuring that
people with disability can obtain, retain, and advance in employment. However, he
also noted that the digital age represented both an opportunity and a challenge in
relation to employment. As Schur and colleagues (2017) pointed out, technology is
unlikely to be a panacea for all workers with disabilities and may in fact worsen
circumstances for some people. Indeed, disability scholars have argued that techno-
logical advances may actually place people with disability in more unequal and
precarious positions (Lin et al. 2019).
Although technology has flourished in the last decade, technological innovations
have rarely been applied to support people with disabilities in their employment or
maximize their productivity at work (Kbar et al. 2016). The modern workplace already
operates at an extremely rapid pace due to the introduction of technology. Some
automated processes may not be easily modified for workers with physical disabilities.
Other forms of technology in the workplace will not be easily managed by workers
who have cognitive confusion or fatigue making these workplaces inaccessible.
Damianidou and colleagues (2019) concluded that the effect of technology differed
depending on the type of technology and the work setting meaning that the best
approach for the future involves personalized matching of technology to the demands
of the job and the capabilities of the worker. Understanding this matching process is,
therefore, an important vocational rehabilitation skill for the twenty-first century.
The potential of technology to support workers with disability and prevent
workplace injury and illness in the workplace is starting to become clear.
Researchers (Smith et al. 2017) have shown that assistive technology, especially
apps for cueing work-related tasks and behaviors and intense immersion in simulated
training prior to, during, and after placement in competitive employment can be
effective in supporting employment outcomes. The importance of cognitively acces-
sible technology was also highlighted in an analysis conducted by Damianidou and
colleagues (2019). They identified a clear benefit of technology designed to support
people with neurological disabilities to perform vocational tasks. They identified
109 features of existing and widely available technologies that could be used in the
workplace to support work tasks. However, use of these features depends on the
ability of the worker to independently establish and manage them. Thus, a potential
future role for vocational rehabilitation counselors will involve thorough knowledge
of different technologies and how they can be applied to many different settings and
tasks to improve worker capability.
Beyond the application of widely available technology, a few innovative and revolu-
tionary systems have been documented in the literature to support disability employment
or injury prevention. For instance, Spook et al. (2019) reviewed the use of sensor-based
applications to monitor health and well-being in physically demanding jobs. Interestingly
31 Disruption in the Workplace 655

workers were enthusiastic about wearable sensor applications to measure and monitor job
demands, occupational heat, noise, and fatigue. Implementation success was dependent
on the quality, comfort and perceived ease of use of these devices, but workers valued the
ability to manage and monitor exposure to stresses. They wanted the opportunity to
receive real-time feedback and access data themselves if needed. If used in this way,
sensor technology could give workers control over their working environments and the
way in which they interact with each other, their tasks, and their supervisors. This type of
data could also provide employers with better understanding of capability across their
entire workforce including workers with disabilities. It would allow them to more
precisely manage complex issues such as graduated return to work following injury
and accommodations.
In a similar vein, Herzog and Harih (2020) developed an automated system to
help employers manage the complexity of providing accommodations. In an inno-
vative decision support system, these researchers used artificial intelligence to assist
in coordinating tasks, workplace characteristics, worker capabilities, and the accom-
modation requirements of employees with disabilities. Systems such as this can
extend beyond a single employer (i.e., small businesses cooperatives) to generate an
inclusive and cooperative environment where people with disabilities can receive
suitable accommodations.
Virtual and extended reality technology is also providing a new medium to support
employment for people with disabilities particularly through improved training and
preparation. Michalski et al. (2020) reviewed the evidence for virtual reality for people
with neurodevelopmental conditions who were starting employment. They found
evidence that training in virtual environments significantly improved real-world
performance compared to no-training control groups and real-world training. For
people with mental health conditions, Smith and colleagues (2017) also found mod-
erate evidence in support of intense immersion in simulated training prior to, during,
and after placement in competitive employment. The application of virtual technolo-
gies may soon extend to the provision of holographic support in the workplace and
virtual immersion of people with disabilities into workplaces.
Artificial intelligence, robotics, 3D printing, holographic technology, and brain-
computer interfaces could revolutionize the future experience of injured and disabled
workers. These technologies will allow better prediction of outcomes, prevention of
injury, informed decision-making, and assistive devices that far exceed the current
expectations. Delivery of vocational rehabilitation will be vastly different, and
vocational rehabilitation professionals will need to rapidly develop skills in the use
of these advanced technologies.

Conclusion

This chapter was an opportunity to reflect on vocational rehabilitation over recent

decades and the trends that will undoubtedly impact on practice in this field in the
next few decades. Vocational rehabilitation has changed a great deal, embracing the
shift from its medical origins in the 1950s to a social and human rights model of
employment. It has also broadened its focus to acknowledge the central role of
656 E. Kendall and V. McLennan

employers and the culture of the workplace as a determinant of successful outcomes.

It has moved from a focus on individuals to a stance that promotes broader shifts in
policy and legislative frameworks. However, vocational rehabilitation is likely to
face its most radical shifts in the next few decades. Trends such as advanced
technology, new business models, personalization, and customization will
completely disrupt the world of work and, therefore, the delivery of vocational
rehabilitation.
In an interesting review of employment programs for people with disabilities,
Man, Shu and Sun (2020) shone a light on the problematic fundamental philosophy
underpinning much of this field. They, along with other researchers, have argued that
the diversity movement required a shift from an “identity-conscious” orientation to
an “identity-blind” orientation. Using an identity-conscious approach, minority
groups with diverse identities require accommodations and modifications tailored
to their special needs. These needs are seen as extraordinary and cast these
employees as outliers in need of affirmative action. In contrast an identity-blind
approach is about affirming diversity as a valuable component of the workplace. It
emphasizes the commonalities across employees and acknowledges the variations in
the population that resource managers need to harness for a creative and productive
culture. Using this approach, it is not unreasonable to expect that accommodations
should be provided to all employees to provide the most fruitful working environ-
ment for everyone.
Along these lines, a review commissioned by the UK government in 2013
concluded that vocational rehabilitation should become a fundamental element of
government strategy to improve the health of all working-age people (Waddell et al.
2013). The next few years will determine whether or not vocational rehabilitation
can respond to the trends that will shape practice into the future. Failure to grasp the
trends outlined in this chapter will make vocational rehabilitation irrelevant, whereas
harnessing them will deliver a product of great value to the workforce and the future
prosperity of entire countries.

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 Part V
Work-Life Interface
Psychological Crossover
Definitions, Explanations, and New Directions
32
Paula Brough, Mina Westman, Shoshi Chen, and
Xi Wen (Carys) Chan

Contents
Introduction to Crossover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 666
Spillover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 666
Theoretical Explanations of Crossover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 667
Westman’s (2001) Crossover Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 667
Positive Crossover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669
The Crossover Process Model (Brough et al. 2018b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 670
The Spillover–Crossover Model (Bakker and Demerouti 2013) . . . . . . . . . . . . . . . . . . . . . . . . . . . 671
Developments in Crossover Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 671
Crossover, Cultural Norms, and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 672
Crossover of Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 673
Crossover Between Team Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 674
Crossover Between Leaders and Followers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 676
Conclusion and Future Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 679
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 681

P. Brough (*)
Centre for Work, Organisation and Wellbeing, Griffith University, Brisbane, QLD, Australia
e-mail: p.brough@griffith.edu.au
M. Westman · S. Chen
Coller School of Management, Tel Aviv University, Tel Aviv, Israel
e-mail: [email protected]; [email protected]
X. W. C. Chan
Centre for Work, Organisation and Wellbeing (WOW), Griffith University, Brisbane, QLD,
Australia
School of Applied Psychology, Griffith Health, Griffith University, Mt Gravatt, QLD, Australia
e-mail: carys.chan@griffith.edu.au

© Springer Nature Switzerland AG 2022 665

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_29
666 P. Brough et al.

Abstract
This chapter describes the interpersonal transfer process of stress, emotions, and
experiences, known as crossover. It defines and differentiates between spillover
and crossover and discusses the three main theoretical explanations of the cross-
over process. It also explains how the crossover process includes the transfer of
both positive and negative emotions and experiences, and how recent work has
demonstrated the transmission of resources (e.g., self-esteem and social support),
between spouses. The chapter also discusses the impact of culture and gender on
the crossover process. Finally, it reviews emerging research assessing how
crossover operates between team members and how team leaders “affect” their
team members via crossover (and vice versa).

Keywords
Crossover · Spillover · Stress · Work–life balance · Work–life conflict · Dyads ·
Teams · Resources

Introduction to Crossover

Occupational stress is an increasingly widespread problem, costing our economies

billions per annum in costs directly related to sick leave, employee turnover, lost
productivity, and compensation payments (Brough et al. 2020). Adverse work
conditions are the primary causes of occupational stress, specifically denoted by
excessive work demands, inadequate work resources, and psychologically unhealthy
work environments (Brough et al. 2020). An important source of occupational stress
also occurs from a crossover process, via direct and indirect interpersonal experi-
ences. Thus, one person’s stress experiences can be transferred to a second individ-
ual eliciting similar experiences of stress and strain. Crossover is defined as “the
interpersonal process that occurs when job stress or psychological strain experi-
enced by one person affects the level of strain of another person in the same social
environment” (Bolger et al. 1989, p. 175). Although research focused on crossover
has been occurring for over 30 years, it has recently received renewed attention.

Spillover

It is important to differentiate between crossover and spillover. Spillover is the

intraindividual (i.e., within person) transfer of emotions or affect (e.g., stress or
strain) from one domain to a second domain. Thus, stress experienced at work may
be “brought home” and the consequences experienced in the home environment.
Such consequences include irritation, anxiety, fatigue, and positive and negative
coping behaviors (e.g., exercise, alcohol consumption). Spillover, therefore, consists
of the transfer of both positive and negative emotions across multiple life domains,
but within one individual. Negative spillover has been commonly defined and
32 Psychological Crossover 667

assessed by the processes of inter-domain conflict, specifically work-to-family con-

flict (WFC) and family-to-work conflict (FWC), originally described by Greenhaus
and Beutell (1985). These terms have also been recently referred to as interference
between the home and work domains, delineated as work-to-family interference
(WFI) and family-to-work interference (FWI; Brough and O’Driscoll 2015).
More specifically, three different types of negative inter-domain conflict/interfer-
ence have been identified: time-based interference, caused by conflicting time
demands from different domains; strain-based interference, caused by strain
from one domain negatively impacting the second domain; and finally, behavior-
based interference, when behavioral norms and expectations in one domain conflict
with expectations in the second domain. For example, authoritative “command and
control” behaviors may be required at work, but are far less relevant within the home
environment (Brough and O’Driscoll 2015). Most workers can relate to the stress-
causing characteristics of juggling time demands between work and home, and
especially those workers who are also parents and carers (i.e., work–life balance;
Brough et al. 2014b). Similarly, many individuals have experienced a difficult
(stressful) day at work and then had difficulties sleeping that night due to feeling
under strain. Behavior-based interference is less prevalent and is commonly
restricted to specific employment roles requiring behaviors that do not fit well in
family life (e.g., military, police).
Considerable evidence over the last 40 years has demonstrated the antecedents,
moderators, and consequences of spillover. While these consequences may be
positive or negative, the majority of the research focuses on the negative outcomes
primarily due to the considerable health and performance consequences such nega-
tive spillover may elicit. Numerous studies have demonstrated that negative spill-
over (i.e., conflict/interference) directly and adversely impacts job satisfaction,
family satisfaction, psychological strain, burnout, work engagement, job commit-
ment, and quality of life (Brough et al. 2020; Drummond et al. 2017). In general,
work demands adversely impact family life (WFI) more so than vice versa (FWI;
Brough and O’Driscoll 2015). Positive spillover has commonly been demonstrated
via assessments of the process of enhancement or enrichment between life domains
(e.g., Brough et al. 2014a; Chan et al. 2016; Timms et al. 2015). As noted above,
while spillover describes the transmission of stress or strain from one domain to
another for the same individual, crossover relates to the transmission of emotions
and experiences from one individual to another.

Theoretical Explanations of Crossover

Westman’s (2001) Crossover Model

Based on role theory (Katz and Kahn 1978), Westman (2001) developed a concep-
tual crossover model which focused on the interpersonal level of analysis (i.e., the
dyad). This model remains the key theoretical explanation of crossover and is
depicted in Fig. 1. The model describes three specific mechanisms by which both
positive and negative experiences and emotions are transferred between individuals.
668 P. Brough et al.

Fig. 1 Westman’s (2001) crossover model. (Note: Adapted from Westman, M. (2001). Stress and
strain crossover. Human Relations, 54(6), 717–751)

The core assumption of this model is that one person’s experience of stress or strain
has an impact on their spouse or partner. Direct crossover is the principal mecha-
nism of crossover and describes the interpersonal transfer of emotional states by
empathy (i.e., empathic identification), commonly demonstrated by the transfer of
strain between spouses. The basis for this view is the finding that crossover effects
appear between closely related partners who care for each other and share the greater
part of their lives together. The impact of occupational stress upon the spouses of
high-risk employees is evident by, for example, the citations of the high divorce rates
of military personnel, police, and prison officers (Beehr et al. 1995; Brough et al.
2016; Westman and Etzion 1995, 2005). It is also evident that distressed leaders, via
a process of direct negative crossover, induce stress and strain in their followers
(Köppe et al. 2018; Lu et al. 2016).
Indirect crossover is the second crossover mechanism and describes how the
interpersonal transfer of emotions occurs through personal attributes (e.g., person-
ality traits, positive and negative affectivity, and workaholism) and interaction
between individuals (Westman 2002), resulting in the partner’s strain. Thus far, the
explanation of crossover as an indirect process has focused on specific coping
strategies and interpersonal transactions such as social support, social undermining,
and communication style (Westman 2002). Indirect crossover may explain, for
example, the compounded impact that an overly critical spouse has upon an indi-
vidual experiencing strain.
Finally, crossover may also occur via common stressors shared between individ-
uals and explains how, for example, a family illness or economic problems may jointly
impact a couple and produce shared, common affective states (e.g., dissatisfaction,
anxiety) in both partners. Both Westman’s subsequent research and studies of
32 Psychological Crossover 669

independent researchers have tested and supported the tenets of this crossover model
and its three mechanisms (e.g., Howe et al. 2004; Lieke et al. 2010; Westman et al.
2011).

Positive Crossover

While the original definition of crossover (Bolger et al. 1989) emphasized job stress
and psychological strain, Westman (2001) suggested broadening the definition of
crossover to include positive as well as negative experiences, emotions, and states.
Thus, positive job events may also cross over to a partner via the three crossover
mechanisms (direct, indirect, and common experiences) and have a positive effect on
their well-being. Just as stressful job demands have a negative impact on the
partner’s well-being, positive feelings following positive job experiences can elicit
positive effect on partner’s well-being (Westman et al. 2009).
Informed by positive psychology, work engagement is one key construct which
has been assessed within positive crossover research. Studies have demonstrated the
crossover of work engagement (e.g., Bakker and Xanthopoulou 2009; Demerouti
et al. 2005; Westman et al. 2009). Studies have also supported the crossover of mood
(Munyon et al. 2009; Song et al. 2008), happiness (Rodríguez-Muñoz et al. 2018),
and marital satisfaction (Liu et al. 2016; van Steenbergen et al. 2014).
Bakker et al. (2005), for example, investigated couples working in various occupa-
tions and found evidence for crossover of vigor and dedication (two of the three work
engagement factors) between both partners, after controlling for key characteristics of
the work and home environments. Westman et al. (2009) also confirmed that vigor
crossed over from business travelers to their working spouses. Additionally, Bakker and
Demerouti (2009) found that work engagement crossed over from wives to husbands,
with the moderating effect of empathy (particularly, perspective taking) strengthening
the crossover process. Specifically, men who were more empathic were more strongly
influenced by their partners’ work engagement, compared to men who were less
empathic. Bakker et al.’s (2011) findings also confirmed the moderating role of per-
spective taking in the crossover process among Japanese couples, but only for women.
That is, women who understood the perspective of their partners scored higher on work
engagement with increasing partner engagement. Moreover, they found that engage-
ment crossover was strongest when both men and women were highly empathic.
In a pertinent study with dual-earner couples based in China, Lu et al. (2016)
assessed how the transfer of work–family conflict occurred between spouses to
influence their levels of well-being. The authors reported results to support this
reciprocal crossover pathway: that is, an individual’s perception of work–family
conflict was negatively related to their spouse’s levels of family satisfaction, physical
health, and well-being. This finding illustrates the importance of minimizing work–
family conflict for both spouses (rather than just focusing on the work–family
conflict of the primary breadwinner), in order to ensure optimal health and satisfac-
tion outcomes for the couple. In a similar study demonstrating positive crossover,
Liu et al. (2016) reported evidence for the transfer of work–family enrichment
between spouses, which influenced the couple’s subsequent experiences of both
670 P. Brough et al.

Fig. 2 The crossover process model. (Note: Adapted from Brough, P., Muller, W., & Westman,
M. (2018). Work, stress, and relationships: The Crossover Process Model. Australian Journal of
Psychology, 70, 341–349)

job satisfaction and marital satisfaction. For a pertinent and comprehensive discus-
sion of the positive and negative crossover within dual-earner couples, see the recent
review by Brough and Westman (2018).

The Crossover Process Model (Brough et al. 2018b)

A recent extension of Westman’s (2001) crossover model is the crossover process

model (CPM; Brough et al. 2018b), which simplifies the inherent mechanisms
within Westman’s original explanation of crossover. The CPM includes within-
person spillover, interpersonal crossover, and dyadic outcomes and clarifies the
actual crossover mechanisms that occur across two domains (e.g., home and work)
via five distinct steps (see Fig. 2). The CPM describes how stress, for example, is
transferred between individuals by these five steps: Step 1 consists of a stress
experience (perceived via the cognitive stress process) within one domain (e.g.,
work). Step 2 is the intra-level stress spillover to a secondary domain (e.g., home).
Step 3 consists of the interpersonal stress crossover to a spouse (for example), after
controlling for the spouse’s own cognitive stress process. Step 4 is the crossover
outcomes (e.g., subsequent strain experienced by the spouse at their work). Finally,
Step 5 consists of the dyadic (joint) outcomes (in this example, for the spouse’s
personal relationship), which also impacts both individuals over time.
This crossover process model is unique in simplifying Westman’s (2001) cross-
over model by focusing on the direct crossover mechanism and incorporating the
known occupational stress process. Hence, constructs within the individual’s psy-
chosocial environments (e.g., job demands, social support, job control) as well as
organizational culture are included within the CPM, with the aim of providing a
comprehensive framework for more detailed empirical assessments.
32 Psychological Crossover 671

The CPM has also demonstrated how crossover of stress from spouses impacts
the health and work performance of employees. Evidence for crossover via both
negative and positive pathways was also demonstrated with the CPM: that is, an
employee’s positive work event impacted both their own and their spouse’s subse-
quent levels of work engagement. A contribution of this model is that the outcome of
the interaction between a strained individual and his/her spouse is not necessarily
negative and instead can be positive because of the contribution of the spouse to the
interaction. Importantly, the CPM has been tested with both mixed- and same-sex
couples, demonstrating that a mix of genders within a dyad is not required for
crossover to occur (Muller and Brough 2017).

The Spillover–Crossover Model (Bakker and Demerouti 2013)

A recent crossover model to note is the spillover–crossover model (SCM; Bakker

and Demerouti 2013). Bakker and Demerouti (2013) developed the spillover–cross-
over model (SCM) by integrating the spillover and crossover literatures to gain a
better insight into the processes that link the work and family domains. Evidence for
the SCM model has been demonstrated in several studies by these authors, including
Bakker et al. (2008) and Bakker et al. (2014). The SCM integrates the processes of
spillover and crossover, describing how work stress spills over to the home domain,
influencing behavior at home, and then crosses over to adversely impact a partner’s
well-being. Bakker et al. (2008) reported that job demands were positively related to
the employee’s own levels of work–family conflict (spillover), which then
influenced their partner’s exhaustion (crossover).
The SCM has also demonstrated its validity in the estimation of positive cross-
over. For example, Bakker et al. (2014) reported that work engagement was posi-
tively related to work–family facilitation (spillover), which in turn also predicted
own and partner’s life satisfaction 1 year later (crossover). Similarly, via a diary
study research methodology, work engagement was found to directly influence an
employee’s sense of happiness, which subsequently influenced their partners’ hap-
piness (Rodríguez-Muñoz et al. 2018). Liu et al. (2016) also demonstrated the
spillover of work–family enrichment and crossover of marital satisfaction between
spouses. In sum, the SCM was supported for both negative and positive emotions
and experiences.

Developments in Crossover Research

Crossover has received renewed recent attention focusing on expanding its approach
from crossover of emotions and experiences to also document the transference of
resources between couples and the crossover of experiences and emotions between
employees, team members, and from leaders to followers. The next section reviews
this recent research, but first discusses the impact of culture and gender on the
crossover process.
672 P. Brough et al.

Crossover, Cultural Norms, and Gender

Cultural norms and gender can each impact both the direct and indirect mechanisms
of the crossover process (Westman et al. 2004; Zhang et al. 2013). Westman (2005)
noted that the main impact of cultural norms on crossover is through its interaction
with gender, particularly with couples based in non-Western cultures. Specifically,
the interaction between gender and culture impacts the symmetry and direction of the
crossover process, as well as the communication style (e.g., social undermining)
within the couple (for a review, see Westman 2016). These studies, which examined
the interface of gender ideology, cultural norms, and crossover, generally report that
(1) the crossover process exhibited stronger pathways from husbands to wives, and
the wives tended to be the recipients of their husbands’ stress and strain; (2) women’s
tending behaviors (caring for family members) under stress may lead them to be
more sensitive and empathetic to their spouse’s signs of distress; wives were more
empathetic and thus more vulnerable to crossover due to traditional gender norms;
and (3) the wives were also more vulnerable to crossover because of their role as
caregivers. In a similar study by Chan (2018) who studied leader–subordinate dyads
in Singapore, subordinates were tolerant of their leaders’ negative emotions, partic-
ularly their male leaders’ negative emotions, due to the pervasive gender stereotypes
that still existed in these workplaces.
Although the number of studies exploring crossover in relation to gender and
culture has increased in the past decade, research results indicating the exact nature
of their relationships remain inconclusive (Westman 2016). More recent research by
Brough et al. (2018b) demonstrated that neither the gender of the initiating partner
nor the gender of the recipient partner significantly influenced the crossover process.
That is, crossover initiated by both males and females was found to be equally likely
to occur and the crossover process occurred regardless of the gender of the second
partner. Brough et al. (2018b) also included a rare assessment of crossover with
same-sex couples and demonstrated that both the initiation and recipient of crossover
occurred regardless of the gender.
In contrast, Abeysekera and Gahan (2019) reported that the crossover effects of
WFC and FWC were more pronounced for women compared to men, as women
continue to undertake primary responsibility for the majority of family duties
shared at the couple level. In Dou et al.’s (2020) study, they utilized the spill-
over–crossover model to examine 157 Chinese managers’ and their spouses’ WFC
and life satisfaction. Specifically, they found that husbands’ WFC was negatively
related to their wives’ life satisfaction, but wives’ WFC had no impact on their
husbands’ life satisfaction. The authors invoked gender role theory to explain this
finding, suggesting that husbands were less likely to reduce their family investment
in the face of WFC as compared to their wives, due to traditional gender role
expectations (Dou et al. 2020). This result is congruent with Westman’s (2016)
gender asymmetry finding, which found that wives tended to be more vulnerable
to negative crossover than their husbands, as women are still subjected to tradi-
tional gender norms, which require them to be the primary caregiver in their
families.
32 Psychological Crossover 673

It was also interesting to note that a recent meta-analytical review of the crossover
of work stressors, work attitudes, and WFC in dyads by Li et al. (2021) revealed no
significant gender differences when they compared male-to-female crossover and
female-to-male crossover. The authors also did not find any significant influence of
gender egalitarianism, a defining cultural aspect, on the crossover process. In light of
the mixed gender symmetry and asymmetry results in relation to the crossover
process, we call for more research that explicitly assesses the three-way interaction
between gender, cultural norms, and crossover process. While numerous studies
have mentioned traditional gender norms as a possible reason for the gender
asymmetrical findings, many of them have not measured or controlled for gender
stereotypes or norms in their statistical analyses. It would also be insightful to probe
the gender effects of crossover in same-sex families (e.g., same-sex couples with
children), who have been shown to divide unpaid labor in a more egalitarian way as
compared to heterosexual families (Kelly and Hauck 2015). Doing so would also
extend the applicability of crossover research to a wider range of dyads beyond
leader–followers, spouses, and family members.

Crossover of Resources

The suggestion that resources can be transferred between individuals is a highly

pertinent development (e.g., Brough and Westman 2018). Evidence indicates that
resources such as social support (Ferguson et al. 2016), resilience (Chen et al. 2015;
Park and Fritz 2015), and self-efficacy and self-esteem (Neff et al. 2012, 2015) are
able to be transferred directly from one spouse to another, positively influencing their
work attitudes.
This positive interpersonal transfer process indicates that individuals can “adopt”
their partners’ resources via crossover to enhance their own pool of resources and
consequently their own levels of positive outcomes, including enhancing their work
attitudes and work performance. This finding contributes to the roles that individual
differences have within the stress process and demonstrates that high-stress job roles
may be mitigated with the reception of positive interpersonal support, from a spouse,
manager, or close colleague. The influence of social support to mitigate occupational
stress experiences has been widely demonstrated in prior studies (e.g., Brough et al.
2018a) and is specifically denoted within some of the key theoretical explanations of
the occupational stress process, notably the job-demand-control-support (JDCS)
model (Johnson and Hall 1988) and the conservation of resources (COR) model
(Hobfoll 1989).
The evidence that resources can be transferred between individuals via crossover
extends these theoretical explanations of the occupational stress process from an
intra-individual process to an inter-personal process. Thus, it appears that
responding to experienced stress with a spiral of available resources (as described
by the COR model; Hobfoll 1989) can be further boosted by the available resources
of your spouse, via the crossover process. Thus, having a spouse and/or a close
colleague with high levels of self-esteem for example can, via crossover, boost your
674 P. Brough et al.

own levels of self-esteem, adding to your pool of available resources (i.e., resource
gain spiral; Hobfoll 1989) and assisting both you and your partner to manage your
work stress experiences (Neff et al. 2015). Neff et al. (2012) explained this process
with self-expansion theory (Aron et al. 2004), whereby during an intimate relation-
ship, individuals increasingly incorporate their partners’ resources, perspectives, and
identities into their own self. Neff et al. (2015) demonstrated, via both a cross-
sectional and a longitudinal research methodology, the occurrence of the positive
crossover of resources such as self-esteem and self-efficacy. Further, their findings
also showed that the crossover of resources in the family resulted in an increase in
partner’s engagement.
One implication of this interpersonal transfer of resources is that for employees
within high risk of stress occupations (e.g., police, military, medical staff), one method
by which their work stress can be managed is to encourage a positive work culture
within their immediate work unit and/or to ensure that they have ready access to a
supportive close colleague (e.g., a peer support officer). The impact of organizational
cultures upon employee well-being and work performance is increasingly being
recognized within the occupational stress literature, especially the benefits of having
a supportive supervisor who “sets the tone” of the immediate work-unit culture. See,
for example, ▶ Chap. 22, “The Effective Management of Whistleblowing” within this
book. It is of course more difficult to ensure that a worker has a supportive spouse (and
ideally one with high levels of self-esteem!), although the value of good personal
relationships is recognized by many workplaces via their provision of couples
counselling sessions offered within their employee support programs (e.g., Brough
et al., 2016; Hammer et al. 2011).

Crossover Between Team Members

Edelwich and Brodsky (1980) wrote in as early as 1980 (p. 25), “If burnout only
affected individuals in isolation, it would be far less important and far less devas-
tating in its impact than it is. Burnout in Human Services Agencies is like an
infection in hospitals; it gets around. It spreads from clients to staff, from one staff
member to another, and from staff back to clients. Perhaps it ought to be called staff
infection.” It is amazing that it took researchers more than 15 years to focus on
crossover at the workplace. In this section, we discuss both crossover among team
members and crossover from leaders to followers.
As previous crossover research was based on the work–family interface, many
prior crossover studies have focused on crossover between life partners in the family
(e.g., Bakker et al. 2009). Based on the role theory (Katz and Kahn 1978), Westman
(2001) suggested that the same processes that exist between couples may also exist
between team members who have frequent interactions. As the simplest level of
crossover is the dyadic process, the same principle can be applied to interactions in
the workplace. The extant crossover literature also supports the existence of a
crossover process in the workplace. Several researchers have focused on the cross-
over of perceived stress and strain between team members. Bakker et al. (2006), for
32 Psychological Crossover 675

example, investigated the crossover of burnout and work engagement among 2229
Royal Dutch constabulary officers working across 85 teams. Their results demon-
strated the crossover phenomenon in the workplace by showing that team-level
burnout and work engagement are significantly related to individual team members’
burnout and work engagement.
Most of the studies which investigated crossover among team members focused
on indirect crossover, specifically examining the associated mediators and modera-
tors. Thus far, empathy, frequency of exposure, similarity, social support, and
cohesion have been studied as moderators of the crossover process in the workplace.
To elaborate, Bakker et al. (2009) found in a literature review that the main crossover
moderators among team members are empathy, frequency of exposure to other team
members, and similarity between the focal employee and their team and between
team members themselves.
In a sample of teachers, Bakker and Schaufeli (2000) also found that the fre-
quency of exposure to colleagues who talked about work-related problems increased
the probability of employees experiencing burnout. In trying to understand their
colleagues’ problems, the teachers had to tune in to the negative emotions expressed.
When the work environment is positive, the closeness and intensive interactions may
act as a double-edged sword, causing effective relationships to become dysfunc-
tional and, in the process, facilitating the crossover of exhaustion. Frequent and
intense interactions may be positive or negative, contingent on the situation and the
parties involved. Thus, frequent and intense interactions may lead to negative
crossover if the crossover process is started by an exhausted employee or to positive
crossover if the other party is an engaged team member. Emotionally exhausted team
members who interact frequently may communicate about their perceptions
concerning work and thus convey their perceptions of job demands and a state of
emotional exhaustion to the other team members.
Westman et al. (2009) found that no direct crossover process occurred between
team members. Instead, they reported that social support and cohesiveness each
significantly moderated the workplace crossover process between team members.
Westman et al. (2009) demonstrated the crossover of job demands and exhaustion in
teams that were high in cohesiveness and social support, in which employees
presumably interacted with each other frequently. These findings are pertinent and
relate to the longitudinal processes of team-level stress and strains. When team
cohesiveness and social support are high, problems were discussed openly among
team members, and the positive cohesive and supportive team atmosphere intensi-
fied the crossover of job demands and exhaustion among team members.
Research by Bakker et al. (2001) further confirmed the existence of burnout
contagion among general practitioners. Bakker et al. (2003) also found evidence
for burnout contagion in the context of a large banking and insurance company. They
showed that burnout at the team level is related to individual team members’ burnout
scores, both directly and indirectly through its relationship with individual members’
job demands, job control, and perceived social support.
Two studies (Bakker et al. 2003; Westman et al. 2009) also found that social
support acted as a moderating factor in the crossover between team members. Social
676 P. Brough et al.

support can be seen as a property of the team and conceptualized at the team level
(Bliese and Castro 2000; Drach-Zahavy 2004). When team social support is high,
team members corroborate their teammates’ stress appraisals agreeing that the
situation is stressful, which increases subsequent individual job stress and exhaus-
tion. Furthermore, when colleagues provide support to stressed or exhausted team
members, the process creates a crossover effect. Listening to others’ work-related
problems may remind them that they experience similar problems, thereby intensi-
fying the crossover of stressors and strains between team members. However, it is
also possible that for team members experiencing high job demands, supportive
interactions between them may alleviate stress and strain in such a way that these
interactions between employees prevent stress and strain to crossover.
Recently, Zagenczyk et al. (2020) conducted a sociocentric social network study
in a US construction company and found that employees had similar levels of
exhaustion as their co-workers with whom they had interactions with, from whom
they sought advice, and who were in similar position levels, but they did not have the
same level of exhaustion as their friends or supervisor. This finding highlighted the
importance of exploring the influence of structural and relational patterns
(i.e., organizational and work-unit-level culture and climate) embedded within an
organization’s formal and informal structures. Meredith et al. (2020) investigated the
crossover of burnout through the application of a social network approach, which
assumes that some relationships provide more information on the feelings and
attitudes of others. Long-term effects of burnout contagion were assessed among
578 teachers working in 12 schools. They showed that interpersonal interactions act
as conduits for burnout contagion, especially when relations are strong in terms of
frequency, embeddedness, and multiplicity. They conclude that it is important to
investigate the functioning of teachers and other employees from an interactionist
perspective, rather than treating these individuals as islands that are unaffected by
daily interactions. Findings indicated that individuals who are strongly connected to
others develop more similar feelings and attitudes.
Together, the reviewed studies demonstrate that the majority of published cross-
over studies between team members found the occurrence of an indirect crossover
process. This may be because establishing the mechanism of direct crossover
requires a high level of empathy between individuals (i.e., as occurs with partners/
spouses), and this is less prevalent between team members. All but one study
examined the crossover from teams to individuals. Multilevel principles suggest
that top-down effects, such as from teams to individuals, are generally more pow-
erful than bottom-up effects, that is, from individuals to teams. As argued by
Kozlowski and Klein (2000), it is more difficult for an individual to impact the
group than for the group (i.e., the “many”) to impact the individual.

Crossover Between Leaders and Followers

Leaders play an important part in the success of any organization because they are a
key human resource. In addition, they have an impact on their followers’
32 Psychological Crossover 677

performance and well-being (Inceoglu et al. 2018). Most accepted definitions of

leadership indicate that the key component of leadership is influence, the ability to
motivate people to perform tasks (see ▶ Chap. 2, “Successful Leadership,” in this
book). Leaders’ behaviors such as support and empowerment, and fostering a good
relationship between leaders and their followers, are leader behaviors that may
reduce and prevent stress and improve their employees’ well-being (Bass 1990;
Yukl 1994).
The question of “How do leaders influence followers’ resources and outcomes?”
may lead to the understanding of the processes underlying the influence of leadership
and thereby advances leadership theory. Recently, researchers have called for a more
integrated perspective on leadership and have suggested examining the role of
followership and influence processes between leaders and followers (e.g., Bono
and Yoon 2012; Uhl-Bien et al. 2014). See also ▶ Chap. 6, “Beyond the Leader-
ship/Followership Dichotomy,” specifically discussing followership in this book.
However, a lack of knowledge still exists regarding how leaders’ stress and well-
being influence their employees’ stress and well-being. One possible way leaders
have a negative or positive impact on their followers is by transmitting emotions and
experiences to their followers via the crossover process.
The crossover of burnout from leaders to followers, for example, has received
scant empirical attention. Since leaders are role models for their followers, the results
of leaders’ burnout may be particularly pronounced in their followers’ outcomes
(Johnson 2008). Huang et al. (2016) proposed an indirect crossover model of
burnout from leaders to followers through changes related to followers’ job and
personal resources. The 6-month two-wave longitudinal study among 104 Chinese
leader–follower dyads showed that the leaders’ burnout at T1 was negatively related
to changes in followers’ job and personal resources over a period of 6 months, which
in turn was negatively related to followers’ burnout at T2. These findings are
important because they imply that the impacts of leaders’ burnout extend beyond
the leaders to their followers.
Pan and Lin (2018) also conducted a study among leader–follower dyads in
China. They extended the study by assessing leader–member exchange (LMX),
which describes the social interaction between leaders and followers (Graen and
Uhl-Bien 1995). They found that LMX buffered the positive relationship between
leaders’ negative affect and abusive supervision. Their results showed that, among
low-LMX dyads, leaders’ negative affect at work cascaded to influence followers’
negative affect at work, their job satisfaction, and personal initiative. These indirect
effects were not found in the high-LMX dyads.
Liu et al. (2021) combined COR theory (Hobfoll 1989) with the job demands–
resources (JD-R) model (Demerouti et al. 2001) and applied a resource crossover
effect perspective to investigate the crossover effect of leadership resources. Specif-
ically, they examined boundary conditions (leader mindfulness) on the exhaustion of
university professors. According to COR theory, mindfulness is a job resource,
which can prevent the loss of resources and thus alleviate emotional exhaustion.
According to the JD-R model, the provision of job resources can relieve the negative
impact of job demands and prevent further loss of resources (Schaufeli 2017). Liu
678 P. Brough et al.

et al. (2021) found that workplace telepressure mediated the relationship between
leader mindfulness and emotional exhaustion. Work telepressure is a fixation with
checking and quickly responding to email messages (Barber and Santuzzi 2015) and
has previously been assessed within the broader “technostress” concept (e.g.,
O’Driscoll et al. 2010). Liu et al. (2021) also demonstrated that leader mindfulness
can be utilized as a job resource to reduce work telepressure, thus reducing the
emotional exhaustion of university teachers. That is, leaders’ mindfulness is a type of
leadership-oriented resource investment that helps university teachers to recover
their resources and prevent resource loss and alleviate employees’ emotional exhaus-
tion. The authors further demonstrated that while mindfulness increased the possi-
bility of acquiring new resources, self-efficacy in managing negative emotions
reduced individual resource loss and prevented further resource loss. Thus, each
resource operated in a different way; mindfulness is the preceding situational
condition of work telepressure prevention, and self-efficacy is the subsequent
boundary condition of work telepressure relief in managing negative emotions.
Several researchers have also demonstrated positive crossover (e.g., engagement)
from leaders to followers. Gutermann et al. (2016) found in a multilevel field study
that leaders’ work engagement was positively linked to that of their followers.
Moreover, in order to investigate the processes of crossover they tested the role of
leader–member exchange (LMX) and found that the quality of the dyadic relation-
ship is one explanation for the crossover of engagement from leaders to followers.
Furthermore, they found an indirect effect via LMX of leaders’ absorption on their
followers’ work engagement. These findings indicate that a leaders’ own state of
mind concerning their work influences their relationships with their followers and
their levels of work engagement.
Similarly, Fan et al. (2020) tested the crossover effects of leader’s resilience on
their followers’ resilience in a longitudinal study conducted in China. Their results
indicated that resilience crossed over from leaders to followers, and the leaders’
resilience contributed to alleviating their followers’ job burnout and facilitating
citizenship behaviors by enhancing followers’ resilience. Ma and colleagues
(2019) also investigated the effects of leader humility on employee constructive
voice behavior based on COR theory and the crossover of resources model. Ma
et al.’s (2019) study was conducted with time-lagged and multi-source survey data
on a sample of 88 supervisors and 449 subordinates in China. Their results supported
the mediation effect, such that leader humility predicted follower constructive voice
behavior via boosting follower relational energy. By integrating COR theory and
crossover of resources model, this study revealed that boosting relational energy is
the mechanism via which humble leaders shape employees’ voice behavior.
In a test of the spillover–crossover model, Ten Brummelhuis et al. (2014)
assessed the impact of the family on the leaders’ FWC and its subsequent impact
on their levels of burnout. Their longitudinal study included 199 leaders and
456 followers and found that leaders’ burnout was negatively related to leaders’
supportive behaviors, indirectly increasing followers’ burnout. They also reported
that leaders’ FWC at Time 1 was positively related to leaders’ burnout at Time 2 and
predicted followers’ subsequent experiences of burnout. Similarly, leaders’ FWE had
32 Psychological Crossover 679

a positive relationship with followers’ engagement through the leaders’ enhanced

engagement. Their findings demonstrate that family influences reach beyond the
family, affecting the well-being of leaders and their followers within their workplace.
Wirtz et al. (2017) provided a rare assessment of the crossover of emotional
exhaustion (burnout) from followers to leaders via a longitudinal study of 315 team
members and 67 leaders. They found that followers’ work engagement crossed over
directly to their leaders. However, the crossover of emotional exhaustion was
moderated by leaders’ emotional self-efficacy. They focused on emotional self-
efficacy because it reflects the process of direct empathic crossover more accurately.
That is, leaders high on emotional self-efficacy are likely motivated to pay attention
to followers’ emotions and psychological well-being, and therefore detect and
identify emotions more easily (Bandura 1997; Judge and Bono 2001) and are
affected by them. Their results revealed that followers’ work engagement was
positively related to leaders’ work engagement 8 months later. This study is the
first to show that crossover of emotional exhaustion and work engagement can occur
over time from team members to leaders. Obviously, further replications of this study
are required to confirm these results and this direction of crossover.

Conclusion and Future Research

This chapter has defined and discussed the crossover process, including describing
the three key theoretical explanations of how crossover occurs between individuals
either within the home or at workplace. Recent research assessing a number of
positive crossover constructs (i.e., engagement, resources) is encouraging and
emphasizes the impact of the transfer of positive (as well as negative) emotions for
workers. This is especially relevant for crossover within our workplaces, and further
research is clearly required to confirm the transfer of stress and strain and work
engagement (for example) between colleagues, team members, and from work
leaders. This issue is of tremendous importance in the workplace. Just as crossover
of burnout at the workplace can cause a burnout climate in the organization, we can
also consider the concept of “positive contagion,” whereby relaxed, positive
employees create a positive organizational culture and an unperturbed organization
(Westman 2002, p. 173). The crossover process proposes that a set of resources
enhances engagement within work settings, thus enhancing teams’ engagement.
This mechanism of resource exchange at the team or organizational level may be
fundamental to creating and sustaining engaged teams and organizations.
The finding that high job-related self-efficacy is not only beneficial for individual
outcomes but also affects their partners via crossover processes has practical impli-
cations for dual-earner couples and their organizations. Supporting employees’
job-related self-efficacy at work might positively affect their partners via the cross-
over processes, which in turn positively affect the partner’s work engagement,
ultimately leading to improved performance. Consequently, crossover of resources
between partners may contribute to a more engaged and resilient family and more
680 P. Brough et al.

Fig. 3 The spillover and crossover processes from managers to followers and from followers to
their spouses. (Note: Westman, M., & Chen, S. (2016). The spillover and crossover processes from
managers to followers: A research agenda. Presented at the 12th European Academy of Occupa-
tional Health Psychology (EAOHP) Conference, Greece, Athens)

resilient organizations. Organizations may facilitate frequent exchanges between

engaged colleagues to promote the crossover of engagement among them, with the
aim of helping employees, teams, and organizations to utilize caravans of resources
that create and enhance engagement. The end result of such a process is an “engaged
organization.” By assisting employees to acquire resources that lead to engagement
and by eliminating obstacles to resource depletion, stress, and strain, organizations
can prevent unnecessary stress and strain and enhance employee well-being and
effectiveness.
In a similar vein, Westman and Chen (2016) proposed a model suggesting that
crossover does affect not only partners and team members but also employees in
other organizations (see Fig. 3). According to this model, demands or resources from
the manager’s home spill over to his/her work resulting in burnout or engagement,
then cross over to a colleague and to the colleague’s spouse at home. A spillover
process transfers the burnout or engagement to the spouse’s workplace and impacts
their team members via crossover. This chain of spillover and crossover can continue
to multiple families and organizations. This is good news if we relate to engagement
but bad news if we are considering burnout. The issue of the impact of gender and
organizational/work-unit cultures is relevant here and is likely also influenced by
experience/expertise – although this is yet to be empirically assessed. Thus, we
suggest that the gender of a leader and how they influence their team members may
be less relevant in some workplaces (e.g., knowledge-based workplaces) as com-
pared to their experience. In other workplaces (e.g., hierarchically structured, male-
dominated workplaces), gender may be more influential than experience/expertise.
We suggest that these finer considerations of how workers interact and influence
each other in modern workplaces are a pertinent area to be considered by future
crossover researchers.
32 Psychological Crossover 681

This chapter suggests that a number of important questions with enormous

applied potential remain for future investigations. Specifically, is the crossover of
resources a phenomenon unique to the investigated resources (e.g., social support,
self-esteem, and self-efficacy), or are there additional resources that may cross over?
How did/does the COVID-19 pandemic affect the crossover process? Is there a
spillover effect from home to work, when work and home are located in the same
physical place? Can we design work environments for sharing and fostering
resources and limiting the crossover of stressors and strains? Can we facilitate
network research in order to direct the crossover of resources among team members?
Do negative and positive crossovers operate in the same way within virtual work
environments? Does crossover between teammates operate in virtual teams?
It is, therefore, clear that over 20 years of crossover research has indeed advanced
our understandings of this psychological interpersonal process. These scholarly
discussions have generated three key theoretical explanations describing this transfer
process within both our work and home contexts. It is also clear that pertinent
questions about this crossover process remain, especially in regard to the crossover
of resources (positive crossover), occurrence of crossover for employees physically
working in their home environments, and crossover between work team members
and between manager-employees. We hope that this chapter encourages researchers
to address these pertinent questions, and we certainly look forward to another 20 plus
years of scholarly crossover discussions.

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Flexible Work Initiatives, Employee
Workplace Well-Being, and Organizational 33
Performance
A Review of Intervention Studies

Melanie De Ruiter and Pascale Peters

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 688
Theoretical Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 689
Theoretical Perspectives on HRM, Workplace Well-Being and Organizational
Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 689
The Importance of Mutual Gains in a Flexible Work Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 690
The Role of the Type and Nature of Flexible Work Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 690
Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 692
Search Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 692
Coding Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 693
Effects of Flexible Work Initiatives on Workplace Well-Being and Performance . . . . . . . . . . . . . 694
Temporal Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 694
Spatial Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 697
Time-Spatial Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 699
Additional Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 699
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 700
Mutual Gains or Competing Outcomes? Effects of Temporal, Spatial, and Time-Spatial
Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 700
Reconsidering Employee and Organizational Gains: An Inclusive Approach . . . . . . . . . . . . . 703
The Differential Effects of the Nature of Flexible Workplace Initiatives: A Typology . . . . 704
Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 705
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 706
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 707

Abstract
This chapter presents a review of intervention studies that examine the simulta-
neous impact of flexible work initiatives on both employee workplace well-being

M. De Ruiter (*) · P. Peters

Center for Strategy, Organization and Leadership, Nyenrode Business Universiteit, Breukelen,
The Netherlands
e-mail: [email protected]; [email protected]

© Springer Nature Switzerland AG 2022 687

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_30
688 M. De Ruiter and P. Peters

and organizational performance. We specifically focus on flexible work initiatives

that change where (physical boundaries) and/or when (temporal boundaries)
employees work (Thompson RJ et al, J Occup Organ Psychol 88:726–749,
2015). Examples include teleworking (spatial flexibility), compressed workweeks
(temporal flexibility), and flexible work elements of new ways of working (time-
spatial flexibility). We exclude initiatives that focus on contractual flexibility such
as contract type and part-time work (cf. Joyce K et al, Cochrane Database Syst Rev
2:CD008009, 2010). As flexible work practices are often part of a more compre-
hensive set of human resource management (HRM) practices, we make use of the
broader HRM literature to better understand the effects of flexible work practices
on well-being and performance. In particular, we draw from three competing
perspectives – the optimistic, pessimistic, and skeptical perspective (Peccei R,
Human resource management and the search for the happy workplace. Inaugural
address. Erasmus Research Institute of Management (ERIM), Rotterdam, 2004) –
which consider whether human resource practices result in mutual gains for the
organization and the employee or whether conflicting outcomes occur (Guest D,
Hum Resour Manag J 27:22–38, 2017; Peccei R, Human resource management
and the search for the happy workplace. Inaugural address. Erasmus Research
Institute of Management (ERIM), Rotterdam, 2004; Van De Voorde K et al, Int
J Manag Rev 14:391–407, 2012). Inspired by these approaches, our central review
question is: “What type of organizational and employee gains, if any, are attained
and what type of organizational and employee losses, if any, are incurred through
the implementation of flexible work initiatives?” We discuss the key benefits and
problems associated with flexible work initiatives in relation to organizational
performance and well-being at work and the role the nature of flexible work
initiatives plays in this relationship.

Keywords
Spatial flexibility · Temporal flexibility · Time-spatial flexibility · HRM ·
Workplace well-being · Organizational performance · Pessimistic perspective ·
Optimistic perspective · Skeptical perspective

Introduction

This chapter presents a review of intervention studies that examine the simultaneous
impact of flexible work initiatives on both employee workplace well-being and organi-
zational performance. We specifically focus on flexible work initiatives that change
where (physical boundaries) and/or when (temporal boundaries) employees work
(Thompson et al. 2015). Examples include teleworking (spatial flexibility), compressed
workweeks (temporal flexibility), and flexible work elements of new ways of working
(time-spatial flexibility). We exclude initiatives that focus on contractual flexibility such
as contract type and part-time work (cf. Joyce et al. 2010). As flexible work practices are
often part of a more comprehensive set of human resource management (HRM)
practices, we make use of the broader HRM literature to better understand the effects
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 689

of flexible work practices on well-being and performance. In particular, we draw from

three competing perspectives – the optimistic, pessimistic, and skeptical perspective
(Peccei 2004) – which consider whether human resource practices result in mutual gains
for the organization and the employee or whether conflicting outcomes occur (Guest
2017; Peccei 2004; Van De Voorde et al. 2012). Inspired by these approaches, our
central review question is: “What type of organizational and employee gains, if any, are
attained and what type of organizational and employee losses, if any, are incurred
through the implementation of flexible work initiatives?” Based on our results, we
discuss the key benefits and problems associated with flexible work initiatives in relation
to organizational performance and well-being at work and the role the nature of flexible
work initiatives plays in this relationship.

Theoretical Background

Theoretical Perspectives on HRM, Workplace Well-Being

and Organizational Performance

The optimistic, pessimistic, and skeptical perspectives on the effect of HRM on well-
being and organizational performance consider two types of organizational perfor-
mance indicators, namely, proximal, i.e., operational performance (e.g., increased
quantity and quality of work; organizational citizenship behavior), and distal per-
formance outcomes, i.e., financial performance (e.g., return on investment) (Peccei
2004; Van De Voorde et al. 2012). Moreover, rather than focusing on an individual’s
overall feeling of well-being, these theoretical approaches limit the consideration of
well-being to workplace well-being (Peccei 2004). Scholars building on these
perspectives as outlined in Peccei (2004) generally draw from Grant, Christianson,
and Price (2007) and conceptualize workplace well-being to include happiness (e.g.,
job satisfaction and engagement), health (strain, such as stress and emotional
exhaustion), and social well-being (organizational support and trust) (Guest 2017;
Van De Voorde et al. 2012). In this chapter, we follow a similar approach. Although
we use the terms well-being and workplace well-being interchangeably, we limit our
focus to workplace well-being as outlined by Grant et al. (2007).
Over the past years, HRM scholars have advocated human resource practices that
are explicitly designed to have positive effects on both workplace well-being and
organizational performance (Guest 2017; Peccei 2004; Van De Voorde et al. 2012).
This so-called optimistic perspective was coined by Peccei (2004) and has come to be
known as the “mutual gains perspective” (e.g., Van De Voorde et al. 2012). According
to this view, organizational performance follows from HRM systems and policies and
practices that lead to more positive affective employee responses and reduced negative
employee behaviors at work (Peccei 2004). The notion of mutuality in the mutual
gains perspective is founded on social exchange theory, wherein both the organization
and the employee are committed to and gain from the exchange.
However, due to unequal power in the exchange relationship, the exchange can be
perceived to be limited or exploitative (Guest 2017). In practice, therefore, there may
also be a negative tradeoff between performance and well-being (Peccei 2004). This
690 M. De Ruiter and P. Peters

competing outcome fits with the “pessimistic” and “skeptical” perspectives (e.g.,
Peccei 2004; Van De Voorde et al. 2012). However, whereas the former assumes a
negative tradeoff between performance and workplace well-being, the latter assumes
that the relationship between HRM, well-being, and organizational performance
may be contingent on situational factors. Moreover, according to the skeptical
perspective, effects may be “mutually contradictory” which implies that some
relationships between HRM practices and employee workplace well-being can be
positive, whereas others can be negative, possibly leading to no net effect of HRM
on organizational performance and well-being (Peccei 2004, p. 6).

The Importance of Mutual Gains in a Flexible Work Context

Guest (2017, p. 22) argued that a mutual gains focus is increasingly necessary since
“changes at work and in the conditions surrounding work risk eroding work-related
well-being with harmful consequences for employees, and potentially, for organiza-
tions.” In this respect, he points out that technological developments have increased
work demands and have led to de-skilling and more close observation and monitor-
ing at work, oftentimes at the expense of employee autonomy, job security, and well-
being. At the same time, however, he views technological advancements to have the
potential to enhance working conditions, as these can open opportunities for auto-
mation of routine activities and offer access to information at a distance which enable
workplace flexibility for employees in both low- and high-skill jobs. Indeed, flexible
work arrangements are mentioned by Guest (2017) to be among the HRM practices
that organizations can implement to promote both well-being and performance.
Even though scholars in a wide range of fields have studied and evaluated the
positive and negative effects of flexible workplace interventions for performance and
workplace well-being (cf. Charalampous et al. 2019; De Menezes and Kelliher 2011;
Gajendran and Harrison 2007), there is a lack of insight in whether or not the mutual
gains hypothesis can be supported in flexible work contexts and whether intended gains
are actually attained or if conflicting outcomes occur. Most studies examine the effects
of flexible working on performance and well-being in isolation (Allen et al. 2015).
However, even though workplace well-being can be viewed “an important outcome in
its own right” (Peccei 2004, p. 3), Guest (2017, p. 28) stated that organizations will not
“promote well-being on ethical grounds alone.” Therefore, for organizations considering
implementing flexible work initiatives, it is essential that studies are conducted which
examine the effects on both workplace well-being and performance simultaneously.
Such studies can give insights into the mutual gains hypothesis and possible
(unintended) tradeoffs or conflicting outcomes. However, due to a lack of research in
this area, organizations may be hesitant to introduce new flexible work programs.

