EMPLOYEE ASSISTANCE PROGRAMS

The term employee assistance program (EAP) refers to a program that provides business and industry with the means of identifying employees whose job performance is negatively affected by personal or job-related problems. The EAP arranges for structured assistance to solve those problems, with the goal of reestablishing the employee's effective job performance. The services of an EAP may be contracted, or the program may be an employer's own creation, designed to fit the unique needs of a company. EAPs typically provide professional, confidential, no- or low-cost assistance for employees with personal problems.

EAPs help employers by identifying troubled workers, by either supervisory referrals or self-referrals. Each referred employee is assessed, and a plan of action is designed to suit his or her needs. The ability to uncover the employee's primary problem is required. The goal is to enable the employees to work again at peak levels. An effective EAP requires a knowledge of resources available in the community.

HISTORY

No one knows when the first employer offered counseling and social work services to its employees. But in 1917 Macy's, the New York City department store, opened an office specifically devoted to helping employees deal with personal problems. Metropolitan Life Insurance Company and Western Electric were also pioneers in the field, but it was not until the years immediately following World War II that a limited form of EAP became relatively common.

In those days, Alcoholics Anonymous was a new organization gaining widespread attention. For the first time, alcohol abuse was perceived by business to be a workplace problem, and many companies started alcoholism programs for their workers. These programs were usually staffed by recovering alcoholics who trained supervisors to spot alcoholics by looking for such symptoms as shaking hands, bloodshot eyes, and alcohol on the breath. These early programs produced gratifying results, but they were severely limited because they identified only late-stage problems. Alcoholics in the early stage whose hands

did not shake and who did not drink on the job did not receive help.

Today, most EAPs pay close attention to the specific needs of clients. For example, until recently few EAPs dealt with gambling-related issues; but now counselors are being trained to deal with gambling addiction and related problems. A number of companies also have EAPs that offer financial and legal referrals to employees with consumer credit or bankruptcy problems and legal concerns. These services are in addition to assistance offered for emotional, family, work, and substance-abuse problems.

Another area that EAPs frequently deal with is critical incident intervention—helping workers handle deaths, suicides, hostage situations, major accidents, and natural disasters, including fires, earthquakes, mudslides, floods, and hurricanes. Employees often need assistance in dealing with the emotional and physical trauma of these natural disasters.

MODERN PROGRAMS

Organizational development, managed care, workers' compensation, child care, and catastrophic disasters are just a few of the issues that are expanding the scope of today's EAPs. The changes going on in corporate America are tremendous. As a result, the role and scope of the company's employee assistance program has evolved with the times. Some EAPs offer workers professional organizational counseling. This service runs the gamut from counseling work-group members who are having problems getting along with one another to counseling survivors of downsizing on how to handle stress.

Managers may have to terminate good employees as well as difficult ones. Besides the emotional effects, there is also a practical side to letting workers go: There is documentation and a procedure to follow. Human resources staff members are stretched to the limit in some cases.

Many EAPs provide disability management services. Companies today want to complement the traditional disability arrangement with a whole-person approach. In many cases workers' self-esteem is tied to their jobs. As workers sit at home recuperating from injuries or disabilities, they may become bored and depressed. In some cases their disabilities may put financial strains on their families. Therefore, there is a need to supplement the medical care a person is receiving with counseling on issues he or she is facing. The goal is to keep the worker connected to the workplace.

Today's EAPs have grown in size and sophistication. In some businesses EAPs are operated through employee associations. Sometimes professional groups or similar businesses and small industries unite to form a consortium. Although all EAPs aim to help both management and employees, there are differences in how they do it. Boiled down to the essentials, these differences come under two headings: who is helped and how that help is provided.

SINGLE-ISSUE PROGRAMS

Single-issue programs aim to help only employees impaired by a specific problem. Their focus is clear, and they are generally small enough to cost the employer relatively little. A disadvantage of single-issue programs is that they may become stigmatized because of the negative connotations of terms such as addiction and alcoholism. Some people may be afraid to use the program for fear of being labeled drunks or addicts. Since the per-person cost of an EAP decreases with the number of people who use it, this stigmatization is an important issue to consider. Furthermore, supervisors tend to look only for symptoms of abuse instead of concentrating on declining job performance.

The greatest weakness of single-issue programs is their lack of preventative power. Late-stage alcoholics and addicts have the highest relapse rate and the least chance for permanent recovery. Single-issue programs tend to find these late-stagers, but recognizing those in the early stages for whom help can be most effective is much more difficult.

BROAD-BRUSH EAPS

Broad-brush EAPs offer help to employees suffering from all kinds of problems, including chemical dependency. For example, a broad-brush program may provide crisis-management services for those whose problems can be dealt with over the short term. Sometimes all that is needed is a chance to talk a problem over with a sympathetic listener. The great advantage of broad-brush programs is their ability to uncover drug and alcohol problems in their early stages. Often early-stagers come to their EAP presenting problems that make no mention of alcohol or drugs. At first clients complain about financial trouble, a stressful marriage, or abuse of problem children. It is only after working with a skilled counselor that the truth is revealed: cocaine bankrupting an executive; a marriage in trouble because the wife drinks and the husband enables her; children acting out because they cannot get the nurturing they need from addicted parents.

One disadvantage of broad-brush programs is that they are usually more expensive than single-issue programs. There are, however, ways to minimize costs by designing a program customized to specialized businesses. Costs can be reduced when multiple businesses form an EAP alliance. In the long run, EAPs can save businesses money by making them more efficient and productive, by reducing accidents, by reducing employee absenteeism/turnover, by raising employee morale and decreasing grievances, and by cutting back on the number of unnecessary insurance claims.

