Mattis (1990) investigated various types of flexible work arrangements for managers and professionals in major US corporations. She examined part-time work, job sharing and telecommuting. Part-time work has only relatively recently been made available to managerial and professional employees, although it has been available for clerical employees for some time. Part-time work includes reduced weekly hours, reduced annual hours and traditional part-time work (work full-time then no work). Job sharing is relatively new and has been used only on a small scale. It also has various forms: shared responsibility for one full-time job, divided responsibility (e.g. separate clients or projects), and unrelated responsibility (completely separate and unrelated tasks). Telecommuting includes work being done at a location other than the main office but being connected electronically.

She reported that most employees select flexible work arrangements to balance work and family responsibilities, and that telecommuting is chosen also to increase productivity and reduce costs as well as to avoid commuting. Although part-timeworkwas the most common flexible work option in the companies studied, both job sharing and telecommuting showed increasing acceptance. Despite these findings, the number of employees on flexible work arrangements constitutes a small percentage of the total company workforce.

Nelson et al. (1990) found that organizational resources (e.g. flexible working hours, a mentor or role model) were associated with fewer symptoms of strain and greater job satisfaction in a sample of 195 female personnel professionals.

INTERVENTION AND POLICY IMPLICATIONS

It is important to target interventions relating to work stress and health since women have unique needs and experiences (Nelson & Burke, 2000a, b). For example, smoking is a distress symptom linked to work stress. Women encounter different problems than men do in trying to quit smoking (Chesney & Nealey, 1996).

Women may fare better in terms of lifestyle factors (e.g. alcohol consumption, healthy eating patterns). Lindquist et al. (1997), in a study of lifestyle stress and blood pressure, found that women were more likely to use healthy coping approaches (e.g. positive attitude) while men were more likely to use unhealthy eating, denial of stress and alcohol. Women may also use social support as a coping mechanism more than men (Matuszek et al., 1995).

Enhancing Executive Women’s Health through Prevention

Because executive women have more resources at their disposal, it is tempting to argue that they should not be targets for organizational interventions. They may be healthier than women at lower levels of the organization, but it is especially important that they are healthy. As decision makers and policy setters, they hold the keys to the well-being of the organization. They also serve as models for the health-related behaviors of the people they lead. An awareness of the needs of different managerial groups can reshape the culture of the organization in healthy ways by broadening and enriching the majority culture. For example, changing an inflexible, long-working-hours culture benefits not only women but men as well.

For male and female executives alike, preventive management involves enhancing strengths and managing risks. Preventive management provides a three-part framework that can be used to develop interventions to improve the health of executive women.Within this framework, there are three levels of interventions: primary, secondary, and tertiary. Primary preventive efforts are directed at eliminating or reducing the sources of stress or the risk factors. Secondary preventive efforts focus on helping executive women manage their responses to the inevitable demands of work and home. Tertiary prevention involves healing executive women and organizations through appropriate professional care. There are guidelines at each level of intervention for organizations and for executive women. Primary prevention efforts should focus on the stressors of politics, overload, barriers to achievement, sexual harassment and other social-sexual behaviors, andwork–home conflict. For organizations, guidelines at the primary level include:

Offer alternative work arrangements and assistance with childcare and elder care. Flexible work schedules, telecommuting, and company assistance with childcare and elder care can help women deal with overload and work–home issues. Patagonia, for example, has taken into consideration employees’ needs for time for personal concerns, and offers flextime and the option of working at home for three hours per day. While childcare and elder care are offered more frequently by large corporations, most medium-sized and small organizations have yet to adopt these benefits.

Develop zero-tolerance policies for social-sexual behaviors and sexual harassment. Victims of sexual harassment suffer depression, headaches, nausea, and other symptoms. Atlantic Richfield has a record of strong policies and has fired several highly placed managers who violated the policies.

Ensure that development and reward systems promote equitable treatment of all employees. To address the wage differential issue, reward systems that promote equitable pay for women are necessary. In addition, audits of development programs should be conducted to see whether women are unfairly disadvantaged in terms of development opportunities. The Federal Government’s commitment to equal opportunities for women has effectively shattered the glass ceiling in the Senior Executive Service, which consists of all top management positions except political appointments.

Design programs that provide social support at work. Efforts to build social support, such as mentoring and networking programs, can be of special benefit to executive women. The phrase “lonely at the top” certainly applies in this case, and programs that foster connections with other executives can help female executives gain social support. Mentoring programs allow women to be either mentors or proteges, or both, and being a provider of social support to others also has beneficial health effects. Mentoring and networking efforts also benefit the organization by developing a diverse talent pool of future executives. Executive women also have a responsibility for preventively managing their health. At the primary level, we propose the following guidelines for them:

Identify your sources of stress and work toward managing or mitigating them. All executives suffer from stress of some form and often do not take the time to do a careful self-analysis to pinpoint exactly the causes of stress. A personal stress management plan, developed through careful introspection, is the best insurance against burnout.