The Role of the Type and Nature of Flexible Work Initiatives

Scholars distinguish different types of flexible work initiatives based on the extent to
which temporal and spatial boundaries can be changed (Thompson et al. 2015).
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 691

While temporal flexibility can be defined as “employer and worker choice regarding
the distribution of worked hours,” spatial flexibility can be defined as “employer or
worker control and choice regarding place of work” (Joyce et al. 2010, p. 9). Some
flexible work initiatives combine temporal and spatial flexibility. For example, work
designs that have become known under the banner “new ways of working” (NWW)
combine elements of temporal and spatial flexibility (Nijp et al. 2016).
Scholars have advocated that when estimating the gain or loss effects of flexible
workplace initiatives, a distinction should be made between time and spatial flexi-
bility. Allen, Johnson, Kiburz, and Shockley (2013) indicated that spatial and
temporal flexibility are not interchangeable and that each may bring about different
challenges for employees. The authors proposed that due to homeworking,
employees may need to show greater self-control to overcome distractions (e.g.,
not watching television) or not engage in personal tasks (such as laundry) as a means
to stall working on a dull task. Furthermore, and what became particularly pertinent
during the COVID-19 pandemic, remote working cannot be introduced by organi-
zations in a reactive ad hoc fashion (Carroll and Conboy 2020). Human resource
managers and immediate supervisors need to carefully consider and reflect on the
effects of implementing remote working for employees and how remote working can
be introduced in a sustainable way (Carroll and Conboy 2020). In addition, as
became apparent based on a recent study in the context of COVID-19, remote
working can have effects beyond the employee in the work context as it has been
associated with an increase in parenting stress and marital conflicts (e.g., Chung et al.
2020). Moreover, digital communication patterns are likely to change when remote
working increases. A recent study, in which digital communication patterns were
compared before and during lockdown measures due to COVID-19 wherein
homeworking was often required, showed that while employees participated in
more meetings and the number of people in a meeting increased, the average length
of meetings decreased (DeFilippis et al. 2020). This seems to point to differences
between meeting length and participation between employees who work in the office
and those who work from home. Although these studies were conducted in a specific
context, the current pandemic will likely have a lasting effect on the organization of
work, and therefore these studies offer relevant insights regarding the implementa-
tion and effects of specific types of flexible work initiatives.
Allen et al.’s (2013) proposition about the important differences between time and
spatial flexibility is echoed by Thompson et al. (2015), who proposed that “it is
phenomenologically different to have the option to alter time and not place, or place
and not time, as well as the option to alter both” (p. 731). Therefore, our first
sub-review question is:

1: How does flexibility type (i.e., temporal, spatial, and time-spatial flexibility) affect
employee happiness, health and social well-being, and proximal and distal
organizational performance?

The literature on flexible working suggests that the nature of flexible work
initiatives (e.g., focused on employee or employer’s interests; level of flexibility;
organization-imposed conditions) may also play a role in organizational
692 M. De Ruiter and P. Peters

performance and well-being. In a review of flexible work interventions and well-

being, Joyce et al. (2010) tentatively concluded that interventions geared at increas-
ing worker control and choice (self-scheduling and gradual/partial retirement) can
positively affect health outcomes, whereas interventions that were aligned with the
employers’ interests had no or negative effects on health. Moreover, Baltes, Briggs,
Huff, Wright, and Neuman (1999) found decreased effectiveness of flextime initia-
tives that had a great deal of flexibility (less than 5 core hours) compared to those
with less flexibility. According to the authors, these striking results may be because
employees find it more challenging to work together as colleagues may not be at
work at the same time. Moreover, higher flexibility may also result in more control
for managers in implementing the schedule (Baltes et al. 1999), which may lead to
negative employee attitudes toward the initiative. Moreover, when flexible work
arrangements are only considered to “accommodate” specific groups of employees
(e.g., valued employees or employees with special needs), flexible work initiatives
may denounce those employees, limit perceived schedule control, or negatively
affect careers (Kelly et al. 2014). Hence, our second review question is:

2: How does the nature of flexibility affect the relationship between flexible work
initiatives and happiness, health and social well-being, and proximal and distal
performance?

Method

Search Strategy

To find existing studies on the effects of spatial, temporal, and time-spatial flexible
work initiatives, we conducted electronic searches in four online databases (APA
PsycINFO; Business Source Complete; Medline; Psychology and Behavioral Sci-
ences Collection). We used the Boolean term AND to combine search terms from the
main categories “spatial flexibility” (e.g., teleworking; homeworking), “temporal
flexibility” (flexible scheduling; compressed workweek), “time-spatial flexibility”
(flexible work arrangements; flexible work practice), “study outcomes” (perfor-
mance; well-being), and “research design” (intervention study; experimental
design). To increase the likelihood that our search was comprehensive, we reviewed
the reference lists of relevant review studies (e.g., De Menezes and Kelliher 2011;
Nijp et al. 2012).

Inclusion Criteria
After the initial identification of potential articles and removal of duplicates,
abstracts were examined to determine if studies adhered to our inclusion criteria. If
abstracts provided insufficient information, full texts were examined. First, we only
included studies that were published between 2004 and 2020. This specific time
period was chosen based on Peccei’s (2004) introduction of the optimistic, pessi-
mistic, and skeptical perspectives on the relationship between HRM, workplace
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 693

well-being, and organizational performance. Second, to overcome limitations of

cross-sectional studies and qualitative evaluations of flexible work initiatives, stud-
ies had to (i) focus on a specific flexible workplace initiative (i.e., broader initiatives
which included temporal and/or spatial flexibility elements but which did not allow
for a separate examination of the effects of those flexibility elements were excluded),
(ii) provide a sufficient description of the intervention (without a proper description,
it would not be possible to identify the type and nature of the initiative), (iii) provide
a controlled experimental design (treatment and control or reference group),
(iv) provide pre- and post-intervention measures, and (v) have outcomes which
should be assessed through objective and/or valid and reliable subjective measure-
ments. Studies that did not meet the first two criteria or studies that met less than four
criteria were excluded (an exception is Nabe-Nielsen et al. (2011, 2012); see
Table 2). Third, to examine whether mutual gains or conflicting outcomes are
realized, studies had to include both an assessment of the effects of the workplace
intervention on organizational performance and workplace well-being. We noticed
that the effects of particular flexible workplace initiatives on performance and
workplace well-being were sometimes presented in multiple articles (e.g., Nabe-
Nielsen et al. 2011, 2012). In such instances, the results were pooled. Fourth, we
limited our search to studies published in peer-reviewed journals. Finally, we only
included studies that were published in English.

Coding Strategy

The selected studies were manually coded according to the following themes:
(i) author and year of publication, (ii) study design and quality, (iii) nature
(i.e., level of flexibility/degree of conditionality), (iv) effect on proximal organiza-
tional performance, (v) effect on distal organizational performance, (vi) effect on
happiness well-being, (vii) effect on health well-being, and (viii) effect on social
well-being. The second theme – study design and quality – provided information on
the type of flexibility (sub-review question 1), while the third theme focused on the
nature of flexibility (sub-review question 2).
While coding the flexible work initiatives, we realized the assessment of the
nature of the initiatives was more challenging than initially expected. In this section,
we therefore elaborate on the coding procedure for this theme. Originally, to code the
nature of flexible work initiatives, we intended to use existing dichotomous catego-
ries. However, the flexible work initiatives included in our review could not be
neatly placed in existing typologies such as employee- versus employer-driven
flexibility (Dettmers et al. 2013). We therefore used an abductive approach to
determine the nature of the flexible work initiatives. To be more specific, during
our coding of the initiatives, we consulted the literature to develop a tentative
typology which would aid in the coding procedure. We focused on two dimensions,
namely, the level of flexibility and the degree of conditionality of the initiatives. The
following categories were developed: “fixed flexibility,” “accommodated flexibil-
ity,” “bounded flexibility,” and “hyper-flexibility.” Fixed flexibility refers to an
694 M. De Ruiter and P. Peters

atypical work schedule that offers employees flexibility in that the initiative (to some
extent) affects employees’ lives outside of work (cf. Kelly et al. 2011), but within the
initiative there is little or no opportunity to change when or where one works.
Accommodated flexibility was inspired by Kelly et al.’s (2014) concept of “accom-
modated flexibility” (p. 491) and refers to flexible work practices for which
employees have to individually request permission to participate or apply to partic-
ular groups that are eligible for flexible working because they fit particular condi-
tions and have to obey to some rules. Accommodated flexibility differs in the extent
to which employees are bound by certain conditions set by the organization or
stakeholders. Bounded flexibility refers to flexible work practices that are oftentimes
collective, intended to empower workers. However, there are also conditions,
imposed by the organization or other stakeholders, that limit the employee’s flexi-
bility. Within these boundaries, however, employees have more schedule control
than usual. Finally, hyper-flexibility refers to a broad scope of flexibility wherein the
employees themselves can fully decide where to work or when to work or both. This
type of flexibility suggests that there are no, or hardly any, external conditions to
consider and that working hours can be fully determined by the individual employee.

Effects of Flexible Work Initiatives on Workplace Well-Being

and Performance

Temporal Flexibility

In this first part, we review the effects of the temporal flexible work initiatives on
workplace well-being and organizational performance (Table 1). In the presentation
of the results, we categorized the four interventions according to their subtypes
(i.e., flexible scheduling and compressed workweeks). First, we present the charac-
teristics of the two flexible scheduling interventions and discuss their effects on
workplace well-being and organizational performance. Next, we present the charac-
teristics of the two compressed workweek interventions and outline their impact on
well-being at work and organizational performance.

Flexible Scheduling
Kauffeld, Jonas, and Frey (2004) conducted a post-evaluation-only quasi-
experimental study in which they examined how a flexible work-time design,
compared to a conventional work-time design, affected organizational and employee
outcomes in the treatment (n ¼ 17) and control groups (n ¼ 14). The authors used
objective and validated self-report measures. We categorized this intervention as
“bounded flexibility.” That is, managers used existing data based on, among others,
customer counts and delay time measurements to develop a time framework. Within
this framework, employees developed a schedule for their team which was based on
their needs. Employees themselves were in charge of short-term corrections to the
schedule. Moreover, employees were not confronted with rules regarding when they
 33

Table 1 Overview of spatial flexible work initiatives

Level of
Type of flexibility/ Proximal Distal
Author temporal degree of organizational organizational Happiness Health well- Social well-
(year) flexibility Study design (quality) conditionality performance performance well-being being being
Amendola Compressed Controlled experiment, Fixed Work – Quality of work Stress (0); –
et al. workweek pre- and post-evaluations, flexibility performance (0); life (+) health (0);
(2011) (10-h objective/valid subjective safety (0)
condition data (A)
reported)
Bell et al. Compressed Controlled experiment, Fixed Work – Quality of life, Quality of life, –
(2015) workweek pre- and post-evaluations, flexibility performance work health
(13 h and objective/ (mixed) dimension () dimension ()
20 min) valid subjective data (A)
Kauffeld Flexible Post-evaluation only, Bounded Objective work – Work – Cooperation
et al. scheduling controlled experiment, flexibility performance (+); satisfaction (+)* with
(2004) objective/valid subjective subjective work colleagues (+)
data (B) performance (+)
Nabe- Flexible Controlled experiment, Bounded Subjective – – Stress (0), Social support
Nielsen scheduling pre- and post-valid data flexibility evaluation of energy (0) (+)
et al. for Well-being; anecdotal quality of patient
Flexible Work Initiatives, Employee Workplace Well-Being, and. . .

(2011, evidence organizational care ()

2012) performance (C)
Note. (A) ¼ study design fulfills all five criteria; (B) ¼ study design fulfills four out of five criteria; (C) ¼ study design fulfills all criteria for workplace well-
being but is less rigorous regarding the assessment of proximal organizational performance.
*
This finding was significant at the p < 0.10 level
 is used to indicate that the outcome was not included in the study
695
696 M. De Ruiter and P. Peters

had to be present. Hence, employees had a considerable amount of flexibility, yet

only within the framework developed by management.
The second flexible scheduling intervention was reported in three studies (Garde
et al. 2011; Nabe-Nielsen et al. 2011, 2012) each examining different dependent
variables. In the present review, the findings of the three studies are pooled. The
quasi-experimental study with reliable and valid pre- and post-surveys examined the
effects of flexible scheduling on employee outcomes among eldercare workers in
Denmark. Information about organizational effects were derived through post-
evaluation interviews. We categorized this intervention as “bounded flexibility.”
Employees implemented self-scheduling through a computer program. Managers
developed the time framework, after which employees were invited to indicate
preferred dates. Prior to finalizing the schedule, managers could make final changes
(Garde et al. 2011).
Regarding employee workplace well-being, Kauffeld et al. (2004) found that
employees who took part in the flexible scheduling initiative scored higher on
subjective measures of happiness well-being and social well-being than the reference
group. In the flexible scheduling intervention among elderly care workers (Nabe-
Nielsen et al. 2011, 2012), treatment group employees did not experience a signif-
icant effect on health well-being compared to the control group. Results showed that
social well-being, in terms of social support, increased significantly from pre- to
post-intervention in the treatment group.
With regard to effects on organizational performance, Kauffeld et al. (2004)
found that employees who took part in the flexible scheduling initiative scored
higher on proximal organizational performance measures compared to employees
in the control group. These results were echoed for the performance outcomes
measured at the group level through objective data. Nabe-Nielsen et al. (2011,
2012) assessed changes in proximal organizational performance (i.e., quality of
care of patients) through anecdotal evidence based on interviews. Self-scheduling
seemed to make it more difficult to ensure quality of care. Employees in the
intervention group indicated they had to work with more different colleagues. This
was a barrier to performance, as they found it easier to obtain quality of care for
patients when they worked with familiar colleagues.

Compressed Workweeks
Two intervention studies (Amendola et al. 2011; Bell et al. 2015) examined the
effects of compressed workweeks on workplace well-being and proximal organiza-
tional performance among police officers. Compressed workweeks are categorized
as “fixed flexibility.” Although employees’ personal lives are affected by the imple-
mentation of compressed workweeks, employees cannot determine their own hours
within this type of initiative. Amendola et al. (2011) compared the effects of a 10 and
12-h compressed workweek to a traditional 8-h workweek, while Bell et al. (2015)
examined the effects of a 13-h and 20-min workweek to that of control group
employees who worked 10-h workweeks.
With regard to workplace well-being, Amendola et al. (2011) found no significant
effects on health well-being for the 10 or 12-h compressed workweeks. A significant
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 697

effect was found for happiness well-being (composite measure composed of job
satisfaction, organizational commitment, job involvement, and schedule satisfac-
tion). The employees in the 10-h shift condition were the most positive about their
quality of work life and those in the 8-h shift condition the least. Bell et al. (2015)
found a significant negative effect on happiness (work quality) and health (health
quality) well-being (measured through subdimensions of quality of life scale) for
police officers in the 13-h and 20-min condition compared to the 10-h shift control
group. With regard to proximal organizational performance, the results of Amendola
et al. (2011) showed that compressed workweeks did not significantly affect several
measures of employee performance. Bell et al. (2015) also included several mea-
sures of work performance, yet the results showed mixed effects. While several
measures of performance were not affected, employees in the 13-h and 20-min shift
condition received more complaints compared to the period in which they were
working 10-h shifts. Moreover, there was an increase in the number of officers
involved in incidents for the 13-h and 20-min shift, while there was a decrease in the
number of officers involved for the 10-h shift. Yet, field interrogations were signif-
icantly higher among police officers in the treatment group (13-h and 20-min
condition).

Spatial Flexibility

In this part, we review the effects of two spatial flexible work initiatives on
workplace well-being and organizational performance (Table 2). We first present
the characteristics of the two teleworking interventions. Next, we discuss their
effects on workplace well-being and organizational performance.
Delanoeije and Verbruggen (2020) used a quasi-experimental design with pre-
and post-measurements and a treatment (n ¼ 34) and control group (n ¼ 30) to
evaluate the effects of a teleworking initiative on happiness and health well-being
and proximal organizational performance within engineering and estimating depart-
ments of a construction and property development firm. The teleworking initiative is
characterized as “accommodated flexibility.” Only employees with certain levels of
performance and long commuting times were allowed to participate in the initiative.
The organization limited the number of days employees could work from home to
2 days and restricted the teleworking days to Tuesdays and Thursdays
(i.e., organizational conditions). Relevant outcome variables were all assessed
through valid and reliable self-report measures.
Bloom et al. (2015) investigated the effects of a homeworking initiative among a
group of call center workers (N ¼ 249) in a travel agency in Shanghai. A quasi-
experimental design with a pre- and post-test was used to examine the effects of
homeworking on workplace well-being and proximal organizational performance.
The initiative was categorized as “fixed flexibility.” That is, although employees
could work from home for a considerable amount of time (4 out of 5 days), the
number of days they had to work from home and the exact day of the week they had
to be in the office were fixed.
 698

Table 2 Overview of spatial and time-spatial flexible work initiatives

Level of
flexibility/ Proximal Distal
Author Type of Study design degree of organizational organizational Happiness well- Health well- Social well-
(year) initiative (quality) conditionality performance performance being being being
Bloom et al. Spatial Controlled Fixed flexibility Employee – Work Work –
(2015) flexibility experiment, performance satisfaction (+) exhaustion ()
pre- or post- (+), work
evaluations, quality (0)
objective/
valid
subjective
data (A)
Delanoeije Spatial Controlled Accommodated Employee – Engagement (0) Stress (/0) –
and flexibility experiment, flexibility performance (0)
Verbruggen pre-or post-
(2020) evaluations,
valid self-
report
measures (A)
Nijp et al. Time- Quasi- Accommodated In-role – Affective Fatigue (0), Support from
(2016) spatial experimental, flexibility performance organizational stress (0), colleagues (0),
flexibility controlled (0), extra-role commitment subjective support from
experiment, performance (0) (0), job health () supervisors (0)
pre- or post- satisfaction (0)
evaluations,
valid self-
report
measures (A)
Note. (A) ¼ study design fulfills all five criteria;  is used to indicate that the outcome was not included in the study
M. De Ruiter and P. Peters
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 699

With regard to employee workplace well-being, the results of Delanoeije and

Verbruggen (2020) showed that there were no significant differences between the
treatment and control group for happiness well-being. Yet, Bloom et al. (2015) found
that employees who took part in the intervention experienced higher happiness well-
being. Regarding health well-being, Delanoeije and Verbruggen (2020) found a
significant difference between the treatment and control group when no control
variables were included, yet when commuting time was controlled for, there was
no longer a significant difference. Hence, according to the authors, reduced levels of
stress in the treatment group can likely be attributed to the reduction in commuting
times. With regard to proximal organizational performance, Delanoeije and
Verbruggen (2020) found no significant differences between the treatment and the
control group. The results of Bloom et al. (2015) showed that employee productivity
increased in the treatment compared to the control group without compromising
quality of work.

Time-Spatial Flexibility

In our review of high-quality intervention studies, we identified one study on time-

spatial flexibility that met our criteria for inclusion. The results of this study are
presented in Table 2. Nijp et al. (2016) employed a quasi-experimental pre- and post-
design with a treatment and reference group in which they used reliable and valid
measurements to assess happiness, health and social well-being, and proximal
organizational performance. This initiative is considered “accommodated flexibility”
since the organization could retract homeworking if an employee performed poorly.
Moreover, there were several conditions set by the organization. Employees were
required to be present at the workplace at least two times a week. Yet, employees
who worked fewer than 3 days were prohibited from homeworking.
Regarding workplace well-being, the results presented in Nijp et al. (2016)
showed no significant effect of the intervention on happiness, social, and two
dimensions of health well-being (stress; fatigue). Employees in the treatment
group, however, reported a small significant decrease in subjective health. Regarding
proximal organizational performance, the results of Nijp et al. (2016) showed no
significant effect on in-role and extra-role performance.

Additional Findings

Since our theoretical underpinning was based on the optimistic, pessimistic, and
skeptical perspective on the impact of HR practices on workplace well-being and
performance, we excluded several variables from our analyses. Although these
additional variables fell outside the scope of our review, we briefly report on some
interesting findings regarding these variables.
For example, while we only reported on workplace well-being and proximal
organizational performance, both intervention studies on compressed workweeks
700 M. De Ruiter and P. Peters

pointed to additional findings. Amendola et al. (2011) showed that while the police
officers in the 12-h compressed workweek experienced negative effects on some
sleep indicators, this was not the case for officers in the 10-h workweek. A similar
result was found in Bell et al. (2015). Compared to compressed workweeks
consisting of 10-h shifts, police officers in the 13-h and 20-min shifts reported
getting less hours of sleep and having worse overall sleep. Furthermore, results of
Amendola et al. (2011) showed that employees in the treatment groups reported less
overtime (a significant cost saving for the organization) than police officers in the
standard 8-h shift group. Moreover, Bell et al. (2015) reported that total quality of
life scores (including dimensions as leisure time, relationships with friends and
children, and helping) were lower among police officers in the 13-h 20-min shift
compared to those in the 10-h shift. Hence, the 10-h compressed workweek posi-
tively affected additional organizational outcomes, while the longer compressed
workweeks (12-h in Amendola et al. 2011 and 13-h and 20-min in Bell et al.
2015) had a negative effect on additional employee outcomes including sleep and
quality of life.

Discussion

This review set out to answer the following review question: What type of organi-
zational and employee gains, if any, are attained and what type of organizational and
employee losses, if any, are incurred through the implementation of flexible work
initiatives? In this section, we discuss our key findings on the gains and losses
associated with spatial, temporal, and time-spatial flexibility in relation to workplace
well-being and organizational performance. In addition, we discuss the importance
of taking a broader approach to the conceptualization of employee and organiza-
tional gains and losses. Moreover, to answer our sub-review questions, we also
discuss the importance of the nature of flexible work characteristics. Finally, we
discuss the limitations of the approach taken in our review and end with a
conclusion.

Mutual Gains or Competing Outcomes? Effects of Temporal, Spatial,

and Time-Spatial Flexibility

Two intervention studies examined the effects of flexible scheduling on workplace

well-being and organizational performance. The results of these studies were similar
in some respects but differed in others. When comparing results, it is important to
take into account that not all studies measured both types of performance or all three
types of well-being. More specially, while Kauffeld et al. (2004) measured both
happiness and social well-being, Nabe-Nielsen et al. (2011) measured health and
social well-being. With regard to social well-being, both Nabe-Nielsen et al. (2011)
and Kauffeld et al. (2004) found positive effects. These studies differed, however,
with regard to proximal organizational performance. While the results presented in
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 701

Kauffeld et al. (2004), based on both objective and subjective measures, showed that
proximal performance was higher in the treatment than in the control group, Nabe-
Nielsen et al. (2012) showed, based on anecdotal evidence, that employees were less
able to provide quality care. Hence, while the flexible scheduling initiative in
Kauffeld et al. (2004) pointed to mutual gains for both the employee and the
organization, the study by Nabe-Nielsen et al. (2011, 2012) pointed to a potential
loss for the organization and limited gains for the employee (health well-being was
not affected, while social well-being was).
Although the studies each examined the role of flexible scheduling, the scope for
employee flexibility may have played a role in the differences in outcomes. Even
though these interventions can be characterized as bounded flexibility, the employees
in Kauffeld et al. (2004) perceived more actual freedom within the confines of a
time-framework devised by management, while managers had the final say over the
flexible scheduling initiative in Nabe-Nielsen et al. (2011, 2012). In fact, based on
anecdotal evidence from the interviews, it was concluded that employees considered
the initiative to be more beneficial to the organization than for themselves, even
though our analysis suggests the opposite. This can be attributed to the fact that
employees often had to fill in their preferred schedule during their off time. Hence,
the latter intervention may have been perceived by the employees as “pseudo-
flexibility.” The promise of more control over worktime may not be perceived as
such on the work floor, which was also found in an intervention study among patient
care workers by Hammer et al. (2016). Rather than being able to have a say over the
schedule, employees may not be able to work with colleagues they are familiar with,
and managers may gain more control over the scheduling as they have the final say
over the schedule (cf. Baltes et al. 1999). Moreover, the outcome may be perceived
as affecting the quality of care which the employees, as professional caregivers,
deem most important.
These two studies on flexible scheduling show that within a particular flexible
initiative type, there may still be important differences that may affect the outcome
and effectiveness of an intervention. However, the differences may also be a result of
the difference in study design. While Nabe-Nielsen et al. (2011, 2012) used self-
reported measures to assess employee workplace well-being, anecdotal evidence
based on interview data was reported for proximal organizational performance.
Hence, the measure of organizational performance was relatively weak. Moreover,
the small sample size and lack of pre-implementation measure may have affected the
results in Kauffeld et al. (2004).
Regarding the studies of the compressed workweeks, there were some interesting
differences. While the 10-h compressed workweek positively affected happiness
well-being and had no effect on health well-being (Amendola et al. 2011), a 13-h and
20-min shift reduced health well-being (Bell et al. 2015). Additionally, this longer
compressed workweek negatively affected happiness well-being. Since both studies
examined the effects of different shift lengths, a one-on-one comparison is not
possible. Nevertheless, the results seem to suggest that there are limits to positive
effects of compressed workweeks depending on the length of a shift. Haley and
Miller (2015) compared compressed workweeks to a “zero-sum game.” They
702 M. De Ruiter and P. Peters

explained that in 10-h 4-day workweeks, employees have less flexibility on 4 days as
two extra work hours are added, yet this is exchanged for 8 free hours on the fifth
day. However, the combined results of these studies seem to suggest that it is not
necessarily a zero-sum game where employees view the extra flexibility on 1 day as
equal or in balance with the limited flexibility on the other days. In the 10-h
condition in Amendola et al. (2011), the additional free hours employees gained
on 1 day seemed to outweigh, rather than merely balance out, the 2 additional hours
they had to work on the other days. That is, employees in this condition showed the
highest ratings of work-life satisfaction. The situation in the 13-h and 20-min
compressed workweek showed that additional free time gained did not outweigh
the costs of working additional hours on the other days (i.e., there was a decrease in
both health and happiness well-being). Therefore, we conclude that compressed
workweeks cannot simply be viewed as a zero-sum game – where working some
extra hours during your shift is balanced out for extra free time another day – it may
come at a cost to one’s happiness and health well-being.
The results of the two studies that examined the effects of teleworking differed
considerably. While one intervention (Bloom et al. 2015) showed positive effects for
happiness well-being and proximal organizational performance (which reflects this
initiative to have mutual gains), the intervention examined in Delanoeije and
Verbruggen (2020) showed no effects on happiness well-being or proximal organi-
zational performance, while health well-being was only affected when commuting
times were not controlled for. In the latter study, mutual gains were therefore not
attained. At the same time, the organization was not worse off in terms of proximal
organizational performance, and employees did benefit in terms of health well-being
due to a reduction in travel time. The difference in the net effect of these initiatives
may be due to the level of flexibility and degree of conditionality. That is, while the
teleworking intervention in Delanoeije and Verbruggen (2020) was considered
accommodated flexibility, employees could only participate when they fulfil strict
criteria (i.e., long commuting times and high performance) and the organization set
the days on which employees were allowed to telework (Tuesdays and Thursdays
only), the initiative in Bloom et al. (2015) was considered fixed flexibility. Accom-
modated flexibility undermines employees’ individual choice to participate in flex-
ible work initiatives, making telework an exception rather than a collective practice,
which may stigmatize them. Moreover, employees may feel hindered by the condi-
tions for flexibility dictated by the organization, as they may be perceived as less
committed, which may also hinder career progress (Kelly et al. 2014). Consequently,
they may not experience much workplace flexibility after all.
In Bloom et al. (2015), the initiative was fixed yet offered a substantial degree of
teleworking intensity (employees worked at home 4 out of 5 days), which reduced
commuting time more than in the initiative presented by Delanoeije and Verbruggen
(2020). The substantial degree of teleworking provided these time-based workers
more time for non-work activities. For clerical and administrative workers, often
time-based waged employees working with measurable output standards or ratios,
flexible working may enable work and nonwork task variation that alleviates the
demands of repetitive work that is cognitively taxing (e.g., data entry tasks). Also
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 703

skilled professional knowledge workers who telework, often doing more task-based
salaried work, may gain time to spend on “autonomous, creative, deep thinking
work” or “to engage in meaningful interactions with customers and clients” (Johnson
et al. 2020, p. 408). Task-oriented workers may suffer from work intensification, and
reduced commuting time is often exchanged for longer hours (Kelliher and Ander-
son 2010). The findings regarding these two initiatives therefore provide further
support for the importance of considering the level of flexibility, the boundedness of
the flexible work initiative, and the type of work.
The intervention examined by Nijp et al. (2016), which was categorized as
accommodated flexibility, did not positively affect proximal organizational perfor-
mance or happiness, social, and most dimensions of health well-being. Yet, one of
the dimensions of health well-being was negatively affected for employees in the
treatment group. The finding with regard to proximal performance resembles a
finding in an intervention study called STAR in an IT division of a Fortune
500 company by Bray et al. (2018) which did not fit our inclusion criteria and was
therefore not included in our review. Bray et al. (2018) also did not find significant
results regarding performance; however they did find that employees in their inter-
vention group reported they worked more efficiently compared to the control group,
without affecting productivity. In a study based on the same intervention as reported
by Bray et al. (2018), Moen et al. (2016) found that intervention workplace well-
being effects after 12 months (i.e., job satisfaction, psychological distress, and
burnout) could be attributed to enhanced schedule control in the intervention
group after 6 months. Schedule changes and working at home, however, did not
affect well-being. Although the type of workers in both cases are all knowledge
workers, the differences between the findings by Nijp et al. (2016) and the STAR
intervention could be that the STAR intervention is less restricted and the degree of
schedule flexibility higher (Kelly et al. 2014). Moreover, in the STAR intervention,
(part of) the workers in the intervention and control group were already used to
flexible working (Kelly et al. 2014), which may have enhanced their readiness to
change (cf. Hammer et al. 2016).

Reconsidering Employee and Organizational Gains: An Inclusive

Approach

Our review was limited to happiness, health, and social workplace well-being and
proximal and distal organizational performance. Hence, we excluded outcomes such
as employee well-being beyond the workplace (e.g., life satisfaction, work-life
conflict) and employee outcomes such as career progress. We also did not consider
crossover effects to family members (cf. Bray et al. 2013). Regarding organizational
performance, we excluded variables as attrition and cost savings, as scholars exam-
ining Peccei’s (2004) perspectives limited their focus to operational and financial
performance (e.g., Van De Voorde et al. 2012). The omission of these variables is an
important shortcoming of the optimistic, pessimistic, and skeptical perspective of the
relationship between HRM, workplace well-being, and performance.
704 M. De Ruiter and P. Peters

In view of the additional findings (section “Additional Findings”) and consider-

ing current workplace trends, including the increase in dual-earner couples and the
increased focus on boundaryless careers and employability, we postulate that the
theoretical perspectives on the relationship between HRM, workplace well-being,
and organizational performance should be reconsidered and extended to include
employee outcomes that focus on career development and promotions and evaluate
well-being outside of the workplace. Moreover, we propose organizational perfor-
mance to move beyond short-term efficiency and financial goals and include absen-
teeism, attrition, reduced real estate costs, and savings in overtime associated with
the implementation of different types of flexible work initiatives. This is in line with
sustainable HRM perspectives that take into account that workers and organizations
operate in wider ecosystems in which short- and long-term effects for both organi-
zations and their employees need to be considered (cf. De Prins et al. 2015). It also
resonates with the work of work-life scholars (cf. Moen et al. 2008) and other
participants of the Work, Family and Health Network who advocates a broader
and integrated multilevel perspective on well-being associated with flexible work-
ing, taking into account the work-family-society interface to understand how people
understand the quality of work life.

The Differential Effects of the Nature of Flexible Workplace

Initiatives: A Typology

The results of our review produced mixed findings regarding the extent to which
mutual gains or competing outcomes are achieved through the implementation of
flexible work initiatives. While some initiatives point to mutual gains (e.g., Kauffeld
et al. 2004), others point to competing and ambiguous outcomes (e.g., Nabe-Nielsen
et al. 2011, 2012). The mixed findings hold true for all three types of flexible work
initiatives (spatial, temporal, and time-spatial flexibility). Hence, the results of our
review do not seem to suggest that any of these three types of flexibility show more
positive results for both the employee and the organization. In fact, across the
flexibility types we found initiatives that had mainly positive outcomes but also
initiatives that had some positive and some negative or null effects. Hence, to better
understand the differences in intervention outcomes, we considered the nature of the
flexible work initiatives irrespective of whether the initiatives were solely spatial,
solely temporal, or a combination of time and spatial elements. Based on our
analyses, we propose that the nature of flexible work initiatives can best be concep-
tualized along two dimensions, level of flexibility, and degree of conditionality. We
present this typology in Fig. 1.
We categorized the interventions as fixed, accommodated, bounded, and hyper-
flexibility. The latter type was not found, which is likely because in the exchange
between an organization and an individual employee, no job can be performed in
complete isolation. An opposite type of fixed may be added in the future, now that
the COVID-19 pandemic requires employees to work from home for a large part of
their schedule (e.g., Anderson and Kelliher 2020) and likely will result in more
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 705

Fig. 1 Typology of the nature of flexible work initiatives

employees working from home in a post-COVID19 society. Within each flexibility

type found in this review, however, there were only a limited number of studies.
Although the limited number of studies makes it difficult to draw meaningful
conclusions, by examining the nature of flexibility for the different initiatives, we
were able to show that flexible work initiatives cannot easily be considered equal.
Rather, the difference in level of flexibility and degree of conditionality will likely
affect the outcome and effectiveness of flexible work initiatives. As can be con-
cluded from Fig. 1, we suggest that the differences in findings between the studies
are likely based on differences not only between but also within flexible workplace
designs. In addition, inspired by Fan et al. (2019), we suggest that research should
focus on constellations of job demands (including working hours, workload, and
strain) and resources (including schedule control, schedule variability, and
homeworking) to understand performance and well-being. Hence more research is
needed to further specify the nature of flexible work initiatives in context.

Limitations

In our review, we only included intervention studies that examined the effects of
flexible work practices (spatial, temporal, and time-spatial flexibility) on both
organizational performance and workplace well-being. Intervention studies that
706 M. De Ruiter and P. Peters

examined only one type of outcome were therefore omitted. Although this criterion
limits the number of studies included in our review, it allowed us to examine whether
flexible work practices are generally beneficial to both the organization and the
employee or whether competing outcomes occur. Hence, it allowed us to test
competing theoretical perspectives on the relationship between HRM, workplace
well-being, and performance (Peccei 2004). None of the intervention studies
included in our review, however, examined the mediating role of workplace well-
being in the relationship between flexible work initiatives and organizational per-
formance. Hence, although we were able to examine whether employees and
organizations experienced gains or losses resulting from flexible work practices for
each single flexible workplace initiative, we were not able to examine the underlying
connection between workplace well-being and organizational performance as
suggested by the mutual gains perspective of Peccei (2004).
Our analysis of the individual practices showed that common dichotomous
categorizations of flexible work initiatives, such as employee-driven versus
employer-driven initiatives (Dettmers et al. 2013), do not adequately describe
different types of flexible work arrangements. Our review provides an initial starting
point to developing a more elaborate typology of flexible work initiatives. The
development of such a typology will provide scholars the opportunity to better
understand, from a theoretical point of view, why certain types of flexible work
initiatives have positive effects while others have no or negative effects. Active use
of a typology in scholarly research will contribute considerably to the development
of a coherent body of knowledge on flexible work initiatives.
In the coding of the flexible work initiatives, we were dependent upon the
descriptions of the initiatives provided in the articles. The level of detail differed
between studies, which sometimes made it challenging to accurately categorize an
initiative. A typology could guide future research in that it offers scholars a common
framework to focus on in intervention studies. Nevertheless, the proposed typology
presented in this chapter is tentative at best. Considering that we still identified
differences in flexibility and conditionality within the four flexibility types, more
research is needed to further develop a fitting typology.

Conclusion

The results of this review pointed to mixed findings regarding the extent to which
mutual gains or competing outcomes are attained through spatial, temporal, or time-
spatial flexible workplace initiatives. We postulate that to truly understand the extent
to which flexible work initiatives result in mutual gains or competing outcomes, a
more inclusive approach to employee and organizational outcomes must be taken.
Moreover, to better understand why some flexible workplace initiatives result in
positive effects for both employees and the organization, we propose a typology
(fixed, accommodated, bounded, and hyper-flexibility) based on two dimensions, the
level of flexibility and the degree of conditionality.
33 Flexible Work Initiatives, Employee Workplace Well-Being, and. . . 707

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Extending Work-Life Balance Initiatives
34
Xi Wen (Carys) Chan and Shirley Tay

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 712
Benefits and Costs of the Provision and Use of WLB Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 713
Benefits to Employees and Organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 713
Costs to Employees and Organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 714
Work and Non-Work Factors Influencing WLB Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715
Organizational Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715
Cultural Traditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 716
Gender Perceptions and Stereotypes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 717
Minority Employees and Migrants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 718
Intergenerational Workforce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 718
The COVID-19 Pandemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 719
Recommendations for Extending WLB Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 720
FSSBs, Supportive Work–Life Culture, and Two-Way Communication . . . . . . . . . . . . . . . . . . . 720
Fostering Inclusive Behaviors by Tackling Long Working Hours . . . . . . . . . . . . . . . . . . . . . . . . . 720
Shift from Flextime and Compressed Work Weeks to Trust-Based Working Hours . . . . . . 721
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 722
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 723

Abstract
In the last decade, we have seen strong growth in published scholarly and
practitioner-focused research on work–life balance initiatives which are
X. W. (Carys) Chan (*)
Centre for Work, Organisation and Wellbeing (WOW), Griffith University, Brisbane, QLD,
Australia
School of Applied Psychology, Griffith Health, Griffith University, Mt Gravatt, QLD, Australia
e-mail: carys.chan@griffith.edu.au
S. Tay
School of Management, College of Business and Law, RMIT University, Melbourne, VIC,
Australia
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 711

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_31
712 X. W. (Carys) Chan and S. Tay

implemented in organizations to assist employees with managing their work and

non-work demands. Correspondingly, the goal of this book chapter is twofold.
First, we seek to take stock of existing scholarly and practitioner-focused research
conducted on work–life balance initiatives, and in so doing, provide a compre-
hensive understanding of the impacts of work–life balance initiatives on organi-
zations and employees. Second, we contend that despite increased scholarly and
practitioner attention on work–life balance initiatives, there remains a significant
gap between the provision and promise of work–life balance initiatives and their
actual uptake and outcomes. We also discuss how the nature of these issues has
changed in light of the COVID-19 pandemic, and what this means for work–life
balance initiatives going forward. Finally, we propose several areas to extend
existing work–life balance initiatives, which we hope can enhance the effective-
ness and intended positive outcomes of work–life balance initiatives.

Keywords
Work–life balance · Work–life balance initiatives · Flexible working
arrangements · Organizational culture · Employee well-being · Diversity ·
Inclusion

Introduction

In response to growing workforce concerns and changing needs regarding work–life

balance (WLB), organizations are now offering initiatives intended to facilitate the
combined functioning of employees’ work and non-work roles (Beauregard 2014;
Brough and O’Driscoll 2010). Broadly termed as work–life balance initiatives (from
hereon, WLB initiatives), these practices can be considered under two main catego-
ries of structural and cultural initiatives and, together, they aim to adapt employment
settings to employees’ work–life needs (Kossek et al. 2010). Structural WLB
initiatives usually take the form of flexible work hours, telework, job sharing,
reduced work week, paid parental and carer’s leave, and financial or informational
assistance with childcare and eldercare services (Beauregard 2011; Brough and
O’Driscoll 2010; Fair Work Ombudsman, 2019; Timms et al. 2015). They may
also take the form of cultural WLB initiatives, such as family supportive supervisor
behaviors (FSSBs), work–family organizational culture, and supportive organiza-
tional climate (Kossek et al. 2010; Timms et al. 2015). Although WLB initiatives are
increasingly common across most organizations in industrialized economies, they
remain underutilized (before the COVID-19 pandemic), complex, vague, inconsis-
tently applied, and evolving in practice and cultural acceptance.
Therefore, the goal of this book chapter is twofold. First, we take stock of existing
scholarly and practitioner research conducted on WLB initiatives, and in so doing,
provide a comprehensive understanding of the impacts of WLB initiatives on
organizations and employees. Second, we contend that despite increased scholarly
and practitioner attention, there remains a significant gap between the provision and
promise of WLB initiatives and their actual uptake and outcomes. We also discuss
34 Extending Work-Life Balance Initiatives 713

how some of the nature of these issues has changed in light of the COVID-19
pandemic, and what this means for WLB initiatives going forward. We end our book
chapter by proposing several areas to extend existing WLB initiatives, which we
hope can enhance the effectiveness and intended positive outcomes of WLB
initiatives.

Benefits and Costs of the Provision and Use of WLB Initiatives

Benefits to Employees and Organizations

Multiple studies have shown that WLB initiatives do benefit both organizations and
employees. For example, a cross-national study conducted by Lewis et al. (2007)
found that the opportunity to use WLB initiatives particularly benefitted working
women as they could better manage both their work and non-work (e.g., domestic
and care) responsibilities. Similarly, Peretz et al. (2018) in a study including orga-
nizations and employees from 21 countries, found that the use of WLB initiatives
reduced employee turnover and absenteeism, especially when the organizational
culture is supportive and encouraging towards employees’ use of WLB initiatives. In
general, there is also a positive spillover effect from employees to organizations as
the benefits of using WLB initiatives accorded to employees tend to also bring
benefits to the organizations they work for (Brough and O’Driscoll 2010; Timms
et al. 2015). Based on longitudinal data from a multi-organization database,
Richman et al. (2008) found that WLB initiatives were related to increased employee
engagement and employee retention, and that use of WLB initiatives was also
positively associated with perceived flexibility by employees.
As well as retaining employees through the provision and use of WLB initiatives,
organizations can gain a competitive edge through talent attraction. Firstly, job
seekers are typically attracted to work for organizations where they can have a
healthy balance between their work, family, and personal commitments (Chimote
and Srivastava 2013; Thompson and Aspinwall 2009). Secondly, WLB initiatives, in
the form of flexible working arrangements, are particularly appealing to parents or
primary caregivers who have difficulty staying in the workforce due to their familial
or care responsibilities. Specifically, the use of WLB initiatives can enable them to
manage their familial or care responsibilities alongside their work demands (Lirio
et al. 2008). Correspondingly, organizations are able to widen the pool of talents for
recruitment, and in so doing, increase the diversity and inclusion of employees.
The bi-directional nature of positive work–family spillover, that is work-to-
family and family-to-work spillover, also indicates that WLB initiatives may pro-
duce positive family-to-work experiences for employees. Indeed, as employees are
given the time and flexibility to attend to their family and other non-work commit-
ments through the use of WLB initiatives, they tend to experience greater life
satisfaction (Beauregard and Henry 2009; Gilley et al. 2015) and increased mental
well-being (Baral and Bhargava 2010). Life satisfaction and mental well-being, in
turn, have been found to be positively associated with job satisfaction, job perfor-
mance, and organizational commitment, and negatively related to withdrawal,
714 X. W. (Carys) Chan and S. Tay

turnover intentions, and actual turnover (Erdogan et al. 2012; Hennekam et al. 2020;
Wright and Bonett 2007). Prior studies (e.g., Bagger and Li 2014; Lapierre et al. 2017;
Wayne et al. 2006) have also shown that family support extended to employees may
manifest in the form of formal (e.g., flexible work arrangements, compressed work
week, and extension of organizational benefits to family members) or informal (e.g.,
FSSBs) WLB initiatives, subsequently facilitating positive work outcomes such as job
satisfaction and increased work performance for employees (Chan et al. 2020).
Finally, the provision of WLB initiatives also signals to employees that organi-
zations trust them to have more autonomy and control in their work. This, in turn,
leads employees to reciprocate with increased job satisfaction, productivity, and
competence, resulting in a win-win situation for both the organizations and
employees (Brescoll et al. 2013; Lazar et al. 2010). Taken together, organizations
have a lot to gain by showing empathy and support towards their employees through
the provision of and encouraging the use of WLB initiatives.

Costs to Employees and Organizations

However, not all WLB initiatives will result in a win-win situation for both
employees and employers (Lazar et al. 2010; Timms et al. 2020). Callan (2007)
showed that the wide use of WLB initiatives by employees may increase the work
load of others in the same team or department, disrupting workflow and fueling
discontent among employees who may experience increased workloads (Callan
2007). Further, while employees access WLB initiatives to accommodate their
non-work needs, they risk experiencing isolation from the rest of their colleagues,
may still be expected to be easily available, and tend to overcompensate by working
longer hours to signal their organizational commitment (Field and Chan 2018). In a
review of 164 articles on WLB initiatives, Perrigino et al. (2018) consistently found
negative attitudes, emotions, and behaviors associated with WLB policies. They
referred to these negative aspects as “work–family backlash” and identified four
types of backlash across the articles: (1) inequity – perceptions of unfairness (e.g.,
being passed on for promotion); (2) stigma – choosing not to use WLB policies for
fear of repercussions; (3) spillover – negative consequences of WLB policies beyond
the work domain (e.g., work-to-family conflict due to longer working hours at
home); and (4) strategic – organizations offering fewer WLB initiatives because
they do not benefit top- and bottom-line performance (Perrigino et al. 2018).
Bourdeau et al. (2019) distinguished between two types of WLB initiatives:
enabling WLB initiatives (e.g., remote working and flextime) “give employees
latitude over when, where, and how much they work, which enables them to
spend time and energy outside of work to take care of themselves and their family
members”; and enclosing WLB initiatives (e.g., onsite childcare and gym facilities)
“promote greater availability for work and longer hours on work premises by
providing services that employees would otherwise seek outside the workplace”
(p. 173). They also proposed that supervisors are more likely to perceive employees
who use enabling WLB initiatives as less devoted to their work than those who use
enclosing WLB initiatives. This is because employees who use enclosing WLB
34 Extending Work-Life Balance Initiatives 715

initiatives tend to spend more time at work, and are thus perceived to have greater
work devotion. The difference in work devotion attributions, in turn, translates into
varying career consequences for employees. Generally, higher work devotion attri-
butions will lead to positive career consequences, as supervisors perceive that
employees are devoted to work. However, lower work devotion attributions will
lead to negative career consequences, as supervisors may withhold career premiums
or invoke career penalties (Bourdeau et al., 2019).
Scholars have also drawn attention to the “fit” between employees’ needs and the
available WLB initiatives (Halvorsen et al. 2020). There is a common perception that
WLB initiatives are primarily “women-only” or “parents-only,” hence employees
who do not fall into those categories are less likely to access WLB initiatives
(Perrigino et al. 2018). Even if they do use WLB initiatives, they use them discreetly
such that their colleagues and supervisors are not aware that they are taking time off
(Beauregard and Henry 2009; Ladge et al. 2015). More recently, caregiver-friendly
workplace policies (CFWPs) and paternal leave have been implemented in many
developed countries in a bid to make WLB initiatives more inclusive (Beauregard
and Henry 2009; Williams et al. 2017). However, they are still not always supported
by employers and supervisors, sending inconsistent messages on the “usability” of
WLB initiatives to employees (Perrigino et al. 2018; Timms et al. 2020).
Lastly, not all WLB initiatives are ultimately beneficial to employees. For exam-
ple, some employees may choose to work evening shifts because that is the time
when they have someone at home to look after their children while they are at work.
It may seem that the flexible paid hours allow them to juggle between their work and
parenting duties. However, it does not necessarily translate into better work and
non-work outcomes for employees (Timms et al. 2015), as they could be missing out
on spending quality time with their children when they are home from school
(Fleetwood 2007). Brough et al. (2009) also found that employees, particularly
working mothers, experienced negative consequences (e.g., being passed on for
promotion) arising from the use and duration of paid parental leave.
When considering both the evidence-based benefits and costs of the provision and
use of WLB initiatives to employees and organizations, it becomes clear that merely
providing and encouraging the use of WLB initiatives are not sufficient to support
most employees. Further, research on the outcomes of WLB initiatives are often
inconclusive (Brough and O’Driscoll 2010; Conradie and de Klerk 2019). In the next
section, we identify and discuss some recent and relevant work and non-work
concepts in relation to WLB initiatives, and building on these insights, we offer
our suggestions to enhance the intended positive outcomes of WLB initiatives.

Work and Non-Work Factors Influencing WLB Initiatives

Organizational Culture

Organizational culture has an essential role in ensuring the integration and subse-
quent uptake of workplace WLB initiatives. Specifically, a supportive and family-
friendly organizational culture tends to facilitate employees’ receptiveness and use
716 X. W. (Carys) Chan and S. Tay

of WLB initiatives (Galea et al. 2014; Gilley et al. 2015; Kalysh et al. 2016;
Thompson and Aspinwall 2009; Timms et al. 2015). One way to find out whether
management genuinely cares about their employees’ needs is via their communica-
tions regarding the WLB initiatives offered by the organization. Having WLB
initiatives in place does not necessarily mean that the employees are utilizing
them, especially if they are not aware of those initiatives (Lazar et al. 2010). In
other words, it is important that employees are kept well-informed on the available
WLB initiatives, so that they are aware about the various policies and practices
which they can adopt to balance their work and non-work commitments. Manage-
ment must also understand the benefits and potential downsides of using the WLB
initiatives, before they advocate for the implementation and use of each WLB
initiative (Lockwood 2003).
A supportive organizational culture should also pay equal attention to two types
of support: instrumental and emotional support (Gilley et al. 2015). That is to say,
other than instrumental support in the form of formal WLB policies and practices,
emotional support in the form of positive encouragement and understanding from
management, supervisors, and co-workers are equally important for WLB initiatives
to be effective (Timms et al. 2020). Importantly, the actual encouragement from
organizations to utilize WLB initiatives is usually transmitted through middle
managers (Parris et al. 2008). However, the use of WLB initiatives by employees
is often viewed skeptically by managers who assume that less work will be produced
if they were not present to monitor their employees (Sahadi 2020). Therefore,
organizations should focus on overcoming any resistance from managers, and ensure
they are fully committed to supporting their subordinates in accessing WLB initia-
tives (Pasamar 2015).

Cultural Traditions

Cultural traditions also influence work–life preferences, including employees’ per-

ceptions and uptake of WLB initiatives. A study conducted by Lewis et al. (2007),
and subsequently Rajan-Rankin (2016), found that WLB initiatives were often
“exported” to developing countries with little consideration of relevant cultural
issues. In particular, Rajan-Rankin (2016) found that collectivism, paternalism,
racialism, and masculinity intersected to shape employees’ work and family roles
in developing countries, often blurring work–life boundaries and encouraging a
greater tolerance for this “blurred” reality. If a work–life policy or practice conflicts
with, or undermines masculinity (e.g., home-based working was associated with a
failure of masculinity in an Indian call center; Rajan-Rankin 2016, p. 236), the
subsequent uptake of such WLB initiatives were disincentivized and discouraged.
Similarly, Chandra (2012) compared Eastern and Western perspectives of WLB, and
found that gender socialization influenced perceptions of WLB in Asian countries,
while employees in Western countries generally accessed more WLB initiatives than
their Eastern counterparts, specifically reporting fewer working hours and more
generous parental leave. Chandra (2012) also found that while American companies
34 Extending Work-Life Balance Initiatives 717

focused on providing flexible working practices, Indian companies were more

comfortable with providing employee welfare programs.

Gender Perceptions and Stereotypes

Gender-blind WLB policies and initiatives are also rarely sufficient to address the
barriers that women face in the workplace and in the course of their career progres-
sion (Doherty 2004). First, many existing senior executives across organizations in
various industries still tend to be men (Schäfer and Gottschall 2015; Sherer and
Zakaria 2018), which reinforces certain gender stereotypes and leadership proto-
types, operating as a form of indirect discrimination against women (Doherty 2004).
For example, there is often a need for employees to be supported by senior managers
in order to secure key positions when climbing the career ladder, and multiple studies
(e.g., Coffman et al. 2017; Cullen and Perez-Truglia 2019) have shown that male
managers and employers tend to hire and promote male employees, while female
managers and employers were more likely to give both male and female employees
an equal chance of being hired or promoted. Further, in organizations with a
disproportionate gender distribution, most commonly with more male leaders at
the top, female employees tend to be more disadvantaged when it comes to perfor-
mance evaluations and promotability (Kalysh et al. 2016). This is especially so for
organizations which may prefer to hire employees who are better able to prioritize
work and commit full-time with regular work hours (Fritz and Van Knippenberg
2018).
As employees progress further to senior management, there is also a lower
tendency for them to work flexibly despite the provision of WLB initiatives. Some
customer-facing industries (e.g., retail and hospitality) tend not to offer their senior
level employees WLB initiatives because they need them to work long hours and be
present to manage their lower level employees who are mostly working shifts
(Doherty 2004). Consequently, this deters women from applying for senior positions
and, in some cases, causes them to ask for lower-level positions with fewer respon-
sibilities once they have children. This further hampers female employees’ career
advancement and development (Roberts and Brown 2019), and reinforces the
predominantly male gender representation at the higher levels across many organi-
zations (Brescoll et al. 2013).
Another study by Noback et al. (2016) of 10,000 middle- and top-level managers
in a Dutch financial services company found that men who worked part-time or a
compressed four-day workweek, earned substantially lower salaries than their
full-time working male colleagues. Specifically, Noback et al. (2016) found that
opting for alternative work arrangements hindered the career advancement of male
employees because doing so deviated from the masculine corporate regime of being
available anywhere and anytime. On the other hand, female employees who opted
for a compressed four-day workweek benefitted, because most women in the
Netherlands generally worked fewer hours due to childcare responsibilities. Never-
theless, Noback et al. (2016) also found that career success was most prevalent
718 X. W. (Carys) Chan and S. Tay

among male managers with families who did not opt for alternative work arrange-
ments (i.e., they worked full-time, five-day weeks).