MODES OF SERVICE

Today's EAPs differ from their predecessors in the mode of service they deliver. It would be impossible to describe all variations that exist, but a short description of several of the most common varieties will provide some insight.

Some EAPs are just a hotline. Employees are encouraged to call a particular number and ask for help. The EAP provides the names and numbers of local public service agencies that may be able to address employees' personal problems. Alone, this just barely qualifies as employee assistance. However, a hotline in conjunction with other services may prove helpful in attracting fearful employees for whom anonymity is essential. And hotlines can be extremely beneficial when depression is a serious problem.

Other EAPs amount to no more than a single individual in the personnel department or the medical office who can direct an employee off-site on the basis of his or her problem. This is not much better than the hotline, and employees may not go near the office for fear of being labeled. Employees required to report to this office because of poor performance evaluations and fear of losing their livelihoods may complain about the lack of confidentiality.

A few very large companies have elaborate on-site EAP divisions with full staffs, including doctors and nurses. Or several geographically close companies with similar concerns or products may join together to form an EAP consortium that contracts with a consulting EAP organization to provide services to employees from each site.

Most EAP providers emphasize the confidential nature of their services and will give the employer numerical information only, without divulging names of EAP-assisted employees. Otherwise, many employees would be hesitant, if not totally unwilling, to admit a personal problem for fear that it would jeopardize their job status or chances for promotions.

However, there may be situations in which an employer may need to know certain types of information. For example, when an employee is engaged in dangerous duties, supervisory personnel may need to know general information about the employee's condition for safety reasons. Therefore, the employer's promise of confidentiality and privacy to employees is extremely important. Whatever level of confidentiality the employer establishes must be maintained; notice must be given to employees and consent obtained for variances. Also, it is important that an employer give employees clear warnings that such disclosures are permitted. Specific state privacy laws may affect the availability of such information.

Some EAP programs provide services to groups of employees during a crisis. For example, a team of counselors from an EAP may work with an entire department affected by a violent workplace incident.

EAPS CAN DETER VIOLENCE

Stress at home or on the job, burnout, or relationships that have soured can result in violent acts at work. Experts estimate that more than 100,000 incidents of workplace violence occur annually in the United States. The typical workplace killer is a middle-aged man, most likely a loner frustrated by problems on the job with few personal contacts outside the workplace. One study showed men were responsible for 98 percent of all violence committed at work. The average age was 36, and firearms were used 81 percent of the time. Following workplace homicides, one-fourth of the murderers killed themselves.

Workplace violence, whether it involves harassment, threats, or physical attack, is a serious and growing problem for employers. Lack of attention to the issue can mean lost lives, discontent, and fear among employees, as well as tremendous cost to companies.

Corporations without preventive measures are particularly subject to lawsuits and higher costs. The best way to prevent workplace violence is to have an effective employee assistance program. Other precautions companies can take to prevent violence are establishing clear guidelines on appropriate behavior, screening applicants carefully, training employees to identify warning signs, and setting up procedures for managers to respond to cries for help. Companies also should look closely at the procedures they use when they terminate employees. Perhaps most important is maintaining a healthy work environment. It really boils down to one person's relationship with another and whether or not the environment fosters mutual respect.

EXTERNAL PROVIDERS

A unique feature of employee assistance programs is the dual responsibility that its professionals have toward both the companies they work for and the individual workers in those organizations who require assistance. The special responsibilities toward the organization go beyond those that social workers have toward their agencies because the occupational setting also is a client to which they have service obligations. At times this dual responsibility creates ethical dilemmas for practitioners. The very existence of a well-functioning EAP is a major source of assistance to the organization as a whole, not just the individual clients who receive direct services.

Both managers and employee clients expect staff members of in-house EAPs to be especially adept in matching an employee's needs with resources that provide prompt and effective intervention. The depth and thoroughness of the assessment is a means of increasing the probability that key problems will be identified and prioritized accurately. Failure to meet these expectations can adversely affect the credibility of the EAP. As a result, most EAPs devote a significant part of program resources to locating, evaluating, and updating their network of providers. The referral function is distinct from the procedures governing the internal services. Referring is the process of locating one or more providers external to the employer to supply ongoing services to deal with employee concerns. These external resources may assume responsibility for all of a client's needs or they may be ancillary to the work being done in-house by an EAP counselor.

Most employees are not well informed about treatment programs, community agencies, or even self-help groups. EAPs must educate them about available services, their relative benefits, and how these resources are viewed in the community. In addition, clients often need to be encouraged to assume a consumer orientation regarding referral sources. Having to apply for any kind of help is intimidating, and it is difficult for the uninitiated to recognize appropriate or inappropriate requirements. Clients should be told that if they decide a resource is not acceptable they may return to the EAP for other options.

PERSONAL PROBLEMS

People thrive on things they do well. Often it is their work. A happy, healthy worker is likely to be a productive one. Conversely, personal problems can hamper an employee's performance. Sometimes problems can be alleviated quickly, but often the problems extend over long periods of time. The impact on the employee will vary, but there will usually be noticeable change in behavior and attitude. Personal problems are significant hurdles that every person living in today's complex society will confront in one fashion or another.

Employees' personal problems can have many sources. Most can be categorized into one of the following categories: substance abuse, health related, family related, and financial. Almost every adult will deal with one or more of these problems. It is how individuals deal with these problems, and the level of support they receive in addressing the issue, that will determine the intensity of the problem's impact.