Stress and burnout in health professionals: paradigms, meaning and the quality of working life

The stress paradigm has gained significant currency in the workplace in the past decade as a model for explaining the consequences of perceived mismatches between demands and coping ability. In many formulations, the onus is on the individual to manage pressure and to cope with the consequences of cognitive or emotional overload. This has resulted in a "stress management industry" that provides skills training in areas such as time management, communication, assertiveness, conflict resolution and relaxation. Such approaches, while helpful to a degree, focus more on symptoms than causes. They ignore (i) the importance of organisational factors and (ii) the potential to change the individual's own paradigm at the deeper level of meaning. This paper will argue that organisations should focus, less on minimising stress, and more on maximising the "quality of working life". It is also proposed that, by helping professionals to change their personal paradigms, to develop self-insight and to formulate a personal model of meaning in which internal values and external behaviour are aligned, they become more resilient to the pressures inherent in their day-to-day work.