Minority Employees and Migrants

Some researchers have also found that female employees, particularly those from
migrant backgrounds, face even more complex struggles when it comes to balancing
their work and family commitments (Ali et al. 2017; Kamenou 2008). For example, a
study with female migrant academics showed that some of them may not have the
privileges of having their extended family around to assist them in domestic matters,
which places them in a more difficult position to balance their work commitments
and childcare responsibilities (Johansson and Śliwa 2014). Not having their
extended family or established support network places strain on female migrant
employees, as they also tend to experience a lack of spousal support, especially if
their spouses are from a traditional masculine society (Ressia 2010). Alongside their
work and familial responsibilities, female migrant employees are also subjected to
discrimination, sociocultural and religious pressures, which WLB policies alone
cannot address adequately (Ali et al. 2017). Correspondingly, multiple studies
(e.g., Ali et al. 2017; Fearfull et al. 2010) have called for inter-organizational and
inter-state cooperation to design, develop, and implement WLB policies and initia-
tives, and to organize outreach programs in schools, women’s organizations, and
religious organizations to raise awareness about the multi-faceted issues migrant
women face and assist them in integrating into the workplace.

Intergenerational Workforce

WLB needs may also differ across generations as employees are at different stages of
their lives (Galea et al. 2014; Thornthwaite 2004) and careers (Pasamar 2015). For
example, Beutell and Wittig-Berman (2008) found that Baby Boomers (born 1946–
1964) reported more work–family conflict than Gen Xers (born 1965–1980) in a
1997 data set from a national survey in the United States. In a more recent study,
Bennett et al. (2017) found that Baby Boomers reported the least work–family
conflict, followed by Millennials (born 1981–1996) and Gen Xers. They explained
that Baby Boomers have been in their careers longer than Gen Xers and Millennials,
and thus had more access to work flexibility, travelled for work less, and were
offered more leave. They also found that Gen Xers reported the highest work–family
conflict, possibly due to high demands in both their work and family lives. Further,
they suggested the fact that more educated women were staying at home during their
children’s early years seemed to imply that companies were not offering enough
flexible options to younger parents. The varying work and non-work demands across
generations cause challenges for organizations to design and implement suitable
WLB initiatives that benefit all employees. Yet, if support for WLB focuses only on
34 Extending Work-Life Balance Initiatives 719

certain lifestyles, or certain working arrangements, it is likely that maximum benefit

will not be realized by organizations or individuals (Kelliher et al. 2019). Therefore,
it is important for managers to play an informal role through initiating work–life
conversations with their employees and enacting FSSBs that support and respond to
both their employees’ work and non-work needs (Kossek 2016).
As the workforce continues to shift with more Millennials and Gen Zs (born
1997–present) joining the labor force, coupled with the rise of non-standard employ-
ment arrangements such as those on casual or part-time contracts, or those who have
multiple jobs, are self-employed, or employed in the “gig economy” (Kelliher et al.
2019), WLB expectations and needs will continue to evolve. For example, younger
generations of employees generally place greater value on WLB and thus prefer
flexible working conditions as compared to older generations of employees (Lyons
and Kuron 2014). Also, more working fathers are participating directly and equitably
in child rearing beyond their financial contributions, in what is known as involved
fathering (Ladge et al. 2015). Even though working fathers generally perceive their
organizational policies to be supportive, entrenched gender norms and expectations
within their organizations may make it difficult for them to be an involved father
(Brough et al. 2009). Hence, many working fathers still have to deal with work–life
challenges through informal, “stealthy” approaches to flexibility (e.g., leaving work
quietly for childcare pick-up), for fear of being stigmatized by their team members or
becoming targets for layoff if they make use of formal WLB initiatives such as paid
paternity leave (Brough et al. 2009; Ladge et al. 2015).

The COVID-19 Pandemic

In 2020, the onset of the coronavirus disease 2019 (COVID-19) has also prompted a
sudden transition to remote working, which is unlikely to reverse post-pandemic
(Carroll and Conboy 2020). Along with the threat and uncertainties of subsequent
waves of COVID-19 cases and other pandemic outbreaks, social distancing, and
lockdown measures are likely to be in place for some time or implemented from time
to time going forward. The stigma associated with remote working prior to COVID-
19 has also disappeared, as many companies such as Google and Atlassian are now
making certain roles permanently remote even as COVID-19 lockdowns are being
lifted (Mishael 2020; Smith 2020). It is clear that structural (or formal) WLB policies
and practices such as telecommuting and remote working are no longer relevant,
since they are now widely implemented. In contrast, the cultural (or informal) WLB
policies and practices including work–family organizational culture and FSSBs have
now taken center stage in determining employee well-being and resilience (Vaziri
et al. 2020). Taken together, these trends spurred by the COVID-19 pandemic will
significantly change the nature and focus of WLB initiatives going forward, hence
we explore some recommendations for extending WLB initiatives in the next
section.
720 X. W. (Carys) Chan and S. Tay

Recommendations for Extending WLB Initiatives

FSSBs, Supportive Work–Life Culture, and Two-Way Communication

Work–life scholars have developed interventions to train managers in FSSBs

(Kossek 2016). These interventions are aimed at guiding managers on how to
discuss their employees’ work and non-work demands and to set goals to track the
effectiveness of their own FSSBs. Also, these interventions have typically focused
on subordinates’ FSSB perceptions of their managers. Nevertheless, recent studies
such as Marescaux et al. (2020) have found that not only do managers need to be
equipped with the skills and self-efficacy to demonstrate FSSBs, they also need to
communicate consistent messages to employees to foster psychological safety and
maximize the effectiveness of their FSSBs. Importantly, Marescaux et al. (2020) also
found that it is important to clarify the expectations of both managers and employees
in relation to FSSBs, so that the content of the associated WLB policies, practices,
and managerial training are developed accordingly, and there is greater alignment
between employees’ work–life preferences and managers’ expectations of their
employees’ job performance.
Both Marescaux et al. (2020) and Vaziri et al. (2020) also found that FSSBs are
particularly relevant and beneficial to employees who prefer to segment or keep clear
boundaries between their work and non-work lives. However, efforts to cultivate
FSSBs and their subsequent positive flow-on effects for both managers and
employees will be in vain if they are not supported by a positive work–life culture
(Marescaux et al. 2020; Timms et al. 2015). Correspondingly, we recommend that
FSSBs should always be implemented with a supportive work–life culture at the
organizational level and two-way communication and mutual understanding
between managers and employees.
In light of the COVID-19 pandemic, FSSBs have also become more prominent in
determining employee well-being and resilience, and play an important role in
fostering a compassionate organizational culture for employees (Vaziri et al.
2020). To cultivate a compassionate and supportive organizational culture during
the pandemic, we recommend that employers provide managers with mandatory
training on FSSBs, which is designed to teach managers about the benefits of
providing support to help employees with their work and non-work demands, and
the different types of supportive non-work (emotional, instrumental, role modelling)
behaviors that managers should exhibit to their employees amid the heightened
uncertainties present in their social environment (Kossek 2016).

Fostering Inclusive Behaviors by Tackling Long Working Hours

With an evolving workforce now spanning five generations (Traditionalists to Gen

Zs), it is imperative that organizations take on a diverse and inclusive approach to
designing and implementing WLB initiatives (Taneja et al. 2012). However, it is
hard to foster diversity in the workplace, especially when the number of female
34 Extending Work-Life Balance Initiatives 721

leaders remains comparatively lower compared to male leaders across most organi-
zations. In fact, while women made progress accessing positions of power and
authority in the 1970s and 1980s, that progress has slowed considerably in the
1990s and stalled completely this century (Ely and Padavic 2020). In particular,
Ely and Padavic (2020) found that what held women back at work was not
necessarily the unique challenge of balancing work–life demands, but a general
culture of overwork accompanied by one-sided encouragement to women to take
advantage of WLB initiatives (e.g., going part-time and shifting to internally facing
roles which demanded shorter working hours). As a result, women’s careers were
often derailed after using these WLB initiatives (see also Brough et al. 2009), while
men stuck to the primary identity of an ideal worker, chose not to use WLB
initiatives, and thus appeared more dedicated to their work.
For WLB initiatives to achieve their intended beneficial outcomes, it is crucial for
organizations and managers to tackle overwork culture head-on (Ely and Padavic
2020), especially since Reid (2015) found that managers could not tell the difference
between employees who actually worked 80 h a week and those who just pretended
to. What was insightful in Reid’s (2015) research was that both men and women
actually encountered similar levels of work–life conflict, but the way women coped
was to make use of formal WLB initiatives to manage their work–life conflict, while
men coped by experimenting with less formal, under-the-radar ways to maintain
organizational commitment. It is thus crucial that employees and managers push
back against overwork. Also, as research increasingly demonstrates the business
case for more reasonable work hours, organizations are now questioning the drivers,
and intended outcomes, of an overwork culture. Since a culture of overwork tends to
cascade from the top of the organizational pyramid to the bottom, organizational
leaders should lead by example and avoid sending out work communications during
non-working hours. It is only through less demanding work hours that women will
not be pushed to take up WLB initiatives, and subsequently suffer negative job and
career consequences such as decreased job satisfaction and failed promotions (see
Brough et al. 2009; Ely and Padavic 2020; Reid 2015). When women are given
equal opportunity to succeed in the workplace through an inclusive culture, women’s
leadership representation at the top will increase, and so will the diversity of an
organization’s workforce (Duke 2017).

Shift from Flextime and Compressed Work Weeks to Trust-Based

Working Hours

One of the widely implemented WLB initiatives is flextime, which is a work

arrangement that allows employees to alter the starting and/or end time of their
workdays. Another WLB initiative that is widely implemented is compressed work
weeks, which allows an employee to work longer hours on some days and meet their
required weekly hours sooner. The employee can then take a day (or part-day) off
with the time they have accrued (e.g., a four-day work week or nine-day fortnight).
WLB initiatives such as flextime and compressed work weeks have produced a range
722 X. W. (Carys) Chan and S. Tay

of employee and organizational benefits (Kossek and Michel 2011). However, in

reality they offer only limited control and choice to employees and are typically
implemented in a way that suits the employer more so than employees (Hyatt and
Coslor 2018). Hyatt and Coslor (2018) also found that work intensified when
employees accessed these WLB initiatives, leading to job fatigue and decreased
job satisfaction.
Truly flexible and self-managed work, known as “trust-based working hours”, has
grown in importance over the last two decades, but is more widely implemented in
Western Europe (especially in as Germany and the Nordic countries; Ilsøe 2010;
Singe and Croucher 2003). With trust-based working hours, time becomes a sec-
ondary consideration as employers do not control the working time of their
employees. Instead, employees become primarily responsible for fulfilling tasks
and meeting targets, thus shifting the focus from a time-based to a results-based
orientation (Singe and Croucher 2003). Trust-based working hours generally lead to
increased WLB, job satisfaction and life satisfaction among employees, as well as
greater alignment between working hours and workloads (Ilsøe 2010). Based on a
panel data comprising more than 5000 German companies, Godart et al. (2014) also
found that trust-based working hours are related to subsequent innovation perfor-
mance of firms through the autonomy and self-management transferred to
employees.
Nevertheless, for trust-based working hours to achieve its positive intended
outcomes for both organizations and employees, Singe and Croucher (2003)
recommended that it has to be implemented with robust manager-employee trust.
Manager-employee trust can be fostered through management styles that encourage
employees’ self-starting behaviors, such as setting their own goals and deciding
where and how they will complete their job tasks. Godart et al. (2014) also cautioned
about the potential work–life conflict that may arise as the boundaries between work
and life blurs without the need to work fixed hours. Despite its weaknesses, trust-
based working hours gives employees the autonomy to choose how they complete
projects, and in so doing, facilitates organizational trust and time management
among employees. Therefore, trust-based working hours has proven to be more
effective than traditional WLB initiatives such as flextime and compressed work
weeks in assisting employees to perform better and become more satisfied in their
jobs (Godart et al. 2014; Hyatt and Coslor 2018).

Conclusion

In this book chapter, we considered existing scholarly and practitioner research

conducted on WLB initiatives, provided a comprehensive understanding of the
impacts of WLB initiatives on organizations and employees, and identified outstand-
ing gaps between the provision and promise of WLB initiatives and their actual
uptake and outcomes. We also discussed how these issues have changed in light of
the COVID-19 pandemic, and how they will shape WLB initiatives in the future. We
ended our book chapter by proposing recommendations for extending WLB
34 Extending Work-Life Balance Initiatives 723

initiatives, which we hope can enhance the effectiveness and intended outcomes of
WLB initiatives. A more urgent, short-term focus should consider cultivating a
compassionate organizational culture alongside the provision and use of WLB
initiatives, since the COVID-19 pandemic has led to high levels of job insecurity,
the threat of infection, and changes to employees’ living arrangements in a short
span of time (Vaziri et al. 2020). In times of uncertainties, no WLB initiatives will
assist employees to manage their work and lives better if their organizations and
managers do not understand and accommodate the multiple stress and demands they
are facing. In the longer term, when the pandemic passes and the global economy
recovers from its deep slump, we urge more organizations to work with their
employees to consider how they might adjust their work processes and WLB policies
and initiatives to implement trust-based working hours. When implemented effec-
tively, trust-based working hours have been shown to reduce working hours (which,
as discussed above, fosters workplace diversity and inclusion), increase employees’
job satisfaction, productivity, and creativity, and enhance firm innovation.

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Shifting the Mental Health Conversation:
Present and Future Applications of the 35
“Thrive at Work” Framework
Present and Future Applications

Sharon K. Parker, Karina Jorritsma, and Mark A. Griffin

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 728
Thrive at Work Framework, SMART Work Design, and Future Work . . . . . . . . . . . . . . . . . . . . . . . . 729
Thrive at Work Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 730
Deep Dive into Prevent Harm and the SMART Work Design Model . . . . . . . . . . . . . . . . . . . . . 738
Positioning for Digitalization and Other Future Work Challenges . . . . . . . . . . . . . . . . . . . . . . . . . 742
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745

Abstract
In this chapter, we describe an integrative framework that synthesizes organiza-
tional approaches to mental health: the Thrive at Work framework. We draw
together literature from multiple perspectives to identify three pillars of
organizational-level approaches to improving mental health and well-being at
work (mitigate illness, prevent harm, and promote thriving); three sub-categories
of workplace strategies within each pillar (two sets focused on changing the work;
one focused on changing individuals); and multiple tactics for each subcategory
of workplace strategies. The comprehensiveness of this framework facilitates a
strategic, non-siloed, and multidisciplinary approach towards mental health and
well-being in the workplace. In particular, we seek to help organizations to go
beyond reactive and/or individualistic approaches to mental health and well-
being, to the proactive consideration of designing healthy work. Thus work
design, and specifically the SMART work design model, is part of the “prevent
harm” pillar, and a distinctive element of our approach. SMART refers to work
that is Stimulating, Mastery-oriented, Agentic, Relational, and Tolerable.
SMART work design addresses the major psychosocial risks that have been

S. K. Parker (*) · K. Jorritsma · M. A. Griffin

Future of Work Institute, Curtin University, Bentley, WA, Australia
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 727

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_37
728 S. K. Parker et al.

identified in research, yet offers a distinct and active perspective in which the
focus is on designing SMART work in a holistic way. We provide examples of
how organizations can use both the Thrive at Work framework and the SMART
work redesign model to improve mental health at work, particularly via enhanc-
ing the quality of the work itself.

Keywords
Work design · SMART work design · Organizational interventions · Well-being ·
Stress · Prevention · Thriving · Harm · Case studies

Introduction

In many organizations, the dominant discourse around mental health is focused on

reactive responses to the mental health problems of individuals. It is imperative to
expand the understanding of mental health and its relationship to the workplace. In
this chapter, we argue for a more holistic, prevention-oriented, and proactive
approach to mental health at work.
We present the Thrive at Work framework to support a more comprehensive
approach to the management of mental health. This framework has been designed to
address six major challenges associated with addressing mental health issues in the
workplace that we have observed in discussions with industry partners and organi-
zations over many years.
First, the dominant discourse assumes that individuals bring pre-existing mental
health issues to work and the organization then needs to respond to these issues.
While it is certainly correct that some individuals come to work with mental health
struggles, there is little acknowledgement in this discourse that individuals might
develop mental health problems as a result of the work itself, or have pre-existing
conditions exacerbated by poor work conditions. As a consequence of this reason-
ing, many organizations focus their efforts primarily or solely on reactive efforts to
detect and support mental ill health, such as establishing the provision of counselling
services, with insufficient attention to the prevention of harm through creating good
work. As we elaborate shortly, there is a vast amount of research linking aspects of
work such as task characteristics, social support, and management practices to
mental health. A focus on pre-existing issues means this preventative approach is
undervalued in many discussions.
Second, many organizations focus on the individual as the primary target of
intervention, placing the responsibility for mental health almost entirely on the
worker. Resilience training is an example. We argue that mental health at work is
the joint responsibility of the individual and the organization, requiring a shared role
in developing individual and organizational strategies for better mental health at
work. In essence, too much attention is given to individual actions to address ill
health, and with much less attention to primary interventions focusing on organiza-
tional actions to address ill health.
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 729

Third, to the extent that organizations do assume responsibility for improving

work, there is a tendency to adopt a compliance-oriented focus on “removing risk”;
a perspective that stems from legal requirements to protect workers from harm
(including psychological harm). We promote a more positive and proactive approach
by encouraging organizations to ensure their work is well-designed and contributes
positively to mental health.
Fourth, perhaps unsurprisingly given legal obligations to prevent harm to
workers, in much discourse in organizations, there is a predominance of focus on
mental “ill health,” rather than on fostering well-being. It is of course vital to give
serious attention to mental ill health, especially given the growth of mental health
problems within society more generally. However, just as the absence of ill health
does not define someone as physically well, the absence of mental ill health does not
define someone as mentally well. The World Health Organization, for example,
defines mental health as “a state of well-being in which every individual realizes his
or her own potential, can cope with the normal stresses of life, can work productively
and fruitfully, and is able to make a contribution to her or his community.” As we
discuss later, we see an important role for promoting well-being in the discussion of
organizational mental health.
Fifth, the idea that “good health is good business,” which is part of Safe Work
Australia’s model of good work design (see https://www.safeworkaustralia.gov.au/
good-work-design) is not widely understood. That is, there is a failure by many in
organizations to appreciate how mental health, and poorly designed work, affects
performance and productivity outcomes for organizations. There is a tendency to
assume that addressing mental health in the workplace is solely a social or legal
obligation rather than a potential source of performance and competitive advantage.
Finally, our observation is that the approach many organizations take to address
mental health issues is piecemeal, siloed, and reactive rather than integrated,
strategic, and proactive. For example, although actions and initiatives introduced
in business processes can have a major impact on workers’ mental health, there is a
tendency to relegate the topic to the health and safety department or human
resources.
For the above reasons, our overall view is that many organizations are not coming
to grips sufficiently with mental health issues in the workplace. In the light of this
background, we developed the Thrive at Work framework, which we elaborate here
(see also thriveatwork.org.au).
Table 1 summarizes these challenges, as well as how our framework addresses
them, which we elaborate next.

Thrive at Work Framework, SMART Work Design,

and Future Work

This section first presents the Thrive at Work framework, example applications, and
key research underpinning the framework. We then discuss the importance of good
work design for preventing mental health and introduce the “SMART” model of
730 S. K. Parker et al.

Table 1 Challenges in how organizations approach mental health at work and how the Thrive at
Work approach addresses these challenges
How challenge is addressed in the thrive
Challenge framework
Focus on individuals bringing pre-existing Includes three pillars, with the first focusing on
mental health issues to work, which then needs accommodation and support of mental ill
to be catered for, rather than the role of work in health (relevant to pre-existing mental health
affecting mental health problems) but the second and third pillar go
beyond to address how work shapes mental
health and well-being
Focus on the individual as the primary target of Explicit recognition within each pillar that
change mental health can be improved through
focusing on changing the work/organization
(first and second category of workplace
strategies within the pillar) or changing the
individual (third category of workplace
strategies within the pillar)
Compliance-oriented focus on removing risks The second pillar addresses psychosocial risk
of work (sometimes referred to as reduction but does so via the idea of designing
“psychosocial risk management”) SMART work, a positive and holistic approach
compared to more traditional approaches
Focus on mental ill health alone Focus on mental ill health and well-being,
including both subjective well-being and
eudaimonic (or active) well-being
Neglect of the business benefits of mental Recognition, especially through the second
health and well-being and third pillar, that ‘good mental health is
good business’
Piecemeal, siloed, and reactive approach to The framework promotes an integrated,
addressing mental health in the workplace strategic, and proactive approach, supported by
the Thrive at Work audit which helps
organizations synthesize practices from diverse
departments

work design. We give examples of how the SMART work design model has been
used, and can be used, in the light of the technological and other change occurring in
organizations.

Thrive at Work Framework

Below we present the rationale for the three pillars of the Thrive at Work framework:
mitigate illness, prevent harm, and promote thriving. We also outline the key
strategies within each pillar, provide example tactics, and briefly describe research
relevant to the framework. We also give some examples of the application of this
framework.

Overview of Pillars, Strategies, and Tactics

The Thrive at Work framework was developed in consultation with industry and
with an extensive evaluation of the often-siloed academic literature and professional
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 731

practice. The three pillars—Mitigate Illness, Prevent Harm, Promote Thriving—

capture overarching goals for managing mental health, with each pillar addressing a
different aspect of the mental health continuum. The distinction between Mitigate
Illness and Prevent Harm maps onto Hurrell Jr and Murphy (1996)s distinction
between primary, secondary, and tertiary intervention strategies according to
whether they reduce/eliminate stressors at the source (Prevent Harm) or whether
they help employees re-appraise or cope more effectively with stress at work
(Mitigate Illness). The distinction between Prevent Harm and Promote Thriving
maps onto Parker et al. (2003)s holistic perspective on mental health that unpacked
primary intervention strategies into those that prevent ill health, such as by reducing
poor well-being or psychological distress (Prevent Harm), and those that promote
positive health, such as by enhancing active mental health (Promote Thriving).
Overall, therefore, the three pillars capture the key distinctions among work mental
health interventions made historically in the organizational literature, and align well
with LaMontagne et al.’s (2014, 2019) ‘integrated approach to workplace mental
health’ framework (manage illness, prevent harm, promote the positive) distilled
from their analysis of intervention strategies across multiple disciplines.
Importantly, and in contrast to previous frameworks, we go beyond broad cate-
gories of interventions to identify sub-categories of workplace strategies. Specifi-
cally, each pillar has three sub-categories of workplace strategies: two of which are
targeted at changing the work or organization (e.g., via the development of new
systems and practices), and one of which is targeted at changing the individual (e.g.,
via training programs aimed to build individual-level awareness); a distinction that
builds on earlier work about different levels of intervention (e.g., Griffin et al. 2000;
Hornung et al. 2010). Each of these workplace strategies then can be executed via
various tactics, examples of which are included in the detailed audit tool and
implementation guides that are freely available from the website: www.
thriveatwork.org.au. Importantly, the specific tactics used by organizations can
vary according to the needs and resources of the organization, and can extend
beyond those indicated. The resulting three pillars, nine workplace strategies, and
multiple tactics create a comprehensive framework that provides organizations with
a clear set of evidence-based strategies and potential tactics to address the full
spectrum of mental health (see Fig. 1).

Mitigate Illness
The pillar of Mitigate Illness encompasses goals to support workers experiencing
mental illness, ill health, and injury, regardless of cause. It is well understood that
mental illness can impact people across all types of workplaces, and all industries.
Approximately 45% of adults between the ages of 16 and 85 will experience a
mental health issue in their lifetime (Australian Bureau of Statistics 2008). Many
Australian adults who experience mental health issues will be of working age and
employed in different roles, across all industries. Research consistently shows that
untreated mental illnesses negatively impact turnover, absenteeism, and workforce
productivity (see, for example, Safework Australia 2012).
Organizations that Mitigate Illness demonstrate to their workforce they are
committed to supporting employees experiencing poor mental health. In turn,
732 S. K. Parker et al.

Pillar Workplace Strategies Example Tactics

Detect & Support Illness Employee training to support others

Mitigate Monitor mental health
Remove barriers to support
Illness Employee Assistance Program
Crisis support

Accommodate Illness Injury management process

Monitor, accommodate, and Return to Work process
treat illness, ill-health and
injury.
Increase Individual Resources for Employee training to help self
Managing Mental Health Stigma reduction for help-seeking

Maintain/Increase Job Resources Stimulating job resources

Prevent Mastery job resources
Agency job resources
Harm Relational job resources

Ensure Tolerable Demands Reduce demands such as cognitive, work load,

Minimise harm and protect physical, and emotional demands
against risk. Increase SMAR job resources

Increase Individual Resources for Job crafting for stress reduction

Preventing Harm Resilience and coping training
Healthy recovery from work

Create Conditions for Growth Organisational support for growth

Promote Transformational leadership
Strength-based capability development
Thriving Continuous learning practices

Create Conditions for Connection Diversity practices

Opportunities for belonging
Optimise well-being and Beneficiary contact
generate future capabilities. Internal knowledge exchange
Community engagement

Increase Individual Resources for Job crafting for personal growth

Thriving Positive psychology practices

Fig. 1 Thrive at work framework with three pillars, workplace strategies, and example tactics
(from thriveatwork.org.au)

employees want to work for and stay in organizations that acknowledge the impor-
tance of mental health and assist employees to recover from mental illness (Instinct
and Reason 2014). Organizations that mitigate mental illness can experience a
significant return on investment, through increased productivity and reduced absen-
teeism (PwC 2014).
We identify three sets of evidence-based workplace strategies that organizations
can adopt to mitigate illness. The first two focus on changing the work or organiza-
tion; the third targets changing individual behavior and attitudes:

1. Detect and Support Illness—organizational strategies to facilitate the early detec-

tion and support of employees experiencing mental ill health, including crisis
support;
2. Accommodate Illness—organizational strategies to assist employees who have
been unwell to recover, while undertaking appropriate and meaningful work; and.
3. Increase Individual Resources for Managing Mental Health—organizational
strategies aimed at increasing employee mental health literacy and help-seeking.
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 733

In contrast to the above two categories which focus strongly on changing

organizational practices and systems, this category has a focus on building the
motivation and capacity of individual workers themselves to manage their own
mental health.

These strategies often come from clinical psychology, health promotion, and
public health perspectives on mental health. Example tactics that can be used to
achieve these strategies are shown in Fig. 1. For example, the provision of employee
advisory programs (EAPs) is a common tactic used by organizations to support
illness.

Prevent Harm
Research consistently finds that the work environment and work itself can signifi-
cantly increase the likelihood of employees developing physical and mental health
conditions, including musculoskeletal conditions, depression, anxiety, and substance
abuse (e.g., Burton 2010; Demerouti et al. 2001; LaMontagne et al. 2007; Parker
2014). The power and validity of this research are reflected in the world-wide
inclusion of these factors (usually referred to as “psychosocial risks”) in most
frameworks about work factors and mental health across the globe (see, for example,
the US NIOSH models and the UK’s Health & Safety Executive models).
The main goal of Prevent Harm, therefore, is to create work environments that
protect employees against known psychosocial risks through good work design and
organizational management. There is good evidence that changes in work design
(or work “redesign”) can improve mental health, especially when accompanied by
training and/or when part of a broader systemic change process (see the review by
Daniels et al. 2017). Likewise, work redesign interventions can enhance job perfor-
mance and productivity (for a review, see Knight and Parker 2019) A summary of
research (Parker 2015) supporting the role of work design for mental health,
including the generation of principles used to underpin Safe Work Australia’s
“Good Work Design” principles, is publicly available here: https://www.
safeworkaustralia.gov.au/system/files/documents/1702/does-the-evidence-theory-
support-good-work-design-principles.pdf.
This pillar relates to prior arguments that too much attention is given to secondary
and tertiary stress management interventions rather than primary ones (see Parker
et al. 2003; Parker 2015). Secondary interventions aim to limit the consequences of
harm, and tertiary interventions focus on treatment, rehabilitation, and compensation
after harm has already been caused (as focused on in the Mitigate Illness pillar). In
contrast, primary interventions aim to prevent potential harm by addressing the
source of the risk (in this case, the risk of poor work design, sometimes referred to
as “psychosocial risks”). The Prevent Harm pillar focuses primarily on primary
interventions. Importantly, there is a legal imperative to go beyond secondary and
tertiary interventions to more preventative approaches. Specifically, Work Health
and Safety Legislation identifies that employers have a duty to take reasonably
practical measures to protect workers from harm, which entails ensuring that risks
are controlled at the highest level of the hierarchy of control (see Parker 2015).
734 S. K. Parker et al.

Prevent harm presents practical strategies within three categories; the first two of
which focus on changing work, and the third focuses on changing individuals. The
first category is Maintain/Increase Job Resources. Job resources are defined as
aspects of jobs that are functional in achieving goals, helping one to manage
demands, and/or stimulating personal development (Demerouti et al. 2001,
p. 501). We further categorize job resources into the “SMAR” component of the
SMART model (elaborated further below). Job resources therefore include aspects of
work that make the work Stimulating, that foster Mastery, that enable Agency, and
that promote Relational aspects of work. We elaborate these elements shortly.
The second category of workplace strategies in Prevent Harm is Ensure Tolerable
Job Demands. Job demands are “those physical, social, or organizational aspects of
the job that require sustained physical or mental effort and are therefore associated
with certain physiological or psychological costs” (Demerouti et al. 2001, p. 501).
There are different types of demands, such as cognitive (e.g., excessive requirement
for vigilance), emotional (e.g., dealing with abusive customers), or physical
demands (e.g., heavy lifting requirement). This category is relevant to the “T” in
the SMART model below, which refers to ensuring that demands are “tolerable”
through managing, preventing, or reducing job demands such that demands do not
exceed the personal resources of an individuals. We elaborate this perspective
shortly.
The third category of workplace strategy in Prevent Harm is Increase Individual
Resources for Preventing Harm. This category, like the third category in Mitigate
Illness above, focuses on organizational strategies to help individuals themselves to
create job resources and effectively manage, reduce, or prevent excessively high job
demands. Job crafting, in which individuals actively shape and mold their work to fit
their needs and abilities (Tims et al. 2013), is an example of how individuals can
boost their job resources or reduce their demands. Other forms of proactive work
behavior, such as voice, taking charge, and negotiating idiosyncratic deals, are also
ways that individuals can create better work for themselves (Parker et al. 2010).
Resilience training is a popular organizational strategy for helping individuals to
prevent harm.

Promote Thriving
The Promote Thriving pillar has as its goal optimizing employee well-being, or
employee thriving, and thereby helps employees to realize their potential and lays
the foundation for their outstanding performance. This element of the framework
focuses on the well-being end of the mental health spectrum (rather than the mental
ill health end).
Well-being refers to optimal psychological functioning and experience (Ryan and
Deci 2001). Two distinct well-being perspectives are predominant in the literature.
The first can broadly be referred to a hedonism, or subjective well-being, and reflects
the idea that well-being is about pleasure and happiness (Warr 1994). Outcomes such
as the presence of positive mood, life satisfaction, and a lack of negative mood make
up subjective well-being, with these states being fostered through individuals’
attaining valued goals and outcomes.
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 735

The second view, the eudaimonic perspective (Waterman 1993), captures the idea
that well-being is more than happiness, and is about the realization of one’s potential.
Examples of eudaimonic concepts include personal growth, feeling autonomous and
independent, self-acceptance, having a clear life purpose, experiencing mastery, and
positive relatedness with others (Ryff and Keyes 1995). Some have referred to the
eudaimonic perspective as reflecting a more “active” approach to mental health
(Parker et al. 2003; Warr 1994) because it contrasts to the notion of people being
“passively contented” (for example, people can feel positive by setting very low
goals for themselves).
We use the term “thriving” to encapsulate both positive levels of subjective well-
being (hedonic) and high active (eudaimonic) well-being, recognizing that these do
not always perfectly align. Living a purposeful and active life can sometimes mean
that subjective well-being is negatively affected. As Warr (1994, p. 86) noted:
“proactive, risk-taking people may be considered healthy in terms of competence,
aspiration and autonomy; but their difficult interactions with the environment may
also make them anxious for a considerable proportion of time.” Thus, from a
eudaimonic/active perspective, negative emotional states like anxiety can still indi-
cate well-being. They only become a sign of poor mental health if the negative
emotional states are sustained over very long time periods or are excessive.
Supporting employees to thrive has many benefits for businesses. Research has
found that thriving employees are more confident and energized, better able to respond
to challenges, and recover quicker from the demands of work (Desrumaux et al. 2015).
When employees thrive, this is also linked to sustainable individual and organizational
performance (Spreitzer and Porath 2012). Organizations with thriving employees expe-
rience greater customer satisfaction and loyalty, productivity, safety performance, and
overall profitability along with reduced turnover and absenteeism (Harter et al. 2002).
We identify three sets of evidence-based activities and actions that organizations
can invest in to create conditions for thriving in the workplace. These strategies often
come from the strategic human resource management, organizational behavior,
organizational psychology, and positive psychology literatures. As with the other
pillars, the first two sets of strategies are work/organizational-level changes, whereas
the third targets change in individuals.
First, related especially to eudaimonic well-being, organizational strategies can
cultivate continuous learning, development, and growth of their employees, which
we refer to as Create Conditions for Growth. These strategies help workers to realize
their potential, and also assist employees to keep up with the changing nature of
work and support their effective performance in uncertain and dynamic conditions.
Second, related to both types of well-being, the second category of organizational
strategies focuses on maximizing the connection employees derive from their work,
which we refer to as Create Conditions for Connection. Having connections and
relationships is an important source of subjective well-being, but the social environ-
ment (such as having strong networks, feeling well supported) also allows people to
thrive and grow psychologically. In the future workplace, given the enhanced
interdependence in the work place, connections and relationships are also vital for
effective co-ordinated performance (Griffin et al. 2007).
736 S. K. Parker et al.

Third, workplace strategies can foster individuals’ motivation and ability, or their
personal resources, to increase their own thriving (Increase Individual Resources for
Thriving). Like the third category in each of the above pillars, this category is
focused on strategies that enable individuals themselves to create a better work
experience. Example tactics include training individuals in mindfulness practices,
and encouraging their strengths-based crafting.

Example Applications
Organizations understanding what impacts mental health and well-being in the
workplace is only one part of the puzzle. Having the knowledge and skills to go
about addressing this issue is another. A recent Australian survey found that 16% of
organizations have not addressed workplace mental health and well-being because
they do not know where to start (Superfriend 2018). A key focus for the development
of the Thrive at Work framework has been to ensure that the framework is useable by
organizations, and that there is a clear implementation process for adopting the
framework to strengthen practice.
The Thrive at Work implementation process (see www.thriveatwork.org.au/
resources) includes:

– A curated list of research findings and statistics that organizations can use to make
a business case for the benefits of developing an integrated mental health and
well-being strategy (see website www.thriveatwork.org.au/resources/business-
case/),
– An audit process and accompanying audit tool to strategically assess the full
range of policies and practices currently in place against the Thrive at Work
framework, including their maturity;
– Guidance on conducting focus groups, interviews, and employee perception
surveys (i.e., methodologies for capturing worker experiences) to assess key
components of work known to impact on employee well-being (as outlined by
the framework);
– A dynamic, interactive platform for depicting results from the employee percep-
tion surveys;
– Suggested approaches to collecting, collating, and analyzing relevant strategic
human resource and business data to provide further indicators of current
employee well-being and outcomes of practice; and,
– Tools for action planning, tracking, and developing mental health and well-being
strategies and practices over time.

The Thrive at Work implementation process has been designed to be useful for a
wide range of workplaces, with varying degrees of existing maturity. Most of the
activities are applicable across a range of industries and organization sizes, and can be
scaled up or down where needed. Multiple organizations have utilized the Thrive at
Work framework to help develop a more strategic and integrated approach to
supporting employee well-being. For example, following an externally led employee
perception survey indicating significantly higher rates of mental health conditions and
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 737

lower mental well-being for staff within their organization than the general population,
one public sector agency opted to undertake the Thrive at Work audit to assess their
existing practices and develop clear action plans for improvement. The audit process
was especially important in bringing together diverse and previously siloed practices:

The thrive at work [audit] workshops really opened our eyes to where we are at and where
we want to be as an organisation. It culminated in key stakeholders in our organisation
coming together to have a good look at how we are travelling in relation to doing the best we
can to thrive at work... At the conclusion of the workshops we certainly had targets and
goals for our future direction of where we are heading. [Audit Participant]

As a second example, encountering increasing levels of staff grievances and

interpersonal conflict within a particular division, another company chose to conduct
a series of focus groups that would enable staff to unpack challenges and opportu-
nities with their current working environment that moved beyond individual-focused
targets for change (i.e., to move beyond conflict resolution and resilience training to
include an assessment of the impact of work design and broader organizational
practices). These focus group activities were especially helpful for managers to
understand the importance of involving participants in a change process:

[Following the focus groups] I realised there was a connection between the individual, the
managerial and organisational roles. Many staff had good ideas about how to improve
things at each level. Improving the working environment could lead to a more team focussed
approach towards issues instead of individuals feeling like they had to deal with problems
themselves. [Focus Group Participant]

Beyond these specific examples, the Thrive at Work framework is publicly

available, and website statistics 1 year after the launch of the framework suggests
significant appetite for this type of model nationally and internationally. We are
aware of multiple organizations auditing themselves using this framework, and we
are also working with a range of organizations to support their implementation of the
framework. As we engage in these activities, we are continuing to develop further
case studies and guides to assist organizations to utilize the Thrive at Work frame-
work in ways that fit their current maturity.
The framework integrates diverse practices and policies across multiple portfolios
and helps build a shared mental model and aligned focus among key stakeholders.
After organizations adopt the framework, we are also observing the introduction of
more mature workplace strategies, with an increasing number of organizations
moving beyond taking stock of current implemented practices, to further strategic
assessment, such as implementing better metrics to tracking employee experiences
and outcomes and evaluating the effectiveness of well-being interventions against
the strategic intent of these interventions (e.g., following the roll-out of an employee
mental health literacy program do employees feel more confident detecting mental
illness and are they more likely to seek early support). We are also observing a move
beyond “mitigate illness” to consider “prevent harm,” supported by the SMART
work design model.
738 S. K. Parker et al.

Deep Dive into Prevent Harm and the SMART Work Design Model

As discussed above, an important rationale for developing the Thrive at Work

framework was to shift the conversation in a direction that oriented key stakeholders
to importance of work in causing poor ill health, protecting against ill health, and in
promoting well-being. We therefore emphasize in the framework the role of work
design in shaping employees’ mental health (Prevent Harm), rather than the pre-
dominant emphasis in industry on how mental health should be accommodated and
supported at work (Mitigate Illness). We also emphasize how the responsibility for
good work design lies with the organization at least as much (and sometimes more)
than with individuals.

Work Design Is Currently Often Overlooked

Despite a great deal of evidence about the importance of a more preventative, work
design-based approach to addressing psychosocial risks, it has traditionally been
challenging for organizational stakeholders to recognize the importance of work
design for employee mental health. On the one hand, there is growing promotion of
the idea that mental ill health is common among the working population, such that
stakeholders often understand that individuals have mental health problems that
derive from their own past circumstances, coping abilities, or personality. From this
perspective, mental health is approached through an inclusion agenda, in which the
importance of effective work participation from all members of the community is
highlighted. At the same time, stakeholders can often appreciate and understand that
highly traumatic work events, such as hospital staff member’s exposure to a violent
incident, cause distress and mental health problems. In this case, there is an under-
standing of the moral imperative of caring for individuals exposed to trauma in the
course of doing their work.
However, it can be difficult for organizational managers and others to understand
that people’s day to day quality of work can significantly affect their mental health.
Sometimes, for example, only after surveys or focus groups in which data is
presented to provide specific “local evidence” (such as developing models that
show how SMART work elements statistically predict outcomes like mental health)
do stakeholders “get it.” Interestingly, this is not the case when talking to employees
themselves—conversations about work stress very quickly turn to factors such as
long working hours or micromanagement.
As a case in point, in a project investigating the mental health of FIFO workers
(Parker et al. 2018a), it was challenging to get some of the stakeholders in the project
team to accept findings from our research showing that levels of mental health varied
significantly across rosters. Those on long rosters (such as working on site for
4 weeks and then being home for 1 week had significantly greater psychological
strain than those with shorter and more even time rosters (e.g., 1 week on, 1 week
off; Parker et al. 2018b). Some of the stakeholders interpreted this finding as
suggesting that “mentally unhealthy people choose long rosters.” However, since
we were informed by workers that they most often cannot select the rosters them-
selves, and since we were able to use statistical modelling to show why longer rosters
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 739

are experienced as stressful (e.g., longer time away from the family, more personal
events missed, greater levels of fatigue, etc.), we were confident that the causality
mostly applied in the direction of rosters affecting mental health. In a longitudinal
study, we also showed how people’s mental health varied significantly across the
roster, with a decline while away on site yet a boost when at home. These variations
as a function of roster would not occur if the more simple explanation (that “mentally
unhealthy people choose long rosters”) applied.
There are a couple of reasons for this tendency of managers and organizational
stakeholders to want to attribute mental health to the person rather than the work.
One reason is the greater responsibility that comes with recognizing the role of work
because it potentially implicates managers’ own actions in other people’s mental
well-being. For example, in the case of the rosters, there are cost implications for
companies—at least in the short term—in accepting that rosters might affect mental
health because they would need to fly workers home more often (longer term, it
could well be that the benefits outweigh the costs although such analyses are
rarely done).
However, a further important reason for neglecting work design is the attribution
bias concept from social psychology (specifically referred to as the “fundamental
attribution error,” Ross 1977), which refers to the natural human tendency to
attribute the cause of negative aspects to an individual’s stable disposition (e.g., a
FIFO worker with poor mental health is “not resilient”) rather than the situation (e.g.,
a FIFO worker with poor mental health has poorly designed rosters). Because of this
bias, therefore, it is difficult for managers and others to “see” the role of work design
in causing mental ill health.
A further challenge in this area is that mental health risks caused by work, or
“psychosocial risks,” cannot be understood in quite the same way as physical risks.
For example, in contrast to physical risks, there are individual differences in
workers’ reactions to psychosocial aspects. When a brick falls on someone’s
helmet-less head, it pretty much hurts everyone, irrespective of whose head or
when/where the event occurred. High levels of workload, however, harm some
people, but not others. High workload can harm a person at one time but not at
another time (e.g., workload might be fine until a person goes through a stressful
divorce). Such differences between understanding physical and psychological risk
make it tricky for organizational stakeholders because they want to manage mental
health through a similar approach to physical health, even when such an approach is
not appropriate.
The SMART work design model was developed to strengthen the focus on work
design as a vehicle for improving mental health. Moreover, we developed this model
to provide a positive and holistic approach to work design, rather than the more
common risk-management approach to work design, as we elaborate below.

The SMART Model of Work Design

Work design is defined as “the content and organization of one’s work tasks,
activities, relationships, and responsibilities” (Parker 2014, p. 662). Work design
applies to all organizations because, to achieve their common goals, organizations
740 S. K. Parker et al.

need to divide labor (break down the goals into smaller tasks and assign them to
individuals or groups) and then integrate the resulting efforts (e.g., co-ordinate the
work of team members). The division of labor, and its reintegration to meet collec-
tive goals, inevitably requires work design decisions about who does what, when,
and how. These decisions, in turn, affect what have been referred to as “work
characteristics,” or how psychologically important attributes of jobs, such as having
“task variety.”
In their classic job characteristics model, Hackman and Oldham (1976) specified
the importance of five core work characteristics (task variety, task identity, task
significance, job autonomy, job feedback) as shaping individuals’ intrinsic motivation,
and, in turn, outcomes such as performance, intention to stay, and absenteeism. Since
this early model, several further theoretical perspectives on work design have emerged
(see Parker et al. 2017, for a review) such as the job demands-control model (Karasek
1979), expansions of the job characteristics model to identify contemporary work
characteristics (e.g., Morgeson and Humphrey 2006; Parker et al. 2001), and social/
relational perspectives (Grant 2007; Grant and Parker 2009). All of these perspectives
consider how the nature and organization of work affect how people think and feel
about their work, and hence shapes outcomes such as job performance and stress.
One consequence of theoretical development, however, has been the proliferation
of work characteristics since Hackman and Oldham’s (1976) initial five core ones.
Indeed Morgeson and Humphrey (2006) identified and assessed 21 work character-
istics, and showed their importance for outcomes such as job satisfaction, organiza-
tional commitment, and job performance in a meta-analysis of over 259 studies
(Humphrey et al. 2007).
To help understand the relationships among these many work characteristics, and
to bring synthesis to a rather overwhelming array of them, Parker and Knight (2020)
employed a higher-order factor analytic approach in which they analyzed the
interrelationships among 21 work characteristics. From this analysis, they identified
five super-ordinate factors of work characteristic: Stimulating (encompassing, for
example, task variety and job challenge), mastery-oriented (e.g., role clarity, feed-
back), agentic (e.g., timing control, method control, participation in decision-
making), relational (e.g., social support, social contact, and teamwork), and tolerable
(e.g., reasonable levels of work load, moderate levels of emotional demands, etc.).
The first four super-ordinate factors (stimulating, mastery-oriented, agentic, rela-
tional, and tolerable) are all “job resources,” whereas tolerable refers to having in
one’s job a level of job demands that do not exceed one’s ability to cope with those
demands. Table 2 summarizes these higher-order factors, and for each, shows the
work characteristics used in Parker and Knight (2020) that were shown to indicate
the factors, the broader set of work characteristics used in the Thrive at Work
framework. We also provide a link between the SMART dimensions and some
common “psychosocial risks.”

Using the SMART Model to Improve Mental Health

We have successfully used the SMART model to improve mental health in the work
place (free resources are shown here: smartworkdesign.com); sometimes as part of
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 741

Table 2 The SMART work design dimensions (based on Parker and Knight 2020)
Example
Definition from Parker and psychosocial
Dimension Knight (2020) Relevant work characteristics risks addressed
Stimulating A high degree of mental Task variety Repetitive
complexity and variety as a Skill variety work
result of the nature and Problem solving demands Excessive
organization of one’s work Information processing vigilance
tasks, responsibilities, and demands Low challenge
relationship Poor skill
utilization
Mastery- When work is organized in a Job feedback Role
oriented way that one can understand Feedback from others ambiguity
what one’s tasks, activities, Role clarity Inadequate
relationships, and Sufficient training feedback
responsibilities are, how they Sufficient information Lack of
“fit” in the wider system, and training
how well they are being Low reward &
executed recognition
Agentic A high degree of autonomy, Decision-making autonomy Low control
control, and influence over Work method autonomy Exclusion
one’s work tasks, activities, work scheduling autonomy from decision-
relationships, and Participative decision- making
responsibilities making Excessive
Flexible working monitoring
Relational Experiencing support, Task significance Bullying,
connection, and an Beneficiary contact harassment &
opportunity to positively Social support incivility
impact others as a result of the A lack of bullying and Excessive
nature and organization of conflict conflict
one’s tasks and activities Isolation/
absence of
social contact
Poor support
Tolerable Work demands that are not Low levels of role overload Role overload
overly taxing of one’s Low levels of family-work Long work
personal resources/coping conflict hours
ability and/or that do not Other cognitive, physical, Work family
significantly impair one’s emotional, and conflict
ability to carry out non-work organizational demands at Injustice
roles work including: Injustice Poorly
demands; badly managed managed
organizational change; change
emotional pressures Emotional
pressure
Poor
environmental
conditions
Others, e.g.,
badly designed
rosters
742 S. K. Parker et al.

the Thrive at Work process, but also sometimes directly when the client has a clear
focus on work design. Typically, an initial step in any intervention process is a
diagnosis, both from the perspective of workers (e.g., the degree to which individ-
uals experience SMART work, their mental health and well-being, etc.) and from the
perspective of organizational practices (e.g., policies that might influence work
design, technological constraints, etc.). The diagnosis can be informal (e.g., in the
case of a very small business, it might consistent of a focus group discussion) or
more systematic and formal process (e.g., involving surveys, focus groups across the
organization, collation of workers’ compensation data; see a free sample SMART
diagnosis survey here: smartworkdesign.com.au).
After diagnosis, if needed, efforts can be made to increase the extent to which
work is SMART. These efforts can range from minor “tweaks” of the existing roles
(such as redistributing a responsibility from one person to another) to major restruc-
tures of roles, activities, and responsibilities, according to need, as well as the
readiness of the organization (for case examples, see smartworkdesign.com.au).
Such change often involves not only a re-allocation of roles and responsibilities,
but also changes to supporting human resource practices, information systems, and
technological change (see Chaps. 8 and 9 in Parker and Wall 1998 for guidance).
Discussing all the steps and processes involved in a major redesign is beyond the
scope of this chapter, but an overarching central principle is the value of employee
participation in any redesign process (see Parker 2015).
Also important is the evaluation of any change (that is, measuring the impact on
work design and mental health/well-being), as well as an openness to continue
developing the work design. As the situation changes, and as redesigns “settle”
and as people’s skill sets grow, there is often a need to make further adjustments.
SMART work can also be fostered through individual-level strategies such as job
crafting (the third set of strategies in the Prevent Harm pillar). These strategies are
sometimes referred to as a “bottom-up” form of work redesign that is initiated by
individuals themselves, rather than the more top down (management-led) strategies
in the Job Resources and Job Demands categories. In fact, scholars have speculated
that top down strategies will be most effective when combined with bottom-up
strategies that seek to get workers’ ready and willing to embrace work redesigns
(Parker 2014), although so far there are few empirical evaluations of this point.

Positioning for Digitalization and Other Future Work Challenges

Current concerns about mental health are likely to increase as change accelerates in
work tasks and organizational management. We have already witnessed the impact
of the COVID-19 pandemic in terms of accelerating introduction of flexible work-
ing, as well as, in many industries, the implementation of online work practices and
digital technologies. As with most technological changes there is potential for both
positive and negative outcomes for mental health. On the one hand, such changes
have the potential for enhancing mental health of employees by providing more
flexible working conditions and access to new resources. On the other hand, they can
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 743

increase psychosocial risks such as work overload and introduce new risks such as
social isolation. Similar arguments about the mixed effects on work design as a result
of digitalization-enabled changes such as automation and the algorithms have been
identified (see Parker and Grote 2020). This wider research suggests that the ultimate
impact of technological and other changes on employees’ mental health will depend
greatly on how work is designed, how changes are implemented, and how organi-
zations are managed.
For example, our research on working from home during COVID-19 flexible
working showed that, for some individuals and organizations, work demands
became less tolerable as a result of children being at home and not in care, the
speed of the transition meaning some individuals were not well set up for remote
work, having highly micromanaging managers (Parker et al. 2020), and increased
workloads. For other individuals and workplaces, work demands became more
tolerable because of increased autonomy over work hours due to being at home.
Importantly, the research also shows that each of these work design factors (e.g.,
workload, level of autonomy) correlates with psychological distress in the expected
ways, consistent with prior research and theory linking work design with mental
health. Although these findings are correlations and not causal paths, the implication
which we can draw from the much broader research base is that psychological
distress will be reduced if people’s work at home is designed to have plenty of job
resources (e.g., a variety of tasks, autonomy over work hours and methods) and
reasonable demands (e.g., good technological set ups to reduce IT hassles). This
suggests the good sense of managers and organizations paying serious attention to
the creation of SMART work at home (as well as in the office or the work site);
especially crucial given evidence that, during COVID-19, many people have expe-
rienced increased levels of psychological distress. For example, in a study based on
working from home in the early days on the pandemic in China, we showed the
powerful role of social support from peers and leaders in mitigating against some of
the challenges of remote work (Wang et al. 2020).
Digital transformation more broadly is increasing uncertainty and complexity in
many aspects of work (Griffin et al. 2019). Uncertainty is manifest at all levels of the
economy from volatile market to insecurity of employment for many individuals.
These fundamental uncertainties can act as stressors that negatively impact on
mental health. Prolonged experience of insecurity can also lead to changes in well-
being that are difficult to reverse. Our recent research shows that experiencing job
insecurity over long periods of time can lead to declines in personality dimensions
(e.g., agreeableness and conscientiousness) that would normally increase over the
life course (Wu et al. 2020).
In many roles, the complexity of work is increasing as technology creates more
varied opportunities for communication and decision-making. Although there is
widespread concern that technology might oversimplify work, many future jobs
will involve both periods of intense interaction with others and periods of simple but
critical tasks such as monitoring for failures. For example, at time, maintainers in
highly automated environment will need to respond urgently to safety-critical
incidents, often as members of a multidisciplinary team working with technological
744 S. K. Parker et al.

systems that monitor and analyze fault data. At other times, maintainers will have a
passive monitoring role that might not require application of skills but still demand
high levels of vigilance. As these patterns of work become more common, we will
need a new understanding of the impact of work on mental health. New work
characteristics, such as variation in workload, are likely to emerge in the future as
important aspects of work that should be assessed.
We draw two major implications for mental health from the above points. First,
digital transformation can have significant negative impact on mental health.
Unpredictable demands combined with varying periods of underload and overload
will expose more people to psychosocial risks. Second, and less obviously, positive
mental health will be an important resource for individual working in future orga-
nizations. Uncertain and complex task environments require greater levels of adap-
tion and innovation from individuals if organizations are to operate effectively in
dynamic environments. Mitigating mental health illness will be insufficient to
develop the motivational attributes and work skills appropriate in these environ-
ments. It will be more important than ever to consider how work is designed to
prevent mental health problems and to promote thriving at work.
Achieving good work, in turn, requires attention to broader issues such as the
need to proactively consider work design when designing, procuring, and
implementing new technologies (Parker and Grote 2020). An example is the work
we have done with the Australian Defence force to help proactively design more
human-centered systems for the operation of the future submarines (Boeing et al.
2020).
We draw similar conclusions from a review of collaborative technologies such as
Zoom, Webex, and Microsoft Teams (Desai et al. in prep). There is a risk that
organizations will adopt technology based on superficial features of the technology,
without considering the goals and processes of collaboration itself. As the require-
ments for human collaboration become more demanding, it is important that the
technology supports and enhances these requirements, rather than adding further
demands.
Because technology is intrinsic to much current disruption, organizations can
easily be drawn to technical solutions for improving mental health. For example,
smartphone apps that monitor physical signals such as heart rate and skin conduc-
tance offer the promise objective and immediate insights into employee health.
Although there are certainly potential gains from this technology, the promise will
not be realized in the absence of the imperatives we have outlined in this chapter. The
conditions for SMART work and thriving individuals can be supported—but will not
be created—through monitoring and data analytics. It is crucial that the mental
health conversation is about the experience of individuals and their work. This
will become ever more important as people strive to create and contribute to a future
embedded in technological innovation and change.
It is also relevant to note that there are exceptionally well-validated methods that
already exist for assessing mental health and well-being— they are as simple as
asking people! Models such as Thrive at Work and SMART are also readily
adaptable to future developments.
35 Shifting the Mental Health Conversation: Present and Future Applications. . . 745

Summary

It has never been more important to consider mental health in the context of work.
Not only is there a mental health “crisis,” accentuated by COVID but already in
existence pre-pandemic, there is vast and rapid change occurring in work. Against
this backdrop, it is vital that we consider how to include individuals with mental
health issues in work, and how to support them effectively. But just as important,
work—when it is poorly designed—can cause mental health issues and/or exacer-
bate already-present conditions. And when work is well-designed, it can play a
protective role and promote thriving, giving people meaning, purpose, a sense of
achievement, the opportunity for connection with others, and many more such
ingredients for mental health and well-being.
We have proposed the Thrive at Work framework as a framework that synthesizes
organization’s approaches to mental health, and that deliberately brings to the fore—
much more so than is currently the case in many practitioners’ minds—the role of
well-designed (or SMART) work.
We hope that the comprehensiveness and structure of this framework will help to
foster more strategic and non-siloed approaches in organizations to achieving the
better mental health and well-being of their employees.

