EAP Service Use in a Managed Behavioral Health Care Organization: From the Employee Perspective

Contemporary employee assistance program (EAP) services are typically provided in broad-brush programs delivered by large external vendors in a network model. Yet research has not kept pace with EAP evolution, including in terms of how EAP clients themselves view services. We surveyed a random sample of EAP service users from a national provider (361 respondents). About one-third of respondents reported getting help for workplace issues. Most learned about the EAP through employer communications such as the company website. The large majority reported that the EAP helped them "a lot" or "some," suggesting they valued this benefit.     

An Elder Care Training Needs Assessment Among Employee Assistance Program Staff

A mail survey of 95 EAP staff members explored the issue of elder care (employee informal care and company formal policy) and collected data pertinent to training needs, competence to handle employed caregiver problems/questions, and company commitment. Major findings were: (1) EAP staff members estimated that one in five employees currently provides care for an older dependent; (2) most (74.5%) staff have not received any training relevant to elder care; (3) self-assessed competence to handle elder care problems was low for 14 of 17 problem-solving domains constituting the Elder Care Competence Index (ECCI), less than half of the respondents felt competent; (4) the few (13.8%) EAP staff members with extensive (2 or more sessions) elder care-specific training experience achieved ECCI scores nearly double those of other workers, p < .01; (5) most (78.8%) companies have not dealt with the issue in any formal way and only 7.6% of their EAP staff believe this inaction to be appropriate; and (6) company commitment (i.e., formal policy- issue studied, offered programs/services or benefits) is directly related to EAP training (p < .01) and consequently to staff competence ( < .05). The implications for training, policy, and future research are discussed.     

Therapeutic Engagement of Adolescents with Emotional and Behavioral Disorders

Youth engagement is increasingly recognized as a preferred approach and often necessary step in the treatment of emotional and behavioral disorders. The purpose of this study was to explore the degree and quality of youth engagement in the therapeutic process, compare engagement scores between youth accessing residential and day treatment, and explore the association between engagement and interpersonal difficulties in a sample of youth with an emotional and/or behavior disorder in residential and day treatment programs based in Southern Ontario. Cross-sectional surveys of standardized measures were administered to youth and a separate survey to their Prime Workers. Relevant constructs included client engagement (as rated by youth and Prime Workers), and youth-rated behavioral screen, interpersonal problems and family functioning. Both Prime Workers and youth rated youth as moderately high in their level of engagement in therapy. Furthermore, Prime Worker and youth ratings did not significantly differ statistically, suggesting that youth may have actually engaged at a moderate level. Interpersonal problems were shown to be negatively associated with youth engagement, and family functioning approached significance for only youth in residential treatment. Assessing youth engagement during the treatment process as an intervention technique may highlight areas where greater clinical efforts are needed. Future considerations include testing methods of sharing and discussing results of an engagement measure within the context of a one-on-one clinical encounter with youth.     

Chapter 10: Ceridian's Experience in the Integration of EAP,Work-Life and Wellness Programs

SUMMARY

This article considers EAP services, work-life and wellness programs and the implications of integrating these services. The concept of how wellness programs enter into this equation is explored as well as how Web-based services have played a significant role. Ceridian's experience in providing these services is explored through a case study, anecdotal information, and other data. This article reviews why integrated EAP services, work-life and wellness programs offer more value when compared to programs that contain individual components. It is concluded that wellness and the Internet continue to play a key role in programs becoming more integrated. It is also suggested that integration is now larger than traditional EAP, work-life, and wellness programs. Other human resource services are becoming more important components of integrated services.     

