This article describes a comparative stress management intervention study. The impacts and outcomes of an individual level intervention (counseling) and an organizational level intervention (increasing employees' participation and control) are compared. The results suggest that counseling has clear benefits for employees' psychological well-being and that the organizational intervention does not. Neither intervention had any impact on perceptions of work characteristics, physical symptoms, or absenteeism. It is suggested that the causal relationship between the work environment and psychological distress have not been demonstrated and that techniques for bringing about change in complex organizations are poorly developed. For these reasons, the strategy of changing work conditions cannot, at present, be expected to improve the psychological states of employees. Thus, whereas organizational interventions that aim to prevent psychological distress may be "better" in ethical and moral terms, individual interventions that aim to treat existing psychological problems or help individual employees manage difficult working conditions appear to be "better" in terms of efficacy and efficiency.