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Workplace Well-Being Initiatives
Evaluating the Costs and Benefits
36
Emike Nasamu, Sara Connolly, Mark Bryan, and Andrew Bryce

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 750
Evaluation Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 751
Implementing CEA in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 754
Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 755
Goal Setting and Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 756
CONNECT+ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 758
Flexible Working Hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 759
Mental Health First Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 761
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 763
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 764

Abstract
There is an extensive academic and practitioner literature on what sorts of
workplace well-being interventions work and for which types of workers (see
Daniels et al., Job design, employment practices and well-being: a systematic
review of intervention studies. Ergonomics 60:1177–1196. 10.1080/
00140139.2017.1303085, 2017; Watson et al., Well-being through learning:
A systematic review of learning interventions in the workplace and their

E. Nasamu (*)
Social and Political Science University, University of Chester, Chester, UK
e-mail: [email protected]
S. Connolly
Norwich Business School, University of East Anglia, Norwich, UK
e-mail: [email protected]
M. Bryan · A. Bryce
Department of Economics, University of Sheffield, Sheffield, UK
e-mail: m.l.bryan@sheffield.ac.uk; a.m.bryce@sheffield.ac.uk

© Springer Nature Switzerland AG 2022 749

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_38
750 E. Nasamu et al.

impact on well-being. Eur J Work Organ Psychol 27(2): 247–268. 10.1080/

1359432X.2018.1435529, 2018; Whitmore et al., Promising practices for health
and wellbeing at work. A review of the evidence landscape. RAND Corporation,
Santa Monica, Cambridge, UK, 2018). However, few of these studies include an
assessment of the costs of the interventions nor do they provide an approach for
evaluating these against the benefits in terms of any improvements in employee
well-being. This chapter aims to provide an overview of the use of a well-being
cost-effectiveness analysis to evaluate workplace interventions and illustrates the
technique using four case study examples of workplace interventions. We explore
ways in which costs of interventions might be calculated, how the well-being and
productivity benefits of interventions might be measured, and finally, how the
cost-effectiveness of the interventions might be assessed.

Keywords
Workplace · Well-being · Interventions · Evaluation · Cost · Productivity · Cost-
effectiveness · Case study

Introduction

Economic appraisals are widely used in welfare economics to inform judgments

across investment choices such as the economic impact of hosting a World Cup or
the Olympic Games (De Nooij et al. 2013; Preuss 2004; Rose and Spiegel 2011).
Traditional welfare economics has based economic judgments on the concepts of
social welfare, and government policy more generally has focused on economic
indicators such as GDP, but “During the past decade, there has been growing
recognition that the measurement of economic progress needs to extend beyond
GDP. The measurement of well-being as a holistic indicator of progress is an
appealing alternative generating a good deal of policy interest” (Coyle 2019, quoted
on https://www.bennettinstitute.cam.ac.uk/research/research-projects/measuring-
wellbeing/). This is explicitly recognized in the UK Treasury Green Book (HMT
2018) and in guidelines offered by equivalent departments in Iceland and
New Zealand where well-being budgets and policy are being pursued (BBC 2019;
The Treasury 2019).
The literature on well-being and policy decision-making is in early stages. There
are ongoing conversations about how to measure well-being and about what aspects
of subjective well-being should be considered for the purpose of making policy
(Helliwell and Barrington-Leigh 2010; Helliwell et al. 2012). For example, Senik
(2011) noted that the three definitions of subjective well-being, life evaluation,
affect, and eudaimonia, although related are quite distinct from one another. There
are also ongoing discussions in the literature about how well-being might be used for
policy-making purposes and what considerations to keep in mind (Stiglitz et al.
2009; O’Donnell et al. 2014). O’Donnell et al. (2014) considered how well-being
might inform policy decision-making which is in its early stages. There are ongoing
36 Workplace Well-Being Initiatives 751

conversations about how to measure policy evaluation and management. In a similar

vein, Deaton (2018) explored how well-being-centered policy might be
implemented, considering some of the measurement issues related to well-being
and the sensitivity of decision-making to these measurement issues. The Organisa-
tion for Economic Co-operation and Development and the UK Office for National
Statistics have provided valuable resources to assist in measuring and benchmarking
well-being at more macrolevels (OECD 2020; ONS 2020).
In the UK, the All Party Parliamentary Group on Wellbeing Economics identifies
improved workplace well-being as one of the key priority areas for government and
private sector investments in the UK (APPG 2019). It recommends that employers
routinely measure worker well-being and publish the results as standard in annual
accounts and that employers put policies in place to train managers on how to
promote well-being, address the management of mental health problems, and give
people more control over how they do their jobs.
Work is important not just for the income it generates but also because it provides
an avenue for some degree of self-realization. Over and beyond pecuniary remuner-
ation, other aspects of work which have strong effects on workplace well-being
include work-life balance, job variety, the need to learn new things and individual
autonomy (De Neve and Ward 2017), as well as managerial competence (Artz et al.
2017). Although people spend most of their time at work, literature has demonstrated
that people are not necessarily happy at work (Kahneman et al. 2004; Bryson and
McKerron 2017). Kahneman et al. (2004) reported findings in which work, when
compared with other activities in the day, is associated with one of the lowest levels
of positive affect (the average of happy feelings like warm/friendly and enjoying
myself) and one of the highest levels of negative affect (the average of negative
emotions like frustrated, depressed, hassled, and worried). Furthermore, Kahneman
et al. (2004) reported that interaction with one’s boss is seen as one of the worst
interactions in a day; it is associated with the highest level of negative affect and one
of the lowest levels of positive affect and is ranked worse than being alone.
Since we know from literature that people value things other than money in the
workplace, the evidence indicates that improving well-being at work does not
necessarily have to do with offering people higher pay. Improving people’s non-
pecuniary workplace experience can yield higher levels of overall well-being. The
benefits of improved workplace well-being do not only accrue to the employees but
also to the employers as improved workplace happiness can lead to improvements in
key indicators such as turnover rate, sickness absences, presenteeism, productivity
(Oswald et al. 2015), and organizational performance (Edmans 2011).

Evaluation Methods

Since employers are faced with limited resources and a plethora of possible work-
place interventions, it is important to have some method of determining which
interventions yield good returns to well-being. While the academic literature can
offer a good starting point for determining which well-being interventions are worth
752 E. Nasamu et al.

considering, in practice, there is limited evidence that providers of well-being

interventions are collecting the data or undertaking rigorous evaluations themselves
(Whitmore et al. 2018). A practical and intuitive method of evaluating the effective-
ness of well-being interventions is essential.
The approach usually recommended by economists and undertaken by central
governments is to conduct a cost-benefit analysis (CBA) where the monetary costs
and the monetary benefits of each intervention are considered and the intervention
which yields the higher monetary net benefit is chosen. Businesses might undertake
a similar exercise, known as a return on investment (ROI), where the ROI provides
guidance on the net gain for every dollar, euro, pound, etc. spent. These are both
good methods when the costs and benefits of the intervention are easily expressed in
monetary terms or there are well-established methods to convert non-tangible costs
or benefits into monetary terms. With well-being interventions, however, the CBA
will not suffice as benefits are expressed in terms of well-being, often life satisfaction
or job satisfaction, or measures of mental health, and there are no well-established or
reliable metrics for converting well-being into monetary values (Clark et al. 2017;
O’Donnell et al. 2014).
A cost-effectiveness approach still evaluates the costs of interventions in mone-
tary terms but it differs in that the benefits are measured in terms of the broad
objectives of the intervention. In the field of medicine, health economists have
adopted a cost-effectiveness approach which weighs the costs of a new drug
treatment or medical procedure against the health benefits of additional years of
life in perfect health, known as a quality-adjusted life years (QALY); see Bryce et al.
2020. In the UK, the National Institute for Health and Care Excellence (NICE) set a
threshold of £20,000–£30,000 per QALY when recommending treatments for pro-
vision by the NHS.
In well-being economics, a similar approach is taken, but the benefits of the cost-
effectiveness approach (CEA) are expressed in non-monetary well-being units. While
the CBA allows an absolute comparison of costs and benefits in monetary terms, the
CEA provides a relative measure, normally expressed as the cost-effectiveness ratio
(CER):

Net cost per participant

CER ¼
Change in well-being per participant

The net cost is a monetary value calculated from the costs of delivery and
participation in the intervention minus any benefits in productivity. The well-being
benefits are captured from any changes in well-being for participants in the inter-
vention. The changes in well-being for participants can be estimated using a
difference in difference approach or a randomized control trial.

Thus, the CER is measured in terms of costs of an intervention measured in

pounds/dollars and well-being benefits (Layard 2016; Peasgood and Wright 2017).
The CER can be used to rank different interventions (assuming that well-being is
measured in the same way) where an intervention with a lower CER is more
36 Workplace Well-Being Initiatives 753

cost-effective. An intervention with a negative CER actually saves money. As with a

QALY, the CER can been assessed against an agreed threshold; any intervention
with a CER below the threshold is considered to be cost-effective.
We therefore propose evaluating workplace interventions using CEA. The What
Works Centre for Wellbeing (WWCW – https://whatworkswellbeing.org) currently
recommends that well-being benefits should be measured using life satisfaction
(LS) as a common currency. Thus, the well-being benefits can be measured by the
gain to life satisfaction over the number of years that the benefits of the intervention
are expected to last. Since life satisfaction is usually measured on a 0–10 scale, we
assume that a 1 point improvement in LS is equivalent to a 10pp improvement in
quality of health, hence is equal to a tenth of a QALY and is sustained for 1 year.
Therefore, an extra unit of life satisfaction over a year converts to a threshold benefit of
between £2,000 and £3,000 (based on the NICE threshold for health interventions).
Using a common currency of life satisfaction enables different interventions to be
compared against each other and also against a CER threshold such as that proposed
above. However, this presents a challenge for many workplace interventions, as
employers, academics, and providers may use other metrics: perhaps the most common
is job satisfaction, but others include mental health, self-esteem, and social support.
Layard (2016) proposed a set of exchange rates to convert between life satisfaction and
well-being measures, based on observed empirical correlations (see Table 1).
It should be noted that the measures considered are all likely to be closely related
to life satisfaction: some are alternative measures of well-being (such as

Table 1 Conversion rates of different measures of well-being into life satisfaction

Well-being measure Range Conversion rate
Life satisfaction (ONSa) 0–10 1
Satisfaction with life scaleb 5–35 0.24
Worthwhile (ONS) 0–10 0.75
Happy (ONS) 0–10 0.72
Anxious (ONS) 0–10 0.35
General Health Questionnairec 0–36 0.21
Short Warwick-Edinburgh Mental Wellbeing Scaled,e 7–35 0.25
Satisfaction with job (BHPSf) 1–7 0.49
Satisfaction with income (BHPS) 1–7 0.61
Satisfaction with amount of leisure time (BHPS) 1–7 0.57
Satisfaction with use of leisure time (BHPS) 1–7 0.62
Satisfaction with social life (BHPS) 1–7 0.60
Satisfaction with health (BHPS) 1–7 0.63
Source: Bryce et al. 2020
Note: based on Tables 1 and 2 in Layard (2016) and author’s own calculations
a
Office of National Statistics (ONS 2011)
b
Pavot and Diener (2008)
c
Goldberg and Williams (1988)
d
Kammann and Flett (1983)
e
Stewart-Brown et al. (2009)
f
British Household Panel Survey (Taylor et al. 2018)
754 E. Nasamu et al.

worthwhileness or quality of life), while others are domain satisfactions that we

would expect to feed into life satisfaction. Where we have these types of measures,
we propose using these exchange rates. Other types of measures, such as self-esteem
or social support, appear much less directly related to life satisfaction (they may
capture very different dimensions of well-being), and it is doubtful that they can be
meaningfully converted to life satisfaction. In these cases, we suggest reporting and
considering the benefits and costs separately (see case studies 2–4). This can still
provide useful information for comparing across interventions, provided that all
report the same outcome measure(s).

Implementing CEA in the Workplace

Although provision of a workplace intervention will involve monetary costs in terms

of delivery and participation, many interventions will yield savings since absence
rates and employee turnover may fall and productivity may rise. It is important to
ensure that any estimates of the productivity benefits can be related to the interven-
tion rather than other workplace or economic factors. It is recommended that these
are estimated by any changes that occur over time among employees who have
benefitted from the intervention (a treatment group) in comparison with a group
working in the same organization who have not been part of the intervention
(a control group). Therefore, the total costs should be calculated net of these cost
savings.
However, it is often difficult to accurately capture productivity, and unmeasured
gains in productivity lead to underestimation of the CER. Similarly, we will under-
estimate effects if there are unmeasured positive spillovers to the well-being of other
workers (not receiving the intervention), family members, or the wider community.
Finally, it is important to have an understanding of the duration of any effects of an
intervention. Knowing how long effects last may be crucial (noting longer-term
effects and costs should be “discounted,” i.e., adjusted for present value over the
lifetime of a project) and may alter the acceptability decision.
For many organizations undertaking a randomized control trial is administratively
difficult and expensive. Pilot studies are often used as a good second best, as these at
least allow a contemporaneous control for changes that may arise outside of the
intervention. Furthermore, interventions are rarely a single item initiative; rather they
form part of a bundle of practices or organizational change. As a consequence, it is
hard in practice to establish causality or to attribute well-being or productivity
improvements to a particular intervention (Patey et al. 2021). In such cases, it is
possible to still be guided by the principles of CEA using the costs of the intervention
alongside any before and after changes in key metrics. Here the final decision-
making will not be made in terms of a CER, rather it will be based on an assessment
of key information which reflects costs and outcomes.
Bryce et al. (2020) have developed a cost-effectiveness calculator which can be
used to evaluate workplace well-being interventions. The calculator provides
detailed guidance on estimating and interpreting the CER. It is of most use when
36 Workplace Well-Being Initiatives 755

interventions are randomized control trials, where the calculator can use before and
after measures for both a treatment and control group to calculate the CER. It is still
very effective when the treatment and control groups are not chosen randomly, as it
uses a difference-in-difference calculation which takes account of level differences
in well-being or sickness absence/productivity before the intervention. This provides
not only estimates for the CER but also confidence intervals which allow us to assess
the upper and lower values which are compared against the threshold of £2,500 per
year of life satisfaction. The calculator provides the user with the flexibility to either
use total costs of an intervention where they are already known or follow prompts to
enter relevant costs and changes in productivity. It also allows users to provide
details on a range of well-being measures which are then converted into life
satisfaction using the conversion rates in Table 1. Daniels et al. (work in progress)
used the calculator in their evaluation of a randomized control trial of two mindful-
ness apps across five police forces in England and Wales (Fitzhugh et al. 2019a,b).

Case Studies

We use four case studies to illustrate how a cost-effectiveness approach might be

used to evaluate a well-being intervention. The case studies cover a range of
interventions in different organizational settings. They are a mix of workplace
interventions and human resource management (HRM) practices and vary in terms
of scale, scope, and therefore cost. None capture the full set of information or data
required to conduct a comprehensive cost-effectiveness evaluation; only one case
study uses data collected in a randomized control trial, with the others using before
and after comparisons. The examples are chosen to illustrate how the technique
might be applied in more real-world business situations and how they might inform
decision-making.
The first case study uses data collected in a randomized control trial and provides
the best evidence of a causal effect of a well-being intervention. The second case
study uses data collected where a new HRM tool was piloted in part of a workforce;
here we can have some confidence in the results because we are able to contrast the
experience of the intervention group with those working elsewhere in the same
organization. The final two case studies simply use before and after data.
In each case, the costs of the intervention are split into three types: participation,
delivery, and other costs. For participation and delivery costs, we estimate the
amount of time that was spent engaging with the intervention both by participants
and those involved in delivering the intervention and the overall costs of this time.
Other costs might include planning, guidance, travel, room hire, or any other costs
incurred in the intervention. In making the final estimate of time costs, we add 25%
in order to account for non-wage labor costs (National Insurance, pensions, etc.).
As noted above, it is important to take account of any impact that the intervention
has upon productivity. Productivity benefits might include direct measurable
improvements in output or be more indirect, accruing because there are fewer days
lost to absences or lower levels of staff turnover. In these cases, we estimate a pro
756 E. Nasamu et al.

rata value using 8 hours for 5 days per week evaluated at hourly rates of pay within
the organization. (For simplicity, we assume a standard working pattern of full-time
work; obviously an organization would be able to collect a full breakdown of the
staff involved and their associated paygrades.) We only use hourly wages to estimate
productivity savings based on changes in days lost or staff turnover; in the case of
staff turnover, we recognize that there may be further cost savings (National Insur-
ance or pensions) or costs accrued (advertising and recruitment) and there may
similarly be other costs/savings associated with absence rates which will be difficult
to accurately assess and are not included in the examples below. Furthermore, while
in a randomized control trial or a pilot study, it is possible to associate changes to a
particular group of participants, it will not be possible where data is collected at a
more aggregate before and after basis, meaning that any results should be treated
with caution.
Total costs  Productivity benefits
The net costs are estimated as follows:
Number of participants:
Finally, as mentioned above, well-being data is not necessarily collected in all
interventions. We only have data on life satisfaction in the first case study. The other
case studies illustrate how the general principles might be applied where other
measures might be used as imperfect proxies (employee engagement, feeling of
control, confidence).

Goal Setting and Planning

This first case study is an example of a stand-alone well-being initiative that could be
offered to staff within an organization. The intervention is a specially designed
online version of a clinically proven well-being intervention on goal setting and
planning (GAP) for working age adults (Oliver and MacLeod 2018). The program
helped employees:

• Identify goals linked to their personal values

• Develop steps to move toward selected goals
• Anticipate and deal with obstacles
• Maintain motivation

The case study uses data collected as part of a randomized control trial on the
effectiveness of the online training with 330 public sector employees across the
UK. There were 158 employees in the intervention and 149 in the control group.
Participants in the intervention reported improved well-being – greater life satisfac-
tion, more positive emotions, less negative emotions, and a greater sense of purpose
– 5 weeks after starting the program and then 3 months later.
The intervention was an online version of an existing face to face goal setting
and planning training course which the research team adapted and piloted with
working-age adults. There were 6 online modules, each taking 30 min to complete,
and participants had the option of follow-up sessions with the research team. There
36 Workplace Well-Being Initiatives 757

Table 2 Estimated costs for the goal setting intervention

Goal setting – randomized control trial intervention
Participation Time spent by employees engaging with intervention and time spent following
costs up with the research team. There were 6 online modules, and each module took
around 30 min to complete, so this is estimated as involving 3 h of work time.
Oliver and MacLeod allocated 30 min of work time for phone conversations
between the research team and the participants.a The participation costs are
estimated at 3.5 h of work time.
158 employees  3.5 h  £12.48b  1.25
Delivery costs This involved preparation, focus groups, and telephone conversations with the
intervention group. Oliver and MacLeod estimated that this involved 75 h of
work time for the research team.
1 researcher  75 h  £28.12c  1.25
There were 2 focus groups; 1 involved 30 min of work-time for 40 national
government administrative employees and the second 2 h of work time for
another group of 10 national government administrative employees,
50 participants in total engaged in 0.5 h of work time.
50 employees  0.5 h  £12.48  1.25
Other costs Travel expenses of £300
Cost of website hosting the intervention of £370
Total costs £12,323.05
a
12 of 158 employees actually took up the offer of the telephone conversation with the researcher, so
this is an overestimate
b
The average hourly wage for national government administrative occupations, ASHE 2019
c
The average hourly wage rate for higher education and teaching professionals, ASHE 2019

was some travel on the part of the research team in setting up the intervention and the
costs of hosting the tool on a website. Estimates for each of the cost elements are
shown in Table 2.
There are no productivity benefits recorded as part of this randomized control
trial; therefore, the actual overall costs are £12,323.05; there were 158 participants
and so the net cost per person per year is £77.99.
Participants reported a 0.48 increase in life satisfaction after 5 weeks and a 0.44
increase in life satisfaction after 3 months. This compares with a decline in life
satisfaction of 0.1 for the control group, so the difference is 0.44 – (0.1) ¼ 0.45.

Net cost per participant 77:99

CER ¼ ¼ ¼ £173:31
Change in life satisfaction per participant 0:45

This intervention costs £173.31 per extra unit of life satisfaction for a year. It is
deemed to be cost-effective since the CER falls below the threshold of £2,500.
However, there are limitations: the study was carried out using waitlist control
protocols, which means that the control group accessed the training after 5 weeks,
and so we have no long-term follow-up on well-being for the control group. We
therefore assume that the average life satisfaction for the control group remains the
same for a year. For the intervention group, the last follow-up is at 3 months; we
therefore assume that any well-being benefits that are apparent at 3 months persist
for a year. A further drawback is that this study did not capture any productivity
758 E. Nasamu et al.

benefits such as reduced sickness, staff turnover, or increased effectiveness at work.

Including these may reduce the net cost per participant, hence the CER, and
strengthen the case for this sort of well-being intervention.

CONNECT+

The second case study illustrates a significant investment in HRM. CONNECT+ is a

personal development program, taking a “whole person” perspective by incorporat-
ing employee well-being using a well-being diagnostic tool and coaching – leading
to personalized well-being plans and resources. The case study organization (Gra-
ham, a construction company, https://whatworkswellbeing.org/practice-examples/
graham/) rolled out the initiative to a pilot group of 400 from their 1,500 employees,
so we treat the remaining 1,100 employees as a control group. Estimates for each of
the cost elements are shown in Table 3.
Graham reports that rates of staff sickness fell by 0.8 days per person per annum
(from 1 day per person per annum before the intervention to 0.2 days per person per
annum after the intervention). For the 400 employees, we record this as 320 days
of absence, which we evaluate pro rata at the average rates of pay (320  8 h 
£14.23). Graham reports that rates of staff turnover for the pilot group fell to 1%
against the company average of 10%. This amounts to 9% of 400 ¼ 36 fewer people
leaving the company per year, evaluated at the average salary (36  40 h a week 
52 weeks £14.23). However, this estimate may be considered to be conservative in
the sense that we only count the productivity benefits in the first year, when perhaps
we would expect the benefits of staff retention to last longer than that.
The net costs per participant of CONNECT+ are estimated as follows:

Total costs  Productivity benefits £61, 279:53  £36, 428:8  £1, 065, 542:4
¼
Number of participants 400
£1, 040, 691:7
¼ ¼ £2, 601:7
400
The productivity benefits associated with CONNECT+ are substantial and result
in significant cost savings per employee (a monetary gain for the organization).
Since this intervention clearly delivers value for money, other types of evaluations,
e.g., CEA, might not be deemed necessary. However, Graham did not record staff
well-being (life satisfaction), but we noted that the engagement index rose from an
average of 88% in 2017 to 95% in 2018. This is a possible indication of improve-
ments in well-being which would reinforce the economic or business case. Further-
more, there were other indications of improved health and well-being within the pilot
group:

• Uptake on the Employee Assistance Program rose from 5% to 10%.

• Participation in well-being activities rose from 20% to 50%.
• Risk of heart attack fell from 60% to 50%.
36 Workplace Well-Being Initiatives 759

Table 3 Estimated costs for CONNECT+

CONNECT+ – before and after pilot to be compared with rest of the
organization
Participation Time spent by employees engaging with personality profiling exercise and
costs workshop, Graham estimated that this involved 2 h of work time for
400 employees.
400 employees  2 h  £14.23 per houra 1.25
Time spent by employees engaging with personal well-being trainer, Graham
estimated that this involved 2 h of work time for 400 employees.
400 employees  2 h  £14.23 per hour 1.25
Delivery costs Facilitator time spent training employees on how to engage with personality
profiling exercise (DISC workshop), Graham estimate that this involved a
1-hour workshop led by one external facilitator (costs included in the external
consultant’s fees) with two HR professionals.
2 HR professionals  1 h  £15.61 per hourb  1.25
Other costs Meetings to discuss the possibility and planning of the initiative (DISC
personality profiling), Graham estimated that this involved their internal well-
being team (6 people) working with the external consultants for 2 h.
6 HR professionals  2 h  £15.61 per hour  1.25
Meetings to discuss the possibility and planning of the initiative (personal well-
being coach), Graham estimated that this involved their internal well-being
team (6 people) working with the external consultants for 2 h.
6 HR professionals  2 h  £15.61 per hour  1.25
Preparation of formal documentation for the initiative (Connect þ), Graham
estimate that this involved 2 HR staff working for 2 h per week for 4 weeks.
2 HR professionals  8 h  £15.61 per hour  1.25
External consultant’s fees ¼ £32,000
Total costs £61,279.53
a
We do not have details on the staff composition for the intervention and so use the average hourly
wage of £14.23 for the construction sector, ASHE 2019
b
The average hourly wage rate for HR professionals, ASHE 2019

• Risk of obesity fell from 60% to 45%.

• Percentage of smokers fell from 20% to 15%.

These figures might also have longer-term implications for improved productiv-
ity. In addition, as a construction company, the reduced sickness absence, the
reduction in staff turnover, and increase in staff engagement could imply that
company health and safety indicators are performing well. For example, we might
anticipate that there are fewer work-related accidents. These types of gains would be
recorded as further negative costs which are not captured in this analysis.

Flexible Working Hours

The third case study illustrates the costs involved in a minor change in HR processes.
An office with a workforce of 160 employees, which supports students on taught
programs in higher education, introduced a program of flexible working hours (flexi-
760 E. Nasamu et al.

time) as a first step in their plan to build a healthy work force and a good working
environment. The flexi-time scheme was adopted in response to feedback from staff
surveys in which staff expressed dissatisfaction with not having enough control over
their workload and work scheduling. The flexi-time scheme is an opt-in scheme,
where eligible staff members are given the option to elect into the program
(132 employees opted in, costs are estimated for this group). Eligibility is dependent
upon staff grade. The scheme gives employees the option to work flexibly around the
core work hours (10 am to 6 pm); the flexi-time options range from an earlier start at
7:30 am to a later finish at 6:30 pm. The scheme is managed with employees being
trusted to log in their work hours into a flexi-time spreadsheet.
The main costs of this intervention relate to the planning and design of the policy
and the associated recording system which involved senior administrators and HR
personnel. There were some costs associated with the communication of the new
policy, team meetings to ensure that staff were fully briefed, and time spent engaging
with the flexi-time intervention. Estimates for each of the cost elements are shown in
Table 4.
For this case study, we have before and after sickness absence and staff turnover
rates for the office, and so we use this average to evaluate changes for the partici-
pants. However, since there is no control group, we are implicitly assuming that the
counterfactual is zero; i.e., sickness rates and staff turnover would have remained the
same in the absence of this intervention. This is likely to overestimate any produc-
tivity gains since there may have been a reduction in sickness absence within the
organization or within the sector, due to other factors outside of the intervention, but
which we can’t measure without a control group. The university teaching support
office reports that rates of staff sickness fell from 0.84 days per person before the

Table 4 Estimated costs for the flexi-time intervention

Flexi-time – before and after comparison
Participation 5 min for those employees who engaged with the intervention
costs 132 employees  5 mins  £12.71a 1.25 ¼ £174.90
1 h for 82 employees who attended briefing on the intervention
82 employees  1 h  £12.71  1.25 ¼ £1302.78
Delivery costs 30 min for 1 employee (grade 8) who prepared newsletter; 5 h, for 3 employees
(1 grade 8 and 2 grade 6) who prepared formal documentation; and 2 h for
3 employees (1 grade 8, 1 grade 6 and 1 grade 4) who trained others on how to
engage with the interventionb ¼ £546.95
Other costs 7 h of work time for 19 employees (5 grade 8, 6 grade 6, 8 grade 4) who met to
discuss plans, 8 h for 7 employees (2 grade 9, 5 grade 8) who debriefed and
developed the policy and recording system for the schemeb ¼ £4,819.63
Total costs £6,844.26
a
We use a weighted average (based on the staff composition of the office) of pay grades when
estimating the participation costs (27 grade 6 at £18.68, 7 grade 5 at £12.68, and 98 grade 4 at
£11.07). The delivery costs and other costs are based on the following pay grades: £33.67 for grade
9 employees, £25.50 for grade 8 employees, £18.68 for grade 6 employees, and £11.07 for grade
4 employees.
b
As before we add 25% to account for any non-wage staff costs.
36 Workplace Well-Being Initiatives 761

intervention to 0.5 days per person per month after the start of the intervention. There
are 132 participants; we record this as 45 days of absence, which are evaluated pro
rata at the average rates of pay (45  8 h working day  £12.71 ¼ £4,575.6).
Rates of staff turnover remained unchanged at 0.6% with 1 employee leaving the
service in the 6 months before and after the intervention.
The net costs per employee of Flexi-time are estimated as follows:

Total costs  Productivity benefits £6, 844:26  £4, 575:60 £2, 268:52
¼ ¼
Number of employees 132 132
¼ £17:19

In this case study, staff well-being (life satisfaction) is not recorded, so we do not
have information on any changes in well-being. We therefore have to assume a zero
well-being impact. However, we know from staff feedback that they feel more in
control of their work and that this is likely to boost individual well-being and staff
engagement with their work, which may yield further productivity gains which are
not captured in this analysis. This is a relatively minor change in HR process;
although there were set-up costs to develop the system and brief the team, the
ongoing costs are low. The net costs of the intervention were £17.19 per participant,
and the changes were welcomed by the staff. Although we cannot conduct a full
cost-effectiveness analysis, the analysis suggests that this intervention was worth
pursuing.

Mental Health First Aid

The final case study illustrates the costs of an increasingly common mental health
initiative. A local authority in England, with a workforce of 7,561 employees,
working in a range of occupations, introduced a program of Mental Health First
Aid (MHFA) England Champions as part of their healthy workforce plan. The
MHFA program provides mental health training to managers and employees on how
to spot the signs of mental ill-health and how to offer support and signpost individuals
to expert help. The local authority aimed to train 300 managers and supervisors in the
first year, and by the end of the year, they had successfully trained 278. While there is a
broad consensus that MHFA training helps increase participants’ knowledge of mental
health issues, reduces stigma around mental ill-health, and increases supportive
behavior toward those who suffer from mental ill-health, the evidence of the long-
term efficiency and cost-effectiveness of MHFA programs is weak (Bell et al. 2018;
Bevan and Wilson 2019; Boocook and Phillimore 2018).
In addition to the MHFA program, the local council authority also ran a campaign
to promote awareness of existing well-being measures:

• Team well-being questionnaire

• In-house mediation
• One-to-one support from in-house well-being officers
762 E. Nasamu et al.

Table 5 Estimated costs for MHFA

MHFA – before and after comparison
Participation 47 h for grade L, 25 h for grade E, and 208 h for grade H ¼ £4,538.96a
cost
Delivery cost Lumpsum paid to external facilitator ¼ £8,579.40
Other cost 30 h for grade L, 20 h for 2 grade E employees ¼ £1,209.857 and logistical costs
of £8,286.935
Total costs £22,615.17
a
Hourly wage rates were provided by the local authority. Grade L, grade E and grade H were
evaluated at hourly rates of £20.61, £8.74 and £11.75 per hour respectively

• Employee assistance program

• A video about 5 ways to well-being
• Email to all new employees outlining well-being support for them

The main costs include tendering for MHFA training delivery, the fee paid to the
external facilitator, training materials, room hire for the training sessions, travel,
accommodation and subsistence while attending the MHFA trainer course, and the
time spent by participants undertaking the training. Estimates for each of the cost
elements are shown in Table 5.
One of the aims of this initiative was to spread awareness of good practice and to
achieve a snowball effect across the organization. Those trained as mental health first
aiders were selected across different departments and in different roles. Therefore,
while the costs apply to those who participated in the training, the benefit is intended
to be across the organization. The local authority was able to provide before and after
sickness absence and staff turnover rates for their staff. Since there is no control
group, we are again implicitly assuming that the counterfactual for these values is
zero. The local authority reported that rates of staff sickness absences due to mental
health increased from 12,355 to 15,448.60 days per annum. This increase of
3093.6 days is evaluated at the average hourly rate of pay (3093.6  8 h working
day  £9.67 ¼ £239,320.90).
The local authority reported that rates of staff turnover fell from 10.29% before
the intervention to 10.13% after the intervention ¼ 0.16% of 7561 employees giving
us 12.09 fewer employees leaving the local authority per year. We evaluated this cost
at the average annual salary of employees of the local council authority
(12.09  £20,111.36 ¼ £243,146.34).
The net costs per employee of MHFA are estimated as follows:

Total costs  Productivity benefits £22, 615:17 þ £239, 320:90  £243, 146:34
¼
Number of employees 7561
£18, 789:73
¼ ¼ £2:49
7561
Staff well-being (life satisfaction) is not recorded, so we are not able to calculate
the cost-effectiveness ratio. We therefore have to assume a zero well-being impact;
36 Workplace Well-Being Initiatives 763

however, we know that the key indicator of interest to the organization – staff
engagement – has improved, and it is likely that well-being has also improved. In
the period following the implementation of the MHFA training, the local authority
noted increased uptake of in-house mediation (from 7 to 24 requests), increased
demand for one-to-one support (from 92 to 135 support sessions), and increased
take-up of the employee assistance program (marginal increase from 6% to 6.2%
usage by eligible employees). The local authority regards the increased take-up of
employee assistance programs as a positive development indicating greater aware-
ness among employees and support from supervisors and managers. Furthermore,
managers reported improved confidence in dealing with employees who experience
mental ill-health. However, the MHFA was one of a number of initiatives being
implemented at the same time, and it is impossible to accurately assign benefits to
one single component.
Although the upfront costs look significant, given the size of the workforce, the
cost per person was just under £3. The estimated impact upon productivity was
mixed: higher sickness days (possibly because of greater acceptance or understand-
ing of mental health issues and less presenteeism) but lower staff turnover. The net
costs of the intervention were £2.49, and it achieved one key objective which was to
improve the confidence of management in responding to employees with mental
health problems. This initiative was supplemented with a general awareness raising
exercise which has not been costed – there would be relatively minor additional costs
associated with the publicity campaign and through the increased uptake of the
in-house mediation and employee assistance program. Although we cannot conduct
a full cost-effectiveness analysis, the analysis suggests that this combination of
interventions was worth pursuing.

Conclusions

CEA offers a useful tool for decision-makers when considering which workplace
interventions to invest in. Not only does this approach allow us to consider like with
like values – costs in monetary terms and benefits in well-being terms – but also it
encourages organizations to reflect on the full range of costs, including any savings.
The comparison of the CER against an acceptability threshold-here we used a value
based on health decision-making in the UK but others might be applied-is also a
strength, since different thresholds might apply in different sectors.
The CEA is currently developed using life satisfaction as the main well-being
metric, while other metrics may also be used. Therefore, the final calculations will
depend upon the reliability or validity of the exchange rate. The absence of longer-
term follow-up on the benefits of interventions does mean that simplifying assump-
tions needs to be made; i.e., the benefits are sustained for at least 1 year. Finally, the
approach does best suit simple rather than more complex or multifaceted
interventions.
The method is most appropriate for data collected in interventions where there is a
treatment and control group, so that it is possible to compare the difference that an
764 E. Nasamu et al.

intervention makes to the treatment group with any changes that arise due to other
common factors in the control group. In the absence of a control group, the implicit
counterfactual is that well-being and productivity will not change in the absence of
the intervention.
Like any tool, the value does depend upon the quality of the information that it
utilizes. The reliability of productivity measures is key to evaluating any savings.
Direct reliable measures of productivity are hard to obtain, especially in service sector
or white collar occupations. Here we have used indirect measure of days of sickness
absence or staff turnover. For these to be reliable measures of changes in productivity,
we would need evidence collected in a randomized control trial or in a pilot study
(as in our CONNECT+ example). In the flexi-time and MHFA case studies, we only
had before and after measures which may be affected by other factors.
In our set of case studies, we only had evidence on changes in life satisfaction in
the goal setting and planning (GAP) case study. The other cases took the general
framework of the CEA and compared the monetary costs with a benefit that was
defined by the main metric of interest to the organization – employee engagement,
control over workload, and confidence. Although a full CEA cannot be conducted to
give us clear evaluations in these cases, the approach still allows the organization to
assess whether the net costs are acceptable in terms of their own goals.
Taking a well-being lens to inform policy decision-making has been gathering
momentum. Governments in New Zealand and Iceland have been leading the way in
developing well-being budgets. International organizations (OECD) and parliamen-
tary bodies (the UK All Party Parliamentary Group on Wellbeing Economics) also
recommend that employers measure well-being and implement initiatives which
enhance employee well-being. Clearly, assessing whether a workplace intervention
improves well-being is a crucial step that needs to be taken before any initiative is
scaled up or rolled out. But, is what we spend on improving well-being worth it
relative to the number of people helped and how much their well-being improves?
This chapter illustrates how CEA can be used to inform exactly this sort of question.
Integrating CEA into business decision-making – as illustrated in these case studies
– can help us develop our collective knowledge about what works (or what doesn’t)
and how much it costs. The resulting evidence can help to design better initiatives
which will improve well-being in the future.

Acknowledgments This work is part of the Learning at Work and Wellbeing program of the What
Works Centre for Wellbeing (www.whatworkswellbeing.org). We acknowledge the support of our
funding partners, administered through Economic and Social Research Council Grant ES/N003586/1.

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 Part VI
Trends and Emerging Challenges for
Management
The Growing “Gig Economy”
Implications for the Health and Safety of Digital Platform
37
Workers

Penny Williams, Paula McDonald, and Robyn Mayes

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 770
Digital Platforms and the Gig Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 771
Growth of the Gig Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 773
Opportunities Associated with Digital Platform Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 775
Health, Safety, and Wellbeing Risks Associated with Digital Platform Work . . . . . . . . . . . . . . . . . 776
Conclusion and Future Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 780
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 781

Abstract
Operating outside national systems of labor regulation, the characteristics of
digital platform work raise new questions about the safety, health, and wellbeing
of workers. Digital platform work is said to provide flexibility and improved
work-life balance for workers, as well as access to income for individuals who
might not otherwise be able to work for health or lifestyle reasons. Emerging
research, however, has also highlighted risks to worker health, safety, and
wellbeing associated with social isolation, competition for work and algorithmic
control, lack of access to protections afforded by employment regulation, and low
prices. The chapter begins by defining key concepts and relationships in digital
platform work. Estimates of the size, growth, and diversity of this form of work
globally are provided. The benefits that digital platform work can offer are
contrasted with a discussion of the associated risks, using examples from recent
empirical research addressing the health, safety, and wellbeing of workers. The
chapter concludes by canvassing a future research agenda in this emerging field.

P. Williams (*) · P. McDonald · R. Mayes

School of Management, QUT Business School, Brisbane, QLD, Australia
e-mail: [email protected]; [email protected]; [email protected]

© Springer Nature Switzerland AG 2022 769

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_32
770 P. Williams et al.

Keywords
Gig economy · Platform work · Self-employed · Health and wellbeing · Safety

Introduction

Over the last decade, digital technologies have driven new business models that have
disrupted existing markets and altered traditional employment models. Through a
website or app, digital platform businesses provide customers with ready access to
goods, labor, and services on-demand. Early digital platforms, such as eBay and
Amazon, provided online marketplaces to buy, sell, and auction goods, while others
such as Facebook created avenues to share content and promote services (Minifie
and Wiltshire 2016). Later platforms enabled peer-to-peer “sharing” of assets such as
homes and cars, or even clothing and toys (Pesole et al. 2018). A popular example of
this type of platform is AirBNB. Individuals, via these platforms, are able to earn an
income from the sale, lease, or licensing of their existing assets.
In contrast to online marketplaces and peer-to-peer sharing platforms, digital
platforms that provide the facility for individuals to sell their labor have also
emerged. These platforms, of which Uber is the most commonly cited example,
have been the subject of significant scholarly debate, especially in relation to their
impact on workers. Despite providing work opportunities and mediating access to
labor, they are neither agencies, nor employers, nor online job boards. Digital labor
platforms go beyond advertising job opportunities to algorithmically “matching”
workers with jobs in real time. “Jobs,” in this context, are usually discrete one-off
tasks, often referred to as “gigs,” which are undertaken by self-employed freelancers
or independent contractors (Bryant 2020). By mediating access to self-employed
workers, digital platforms broker work arrangements that operate outside of the
regulatory and legal frameworks that govern traditional employment, and have
created an online labor market that consists of episodic, nonstandard forms of
employment that are rarely captured in labor force statistics. This free market system
where workers are paid for discrete “gigs” has become commonly known as the “gig
economy.”
Operating outside national systems of labor regulation, the characteristics of
digital platform work raise new questions about the safety, health, and wellbeing
of workers. Digital platform work is said to provide flexibility and improved work-
life balance for workers, as well as access to income for individuals who might not
otherwise be able to work for health or lifestyle reasons. Emerging research,
however, has also highlighted risks to worker health, safety, and wellbeing associ-
ated with social isolation, competition for work and algorithmic control, lack of
access to protections afforded by employment regulation, and low prices. This
chapter examines the interwoven and contested debates surrounding digital platform
work, with a specific focus on health and safety implications for workers. The
chapter begins by defining key concepts and relationships in digital platform work.
Estimates of the size, growth, and diversity of this form of work globally are
37 The Growing “Gig Economy” 771

provided. The benefits that digital platform work can offer are contrasted with a
discussion of the associated risks, using examples from recent empirical research
addressing the health, safety, and wellbeing of workers. The chapter concludes by
canvassing a future research agenda in this emerging field.

Digital Platforms and the Gig Economy

Digital platform work is an emergent feature of the broader labor market character-
ized by short-term, temporary “gigs” mediated by digital platforms businesses that
connect workers who are usually designated as self-employed or independent
contractors, to clients/consumers via a website or app. While digital platform firms
share some similar features, the architecture of their business models varies widely.
Consequently, scholars have attempted to define and categorize digital platforms in
various ways. For example, Strowel and Vergote (2018) differentiate between digital
platforms that provide: access to information or content (such as Facebook and
Instagram); goods and services (such as eBay, AirBNB, or Uber); and access to
capital (GoFundMe). Another taxonomy of platform businesses considers how users
can differentially earn an income. Income can be earned via digital platforms by
buying or selling goods through platforms such as Etsy or eBay; or obtaining
crowdfunding via platforms such as GoFundMe or KickStarter; through renting or
leasing homes, cars, or other assets via AirBNB, CarNextDoor, or others; licensing
creative works on platforms like iStockPhoto; and by providing labor in return for
payment (Pesole et al. 2018; Strowel and Vergote 2018). This final category is
exemplified by platforms such as Uber and Foodora, but also extends to services
such as home maintenance, computer programming, or any type of work that is done
by a person. Some digital platforms enable multiple methods of income generation,
further illustrating the heterogeneity of platform business models. For instance, in
creative work like graphic design and photography, some platforms provide a facility
for artists to display portfolios of work, license images or designs for use, as well as
opportunities to find clients for whom they will undertake a specific task or produce a
custom piece of creative work (McDonald et al. 2020a). It is this broad envelope of
digital platforms that are ubiquitously referred to as the “digital economy.”
Digital platform businesses connect individuals or businesses seeking labor or
service with freelance workers willing to provide that labor or service for a fee.
Workers are self-employed freelancers or independent contractors who undertake
short term “gigs” that are requested by clients while being distributed and monitored
by platform technology. Platform work can encompass tasks that can be either
completed online or performed in person at a specified location (Drahokoupil and
Fabo 2016; Pesole et al. 2018). For example, services such as data entry, graphic
design, and computer programming can all be delivered online, while work that
involves driving, food delivery, or home maintenance is usually undertaken “in
person.”
Importantly, digital platforms that intermediate work that is completed “online”
create new boundaryless labor markets, giving clients access to labor that is not
772 P. Williams et al.

restricted by physical location or regulatory boundaries. As Drahokoupil and Fabo

(2016, p. 2) explain, these platforms connect demand in one location, with remote
supply, “possibly based abroad.” Platform work that is completed exclusively online
can span highly skilled professional services where the task is allocated to one
individual, or alternatively, unskilled work where the tasks can be disaggregated
into routine micro-tasks outsourced to a virtual “crowd” of unknown workers
(Drahokoupil and Fabo 2016; Coyle 2017; Ticona and Mateescu 2018). For exam-
ple, on platforms such as Upwork or 99 Designs, clients are matched with, or choose,
a preferred worker who has competed with other workers to be allocated the required
task (Pongratz 2018). In contrast, Amazon Mechanical Turk and Clickworker are
examples of micro-tasking platforms where tasks that require limited time and skills
(e.g., image-tagging or categorization) are distributed to a largely invisible work-
force who complete the task (Aloisi 2015; Irani 2015). As a subset of gig workers,
these workers are known as micro-taskers or click-workers to denote the repetitive
nature and minutiae of the tasks they do.
While digital platforms operate various business models, there are some impor-
tant similarities in all platform work. These are succinctly outlined by the European
Foundation for the Improvement of Living and Working Conditions (Eurofound) as
including: paid work organized through an online platform; the involvement of three
parties (the online platform, the client, and the worker); an aim to carry out specific
tasks or solve specific problems; outsourced or contracted work; jobs that are broken
down into tasks; and services that are provided on demand (De Groen et al. 2018,
p. 9; Florisson and Mandl 2018, p. 2).
Digital platform workers are freelancers or independent contractors, not
employees. They generally provide their own equipment and can choose where
and how many hours they work and which jobs or tasks to undertake. However,
digital platform workers are also managed, tracked, and evaluated on the platform
via the use of technology and algorithms that determine the allocation of tasks, track
performance, and manage payments to the worker. The technology adopted by
digital platforms represents a form of managerial control that goes beyond what is
typically associated with a traditional contracting arrangement in scale and reach. It
is these forms of control that raise important questions about the role, relationship,
and obligations of digital platform firms to their workers. These questions include
who is the “employer” and who is responsible for the health and safety of the
worker?
The various ways in which digital platform work can be undertaken, and the
unique ways in which digital platforms use technology to simultaneously distance
and control workers, highlight the complexities of categorizing, regulating, and
determining the quality of digital platform work. Platform firms often have no
physical location and define themselves as merely “marketplaces” or “technology
companies” that connect clients with services. Workers may access work across
several platforms simultaneously from anywhere in the world, working for single or
multiple clients who may be individuals or businesses, and undertake work occa-
sionally or regularly as they choose. For example, the practice of “multi-apping,”
where workers accept concurrent jobs from multiple platforms is common in
37 The Growing “Gig Economy” 773

ridesharing and food delivery sectors (Goods et al. 2019). Workers can also register
for work with a platform, yet never actually undertake any tasks.
The working conditions and experiences of digital platform workers offering
in-person services in a defined location are likely to be very different from virtual
workers who may be located in a different country to the client or the platform.
Working conditions also vary by the type of work undertaken. For example, the work
environment of those who care for the aged or people with a disability in their homes
is markedly different to the work environment of Uber drivers or software devel-
opers. What all digital platform workers share in common, however, is that they are
deemed independent contractors who, in most instances, are not protected by an
employment contract (and employer obligations therein) or existing labor regulation.
This contractually shifts the usual risks of doing business from firms to workers.
The diversity and commonalities in the characteristics of digital platforms and the
work they intermediate have the potential to impact on the health, safety, and
wellbeing of workers in diverse ways that are further complicated by the designation
of gig workers as independent contractors. There are known physical hazards, for
example, associated with driving for long periods, the use of home cleaning agents,
and poorly designed workstations and intensive keyboard activity commonly asso-
ciated with virtual work (Tran and Sokas 2017). When these activities are performed
as paid labor outside of a clear employment relationship, or traditional client-
supplier relationship, the responsibilities for compliance with health and safety
regulations becomes obscured. The specific risks for workers are further articulated
later in this chapter. The significance of risks to worker health and safety in digital
platform work is particularly crucial given its growing size and diversity.

Growth of the Gig Economy

Digital platform work is a growing and increasingly diversified phenomenon. Media

and scholarly attention have tended to focus on high profile platforms such as
Amazon Mechanical Turk, Uber, and food delivery platforms such as Foodora and
Ubereats. These platforms are often considered trailblazers, in the sense they were
some of the first to use internet technologies and algorithms to mediate the distribu-
tion and execution of tasks between clients and workers. Digital platform work,
however, is now emerging in a vast array of industries, professions, and occupations,
both skilled and unskilled. Beyond ridesharing and food delivery, in-person platform
work now extends to tasks in home maintenance and odd jobs, domestic services,
skilled trade work, education, and aged, disability, and childcare. Virtual or internet-
based platform work provides services such as web and graphic design, coding, data
entry and clerical services, translation and transcription, project management and
professional advice such as financial advice. Available data indicates growth in both
the number of platform businesses and the number of workers participating (Evans
and Gawer 2016; De Groen et al. 2017a; Heeks 2017; Kässi and Lehdonvirta 2018;
McDonald et al. 2020b). While precise estimates of participation vary depending on
the specific methods deployed, studies generally indicate that a significant and
774 P. Williams et al.

growing minority of the workforce are drawing at least some of their income from
digital platform work.
In the USA, approximately 1% of adults have been estimated to be participating
in digital platform work (Farrell et al. 2018). However, when platform workers who
participate as a secondary job or for additional income are included, estimates
increase to as high as 8% of the US working age adults (Smith 2016). In the UK,
12.6% of the adult population of internet users were found to have used digital
platforms to access work at some time (Pesole et al. 2018), and up to 4.4% currently
(Balaram et al. 2017; CIPD 2017; BEIS 2018). Across Europe, participation rates
vary from less than 7% in France, Sweden, Poland, and Slovakia to more than 10%
of adults in Spain, Germany, and Portugal (Pesole et al. 2018; Piasna and
Drahokoupil 2019). In Australia, participation rates are similar. Over 13% of internet
users have at some time undertaken work through digital platforms, and 7.1% at the
time the survey was completed (McDonald et al. 2020b).
Few people, however, engage with digital platforms on a full-time basis. Platform
work provides the main source of income for only 2% of all workers in most
developed nations (Huws et al. 2017; Pesole et al. 2018; McDonald et al. 2020b).
This is because most individuals participate only sporadically to provide additional
income when needed or to supplement gaps in their usual income. It remains
uncertain whether these patterns are similar in less developed nations because
there have been few comparative prevalence studies in these countries. The available
evidence suggests, however, that 1.5% of the total workforce, equating to around
40 million workers in the Global South, are earning an income through digital
platform work, and that these workers are concentrated in India, the Philippines,
Pakistan, and Bangladesh (Heeks 2017). Data from the Online Labour Index (OLI)
which tracks tasks posted online, supports these estimates, with the largest propor-
tion of digital platform workers being located in India (24%) and Bangladesh (16%)
and most client demand originating in the USA and UK (Kässi and Lehdonvirta
2018). Other studies have further suggested that the concentration of demand for
online digital platform work in wealthy nations creates a price-driven market and
unequal competition between workers in developed nations and those in developing
countries, lowering wages and conditions for all workers (Graham and Anwar 2018).
These patterns of participation and open-market competition across geographic and
socioeconomic boundaries raise crucial questions regarding the pressures, demands,
and potential vulnerabilities placed on workers in particular regions.
Digital platform workers are demographically diverse; however, some groups are
more likely to participate. Young males are more likely to participate in platform
work than women and older workers, as are migrant workers and people who would
otherwise be unemployed (Eurofound 2019; McDonald et al. 2020b). These patterns
vary across different types of work. Women, for example, make up a higher
proportion of platform workers doing clerical or data entry and care work, and
younger males and students are more likely to undertake food delivery work
(McDonald et al. 2020b). The demographic characteristics of those most likely to
undertake digital platform work has fueled much of the debate about the opportuni-
ties and risks of such work. The participation of migrants, students, and those who
37 The Growing “Gig Economy” 775

are unemployed or underemployed underpins concerns that digital platform work

exploits vulnerable workers and entrenches them in precarious working conditions.
In contrast, advocates of platform work argue that these patterns demonstrate
significant new employment opportunities for those who cannot find traditional
forms of employment (Minifie and Wiltshire 2016). These opposing positions
illustrate other debates about whether, and to what extent, platform work provides
greater freedom, flexibility, and choice than traditional forms of employment, or
conversely, poorer quality work and associated risks of economic insecurity and
threats to physical and psychological safety. These opposing viewpoints in relation
to the working conditions of platform workers and the potential implications for
safety, health, and wellbeing are considered further in the remaining sections of the
chapter.

