21.1 A MORE POSITIVE FUTURE

While there are concerns and issues in the domain of work and health psychology as we expressed in the opening chapter for this third edition of the Handbook, there are positive advances emerging as well. Hence, we see a more positive future (Cartwright & Cooper, 2008). Along this line, Macik-Frey, Quick and Nelson (2007) identify four of these positive advances in the broad domain of occupational health. These are: positive health, leadership, mood and emotion, and intervention. Here we touch on the first three of these issues, reserving the issue of interventions for Section 21.3 as the conclusion of the chapter.

21.2 PSYCHOLOGICALLY HEALTHY WORKPLACES

Macik-Frey, Quick and Nelson (2007) suggest that occupational health psychology emerged from preventive medicine, psychology and engineering with the aim of either preventing health problems in organizations or helping to repair the damage, some of which inevitably occurs. As we have noted above, prevention and treatment (i.e., repairing damage) are only two of the missions of psychology. The emergent third mission of psychology is to build upon strength factors, which is the domain of positive psychology as we have traced it in the positive advances noted in Section 21.1. In this vein the psychologically healthy workplace initiatives in the United States emerged from the cooperative agreement between the National Institute for Occupational Safety and Health and the American Psychological Association. Macik-Frey et al. (2009) present a framework for psychologically healthy workplaces based on a critical review of the research literature. The key issues within this framework are health workplace practices, employee well-being and organizational improvements. Underpinning this framework is a set of four guiding principles of organizational health that were originally set forth by Adkins, Quick and Moe (2000). These principles are:

1. Health exists on a continuum of mortality to vibrant well-being.
2. Organizational health is a continuous process, not an obtainable state.
3. Health is systemic in nature and results from interconnections of multiple factors.
4. Organizational health relies on fulfilling relationships that are achieved through communication, collaboration and relationship-building actions.

The PATH (Practices for Achievement of Total Health) model is briefly summarized below. The PATH model originates in healthy workplace practices, which are proposed to positively impact both employee well-being and organizational improvements. Please see Macik-Frey et al. (2009) for a full set of original references and details on the development and presentation of the model. The model provides for the interaction of employee well-being and organizational improvements, the two outcome variables.

21.3 INTERVENTIONS

Lest we paint an overly positive picture of work and health psychology, a caveat is in order. Over the years, the editors of the Journal of Occupational Health Psychology and others have called for intervention studies to validate the theories and practices in our disciplinary domain. We continue to be concerned with the relatively few research studies that have emerged despite these calls for well-designed intervention studies. The narrower field of health psychology alone does have a set of individual intervention studies that cover a range of specific and individual therapeutic interventions. However, we need more and different studies. The notion of organizational therapy which Edgar Schein and Manfred Ketz de Vries talked about in the late 1990s never caught on. So, maybe we need to create more of a bridge between the domains of work and health psychology with that of organizational development.

True, there has been considerable knowledge accumulated concerning risk factors in organizations, along with their connections to occupational illnesses and injuries, but comparably less is known about effective interventions for reducing the risk factors. Reviews of the intervention literature have produced disappointing results. Health promotion programmes, along with other occupational health and safety interventions as a whole, have not demonstrated sustained changes in employee behaviours. It should be recognized that researchers face challenges in studying interventions, and that control group designs and randomization are not often possible. And, interventions are often guided by practical considerations, rather than being informed by theory.

Additionally, it is true that interventions evolve and change once they are implemented. Consider, for example, the history of health circles used in Germany which were adapted from quality circles and other employee participation approaches. Health circles operate on the assumption that employees are in the best position to improve their own job conditions (Macik-Frey, Quick & Nelson, 2007). They evolved from simple research projects focused on changing work conditions (risk factors) to comprehensive programmes that are now commonly used to enhance employees’ health. A typical health circle process takes 15 months to complete, including a health report and survey, multiple health circle meetings and evaluation. Originally health circles only included employees, but some companies now use separate health circles for managers.

To end on a positive note, we do need to build on the emergence of the positive science of strength factors and well-being. There is now an accumulating body of research evidence about such individual strength factors as self-reliance, resilience, vigour, engagement and hope. These strength factors have been linked to individual health outcomes. The natural next step is to go into workplaces and design and then test and examine ways to enhance these strengths for collective health and well-being. These interventions should then be evaluated, well-designed, scientific studies. We need both great practical science and great scientific practice – they go together like a hand in a glove. Care should be taken to address the level of change intended (individual and/or organizational). As just mentioned, many studies have focused on the individual as the target of change, and have shown that individual-level interventions alone may not enhance health if the organization does not change too. The concept of healthy organizations means that along with profits and productivity, the collective well-being of employees is an important outcome.