Stress management programmes were implemented for direct care staff in two group homes for people with learning disabilities. Staff working in three similar homes were used as controls. Assessments were made of anxiety and depression levels and demands, supports and constraints at work. Staff in the intervention houses were also observed at work to determine who they were interacting with, the nature and type of the interaction and the amount of time spent on different aspects of the job. This information was used to inform and develop an intervention aimed at the groups of staff involved. Goals were set with the aim of reducing levels of anxiety and depression in staff and these were subject to review. Reassessment in intervention houses showed reductions in anxiety and increased perceived support when compared to controls. There were also changes in some observational measures, particularly increased positive interactions and assistance given to clients, and formal education programmes. These results suggest that intervening to reduce levels of anxiety and depression can have a positive impact on work performance in these settings.