Opportunities Associated with Digital Platform Work

For individuals who find working in traditional forms of employment problematic,

platform work may provide a viable alternative. In a tight labor market where
permanent positions are scarce, digital platforms can provide easy access to work
opportunities. On most platforms, workers do not need to provide evidence of their
stated qualifications, experience, or work history to register, and the majority of
in-person platform work especially does not require a large investment in equipment,
meaning that barriers to entry are relatively low (Eurofound 2019). The prevalence
studies highlighted earlier revealed higher levels of participation by people who
would be otherwise unemployed, and by migrant workers and students, who may not
have the qualifications or experience to successfully compete for permanent employ-
ment (McDonald et al. 2020b). Other scholars have also suggested that digital
platform work can provide a viable employment option for individuals who may
be attempting to re-skill and reenter the workforce after an extended absence or
because of limited or outdated education (Coyle 2017; Graham et al. 2017b). Skills
creation, choice of work, and the sense of possibility are positive aspects of platform
work that can enhance wellbeing (Fernández-Macías 2018; Ropponen et al. 2019).
Globally, the rise of virtual/online digital platform work has also opened up cross-
border work opportunities. Research demonstrates that this form of work can
provide more income and a relatively safer work environment for workers in poorer
countries and that it can minimize the usual disruption to family that occurs
alongside employment-driven labor migration (Horton 2011; Harris and Srinivasan
2013). In one study of gig workers in Sub-Saharan Africa and South-East Asia for
example, local employment opportunities were limited, but workers earned higher
incomes by completing micro-tasks online for global clients (Graham et al. 2017b).
More commonly, individuals use digital platform work to supplement their
existing income stream or to cushion a temporary reduction in their household
income. Some workers, for example, participate in digital platform work as a source
of income between jobs, following the loss of employment or during a period of
forced leave (Minifie and Wiltshire 2016; McDonald et al. 2019). Others use digital
776 P. Williams et al.

platform work as a convenient way to access additional funds quickly to cover

unexpected household expenses or finance indulgences such as holidays (Graham
et al. 2017a; Schor and Attwood-Charles 2017). In this sense, platform work can
potentially reduce stress associated with financial instability and provide individuals
with a greater sense of control over their personal circumstances.
The flexibility and control that platform workers experience in being able to
choose how frequently and when to participate in digital platform work make it an
attractive work option for those that cannot work “standard” work hours or who are
seeking occasional work (Drahokoupil and Piasna 2019). For example, students,
who are disproportionately represented in platform worker statistics (McDonald
et al. 2020b, p. 34), may be attracted to gig work because of the relative ease with
which they can change their work hours when their study schedule changes. Unlike
traditional employment, there are no “minimum hours” requirements in digital
platform work. Hence, it has been argued that digital platform work also presents
a viable work option for people with a disability or other health issue that may limit
the hours they can work (De Stefano 2016; Berg et al. 2018). However, this has yet
to be empirically explored.
Many studies on the motivations of platform workers highlight flexibility and
autonomy over their working lives as key drivers of participation (Chen et al. 2019;
Lehdonvirta 2018; Wood 2018). A study of Uber drivers in the UK demonstrated
that despite relatively low hourly earnings, drivers valued the ability to choose their
hours and maintain schedule flexibility, and that this contributed to higher levels of
life satisfaction and subjective wellbeing (Berger et al. 2019). It should be noted,
however, that drivers in this study were mostly male immigrants from lower
socioeconomic backgrounds who also held other jobs, so relatively small increases
in income provided by platform intermediated driving may have increased wellbeing
to a greater extent compared with those with greater financial resources (Berger et al.
2019).
Alongside findings which suggest that platform work confers flexibility and
associated wellbeing, other research paradoxically suggests that control mechanisms
built into platform business models actually reduces flexibility and autonomy expe-
rienced by workers (Shapiro 2018). For example, in Berger et al.’s (2019) study of
Uber drivers reported above, platform control mechanisms also resulted in higher
levels of anxiety. The negative health impacts associated with platform work are
discussed further in the next section.

Health, Safety, and Wellbeing Risks Associated with Digital

Platform Work

There are many characteristics of digital platform work likely to impact worker
health and safety. Despite citing temporal flexibility as a benefit, workers frequently
report that the availability of work can be unpredictable and that platform mecha-
nisms control and influence their schedule in ways that can also limit flexibility. In
some types of platform work, for example, tasks are allocated based on worker
37 The Growing “Gig Economy” 777

responsiveness and the ratings and reviews of clients. Studies have demonstrated
how Uber drivers and food delivery riders have been penalized for not accepting ride
allocations (Rosenblat and Stark 2016; De Groen et al. 2018; Reid-Musson et al.
2020), and how photographers have lost job opportunities by not responding within
minutes to a call for a quote (McDonald et al. 2020a). Hence, platform workers who
wish to maintain their ratings or obtain the best paid opportunities, can experience
being “constantly on call” with negative ramifications for psychological health and
work-life boundary management (Eurofound 2015; Garben 2019). On many digital
platforms, work is allocated to those with the best client ratings, and poor ratings or
reviews can lead to fewer work opportunities, and in extreme cases, exclusion from
the platform, which can occur at the platform firm’s complete discretion (Williams et
al. 2021; Ropponen et al. 2019). The need to maintain high ratings and reviews in
order secure future work drives worker behavior, including the propensity to work
unsocial hours or take greater risks to personal safety in order to achieve a higher
rating (Martin et al. 2016; Schörpf et al. 2017; Ropponen et al. 2019; Reid-Musson
et al. 2020). Further, creative platform workers have reported working additional
hours for free in order to achieve higher client ratings (Schörpf et al. 2017; Nemkova
et al. 2019). These studies found that rating and review systems and unrealistic client
expectations contributed to both long hours and lower prices for their work. These
creatives also described experiencing a consequential diminished artistic expression
and sense of meaning in relation to their work (Nemkova et al. 2019).
To maintain their online reputation and secure ongoing access to work and
income, platform workers avoid taking breaks or cancelling work for any reason
including ill health. This behavior has been illustrated in studies of platform delivery
drivers (Christie and Ward 2019; De Groen et al. 2018). A study by Christie and
Ward (2019) described how drivers worked long hours, avoided taking breaks, and
continued working, even when fatigued. The study further explained how the time
pressures associated with getting a good rating as a delivery driver fueled risk taking,
including speeding, ignoring road signs, and driving in poor weather conditions
(Christie and Ward 2019). Such risky behaviors are driven not just by rating and
review mechanisms but also by competition from other platform workers. The role
of digital platforms as “connectors” encourages opportunistic behavior and compe-
tition between workers, driving them to be responsive and market-competitive in
order to “win” the job or task (Ropponen et al. 2019; Veen et al. 2019). The
consequence of such competition is work intensification in the form of pressure to
deliver in tight timeframes and/or for a much lower price.
When the prices paid for work are low, many workers have to work longer hours
or undertake more tasks simply to maintain their income (Wilde 2016; ILO 2018).
Low prices are a particular problem for workers who are reliant upon digital platform
work as their primary source of income, not only because they get paid less, but
because in working longer hours they lose much of the temporal autonomy that
platform work is said to offer (Kuhn and Maleki 2017). For example, Uber has
implemented surge pricing that simultaneously encourages drivers to work longer
hours at times of high demand, thereby increasing their earnings but at the same time
limiting their flexibility (Chen and Sheldon 2015; Newlands et al. 2017). Other
778 P. Williams et al.

studies have similarly shown that in order to meet the demands of clients, platform,
workers will work long hours or nights and weekends, especially if this increases
their remuneration (Pichault and Mckeown 2019; Ropponen et al. 2019; Shevchuk
et al. 2019).
Long work hours impact worker wellbeing in multiple ways, firstly, via negative
effects on work-life balance and well-being, when workers become sleep-deprived,
overworked, and exhausted (De Neve et al. 2018; Shevchuk et al. 2019; Wood et al.
2019). For the many platform workers who also have another job, total hours worked
may be high, even if participation is intermittent. Secondly, unsocial work hours can
contribute to feelings of isolation, and this may be further exacerbated by the
independent nature of platform work (De Neve et al. 2018; Tran and Sokas 2017).
That is, platform workers frequently miss out on the social benefits of working in
teams or collaborating with other workers, instead competing for tasks that they
undertake alone, and in the case of micro-workers and click-workers, completely
dislocated from any interaction with a human client (Lewchuk 2017; Shevchuk et al.
2019; Kilhoffer et al. 2020). The health implications of stress related to work
intensification, night work, and long work hours are well known (De Neve et al.
2018). Yet in platform work, where workers are self-employed contractors, these
risks are not the responsibility of either the platform firm or the client to manage.
Further, unlike employees, platform workers are not subject to the usual health and
safety regulations, or apparatus that provides safeguards around working hours and
conditions.
Risks to health and safety are not limited to irregular work patterns. Platform
workers are also subjected to significant physical safety hazards. Some hazards are
obvious, such as falls and machine-related injuries associated with maintenance
undertaken in households, and traffic related accidents in transport and food delivery
work. Studies have shown how drivers and riders exacerbate these risks by priori-
tizing speed over road safety and because they can become distracted by responding
to the app on their phone while driving (Christie and Ward 2019). Collisions and
“near misses” are a common occurrence in digital platform delivery driving (Christie
and Ward 2019), and workers experience increased risks of injuries from driving
when fatigued or when driving in poor weather conditions (De Groen et al. 2018;
Industrial Relations Victoria 2020). Riders are also responsible for the provision and
maintenance of their own equipment, such as bikes and safety gear, and are not
always obliged by the platform to wear high-visibility clothing or clothing appro-
priate for extreme weather conditions (De Groen et al. 2018). A lack of adequate
protections or faulty equipment can exacerbate risks. As noted earlier, these behav-
iors are triggered by the functions through which the platform allocates and distrib-
utes work and by payment systems that are linked to client waiting times and client
ratings.
The absence of governance frameworks that regulate or guide the gig economy
also expose platform workers to additional risks not usually experienced by
employees or agency contractors. For example, delivery drivers have reported
experiencing physical and sexual assault in the course of their work, as well as
being subjected to legal risks associated with requests to deliver illegal drugs,
37 The Growing “Gig Economy” 779

chemicals, alcohol, or stolen goods (Ticona et al. 2016; Huws et al. 2017; Reid-
Musson et al. 2020). Accessing domestic cleaning or care work via digital platforms
can also pose risks for workers who are often provided with little information about
the client or the required task prior to accepting the job (Ticona and Mateescu 2018).
This can result in potentially heightened safety risks for workers such as exposure to
illness, disease, or physical hazards in the clients’ home, and resolutions may be
difficult to negotiate (Trojansky 2020). Workers have subsequently described feeling
uncomfortable or threatened, having to undertake hazardous cleaning jobs for which
they were ill-equipped, or needing to fend off sexual solicitations (Ticona et al.
2016). Platform workers have also reported being subject to racial vilification,
discrimination, and harassment (Ticona et al. 2016; Graham et al. 2017b), but they
often do not have access to avenues of redress that would typically be available in a
traditional employment relationship nor the agency to walk away from a client
without risking a poor rating.
These encounters are not, however, limited to in-person platform work. Online
workers also experience racial and gender discrimination, and they may be excluded
from work opportunities because of their location (Beerepoot and Lambregts 2015;
Graham et al. 2017b). They may also face physical and psychosocial work hazards.
Long hours at workstations that are not ergonomically designed may lead to mus-
culoskeletal or repetitive strain problems, and as noted earlier, feelings of depression
and social isolation can emerge from a lack of human interaction (Huws 2016;
Shevchuk et al. 2019; Wood et al. 2019). Yet platforms take no responsibility for
minimizing risks in home working environments, and nor do workers have access to
workers compensation or other forms of company-provided insurance to support
rehabilitation if injury does occur (Garben 2019).
As independent contractors, platform workers have access to few, if any, worker
entitlements, very little income security, and they often experience insufficient
access to work through digital platforms (Berg et al. 2018). Work is done on a
piece-rate basis, and earnings are frequently unpredictable. Unpaid labor is a fixture
of platform work as workers spend considerable time searching and bidding for
work, updating profiles, monitoring ratings and reviews, or waiting for tasks or client
responses (Berg 2016; McDonald et al. 2019). Through the terms and conditions of
use, platforms also have the discretion to change payment rates, or methods of
payment, or exclude workers from the platform (Huws et al. 2017; Williams et al.
2021). Clients too can refuse to pay, and platforms usually have limited dispute
resolution or mediation processes that support workers to receive fair remuneration
in these instances. These features exemplify the precarity of digital platform work.
Precarious and piece-rate work is significantly related to negative health outcomes
(Lewchuk 2017; Davis and Hoyt 2020), and workers who undertake nonstandard
work are at greater risk of injury and illness than those in standard employment
arrangements (Howard 2017).
The methods adopted by digital platforms to incentivize and reward workers
further promote the maladaptive worker behaviors outlined earlier that increase risks
to worker health, safety, and wellbeing (Garben 2019). In a traditional employment
relationship, such behaviors would attract significant costs for the organization in
780 P. Williams et al.

terms of absenteeism, worker turnover, lower performance, or insurance claim costs.

Digital platforms, in contrast, are not employers and so avoid all such negative
impacts, leaving the worker to bear all the risks. This business model may have long-
term implications for society, however, if platform workers are unable to work due to
ill health or injury and do not have access to state-provided workers compensation
insurance, so must rely on government welfare support systems to live.
The management of risk in the gig economy is a challenge likely to be contested
through legal avenues. For example, in Australia, all State and Territory Work Health
and Safety laws place the responsibility for the health and safety of workers on the
“person conducting a business or undertaking” (PCBU) (Safe Work Australia 2019).
Whether a digital platform may be classified as a PCBU, and therefore be expected to
manage workplace health and safety risks for gig workers, is contested and compli-
cated by factors such as the business model adopted by the platform, the definition of
digital platforms as labor hire companies or technology providers, the contractual
relationship (if any) between the worker and the client, and the practice of multi-
apping, where workers work for multiple platforms at once (Horton et al. 2018).
Some argue that platforms such as Uber might be reasonably expected to manage
known risks; however, platforms who offer a wide variety of tasks could not possibly
anticipate or manage the myriad of potential risks (Horton et al. 2018). The question
of the client’s responsibility in managing risk remains.
Relatedly, the classification of workers in the gig economy has led to many legal
challenges (see Howard 2017 and Stewart and McCrystal 2019 for examples) and
calls for greater social protections for precarious workers (Benach et al. 2016; Tran
and Sokas 2017). Despite a business model designed to circumvent collective action,
some groups of workers have begun to mobilize in an effort to draw attention to the
significant safety risks they experience (Tassinari et al. 2020). Yet establishing labor
protections for a dispersed and isolated workforce, especially where the on-demand
labor operates across international boundaries, is challenging (ILO 2016), not least
because it threatens the very business models which digital platforms have devel-
oped and deployed to disrupt existing markets (De Groen et al. 2017b; Garben
2019). Globally, responses to worker precarity have varied. However, in January
2019, the International Labour Organization’s (ILO) Global Commission on the
Future of Work proposed a Universal Labour Guarantee that would, among other
things, establish a set of basic working conditions, limits on hours of work, and safe
and healthy workplaces, to address the issues faced by digital platform workers (ILO
2019).

Conclusion and Future Research

This chapter has examined the contested debates surrounding digital platform work,
with a specific focus on health and safety implications for workers. Research has
demonstrated the flexibility advantages inherent in this growing form of work and
the variable opportunities it provides, depending on the location and individual
circumstances of the worker, for income generation. On balance, however, extent
37 The Growing “Gig Economy” 781

research raises a concerning array of economic, social, and health risks – both
physical and psychological – faced by platform workers. Such risks are associated
with the status of digital platform workers as contractors rather than employees, their
relative isolation as workers, low pay rates in some forms of work, and the lack of
regulatory apparatus available to workers when things go wrong.
As the chapter established, research into the health and safety outcomes for
workers in the gig economy is still in its infancy and there remain many unanswered
questions that signal important areas for future research. For example, we do not yet
know the long-term health consequences of distinct types of gig work, nor the
various ways that workers and/or platforms might attempt to mitigate health and
safety risks. To date, the literature is also silent on the question of whether health
outcomes improve or diminish for platform workers who seek such work due to
preexisting health conditions that preclude them from traditional forms of employ-
ment. As Benach et al. (2016) note, precarious digital platform work may be better
than no work at all. Although driving and delivery work, including its health and
safety risks, has been the focus of significant attention, far less research has exam-
ined the myriad of other forms of platform work such as care work, educational and
translation services, and creative work. There is also a need to extend the current
myopic focus on platform work undertaken in developed economies and to addi-
tionally explore how workers are affected, for better or worse, in the Global South,
especially in parts of the world where there is a more than ample supply of willing
workers catering to the demands for cheap labor in the Global North.

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Workplace Mistreatment
A Review of the Literature and Agenda for Future
38
Research

Tara C. Reich and Rashpal K. Dhensa-Kahlon

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 788
First, What Are We Talking About? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 789
Is Workplace Mistreatment a Big Deal? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 790
What Are the “Causes” of Workplace Mistreatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 791
Organizational Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 791
Individual Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 792
Relational Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 794
What Can Be Done About Workplace Mistreatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 794
Preventing Workplace Mistreatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 795
Helping Victims Cope with Workplace Mistreatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 795
Dealing with the Aftermath of Workplace Mistreatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 796
Can Third-Parties Help Address Workplace Mistreatment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 796
Perceiving Victim Need and Deservingness: Decision-Tree Model of Intervention . . . . . . . 797
Perceiving Victim Need and Deservingness: Deontic Motivation for Intervention . . . . . . . . 798
Some Future Directions for Third-Party Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 800
Victim Humor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 800
Victim Talk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801
Some Additional Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 802
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 802

T. C. Reich (*)
Kings Business School, Kings College London, London, UK
e-mail: [email protected]
R. K. Dhensa-Kahlon
Birkbeck, University of London, London, UK
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 787

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_33
788 T. C. Reich and R. K. Dhensa-Kahlon

Abstract
As the line between work and life continues to blur, stakeholders increasingly expect
organizations to take an active role demonstrating care and compassion for their
employees. This is likely to include preventing and addressing instances of interper-
sonal mistreatment at work. However, despite decades of research to understand
workplace mistreatment in its various forms, effective interventions remain elusive,
with recommendations for practice often relying on untested assumptions. In this
chapter, we discuss the current state of the workplace mistreatment literature,
highlighting some key predictors of both experienced and enacted mistreatment –
along with the theoretical perspectives used to understand them – as well as some of
the interventions proposed (but rarely tested) to help address them. We also discuss
the potential role of third parties – those who witness or learn about mistreatment but
are not directly involved – to help address mistreatment, noting the limits of this
perspective as well as some important avenues for future research.

Keywords
Workplace mistreatment · Workplace aggression · Workplace incivility ·
Workplace bullying · Interventions · Third parties

Introduction

In modern organizations, the line between work and life continues to blur.
Employees are spending more of their time engaged in work and work-related
activities (Gavin and Mason 2004; Schor 2008). The COVID-19 pandemic seems
likely to exacerbate this trend; with millions working from home, the distinction
between our work and personal lives is likely to continue to erode (Rudolph et al.
2020). The increasing demands on employees coincide with what Gunter McGrath
(2014) termed the “era of empathy,” in which stakeholders increasingly see the role
of management as one involving demonstrable care and concern for their employees.
An era of empathy is likely to involve organizational intervention in negative
interpersonal interactions among employees. Workplace mistreatment is an unfortu-
nately common (e.g., Schat et al. 2006; Rayner 1997) and predictably negative
experience for employees. However, despite decades of research, little is known
about how to effectively prevent or intervene in mistreatment at work.
In this chapter, we review the workplace mistreatment literature to highlight some
of the key predictors from the perspective of those who are targeted for mistreatment
(“victims”) as well as those who perpetrate it (“actors”). We also discuss some
theoretical perspectives used to understand why mistreatment happens as well as
how these relate (or not) to potential interventions. Next, we review the potential role
of third parties (i.e., those who witness or learn about mistreatment but are not
directly involved) to help address (and exacerbate) mistreatment. Finally, we discuss
some important avenues for future research.
38 Workplace Mistreatment 789

First, What Are We Talking About?

Workplace mistreatment is an umbrella term for negative interpersonal interactions

at work. In the academic literature, researchers have introduced an abundance of
constructs that fall under this broad umbrella. Although these constructs represent
important conceptual differences (Tepper and Henle 2011), they are measured in
very similar ways (see Hershcovis and Reich 2013), making the distinctions among
them unclear.
For example, “bullying” refers to “a situation where one or several individuals
persistently over a period of time perceive themselves to be on the receiving end of
negative actions from one or several persons, in a situation where the target of
bullying has difficulty in defending himself or herself against these actions”
(Einarsen and Skogstad 1996, p. 191), whereas “abusive supervision” reflects “the
extent to which supervisors engage in the sustained display of hostile verbal and
nonverbal behaviors, excluding physical contact” (Tepper 2000, p. 178). “Social
undermining” is a “behavior intended to hinder, over time, the ability to establish and
maintain positive interpersonal relationships, work-related success, and favorable
reputation” (Duffy et al. 2002, p. 332), whereas “workplace incivility” is meant to
encompass “low-intensity deviant behavior with ambiguous intent to harm the
target, in violation of workplace norms for mutual respect” (Andersson and Pearson
1999, p. 457). The definitions of these terms imply differences with respect to their
persistence (i.e., bullying, abusive supervision, and social undermining persist over
time, whereas workplace incivility may not), intensity (i.e., abusive supervision
involves perceived hostility, whereas incivility is by definition low intensity and
ambiguous in terms of intent), and source (i.e., abusive supervision implies that the
source is a position of formal power, whereas bullying may be perpetrated by one or
multiple people with any form of relationship to the victim).
Despite the conceptual differences, in practice, the scales used to measure these
constructs are almost identical (Hershcovis and Reich 2013). For example, the
(Revised) Negative Acts Questionnaire (NAQ-R; Einarsen et al. 2009) and the
Workplace Incivility Scale (WIS; Cortina et al. 2001), which are the most commonly
used scales to measure bullying and incivility, respectively, both ask respondents
how frequently they were insulted, ignored, and undermined with respect to one’s
work. Perhaps even more importantly, neither scale even attempts to capture respon-
dents’ perception of the intensity or the perceived intent of these experiences
(Hershcovis 2011; Hershcovis and Reich 2013).
This similar approach to measurement likely explains much of the overlap among
the outcomes of workplace mistreatment. For example, given its higher intensity,
one might expect that victims of bullying would suffer more from their experiences
compared to victims of incivility. However, their negative effects on employee
attitudes (i.e., job satisfaction, turnover intent, and affective commitment) and
psychological and physical well-being are effectively the same (Hershcovis 2011).
In other words, “at some level all of the research using these different definitions
deals with essentially the same thing” (Aquino and Thau 2009, p. 722). As such, we
use the term “workplace mistreatment” to refer to the broad literature on negative
790 T. C. Reich and R. K. Dhensa-Kahlon

interpersonal interactions at work and draw on findings from across this literature in
our discussions below.
This chapter is structured as follows. First, we outline the imperative for the study
of workplace mistreatment. We then review some key outcomes, as well as pre-
dictors, of workplace mistreatment from the perspective of both victims and perpe-
trators, along with the theoretical perspectives used to explain them. Next, we
discuss how these theories connect to ideas for interventions in workplace mistreat-
ment. Finally, we discuss the potential role of third-party observers to intervene in
incidents of workplace mistreatment and identify important avenues for further
research.

Is Workplace Mistreatment a Big Deal?

The short answer is: yes. Although physical acts of aggression are relatively rare,
some estimates suggest that nearly half of the employees will experience some form
of psychological mistreatment at work (e.g., Schat et al. 2006; Rayner 1997).
Victims of mistreatment experience a host of negative outcomes, including increased
depression and anxiety (e.g., Cortina et al. 2001; Hansen et al. 2006; Tepper 2000),
somatic symptoms (e.g., LeBlanc and Kelloway 2002; Zapf et al. 1996), and
posttraumatic stress (e.g., Matthiesen and Einarsen 2004). Experienced mistreatment
is also associated with greater work–family conflict (e.g., He et al. 2020), lower life
satisfaction (e.g., He et al. 2020; Tepper 2000), and sleep problems (Nielsen et al.
2020). Victims are also less satisfied with and committed to their jobs and more
likely to intend to quit (e.g., Bowling and Beehr 2006; Hershcovis 2011; Hershcovis
and Barling 2010).
The negative effects of mistreatment also extend beyond targets. Researchers
have found that third parties to workplace mistreatment – those who witness but are
not involved in the mistreatment themselves – experience emotional drain (Totterdell
et al. 2012) and stress (Vartia 2001). And a small but growing literature suggests that
perpetrators (i.e., those who enact mistreatment toward others) experience negative
outcomes as well. For example, Qin et al. (2018) found that while enacting abusive
behavior had some positive outcomes for supervisors in the short term, such as
greater engagement via improved recovery (especially among supervisors with high
job demands and who are low in empathic concern), after a week these benefits more
than disappeared. Perpetrators also report poorer performance due to reduced sense
of self-worth (Priesemuth and Bigelow 2020), as well as lower need fulfilment and
difficulty relaxing at home (Foulk et al. 2018).
Indeed, workplace mistreatment is a costly problem for organizations. Some
estimate a price tag of $14,000 USD per employee (Pearson and Porath 2009)
because of the lost productivity due to the negative effects of mistreatment on victim
performance (e.g., Harris et al. 2007; Schat and Frone 2011) as well as their sickness-
related absence (e.g., Kivimäki et al. 2000; Sprigg et al. 2010). Taken together, there
is a clear need to understand workplace mistreatment given its pervasiveness and
negative effects on all involved.
38 Workplace Mistreatment 791

What Are the “Causes” of Workplace Mistreatment?

A good deal of research has been conducted to explore the contextual and disposi-
tional factors that contribute to the experience and (although to a lesser extent)
enactment of workplace mistreatment from a variety of theoretical perspectives.
These theories include (but are certainly not limited to) stress theory, victim precip-
itation model, and social exchange theory. Although not mutually exclusive, each
reflects a different perspective on why mistreatment happens, attributing the cause to
organizational, individual, and relational factors, respectively. Although research
from the perspective of the target (or “victim”) evolved separately from research
from the perspective of the perpetrator (or “actor”), there is considerable overlap in
terms of the conclusions (Hershcovis and Reich 2013). As such, in this section, we
review some of the evidences linked to these perspectives to help explain why
mistreatment happens.

Organizational Factors

Researchers have examined workplace mistreatment as both a source and an out-

come of occupational stress (e.g., Bowling and Beehr 2006). Meta-analytic evidence
suggests that experienced mistreatment is higher among employees working in jobs
that lack clarity or predictability with regard to job behaviors (i.e., high role
ambiguity) that involve incompatible demands (i.e., high role conflict) and/or
involve “too much” to do (i.e., high role overload). Victims of mistreatment also
report greater work constraints (i.e., factors that limit a job holder’s enactment of a
role) and a lack of autonomy or freedom in terms of how they perform the work
(Bowling and Beehr 2006).
As an important source of stress, a poor working relationship with one’s super-
visor is also associated with experienced mistreatment. Research suggests that
employees perceive greater mistreatment when they have a supervisor who adopts
an authoritarian (i.e., “do as I say”; Coyne et al. 2003) or a laissez-faire (i.e., a hands-
off approach; Skogstad et al. 2007) leadership style. Experienced mistreatment is
also associated with perceived interpersonal unfairness from (e.g., Berry et al. 2007;
Hershcovis et al. 2007), as well as greater dissatisfaction with (Einarsen et al. 1994),
one’s supervisor.
The climate of the organization has also been found to predict experienced
mistreatment, especially when it conveys a general permissiveness toward mistreat-
ment through a lack of organizational policies that prevent mistreatment and/or
shared perceptions that mistreatment goes unpunished (e.g., Ambrose and Ganegoda
2020; Dhanani et al. 2020). Overly competitive work environments, wherein goal
achievement is rewarded regardless of the costs involved, are also associated with
greater perceptions of mistreatment (Coyne et al. 2003; Vartia 1996).
In terms of enacted mistreatment, employees report engaging in more mistreat-
ment toward their colleagues when they experience greater stress at work. Indeed,
enacted mistreatment is associated with greater role conflict and ambiguity
792 T. C. Reich and R. K. Dhensa-Kahlon

(e.g., Einarsen et al. 1994), greater job stress (e.g., Glomb 2002), higher workload,
and lower autonomy (Baillien et al. 2011). Employees also report engaging in more
mistreatment when the organizational climate is more tolerant of mistreatment
(e.g., Aquino and Lamertz 2004; Barling et al. 2009).
Given that victims and perpetrators of workplace mistreatment will typically
share a work environment, the overlap between these organization-based predictors
of experienced and enacted mistreatment makes sense. Indeed, as Bowling and
Beehr noted in their 2006 review, “victims who report the presence of high levels
of stressors might be indicating the presence of ambient stressors experienced by
everyone in the victim’s work environment” (p. 1000). This view is consistent with
resource-based theories of occupational stress, such as the job demands-resources
model (JD-R; Demerouti et al. 2001). According to the JD-R, when people perceive
greater demands from their job (e.g., high work pressure) relative to the resources
they have available to deal with them (e.g., autonomy), they experience strain,
exhaustion, and burnout. Therefore, excessive demands (coupled with insufficient
resources) from the organization may act as a source of stress leading some
employees to lash out aggressively and, consequently, others to perceive themselves
to be the victim.

Individual Factors

A shared work environment provides one potential explanation for the link between
stressful working conditions and mistreatment; however, it is not the only possibility.
Indeed, as Bowling and Beehr (2006) acknowledge, “work stressors might produce
negative emotional and behavioral responses that encourage victimization”
(p. 1000). That is, it may be employees’ reactions to their stressful work environ-
ments that make them more likely to be targeted for mistreatment (e.g., Fan et al.
2020). This interpretation would be consistent with the – albeit controversial –
victim precipitation perspective, which considers how victims contribute to their
own mistreatment through their characteristics and behaviors (Curtis 1974;
Schafer 1968).
For example, although there is mixed evidence about the relationship between
personality variables and experienced mistreatment, one of the few dispositional
factors that are consistently associated with victims of mistreatment is negative affect
(Aquino and Thau 2009; Bowling and Beehr 2006). Negative affect refers to one’s
predisposition to experience negative emotions such as anger, fear, and worry
(Watson and Clark 1984). At least three explanations have been proposed to account
for this relationship. First, consistent with the stress-based argument proposed
above, negative affect could be a consequence of experienced mistreatment, espe-
cially over time (e.g., Mikkelsen and Einarsen 2002) (see also Dhanani et al. 2020).
Alternatively, employees high in negative affect may be inclined to interpret ambig-
uous interpersonal treatment from their colleagues as more hostile, thereby perceiv-
ing themselves to be mistreated regardless of the perpetrator intent (e.g., Matthiesen
and Einarsen 2004). However, a third potential explanation is that – consistent with
38 Workplace Mistreatment 793

the victim precipitation perspective – employees who display these negative emo-
tions may be perceived by their colleagues as unpleasant, which may provoke
mistreatment from their colleagues (e.g., Aquino et al. 1999).
Similar bidirectional effects have been proposed to explain the association
between experienced mistreatment and victims’ higher trait anger (Vie et al. 2010),
lower self-esteem (Bowling and Beehr 2006) and emotional stability (Coyne et al.
2003), and low levels of citizenship behavior (Aquino and Bommer 2003). The
potential for victim characteristics to contribute to their being targeted for mistreat-
ment is also consistent with Kim and Glomb’s (2010) finding that victims of
mistreatment tend to have higher levels of cognitive ability (reported in their aptly-
named paper “Get smarty pants: Cognitive ability, personality, and victimization”).
Interestingly, however, many of the individual attributes associated with experi-
enced mistreatment are associated with enacted mistreatment as well. For example,
perpetrators of mistreatment are also characterized by high levels of negative affect
and trait anger (Hepworth and Towler 2004; Hershcovis et al. 2007) as well as lower
self-esteem (Inness et al. 2005) and core-self evaluations (Ferris et al. 2011). Indeed,
although there are exceptions – for example, perpetrators tend to hold more favor-
able attitudes toward revenge (Douglas and Martinko 2001) – the dispositional
characteristics of victims and perpetrators are more similar than different
(Hershcovis and Reich 2013).
A potential explanation for the lack of clarity about the personality characteristics of
victims and perpetrators is that – rather than being different people – victims and
perpetrators may instead just occupy different roles. That is, according to Aquino and
Lamertz’s (2004) relational model of workplace victimization, victims and perpetrators of
mistreatment can only be understood within a relational context; although there may be
certain characteristics that predispose individuals to become a victim or to perpetrate
mistreatment, the labels “victim” and “perpetrator” actually reflect relational roles, such
that neither exists without the other. Aquino and Lamertz (2004) identified four arche-
typal roles. The “submissive victim” is weak and vulnerable, and therefore an easy target
for one keen to dominate. The “provocative victim” is hostile and aggressive, irking to
colleagues who may lash out in response. The “domineering perpetrator” seeks status and
power and takes advantage of those who present as weak. Finally, the “reactive perpe-
trator” is quick to anger, especially in response to perceived provocation. According to the
relational model, mistreatment occurs when these role occupants interact, becoming
“institutionalized” in the interactions between the submissive victim and domineering
perpetrator and between the provocative victim and reactive perpetrator.
These archetypes present a fractured picture of who becomes a victim as well as a
perpetrator of mistreatment. Some victims are fearful and weak, whereas others are
obnoxious and irritating. Some perpetrators are hostile and power-seeking, whereas
others have difficulty controlling their impulses. Interestingly, all four seem to
clearly relate to negative affect; submissive victims are fearful and anxious whereas
both provocative victims and reactive perpetrators are quick to anger. However, and
perhaps most importantly, neither exists without the other. Victims and perpetrators
are inextricably linked and, as we describe below, in some cases may occupy both
roles at the same time.
794 T. C. Reich and R. K. Dhensa-Kahlon

Relational Factors

The potential for employees to be both victims and perpetrators of mistreatment is

captured by the social exchange perspective. Based on the work of Blau (1964),
social exchange theory posits that behavior within an organization is the result of an
exchange process, such that when an individual does another a favor, there is an
expectation of a future return (Coyle-Shapiro et al. 2004). Just as recipients of
beneficial treatment reciprocate with gestures to benefit the giver, the receipt of
negative treatment (e.g., mistreatment) is likely to lead to the reciprocation of harm.
Consistent with this view, one of the most robust findings in the workplace mis-
treatment literature is the strong positive correlation between experienced and
enacted mistreatment (e.g., Hershcovis and Reich 2013; Stavrova et al. 2020).
Indeed, reciprocating harm as a form of retaliation against a perpetrator is construed
as a morally legitimate response to mistreatment (e.g., Bies et al. 1997; Tripp et al.
2002; Aquino et al. 2006). The strong positive correlation between experienced and
enacted mistreatment, along with the overlap among the organizational and individ-
ual characteristics of victims and perpetrators, led Hershcovis and Reich (2013) to
suggest that the labels of “victim” (or “target”) and “perpetrator” may reflect the way
mistreatment is measured (i.e., in terms of asking about one’s experienced
vs. enacted behaviors) as opposed to capturing different individuals.
It is also important to recognize that mistreatment does not occur in a social
vacuum. Indeed, researchers have found that victims who are singled out for
mistreatment experience worse outcomes compared to those whose colleagues are
also mistreated (Duffy et al. 2006; Zhao et al. 2020), and positive treatment from
peers can buffer the negative effect of mistreatment from a supervisor (Bendersky
and Brockner 2020). Indeed, the potential role of third parties – those present during
(or who learn about) mistreatment – to both buffer and exacerbate the negative
effects of mistreatment on victims is discussed in detail later.
Of course, the perspectives reviewed above represent some (but not all) of the
dominant approaches researchers have used to understand workplace mistreatment.
Findings suggest that stressful working conditions can lead employees to engage in
mistreatment toward their colleagues and that employees’ reactions to these environ-
ments and experiences may also contribute to (perceived or actual) mistreatment.
However, it is also important to recognize that at least some employees may be engaged
in some form of “tit-for-tat” exchange, in which they are both victims and perpetrators of
mistreatment. Taken together, the evidence suggests that mistreatment is affected by a
range of organizational, individual, and relational factors. As such, effectively
addressing workplace mistreatment requires a similarly multipronged approach.

What Can Be Done About Workplace Mistreatment?

Compared to research exploring its predictors and consequence, substantially less

attention has been paid to how to effectively address or intervene in workplace
mistreatment. Often, potential interventions are implied or proposed within a set of
38 Workplace Mistreatment 795

study implications, but they are rarely tested directly. In a 2015 white paper for the
Society of Industrial and Organizational Psychology (SIOP), Hershcovis et al.
(2015) classified mistreatment interventions into primary, secondary, and tertiary
approaches; we follow this approach below, reviewing some of the evidences related
to organizational approaches to preventing, helping employees cope with, and
responding to mistreatment at work, respectively.

Preventing Workplace Mistreatment

Primary interventions are those aimed at preventing mistreatment from occurring in

the first place. In line with the organizational predictors of workplace mistreatment,
some approaches have targeted sources of organizational stress. For example, Hoel
and Giga (2006) examined the effect of policy communication as well as stress
management and negative behavior awareness training using a randomized control
trial in five organizations in the UK. Unfortunately, they found little evidence to
suggest that these practices were effective in terms of the incidence of experience of
bullying. Similarly, in a review of primary interventions which included training
employees on workplace relational civility, positive relational management, and
emotional intelligence, Di Fabio and Duradoni (2019) were unable to offer much
evidence to support their effectiveness, possibly because each addresses only part of
the reason why mistreatment happens.
The Civility Respect and Engagement in the Workplace (CREW) program, on the
other hand, developed by the United Stated Veterans Health Administration has been
more successful. CREW involves training employees to better understand their inter-
personal impact at work and is associated with improvements in perceived workplace
civility (Osatuke et al. 2009), as well as job satisfaction, organizational commitment, and
trust in management (Leiter et al. 2012), sustained over 12 months. In contrast to the
interventions mentioned above, the effectiveness of CREW may be attributed to its
multipronged approach. For example, explaining the sustained improvements in civility
and respect, Leiter et al. noted, “These gains may be perpetuated because improvements
in civility increase the resource base of a work unit, such that civility exchanges are more
likely to enhance employees’ self-esteem and energy at work” (pp. 431–432). In other
words, CREW integrates efforts to develop individual resources (i.e., self-esteem) as
well as better quality exchange relationships among employees, both of which help to
manage the demands of a stressful work environment.

Helping Victims Cope with Workplace Mistreatment

Secondary interventions seek to equip employees with resources to cope, should

they become targets of mistreatment at work. For example, research conducted by
Niven and colleagues suggests that victims who are able to reappraise their experi-
ence by attributing the perpetrator’s actions to external factors – thereby
depersonalizing the mistreatment – experience better outcomes compared to those
796 T. C. Reich and R. K. Dhensa-Kahlon

who ruminate on their negative experience (Niven et al. 2013a,b). Niven et al. explain
these findings from a stressor-strain perspective, suggesting that rumination about
mistreatment serves to prolong the associated strain reaction. Although Niven et al.
focused on victims’ internal experiences (i.e., stress appraisals), rumination may influ-
ence how victims are perceived by others as well. For example, paralleling the effects of
negative affect, those who ruminate about previous negative experiences may be
perceived by would-be perpetrators as an easy or deserving target (i.e., candidates for
the submissive or provocative victim role archetype; Aquino and Lamertz 2004). In
other words, reducing rumination among victims may also lessen the chance they will be
revictimized by a would-be domineering or reactive perpetrator.
A recent study by Deng et al. (2020) also examined the effect of rumination, but
focused on perpetrators of mistreatment (i.e., abusive supervisors). Deng et al. found
that rumination led to efforts to reconcile with the victim among supervisors with
low levels of independent self-construal (the tendency to define oneself as
possessing attributes and abilities that fundamentally separate them from others).
However, if the supervisor had high levels of independent self-construal, rumination
led them to blame the victim instead. This suggests that rumination – although
potentially helpful for encouraging some supervisors to reconcile with those they
have mistreated – is generally unproductive for both victims and perpetrators.

Dealing with the Aftermath of Workplace Mistreatment

Finally, tertiary interventions focus on the aftermath of mistreatment and aim to

reduce the negative consequences. Examples of tertiary interventions include orga-
nizational provision of counselling to victims (e.g., Tehrani 2002) or third-party
mediators (Saam 2010). Although these interventions seem promising – especially in
terms of their potential to improve the stress appraisals and relationships among
employees – little research exists on the effectiveness of these approaches.
Given the paucity of evidence on effective interventions, disappointingly, the best
advice for victims of mistreatment to date seems to be to avoid the perpetrator or to leave
their organization altogether (Aquino and Thau 2009; Zapf and Gross 2001). Victims
who speak up – which is often a precondition for secondary or tertiary interventions –
tend to be targeted for further mistreatment, whereas those who keep mistreatment to
themselves experience psychological and physical harm in the form of rumination,
depression, stress, poorer immune responses, and disease progression (Cortina and
Magley 2003). A potential alternative to this double bind for victims of mistreatment
is reflected in the growing literature on third-party intervention, which we discuss next.

Can Third-Parties Help Address Workplace Mistreatment?

An alternative route for intervention in workplace mistreatment is presented in the

growing literature on third-party observers, or those who witness or learn about an
incident of mistreatment but are not directly involved. Third parties are often present
38 Workplace Mistreatment 797

when mistreatment happens (Glomb 2002; Porath and Pearson 2010), and –
although vicarious mistreatment can lead to negative outcomes for them as well
(see Dhanani and LaPalme 2019) – researchers have suggested that third-party
observers may be well positioned to intervene in incidents of mistreatment. Indeed,
several models have been developed to explain when and why third parties intervene
in the mistreatment of others, as we discuss next.

Perceiving Victim Need and Deservingness: Decision-Tree Model

of Intervention

Although focused on observers of sexual harassment, early work by Bowes-Sperry

and O’Leary-Kelly (2005) provides insight into the decision-making undertaken by
third parties to mistreatment if, and when, they decide to intervene in the mistreat-
ment of others. Bowes-Sperry and O’Leary-Kelly reasoned that, because victims of
sexual harassment are often unwilling to challenge the perpetrator or report their
experience (e.g., Knapp et al. 1997), observers may be better able to provide victims
with the help they need. Based on Latané and Darley’s (1970) bystander intervention
framework, their model proposed a decision tree wherein observers must first notice
the event, interpret it as one requiring some form of action (i.e., intervention), take
personal responsibility for intervention, and decide on the form of that intervention
in terms of its immediacy (i.e., should I act now or later?) and involvement (i.e., how
immersed in the event should I get?).
Each step is influenced by several factors. For example, observers are more likely to
decide that action is required when the event is unambiguous in terms of the harm caused
to the victim. Bowes-Sperry and O’Leary-Kelly (2005) noted that the most obvious way
to reduce event ambiguity is through a direct appeal from the victim for help, “because
the target has labeled it as one that requires action” (p. 293). In other words, when a victim
makes their need for help clear to a third party, they are more likely to get it.
However, according to this model, need alone is insufficient to prompt interven-
tion from third parties, because they still need to take responsibility for doing
so. Bowes-Sperry and O’Leary-Kelly (2005) argued that, among those who deter-
mine that action is required, observers would be more likely to take personal
responsibility for intervening in the event if they shared a salient identity with the
victim, noting “These social connections lead individuals to develop ‘an empathic
altruism’ (Turner, 1985: 111), in which they feel obliged to support the needs and
goals of other ingroup members” (p. 297). In other words, third parties need to
perceive the victim to be someone who is deserving of their help (e.g., by virtue of
their personal connection).
Third parties who notice and take responsibility for intervening in the event may
then intervene, with the form of that intervention dependent on a cost–benefit
analysis, such that third parties will select the response that maximizes effectiveness
while minimizing potential costs to them. The importance of overcoming the
ambiguity of the event and subsequent cost–benefit analysis of intervention was
also highlighted in a recent policy capturing review from Jensen and Raver (2020).
798 T. C. Reich and R. K. Dhensa-Kahlon

Perceiving Victim Need and Deservingness: Deontic Motivation

for Intervention

Perceived costs and benefits of intervention feature in other models of third-party

reactions as well; however, as in Bowes-Sperry and O’Leary-Kelly’s (2005) model,
they are typically secondary considerations. Indeed, the dominant theoretical lens in
the third party to workplace mistreatment literature is Folger’s (2001) deontic model.
According to the deontic model, individuals have an evolutionary-based, morally
motivated negative reaction to the unfair treatment of others which can motivate
them to intervene to restore justice, even at a personal cost. The deontic model
proposes that people care about justice because it is a moral “ought” representing
how people should be treated (“deon” is a Greek term that refers to one’s duty or
obligation; Skarlicki and Kulik 2004), rather than for purely self-interested reasons.
In developing their model of third-party reactions to mistreatment, Skarlicki and
Kulik (2004) drew on fairness theory (Folger and Cropanzano 2001) to argue that
third-party perceptions of (in)justice depend on their judgments of the aversiveness
of the event (i.e., would the victim have been better off if the event had not
happened?), attributions of intent (i.e., could the perpetrator have behaved differ-
ently?), and moral and normative responsibility (i.e., should the perpetrator have
behaved differently?). They reasoned that third parties who perceive that a victim
was negatively impacted and undeserving of their mistreatment would be more
likely to engage in deontic action to restore justice, provided that they perceive
that the potential benefits of intervention outweigh the costs. Although Skarlicki and
Kulik recognized a number of factors that contribute to this cost–benefit analysis
(e.g., the third party’s vulnerability to future mistreatment), a key consideration is the
third party’s assessment of their own as well as the victim’s resources. Specifically,
they reasoned that third-party intervention would be most likely when third parties
“perceive that they can do something for a victim that the victim cannot do on his or
her own (Utne & Kidd, 1980)” (p. 207), that is, when the victim needs their help.
O’Reilly and Aquino (2011) drew on similar theoretical foundations to develop
their model of third parties’ morally motivated reactions to the mistreatment of
others. They argued that third parties experience moral anger as an immediate
response to the mistreatment of another (Folger 2001). This moral anger prompts a
sensemaking process in which third parties determine whether an injustice has
taken place based on their perceptions of the severity of harm, attributions of blame
to the perpetrator, and victim’s deservingness, which they link to fairness theory’s
would, could, and should judgments, respectively (Folger and Cropanzano 2001).
If the third party determines that an injustice has indeed occurred, their moral anger
is intensified prompting an approach motivation to intervene. However, as in the
models described above, O’Reilly and Aquino proposed that the specific form of
the third party’s reaction (i.e., whether they punish a perpetrator directly or
indirectly, or aid the victim) depends on the third party’s confidence in the
organization’s disciplinary system to address the incident without their involve-
ment, as well as the power dynamics among the third party, perpetrator, and victim.
Of particular note, O’Reilly and Aquino reasoned that third parties would only act
38 Workplace Mistreatment 799

to restore justice if they were sufficiently powerful in terms of their resources and
(relative) position. Indeed, O’Reilly and Aquino recognized that “when third
parties perceive that they have relatively less power than the victim, they may
deem their intervention as being less efficacious than if the victim were to act on his
or her own to achieve justice or to cope with the harm caused by the perpetrator”
(pp. 536–537). In other words, as in the models described above, third parties are
only expected to intervene in mistreatment when they perceive that the victim is in
need of their help. If the victim does not need the help a third party can provide,
intervention would likely be considered inappropriate. Although limited, empirical
research provides some support for the expected effects of third-party power on
their reactions to this mistreatment of others. For example, in a series of experi-
ments as well as a critical incident study, Hershcovis et al. (2017) found that third
parties who had low (formal) power relative to the victim and perpetrator were less
likely to confront and more likely to avoid the perpetrator compared to those with
high power.
The importance of victim deservingness is also increasingly apparent. Given the
deontic model’s focus on third-party motivation to restore justice (Folger 2001), it is
not surprising that most of the empirical research based on this model has focused on
reactions that punish the perpetrator and/or support the victim (e.g., Hershcovis and
Bhatnagar 2017; Lotz et al. 2011; Reich and Hershcovis 2015; Turillo et al. 2002).
However, mounting evidence indicates that third-party reactions are not always
supportive of the victim. For example, using a critical incident design, Mitchell
et al. (2015) found that third-party reactions toward victims of mistreatment from
supervisors (i.e., abusive supervision) were moderated by third-party scope of justice
(SOJ), or their “beliefs about whether another person deserves to be treated disre-
spectfully and unfairly (Opotow 2012)” (p. 1042). A victim within the third party’s
SOJ is effectively deemed to be deserving of fair treatment, making deontic reactions
to their mistreatment appropriate. However, if the victim is not included in the third
party’s SOJ, their mistreatment would not constitute an injustice, because they are
not perceived to be deserving of fair treatment in the first place. Indeed, Mitchell
et al. found that while – consistent with the deontic model (Folger 2001) – third
parties experienced moral anger in response to the mistreatment of a victim within
their SOJ, they actually experienced pleasure (or schadenfreude) in response to the
mistreatment of a victim outside their SOJ.
Subsequent theory and empirical research have sought to further explore the
diversity of third-party reactions (e.g., Qiao et al. 2019; Zhou et al. 2020). For
example, in a 2019 theory paper, Li et al. (2019) proposed that third parties would
experience schadenfreude (as opposed to anger) when mistreatment was aligned
with their own goals. In support of this expectation, Chen et al. (2020) found that
third-party reactions of empathy and schadenfreude, as well as subsequent helping
behavior, were moderated by their goal competitiveness with the victim. Similarly,
Liu et al. (2020) found that third parties who did not depend on the victim for task
completion (as well as those high in Machiavellianism and psychopathy) were more
likely to experience schadenfreude and less likely to experience anger in response to
incivility directed toward a colleague.
800 T. C. Reich and R. K. Dhensa-Kahlon

In sum, third-party emotional and behavioral reactions to the mistreatment of

others depend at least in part on their perceptions of a victim’s need and
deservingness. Although understanding the factors that promote and deter third-
party intervention in the mistreatment of others is important, most theoretical and
empirical work has conceptualized these perceptions as exogenous to the victim.
That is, third parties are expected to intervene if they believe that the victim both
needs and deserves their help. However, victims may be able to influence third-party
perceptions about whether they need and deserve help, in which case they might be
able to agentically seek support. In the final section of this chapter, we discuss
avenues for future research exploring how victims may be able to encourage or elicit
help from third parties.

Some Future Directions for Third-Party Research

If third-party reactions do indeed depend on the extent to which they see the victim
as in need and deserving of their help, a potentially fruitful avenue for future research
is to explore how victims may be able to influence these perceptions. Although there
are several means by which victims may be able to send signals about their need and
deservingness, in the subsections below, we focus on two in particular: humor
and talk.

Victim Humor

In the academic literature, “humor” is defined as an event between two or more

people in which at least one experiences amusement and appraises the event as funny
(Martin 2007). Humor is often used by employees in situations that are perceived as
ambiguous (e.g., an uncivil interaction between a perpetrator and victim) or those in
which a more direct response is socially risky (e.g., standing up to or reporting a
perpetrator) (Duncan et al. 1990).
According to Martin et al. (2003), there are four “types” of humor, which differ
along two dimensions: the valence of the humor (i.e., positive or negative) and the
focus of the humor (i.e., on the self vs. on another). Affiliative humor is positive and
other-focused, intended to amuse and connect with others. Self-enhancing humor is
positive and self-focused, intended to amuse oneself by adopting a humorous
outlook on life. Self-defeating humor is negative and self-focused and involves
disparaging the self to amuse others. Finally, aggressive humor is negative and
other-focused, intended to disparage others. These different types of humor are
used to connect with or repel others (i.e., affiliative and self-enhancing vs. self-
defeating and aggressive), and may thus be a means to signal whether one is
deserving of help (i.e., victims who use a positively valenced type of humor may
be perceived as warmer and therefore more deserving compared to those who use
negatively valenced humor). Humor type may also send signals about victim need;
38 Workplace Mistreatment 801

for example, because affiliative and aggressive humor is intended for others, their
use by a victim could be perceived as a signal of their power.
Although these ideas are yet to be fully tested, some preliminary evidence from
Dhensa-Kahlon et al. (2019) suggests that victims’ use of humor is indeed associated
with third-party perceptions of victim deservingness and need in the predicted
direction. However, additional research is needed to determine whether these per-
ceptions translate to third-party intervention (i.e., whether and how they choose to
help the victim).