Experiences of internal and hybrid employee assistance program managers: Factors associated with successful,at-risk,and eliminated programs

Employee Assistance Programs (EAPs) originated as workplace-focused programs delivered largely by peer employees. Over the past 25 years, the once standard internal EAP has largely been replaced by internal/external hybrid programs or outsourced EAP vendors. Many long-standing internal programs have been downsized or eliminated, along with their internal program manager positions. This qualitative study examined the organizational, leadership, and programmatic characteristics associated with the internal and internal/hybrid EAPs from the perspectives of EAP managers working in programs that have thrived and those that have depreciated. Twenty-four current and former internal or internal/hybrid EAP managers were interviewed using a semistructured interview schedule. Qualitative methods were used to identify patterns and themes within the data to describe the experience of internal and internal/hybrid EAP managers and the critical success and risk factors associated with their positions and programs. Five final themes, with 15 subthemes emerged from the data, suggesting that both individual and organizational characteristics of EAP internal and hybrid programs are important to the program’s sustainability. These findings offer insights regarding best practices and critical success factors to EAP professionals, EAP purchasers, and the EAP industry.     

Resistant Employees

The goal of Employee Assistance Programs (EAP) is to assist employees with a host of emotional, behavior, and family problems which interfere with their ability to function optimally on the job (Sussal & Ojakian, 1988). EAP counselors work to quickly identify, assess and resolve employees' problems. Frequently, there are employees, who seek EAP assistance, but are resistant to changing their behavior. The purpose of this article is to propose the use of Brief Counseling (BC) intervention techniques with resistant employees.     

Workplace Problems and Needs for Lesbian and Gay Male Employees

Abstract

This article presents research findings pursuant to the problems and needs of lesbian and gay male employees, as perceived from a randomly selected national sample of employee assistance professionals. The research was based on a conceptual model for framing workplace interventions addressing issues of protection, inclusion and equity (PIE) for gay/lesbian employees. Findings indicate that heterosexual employees greatly underestimate the level of discrimination sexual minorities experience; women respondents were more sensitive to gay/ lesbian workplace issues than men; existing EAP and human resource services, programs and policies inadequately address gay/lesbian needs; significant differences exist between heterosexual and gay/lesbian employees' on perceptions of diversity training content and gay/lesbian EAP professionals feel the workplace is only somewhat “safe” for them as sexual minority employees.     

Decisions on placement and family preservation. Agreement and targeting

Vignettes presented to experts and workers in the child welfare field were used to explore the degree of agreement on decisions to place children in substitute care or to refer them to family preservation services. The design allowed for investigation of the problem of targeting in family preservation programs. Findings indicate considerable inconsistency in decisions among experts and workers, particularly in decisions to refer to family preservation and other in-home services. Contrary to the stated intentions of family preservation services, a majority of the referrals to these programs do not involve children who would have been placed in the absence of these programs.     

Chapter 2: The Business Case for the Integration of Employee Assistance,Work-Life and Wellness Services

SUMMARY

Employee assistance programs (EAP), work-life programs and wellness programs are three commonly provided kinds of interventions that have the goals of reducing healthcare costs, improving employee performance and fostering a healthier workplace culture. The integration of these kinds of programs is a recent trend that has the potential to offer additional synergistic benefits. New studies have linked comprehensive delivery services that support human capital needs with bottom-line financial success of the company. This evidence can be used to make the business case for offering EAP, work-life and wellness services in an integrated capacity. However, while promising, the scientific evidence thus far in this area has methodological limitations and there are critical aspects that require further study.     

Military Caregivers

Military caregivers provide essential services for their veteran or military service members who have serious injuries or illness. Of the estimated 39.8 million Americans who provide care for an adult, 1.1 million care for a post 9/11 veteran or service member. Caregivers may experience greater physical or mental health concerns including stress, depression and/or chronic illness, and have greater financial burden than their non-caregiving counterparts. Policy shifts such as the Caregivers and Veterans Omnibus Health Services Act of 2010 (2018) have created and expanded programs to support caregivers. Practitioners working with injured or ill military service members or veterans and their families should include a comprehensive biopsychosocial assessment of the whole family, utilizing several interventions, such as support groups, peer support, psychoeducational programs, training, individual and family counseling, and/or respite care services, to improve family function and reduce caregiver burden.     

