Occup. Med. Vol. 48, No. 6, pp. 361-368, 1998 Copyright © 1998 Lippincott Williams & Wilkins lor SOM Printed in Great Britain. All rights reserved 0962-7480/98 The self-reported well-being of employees facing organizational change: effects of an intervention D. Iwi, J. Watson, P. Barber, N. Kimber and G. Sharman Division of Psychiatry and Psychology, United Medical School, Guy's Hospital, London, SE1 9RT, UK The objective of this study was to investigate the self-reported well-being of employees facing organizational change, and the effect of an intervention. It was a controlled intervention study. Subjects were allocated to study and control groups, and brief individual counselling was offered to the subjects in the study groups. Questionnaire measures were administered before and after counselling (a 3-month interval), and non-counselled subjects also completed questionnaires at the same times. The setting was 15 estate offices in an urban local authority Housing Department. Subjects comprised the total workforce of the Housing Management division: 193 employees, male and female, aged 22-62 years, facing compulsory competitive tendering between 1994-97. Main outcome measures were baseline and comparative measures of psychological morbidity, including the General Health Questionnaire (GHQ) and the Occupational Stress Indicator (OSI). Questionnaire response rates were 72% and 47% on first and second occasions respectively. The uptake of counselling was 37%. In comparison with (1) the UK norms for the OSI and (2) the norms for a similar occupational group, this group of workers were under more work-related pressure and their self-reported health was markedly poorer. They were not however at a disadvantage in terms of coping strategies. Those accepting the offer of counselling were subject to greater levels of work stress, had poorer self-reported health and markedly lower levels of job satisfaction than those who did not. Questionnaire scores were not significantly different before and after counselling, giving no evidence of treatment effects on symptomatology. However, almost all subjects rated counselling as having been extremely helpful. This study suggests that adverse effects on staff facing organizational change may be ameliorated by improved management practice. Key words: Counselling; cognitive analytic therapy; intervention; organizational change; redundancy; well-being. Occup. Med. Vol. 48, 361-368, 1998 Received 8 December 1997; accepted in final form 9 March 1998. INTRODUCTION The association of unemployment with ill-health is a major concern for society, reflected increasingly in the media and in the literature on occupational stress, occurring against the background of widespread unem- ployment in the UK and elsewhere, under market and political influences which affect both private and public enterprises. As part of this picture, local authorities throughout Britain have followed a comprehensive This work was presented in a dissertation accepted for the first author's membership of the Faculty of Occupational Medicine of the Royal College of Physicians of London. Correspondence and reprint requests to: J. Watson, Division of Psychiatry and Psychology, United Medical School, Guy's Hospital, London, SE1 9RT, UK. Tel: (+44) 171 955 4247; Fax: (+44) 171 955 2976. programme of compulsory competitive tendering (CCT) of their services, with resultant job insecurity and pro- longed periods of uncertainty for their employees. Meeting employees' needs in this situation provides a challenge to occupational health practitioners, whose responsibilities extend to employees who are at risk of losing their jobs. 1 Previous research 2 ' 3 has demonstrated a higher morbidity in the unemployed but few studies have determined measures of health and well-being in those who are threatened with redundancy. This study addresses the problems of employees facing organiza- tional change and job insecurity associated with CCT. The paper is concerned solely with medical and psychosocial effects of the downsizing process and their management; or- ganizational and political considerations are outside its scope. Job insecurity and resultant employee stress pose a serious problem for organizations in a world of rapid and difficult change. In the UK, time off work due to by guest on December 24, 2015 http://occmed.oxfordjournals.org/ Downloaded from