Victim Talk

Another potential means by which victims could influence third-party perceptions of

their need and deservingness is through their use of talk, or how they discuss or
explain their side of an incident of mistreatment with significant others (i.e., third
parties) (Baer et al. 2018; Dhensa 2011). Paralleling Niven et al.’s (2013a, b) work
on rumination, talk can help victims of mistreatment reframe the perpetrator’s
actions in a different light (Baer et al. 2018). Although this research assumes that
third parties are both available and willing to engage in talk with victims –
suggesting that those approached by the victim will be sympathetic toward them
or “on their side” – the type of talk victims engage in may influence third-party
perceptions of whether they need and deserve their help.
According to Dhensa (2011), two types of talk exist in the aftermath of mistreat-
ment: talk reflecting one’s emotions (venting) or cognitions. Venting, where one
expresses their negative emotions, typically signals that one is in distress (Kennedy-
Moore and Watson 2001). As such, venting might influence third-party perceptions
that the victim needs their help. However, the negative tone of venting talk – which
can include name-calling and/or gossiping about the perpetrator – may undermine
third-party perceptions of victim deservingness, as anger is associated with greater
perceived power compared to expressions of sadness (e.g., Tiedens 2001; Tiedens
et al. 2000). By contrast, by focusing talk on their cognitions and emphasizing their
intention to find rational and constructive approaches to problem-solving (Dhensa
2011), victims may be better able to convey their need as well as their deservingness
of third-party help.

Some Additional Considerations

Although victims may use humor or talk to send signals to third parties about their
need and deservingness of help, it is important to recognize that these types of
reactions may not come easily to victims. For example, depending on the nature and
source of the original offence, victims may find it difficult to make a joke in
response. As such, future research would benefit from considering alternative
strategies for conveying need and deservingness.
802 T. C. Reich and R. K. Dhensa-Kahlon

In addition, a key determinant of the effects of these signals may be the extent to
which third parties perceive the accompanying emotional expression to be appro-
priate (Cheshin 2020). For example, although the experience of sadness is unpleas-
ant for victims, the display of sadness may increase the likelihood that one will
receive support or comfort (Hendriks et al. 2008). As such, third parties may
perceive a humorous response to mistreatment as inappropriate or inconsistent
with the “victim” role, though we suspect this will also depend on the intensity of
the original offence.
Finally, despite the focus on third-party intervention in mistreatment (e.g.,
Bowes-Sperry and O’Leary-Kelly 2005; O’Reilly and Aquino 2011), it is important
to recognize that the effects of this intervention are not yet understood. That is, does
third-party punishment of a perpetrator or support of a victim actually lead to better
outcomes for those involved or the organizations they work for? Additional research
is needed to find out.

Conclusion

Workplace mistreatment is a significant problem for organizations, and employees

will increasingly look to organizations to address it. Understanding when and why
mistreatment happens is essential to designing effective interventions; given the
range of organizational, individual, and relational factors involved, interventions that
address these together are likely to be more effective than those targeting one or two.
In addition to organization-based interventions, third parties may offer an impor-
tant source of support for victims. Although current theory positions victims as
relatively passive in this process, we suggest that they may be able to influence third-
party reactions by signaling their need and deservingness. We encourage additional
research to explore these ideas.

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Managing Health, Safety, and Well-Being at
Work Within Changing Legal and Policy 39
Frameworks

Stavroula Leka and Aditya Jain

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 810
Hard Versus Soft Law Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 811
Evolution of Policy on Health, Safety, and Well-Being at Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 812
Examples of Hard and Soft Law Instruments at International and Regional Level . . . . . . . . 814
Examples of Hard and Soft Law Instruments at National Level . . . . . . . . . . . . . . . . . . . . . . . . . . . 816
Examples of Hard and Soft Law Instruments at the Sectoral Level . . . . . . . . . . . . . . . . . . . . . . . . 817
Examples of Soft Law Instruments at the Organizational Level . . . . . . . . . . . . . . . . . . . . . . . . . . . 818
Balancing Hard and Soft Law Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 820
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 823
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 823

Abstract
The aim of this chapter is to present key policy approaches to managing health,
safety, and well-being at the macrolevel (international, regional, national), meso-
level (sectoral), and microlevel (organizational). We will first begin by defining
key concepts before proceeding to explain hard and soft law and the evolution of
policy in occupational health and safety. We will then present examples of both
these types of approaches at various levels. Recent integrated approaches will
also be discussed. We will conclude by considering advantages and disadvantages
of these various policy approaches and the need of finding balance in policy and
practice.

S. Leka (*)
Cork University Business School, University College Cork, Cork, Ireland
e-mail: [email protected]
A. Jain
Nottingham University Business School, University of Nottingham, Nottingham, UK
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 809

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_34
810 S. Leka and A. Jain

Keywords
Health · Safety · Well-being · Legislation · Policy · Hard law · Soft law

Introduction

This chapter focuses on the role of legislation and policy in managing health, safety,
and well-being at work. The work environment and the nature of work itself are both
important influences on health, safety, and well-being (HSW). As a result, workplace
health and safety or occupational health and safety have been key areas of concern
for many years. Traditionally, more focus has been placed on safety concerns in the
workplace, while health concerns became more prominent with the changing nature
of work. Well-being, on the other hand, is increasingly being considered in relation
to work and the workplace in recent years.
A good starting point in understanding this evolution in focus and thinking is
definitions. According to the Oxford dictionary, safety is defined as the condition of
being safe, freedom from danger, risk, or injury. Safety can also refer to the control of
recognized hazards in order to achieve an acceptable level of risk. In terms of work,
this mainly concerns physical aspects of the work environment. However, the
changing nature of work has been associated with the emergence of new types of
risk relating to psychological and social aspects of the work environment. This has
brought about greater focus on health at work. A very influential definition that
shaped thinking and action in subsequent years was the World Health Organization’s
definition of health as a state of complete physical, mental, and social well-being and
not merely the absence of disease or infirmity (World Health Organization [WHO]
1948). This definition promoted a more holistic view of health away from a mere
focus on physical aspects toward considering social and mental health aspects.
Although the WHO definition already refers to a state of well-being, definitions of
well-being include additional dimensions to health, such as social, economic, psy-
chological, and spiritual. Well-being refers to a good or satisfactory condition of
existence, a state characterized by health, happiness, and prosperity. Obviously,
achieving this state is not relevant to the workplace or work alone. As such, actions
to improve HSW can be taken within the work context and outside of it. Actions
taken in the workplace represent workplace interventions that are implemented in the
work setting and consider the characteristics of work environments and workers. On
the other hand, actions taken outside the workplace represent public health inter-
ventions that are implemented in various settings (e.g., in schools, communities, or
countries) and take into consideration the characteristics of particular populations.
A key question in terms of HSW interventions when it comes to the workplace
concerns responsibility. While every individual is responsible for their own actions
in various contexts of life, in a specific setting like the workplace, additional
responsibility lies with the employer since the work environment will expose
workers to particular work characteristics that might in turn pose a certain level of
risk to their HSW. While employer responsibility might be formalized under law, this
39 Managing Health, Safety, and Well-Being at Work Within Changing Legal and. . . 811

is not the case across countries or in relation to all possible types of risks to workers’
HSW and in particular new and emerging risks, or risks that are either new or gain in
prevalence with the changing nature of work. Accordingly, it is important to consider
not only legal duties (found in instruments of hard law) that employers have toward
their workforce but also ethical duties that will extend beyond legal compliance
(often outlined in other types of policies, called soft law).
This chapter discusses the role of legislation and policy for managing HSW at
work, considering their evolution across time. Various types of hard and soft law
instruments are explained, and their advantages and disadvantages are discussed.
Examples of hard and soft law instruments at micro-, meso-, and macro-level
(macro-level refers to the international, regional (such as European), or national
level; meso-level refers to the provincial or sectoral level; micro-level refers to the
organizational level) are also considered.

Hard Versus Soft Law Approaches

On the basis of existing literature, Leka et al. (2011a) classified policy-level

approaches as:

• Legislation development
• Standards at national/stakeholder levels
• Stakeholder/collective agreements
• International organization action
• Social dialogue initiatives
• National strategy development
• Development of guidelines
• Economic incentives/programs
• Establishing networks/partnerships

When developing policy approaches, the ideal is for complementarity to exist

across various initiatives whether they are focusing on public or occupational health
issues, economic issues, social security, or sustainability. However, it has been widely
acknowledged that such complementarity rarely exists due to different priorities and
perspectives among policymakers (Iavicoli et al. 2014). This concerns also policies of
relevance to HSW. In addition, the development and implementation of policy
approaches is dependent on the context in which these take place. This means that
approaches will vary across countries, both within developed countries and between
them and developing countries. Indeed, certain perspectives and approaches (e.g.,
human rights) might be very limited in specific countries due to conflicting interests
and priorities, values and cultures, and historic developments. This presents important
challenges for the translation of knowledge into practice in these contexts. Let us first
consider the different types of policy approaches and their aims.
Approaches developed and implemented by various stakeholders at the international,
national, regional, sectoral, and enterprise level to promote HSW at work include “hard” or
812 S. Leka and A. Jain

“regulatory approaches,” e.g., laws and regulations such as national legislation, Interna-
tional Labour Organization (ILO) conventions, and European Union directives, as well as
“soft” or “nonbinding/voluntary” approaches developed by recognized national, regional,
sectoral, and international organizations which may take the form of specifications,
guidance, social partner agreements, and establishment of networks and partnerships.
Hard law is defined as a policy relying primarily on the authority and power of the
state in the construction, operation, and implementation, including enforcement, of
arrangements at international, national, or subnational level (Kirton and Trebilcock
2004). Hard law, based on the concept of “legalization,” is also used to refer to
legally binding obligations that are precise (or can be made precise through adjudi-
cation or the issuance of detailed regulations) and that delegate authority for
interpreting and implementing the law (Abbott and Snidal 2000). Statutes or regu-
lations in highly developed national legal systems are generally taken as prototypical
of hard legalization (Abbott et al. 2000). At the intergovernmental level, they can
take the form of legally binding treaties, conventions, and directives.
Soft law in contrast refers to policies that rely primarily on the participation and
resources of nongovernmental actors in the construction, operation, and implemen-
tation of a governance arrangement (Abbott and Snidal 2000). According to
Ikenberry (2001), in a soft law regime, the formal legal, regulatory authority of
governments is not relied upon and may not be even contained in institutional design
and operation. Furthermore, there is voluntary participation in policy development
and a strong reliance on consensus-based decision-making for action and, more
broadly, as a source of institutional binding and legitimacy. In such a regime, any
participant is free to leave at any time and to adhere to the regime or not, without
invoking the sanctioning power of state authority (Ikenberry 2001).
State and non-state actors can achieve many of their goals through soft legaliza-
tion that is more easily attained or sometimes preferable. Soft law can provide a basis
for efficient international “contracts,” and it helps create normative “covenants” and
discourses (Abbott and Snidal 2000). Soft law instruments range from treaties,
which include only soft obligations (legal soft law), to nonbinding or voluntary
resolutions and codes of conduct formulated and accepted by international and
regional organizations (nonlegal soft law), to statements prepared by individuals in
a nongovernmental capacity, but which purport to lay down international principles.
They also include voluntary standards designed and adopted by businesses and civil
society to guide their shared understanding (Chinkin 1989; Kirton and Trebilcock
2004). The following sections will discuss the evolution of policy on HSW and
present examples of hard and soft law instruments developed in various countries.

Evolution of Policy on Health, Safety, and Well-Being at Work

Hard and soft law on HSW at work have evolved in line with socioeconomic and
political development across time as well as new knowledge and evidence. Stake-
holder interests have also shaped these developments, and with the number of
stakeholders having vested interests in HSW, the policy landscape has become
more complex.
39 Managing Health, Safety, and Well-Being at Work Within Changing Legal and. . . 813

Early policies were mostly focused around safety and to lesser degree health. For
example, in the nineteenth century, the industrial revolution changed the way the
workforce worked with the introduction of mechanization and large-scale factories,
bringing with it dangerous working conditions. These factors led to industrial
accidents and child labor for extremely long hours in hazardous conditions. As a
result, new legislation was introduced in newly industrialized countries, e.g., in the
UK; the first piece of occupational safety and health (OSH) legislation, the Health
and Morals of Apprentices Act, was introduced in 1802. It was targeted at those
employed (particularly children) in cotton mills and other factories with 3 or more
apprentices employed or 20 employees; it restricted the working day to 12 h and
envisioned a phased elimination of night work. During this period there was
apprehension toward prosecuting employers for OSH issues on the basis that they
provided jobs to society, an argument that still prevails to this day and has led to a
trend toward deregulation in many countries.
Early OSH regulation was piecemeal and ad hoc which resulted in an excessive
number of pieces of legislation in many countries. However, a shift took place in the
1970s with the introduction of new legislation (e.g., Health and Safety at Work Act
1974 in the UK, based on the Robens Report on Safety and Health at Work in 1972)
that was meant to be goal setting rather than prescriptive, changing the focus to
prevention rather than compensation. This shift was seen as a way to ensure risk to
health and safety was dealt with by those who created it but also promoted the
concept of self-regulation which is inherent in soft law approaches.
The risk-based approach gained in importance through the introduction of
legislation with a strong focus on the principle of risk management. For example,
in the European Union, the Framework Directive on the introduction of measures
to encourage improvements in the safety and health of workers at work was
introduced in 1989. It focused on systematic risk assessment and internal compe-
tence. It also established the principle that the employer has a duty to ensure the
safety and health of workers in every aspect related to their work, crucially
broadening the scope of health and safety with the inclusion of issues such as the
organization of work and social relationships. This was timely as new findings
around this time highlighted work-related stress to be a significant issue affecting
the workforce. This has remained constant over the past 30 years and has meant
that more specific legislation around health (including psychological or mental
health) has been introduced in many countries as well as many additional soft law
instruments in this area.
At the same time, developments were taking place in the soft law arena as well.
For example, in the UK, the Health and Safety at Work Act 1974 also introduced
Approved Codes of Practice (ACoPs). ACoPs are important because they allow
some flexibility in dealing with legislation. Failing to comply with a provision of an
ACoP was not in itself an offence, but if a statutory requirement is not satisfied in
some other way, then one could be found guilty of contravening the regulation or
sections of the HSWA (Fairman 1994). In this way, ACoPs are considered quasi-
legal forms of guidance. The concept of ACoPs existed before the 1974 Act. They
were common in certain sectors, for example, they were well regarded by managers
and trade unions as underpinning safety in the mining industry.
814 S. Leka and A. Jain

Standardization is another area of soft law that has seen increased development
over the years. The first national standards body to be established was the British
Standards Institution (BSI) in 1901, while in the USA the American National
Standards Institute (ANSI) was established in 1918. The International Organization
for Standardization (ISO) was officially established in 1947, with 67 technical
committees. In terms of occupational health and safety, BSI collaborated with
OSH experts and stakeholders from around the world to create the OHSAS 18001:
1999. A second partner document, the OHSAS 18002:2000, was established as a
guideline for implementation of 18,001. Following years of consultation on the need
for an international standard on health and safety, ISO 45001 was developed and
launched in 2018. A practical guide to the standard for small organizations followed,
while ISO45003 on psychological health and safety at work was published in 2021.
Apart from standards, other forms of examples of soft law include social partner
agreements or guidance and tools available at regional, national, or sectoral level. For
example, in Europe, participants in European social dialogue – ETUC (trade unions),
BUSINESSEUROPE (private sector employers), UEAPME (small businesses), and
CEEP (public employers) – have concluded a number of “voluntary” or autonomous
agreements. Examples include framework agreements on telework (2002), work-related
stress (2004), harassment and violence at work (2007), inclusive labor markets (2010),
and digitalization (2020). An autonomous agreement signed by the European social
partners creates a contractual obligation for the affiliated organizations of the signatory
parties to implement the agreement at each appropriate level of the national system of
industrial relations instead of being incorporated into a directive. Social partners then have
to report implementation activities in each EU country to the European Commission.
Other voluntary approaches include sectoral policies which are comprehensive,
integrated, and coordinated initiatives targeted to address a sector’s specific objec-
tives. As in the case of macrolevel policies, the development of “meso” sectoral
policies usually involves consultations with several stakeholders (both public and
private) and user groups at the national and supranational (e.g., European) levels;
however only sector specific stakeholders are involved.
Recently, approaches and models have been developed that aim to integrate the
various specialist views on HSW at the workplace. An important reason was the need
to combine the two often separated worlds of traditional occupational health and
safety and workplace health promotion. While the first focuses on the prevention of
occupational or work-related injuries and diseases, the second aims to prevent or
reduce public health issues at the workplace, especially those that can be influenced
through lifestyle interventions. Examples of these approaches exist at national level
(e.g., US NIOSH Total Worker Health™) and international level (e.g., WHO
Healthy Workplace Model and ISSA Vision Zero).

Examples of Hard and Soft Law Instruments at International

and Regional Level

A global example of international hard law comes from the International Labour
Organization (ILO) through the issuing of occupational health and safety (OSH)-related
39 Managing Health, Safety, and Well-Being at Work Within Changing Legal and. . . 815

conventions. These instruments seek to establish basic standards to ensure workers’

health and safety. If ratified, a convention comes into force 1 year after the date of
ratification and is legally binding. Ratifying countries commit to applying the conven-
tion in local legislation and practice and to regularly reporting on its application. While
conventions No. 155, No. 161, and No.187 are recognized as the three key OSH
conventions, there are several conventions of relevance to HSW (see Jain et al. 2018).
Global initiatives also exist within the “soft law” approach. Examples include
ILO recommendations or standards set by international standardization bodies. As
with ILO conventions, recommendations are drawn up by representatives of gov-
ernments, employers, and workers. Recommendations are designed to establish
standards through the provision of guidance usually (although not necessarily)
related to an existing convention. For example, recommendation 164 on Occupa-
tional Safety and Health (1981) is directly relevant to the convention of the same
title. Another example from the ILO is the Seoul Declaration on Safety and Health at
Work (2008) which asserts that entitlement to a safe and healthy work environment
is a fundamental human right. It follows that this should be protected through
responsible practices at the policy and business levels, and efforts have been made
through corporate social responsibility initiatives to address these issues.
In terms of comprehensive soft law approaches, mentioned earlier, in 2017, the
International Social Security Association (ISSA) launched the first global campaign
to improve safety, health, and well-being at work. The campaign aims to engage
companies worldwide to systematically cut down on occupational accidents and
diseases by investing in a healthy and motivated workforce. “Vision Zero” is a
transformational approach to prevention that integrates the three dimensions of
safety, health, and well-being at all levels of work. The ISSA’s Vision Zero concept
is flexible and can be adjusted to the specific safety, health, or well-being priorities
for prevention in any given context. It includes guidance on seven golden rules of
Vision Zero:

1. Take leadership – demonstrate commitment

2. Identify hazards – control risks
3. Define targets – develop programs
4. Ensure a safe and healthy system – be well-organized
5. Ensure safety and health in machines, equipment, and workplaces
6. Improve qualifications – develop competence
7. Invest in people – motivate by participation

Associated with these 7 golden rules are 14 proactive leading indicators that
organizations can use to implement good practice in managing HSW based on the
principle of prevention (Zwetsloot et al. 2020).
The Framework Directive 89/391/EEC on Safety and Health of Workers at Work,
mentioned earlier, is an example of a regional hard law instrument. It lays down
employers’ general obligations to ensure workers’ health and safety regarding work,
“addressing all types of risk.” To target more specific aspects of safety and health at
work, a series of individual directives were also adopted, although the Framework
Directive continues to apply to all areas of work. Where the provisions in individual
816 S. Leka and A. Jain

directives are more specific and/or stringent, these provisions prevail. Individual
directives tailor the principles of the Framework Directive to specific tasks, specific
hazards at work, specific workplaces and sectors, specific groups of workers, and
certain work-related aspects (European Commission 2004). The individual direc-
tives define how to assess these risks and, in some instances, set limit values for
certain substances or agents. Over 60 individual EU directives which set minimum
health and safety requirements for the protection of workers have been adopted and
implemented in the EU. Any standards established in individual directives are the
minimum standards deemed necessary to protect workers; however, member states
are allowed to maintain or establish higher levels of protection.
On the other hand, in terms of regional soft law, the implementation of some of
the European social partner agreements has been evaluated by the European Com-
mission. For example, the European Commission published the results of a study on
the implementation of the autonomous framework agreement on “harassment and
violence at work” in 2016. The implementation actions have slightly tended toward
less “binding” activities (guidance, declarations, translation, and dissemination) than
it was the case for previous European autonomous framework agreements. However,
several sectoral agreements emerged as a result. In 2009, European social partners
from the commerce sector adopted a toolkit entitled “Preventing Third-Party Vio-
lence in Commerce.” One year later, multi-sectoral guidelines to tackle third-party
work-related violence and harassment were signed by European social partners in
the commerce, healthcare, local and regional government, private security, and
education sectors. In the European railway sector, a good practice guide and
recommendations were adopted to promoting security and the feeling of security
vis-à-vis third-party violence. More recently, the European Community Shipowners’
Associations and the European Transport Workers’ Federation agreed on guidelines
to shipping companies for eliminating workplace harassment and bullying. In
particular, the trade unions in the education sector have also been very active in
this field, having drafted an implementation guide to the cross-industry autonomous
framework agreement for teaching unions and practical guidelines for anti-cyber
harassment measures in education (European Commission 2016).

Examples of Hard and Soft Law Instruments at National Level

National laws may conform to criteria established in international (e.g., if the country
has ratified an ILO convention) and regional policies (e.g., EU directives); however,
there are large variations in the scope and coverage of national health and safety laws
(ILO 2004). To implement national legislation, most countries have designated
occupational health and safety authorities and inspection systems to ensure compli-
ance. In several countries, particularly developed countries, there are mechanisms for
national surveillance (collection and analysis of data) on health and safety, tripartite
(employers, trade unions, and government) consultation mechanisms or bodies, access
to occupational health and safety services, occupational health and safety research
institutions, and links with worker injury insurance schemes and institutions.
39 Managing Health, Safety, and Well-Being at Work Within Changing Legal and. . . 817

For example, in Australia, the Work Health and Safety Act, which is supported by
relevant regulations and several codes of practice (Safe Work Australia 2016),
establishes the general duties that are placed on various parties involved in the
conduct of work. The relevant regulations focus on various aspects pertaining to
health and safety at work including falls, driving, and electrical safety, as well as
plant and structures, construction work, hazardous chemicals, asbestos, major hazard
fatalities, mines, and a review of decisions, exemptions, and prescribed serious
illnesses.
National legislation can also focus on more specific issues. For example, in
Sweden, the “Organisational and Social Work Environment” (AFS 2015: 4) pro-
visions, which came into effect on 31 March 2016, regulate knowledge require-
ments, goals, workloads, working hours, and victimization. The provisions have
been developed in consultation with the labor market partners and have a focus on
preventive work environment management. These regulations concretize the Swed-
ish Work Environment Act, which is a general legislation, and clarify – as well as
supplement – the systematic work environment management that all employers are
obliged to carry out.
At national level, an example of soft law approach comes from Japan. The Mental
Health Action Checklist is a list of 30 action items which could be useful in
improving the psychosocial work environment (Yoshikawa et al. 2007). It is a tool
developed for facilitating worker participation, and it is a guide for improving work
environments for worker mental health based on collecting, sorting, and classifying
more than 250 good practices obtained from successful cases among Japanese
workplaces. It focuses on six technical areas: sharing work planning, work time
and organization, ergonomic work methods, workplace environment, mutual support
in the workplace, and preparedness and care (Yoshikawa et al. 2007). It has been
extensively used in workplaces in Japan and has been shown to be effective in
reducing depression and sick leave among workers. For example, an intervention
study demonstrated that a worker participatory approach using the checklist was
effective in reducing job stressors and depression among white-collar workers
(Kobayashi et al. 2008). Similarly, the Management Standards for Work-related
Stress, developed by the Health and Safety Executive (HSE) in the UK (Mackay
et al. 2004) and adapted by INAIL in Italy (Iavicoli et al. 2014), include guidance,
survey, and focus group tools that allow organizations to benchmark their practice
against good practice standards (for a discussion on their evaluation, see Iavicoli
et al. 2014).

Examples of Hard and Soft Law Instruments at the Sectoral Level

Several sectoral directives have been developed by the European Commission.

Examples include Directive 2017/159/EU – Work in Fishing Convention of
19 December 2016 – and Directive 2010/32/EU, prevention from sharp injuries in
the hospital and healthcare sector of 10 May 2010. These sectoral hard law instru-
ments are the result of agreements concluded at sectoral level by social partners.
818 S. Leka and A. Jain

There are several examples of soft law initiatives at the sectoral level. The Work
and Health Covenants in the Netherlands are such an example. From 1998 until
2007, the Dutch Ministry of Social Affairs and Employment actively encouraged
and subsidized a sectoral approach to OSH risk management. The overall aim was to
achieve a reduction of about 10% in exposure to sector-specific OSH risks over a
period of approximately 3 years. These sectoral risk management projects were
called Work and Health Covenants. A covenant can be described as an agreement
between employers and employee representatives of a sector who – in the presence
and with the advice of the ministry – agree on the risks to tackle, the approach or
measures to take, and the specific goals to be formulated at the sectoral level. About
50 high-risk sectors (i.e., sectors in which either 40% of workers or at least 50,000
workers were exposed to primary work risks, including high job demands, high
physical demands, and working with health-damaging chemicals) participated in the
initiative (Taris et al. 2010).

Examples of Soft Law Instruments at the Organizational Level

Organizations themselves also develop internal guidelines and standards on the basis
of existing legislation and soft law policies and good practice principles. These may
be done through business networks or directly by a specific organization. For
example, policy approaches can be developed and implemented at the
interorganizational level, where civil actors, with or without the involvement of
governmental actors, organize to promote specific areas of interest.
For example, CSR (Corporate Social Responsibility) Europe is the leading
European business network for corporate social responsibility for more than
10,000 organizations. Its mission is to support member companies with integrating
CSR into the way they do business on a daily basis. CSR Europe sees the issue of
HSW in the workplace as core to CSR objectives. Initiatives have focused on well-
being at work and more recently the future of work.
Several examples also exist at the organizational level. Box 1 refers to such an
example from an oil and gas company in Norway (Bergh et al. 2014), which adapted
international good practice guidance to develop its own standards and processes for
the management of psychosocial risks in the workplace.

Box 1 Establishment of Internal Requirements and Guidelines for Psychosocial

Risk Management – Statoil (Now Equinor), Norway
In the process of establishing psychosocial requirements into the company’s
corporate requirements, a focus on the design, management, and organization
of work needed to be incorporated into the existing requirements. The psy-
chosocial requirements that were added into the existing requirements
included the following aspects: “workplaces and work processes should be

(continued)
39 Managing Health, Safety, and Well-Being at Work Within Changing Legal and. . . 819

Box 1 (continued)
organized in a way that prevents employees from being exposed to psychoso-
cial hazards with risks of developing ill health. Effort should be made to avoid
work-related stress and ill health due to the psychosocial working environ-
ment. Coarse psychosocial hazard identification should be performed regularly
on an annual basis. Attention should be paid to determinants such as job
content, workload and work schedule, job control, interpersonal relationships
at work, role in organization, bullying, home-work interface, and organiza-
tional change. Health and working environment risks, including psychosocial
risk, should be managed in a systematic, ongoing manner within the organi-
zational context. Results from the coarse psychosocial hazard identification
should indicate where to implement further in-depth assessments in line with
best practice principles for psychosocial risk management described in the
guideline for the psychosocial risk management approach. The requirements
in relation to the psychosocial work environment also include hazards such as
violence, bullying, and harassment at work. Complaints of bullying should be
handled in accordance with the internal work process for handling bullying
cases.”
Furthermore, a guideline for psychosocial risk management (PRIMA) was
developed as part of the company’s internal requirements. The guideline was
adapted through the Psychosocial Risk Management Excellence Framework
(PRIMA-EF) (Leka and Cox 2008). Some adjustments were made in order to
fit the company’s management system. One of the more important adjustments
was to introduce “upside risk” into the guideline for managing psychosocial
risk. This was in line with how the company defines risk in two dimensions:
upside and downside risk. Risk is defined as the deviation from a specified
reference value and the associated uncertainty, i.e., positive deviation ¼ upside
risk and negative deviation ¼ downside risk.
A guideline is, in this company, listed as advisory documentation and is a
description of recommended practices, techniques, methods, and user man-
uals. As such, the guideline is the application of the risk management frame-
work to psychosocial risks in the workplace. It is based on the principles of
prevention in line with the control cycle.
Steps in the psychosocial risk management process include:

1. Trigger in-depth psychosocial risk assessment.

2. Start-up and familiarization: plan ahead and prepare the organization.
3. Risk identification and assessment: identify psychosocial factors that may
affect employees’ health (both upside and downside risk should be
included).
4. Identify interventions: involve employees in discussions when identifying
interventions. Make an action plan.

(continued)
820 S. Leka and A. Jain

Box 1 (continued)
5. Risk intervention: implement action plan in order to deal with the identified
factors.
6. Evaluation: recommendations and further work must include an evaluation
of the short-term and long-term effect of the measures.

Findings and interventions should be evaluated and included in a system-

atic and continuous evaluation and improvement of the psychosocial work
environment. It is important to include the entire control cycle and through this
process achieve organizational development and training.
PRIMA is based on the process of triangulation: using multiple data
collection methods and cross-checking the reliability and validity of the data
collected. The method is based on a review of organizational documentation
and systems, qualitative methods (such as interviews and focus groups) and
quantitative methods (surveys). PRIMA is facilitated by experts with appro-
priate training and experience in psychosocial risk management.
Source: Adapted from Bergh et al. 2014.

Balancing Hard and Soft Law Approaches

As we have discussed in this chapter, both hard law (binding) and soft law (volun-
tary) policy approaches have been developed and implemented to address HSW at
work. Both of these approaches have several advantages and disadvantages.
Hard law offers the legitimacy, the strong surveillance and enforcement mecha-
nisms, and the guaranteed resources that soft law often lacks. Hard law has been
reported to be one of the most important motivators for organizations to engage with
HSW (EU-OSHA 2010). However, a hard law approach, promoted alone, may have
some drawbacks. OSH regulation in the EU and other developed countries covers
traditional health risks (e.g., physical risks) and emerging risks (e.g., psychosocial
risks). However, in practice, actions mostly target traditional hazards, for example,
chemical hazards (HSE 2005), as these are perceived to have the greatest potential to
disable or kill (WHO 2010). As the focus has moved away from this, toward the
prevention of ill health, the regulatory approach has been found to be less effective
due to the lack of specific coverage of risks, and unclear terminology. This has
brought about confusion among experts, policymakers, and other key actors like
employers, employees, and occupational health services (HSE 2005; Leka et al.
2011b).
Additionally, a regulatory approach is most likely to be effective in developed
countries, where a more advanced framework is available to effectively translate
policy into practice. Indeed, in developing countries, OSH legislation often does not
meet international standards and is often not enforced (Joubert 2002). Furthermore,
39 Managing Health, Safety, and Well-Being at Work Within Changing Legal and. . . 821

most workers are not covered by these laws. However, even in developed nations,
there have been ongoing challenges in relation to law enforcement since enforce-
ment agencies (e.g., labor inspectorates) have found their resources cut in light of
budget reviews (Leka et al. 2015).
A further issue is that nations might choose not to make use of legislative policy
initiatives where available. Many countries (both developed and developing) choose
not to ratify ILO OSH conventions. Furthermore, there is a desire to minimize the
regulatory burden placed on organizations, especially SMEs (HSE 2005). Addition-
ally, if dissatisfied with the state of legislation, business can lobby for changes in
legislation (Bain 1997). Similarly, if deterrents are not established properly, this may
fail to regulate organizational behavior, and organizations may view fines as “oper-
ational licenses” to be paid (McBarnet 2009). Businesses have also become
extremely adept at dealing with legal burdens through the art of “creative compli-
ance” where legislation is adhered to but only superficially and not in “spirit” (Gold
and Duncan 1993). In these cases, enforcement is not an option because in the
strictest of senses, these organizations have not violated any laws. A further issue is
that regulation is designed to target minimum requirements (EU-OSHA 2010). Thus,
even if one envisioned a scenario where organizations were compliant with these
requirements, it is questionable whether the high-level goals established by organi-
zations like the WHO and ILO could be achieved.
In contrast, soft law offers advantages such as timely actions when governments
are stalemated; bottom-up initiatives that bring additional legitimacy, expertise, and
other resources for making and enforcing new norms and standards; and an effective
means for direct civil society participation in global governance. These benefits are
particularly important at a time when the demands of intensifying globalization may
outstrip capacities of national governments (Kirton and Trebilcock 2004). Soft law
has also been found to be more precise and user friendly than hard law in relation to
HSW (Leka et al. 2015).
Nonetheless, the soft law approach comes with its own challenges. It may lack the
legitimacy and strong surveillance and enforcement mechanisms offered by hard
law. With a broader array of stakeholders, soft law may promote compromise, or
even compromised standards, less stringent than those delivered by governments
acting with their full authority (Chinkin 1989). Soft law can also lead to uncertainty,
as competing sets of voluntary standards struggle for dominance and as actors
remain unclear about the costs of compliance or its absence and about when
governments might intervene to impose a potentially different mandatory regime
(Kirton and Trebilcock 2004).
There are also some overarching issues that concern both approaches. One of
them relates to the fact that policies are made and implemented in multi-actor
contexts, and the various stakeholders frequently view problems and solutions
differently, and some will try to influence the aim and direction of a policy all the
way through the policy process. Such situations call for more attention to be paid to
different rationalities and lines of argument (Hanberger 2001). The economic argu-
ment relates, for example, to availability and provision of resources, unemployment
rates, labor productivity, as well as social factors such as freedom of association and
822 S. Leka and A. Jain

union participation in public policy. The political argument relates to the system of
governance (federal, central, unitary, intergovernmental), political stability, etc. The
context has a direct impact on the policy framework for HSW, the actors who are
included or excluded from the development of policies and their perception of HSW
risks, the process of negotiation, development and implementation of these policies,
and policy outcomes. These have an impact on the actions taken by governments,
regions, and organizations to manage HSW and alleviate possible negative outcomes
in terms of incidence of accidents, diseases, health conditions, and related business
outcomes (e.g., absenteeism, presenteeism, and human error). In order for balance to
be achieved between different approaches, it is important to align perspectives across
key stakeholders and across different types of policies and social and economic
agendas.
Increasingly, emphasis is being placed on the integration of HSW policies, both at
the organizational and the national level. At the organizational level, there is growing
recognition that HSW is associated with strategic and often intangible benefits
(Johanson et al. 2007; Zwetsloot and van Scheppingen 2007), thus a need for
alternatives to business cases narrowly oriented toward economic outcomes. The
need for a holistic approach is particularly important, not only for financial reasons
but also for legal and moral reasons, which drive businesses to engage in HSW
(EU-OSHA 2015).
At the national policy level, the collaboration between different policy sectors
reflects the trend of the cooperation and interdependence between occupational
safety and health, occupational health services, human resource development, and
business management (Anttonen and Räsänen 2009). The increased recognition of
the role played by various stakeholders and the need for their active participation has
led to the development of the Health in All Policies (HiAP) approach (Ollila et al.
2013) which can facilitate the mainstreaming of HSW policies across sectors and
levels. The use of integrative approaches, such as those advocated by the HiAP
approach applied to work and employment (Rantanen et al. 2013), can facilitate the
aligning of perspectives and mainstream HSW at the societal level.
Rantanen et al. (2013) applied the HiAP approach to work, health, and employ-
ment. Recognizing the roles of national, intergovernmental, and supranational polit-
ical and policy actors and the need for integrating their various HSW policy
mandates, approaches, and initiatives, they proposed a multi-sectoral policy inter-
vention framework. This framework is a chain process with several entry points that
can be used to align these varied approaches and initiatives. Policymakers can utilize
such entry points as opportunities arise, as they work toward reaching the objective
of sustainable health, work ability, and quality of working life for workers
(i.e., decent work and decent life), and implement actions which need active multi-
sectoral and tripartite collaboration and contribution (Rantanen et al. 2013).
For balance to be achieved in the HSW policy arena, it is important for
policymakers to ensure the integration and coordination of policies relevant to
HSW at work. Decisions in relation to HSW policy development are complex, and
the actors involved in the process will represent different political, cultural, and
process influences and therefore, in turn, will have an impact on decisions being
39 Managing Health, Safety, and Well-Being at Work Within Changing Legal and. . . 823

made when translating knowledge into policy and practice to address HSW issues.
The development of comprehensive, integrated, and coordinated initiatives targeted
to address HSW requires consultations among several stakeholders (both public and
private) across sectors and user groups at the national and supranational levels. At
the same time, regulators should ensure the availability of appropriate services,
infrastructures, and human resources for promoting HSW.

Conclusion

This chapter presented key policy approaches to managing HSW at the macrolevel
(international, regional, national), mesolevel (sectoral), and microlevel (organiza-
tional). The evolution of OSH policymaking was outlined with the concepts of hard
and soft law explained. Examples of binding, voluntary, and integrated policy
approaches were then presented. Finally, the advantages and disadvantages of
these approaches and challenges in translating knowledge into policy and practice
were discussed. An alignment of perspectives and approaches would be the ideal
way forward in relation to HSW, and steps have been made in the right direction as
has been discussed in this chapter. For this to be achieved, there needs to be a balance
among evidence, capabilities, and morality, and this concerns both the policy and the
organizational level.

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Psychological Adjustment and Post-arrival
Cross-cultural Training for Better 40
Expatriation
A Systematic Review

Sheetal Gai , Paula Brough, and Elliroma Gardiner

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 828
Purpose of This Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830
Cross-Cultural Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 830
Psychological Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831
Cross-Cultural Training (CCT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831
Evidence of CCT Effectiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831
Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 833
Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 833
Search Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 833
Data Extraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 834
Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 834
Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 836
Descriptive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 836
Data Analyses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 837

S. Gai (*)
Centre for Work, Organisation and Wellbeing and School of Applied Psychology, Griffith
University, Brisbane, QLD, Australia
e-mail: sheetal.gai@griffithuni.edu.au
P. Brough
Centre for Work, Organisation and Wellbeing, Griffith University, Brisbane, QLD, Australia
e-mail: p.brough@griffith.edu.au
E. Gardiner
School of Management, QUT Business School, Queensland University of Technology, Brisbane,
QLD, Australia
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 827

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_39
828 S. Gai et al.

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 845
CCT Effectiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 846
Research Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 848
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 848
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 849

Abstract
Globalization has produced increasingly multicultural workplaces, resulting in a
proliferation of cross-cultural difficulties for expatriate employees and their
work organizations. Expatriate workers often experience high levels of stress,
and because of this, the rate of mental ill-health among expatriates is increasing.
The review argues that examining psychological adjustment can advance our
understanding of the role of mental health in expatriate success. Thus, this
review first examines the prevalence and significance of measuring the psycho-
logical adjustment dimension among multinational corporation (MNC) expa-
triate workers in the cross-cultural literature. Second, this review examines the
role of cross-cultural training (pre-departure and post-arrival) and its effective-
ness on expatriation success. This review analyzed 22 empirical studies
published between 1994 and 2020 that examined either or both: (1) cross-
cultural adjustment, emphasizing the psychological adjustment component,
and (2) cross-cultural training, emphasizing the effectiveness and impact of
pre-departure and post-arrival cross-cultural training on long-term expatriation
success among MNC expatriate workers. This review was conducted with a
specific goal of increasing our understanding of the role of psychological
adjustment and how appropriate cross-cultural training may increase expatriate
success.

Keywords
Expatriate employees · Stress · Cross-cultural adjustment · Cross-cultural
training · Information and communication technology

Introduction

In the digitalization era, global assignments have become increasingly important for
multinational corporations (MNCs). To achieve this objective, MNCs continue to
increase international employment opportunities worldwide (Liu 2020, July 30; ILO
2019). MNCs primarily depend on expatriates for growth and advantage (Singh and
Mahmud 2018). Research traditionally considered “expatriate” as people who were
sent to work in another unit of the same company located in a foreign country,
referred to as organizational expats (Cerdin and Selmer 2013). However, new trends
in the international job market are making way for “independent internationally
mobile professionals” expatriates, commonly referred to as “self-initiated expatri-
ates” – a highly skilled worker with unique expertise, knowledge, and technical
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 829

skills (Cerdin and Selmer 2013; Doherty 2013). With increasing globalization, the
expatriate workers will consist of 87.5 million employees in 2021.
Expatriate workers are key contributors to the rapidly expanding information and
communication technology sector (ICT; Foged et al. 2019). Indeed, the ICT sector is
one of the largest sectors for employing highly skilled expatriates, followed by the
hospitality sector (OECD 2020). ICT expatriates are employed within many product
and services industries, including information technology, education, digital, media,
telecommunication, financial, insurance, construction, manufacturing, retail, and
other services. Overall, the ICT MNCs have become culturally diverse entities,
with highly skilled employees migrating temporarily and permanently to numerous
host countries. Since 2016, the ICT industry has produced considerable gains and
economic growth worth US$ 11.5 trillion globally, equivalent to 15.5% of global
GDP (Henry-Nickle et al. 2019, March 29).
According to an OECD (2020) report, the numbers of expatriate workers have
increased exponentially since 2005. Foreign-born workers in OECD countries now
amount to approximately 14% of national employees, compared to 9% in 2005.
Correspondingly in the United States, this population has increased to 18% from
16%, and in Australia, an increase of 30% from 26%. It is further illustrated in the
report that the ICT sector is one of the largest sectors for employing highly skilled
expatriates (50% the USA and 53% OECD countries), followed by the hospitality
sector (27%). For instance, in the United States, the percentage of recent migrant
expatriates working in this sector accounted for a total of 7% in 2018, from only 2%
in 2005. Similarly, in European countries, there are almost 4% of expatriates
working in the ICT sector.
Working abroad requires an adjustment to the host country. Expatriates experi-
ence a transition period where they prepare to leave their home country and then
arrive, adapt, and work in the host country (Sussman 2011). This transition includes
several emotionally demanding challenges (Haslberger et al. 2013), especially when
significant cultural differences exist between the home and host countries. A recent
review of MNC expatriate employees revealed that 83% reported experiencing
psychological stress due to the cultural gap between their home and host countries,
primarily caused by the new environment, family routine changes, and daily inter-
actions with society (Chen 2019). MNC expatriate workers also commonly experi-
ence occupational stress due to heavy workloads, long working hours, working
across multi-geographical locations, and pressure from their managers and clients
(Upadhya and Vasavi 2006).
One of the costliest elements of expatriate management is expatriate failure,
commonly experienced in terms of inadequate job performance, adjustment prob-
lems, and an early return to the home country (Sterle et al. 2018). When expatriates
do not adjust well to their host country, they may experience high levels of psycho-
logical distress, resulting in burnout, social withdrawal, poor work performance, low
job satisfaction, and turnover (Harari et al. 2018; Sterle et al. 2018). Expatriate
failure estimates are as high as 40%, and these failures cost MNCs an average of
US$ 2 billion a year (Burgess 2016). Expatriate failures are primarily attributed to
inadequate assessments of expatriate’s adaptability skills, with an average of 20% of
830 S. Gai et al.

expatriates experiencing notable difficulties in adjusting to the new host country

(Singh and Mahmud 2018).
It is, therefore, in the interests of multinational organizations to improve the long-
term success rate of expatriate employees. An emerging school of thought suggests a
direct approach in examining levels of psychological strain experienced by expatriate
employees and how this strain and other challenges impact the adjustment of these
expatriate workers within their new host environments (Davis et al. 2018; Platanitis
2017). Clearly, the need for continuous adaptation and transition support is funda-
mental to ensure the successful adjustment and retention of expatriate employees
(Podsiadlowski et al. 2013). Cross-cultural training (CCT) is one such method
designed to enhance expatriate workers’ successful adjustment and retention.
The cross-cultural training market is expected to grow by US$1.22 billion by
2024 (Maida 2020). This growth is primarily driven by the need to offer
improved expatriate adjustment experiences in order to retain staff (Arcari
2019; Javvadi 2016). However, given the continuing quantity and costs of
expatriate failures, this improved CCT support is clearly not successful (Schickel
2018). To enunciate the common deficiencies in cross-cultural adjustment and
training and the subsequent economic consequences for employers, a systematic
review of the pertinent issues related to expatriate worker adjustment is required.
The current study reviews the evidence concerning MNC expatriate worker
adjustment, the availability of cross-cultural training programs for these workers,
and the effectiveness of such programs. This review aims to highlight the training
advances required to ensure expatriate workers’ successful long-term employ-
ment, especially those employed within the MNC ICT sector.

Purpose of This Review

The current chapter has three aims. First, to assess the cross-cultural adjustment
(CCA) challenges that MNC ICT expatriate workers commonly experience. Second,
to assess the available forms of cross-cultural training and analyze its effectiveness in
terms of better expatriation success. Third, since methodological issues have long
been acknowledged in the literature, this review evaluates the evidence of empirical
research and theoretical trends and provides recommendations for advancing knowl-
edge in this field to improve and explain expatriation success.

Cross-Cultural Adjustment

Cross-cultural adjustment is defined as the process of adaptation to living and

working in a foreign culture (Okpara and Kabongo 2011). Adjustment is considered
successful if expatriates effectively navigate the demands of living and working in a
new host country. Nevertheless, given the multifaceted nature of adjustment, the
extant literature has examined antecedents of adjustment and its outcomes, from a
sociocultural perspective, such as length of assignments, age of expatriate, and prior
international experience. Most expatriate research, to date, excludes psychological
strain factors that influence adjustment (Doki et al. 2018).
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 831

Psychological Adjustment

Cross-cultural psychological adjustment is a psychological contact process empha-

sizing stress and mental well-being factors that impact cross-cultural adaptation for
expatriate workers while in their new host country (Haslberger et al. 2013). Psycho-
logical adjustment refers to the general emotional and affective state of well-being
and life satisfaction, focusing on an individual’s beliefs, perceptions, values, ideol-
ogies, and attitudes (Gebregergis et al. 2019). Psychological factors play an impor-
tant role in influencing adjustment during expatriation (Shin et al. 2003). Working
abroad is typically a difficult experience; adapting to heightened stress contributes to
the development of mental health disorders among MNC expatriate workers (Doki
et al. 2018; Valk 2003). For example, Truman et al. (2011) reported that expatriate
workers experienced a 50% higher risk for mental health problems, such as inter-
nalizing problems (stress, suicide, anxiety, loneliness, and depression), externalizing
problems (attention deficit, hyperactivity, conduct and impulse control), and sub-
stance misuse disorders, compared to native workers. Expatriate workers may also
experience challenges with cognition such as difficulties with understanding rela-
tionships, misunderstandings caused by cultural differences, frustration, insomnia,
fear of isolation, the uncertainty of the future, concerns over health and security, and
decreased well-being (Chen 2019; Doki et al. 2018; Gai et al. 2011; Vijayakumar
and Cunningham 2019).
Ward and colleagues (2001) reported that successful cross-cultural adjustment is
the culmination of enhanced emotional resilience, effective cognitive restructuring,
and the display of appropriate behavioral and social skills. Thus, achieving a holistic
approach that features learning and exhibiting new behaviors and cognitive changes
in the host culture is crucial for a successful adjustment (Zhang 2013). Therefore, it
is necessary to clearly understand the psychological adjustment that expatriate
workers experience within their new host country (Sussman 2011). The current
review investigates evidence of psychological adjustment within MNCs. Informed
by this work, our first research question therefore is:

Research Question 1: How often is psychological adjustment assessed within the

cross-cultural literature for MNC expatriates?

Cross-Cultural Training (CCT)

Evidence of CCT Effectiveness

CCT aims to improve an individual’s intercultural learning skills by developing the

cognitive, affective, and behavioral competencies necessary for successful interac-
tions across dissimilar cultures (Ko and Li Yang 2011). Most CCT programs
primarily provide advanced cultural information such as social and behavioral
etiquette, advice on housing, shopping, and medical care; courses on residential
briefing (housing, school); and environmental briefing (climate, geography) via
pre-departure training. The majority of current CCT programs rarely focus on
832 S. Gai et al.

helping MNC expatriate employees develop their coping strategies or consider the
expatriate employees’ challenging situations when residing in the host country
(Persson and Segerud 2017).
Evidence indicates that while cross-cultural training commonly has a positive
effect on adjustment dimensions, CCT (especially pre-departure training) is often
perceived as problematic, particularly because of the conflicting results regarding the
tangible benefits of this training for the expatriate workers (Abdullah and Jin 2015;
Mnengisa 2017). Most pre-departure CCT programs are aimed at generic cultural
changes and have standard structures suitable for all expatriates, including standard
goals such as establishing familiarity with the host country, language training, and
general etiquette; living standards; and basic cultural norms (Pruetipibultham 2012).
As a result, most existing CCT for MNC expatriate workers is unsuccessful in
reducing expatriate failure costs, and the long-term expatriation benefit is intermittent.
There are several reasons for current CCT failure that exhibits minimal effective-
ness. First, the short CCT programs; 1 day of training does not enable expatriates to
fully understand the changes they will likely experience upon arrival. Second,
expatriate management is currently adopted as a one-size-fits-all function, when a
more tailored, situation-specific approach would be more effective. Third, the
simplistic implementation of CCT is problematic and commonly includes the lack
of effective designs, a wide range of included models, different types of training, and
the complexity of the subject (Joshua-Gojer 2012). For training programs to be
effective, they need to consider whom an intervention works, why, how, and what
circumstances it is crucial (Biggs and Brough 2015). Continuous cultural adaption
requires expatriates to develop new skills. Recent research is advocating CCT to be
integrated with the individual’s psychological needs while in their host country, that
is, the receipt of CCT training post-arrival (Chen and Chang 2015). Informed by this
research, our second research question, therefore, is:

Research Question 2. What types of cross-cultural training programs are available,

and how effective are they in MNCs?

The challenges of developing effective CCT programs have attracted recent

scholarly attention, highlighting the need for tailored programs to better meet
MNC expatriates’ adjustment needs within their host environment (Robert and
Goemans 2014; Tahir and Ertek 2018). For these training programs to be effective,
they require a firm grounding in both theory and empirical evidence (Brough and
Hawkes 2019). The extent to which the CCT adjustment programs reported in the
literature adopt this evidence-based foundation is currently not clear.
Theoretical Perspectives. Theoretical development is important for all applied
research fields; however, within the cross-cultural literature, clear theoretical expla-
nations of expatriate adjustment are scarce (Davis et al. 2018). Existing reviews
indicate CCT programs are rarely informative, primarily because the development
and design of these programs are not firmly associated with theory (Lenartowicz
et al. 2014). Recent observations noted that the inadequate use of theoretical
explanations contributes to the difficulty in measuring improvements in expatriate
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 833

adjustment (Takeuchi and Wang 2019). The common theoretical models cited within
the MNC’s cross-cultural literature, including Black et al.’s theory (Cheema 2012),
social learning theory (O’Sullivan et al. 2002), and the theory of cultural shock
(Wurtz 2014), are predominately approached from a sociocultural aspect. In sum, the
increasing dynamic of the adjustment paradigm now requires a more comprehensive
framework to provide a clear theoretical explanation of long-term expatriate adjust-
ment. This review’s final research question, therefore, is:

Research Question 3: Which theories are commonly utilized to best explain cross-
cultural adjustment and training within the MNC cross-cultural literature?

Method

Design

This systematic review adopts the 15-step framework devised by Pickering and
Byrne (2014) and the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) statement (Moher et al. 2009). The process included
focusing on research questions, explicating search, selecting protocols, and
specifying inclusion and exclusion criteria. Inclusion criteria included empirical,
original quantitative research, qualitative/mixed method, thus facilitating the
reproducible and replicable design and accommodating diverse combinations of
heterogeneous variables (Maxwell et al. 2020). Articles within this review were
searched and categorized through a structured search process using relevant
keywords. The identified literature was examined against a series of inclusion
standards that represented the current research topic (Pickering and Byrne 2014).
Only studies that informed psychological adjustment issues and/or evaluated the
effectiveness and impact of pre-post cross-cultural training were considered for
this review. Included studies were those with MNC expatriate workers (not
student samples) as research participants. Meta-analyses and theoretical or con-
ceptual papers were excluded as part of this review (Chen and Gardiner 2019; Sit
et al. 2017).

Search Strategies

Keyword searches across four electronic literature databases were conducted in June
2020: ProQuest (yielding 7166 returned items, of which 6591 were extracted); Scopus
(yielding 2772 returned items, of which 2074 were extracted); PsycINFO (yielding
1294 returned items, of which 103 were extracted); and Web of Science (yielding
179 returned items, of which 27 were extracted). The search terms (Table 1) were
consistent across all databases. In addition, the results were restricted to academic
empirical articles published on or before June 30, 2020. Table 1 summarizes the search
terms and inclusion/exclusion criteria employed by the current review.
834 S. Gai et al.