Take advantage of developmental opportunities and high-profile assignments. Women should recognize that top executives see a lack of experience as a barrier to women’s achievement; therefore, high-visibility opportunities offer ways to enhance experience and gain exposure within the organization.

Recognize the inevitability of work–home conflict and work to manage it. Women executives need to ask for programs like flexible work arrangements and for assistance from other family members such as spouses. They need to recognize that asking for help is a sign of strength and that they can overcome their ownlimitations by asking for help from others.
Develop personal resilience by changing your perceptions. Part of primary prevention is changing the stressor. Alternatively, executive women can change their perceptions of stressors, which is also effective. Optimism and positive self-talk can transform a threat into a challenge that can be overcome. Secondary prevention efforts focus on helping women manage their own responses to stress, and usually come in the form of exercise or ways to emotionally release tension.

Organizations can assist women in several ways, including:

Make exercise facilities and childcare options available. As noted earlier, women are less likely to utilize exercise as a coping technique than are men. This may be so because women have less discretionary time to pursue options like health club memberships, and often must find childcare to be able to exercise. Organizations can provide convenient exercise facilities with babysitting services, along with flextime, to help remedy this problem. On-site facilities with childcarewould be ideal. Referrals to appropriate exercise facilities offer another alternative.

Encourage networking groups to facilitate emotional release. Talking with trusted colleagues provides emotional ventilation. It allows executive women to reconstruct their experiences and move beyond them through verbal expression.

Encourage training in yoga and meditation. There are a variety of methods for muscular and psychological relaxation. Training in relaxation methods can help women more effectively transition from the work into the home environment with less stress spillover. Executivewomen must also take responsibility for secondary prevention. The suggestions for executive women parallel those for the organization.

Make exercise a daily ritual. The best way to make exercise a priority is to schedule it on the calendar.

Talk to others. Talking about experiences allows individuals to solve problems rather than ruminate or obsess about events. It allows executive women to work through their experiences and to benefit from input from others.

Learn a meditation technique. Meditation has been found to be a powerful antidote to the stress of executive life. It has beneficial effects on both mind and body. It must be noted, however, that secondary prevention alone is a palliative technique. Without accompanying primary interventions that focus on changing the stressors, little headway can be gained by executive women or organizations. Tertiary prevention efforts are directed at symptom management or at healing the wounds of executive life. Organizations have a major role to play in this level of prevention.

Ensure that employee assistance programs provide appropriate professional care. It is essential that employee assistance programs recognize the special needs of women in providing services or referrals to appropriate professional care. Certain behavioral distress symptoms, such as eating disorders, alcohol abuse, and smoking, may be more effectively treated with gender-specific interventions. Executive women must also take responsibility for tertiary prevention.

Develop a network of qualified professionals to rely on. This means establishing relationships with physicians, psychologists, and other trained professionals in advance of the need so that they will be available in times of crisis.

The three-level prevention framework provides ways of understanding what both executives and organizations can do to manage risks and enhance health. Care must be taken in these efforts to recognize that women at different life stages may have different needs. Childcare assistance, for example, may not be a high priority for mid-life women. Because they have spent many years putting others first—employees, co-workers, spouses, and children—they may need more personal time for putting themselves first. This raises the importance of dialogue between executivewomen and others in the organization. To develop interventions that improve the health and well-being of executive women, decision makers must listen to women’s concerns and ascertain what they need. The perceptions of others concerning what might benefit executive women may not be accurate. A psychologist at the executive level can be an invaluable guardian of mental health and well-being. There are two models of this working relationship. The psychologist might be employed as a member of the CEO’s staff, or might serve as an outside consultant.

The health and well-being of the organization is dependent on the health and well-being of all of its members. Women at the top of the organization are no exception. In a study mentioned earlier, company initiatives in general areas likely to address some of the demands experienced by managerial and professional women included work and family programs, flexible work arrangements, leadership and career development, mentoring programs, and total cultural change (Mattis, 1994). The most proactive approach organizations can take is to change the source of stress; that is, find out what is causing executive women’s stress and modify the cause.

In addition to attacking the causes of stress, companies can help women manage their own responses to stress. As a final line of defense, organizations need to have employee assistance programs that recognize the health needs of women in providing services and referring women to professional care. The three-part preventive management framework proposes that interventions mainly consist of the primary level, supplemented by secondary and tertiary prevention. This framework provides an effective means for enhancing executive women’s strengths and managing their health risks.

