Many small and medium sized enterprises (SMEs) experience challenges related to the psychosocial working environment these years. Enterprises that deal with for instance industrial service, repair and maintenance meet with the fact that their employees are strained by issues such as high workload, customer handling and communication etc. Small and medium sized information and communications technology enterprises (ICT) and particularly IT consulting enterprises are also facing a number of challenges regarding the psychosocial working environment. Especially high demands at work, poor planning, sharp deadlines and project management constitute the main problems. Both business groups suggest that these challenges can lead to work-related stress, increased absenteeism, decreased productivity etc. If the enterprises do not change practice and do something about the work-related risk factors, they will risk more and new cases of employees with work-related stress.

Changes in Working Environment Act of October 2010 suggests the need for companies to introduce new ways of running the daily management and organization of work, including working environment. It has opened up new opportunities for companies to integrate consideration of the psychosocial working environment in their daily work and to make the organization suit the individual business needs and organizational design. Many SMEs have access to the tools so they are able to develop and implement preventive strategies in relation to the psychosocial working environment. But they lack the process tools of stress management and are uncertain about the task. Typically, companies do not have access to internal resource persons who can operate, sustain and create visibility according to the change. Hence, there is a need for new knowledge on how SMEs can initiate and implement primary prevention and thereby allow that they get hold of the underlying organizational mechanisms that lead to work-related stress. We refer to the instruments as methods and tools and the common characteristics consist of the fact that they support the working environment. At the same time they indicate how the enterprises can handle work-related stress and psychological working environment, and how to initiate management efforts.

The experience from other projects shows that enterprises typically do not have the organizational room that allows common, systematic reflection, assessment and development of new strategies and initiatives. Therefore, it is a fundamental premise of the phases of the model that they are based on organizational room of reflection and development of strategies, initiatives and planning efforts. The results of the development project "Knowledge Work and stress - between enthusiasm and strain" point to a number of key conditions that must be present if a development project can succeed and become embedded in the enterprise. The conditions consist in the fact that the process will be supported by operators who have access to and can drive processes, and that the actors use appropriate methods and provide visibility about the process. There is thus no question of a classic change management approach and understanding of the sustainability, but rather a dynamic development process based on "Design Thinking". It is a practical and creative process in which the SME creates ideas which it develops through collaboration, system understanding, visualization, testing, repeating and adjustment. This approach is also reflected in the project's research activities.