Psychological Adjustment in Intercountry and Domestic Adopted Adolescents: A Systematic Review

Understanding if adoptees present a higher risk of developing psychological problems, compared to non-adopted peers, is a research topic that has aroused considerable interest. This paper reviews research results focusing on the psychological adjustment in intercountry and domestic adopted adolescents. Two hundred and fifty-eight publications were initially identified in different databases but, due to previously defined inclusion criteria, only twelve studies, published between January 2004 and June 2016, were analyzed. Results indicate that, when compared to non-adopted peers, these adoptees showed more psychological problems, namely in externalized behaviors, and a higher attendance at mental health services. A considerable relationship was found between the age at adoption and the likelihood of the development of behavioral and emotional problems. Nevertheless, the relevance of taking into account adoption related variables in order to understand the variability of adoptees’ psychological adjustment is also underlined. This systematic review draws attention to the need for further studies in this topic resorting to more complex research designs which will allow for the identification of different pathways that may lead to (mal) adaptive functioning, psychological (mal) adjustment and the wellbeing of adolescent adoptees.     

Effectively addressing mental health issues in child welfare practice: the family connection

Nonprofit family-run organizations, such as Tennessee Voices for Children (TVC), are providing leadership in advocating for and delivering services to children and families in need. Utilizing a family-driven approach and a staff partially comprised of parent-professionals, TVC's Nashville Connection and Family Connection programs have strengthened families by providing alternatives to state custody for children and families living with serious emotional or behavioral problems. TVC's Nashville Connection and Family Connection programs did this by coordinating support services, building community bridges, and providing comprehensive in-home services.     

Children with serious emotional disturbance: the impact of poverty and receipt of public assistance on behavior, functioning, and service use

The present study examines the associations between poverty status, receipt of public assistance, service use, and children's mental health. Using a sample of children with serious emotional disturbances, findings from logistic regressions indicated that although no significant associations were found between poverty status and emotional or behavioral problems, families living below the poverty threshold were more likely to receive fewer services, even after controlling for receipt of Medicaid or SSI. Significant associations were also found for child's age, race/ethnicity, caregiver education, Medicaid and TANF receipt, child and family mental-health-risk factors. Poor families were more likely to have older children, be non-white, have fewer years of education, receive public assistance, and have more family mental-health-risk factors, but less child mental-health-risk factors. While a higher percentage of nonpoor families received medication management and residential treatment services, more poor families received support services such as transportation and flexible funds. Implications for the findings are discussed.     

The Need for Domestic Violence Laws With Adequate Legal and Social Support Services

Long overlooked by the law, the area of family violence is one of the most strident examples of the law's potential impotency when unsupported by strong enforcement procedures and serious re-education programs. The law, by itself, is simply a grouping of words and phrases, innocuous in and of themselves. A law must have the backing of the community for which it is passed. If it means a major change in the lifestyle of the people, concurrent services must be made available to facilitate that change. A domestic violence law without necessary support services involving medical, legal, psychological, economic, and child care needs may as well not exist at all. Even though most states have passed some recent legislation involving family violence, much more needs to be done in order to adequately implement those laws. The major thrust of this article seeks the development of comprehensive domestic violence programs which take into consideration all aspects of the problem.     

Social and emotional learning services and child outcomes in third grade: Evidence from a cohort of Head Start participants

A variety of universal school-based social and emotional learning (SEL) programs have been designed in the past decades to help children improve social–emotional and academic skills. Evidence on the effectiveness of SEL programs has been mixed in the literature. Using data from a longitudinal follow-up study of children (n = 414) originally enrolled in a clustered randomized controlled trial (RCT) when they were in Head Start, we examined whether universal SEL services in third grade were associated with the development of children from disadvantaged families. We took advantage of pairwise matching in the RCT design to compare children who had similar family background and preschool experiences but received different doses of SEL services in third grade. The results showed that the frequent (i.e., weekly to daily) exposure to SEL opportunities was associated with favorable social–emotional and academic development in third grade, including increased social skills, student–teacher relationship, and academic skills, as well as reduced impulsiveness.     

