Employee assistance program

Employee Assistance Programs (EAPs) are employee benefit programs offered by many employers, typically in conjunction with a health insurance plan. EAPs are intended to help employees deal with personal problems that might adversely impact their work performance, health, and well-being. EAPs generally include assessment, short-term counseling and referral services for employees and their household members. Dr. Warren Shepell was a pioneer in EAP in Canada and started EAPs in Canada in 1978.

Employees

Employees and their household members may use EAPs to help manage issues that could adversely impact their work and personal lives. EAP counselors typically provide assessment, support, and if needed, referrals to additional resources. These programs are becoming increasingly more common in today's worksites, and as the field grows, the responsibilities of employee assistance professionals are expanding as well. The issues for which EAPs provide support vary, but examples include

• substance abuse
• safe working environment
• emotional distress
• major life events, including births, accidents and deaths
• health care concerns
• financial or legal concerns
• family/personal relationship issues
• work relationship issues
• concerns about aging parents

An EAP's services are usually free to the employee or household member, having been pre-paid by the employer. In many cases, an employer contracts with a third-party company to manage its EAP. Many of these firms rely upon resources from skilled vendors of specialized products to supplement their services. Confidentiality is maintained in accordance with privacy laws and professional ethical standards. Employers usually do not know who is using their employee assistance programs, unless there are extenuating circumstances and the proper release forms have been signed. In some circumstances, an employee may be advised by management to seek EAP assistance due to job performance or behavioral problems. This practice has been thought to raise concerns for some, who believe that the EAP may place the employer's interests above the health and well-being of the employee. However, when done properly and with a highly qualified vendor, both the employer and the employee benefit. In fact, the goal of these supervisory referrals is to help the employee retain their job and get assistance for any problems or issues that may be impacting their performance. And, most importantly, any referrals for job performance issues or concerns are always confidential.

Not all states require such EAP providers to be licensed. As a result, the options for an employee who is dissatisfied with his or her EAP experience may be more limited than with a traditional health insurance provider. Some argue that more government oversight and greater involvement from consumer advocacy groups is essential to ensure employees receive fair treatment by EAP providers. California is one state that requires EAPs that are delivering actual counseling services on a pre-paid (or capitated) basis for more than 3 sessions within any six-month period to have a Knox-Keene license. This is a specialty license for psychological services and is mandated by the Knox-Keene Health Care Service Plan Act of 1975.

The State's Department of Managed Health Care regulates these licensed plans and acts as a watchdog for the consumer with regard to grievances, access to quality care, and ensuring that the EAP plan has an appropriate level of tangible net equity to deliver services to plan members. Title 28, Rule 1300.43.14 of the California Code of Regulations allows EAPs without a Knox-Keene license to request an exemption if they are just an assess and refer model, without delivering actual counseling services.

Employers

Some studies indicate that offering EAPs may result in various benefits for employers, including lower medical costs, reduced turnover and absenteeism, and higher employee productivity. Critics of these studies question the scientific validity of their findings, noting small sample sizes, lack of experimental control groups, and lack of standardized measures as primary concerns. Proponents, however, argue that the consistency of positive findings across studies in different service sectors denote at least some positive effect of programs, even if the most effective components of such programs have not been determined . EAPs may also provide other services to employers, such as supervisory consultations, support to troubled work teams, training and education programs, and critical incident services.

The broad array of services provided to employers by today's EAPs make a good business case for external programs. External EAPs can provide more than just psychological counseling through the integration of a host of "work/life" resources. These kinds of resources can help employees wrestling with the associated demands of starting a family, dealing with personal finances, legal problems or the stresses of being a working caregiver with aging parents. A full-service, integrated external EAP can provide all these services through one single, toll-free number that is accessible 24 hours a day and 7 days a week.

External EAPs also provide the added benefit to employees of delivering confidential counseling services off-site, away from the eyes and ears of fellow workers, managers, or the Human Resources department. It needs to be noted, however, that EAP services are paid for by employers who then become the "clients" of the EAP company. A high-quality EAP will effectively communicate to employees that the organization is sponsoring the benefit but that it is confidential (within the scope of state and federal laws) and free to them. These EAPs maintain a strict adherence to the concept of serving two clients; the employer and the employee. If the employee improves as a result of the use of this benefit, then both the employer and the employee are winners—the employer has a good, highly motivated and high-performing employee and the employee gains assistance with a personal problem that was previously impacting their ability to focus on their job.

Most EAP companies are not regulated by state or local agencies, leaving both companies and clients with little recourse in the event that the EAP fails in some way. Clients who feel mistreated may file a complaint with the relevant state agency against the individual therapist. This can be a no win situation for everyone, including the EAP company, which has a great deal to lose, including its reputation amongst employees who, if they mistrust it, will not use the program. Some states, like California, do regulate EAPs that deliver counseling services through the Department of Managed Health Care which also regulates HMOs, Vision and Dental plans. This oversight provides a grievance process for consumers that wish to register a complaint against licensed health plans.

There are many "free" EAPs out there who merely act as a "1 800" number and are not workplace specialists. These are usually large insurance carriers that bundle their "so called" EAP into a disability program and have very little visibility.

In business it is customary to look at returns on investment. The provision of employee assistance services has established business benefits, including increased productivity of employees (termed "presenteeism") and decreased absenteeism . What’s not well established is how to asess the value between providers in this space. Not all EAP solutions are the same, though on the surface they appear to be.