Table 1 Inclusion-exclusion criteria and search terms

Inclusion Exclusion Search terms
Psychological Literature reviews, meta- Expatriate employees* OR “working
adjustment analyses, theoretical or abroad” OR “IT employee*” OR
Cross-cultural conceptual papers “highly skilled IT worker*” OR
adjustment Student population articles “skilled technology employee*” OR
Effectiveness and “skilled visa*” AND acculturation*
impact of cross-cultural OR adjust* OR stress* OR well-being
training (pre-post) OR “wellbeing” AND intervention*
OR “stress management*” OR
“expatriate employees management*”
OR “cross-cultural training*” OR
“intercultural training*”
Working expatriate Non-technology sectors
employees in
technology industry/
sectors
English language Non-English articles
empirical peer-reviewed
articles
Gray literature Studies published after
June 2020
Note. Wildcard “*” was used to assure that all the possible combinations of the lexeme of research
keywords were obtained. This was done keeping in mind the diverse nature of this research and to
ensure that all research terms and concepts were well covered. “IT”/“technology” sector is referred
as multinational corporations in the most review studies

Data Extraction

The screening process for identifying the eligible articles is summarized using the
modified PRISMA statement flow chart in Fig. 1. First, articles from each database
were merged in an EndNote reference library, and the stated extraction process was
followed. A total of 11,411 articles were identified, and duplicates were removed
(n ¼ 2614). Of the remaining 8797 articles, a total of 6292 (titles and keywords) and
2400 (abstract reading) articles were removed because they did not meet the
inclusion criteria. Second, a total of 105 articles were selected for a full review.
Third, 54 articles were excluded because they did not meet the review criteria after
the full-text screening, and 29 articles were further removed because they were only
conceptual or theoretical. Finally, a total of 22 relevant articles met all the eligibility
criteria for synthesis. The data were entered into an electronic database by the first
author (SG). Methodological rigor was achieved where all 22 articles were evaluated
by the third author (EG). The inter-rater reliability of 100% was established using
Cohen’s coefficient, indicating a strong agreement between the two coders.

Data Analysis

Research Question 1. For the first research question, codes were developed based
on the existing framework of the recognized categories of adjustment dimensions
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 835

Identification through

Web of Science
Identification
Databases

PsycINFO
ProQuest

Scopus
(n = 11411)

Records after duplicates removed

(n = 2614)
Screening

Records screened Records excluded

(n = 8797) Title/Keywords (n =
6292)
Abstracts (n = 2400)
Eligibility

Full-text articles assessed Full-text articles

for eligibility excluded
(n = 105) (n = 83)

Studies included (n = 22)

Included

quantitative synthesis (n = 17); qualitative synthesis

(n = 4); mixed method (n = 1)

Fig. 1 Modified PRISMA statement. (Note. Criteria for exclusion of literature and meta-analyses
of theoretical or conceptual papers, non-English articles, and studies published after June 2020)

(e.g., Black and Mendenhall 1991). The dimensions’ classification drew upon the
three-dimension model of CCA: general adjustment, work adjustment, and interac-
tive adjustment (Black and Mendenhall 1991). The analysis assessed evidence for
psychological adjustment in this MNC expatriate literature.
836 S. Gai et al.

Research Question 2. For the second research question, codes were developed to
identify the different types of training and the training effectiveness described within
the selected articles. Codes were also developed to identify the types of training
offered before arrival (pre-departure training) or in the host country (post-arrival
training). Additionally, evaluations of CCT programs’ effectiveness were catego-
rized via two codes: “validated via survey” and “validated via implementing.” The
“validated via survey” category represented articles that evaluated CCT effectiveness
by using survey methods and/or interviews with expatriate trainees. The “validated
via implementing” category included articles that administered a CCT program and
studied the program’s effectiveness. The impact of training methods as an influenc-
ing factor in determining the effectiveness of programs was also assessed.
Research Question 3. For the third question, codes were developed to identify
the theories cited in the reviewed articles. Specifically, literature that included at least
one theory that guided the research hypotheses and/or the training within a study was
coded as “theory-based.” Studies that alluded to theories within the introduction
and/or discussion sections but that did not directly inform the hypotheses and/or the
training were coded as “partially theory-based.” Articles that did not refer to any
theory were coded as “non-theoretical” (Burgess et al. 2020).

Results

Descriptive

A total of 22 empirical studies published between 1994 and 2020 were included in
the review. As shown in Fig. 2, one to two articles on this topic have been published
annually. Surprisingly, the data indicated that empirically based studies in this field
are relatively scarce, for example, no research was published in many years in this
period (specifically in years 1995–2000, 2004, 2007, 2010, and 2013).
Table 2 summarizes the demographic details and the research methods of the
included studies. Most studies adopted a quantitative research design (n ¼ 17; 77%),
four studies (18%) included a qualitative research design, and one study employed a
mixed method design (4.5%). Nineteen articles were published in peer-reviewed
journals, one article was a full conference paper, and two entries were postgraduate
dissertations. The data indicated that expatriate movement is higher from developed to
developing economies (n ¼ 11; 50%; e.g., USA to India), followed by developed to
developed economies (n ¼ 10; 45%; e.g., UK to USA). A smaller proportion of studies
represent expatriate employees moving from developing to developed economies
(n ¼ 3; 13%; e.g., India to Australia) and developing to developing economies
(n ¼ 3; 13%; e.g., India to Malaysia). Thus, the results clearly demonstrate a focus on
the Western (developed) expatriate perspectives (n ¼ 16; 72%) within this literature.
Participants described within the research studies were predominately male
(n ¼ 3267; 75%; female, n ¼ 766; 25%) and employed in the information technol-
ogy telecommunications, banking/financial services, and engineering sectors. Over
half (n ¼ 2298; 57%) of the respondents held undergraduate degrees, and approx-
imately 35% (n ¼ 1411) held a master’s degree.
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 837

Fig. 2 Frequency of publications between 1994 and 2020

Data Analyses

Research Question 1. The analysis revealed that 18 studies (81%) investigated general
adjustment, 16 studies (72%) investigated work adjustment only, and interaction adjust-
ment was reported in 15 studies (68%). Seven studies (31%) investigated psychological
adjustment as a single dimension. Psychological adjustment refers to a person’s subjec-
tive well-being and satisfaction within the new host country, whereas the sociocultural
adjustment refers to the individual’s ability to fit into the new culture (Selmer 2002).
Psychological adjustment is best interpreted with the stress and coping framework,
emphasizing the negative consequences of cross-cultural interactions that produce
mental health issues such as anxiety, depression, loneliness, and stress (Ersoy 2020;
Okpara and Kabongo 2011). Expatriation without psychological comfort within the new
culture makes it difficult for expatriates to develop appropriate skills to adjust (Wang and
Tran 2012). To summarize, although the literature suggests that adjustment to psycho-
logical challenges is central to successful adaptation, the specific psychological adjust-
ment process undertaken by expatriate workers is rarely assessed. How expatriates
experience psychological adjustment while living and working in the host country
remains an under-explored area.
Research Question 2. Table 3 presents evidence of how the reviewed studies
evaluated and measured the effectiveness of CCT on the adjustment dimensions. The
results revealed five studies (22%) which focused on pre-departure training aspects,
with two of these studies (9%) validating their effectiveness via a training program
and the remaining three studies (13%) validating their effectiveness with self-report
 838

Table 2 Demographic details of included studies

Articles Geographical mapping of Study Total average
# Author(s) Year expatriation N design Education expatriation experience
1 Caligiuri et al. 2001 A 73 Quantitative N/A 10.6 months
2 Shah and 2017 C 47 Qualitative N/A N/A
Barker
3 Reichard et al. 2014 A 219 Quantitative 82% undergraduate degree and N/A
18% master’s degree
4 Wang 2012 B, D 228 Quantitative N/A 12 months
5 Cheema 2012 A, B 15 Quantitative N/A 84 months
6 Puck et al. 2008 A, C 339 Mixed N/A 22 months
method
7 Okpara and 2011 B 226 Quantitative More than 50% master’s and PhD 24 months
Kabongo
8 Chien 2012 A 90 Quantitative N/A 12 months
9 Selmer 2010 B 651 Quantitative Undergraduate 42.4% and higher 60 months
36.97%
10 Hutchings 2003 B 22 Qualitative N/A N/A
11 Fish 2005 A 244 Quantitative N/A N/A
S. Gai et al.
 40

12 Brewster and 1994 A 251 Quantitative 53% had university degree N/A
Pickard
13 Waxin and 2005 B, D 224 Quantitative N/A 20 months
Panaccio
14 Okpara 2016 B 120 Quantitative 66% undergraduate degree, N/A
32% master’s
15 Selmer 2002 B 343 Quantitative N/A 48
16 Fish and 2008 B 244 Quantitative N/A N/A
Bhanugopan
17 Chen and 2018 A, C 191 Quantitative Undergraduate and higher N/A
Shaffer
18 Li-Yueh Lee 2006 D 197 Quantitative 97% were graduate or above 0–60 months
19 Abdullah and 2015 4 Qualitative 25% undergraduate and 156 months
Jin 75% master’s
20 Selmer 2001 B 95 Quantitative N/A 48 months
21 Wurtz 2014 A, B 206 Quantitative N/A N/A
22 O’Sullivan 2002 A 4 Qualitative N/A N/A
et al.
Note. MNCs ¼ broad representation of different sectors in the high-tech industry, comprising of information, insurance, media, banking/financial services
industry. Expatriation of participants from developed to developed countries ¼ A; developed to developing countries ¼ B; developing to developed ¼ C; and
developing to developing ¼ D. N/A indicates that the relevant information was not available
Psychological Adjustment and Post-arrival Cross-cultural Training for. . .
839
840 S. Gai et al.

Table 3 Theoretical approach, dimensions of adjustment with focus in CCT and method of
validity of training
Validity of
training
method –
Article Theory Type Dimensions of discussed/
# Key theories categorization of CCT adjustment demonstrated
1 Met-expectation Theory based PDT Cross-cultural Validated via
theory (Vroom adjustment – implementing
1964) three dimensions
2 Integration of Theory based PAT Work and Validated via
multiple interaction survey/
theoretical adjustment interview
perspectives method
3 Cross-cultural Theory based PDT Cross-cultural Validated via
PsyCap and adjustment – implementing
broaden-and- general and
build theory on psychological
positive emotions orientation
(Fredrickson
1998)
4 Cognitive Partial theory PDT Expatriate Validated via
adjustment based and employees survey
PAT adjustment – method
generic,
interactive, and
work and job
(psychological
orientation)
5 Social learning Partial theory PDT Emotional Validated via
(Bandura 1977), based and adjustment, survey
cultural shock PAT spousal method
(Oberg 1954), adjustment, work
adult learning, adjustment, and
sequential model interactive
theory (Knowles adjustment
1970)
6 Not indicated N/A PDT Cross-cultural Validated via
adjustment – survey
three dimensions method
7 International Theory based CCT Cross-cultural Validated via
adjustment method adjustment – survey
(Black et al. three dimensions method
1991) and teaching
method
(psychological
orientation)
8 Social learning Theory based CCT Cross-cultural Validated via
theory (Bandura method adjustment – survey
1977) three dimensions method
and teaching
methods
(continued)
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 841

Table 3 (continued)
Validity of
training
method –
Article Theory Type Dimensions of discussed/
# Key theories categorization of CCT adjustment demonstrated
9 Not indicated N/A PDT Cross-cultural N/A
and adjustment –
PAT three dimensions
10 Not indicated N/A PDT Cross-cultural Validated via
and adjustment – survey
PAT three dimensions method
11 International Partial theory PDT Psychological, N/A
adjustment based and sociocultural
(Black et al. PAT adjustment
1991) (psychological
orientation)
12 International Partial theory PDT Cross-cultural N/A
adjustment theory based adjustment –
(Black et al. three dimensions
1991)
13 Not indicated N/A CCT Cross-cultural N/A
method adjustment –
three dimensions
and teaching
methods
14 Intercultural Theory based CCT Cross-cultural Validated via
adjustment model method adjustment – survey/
(Parker and three dimensions interview
McEvoy 1993) and teaching method
International methods
adjustment
(Black et al.
1991)
15 The notion of Theory based CCT Psychological, Validated via
anticipatory sociocultural, and survey
adjustment anticipatory method
(international adjustment
adjustment
theory; Black
et al. (1991))
16 International Partial theory PDT Psychological, Validated via
adjustment theory based and sociocultural survey
(Black et al. PAT adjustment method
1991)
17 Stress model Theory based CCT Cross-cultural Validated via
(Lazarus and adjustment – survey
Folkman 1984). three dimensions method
Model of spouse
adjustment
(Shaffer and
Harrison 2001)
(continued)
842 S. Gai et al.

Table 3 (continued)
Validity of
training
method –
Article Theory Type Dimensions of discussed/
# Key theories categorization of CCT adjustment demonstrated
18 Contingency Partial theory CCT Cross-cultural Validated via
theory based adjustment – survey
three dimensions method
19 Not indicated N/A PDT Cross-cultural Validated via
adjustment – survey
three dimensions method
20 Not indicated N/A PDT Effectiveness of Validated via
cross-cultural survey
training method
21 Social learning Theory based PDT Effectiveness of Validated via
theory (Bandura and cross-cultural survey
1977) PAT training method
22 Integration of Partial theory PDT Effectiveness of Validated via
multiple based and cross-cultural survey
theoretical PAT training method
perspectives
Note. Table depicts only studies that presented theory based that guided the hypothesis and/or
interventions/training and partial theory did not inform the hypotheses and/or interventions.
N/A ¼ indicative of theory based CCT not applied in studies. Abbreviations: pre-departure training
(PDT); post-arrival training (PAT); cross-cultural training (CCT)

surveys. Nine studies (40%) evaluated the effectiveness of both pre-departure and
post-arrival training with a survey, for the three dimensions of adjustment
(i.e., general, work, and interaction adjustment), while five studies (22%) evaluated
the effectiveness of pre and post CCT for psychological adjustment.
Of these five studies, one study (4.5%) validated the effectiveness via
implementing the pre-departure training on the psychological dimension (Reichard
and Louw-Potgieter 2014) and reported that a generic one-size-fits-all strategy is not
scalable. Instead Reichard and Louw-Potgieter (2014) suggested the use of positive
psychological capital (PsyCap, referring to an individual’s positive psychological
state of development) within the cross-cultural context. Their results revealed statis-
tically significant increases in cultural intelligence (F(1, 70) ¼ 11.83, p < 0.001) and
positive emotions (F(1, 63) ¼ 38.24, p < 0.001) and a significant decrease in
ethnocentrism (F(1, 70) ¼ 16.64, p < 0.001), after PsyCap training. Four other
studies (18%) also validated the pre-departure and post-arrival training effectiveness
on the psychological dimension via the survey (Cheema 2012; Fish 2005; Fish and
Bhanugopan 2008; Selmer 2002).
Correlation analyses and statistical tests of significance for each of the quantita-
tive studies (n ¼ 17; 77%) revealed mixed findings, with some failing to find any
relationship and others finding positive as well as negative associations between
CCT programs and adjustment dimensions (e.g., Abdullah and Jin 2015; Puck et al.
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 843

Table 4 Summary of contents covered and duration of training exhibited in the inclusion studies
Article Type of
# Content covered training Duration
1 General aspects of the target Pre-departure 1 day
culture were also covered: training
housing, shopping, medical
facilities, recreational/
entertainment facilities, social
customs/etiquette, culture shock,
and dominant values in the host
country. 14 dimensions –
business issues: business
protocol, work ethic,
management style, how to
motivate personnel, how to give
feedback, and problem-solving
3 Cross-cultural PsyCap training – Pre-departure 2 hours per session
four phases to increase efficacy, training
hope, optimism, and resilience (classroom)
targeted exercises focused on
creating self-awareness,
reframing past events, building
broad cross-cultural interaction
skills, and identifying multiple
strategies for success in cross-
cultural interactions
4 General CCT, language training Pre-departure Average pre-departure training
training, post- one day ¼ 49.1%. Average
arrival training post-arrival training one week
to one month ¼ 46.5%
5 CCT – (a) cultural shock and Pre-departure N/A
transition; (b) professional and training and
working life; (c) cultural post-departure
awareness and understanding; training
(d) language and
communication; (e) general
cultural training; (f) living in
China
12 Residential briefing courses, Pre-departure 1 week intensive
environmental briefing, and
cultural orientation and
information giving

2008). For instance, Puck et al. (2008) found that neither participating in CCT nor
the length of pre-departure training was predictive of work and interaction adjust-
ment. However, the authors reported a small positive effect between training com-
prehensiveness and general adjustment. One study found that post-arrival training
had the most positive influence on expatriate workers’ adjustment and performance,
compared to pre-departure training (Wang and Tran 2012). The study also demon-
strated a strong positive correlation between the work adjustment dimension and
844 S. Gai et al.

Table 5 Summary of cross-cultural training method results

Article
# Training methods Results
7 General conventional training, specific Revealed specific experimental CCT was
conventional training, general the most significant predictor of
experimental training, and specific expatriate adjustment (R2 ¼ 0.53;
experimental training p < 001). Specific experimental training
and psychological adjustment (r ¼ 0.45,
p < 0.05)
8 Symbolic learning and participatory Participatory learning has a better impact
learning, experiential learning on adjustment dimensions, especially
work adjustment. Symbolic learning
(mean ¼ 2.77; SD ¼ 0.62). Participatory
learning (mean ¼ 2.84; SD ¼ 0.59)
13 Pre-post conventional and experimental Specific experimental training methods
(general and in host) – training methods are most effective on all three dimensions
conventional (general and in host), – work adjustment (F ¼ 6.93, p < 0.01),
experimental (general and in host) interactive adjustment (F test ¼ 15:68),
and general adjustment (F ¼ 8:57,
p < 0.01) – especially if delivered in host
country
18 Experiential learning, perceived need for Perceived need for expatriate employees
training training had significant impact on the
effectiveness of training (R2 ¼ 0.548,
p < 0.000). Experiential training method
has significant influence on effectiveness
of training and improves the three
adjustment dimensions (R2 ¼ 0.654,
p < 0.000)
Note. All four studies established strong positive correlation between specific experimental training
methods and expatriate employees’ adjustment dimensions

post-arrival training and predicted that post-arrival training is highly beneficial for
effective expatriate adjustment. Four studies (18%) used qualitative semi-structured
interviews to measure training aspects and to assess the need for post-arrival CCT.
Thus, understanding the potential adjustment dimensions is central to establishing
what specific type of CCT is most likely to help expatriates best adjust to their new
cultural settings.
The “method of training” was also identified as an important component for
promoting successful adjustment. Tables 4 and 5 summarize the CCT contents,
duration of the training, and training method within the reviewed studies.
Two-thirds (n ¼ 17; 77%) of the reviewed studies mentioned the use of didactic
sessions in their CCT. The sessions mostly comprised of lecture-driven group
discussions on predetermined cultural issues such as language, etiquette, understand-
ing housing procedures, shopping, medical care, and recreational facilities. How-
ever, there was minimal indication that any evidence-based individual or group
activities, role plays, cognitive restructuring, or rehearsals of behavioral strategies
were included in these group discussions. The most common training content
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 845

covered during CCT was information/briefing sessions (a one-way communication

of hard facts) of culture awareness, culture shock and dominant values of the host
country, cultural orientation, cultural awareness, business protocol, language train-
ing, job-related training, and management training (Caligiuri et al. 2001; Lee and
Croker 2006; Selmer 2010). Six studies (27%) reported the duration/length of the
training duration from one hour to one week, with the average duration of CCT being
one day.
Four studies (18%) explicitly concentrated on training methods and put forward a
comprehensive training program that included specific experimental approaches.
The studies demonstrated that tailored CCT is more beneficial in comparison with
generic traditional CCT (Okpara and Kabongo 2011; Waxin and Panaccio 2005). For
instance, Okpara and Kabongo (2011) noted that expatriate managers experiencing
difficulty with psychological adjustment due to life changes, stress, and depression
did not benefit from the general conventional CCT to help them cope within the host
country. Lee and Croker (2006) highlighted that identifying a perceived need for
training has a significant impact on the effectiveness of the training. Further, some
studies reported that an experiential training approach had positive benefits for
expatriates while adapting to the new culture (Chien 2012; Lee and Croker 2006;
Waxin and Panaccio 2005). Chien (2012) asserted that participatory learning
methods such as role play, simulation, and real-time experiences were significantly
higher in quality as compared to symbolic learning methods such as factual training
via verbal-and-written language and observation. Overall, the results demonstrated
that the experiential training method is a significant predictor of successful
adjustment.
Research Question 3. Table 3 also summarizes the theoretical approaches
represented in this dataset. Only nine studies (40%) were classified as being
theory-based. Seven studies (31%) were partially theory-based, because the theory
was only included in the introduction or discussion sections and did not directly
inform the method or results sections. The most frequently cited theories by ten of
the reviewed articles (45%) were Black et al.’s (1991) U-shaped theory and social
learning theory (Wurtz 2014). Cross-cultural theories, including adult learning
(Cheema 2012), sequential model theory (Okpara and Kabongo 2011), and
intercultural adjustment (Shah and Barker 2017), were also cited, but to a lesser
extent by two of the studies (9%). Six studies (27%) were non-theoretical and did not
mention any theoretical perspectives at all. Four studies (18%) described theory-
based training methodologies. Two studies (9%) adopted a partial theory-based
approach to developing pre-departure and/or post-arrival training programs from a
psychological adjustment perspective.

Discussion

The cross-cultural literature identifies values, beliefs, and behavioral perspectives as

major concerns for expatriate employees (Kuo 2012). However, most empirical
studies to date examine the adjustment of an MNC’s expatriate employee from a
846 S. Gai et al.

sociocultural perspective: the impact of geographical distance, length of the assign-

ment, and the employee’s age and family circumstances on adjustment (Polón 2017).
Only a small group of articles in this review investigated the significance of viewing
psychological adjustment as a single dimension and reported that the specific aspects
of psychological strain experienced by MNC expatriate workers experience remain
unclear (Chen 2019). Andersen (2019) revealed that psychological well-being is a
term rarely employed within this field and reported that only one-third of studies
measured psychological well-being and/or psychological strain.
Both Doki et al. (2018) and Haslberger et al. (2013) reported the importance
of identifying psychological adjustment strategies for MNC expatriate
employees, emphasizing the importance of assessing the specific dimensions of
affect, behavioral, and cognitive psychological adjustment during expatriation.
The current review clarifies the need to comprehend these experiences better to
implement successful adjustment strategies within the host countries for expatri-
ate workers. Overall, the extant literature demonstrates that psychological adjust-
ment, together with sociocultural adjustment, is a crucial aspect of cross-cultural
research and is worthy of future attention; this is the first recommendation this
review offers.

CCT Effectiveness

According to Haslberger et al. (2013), the actual adjustment in the adaptation process
is a persistent phenomenon and starts upon arrival in the host country. For training to
support the adjustment, it must provide competencies designed to understand and
manage the conflicting situations arising from daily challenges (Joshua-Gojer 2012).
The research assessed by this review highlighted that the mere existence of CCT is
not enough. Given the poor history of existing CCT (especially pre-departure
training) effectiveness, many MNCs do not provide CCT for their employees,
which is commonly considered unnecessary (Cheema 2012; Shen 2005). For CCT
programs to be beneficial, they are required to assist employees to develop the
necessary skills to adjust successfully, not only before the transfer (pre-departure
training), but this assistance should be continuously integrated based on experiential
interactions within a learning environment upon arrival (Abdullah and Jin 2015;
Joshua-Gojer 2012).
Mendenhall and Stahl (2000) advocated three new areas for effective CCT pro-
grams: host country real-time training, global mindset training (skills for resolving
specific problems related to cross-cultural challenges), and internet-based training.
Therefore, it is vital to develop specific, experimental cross-cultural training for
expatriate workers in real-time while they adjust to their new host country. This type
of training is anticipated to reduce the negative effects on the psychological strain
that expatriates may experience within their new culture (Okpara and Kabongo
2011). This approach will also best assist expatriate employees in adjusting their
cognitive process (i.e., “mental maps”) and adapting their behavior during expatri-
ation adjustment phases (Wang and Tran 2012).
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 847

Only a handful of researchers have examined the effects of post-arrival training,

clearly suggesting a more rigorous form of training strategies is required, specifically
targeting expatriate workers’ psychological issues while living in their new host
country (Takeuchi and Wang 2019). While post-arrival cross-cultural programs are
relatively rare, they have exhibited significant positive effects on adjustment by
directly facilitating the change process upon arrival. It is reported that post-arrival
CCT programs also counteract the commonly experienced “surprise upon arrival”
situations (Fish 2005, p. 227).
Importantly, Kuo (2012) emphasized both the importance of the timing of the
CCT and an employee’s motivation to learn as key aspects for a successful adjust-
ment in the host country. Reichard and Louw-Potgieter (2014) reported that when
these two aspects coincide with expatriates’ psychological strain experience in the
host country, a training program is more likely to be effective. Thus, educating
expatriate workers about psychological resources results in higher adjustment effec-
tiveness (e.g., increase in cultural intelligence, positive emotions, and decrease in
ethnocentrism). Hanzmann (2016) also claimed that CCT programs would be
beneficial if the learning material is adjusted to the individual’s actual psychological
state and experience.
Other training components, including the specific training content and the teach-
ing methods employed to deliver the program, also appear to influence these pro-
grams’ effectiveness (Chien 2012). In sum, the results of the current review highlight
that post-arrival CCT assists in enhancing expatriate adjustment dimensions within
the host country as compared to pre-departure training. Therefore, the second
recommendation offered by this review is for a greater focus on the development
and administration of effective post-arrival CCT, in order to increase the long-term
success of expatriates’ adjustment (Al Mahrouqi 2018).
Subsequently, this review also strongly reaffirms that the lack of empirical cross-
cultural studies undermines progress in this field, potentially masking the true
benefits of CCT on adjustment (Joshua-Gojer 2012). The data produced by this
review also demonstrate that the development and evaluation of training programs
are rarely theoretically based (Cheema 2012). Therefore, researchers must identify
the theoretical perspectives that drive the training programs they develop, as this will
comprehensively explain how CCT facilitates an expatriate’s success on an overseas
assignment. Therefore, our third and final recommendation based on this review’s
findings is that subsequent cross-cultural research includes accepted theoretical
perspectives to inform the design, assessment, and evaluation of their CCT pro-
grams. In sum, this evidence echoes recent calls to increase the theoretical rigor and
research precision of studies investigating the adjustment and training of expatriate
workers (Davis et al. 2018; Sit et al. 2017).
Based on the relevant theoretical dimensions reviewed, this paper summarizes
that the study of expatriate adjustment and training emanated from two main
theoretical foundations, that is, culture learning (learn the sociocultural knowledge
and cultural practices) and social identification models (inter-group perceptions and
relations) (Zhou et al. 2008). However, for expatriates to be effective in their host
country, they need to develop competences to help reduce stress and facilitate coping
848 S. Gai et al.

(Sussman 2011; Zhou et al. 2008). This review identified few studies with stress and
coping theoretical frameworks (understanding the psychological transitions with
outcome variables variants of psychological well-being), for example, Lazarus and
Folkman’s stress model and broaden-and-build theory on positive emotions (Chen
and Shaffer 2018; Reichard and Louw-Potgieter 2014). Moreover, recent research
indicates that CCT programs with both behavioral and affective components along
with cognitive dimensions were found to be more effective than cognitive (didactic)-
alone programs (Sit et al. 2017), thus suggesting there is increasing need to orient
extending research within the context of a comprehensive psychological theory of
cross-cultural adjustment and training.

Research Limitations

Because of the focused nature of this review, there were several research limitations.
Only articles from an MNC ICT sector perspective were included. The review only
considered peer-reviewed empirical articles published in the English language,
potentially limiting the scope of evidence evaluated. Due to problems with the
search terms execution, the small number of included studies limits the generaliz-
ability of the findings to other occupations and other expatriate populations. In
addition, the review focused only on quantitative outcomes represented in the
articles, not emphasizing any qualitative data. There is scope for future research to
focus on qualitative data to explain CCT programs effectiveness, especially when a
majority of the programs are non-theory based.

Conclusion

This review adds to the expatriate employees’ existing literature, especially within
the host country perspectives. The MNC ICT sector, with its remarkable growth
projections is among the top recruiter of the expatriate population globally. The fact
that international assignments are costly and that the main reason for expatriate
failures is adjustment-related issues, this review is clearly relevant and timely. An
expatriate employee’s success is their willingness to embark on new experiences,
learn, and successfully adjust to working and living in a foreign culture. Usually,
expatriation is a stressful process, and global MNCs must be aware of the challenges
and recognize the importance of expatriate employee well-being. It is necessary to
better prepare expatriates to adapt to the changing cross-cultural environment by
improving their social and psychological well-being. The extant literature demon-
strates that due to a lack of empirical evidence, there is no clear picture of CCT
concerning the adoption of successful research designs, content, effectiveness, and
implementation perspectives (Joshua-Gojer 2012). As a result, this field requires
further advancement in the synthesis of the literature and applications for future
research.
40 Psychological Adjustment and Post-arrival Cross-cultural Training for. . . 849

Research in the post-arrival, cross-cultural adjustment and training field is an

emerging area of interest. This review is the first to present the interrelationships
between cross-cultural psychological adjustment and available CCT for the MNC
technology sector to assess expatriate employees’ success within their host country.
In summary, the results of this review inform broader debates concerning the
inclusion of psychological adjustment components (He et al. 2019) and the appro-
priateness and limitations of current CCT (Hånberg and Österdahl 2009). This
review recognizes that it is time to clarify the limitations of pre-departure training
as being a useful standard by which to ensure expatriate success. Instead, this review
demonstrates that a conceptual shift within CCT research is urgently required,
suggesting that continuous CCT programs in the host country are vital for expatriate
employees’ successful adjustment.

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The Decline of Trade Unions and Worker
Representation 41
Implications for Employee Health and Well-Being

Elsa Underhill

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 856
Declining Union Membership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 857
How Unions Protect Worker Health and Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 858
How Effective Are WHS Representatives? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 859
Does Direct Employee Participation Offer an Alternative to WHS Representatives? . . . . . . . . . 861
Does Employee Participation in Nonunion Workplaces Improve Worker Well-Being? . . . . . . . 863
Discussion and Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 866
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 869

Abstract
This chapter considers the implications of changes to trade unions and indepen-
dent worker representation for employee health and well-being. It shows how
employee involvement, through worker health and safety (WHS) representatives
supported by trade unions, has been widely recognized as a critical means of
preventing workplace injuries and improving workplace health and well-being.
However, as union membership declines, can workers continue to be effectively
involved in decisions concerning their workplace health and well-being? Do
other forms of employee participation offer sufficient involvement in workplace
decisions to protect workers from adverse health and safety outcomes? This
chapter reviews the processes which strengthen the impact of WHS representa-
tives on worker health and well-being and assesses whether alternative employee
participation processes can offer comparable levels of protection to workers. The
chapter concludes that direct employee participation is insufficient to protect
worker well-being, and a stronger foundation of collective representation is

E. Underhill (*)
Department of Management, Deakin University, Melbourne, VIC, Australia
e-mail: [email protected]

© Springer Nature Switzerland AG 2022 855

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8_40
856 E. Underhill

necessary to overcome current weaknesses in employee voice through shared

decision-making in workplace health and safety.

Keywords
Trade unions · Occupational health and safety · Worker representation ·
Employee participation · Worker well-being

Introduction

The focus of this chapter is upon how the decline of trade unions and independent
worker representation affects employee health and well-being. Employee involve-
ment, through independent work, health, and safety (WHS) representatives
supported by trade unions, is widely recognized as a critical means of preventing
workplace injuries and improving worker health and well-being. As union member-
ship declines, how can workers continue to be involved in decisions concerning their
workplace health and well-being? Do other forms of employee participation offer
sufficient involvement in workplace decisions to protect workers from adverse
health and safety outcomes? In this chapter, we look at the occupational health and
safety (OHS) and worker well-being implications of these changes. This chapter
reviews the multiple processes which strengthen the impact of WHS representation
on worker health and well-being and assesses whether alternative employee partic-
ipation processes can offer comparable levels of protection to workers.
This chapter begins with an account of the factors that have contributed to
declining union membership in most developed economies. The next section
explains how unions contribute to improvements in worker health and well-being.
Unions do not always act alone. In many workplaces, both union and nonunionized,
worker health and safety representatives can also deal with health and well-being
issues. The following section considers the importance of WHS representatives in
unionized workplaces and explains the role of unions in supporting and improving
the effectiveness of WHS representatives. The declining role of unions, and union
power, has adverse implications for the sustainability of independent WHS worker
representation and well-being. Do alternative forms of employee participation offer
comparable benefits? Fourth section considers how direct employee participation
has evolved as an alternative to union representation, and emerging problems in
direct participation. While there is only limited research on the effects of employee
participation on worker well-being in nonunion workplaces, the next section con-
siders those findings, and in particular the failure to address psychosocial hazards.
This chapter concludes that factors that have contributed to the decline of unions are
also barriers to effective worker representation, leaving a gap that is not filled by
direct employee participation. Given the likely prognosis that weakened employee
voice will lead to an upsurge in managerial prerogative and declining health and
well-being outcomes, there is a need to reconsider how public policy can rectify the
growing imbalance in management and worker power.
41 The Decline of Trade Unions and Worker Representation 857

Declining Union Membership

Trade union membership in most advanced industrial economies has declined

steadily since the 1980s (Visser 2019). In Australia, around 2.5 million workers
belonged to unions in 1976, compared to around 1.5 million in 2018, or 14% of the
workforce. While a small number of industries such as health, education, and public
administration have maintained relatively high levels of union membership (30–
40%), growth industries such as hospitality and retail have fallen to negligible levels
(Parliamentary Library 2018). This international trend toward falling union mem-
bership is of concern to policy makers charged with promoting worker equality and
rights, such as the International Labour Organization [ILO] (the labor agency of the
United Nations), and the subject of much international research. Studies have
repeatedly identified common factors which have contributed to the loss of union
membership, and power, over the past 40 years.
First is structural change in the economy, with employment shifting away from
traditionally unionized industries (such as manufacturing) toward service work (such
as hospitality and retail) (Peetz 1998; Mundlak 2020). Globalization has contributed
to this shift, with multinationals turning to low-cost production in developing
countries which in turn undermine conditions and institutions in developed econo-
mies through the threat of offshoring. This has undermined traditional union strong-
holds such as manufacturing, and also emerging industries of the 1990s such as call
centers and software development (Gumbrell-McCormick and Hyman 2019: 100).
Second is change to organizational structures as vertical integration gives way to
horizontal networks and supply chains (Mundlak 2020). Larger organizations,
formerly the bedrock of comprehensive union collective agreements, have increas-
ingly become networks of outsourced suppliers, competing on low margins and
unwilling to engage with unions. These networks of suppliers pose enormous
organizing challenges for unions that seek to access workers dispersed across a
large number of employers and workplaces. Third, and related to the second, is the
growth of precarious forms of employment, such as casual, zero-hours and pseudo
self-employment/sham contractors. Around one-quarter of the Australian workforce
are now employed as casuals, and another 10% on an independent contracting basis.
Working more irregular hours, and less engaged with a single workplace, these
workers are highly vulnerable to dismissal should they join a union. Also the benefits
which unions negotiate for permanent employees, such as fair grievance processes or
consultation on workplace change, are of negligible value to precarious workers
without secure employment (Stanford 2019).
Fourth, governments have privatized their services extensively since the late
1980s, shifting workers from stable unionized public sector positions to more
fragmented organizations that are dependent upon tendering processes based pri-
marily upon cost containment (Mundlak 2020). Tenured public sector employment
has been reduced, displaced by casual temporary agency workers excluded from
restrictive public sector headcounts. Fifth, from the 1980s, neoliberalist government
policies in most western economies promoted regulatory reforms that reduced union
power through a range of wide-reaching measures including restrictions on
858 E. Underhill

compulsory unionism and industrial action, limiting union rights to enter work-
places, and narrowing the scope of collective bargaining (Isaac 2018). Unions have
struggled to protect past gains, and lacked resources to extend union membership.
Finally, individualist and anticollectivist policies promoted by governments are
reflected in shifting social values which promote individual over collective rights,
and reinforce the belief that unions are a relic of the past. They are no longer
regarded as relevant to a mobile, educated workforce. Young activists, formerly
the future of unions, are drawn instead toward identity politics, and social/NGO
movements as a medium for change, rather than to work-based institutions such as
unions (Mundlak 2020).
These factors have all contributed to a substantial decline in union presence and
power. Accompanying the decline has been a rise in concern about growing eco-
nomic inequality which is one outcome of the changes discussed above. The ILO, for
example, has stated “Among policy-makers, ILO constituents and the general public
alike, there is a growing consensus that the current trend of rising inequality is not
only undesirable, but also unsustainable” (ILO 2020). In this chapter, we focus upon
the implications of union decline for worker health and well-being and, in particular,
the role of WHS representation and employee participation in health and safety.

How Unions Protect Worker Health and Well-Being

Research findings are clear that unionism has a positive relationship with good
health and well-being outcomes. Trade unions provide a mechanism for collective
voice at the workplace. They can offer formal representation at the highest level such
as through representation on company boards and work councils, but in most
developed economies, they offer collective voice through elected representatives,
such as shop stewards or job delegates. Collective representation offers a range of
benefits to workers. These include the “union wage effect” whereby employees in
unionized workplaces earn more than their counterparts in nonunionized work-
places; better terms and conditions of employment; and protection for employees
that are otherwise reluctant to raise concerns with management for fear of discrim-
ination or dismissal (Ollé-Espluga et al. 2019). Turning to worker health and well-
being, unions have historically played a critical role in the development of occupa-
tional health and safety [OHS] protection (both legislative and workplace based) and
in workers’ compensation. As Quinlan et al. (2010: 470) summarize: “unions help
workers raise OHS issues, provide logistical support for health and safety represen-
tatives (such as training) and have increasingly used collective bargaining and
industrial tribunals to address OHS issues.” Early studies of the impact of unionism
upon worker health and well-being focused upon injury outcomes, with findings
consistently demonstrating unionized workplaces had lower injury rates compared to
nonunion workplaces (Walters and Frick 2000).
With the growing awareness of psychosocial risks, studies turned to evaluating
the impact of unionism on employee well-being, especially during periods of
organizational change when occupational stress and anxiety is heightened.
41 The Decline of Trade Unions and Worker Representation 859

Consistent with the injury-based studies (measuring OHS outcomes based upon
injury rates), these studies also found union presence has a direct and positive
bearing on employee well-being (e.g., Godard 2010; Bryson et al. 2013; Douglas
et al. 2017; Ogbonnaya et al. 2019). Bryson et al. (2013), for example, explained
how unions can mitigate the negative effects of organizational change through
negotiating changes that better accommodate workers’ needs; through consultations
that bring a sense of procedural fairness; negotiating job security commitments that
facilitate the delivery of organizational change; providing social support to reduce
the impact of stress and work strain on those undergoing organizational change; and
achieving wage increases that deliver worker acceptance of change.
However, as we have observed, union membership has been declining – a fact
which must call into question how widespread the positive effects of unionism on
employee health and well-being remain. In the following section, we examine how
WHS representatives can function in that environment.

How Effective Are WHS Representatives?

In most western economies, WHS representatives are supported by legislative rights,

such as the right of representatives to information about workplace risks, the right to
stop work when those risks pose a threat to workers’ health and well-being, the right
to resources including time off from normal duties to perform OHS duties, and the
right to be consulted over OHS risks. These rights, enshrined in law, are intended in
part to prevent organizations from discriminating against OHS representatives
whose actions can prioritize workers’ well-being over production. However, many
of these rights can be circumscribed in practice when consultation, rather than
negotiation, is the minimum prescribed standard and there is no union presence at
the workplace to demand management negotiate over OHS. Ultimately, management
retains the right to decide how OHS is managed, subject only to complying with their
obligations under the relevant OHS laws, and directions from OHS inspectors
(James 2009). Hence, better outcomes linked to WHS representatives are interrelated
with the support those representatives receive from unions, and their ability to draw
upon industrial power to counter managerial power.
In unionized workplaces, WHS representatives have been typically well trained,
usually through comprehensive union-supplied training based upon labor education
principles. Training means they are better informed to participate effectively in OHS
decisions. They also have external expertise to draw upon. The expertise of union
health and safety officials, as well as union-based networks of WHS representatives,
can be quickly drawn upon when issues arise beyond their scope of knowledge
(Loudoun and Walters 2009). Thus, they are not wholly reliant upon information
supplied by their employer. This positions them to inform and mobilize coworkers
and, when necessary, challenge management decisions which may prioritize other
organizational objectives over health and well-being (Walters and Frick 2000;
Walters et al. 2005; Hall et al. 2006; Walters and Nichols 2009; Quinlan et al.
2010; Walters and Wadsworth 2020). Together these factors pressure managers to
860 E. Underhill

increase the importance they place on OHS, improve the way they manage it, and
develop a long-term commitment to maintaining better OHS standards (James 2009;
Underhill et al. 2016).
Predictably, WHS representatives are more likely to exist in unionized work-
places because of a greater awareness of OHS and worker rights, and because of a
greater ability to activate those rights without fear of reprisals (Quinlan et al. 2010;
Ollé-Espluga et al. 2019). In addition, under Australian law and to varying degrees in
international jurisdictions, union involvement in workplace health and safety is
underpinned by laws which offer unions a role in the election of WHS representa-
tives, give a right to enter a workplace to investigate suspected breaches of WHS
laws, and allow consultation with workers about health and safety at work (Safe
Work Australia 2019).
Yet, not all unionized workplaces have active WHS representative structures in
place. Also, international research suggests that WHS representatives are struggling
to remain active and independent of management. In Canada, for example,
Lewchuck et al. (2009) found the rise of neoliberalism and decline of management
commitment to WHS representatives, and OHS in general had contributed to a
growing reluctance of workers to activate WHS representation. There was also an
emerging disinterest in OHS by workers and unions as the management of such
issues became more professionalized. In the United Kingdom, Walters and Nichols’
(2007) study across three industries found that without senior management commit-
ment to OHS, even unionized workplaces struggled to recognize WHS representa-
tives – a fact demonstrated by a lack of time to perform duties and by management
unwillingness to share OHS information. WHS representatives’ involvement was at
the discretion of management. Workforce views were ignored and senior manage-
ment placed an emphasis on procedural issues rather than the substance of managing
workplace OHS. In Denmark, research has identified unionized organizations where
OHS has become integrated or mainstreamed into other management processes, and
WHS representatives in turn have become incorporated into management systems
and structures. The impact on OHS outcomes of this potential shift in WHS
representatives’ independence, accompanied by distancing from the workers
whom they are supposed to represent, has not yet been evaluated (Hasle et al.
2019). Finally, a recent Spanish study (Ollé-Espluga et al. 2019) found that when
WHS representatives were relatively inactive and not widely known within the
workplace, workers turned to management for OHS information. As a result, they
were poorly informed about which OHS issues they could act upon, while psycho-
social risks were commonly dismissed as “just part of the job.”
The declining power of unions at workplace level coupled with the growth of
unitarist management approaches also appears to be curtailing the role of WHS
representatives. Walters and Wadsworth’s (2020) study of WHS representation
processes (including both WHS representatives and OHS committees) in 147 orga-
nizations in seven EU member states identified three common trends. First, WHS
representatives were offered only limited support and cooperation by employers and
managers. They were allowed insufficient time and resources, for example, to attend
WHS training and to perform their roles even though those roles were formally
41 The Decline of Trade Unions and Worker Representation 861

recognized. Second, they were marginalized by safety management systems which

focused upon behavioral change and direct employee participation. Third, their
activities were incorporated into OHS management systems which were controlled
by management. Their independence was thus undermined, and coworkers saw them
as another layer of management, promoting compliance with individualized
behavior-based safety systems and communicating management’s messages. Since
management shaped and controlled the processes for WHS representation, and WHS
representatives regarded management as holding superior knowledge about OHS,
they turned to management for advice, rather than an external source such as a union.
Walters and Wadsworth (2020) interpret this trend to be, in part, a reflection of the
broader shift toward a stronger unitarist managerial philosophy within which work-
place health and safety is not regarded as an area of conflict, and WHS responsibil-
ities become individualized rather than protected by collective interests. They also
note, importantly, that there is not yet a body of evidence to support the effectiveness
of a unitarist approach to mitigating OHS risks.
The evidence discussed in this section shows that declining union membership is
associated with growing weakness of WHS representation. External unions are less
likely to provide an independent source of strength, while WHS representatives have
become increasingly dependent on management for information or have been
sidelined from management structures and processes. As WHS representatives risk
further marginalization, do other forms of employee participation provide a sustain-
able alternative?

Does Direct Employee Participation Offer an Alternative to WHS

Representatives?

Researchers have found that as unionism has declined, organizations have shifted
away from indirect representation, through employee-elected WHS representation,
to more direct methods of employee participation in OHS (Walters and Wadsworth
2020). The concept of employee participation has held different meanings over time,
and between different key stakeholders. It can involve as little participation as
suggestion boxes, more immediate involvement in day-to-day work such as semi-
autonomous teams, joint consultation on major issues such as workforce redundan-
cies, or employee representation on work councils taking major organizational
decisions. It can be pseudoparticipation, where information sharing amounts to little
more than persuading employees to agree to a predetermined outcome, or (less
commonly) full participation where power is shared equally between employees
and management (Pateman 1970).
Gollan and Xu (2015) summarize the evolution of the meaning of employee
participation, commencing in the 1960s/1970s when unions held significant work-
place power, and collectivism was the norm. Employee participation was seen as an
extension of unionism, promoting workplace democracy as a fundamental principle
in a democratic society, through formal channels of employees’ direct and represen-
tative involvement in decision-making throughout the organizational hierarchy. In
862 E. Underhill

the 1980s, as unionism began to decline and human resource management pro-
fessionals emerged, employee participation was narrowed in scope from collective to
direct employee involvement, and to decisions limited to the immediate job situa-
tion. Organizations viewed this transformation from collective to direct participation
as a means of improving efficiency and productivity, far removed from the principles
of workplace democracy espoused 20 years earlier. By the 1990s, with the expansion
of knowledge work, organizations focused upon employee empowerment through
means such as semiautonomous team work, eventually followed in the 2000s by an
emphasis upon employee engagement and employee voice. The evolution described
by Gollan and Xu (2015) illustrates how the concept of employee participation has
changed from a form of workplace democracy to a human resource strategy with a
far stronger focus on organizational objectives. Reflecting this, a study by EPOC in
the early 2000s found the shaping of direct participation in EU countries was mostly
developed without input from employee representatives (EPOC 2005 cited in Knud-
sen et al. 2011). A consequence of these shifting sands of employee participation is
the lack of agreement over what the concept actually means for employee practices.
As Wilkinson et al. (2020) point out the meaning and form of employee participation
differs considerably across disciplines. Human resource professionals, for example,
are more likely to view employee participation as the promotion of employee
engagement to indoctrinate a more committed workforce. From an industrial rela-
tions perspective, however, there is an expectation that workers will have a degree of
autonomy, and will exercise collective voice to create a countervailing source of
power against management when having input into organizational decision-making.
Despite diverse views on desired forms of employee participation, there is agree-
ment on the overriding characteristics which can be categorized as direct or indirect
participation, and formal and informal participation. Direct participation involves
individual workers and may involve minimal communication between workers and
their supervisors but may also extend to quality circles and problem-solving teams.
The form it takes is largely at the discretion of management. Hence Wilkinson et al.
(2020: 11) note “employers interested in paternalism, social welfare or HRM arrange-
ments would tend to eschew the traditional collectivist adversarial model for direct
communications of voice.” Indirect employee participation involves representative
processes such as WHS representatives. It is more likely in unionized workplaces,
with job delegates representing workers in collective negotiations, or through formal
processes such as consultative committees (Gollan and Xu 2015); it offers scope for
more significant issues to be determined with input from employees. This distinction is
important from a health, safety, and well-being perspective because resolving WHS
issues can involve reprioritizing organizational resources, extensive sharing of infor-
mation, and acknowledging that not all expertise is held within the organization.
Knudsen et al. (2011) add a further two fundamental characteristics of employee
participation: It involves employees’ influence on decision-making, and it takes
place in a context otherwise dominated by management prerogative. In other
words, it involves employees having some degree of influence over decisions
which would otherwise be determined by management. In this way, it represents a
modification to traditional organizational decision-making hierarchies.
41 The Decline of Trade Unions and Worker Representation 863

These basic characteristics point to a major weakness of direct participation for

worker health and well-being. The form and content of direct participation is
predominantly determined by managers that control the process, thereby limiting
its scope to matters which do not encroach on managerial prerogative; individual
workers are not well placed to negotiate the breadth and depth of issues that may
need to be addressed to remedy WHS risks (both physical and psychosocial). Indeed,
the risk of challenging organization decision-making hierarchies is itself likely to
deter many workers from attempting to do so (Ollé-Espluga et al. 2019).
Yet, there are sound reasons for involving employees in OHS, with employee
involvement being shown repeatedly to benefit organizations from an OHS perspec-
tive, and those benefits can flow to other aspects of employee performance such as
greater commitment to organizational objectives. Quinlan et al. (2010) observe that
first, because employees are undertaking the work tasks, they understand them best
and can use that knowledge to identify risks and hazards which management may not
be aware of. Second, the solutions that flow from that knowledge can be more
effective and less costly than those offered by external advisors with more superficial
understanding of the work. Third, involvement in OHS problem solving brings
ownership of solutions, including dissemination of information and better under-
standing of why particular solutions are adopted. Finally, feedback on OHS pro-
grams provides a better path to creating new and improved approaches and
operations, rather than relying on more abstract and remote measures such as lost
time injuries. The next section examines if there is evidence of a willingness by
management, in nonunionized firms, to constructively engage employees in direct
participation to resolve OHS issues.

Does Employee Participation in Nonunion Workplaces Improve

Worker Well-Being?

Direct evidence on this question is inconclusive. Only a small number of studies

have explicitly examined OHS issues when researching employee participation in
nonunion workplaces. Gomez et al. (2010) examined the emergence of various
forms of voice in Britain and found widespread use of employee voice in nonunion
workplaces, arguing that the demand for voice does not go away in nonunion
workplaces – it is instead supplanted by other forms of direct voice promoted by
HRM professionals. However, while more individualized forms of voice involving
problem-solving groups, team briefings, and meetings between management and
workers allowed some information sharing, they did not extend beyond consultation
into negotiation. Informal processes such as raising OHS issues at meetings or in
day-to-day communication between workers and supervisors offered other pathways
to sharing concerns but were also framed, and thereby limited, by management.
Donaghey et al. (2011) also documented a nonunion case involving direct employee
representation processes in the United Kingdom. They tracked the progress of a
consultative process in which the scope and function was progressively narrowed
and weakened, ensuring that managerial prerogative was preserved. Over time,
864 E. Underhill

workers felt their concerns could be voiced but not addressed, while management
viewed the process as a means of eliciting ideas to complement organizational
effectiveness and assist organizational change. Donaghey et al. (2011: 179) con-
curred with earlier studies that “non-union workplace voice is unlikely to be
meaningful unless supported by legislation/regulation – left to their own devices
many employers introduce weak forms of employee voice of which workers may be
sceptical.”
A recurring theme in research evaluating employee participatory processes is that
workers can raise concerns, but too often they are not listened to or their concerns are
not acted upon. Gumbrell-McCormick and Hyman (2019), for example, concluded
that employee participation is “inherently ambiguous, often intended to legitimise
managerial authority by offering employees the illusion of influence (‘pseudo-
participation’) through mechanisms such as team work” (Gumbrell-McCormick
and Hyman 2019: 93). Quinlan’s (2014) international analysis of fatal incidents
and major disasters in high hazard industries, while not exclusively a study of
employee participation processes, found management’s refusal to acknowledge
worker or supervisor safety concerns were one of ten pathways to “death and
disaster.” According to Quinlan, “reasons why these concerns were ignored include
the hierarchical nature of work relations and the consequent downgrading of sub-
ordinates’ views or expertise to make judgments; the top-down nature of safety
systems and inadequate feedback loops; overriding priorities like production dead-
lines; and unwillingness to accept unwelcome news. . . the importance of listening to
a range of narratives is seldom accorded sufficient recognition” (Quinlan 2014: 188).
Turning to Australia, there is a gap in contemporary knowledge about the extent to
which employers share information, encourage employee participation, and respond to
worker concerns about OHS. The most recent research, conducted by the Australian
Council of Trade Unions (the peak national body for trade unions) in 2019, involved a
survey of more than 25,000 workers (ACTU 2019). Respondents (union and non-
union) reported that while employers were willing to meet with staff and appeared
open to complaints, they were unwilling to make the necessary workplace changes
that would prevent further injuries (ACTU 2019). The situation was notably poorer
among nonunion respondents who were twice as likely as union members to report
that they were never consulted about safety at work. While survey respondents were
more likely to have a keen interest in OHS, more than 60% still reported having
experienced poor mental health because psychological hazards had not been
addressed; most said their employer did not take mental health issues seriously.
The failure to address psychological hazards, notwithstanding a shift toward
direct employee participation intended to encourage engagement and commitment,
reflects the weakness of participatory models. Knudsen et al. (2011: 380) note that,
in theory, an expansion in employee participation should enhance job control in
ways that improve the balance between demands and control identified by Karasek
(1979) as a major source of occupational stress. But instead, there has been “a
simultaneous increase in direct participation and work-related stress and stress-
related illness, thus indicating that contemporary forms of participation may be
framed in ways that fail to secure the type of employee job control that Karasek
41 The Decline of Trade Unions and Worker Representation 865

identified and advocated.” Knudsen et al. (2011) examined 11 Danish workplaces

with varying degrees and forms of worker participation to assess how employee
participation interacted with quality of work environment. The best psychosocial
work environments were found in workplaces where both direct worker participation
and strong collective participation were integrated, supported by worker and man-
agement commitment to shared decision-making, including the form and content of
direct participation at task level. This meant, for example, downward pressures for
high job demands could be “confronted in ways that prevent strain and stress”
(2011: 394). Here, “participation was based on the common understanding that it
should benefit employee well-being as well as performance” (Knudsen et al. 2011:
393). Importantly, participation models developed by management and dominated
by direct participation, with only weak or nonexistent representative participation,
were not associated with a positive psychosocial work environment. A similar
outcome was found for those with representative participation but only weak direct
participation, where work pressures continued to dominate everyday working life.
They concluded that “As long as workplace democracy rests on an informal foun-
dation it remains fragile and depends very much on the values and convictions held
by management” (Knudsen et al. 2011: 394).
Studies of the impact of direct worker participation on worker well-being are
consistent in their findings that participation is insufficient, on its own, to support a
safe and healthy work environment. Even in jurisdictions which require information
sharing and consultation with employees by law, such as the European Union and the
EU Directive Establishing a General Framework for Informing and Consulting
Employees, research has identified multiple ways in which employers fail to comply
with either the form or the spirit (or both) of such consultation (Hickland et al. 2020).
Hickland et al. (2020: 2) describe the processes by which “employers silence
employee voice by failing to either disclose information or abstaining from genuine
dialogue, which is a vital precursor for meaningful employee voice.” They catego-
rize employers’ responses into three groups: avoidance, suppression, and neglect.
Each of these are utilized with respect to participation in workplace health, safety,
and well-being issues depending on the context and institutional framework. Like
Knudsen et al. (2011), they note that the widespread emergence of occupational
stress points to the failure of employers to recognize the importance of employee
voice in mitigating risks (by genuine consultation on organizational change) and
identifying solutions. Without a formal process for the involvement of worker
representatives, employees are likely to be subject to the vagaries of local manage-
ment on how often and on what issues their views may be sought (Hickland et al.
2020). As Wilkinson et al. (2020: 11) note, “line managers form relationships at the
workplace level that can frustrate, lubricate or bypass voice opportunities.” The
reach of employee participation in decision-making can also be colored by mana-
gerial perceptions of which employees are more suitable for engagement in decision-
making (Timming 2005). On the other hand, employees may also choose not to
participate when the participatory system is viewed as ineffective, when they lack the
resources to meaningfully participate, or when they fear the consequences of such
participation (Wilkinson et al. 2018).
866 E. Underhill

More formal participative models, which incorporate collective interests and

representation rights and move beyond “voice without muscle” (Kaufman and
Taras 2010, cited in Wilkinson et al. 2020: 12), are needed. This is particularly
important in relation to psychosocial hazards where the shift toward individualized,
behavior-based management perspectives, such as offering “healthy lifestyle pro-
grams” rather than addressing fundamental causes such as work intensification, job
insecurity, and workplace bullying, has become more commonplace (Oakman et al.
2018; Walters and Wadsworth 2020). The failure to address psychosocial hazards
has been widely identified in research across developed economies as a major
concern for the future well-being of the workforce, and in turn organizational
performance. Dollard and Neser (2019) warn that with future workplaces designed
for intensive productivity without consideration of worker well-being, “we are
heading for an increasingly and permanently mentally unhealthy world of work,
with flow on effects to families and communities around the world.” Employees in
nonunionized workplaces, reliant solely upon direct participation processes, are
poorly placed to resist these trends. The eradication of fundamental workplace
risks involves a conflict between the rights and interests of employees and those of
their employer. Even unionized workplaces struggle to make headway against
managerial prerogative on these issues (Walters and Nichols 2009).

