The current managed healthcare environment stresses brief and effective short-term therapy. However, often this short-term treatment does not lead to long-term behavioral changes and clients return to therapy many times for help with the same dysfunctional behavioral patterns. The main problem with these traditional forms of treatment is the assumption that clients have the basic skills to change their ineffective behaviors. Yet, many people lack the basic skills to manage our highly stressful society, and may take years to master new behavioral management skills. Examining the relationship between stress and coping, this study explored both short--and long-term approaches to behavioral change relative to occupational burnout, and focused upon the teaching of skills to manage stress. Subjects who participated in a 6-week stressmanagement program reported only temporary decreases in burnout, while those subjects who received 1-hour coping "refresher" sessions at 5 months, 11 months, and 17 months showed consistent decreases in burnout throughout a 2 1/2 year period. These results suggest that psychologists can be much more effective behavioral change agents through long-term approaches that emphasize teaching new skills to manage chronic behavioral problems. Given the changes in the health insurance industry and the way therapeutic services are provided, the field may need to rethink approaches that are grounded in personality theory and abnormal psychology to approaches that emphasize principles of leaming theory.During the past decade, researchers have paid a great deal of attention to the outcomes of stressful environments. In particular, discussion of hazardous wastes, nuclear war, the destruction of the environment, the depletion of natural resources, and the presence of food additives are current topics of concern for both children and adults. Society is changing rapidly, divorce and remarriage are common, both parents are typically working and spending less time with children, and society is plagued by drug abuse, violence, and AIDS. With such an array of problematic societal issues, it is not surprising that we are becoming increasingly aware of stress and its consequences (Hetherington, 1984). When one thinks of the effects of stress on an individual and attempts to identify possible outcomes, the "fight or flight" metaphor is typically recognized. This distinction was identified by Cannon in 1929 when he explored the role of the central nervous system and the adrenal system in the response to a stressor (Cannon, 1932). In an extension of Cannon's work, Selye, in his laboratory experiments on the effects of noxious substances on animals, proposed that when an individual is exposed to a stressful stimulus he/she responds with a predictable set