Progress in understanding and developing effective responses to work-related stress has been elusive, patchy, and inconsistent. The reasons for this are reviewed, and the inadequacy of traditional stress management techniques and organisational interventions to tackle it are examined. Although necessary, clinical responses to distressed individuals and organisations in isolation can never deal effectively with the overall increasing levels of stress found. Neither can attempts to 'fit' individuals to cope with ever more demanding work patterns and practices. The reviewed evidence suggests that an integrated approach that acknowledges how social, economic, political, and organisational factors impact on individual needs and values is needed. This integrated approach is described, with its required input from communities and politicians, as well as occupational health specialists. The article concludes that work-related stress is the result of complex psychosocial interactions that simply cannot be effectively understood or treated by any one professional group or theoretical approach.