Two potential measures to differentiate EAP providers are the quality of the solution provided and the utilization rates. Utilization rates are the percent of employees who make use of the EAP's services in a given year and suggested annual utilization targets range from 5-8% . A percentage that is too low may indicate that the employees do not know about the program or that they are reluctant to use it.

Workplace bullying and EAP concerns

Workplace bullying or mobbing targets should be leery of EAPs, particularly in-house EAPs. Unfortunately, sometimes the EAPs are used as a feedback mechanism to assist management with further bullying strategies. In-house EAP counselors are employees of the organization and are, therefore, under management control and may not be neutral. Contracted EAPs are paid by management so their neutrality is questionable as well. In a unionized workplace EA counselors are usually in management. Furthermore, management generally use Human Resources (HR) and EAPs in an unwitting collusion to further bully the target. HR representatives may contact the in-house EAP counselor seeking the target's confidential information and even going so far as directing the counselor to ask a specific question(s) to obtain key information that may be useful for further action against the target. Generally, the objective of the bully is to make the target resign and this is referred to as constructive dismissal. EAPs are not designed to help the target and are sometimes manipulated by both the union and management to the detriment of the target.

Sometimes a target will contact the EAP complaining about workplace bullying and an EAP counselor may come to the workplace and give a generic respectful workplace group presentation. However, this presentation, as reflected in typical promotional material, will imply that bullying is co-worker(s) on co-worker that occurs only because management is unaware of the situation, rather than as the manager as the bully and research indicates that 70% to 81% of bullies are bosses. Typically, managers in attendance will announce they have an "open door policy" and staff can come to them at any time with any concerns. But, bully managers often encourage their staff to join in and many do either willing or unwittingly. Also, the counselor may highlight human rights laws, but workplace bullying is generally outside human rights laws particularly if manager and the target are of the same race and sex, or if the manager belongs to a minority group but the target doesn't. Typically, these presentations skirt the specific problem the target is experiencing.

Many managers view EAP enrollment as demeaning to the employee or a means to “straighten out” the target. Management or even a union steward (who is hostile towards the target) may leak to the target's co-workers that the target has entered into an EAP to make the target appear unstable and weak thus further undermining and isolating the target.

Typically, when the bullying turns critical, management with the help of HR will fabricate frivolous work performance allegations against the target and apply a progressive discipline policy (i.e. reprimand, suspension and dismissal). In an unionized workplace the collective agreement usually suggests that under-performing employees voluntarily enter an EAP program. EAP's are based on the premise that the unsatisfactory work performance is due to non-workplace factors such as substance abuse, financial problems, family and/or relationship conflicts, physical or emotional illness, however, these are unrelated to or the cause of workplace bullying, so the EAP is unlikely to help the target. Usually, union relations officers encourage the target to enter EAPs in anticipation of a possible suspension or dismissal as the EAP involvement may be used as a component of the legal defense strategy to make it appear to an arbitration tribunal that the target was making a serious effort to correct their alleged performance problems. If the target is unwilling to enter a EAP, then management may use this at an arbitration tribunal to make it appear that the target has a "bad attitude". Generally, the employer will use as many fabricated false allegations and witnesses as possible, but this usually results in management's own extensive and glaring evidence and testimony inconsistencies that can be bizarre. Also, prior to the tribunal some of management's potential witnesses may panic and try to avoid being called as a witness by discrediting themselves. Management's potential witnesses are often motivated by envy toward the target, trying to use or sabotage the target to further their own careers, or are unwitting bully participants.

The concerns that employees may have about internal EAPs, however, have been shown to wane after using the program. In Harlow's large sample of employees with access to an internal EAP, having utilized the program predicted employees' increased favorable ratings of the EAP as a benefit, including the perceived ease of access, decreased sense of a negative effect on their career from using the service, increased perception of the maintenance of confidentiality, and increased sense of overall effectiveness. Harlow posited that the small proportion of employees who typically utilize an internal EAP contributes to the promulgation of negative perceptions of such programs, and that these perceptions decrease dramatically when employees actually use the service. However, the conclusion of this study stated: "Because the results of the study were specific to one EAP organization, any generalizations of the findings must be made with caution."

Associations

The Employee Assistance Professionals Association (EAPA) is one of the world’s largest, oldest, and most respected membership organizations for employee assistance professionals. With nearly 5,000 members in over 30 countries around the globe, EAPA is the world’s most relied upon source of information and support for and about the employee assistance profession. EAPA publishes the Journal of Employee Assistance, hosts professional conferences and offers training and other resources to fulfill its mission.

The Employee Assistance Society of North America (EASNA) is a bi-national association whose members consist of individuals, organizations, employers, and students in Canada and the US interested in advancing knowledge, research, and best practices toward achieving healthy and productive workplaces.

The Employee Assistance European Forum (EAEF) is a non-profit organisation for individuals and organisations interested in the development of Employee Assistance and Work-Life services in Europe, including EAPs. The EAEF was formed in September 2002 to become the voice for EA professionals in Europe. Participation in the EAEF has grown rapidly and now involves over 60 EA professionals drawn from 23 countries.

The EAPA’s, EASNA's and EAEF's mission is to promote the highest standards of EA practice and the continuing development of employee assistance professionals, programs and services.

See also

• Occupational health psychology
• Work-life balance
• Workplace interventions
• Workplace stress
• Workplace wellness

External links

• Employee Assistance European Forum
• Employee Assistance Professionals Association
• Employee Assistance Society of North America