Impaired Job Performance and Worksite Trigger Incidents:

Relatively little empirical research has been done on the supervisory referral of employees to employee assistance programs (EAPs). Inclusion of constructive confrontation (supervisory referral) into program standards and its continued promotion as "central strategy" of program theory and operation calls for critical investigation of supervisors' referral behavior, factors affecting their use of the strategy, and its effectiveness with the referred employees. This study examined two factors found to influence referral action-job performance and occurrence of an incident at the worksite which serves as a "trigger event" for the supervisor. Supervisors (N = 415) at 25 sites from seven organizations responded to a survey regarding their referral behavior. Both impaired job performance and worksite incidents were found to have significant relationship to the EAP referral handling of a specific "job problems" employee. Reported occurrence of a dramatic worksite incident accounted for about eight times as much of the observed referral index variance as a job performance (impairment) rating scale. An interesting, but statistically nonsignificant, trend was also found - the more "public" the incident, the greater the referral action taken. About half of the respondent supervisors were found to have taken no referral action whatever with their "job problems" subordinate. These findings raise questions about supervisors' perceptions of EAPs and their motivations in referral. More research into referral dynamics is needed if EAPs are to achieve their potential to help impaired workers and maximize cost savings for their host organizations.     

Counselling Disabled People: a counsellor's perspective

For many years professionals have assumed that disability is a problem for impaired individuals and that it is the disability that causes emotional or psychological problems. Whether this is true and whether a specific model of counselling is needed to help disabled people to cope with the emotional effects of their disability has not been widely researched and this is examined in this piece of research. The causes of psychological distress are discussed and the ways in which counsellors work are studied. Using a grounded methodological approach, disabled and able bodied counsellors of disabled people were interviewed as this was considered to be the most sensitive way of exploring this area. The findings show that more often than not it is the client's lack of control over their physical and social environment and not the impairment that causes emotional difficulties. Counsellors indicated that, through the facilitation of counselling, a sense of self empowerment in practical, emotional and social areas could be achieved and this was the central theme emerging as the most distinctive aspect of counselling clients with physical impairments.     

Case Studies of Federal Occupational Health's EAP Responses to Natural Disasters

Summary

Employee assistance professionals have increasingly been called upon to address the emotional and mental health needs of customer organizations and their employees in response to large-scale natural or man-made disasters. In doing so, employee assistance program (EAP) professionals must use a repertoire of responses that encompasses a broad range of interventions, generally anchored in an understanding of and focus on the organization and its culture, mission, management and labor concerns, and other critical characteristics. The EAP's fallback response to a crisis affecting the workplace is often a critical incident stress debriefing or close variant of it. However, EAPs can best serve their customers at all levels with interventions attuned to an understanding of the workplace culture gained through a consultative relationship with management, while factoring in the nature of the disaster, the length of time and characteristics of the disaster's aftermath, and the nuances of the employees' physical and emotional needs throughout the entire disaster response and recovery process.

This article highlights these issues through the presentation of two case studies, gained from the hurricane response activities of the Federal Occupational Health (FOH) EAP. FOH, a service unit within the U.S. Department of Health and Human Services' Program Support Center, has 60 years of experience working in partnership with its federal agency customers to deliver comprehensive occupational health services to improve the health, safety, and productivity of the federal workforce. FOH's EAP contracts with vendor organizations to provide direct employee assistance, work/life, and related services to more than 1.3 million federal employees. The first case study describes (from the first person perspective) an on-site, multi-focused EAP intervention at a federal facility. The second case study describes management consultation with the U.S. Postal Service in response to major hurricane activity.     

Family participation in child protection

The paper summarizes a Department of Health funded research study of the extent to which parents and children were involved in the child protection work of seven English social services departments. The child protection process and the social work practice with a cohort of 220 consecutive cases is described for the period before the initial conference and the 6 months following it. The authors draw on interview data from parents, young people and social workers and on social work records to assess whether the process and practice were participatory and the extent to which family members were actually involved in the decisions and the work. They concluded that there was benefit for parents and children in attempts to involve them, even thought only 3% of 378 family members were rated as partners in the protection process and a further 13% were rated as participating to a considerable extent. There was a statistically significant association between the participation of family members and the interim outcomes for the parents and children being rated by the researchers as good or moderately good.