Implications for Interventions

The three-part preventive management framework provides a framework for integrating the preceding review into suggestions for interventions that would target the stress-related challenges of working women. Primary preventive efforts, directed at changing the source of stress, should focus on the stressors of politics, overload, barriers to achievement, sexual harassment and other social-sexual behaviors, and work–home conflict (Burke, 1996a, b). Flexible work schedules, alternative work arrangements like telecommuting, and company assistance with childcare and elder care can help women deal with overload and work– home issues (Mattis, 1994). Politics, barriers to achievement and sexual harassment can be effectively diminished by aggressive organizational efforts in terms of corporate policy, and a system of rewards that reinforces equitable treatment of all organizational members (Schwartz, 1992). Efforts to build in social support at work, such as in mentoring programs, can be of special benefit to working women (Kram, 1996).

Secondary prevention efforts focus on helping women manage their own responses to stress, and usually come in the form of exercise or ways to emotionally release tension. As noted earlier, women are less likely to utilize exercise as a coping technique than are men. Interventions that educate women about the stress management benefits of exercise and encourage them to engage in exercise are warranted. Support groups to facilitate emotional release and training in relaxation methods can help women more effectively with the transition from the work to the home environment with less stress spillover. Tertiary prevention efforts are directed at symptom management. It is essential that employee assistance programs recognize the special needs ofwomen in provision of services or referral to appropriate professional care. As mentioned above, certain behavioral distress symptoms, such as eating disorders, alcohol abuse and smoking, may be more effectively treated with gender-specific interventions.

One of the issues that must be addressed by organizations is how to alter employment demands so that they mesh more easily with family responsibilities. Unfortunately, most employers do not consider their employees’ concerns as family members to be organizational concerns (Friedman, 1990). Policies and practices are designed as if responsibilities outside the job were subordinate to work demands. If, rather than ignoring these, companies were to acknowledge them and assist their employees, a great deal of employment–family conflict could be alleviated (Friedman et al., 1998).

Offermann & Armitage (1993) provide an inventory of stress management intervention options for women managers, categorizing them by target: society at large, organizations, and women themselves. Unfortunately, few examples of their application, and even fewer of their evaluation and effectiveness, are available. Some exceptions are Kossek (1990), Rushforth (1991), Miller (1984) and Goff et al. (1990).

One area in which the company could assist is childcare. Childcare is a demand on the family that poses conflict between work and family interests, particularly in the singleparent family. Other benefits could encourage men to take a more active role in the family through the provision of paternity leave. A second area in which organizations could take action involves the concept of what constitutes a career. Most organizations currently define career in a narrow sense in terms of progress and upward mobility, and in so doing preclude a lifestyle that deviates from the masculine one. For example, persons who move through the ranks efficiently and quickly are rewarded, and it is almost always assumed that the highly motivated person works his or her way upwards faster than the person who is minimally motivated. As a result, the part-time worker (whether part-time for one year or five) is tolerated rather than accepted, and may even be referred to as a casual worker. It is not recognized that individuals pursuing careers may have other commitments (e.g. family responsibilities and/or interests related to personal growth), which demand substantial time and energy. It is primarily during the years when women are experiencing pregnancy, childbirth, and rearing young children that societal institutions should acknowledge and accommodate alternative lifestyles to the one currently assumed for all members of society. Lack of 24-hour childcare, inadequately paid maternity leave, and the assumption that all committed employees should work an 8–12 hour day constitute discrimination against women (Greenglass, 1985). Moreover, organizations can introduce programs to promote a climate that is responsive to the needs of women and men, particularly when they are raising a young family (Schwartz, 1989). For example, flextime can be introduced such that workers can schedule their work in different time frames, depending on their needs and possibilities at particular stages in their life cycle.

FUTURE RESEARCH AND ACTION DIRECTIONS

There have been some pleasantly encouraging signs that research interest in the content examined in this chapter has increased. This is shownparticularly in studies ofwork and family, and occupational stress experienced by managerial women (Freedman & Phillips, 1988). On the other hand, several other areas are still under-researched (Repetti et al., 1989). These would include the effects of employment gaps on career satisfaction, consequences of the more varied patterns thatwomen’s careers reveal, gender proportions, and the effects of variouswork experiences (Morrison, 1992) on both career aspirations and emotional well-being.

Considerably more work needs to be done on the potential benefits of efforts of organizations to support the career aspirations of managerial and professional women through cultural change efforts and policy implementation (Morrison, 1992). There is an urgent need to document best practice in this area (Kraut, 1992). It is important to develop case studies of successful and less than successful change efforts to further our understanding of how best to bring about positive change. These case studies would also prove useful to organizations interested in creating a level playing field. Case studies would share the efforts of other organizations, a very persuasive and credible way to change attitudes and be helpful. In addition, more research attention needs to address the effectiveness of a variety of specific policies for creating a women-friendly environment (Galinsky & Stein, 1990; Kraut, 1990). These include policies in the areas of sexual harassment, flexible working hours, part-time work, and working at home. Without the active support by the top of the organizations, training in their understanding and use, and consistent and intelligent applications, well-conceived policies often fall considerably short. This seems particularly important because there has been recent speculation that companies may be less family-friendly in an increasingly competitive marketplace (Fierman, 1994).