Discussion and Conclusion

What prognosis does this chapter offer on union and WHS representations and its
effects on employee health and well-being? The evidence discussed above suggests
prospects may be poor. First, in recent decades, union membership has declined
rapidly, along with the union power necessary to support WHS representatives.
Second, while data on the number of WHS representatives is unavailable, interna-
tional research suggests their role appears to be dividing in both positive and
negative directions. On the one hand, the Danish experience points to such profes-
sionalization of WHS representatives that they are integrated into management
structures (Hasle et al. 2019). On the other hand, the EU experience more broadly
points to WHS representatives becoming more dependent upon management for
expertise, while viewing OHS through a managerial lens which limits their perspec-
tive on the need to pursue worker well-being.
Also, with the decline of collective voice, organizations are turning to more direct
employee participatory models which are shaped by management and attuned to
reinforcing managerial prerogative. These approaches are consistent with behavior-
based approaches to managing OHS which are also becoming more widespread,
such as individual counseling, resilience, and lifestyle programs. They ignore the
foundational principle of OHS (to make workplaces safe by removing risks) focus-
ing instead upon changing worker behavior. All these direct participation approaches
leave decisions in the hands of management whose interests override those of
workers.
41 The Decline of Trade Unions and Worker Representation 867

International research highlights the weaknesses of direct employee participation

as an alternative to union-backed WHS representation. In their crudest forms,
employee participation models are typically introduced and framed by management,
and participation is limited to issues which benefit organizations while assuming that
employees benefit enough to remain engaged with the process. They are akin to
“trickle down economics,” where the elite receive all initial gains, with the expec-
tation that some gains will trickle down to the bottom of the hierarchy. However, too
many threats to worker well-being, such as psychosocial risks which are now
recognized as a major health concern in advanced economies, cannot be eradicated
without substantial change to work organization, employment practices, and orga-
nizational hierarchies. These issues are not trivial or easily remedied. They require
substantial management commitment to genuine employee involvement and engage-
ment in decision-marking processes, and a willingness to overturn established
structures and processes in order to enable healthy, socially responsible practices.
They also require employees to acquire skills, knowledge, and resources, including
access to expertise in negotiating workplace change, to influence health and well-
being. However, studies of employee participation have not found sufficient man-
agement commitment toward recognizing the right of employees to engage in
genuine decision-making. Even WHS representatives in unionized workplaces can
face a high level of resistance from management; without strong countervailing
power, employee voice is easily overlooked or ignored. Improvements in OHS,
including the right to independent worker representation, have been achieved
through a history of worker activism and pressure, not through the cooperation
and trust which management believe they are promoting through employee partic-
ipation (Walters and Quinlan 2020).
To some extent, an explanation for poor employee commitment to adequate
participation can be found in the same factors that explain declining union member-
ship. First, organizations forced to prioritize costs to compete in global markets will
also fail to prioritize employee involvement in OHS where that potentially raises
short-term production costs. Second, organizational structures that have evolved
through outsourcing and privatization to produce reduced core organizations with
networks of suppliers increasingly rely upon a more precarious workforce that
remains distanced from employee involvement in OHS. Workers with job insecurity,
irregular working hours, low pay, and high job demands will not be included in
participatory processes. They are at greater risk of victimization for raising concerns,
and poorly placed to draw upon the support of fellow workers when expressing
concerns (Underhill and Quinlan 2011; Quinlan 2016). The very notion of employee
participation is at odds with employment systems that rely upon on call workers,
show a lack of commitment to employees, and pay low wages. Instead, Pilbeam
et al.’s (2020) systematic review of international studies on outsourced work found a
range of safety risks associated with economic and reward pressures were height-
ened among workers employed in outsourced functions.
Third, the more individualist philosophies that underpin neoliberal government
policies, and support unitarist management styles, also encourage managers to
believe, mistakenly, that worker well-being can be suitably managed at an individual
868 E. Underhill

level. This runs counter to one of the defining strengths of union-based WHS
representation that “successful resolution of many health and safety matters requires
a deeper and wider understanding of their organisational context” (Loudoun and
Walters 2009: 182). Unitarist managers are unlikely to accept that individual solu-
tions are not solutions but are pushing the risks, and costs, of poor workplace
environments onto workers. Excessive work hours, for example, may continue to
be regarded as a personal problem when raised by individual workers on an ad hoc
basis. Yet in reality, excessive working hours are more likely to be part of a poor
psychosocial working environment impacting a group of workers, many of whom
are reluctant to voice their concern for fear of retribution.
What then are the options for worker involvement in workplace health and well-
being in the absence of union-supported WHS representatives? WHS representatives
are (in most advanced economies) supported by legislation which gives them rights
beyond those typically associated with employee participation, such as the right to
information, resources, training, and paid time to fulfill their role. These rights exist
irrespective of whether they are located in unionized or nonunionized workplaces.
However, research into unionized workplaces has found these rights are more likely
to be asserted, because of the nature of the training WHS representatives receive
(including developing an understanding of the importance of work organization),
and their ability to draw upon union OHS and negotiation expertise. Underpinning
these attributes is their capacity to use coercive power to force management to
prioritize and act on OHS concerns. Where this coercive power is lacking in
nonunion workplaces, an active, well-funded state labor and OHS inspectorate can
support WHS representatives’ rights. However, such representatives can still
encounter organizational resistance to acting upon OHS issues, especially those
organizations operating in highly competitive markets. State-funded inspectorates
can threaten prosecutions, but they do not have a constant workplace presence, and
they do not offer a collective countervailing power. As such, they can assist WHS
representatives, but they cannot ensure their effectiveness because they cannot fill
the void created by union decline.
Other forms of employee participation in nonunion workplaces can take the form
of joint OHS-consultative committees. These might be seen as an alternative to WHS
representation, because they rely less on the skills and expertise of individual
employees. The experience of OHS joint consultative committees, commonly pro-
moted by legislation, is instructive. A study by Eaton and Nocerino (2000 cited in
Quinlan et al. 2010) in the United States found two factors likely to compromise their
effectiveness: First, they needed the scope to act on genuine OHS issues, and not
simply trivial or housekeeping matters; and second, they needed to be trained.
Ideally, a more equitable distribution of employee participation in organizations
through formal joint committee processes might, as Aristotle (1996 cited in Timming
2005) observed, result in managers being surprised at finding “excellence” in the
most unlikely of places. Even the lowest paid and the least educated employees are
capable of both “governing and being governed” (Aristotle 1996: 189) given the
right opportunities. However, not all managers reach this conclusion although Hasle
et al.’s (2019) Danish study highlights how organizations that prioritize social
41 The Decline of Trade Unions and Worker Representation 869

responsibility have also promoted and integrated OHS into their management
systems. It is unknown, however, whether professionalizing WHS representatives
results in disengagement from fellow workers in such a way that is contradictory to
the concept of worker representation. Also, it should be recalled that Hasle et al.
(2019) studied unionized firms; whether nonunionized firms embrace OHS so
comprehensively under the banner of corporate social responsibility is unknown.
Research overwhelmingly supports the conclusion that better OHS outcomes are
achieved in workplaces with WHS representatives, supported by unions that offer a
countervailing power to organizations. Such arrangements are socially responsible
and offer financial benefits to organizations. However, establishing effective WHS
representation in nonunionized organizations is challenging. They may be supported
by organizational resources, but they lack independence, and their knowledge is
likely to be organizational specific and therefore limited. Even with management
commitment to their role, it is difficult to envisage how they might be empowered
sufficiently to fill the gap created by the absence of collective power. Under these
circumstances, it is clear that concerns about a pending crisis in workplace health and
well-being must still be seriously considered.

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Handbook of research on employee voice. Edward Elgar, Cheltenham, pp 2–18
Index

A individual’s control, 530

ABC framework, 78 occupational health and safety, 532–533
Ability-enhancing practices, 377 ‘older’ or ‘mature’ worker, 529
Ability-motivation-opportunity (AMO) organizations, 529
model, 377 physiology, 530–531
Abusive/destructive leadership, 21 principles, 530
Abusive leadership, 72 psychosocial, 531–532
Abusive supervision, 127 social identities shift, 534
Acceptance and Commitment Therapy workforce participation, 528
(ACT), 607 Ageism, 533–534
Accident underreporting Aggregability, 516
individual level, 70 Aggression, 790
organizational level, 71 AirBNB, 770, 771
Accommodated flexibility, 694, 699, 702, 703 Akaike information criterion (AIC), 599
Accommodations, 643, 644, 652 Antecedents-Behaviour-Consequences
Active destructive leadership, 72 framework, 78
Active followers, 122 Anticipatory justice, 299
Activists, 125 Anti-cyber harassment measures, 816
Acute/chronic health problems, 276 Anti-retaliation models, 445
Ad-hoc basis, 491 Anti-social behaviors, 126
Affective perception, 295 Anxiety, 577, 578
Affective reaction, 295 Approved Codes of Practice
Age-awareness training, 537 (ACoPs), 813
Age discrimination, 529, 534, 536 Archetypes, 793
Age diversity, 536 Areas of worklife model
Age-friendly climate, 536–537 cynicism/depersonalization, 603
Ageing employees, 602
obesity and, 549 employment relationship, 603
process, 6 implications, 604
professional groups, 562 ineffective profile, 603
social care workforce, 552 law enforcement, 603
Ageing worker meta-analyses, 603
ageism, 533–534 multifaceted assessment, 604
chronological age, 529 organizational values, 602
cognition, 531 overextended profile, 604
description, 528 person-oriented approach, 604
gender norms, 535 surveys of healthcare, 603
homogenous, 530 syndrome, 604

© Springer Nature Switzerland AG 2022 873

P. Brough et al. (eds.), Handbook on Management and Employment Practices,
Handbook Series in Occupational Health Sciences,
https://doi.org/10.1007/978-3-030-29010-8
874 Index

Areas of worklife model (cont.) individual vs. organizational interventions,

uni-directional causal model, 603 607, 608
values conflicts, 603 interventions, 605, 606
workload, 604 MBI, 600–602
Artificial intelligence, 655 occupational condition, 598
Augmentation hypothesis, 79 organizational action, 605
Authentic/ethical leaderships, 44 organizational leaders, 605
Authentic leadership, 72, 74 organizations, 598
Automated system, 655 participants, 605
Avoidance-focused coping responses, 127 social context, 611
social encounters, 609, 610
syndrome, 605
transactional mode, 598
B workplace stress, 610
Bad follower, 122 Bystanders, 125
Barbuto’s theory, 124
Bayesian information criterion (BIC), 599
Behavioral approach, 18, 359 C
Behavioral governance theory, 235 Callous-manipulative behavior, 83
Behavioral inhibition, 359 Cancer rehabilitation programs, 650
Behavioral safety, 78 Career opportunities, 272
Behavioral symptoms, 577 Career satisfaction, 49, 401, 403
Behavior-based approach, 79 Career selection, 484
Behavior-based interference, 667 Career skills, 48
Benign followers, 124 CarNextDoor, 771
Between-person level, 82 Carpal tunnel syndrome (CTS), 559
Between-person relationships, 81 Case studies, 737
Bidirectional effects, 793 Chair-specific sensor mat calibration, 561
Biomathematical models, 629 Change management, 160–162, 164
Biomedical models, 648 Charismatic and transformational
Board of directors, 230 approaches, 20
employee health and well-being Chief executive officers (CEOs), 231
establishing a culture, 237 Civility, Respect, and Engagement with Work
making OHS, 237 (CREW)
oversee operations, 238, 239 collaborative format, 609
performance indicators, 238 evaluation quality, 610
practical guide, engagement, 242, 243 goal oriented, 609
engagement in OHS intervention, 609
drivers, 239, 240 process, 609
level of competence, 239 strategic quality, 610
opportunity, 240–242 sustained, 610
responsibilities, CEOs targeted, 609
incentivizing and controlling, 234 urgency, 609
priorities, 236 Veterans Health Authority, 609
social influence, 235, 236 Climate disease, 650
supporting and encouraging, 235 Coding strategy, 693
Bounded flexibility, 694, 701 Cognition, 531
Broaden-and-build theory, 55, 56 expectancy, 74
Burnout, 6 instrumentality, 74
change the workplace, 608 valence, 74
contagion, 676 Cognitive behavioral therapy (CBT), 581,
employees’ relationships, 598 585, 589
evaluation research project, 605 Cognitively accessible technology, 654
Index 875

Cognitive restructuring, 126 Compassionate leadership, 104–105

Cohen’s coefficient, 834 Compassionate Leadership Behavior Index
Cohesion, 28 (CLBI), 105
Collaborative team learning, 76 Compensation claim, 647
Collective engagement, 493, 494 Competency approaches, 95
Colluders, 124 Compliance, 124
Color bar, 334 Compressed workweeks, 696, 697, 700–702
Common mental health problems (CMPs), 6 Conceptual distinctiveness, 80
anxiety, 576 Conceptual distinctness, 80
behaviors/social relationships, 575 Conceptualizing leadership, 121
best-practice strategies, 586, 588 Conformers, 124
cognitive/cognitive behaviour therapy, 584 Conservation of resources (COR) model, 673
complexities, 574 Conservation of resources theory (COR), 53,
components, 579 54, 59, 271, 274, 358, 403, 465–466
depression, 576, 583, 585 Construction
digital mental health intervention, 584 industry, 557–559
economic cost, 574 workers, 556–557
effective management, 582 Constructive manner, 126
effectiveness, 586 Contingency approach, 18–19, 408
effective workplace strategies, 576 Contingent reward leadership, 74
employees, 574 Control mechanisms, 505
employment outcomes, 582 Coronary heart disease (CHD), 293
evidence-base, 590 Corporate boards, 5, 231
financial responsibilities, 575 Corporate governance model, 236
impact, 579–581 Corporate social responsibility (CSR), 649, 818
interventions, 575 Cost-Benefit Analysis (CBA), 752
intervention strategies, 582 Cost-effectiveness approach (CEA), 752–755
intervention types, 584 Courageous followership, 121
lack of participation, 579 COVID-19, 650
management, 581, 582 Critical HRM (CHRM), 513
management strategies, 578 Critical perspective, 379–380
multi-domain interventions, 585 Cross-cultural adjustment (CCA), 830
outcomes, 591 Cross-cultural training (CCT), 830–833
practical strategies, 575 Crossover
proactive interventions, 575 cultural norms, and gender, 672–673
psychological therapies, 582 inter-personal transfer, 674
psychological wellbeing, 584 leaders and followers, 676–679
RTW, 586 occupational stress, 666
stress-related conditions, 576 person’s stress, 666
sustainable-focused approaches, 575 positive, 669–670
symptoms (see Symptoms, CMPs) process, 6
treatment and psychological of resources, 673–674
interventions, 583 team members, 674–676
up-to-date evidence, 589, 590 Crossover Process Model (CPM), 670–671
work disability, 574, 583 Culture learning model, 847
working-age adults, 576
workplace-based prevention, 583
workplace interventions, 585 D
workplace management, 575, 586–589 Decision making, 118, 648
workplace participatory intervention, 582 Decision-tree model, 797
work-related aspects, 584 Degree of self-realization, 751
work-related issues, 578 Demand experience-sampling, 84
Comparison groups, 645 Deontic motivation, 797–800
876 Index

Depression, 576, 577, 583 organizational acceptability, 648

Descriptive group, 120 payments, 649
Despite equality legislation, 333 stakeholders, 647
Destructive leadership, 123, 125, 126, 130 strategies, 649
Developmental HR practices technology, 654
career development, 397, 399 work, 336
career self-management and Disclosure, 142, 146–148, 487, 488
satisfaction, 399 Discrete event, 271
career stage and employee age, 409 Discrimination, 135, 136, 138, 337, 484, 485,
communication, 411 640, 641
definition, 394, 396 Dispositional resistance to change (DRTC), 263
detrimental effects, 410 Disruptive change, 163, 164
developmental performance appraisal, Distal performance, 689
397, 399 Distributive justice, 287, 301
distinctive consequences, 410 Diversity, 713
employee evaluations, 399 management, 332
employee performance, 397 Double-edged sword, 675
employee’s perceptions, 400 Downside risk, 819
employee well-being, 395, 396 Downsizing, 4, 195, 196
example measures, 398 art-based intervention, 179
factors, 403 beneficial program, 185
implementation, 394 complex effects, 183, 184
low-quality employee-employer depression-free subjects, 183
relationship, 408 depressive feelings in employees, 177
management, 412 deteriorated functions, 178
manager behaviors, 403, 408 direction of causality, 182
meta-analytic support, 400 endocrinological changes, 181
over time impact, 411 full spectrum effects, 179–181
performance appraisal, 399 genetic factors, 178
performance management system, 400 health consequences, 185
perspectives, 395, 401, 404, 406 health effects, 176
supporting well-being (see Well-being) HPA axis, 177, 178
theoretical development and research, 410 ill health development, 177
trade offs, 409 large-scale reactives, 182
training, 397 long term unemployment, 176
Diehards, 125 organization of, 184
Digital communication, 691 pattern of reactions, 178
Digitalization positioning, 742–744 phases, 177
Digital platform work, 770 prescription of medication, 183
future research, 780 response to possibilities, 176
and Gig economy, 771–773 stress mechanisms, 177
health, safety and wellbeing, 776–780 unemployment effects, 179
opportunities associated with, 775–776 work organization, 178
Direct crossover, 668 youth unemployment, 184
Directive performance management, 507–511 3D printing, 653
Disabilities of the arm, shoulder and hand Dual-earner couples, 669
(DASH), 555 Dyads, 672, 673, 677
Disability, 135, 137, 138, 140, 146–148, 151,
332, 344, 640, 641 E
category, 338 Economic appraisals, 750
management, 643, 647 Economic indicators, 750
medical/individual problem, 647 Effort-reward imbalance (ERI) model, 271,
models, 334, 335 272, 463–464
Index 877

Emotional exhaustion, 274, 679 CCT effectiveness, 830, 846–848

Emotional intelligence, 18 contents covered, 843
Emotion-focused approach, 126 correlation analyses, 842
Empirical articles, 47 cross-cultural literature, 845
Empirical test, 451–453 cross-cultural theories, 845
Employee(s), 791 cross-cultural training method, 844
health, 291, 395, 410 data analysis, 834, 836
life cycle, 394 data extraction, 834
participation, 856, 861, 862, 864, 865, descriptive, 836
867, 868 design, 833
voice, 492 duration of training, 843
Employee health and wellbeing, 94–96 effectiveness, CCT, 837
compassionate leadership, 104–105 frequency of publications, 837
UK health and social care settings, 104 hospitality sector, 829
Employee-organization context, 275 host environments, 830
Employee-organization relationship, 270 ICT sector, 829
Employee Resource Groups (ERGs), 491–493 inclusion-exclusion criteria, 834
Employee well-being, 47, 59, 395–397, 401 method of training, 844, 845
effective implementation of lean MNCs, 828
management for sustainable, modified PRISMA statement, 835
218–223 multinational organizations, 830
impact of lean management on, 211–214 OECD countries, 829
job demands-resources model, 214–218 organizational expats, 828
Employer-employee bond, 645 participatory learning methods, 845
Employment conditions, 231 psychological adjustment, 831, 837, 846
Employment market, 534 psychological capital (PsyCap), 842
Employment opportunities, 653 psychological dimension, 842
Empowering leadership, 72, 74 psychological distress, 829
Enabling performance management systems, psychological stress, 829
511–512 psychological well-being, 846
End-user engagement, 651 qualitative semi-structured interviews, 844
Environmental Issues, 620 research limitations, 848
Equity theory, 287, 300, 304 search strategies, 833
Ergonomics, 553, 554, 556, 558, 560, 561 search terms, 834
Ethical culture, 5, 418, 419 self-initiated expatriates, 828
drivers, 425–427 social learning theory, 845
management, 427–429 socio-cultural perspective, 846
organization, 420–422 statistical tests, 842
unethical behavior, 429, 430 theory-based, 845
virtue, 422–424 transition, 829
Ethical decision-making (EDM) United States, 829
I-EDM, 440 U-shaped theory, 845
organizational theories, 443 validity of training, 840–842
theoretical models, 440 Expectancy theory, 74
training, 441
Ethical virtues, 421
Ethnicity, 334 F
Eudaimonic well-being, 46, 735 Fairness at work
European Commission, 816 definitions and measurement, 287, 289
Evidence-based safety leadership, 73 health (see Health-related consequences)
Expatriate employees justice, 286 (see also Organizational
adaptation and transition support, 830 change)
CCA, 830 organizational changes, 286
878 Index

Fairness at work (cont.) Formal team leader, 128

relevance, 289, 290 Fostering employee wellbeing, organizational
wider consequences, 296, 297 goals, 515–518
work-related consequences, 291 Framework for managers, 515–518
Fairness Heuristics Theory, 299, 302 Friction-reducing devices (FRD), 555
Fairness perceptions, 289 Full-range leadership framework, 71
Family satisfaction, 667
Family-to-work conflict (FWC), 667
G
Fatigue, 616–618, 621
Gender, 333
adapted safety error trajectory framework,
identity, 482, 483, 490
629–633
neutral language, 489
causes, 618–620
norms, 535
continuous operator monitoring, 622
General systems theory, 384
fitness, duty tests, 621, 622
Generativity, 274
managing driver, 627, 628
Gig economy, 7, 652, 770
measurement, 621
and digital platforms, 771–773
monitoring driver, 626, 627
growth of, 773–775
organizational culture, 627
Global trends, 649
performance based monitoring, 623
Goal-misalignment problem, 508
work driving context, 623–625
Goal setting and planning (GAP), 756, 764
Fight-flight-freeze stress, 126
GoFundMe, 771
Financial management models, 648
Group engagement model, 301
Fixed flexibility, 693, 702
Flexible scheduling, 701
Flexible work arrangement (FWA), H
537–538, 713 Hand arm vibration syndrome (HAVS), 557
Flexible work initiatives, 7, 693 Happiness, 396, 409, 410
Flexible workplace, 690, 705, 706 Harassment/violence at work, 816
Follower-centric approach, 118, 119, 123 Hard/regulatory approaches, 812
Follower confrontation, 126 Hard/soft law instruments
Followership, 118 balancing, 820–823
behaviors, 120 international and regional level, 814, 816
characteristics, 120 national level, 816, 817
components, 122 organization level, 818
conceptualizations, 119 sectoral level, 817, 818
definition, 118, 119 Hard law, 812
destructive leaders, 123 Hard vs. soft law, 811, 812
dichotomy, 128 Harm, 733–734
leadership, 119 overlooked, 738–739
limitations, 126 SMART model, 740
literature, 120 Health, 396, 410
outcomes, 120 conditions, 538
perspectives, 122 professionals, 648
practical implications, 129 and well-being, 272, 275
research, 120 Health, safety and wellbeing (HSW)
theoretical lenses, 121 hard and soft law (see Hard/soft law
theories, 121 instruments)
virtual teams, 127 hard vs. soft law, 811, 812
Follower typologies, 118, 124, 125, 130 influences, 810
Foodora, 771 interventions, 810
Foot Health Promotion Programme policy evolution, 812–814
(FHPP), 555 social and mental health, 810
Index 879

Health and Safety at Work Act, 550 Hybridity, 520

Health and Safety Executive (HSE), 817 Hyper flexibility, 694
Health and Safety Executive’s Hypothalamo-Pituitary-Adrenocortical
(2019), 579 (HPA), 177
Health and Safety Regulations, 556
Health and Social Care Workers
ageing, 552 I
jobs, 551 Ill-being, 51
MSD workers, 552–554 Illnesses, 641
professionals, 554–556 Impairments, 136
Health in All Policies (HiAP), 822 Implementer, 125
Health-related consequences Implicit followership theories, 121, 122
causal and reversed relationships, 295 Implicit leadership theories, 121
longitudinal evidence, 292, 294 Inclusion, 138, 143, 332, 336, 339, 482,
reversed effects, 295, 296 483, 488
underlying mechanisms, 294, 295 criteria, 692
Health Work and Wellbeing Programme, 576 Inconsistent leadership, 77
Healthy leadership, 93 Incremental change, 162, 163
Healthy lifestyles, 556, 558 Indirect crossover, 668
Hedonic well-being constructs, 46 Individual(s), 272
High commitment management, 396 attributes, 793
High involvement, 396 characteristics, 273
High Performance Work Practices, 396 practices, 706
High-performance work system (HPWS) Individualist, 125
approach, 363, 396 Informal learning, 316, 317, 325
Holistic leadership model, 23 Informational justice, 288
Homophobia, 487, 493, 497 Information and communication technology
Horizontal modes, 128 sector (ICT), 8, 829
HR attributions, 401, 402 Injured workers, 648
HR perceptions, 401, 402 Injuries, 70
HR practices, 221–223 Injury illness, 641
HR process, 401 Innovation teams, 128
Human factors, 554 Insomnia, 274
Human resource development (HRD), 314 Insurers, 648
Human resource management (HRM), 5, 94, Integration, 57
222, 314, 394, 482, 494, 688–690, Integrationist perspective, 372–374
692, 704, 706 Integrative model, 21–24
Human resource management (HRM) Intentional vs. unintentional behaviours, 70
practices, 370, 755 Interactional justice, 288
benefits of, 370 Interdependent relationships, 122
conceptualizations of, 371–372 Internalization, 57
critical perspective, 379–380 International Classification of Diseases
implementation of, 380–382 (ICD—11), 598
integrationist perspective, 372–374 International Labor Organization (ILO), 814
isolationist perspective, 374–375 International Social Security Association
methodological issues, 382–385 (ISSA), 815
mutual gains perspective, 377–379 International Standardization Organization
practices, performance and black box, (ISO), 814
375–377 Interpersonal justice, 288
Human resources (HR) policies, 536 Intersectionality, 345
Humiliation tactics, 123 Interventions, 79, 651, 704, 788, 790, 794, 795
Hybrid control, 521 Intimation tactics, 123
880 Index

ISO 45001, 814 framework, 17

ISO 45003, 814 integrative model, 21–24
Isolationist perspective, 374–375 leader, 17
multi-level perspective, 17
power distance, autonomy, and culture, 32
J safety-related outcomes, 4
JD-R model, 318 servant, 4
Job Characteristics Model, 740 task characteristics, 31–32
Job crafting, 539–540 theoretical approaches, 17–21
Job-Demand-Control-Support (JDCS) Leadership review
model, 673 employee creativity, 25
Job demands, 59 employee engagement, 24
Job Demands Control (JD-C), 318 performance, 25
Job demands-control-support framework, PsyCap, 26
464–465 wellbeing and burnout, 25
Job demands-resources (JD-R), 461–462 Lean foundations, 220
model, 53, 214–218, 272, 539, 677 Lean implementation, 219
theory, 358–359, 403 Lean job demands, 224
Job insecurity, 274 Lean job resources, 215
Job placement, 644 Lean management, 210
Job-related self-efficacy, 679 effective implementation for sustainable
Job resources, 214 employee well-being, 218–223
Job satisfaction, 553, 667 impact on employee wellbeing, 211–214
Job security, 255 job demands-resources model, 214–218
Justice, 286, 289 Lean social pillar, 220
enactment, 290 Lean transformation, 5
Legalization, 812
Legislation, 811, 813, 818, 821
K Lesbian, gay, bisexual, transgender, queer and
Key Performance Indicators (KPIs), 508 intersex (LGBTQI+)
collective engagement, 493, 494
disclosure, 487, 488
L emergency support measures, 495
Labor force, 640 equality, 495
Labor Force Survey (LFS), 551 ERGs, 491–493
Labor market, 176 facing criticism, 496
Labor process theory, 211, 379 homophobic/transphobic bullying, 483
Laissez-faire leadership, 71 inclusion, 482, 483, 488
Latent profile analysis (LPA), 600 interventions, 496
Layoff survivors, 195, 196 organizational challenges, 482
Leader behavioral integrity, 76 policies and practices, 494
Leader-centric approach, 118 risk of tokenism, 486, 487
Leader-follower interaction process, 125 signals, 489, 490
Leader-member exchange (LMX), 19–20, 49, social diversity issues, 483
52, 408, 677, 678 systems, 490, 491
patterns, 30 unprofessional, 483
Leadership, 68 workplace challenges, 484–486
academic and general literature, 16 LGBT ideology, 496
causal modelling, 32–33 Life-limiting conditions, 341–344
characteristics, 4 Line manager competencies
definition, 16 behaviors, 93
economic lens, 33 employee health and wellbeing, 94–96
followership dichotomy, 130 health, safety and wellbeing, 100–102
Index 881

health and wellbeing activities, 93 Managers behaviors, 72

preventing and reducing stress, 96–99 Managing engagement, 101
promotion, prevention, maintenance, 92 Managing return to work, 102–104
Line managers, 223 Managing wellbeing
Lipman-Blumen’s malevolent followers, 125 employee health, 94–96
Live with contract breach, 270 health and, 93, 106–110
Longitudinal research designs, 84 manager behaviors, 102
manager participants, 106
SMCIT, 99
M workplace, 92
Macro level policies, 814 Masculine-coded words, 489
Male-to-female crossover, 673 Maslach Burnout Inventory (MBI), 600–602
Malevolent followers, 125 Maslach Burnout Inventory General Scale
Management, 418, 420, 423, 425 (MBI-GS), 599, 602
Management and employment practices Maturity Model for Management Development
ageing process, 6 Programmes, 108
cause of ill-health, 2 Mean certified sick leave, 253
COVID-19 impact, 9 Measurability, 516
COVID-19 pandemic, 3 Mediating mechanisms, 49
downsizing, 4 Mediators, 75, 77
employee wellbeing, 5 Mental health, 192, 197
employment landscape, 9 care sector, 580
followership, 4 conditions, 650
gig economy, 7 problems, 831
impact of change on health, 5 Meso-level explanation, 440
leadership, 4 Meso sectoral policies, 814
line managers role, 2 Meta-analysis, 18, 21
management competencies, 4 Meta-analytic evidence, 75
management of change, 4 Mindfulness, 48
managers and workplace acceptance, and value intervention, 607
accommodations, 4 and meditation interventions, 105–106
mutual gains, 2 Moderators, 273
occupational health, 2 Modernization, 653
psychological contract, 5 Modern positive approaches, 20–21
psychosocial safety climate, 6 Morally-motivated reactions, 798
reasons, 2 Motivation-enhancing practices, 377
standard differentiation, 3 Multi-component programs, 651
work-life interface, 6 Multi-disciplinary approach, 440
Management-by-exception active (MEA), 71 Multifactor Leadership Questionnaire
Management-by-exception passive (MEP) (MLQ), 129
leadership, 71 Multilevel analysis, 382–383
Management competencies Multi-level theoretical explanations, 440–441
employee health and wellbeing, 94–96 Multinational corporate (MNCs), 828
health, safety and wellbeing, 100–102 Multiple sclerosis, 644
health and wellbeing, 106–110 Muscular-skeletal problems, 6
preventing and reducing stress, 96–99 Musculoskeletal disorders (MSDs), 548, 644
supporting employees, 102–104 construction industry, 557–559
sustainable employee engagement, 99 construction workers, 556–557
Management Competencies for Preventing and effective risk management, 562–564
Reducing Stress (MCPARS), 96 in health and social care, 552–554
Manager competencies, see Line manager health and social care professionals,
competencies 554–556
Managers’ assessments, 451 multiple risk factors, 549
882 Index

Musculoskeletal disorders (MSDs) (cont.) Occupational safety and health (OSH), 102,
occupational health management, 549–550 813, 814
prevalence, 550–552 Occupational stress, 666
psychological and social factors, 561–562 Office work, 560
sedentary occupations, 548 Older worker
sedentary professions, 559–560 aged 45 years and over, 529
taking a break, 560–561 description, 530
workers to return jobs, 564 early retirement intentions, 535
Musculoskeletal injuries, 644 health and safety risk, 533
Mutual gains perspective, 2, 377–379, homogenous view, 530
396, 410 noisy environments, 531
psychosocial working conditions, 532
social experiences, 532
stereotypes, 535
N Operational performance, 689
Natural control groups, 645 Operative management, 230
Negative behaviors, 123 Opportunity-enhancing practices, 377
Negative emotions, 274 Optimistic perspective, 689
Negative safety-related outcomes, 74 Organizational and Social Work Environment,
Negative workplace culture, 648 817
Neurobiology, 618 Organizational career management, 399
New ways of working (NWW), 691 Organizational change
attributes, 298
boundary conditions, 302, 303
before change, 299, 300
O defining, 161
Objective measures of exposure to disruptive change, 163, 164
organizational change, 249 during and after change, 300, 301
downsizing, 250–251 emergent, 162, 163
mergers, 252 implications, 170, 171
privatization, 252 intervention studies, 303, 304
research, 253–254 organizational capability, 170
restructuring, 251–252 performance, 167, 168
unit-level upsizing and downsizing, 252 pre-change time, 298
Occupational health primary objective, wellbeing, 166
management, 549–550 secondary objective, wellbeing, 165, 166
support, 549 stability, 301, 302
Occupational health and safety (OHS), 231, sustainable management, 168, 169
395, 532–533, 856 timeline, 298
boards’ engagement, 239–242 wellbeing, 164
boards of directors responsibilities Organizational change and employee health and
(see Boards of directors) well-being
employee health impact on organizational objective measures, 250–254
performance, 232, 233 recommendations for future research,
employee relations, 234 261–263
integrated systems, 234 subjective measures, 254–261
poor working conditions, 232 Organizational context, 646
prevention of risks, 232 Organizational culture, 627, 712, 713, 715, 716
protection and promotion, 234 Organizational design, 163, 166, 168–170
risks, 232 Organizational development models, 648
strategy, 237 Organizational efforts, 482
training and development, 234 Organizational factors, 791–792
Occupational health guidelines, 587 Organizational goals, 515–520
Index 883

Organizational interventions, 605, 606 planning and evaluation, 514

challenges, 730 systems, 518–520
individuals, 728 wellbeing, 505–506
legal obligations, 729 Performance-related well-being, 52
mental health issues, 729 Personalization, 490
Organizational justice, 440, 447 Person-centered approach, 81
definition, 286 Person conducting a business or undertaking–
dimensions, 288 (PCBU), 780
gender, 303 Person-job fit, 539
literature, 289 Personnel management models, 648
mental health, 292 Person-oriented approaches
meta-analyses, 291 components, 599
perceptions, 291, 295 critical decision, 599
sickness, 293 elements, 599
work-related consequences, 291 entropy, 599
(see also Fairness at work) processes, 599
Organizational leadership profile analysis, 600
ethical organizational culture, 31 techniques, 599
ever-changing nature, 30–31 theoretical/practical interest, 600
non-executive leadership, 29 value statistical analysis, 600
psychosocial safety climate, 30 Physical health, 191, 273
Organizational-level variables, 446 Physical symptoms, 577
Organizational performance, 688–690, Physiology, 530–531
692–694, 696, 697, 699–704, 706 Policy decision-making, 750
Organizational resources, 402, 403 Policy-level approaches, 811
Organizational strategies in ageing Political environment, 496
age-friendly climate, 536–537 Positive contagion, 679
FWA, 537–538 Positive crossover, 669–670
job crafting, 539–540 Positive emotions, 55, 60
training, 538–539 Positive organizational culture, 648
Organizational stressor, 272 Positive resolution, 276
Organizational system, 119 Positive safety leadership, 73
Organizations change, 160, 161 Post-traumatic stress disorder (PTSD), 338, 578
Organization’s ethical climate, 448 Post-violation model, 276, 279
Organizing modes, 128, 129 Preferred Reporting Items for Systematic
Reviews and Meta-Analyses
Statement (PRISMA), 833
Prejudice, 337
P Prescriptive group, 120
Participants, 125 Presenteeism, 641
Participation restrictions, 136 Preventing work stress, 96–99
Partner, 125 Prevention-focused safe behaviors, 70
Passive destructive leadership, 83 Private companies
Passive followers, 122 board of directors, 230
Peer mentoring, 647 OHS (see Occupational health and safety
Performance appraisal, 399 (OHS))
Performance management, 505 problem, 231
control-oriented and learning, 512 vs. public organizations, 231
directive, 507–511 responsibility, 231
enabling, 511–512 Proactive followers, 122
evidence-based insights, 515 Proactive followership, 122, 128, 129
involvement-oriented, 512 Problem-focused approach, 126
physical wellbeing, 504 Procedural justice, 288
884 Index

Productivity, 319, 325 practice and intervention, 473

norms, 337 research design and measurement, 472–473
Programs timing duration, 645 and safety signal theory, 462
Pro-social reporting, 443 Psychosocial work environment, 817
Pseudo-flexibility, 701 Psychosocial working conditions, 641
Psychological capital (PsyCap), 26 Psychosomatic strain, 274
Psychological contract breach, 270–273, 275 Public health, 191, 192, 204
accumulative, 277 Public sector employees, 272
career, 272 Public-service workers, 447
chronic health problems, 275–277
definition, 271
emotional exhaustion, 274 Q
empirical investigations, 271 Quasi-experimental design, 697
employee burnout, 273
event-based, 277
experience, 271 R
health, 273, 278 Race, 333
infancy, 273 Randomized control trials (RCT), 554, 582,
insomnia, 274 584, 605
macro context, 275 Recession, 190–192
mental health, 272 effects and management, 195–202, 204
moderators, 278 occupational safety and health management,
negative effects, 277 192–195
negative emotions, 274 Referent power, 123
negative health, 273 Rehabilitation, 641
organization, 271 Relational approaches, 19–20
organizational context, 274 Relational coordination theory, 220
physical health, 273 Relational justice, 288
research designs, 279 Relationships, 22
stress, 274, 277 Relative deprivation, 287
theoretical development, 277 Repetitive lower limb movement (RLLM), 558
violation, 271, 273, 279 Replicability, 517
Psychological contracts, 270 Resource(s), 666, 671, 673–674
Psychological contract violation, 271 allocation theories, 53, 56
Psychological health, 462, 467–469, 471, 473 caravan passageways, 465
Psychological safety climate, 28 Return on Investment (ROI), 752
Psychological strain, 667 Return to work (RTW), 586, 588
Psychological symptoms, 577 interventions, 650
Psychosocial behavioral, 646 plans, 646
Psychosocial health, 531–532 Revenge-seeking, 271
Psychosocial risk, 195, 200, 201, 203, 204 Reverse causality, 383–385
Psychosocial Risk Management Excellence Revolutionary systems, 654
Framework (PRIMA-EF), 819 Risk management, 813
Psychosocial risk management (PRIMA), Risk of tokenism, 486, 487
818–820 Robotic Construction Worker (RCW), 558
Psychosocial safety climate, 30, 360 Role-playing activities, 130
conservation of resources theory, 465–466
countries and occupations, 469–471
effort-reward imbalance model, 463–464 S
extension of strategic HRM, 466–467 Safety, 810
functions, 467–469 citizenship behavior, 69, 75
and job demands-control-support, 464–465 climate, 75
and job demands-resources, 461–462 coaching, 79
Index 885

compliance, 69 JD-R model, 53, 54

error trajectory framework, 629 job demends, 59
initiative, 69 leader-centric, 54
participation, 69 meta-analyses, 44
performance, 69 methodology, 46
signal theory, 462 mindset, 44
Safety leadership, 71, 78 mode, 44
behaviors, 72 motive, 44
dark side, 83 multiple stakeholders, 44
interventions, 79 negative, 47
positive side, 82 organizational performance, 45
Safety-oriented interactions, 84 positive, 47
Safety-related behaviors, 69 predictor, 47
dimensions, 69 satisfaction, 49
goal, 69 scholars, 47
work, 69 stakeholders, 47
Safety-related outcomes, 73 team-level, 50
Safety-related policies, 68 theoretical framework, 45, 52
Safety-specific transformational leadership, 79 vs. transformational leadership, 45
Same-sex marriage, 489 well-being, 46, 47
Satisfaction, 48 work engagement, 50
Scholars, 47, 48, 68 Sexual harassment, 797
Scope of justice (SOJ), 799 Sexual orientation, 482, 483
Second-order two-factor structure, 122 Shared leadership, 121, 127
Sedentary occupations, 548 Shared mental models, 27
Sedentary professions, 559–560 Sickness absence, 574, 576, 583, 585, 586,
Self-control, 56 589, 591
Self-determination, 652 Signal/attraction-selection-attrition theories,
Self-determination theory (SDT), 53, 56, 57, 485
75, 378 Simplistic dichotomies, 130
Self-directed business models, 649 Simultaneous influence, 450
Self-efficacy, 674 Six-factor structure, 122
Self-employed, 770, 771, 778 Skeptical perspective, 689, 692, 699, 703
Self-employment, 653 Skill development, 401
Self-esteem, 674 Sleepiness, 617
Self-managed solutions, 651 SMART work design, 739–740
Self-management skills, 76 digitalization positioning, 742–744
Self-regulation theory, 74, 76 dimensions, 741
Self-scheduling, 696 prevent harm, 738–742
Sensor-based applications, 654 thrive at work, 730–737
Servant leadership, 60, 72, 74 Social dynamics, 609
career satisfaction, 49 Social Encounters Scale, 608
career skills, 48 Social exchange theory, 45, 52, 58, 73, 75, 84,
definition, 44 287, 378
elements, 44 Social identification model, 847
empirical articles, 47 Social identities shift, 534
empirical studies, 57 Social identity theory, 439
employees well-being, 59 Social information-processing theory, 73
eudaimonic well-being, 49, 50, 55 Social learning theory, 45, 53, 73, 845
group-level, 50 Social support, 464, 675
hedonic well-being, 48, 49 Social symptoms, 577
ill-being, 51, 52 Social vacuum, 794
individual-level, 58 Social well-being, 396, 409, 410
886 Index

Society for Human Resource Management, 489 T

Society of Industrial and Organizational Taoism, 118
Psychology (SIOP), 795 Target similarity model, 291
Socio-affective components, 33 Task-and people-focused leadership, 18
Softer lean management practices (SLPs), 217 Task characteristics, 31–32
Soft law, 812 Team building, 130
Soft/non-binding/voluntary, 812 Team characteristics/dynamics, 24
Spatial flexibility, 688, 691–693, 697, 699, 700 Team-high quality member exchange (TMX),
Spillover 50
command and control, 667 Team leadership
enhancement or enrichment, 667 cohesion, 28
transfer of emotions, 666 learning, 27
Spillover-crossover model (SCM), 670–671 potency, 28–29
Stakeholders, 44, 47, 60, 647 psychological safety climate, 28
Standardization, 814 shared mental models, 27
STAR intervention, 703 viability, 29
Stigma, 485 Team-member exchange, 52
Strain-based interference, 667 Teams, 676, 679, 681
Strategic HRM, 466–467 Technology, 654
Strategies, disability inclusion, 345, 346 Telepressure, 678
Strength-based approach, 651 Teleworking, 702
Strengthening a Culture Of Respect and initiative, 697
Engagement (SCORE), 610 Temporal flexibility, 688, 691, 692, 694
Stress, 729, 731, 733, 740, 829, 831, 837, 848 The Civility Respect and Engagement in
Stress and related disorders, 578 the Workplace (CREW)
Stress Management Competency Indicator Tool programme, 795
(SMCIT), 97, 99 Theoretical approaches
Stroke rehabilitation, 644 behavioral, 18
Structural power, 123 charismatic and transformational, 20
Structure or production-oriented, 18 contingency, 18–19
Subjective measures of exposure to modern positive approaches, 20–21
organizational change relational, 19–20
downsizing, 255 trait, 17–18
implementation of technology, 257 Theoretically-driven conceptual
mergers, 256–257 framework, 222
privatization, 256 Theoretically-grounded empirical studies, 53
research, 259–260 Theoretical mechanisms, 45
restructuring, 256 Theoretical models, 58
Submissive/aggressive reactions, 126 Theorizing wellbeing, 318
Supervisor Support for Return to Work The swiss cheese model, 628
(SSRW), 103 Third-parties
Supportive organizational cultures, 648 additional considerations, 801–802
Susceptible followers, 124 decision-tree model, 797
Sustainable Development Goals (SDGs), 640 deontic motivation, 797–800
Sustainable employee engagement, 99, 101 victim humor, 800–801
Symptoms, CMPs victim talk, 801
anxiety, 577, 578 Threat and error management, 628
depression, 576, 577 Thriving
mental health problems, 576 example applications, 736–737
stress and related disorders, 578 mitigate illness, 731–733
Synergistic effect, 373, 399 pillars, strategies, and tactics, 730–731
Index 887

prevent harm, 733–734 Virtual/extended reality technology, 655

promotion, 734–736 Virtual teams, 127
at work framework, 732 Vision Zero, 815
Time-based interference, 667 Visual display units (VDUs), 561
Time consuming global system, 400 Visual impairments, 644
Time-spatial flexibility, 688, 691, 692, 699, Vocational rehabilitation, 642–644
700, 704, 705 businesses/self-employment, 652, 653
Total preventative maintenance (TPM), 221 challenges, 650
Toxic triangle, 124 clinical/disease-focused, 650
Toyotism, 210 employment opportunities, 653
Trade union, 856 employment outcomes, 646
membership, 857, 858 future, 649
non-union workplaces, 863–866 interventions, 646
well-being, 859 personalized interventions, 651
WHS representatives, 859–863, 866–869 physical/mental health, 649
worker health, 858 positive supervisor, 647
Training, 315, 316, 318, 321, 324, 325, principles, 651
538–539 processes, 6
Trait approaches, 17–18 technology, 653, 654
Transactional active leadership, 76 timing, 645
Transactional leadership, 20, 71 workplace environment, 647
Transformational change, 258 Voice
Transformational leadership, 18, 20, 44, 71, 74 definition, 354–356
Transitioning, 486 employees, 361
Transphobia, 487, 493, 497 future research for well-being, 363
Traumatic upper limb injuries, 644 human resource role, 363
Tyrannical leadership, 72 manager’s role, 362
and wellbeing, 357–361

U
Uber, 771, 777 W
Uncertainty management model, 299 Well-being, 46, 127, 129, 164, 314–317,
Uncertainty-related problem, 519 324–326, 729, 734–736, 738,
Undervaluing, disabled people, 338, 339 744, 810
Unemployment, 176 definition, 356–357
Unemployment rates, 640 employee HR perceptions and attributions,
Unethical behavior, 418, 431 401, 402
Unintentional safe behaviors, 70 employees’ role, 361
Universal design, 143, 146 human resource role, 363
Unsafe behaviors, 70 manager’s role, 362
Upside risk, 819 organizational resources, 402, 403
U-shaped curvilinear relationship, 74, 77 skills development and career
satisfaction, 401
theorizing, 317, 318
V and voice, 357–361
Varied experiences, disability, 339–341 Westman’s (2001) Crossover Model, 667–668
Verbal harassment, 485 Whistleblowing
Vertical modes, 128 description, 438
Veterans Health Authority, 609 effective management, 441–443
Victim humor, 800–801 empirical test, 451–453
Victim talk, 801 hypothesized multi-level, 444
888 Index

Whistleblowing (cont.) organizational culture, 715, 716

interactions, 450–451 recommendations, 720
managers impact, 448–449 stereotypes, 717
multi-Level theoretical explanations, Work-life interface, 6
440–441 Workplace accommodations, 135, 136,
organizational behavior, 439 138, 139
organization impact, 446–448 benefits, 139–141
partial test, 452 career planning, 151
prevent observed wrongdoing, 438 development, 149
process model, 450–451 flexible work locations, 144
regulatory context impact, 444–446 flexible work times, 144
reporter’s impact, 449–450 handling the disclosure, 147, 148
research implications, 453–454 idiosyncratic deals, 145
response model, 439, 443–444 implementation issues, 141–143
theoretical perspectives, 439–440 individual preferences, 145
Within individuals, 81 initial implementation, 148, 149
Within-person level, 82 performance review, 149
Work and Health Covenants, 818 recruitment and selection processes,
Work-based learning, 314, 315 146, 147
benefits, 319, 320 stage, employment cycle, 150
implementing, 323–326 types, 140
processes, 5 universal design, 146
scope, 315–317 Workplace bullying, 789, 795
theorizing, 317–319 Workplace challenges, 484–486
trade-offs, 320–323 Workplace environment, 647
Work design Workplace incivility, 789
example applications, 736–737 Workplace interventions, 575, 581, 583,
mitigate illness, 731–733 585, 589
overlooked, 738–739 Workplace mistreatment
pillars, strategies, and tactics, 730–731 aftermath, 796
prevent harm, 733–734 bullying, 789
promote thriving, 734–736 COVID-19 pandemic, 788
Work disability, 136–138, 650 helping victims, 795–796
Work engagement, 50 individual factors, 792–793
Work environment, 810 negative interpersonal interactions, 789
Worker participatory approach, 817 organizational factors, 791–792
Worker representation, 856, 867, 869 preventing, 795
Workers’ education, 534 relational factors, 793–794
Worker well-being, 856, 864, 866, 867 sickness-related absence, 790
Work–family interface, 674 victims, 790
Work-family-society interface, 704 Workplace policies, 489
Working conditions, 462, 464, 467, 470 Workplace wellbeing, 688–690, 693, 694, 696,
Work-life balance, 487, 667 697, 699, 700, 703, 706
Work–life balance initiatives, 7, 712 case studies
benefits, 713, 714 CONNECT+, 758, 759
costs to employees, 714, 715 costs of intervention, 755
COVID-19, 719, 723 data collection, 755
cultural traditions, 716 flexible working hours, 759–761
flextime, 721, 722 GAP, 756–758
fostering inclusive behaviours, 721 HRM, 755
gender perceptions, 717 mental health first aid, 761–763
intergenerational workforce, 718, 719 net costs, 756
migrants, 718 productivity benefits, 755
minority employees, 718 effects, 751
Index 889

evaluation methods Work-relevant relationship functions, 60

CBA, 752 Work stress, 464, 467, 553
CEA, 752–755 Work telepressure, 678
interventions, 751 Work-to-family conflict (WFC), 667
life satisfaction, 753 Work-to-family interference (WFI), 667
practical and intuitive, 752 World Health Organization (WHO), 580,
ROI, 752 598, 810
government and private sector World market, 176
investments, 751 Wrong-doing
non-pecuniary workplace experience, 751 internal reporting, 453
wellbeing economics, 751 organization, 446
Work-related consequences, 291 reporter/manager/organizational
Work related musculoskeletal disorders outcomes, 450
(WRMSDs) reporting, 450
biomechanical engineering, 549 situational characteristics, 454
description, 549
employment, 549
MSD, 548
occurrence, 563 Y
postural awareness, 558 Youth unemployment, 184
primary care nurses, 553
risk factors, 549
Work-related skills, 643
Work related upper limb disorders Z
(WRULDs), 550 Zero-sum game, 701