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And perhaps the most dif cult question of all is what treatment or intervention or service is the most helpful for a given patient (with a given level of severity, chronicity and comorbidity, motivation and coping skills) at a certain point in time (taking into account previous treatment history and current life circumstances) In order to answer these questions we need to integrate the best research evidence with clinical expertise and patient values (Sackett, 2000)..

develop standards of management practice for controlling work-related stressors. At this time no approved code of practice has emerged. To conclude, workplace stress is not going to be eliminated merely by passing legislation or having workable policies in the organisation. A thorough analysis of the sources of stress- and evidence-based stress management interventions will help to alleviate this problem in the workplace. [Editor s comment After this chapter was submitted the Court of Appeal, in London, issued an important judgement. Four cases, concerning employers liability for employee s psychiatric illness caused by stress at work, were brought together (Sutherland v. Hatton [2002] 2 All ER 1]. It has made the tests stricter. Injury to the speci c person must now be reasonably foreseeable. That would require study of the individual s characteristics and the job. Relevant factors for the employer to consider include the nature and extent of the work (with employers being more alert where jobs are intellectually or emotionally demanding), and the employee s behaviour. Employers could, in the absence of being told otherwise, assume that employees could cope and did not need to make searching enquiries. Employees returning to work, after sickness breaks, could be assumed to be t but uncharacteristic regular or long illness breaks could put them on guard. The employer s duty to act arose when it would be plain to any reasonable employer that there were problems. When deciding what the employer should do, account should be taken of the size and scope of the business as well as available resources.]

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Similarly, communication of the organization s ethics and fraud program to the workforce would seem to be an obvious component of an effective fraud detection program. However, 34 percent of the respondents noted that their program was well-intentioned but meaningless to employees, while an additional 21 percent stated that no such program existed. When asked how their fraud detection programs could be enhanced, 63 percent of survey participants recommended requiring strict monitoring of basic internal controls.9

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