Work-related stress in SMEs is an increasing problem. However, knowledge regarding stress management interventions in SMEs is limited. Often SMEs lack professional in-house facilitator resources to assist change processes. The aim of this paper is to describe the outcomes of four SMEs applying a participatory multi-level intervention model known as "PoWRS" and identify enablers and barriers related to the intervention. The companies' outcomes regard the specific intervention, influence on productivity and well-being, and unexpected outcomes. Main enabling factors included multi-level engagement in reflections, decision making and implementation of the changes through all phases, local untrained facilitators assisting the process, active line managers and senior management, continuous evaluations and adjustments and visualization of the progress.Some of the critical barriers were lack of process experience, imbalance between operations and development, and lack of management support. Implications of the findings for work-related stress preventions in SME using the model are discussed.3