DISCUSSION PAPER 5
Employee Assistance Programs
- Philosophy, theory and practice
Royal Canadian Mounted Police
External Review Committee
Chairman
René J. Marin, OMM, O.C., LLD
Vice-Chairman
F. Jennifer Lynch
Members
Joanne McLeod, C.M., Q.C.
William Millar
Mary Saunders, Q.C.
Executive Director
Simon Coakeley
The Committee publishes a series of discussion papers to elicit public comment to
assist the Committee in the formulation of recommendations pursuant to the Royal
Canadian Mounted Police Act (1986). The views expressed in this paper are not
necessarily the views of the Committee.
Comments are invited; they should be addressed to:
Simon Coakeley
Executive Director
RCMP External Review Committee
Postal Box 1159, Station "B"
Ottawa, Ontario
K1P 5R2
Fax: (613) 990-8969
Discussion Paper Series
Number 5: Employee Assistance Programs
Director of Research
Lynne Bennett
with the assistance of:
Simon Coakeley
Yvonne Martin
Consultants:
Simon L. Dolan, Ph.D.
Jacob Wolpin, Ph.D.
Marie Reine van Ameringen, Ph.D.
Also published:
Discussion paper 1
Suspensions - A Balanced View
Suspensions - Consultation Report
Discussion paper 2
Relocation - A Painless Process?
Relocation - Consultation Report
Discussion paper 3
Medical Discharge - A Police Perspective
Medical Discharge - Consultation Report
Discussion paper 4
Post-Complaint Management - The Impact of Complaint Procedures
on Police Discipline
FOREWORD
This research paper is the fifth in a series produced by the Research Directorate of
the RCMP External Review Committee for discussion purposes. This document is an abridged
version of a more comprehensive paper prepared for the Committee by Shimon Dolan and Jacob
Wolpin (Dolan & Wolpin, 1990).
The complete report, copies of which are available by writing to the Committee's
Director of Research, consists of more than 200 pages of discussion, analysis, tables, and
an extensive bibliography. As in this abridgement, the complete report discusses Employee
Assistance Programs in general while making specific reference to both Canadian and police
experience.
This document is a simplified report written for the decision makers. Its goal is to
enable the reader to understand the complexity involved in choosing, implementing,
evaluating and managing an EAP, particularly in the context of policing.
Simon Coakeley
Executive Director
RCMP External Review Committee
Table of Contents
Chapter I: The Increased Popularity of EAPS
Chapter II: EAPS: History and Definition
Chapter III: Models for EAP
Chapter IV: Implementing, Maintaining and Evaluating an EAP
Chapter V: Job-Based Programs in the Police Force
Chapter VI: Final Reflections and Conclusions
Notes
References
Over the past 25 years, Employee Assistance Programs
(EAPS) have grown dramatically in quantity, focus, scope and importance to all work
organizations.1 This new form of intervention has been implemented not only in
the United States2 but to varying degrees and in different packages in
countries such as: Canada,3 West Germany,4 England,5 New
Zealand,6 and Australia,7 to name a few.
In varying forms EAPs have also been adopted by
unions and by medical, legal and other professional societies as well as by most civilian
federal workers in the United States (Roman et al., 1987). More than two decades ago, the
Washington Business Group on Health suggested that EAPs would become the most effective
and practical system/method for delivering mental health services to employees in the
future (Goldbeck, 1978).
According to numerous sources, there has been a
robust growth of EAPs in Canada over the last two decades.8 According to
surveys conducted in British Columbia (Lynch, 1983) and Ontario (MacDonald & Dooley,
1989b), establishment of EAPs on worksites vary anywhere from 6 to 53 per cent, depending
on the size of the organization. Interest continues to grow. In Canada, various branches
of government, as well as health and education services, were found to be more likely to
have EAPS, whereas the construction and retail trade sectors were found to be
under-represented.
The growing need for EAPs has been repeatedly
suggested by scholars and practitioners. For example, Sheppel (1989) argues that, in 1983
alone, Canadians lost 83 million days of work due to emotional and behavioral problems. Of
the employees surveyed, 61 per cent reported emotional problems as the primary reason for
absence from work. In addition, 65 to 80 per cent of employee terminations were due to
personal rather than technical factors.
After businesses and industries realized that human
beings bring their health problems to work (Miller, 1984; 1985), and following a
considerable rise in the incidence of mental and emotional difficulties (e.g., divorce,
substance abuse, single parenthood, stress, depression) among the workforce,9 corporations
extended a helping hand to their work force through the creation of EAPs in order to serve
the interests of both management and employees.10
The United States Bureau of National Affairs, in a
special report (BNA, 1987), considered the following events to be major reasons for the
growth of EAPs in the United States: federal seed money grants, broadening of workers'
compensation/handicap coverage, expansion of benefits and a changing corporate culture. To
this list, Roman and Blum (1988) added the perceived escalation of health care costs borne
by employers and increased sensitivity to personal health and fitness, consistent with the
goals of health promotion.11
It is important to note that EAPs developed with
different purposes in mind will have different goals and definitions of success. These can
be categorized as "benefit to the employee" (e.g., to reduce health risks,
promote "welliness", improve quality of life) or "benefit to the employer'
(e.g., to improve productivity and profits, resolve management problems, limit employer
liability). However the literature suggests that the focus is shifting towards a more
comprehensive "employer benefit".12These changes have "profound
implications for the way EAPs are organized, staffed, and designed to function"
(McClellan & Miller, 1988, p. 26).
Job-based programs can be found in both private and
public sectors, functioning "under various auspices: union, management, joint
labour-management, or a consortium of several industrial organizations, or unions"
(Straussner, 1988, p. 53).
In the private sector, EAPs are justified on an
economic basis as well as on their assumed contribution to the company's human resources
(Schmitz, 1983). Basically, EAPs in industry have two main goals: to prevent or detect all
problems that affect work performance and to maintain or restore healthy (mental and
physical) human resources. Major emotional and personal problems are addressed, including
off-the-job problems when it is assumed that productivity might be affected, through
counselling and supportive services. For this reason, financial, legal, marital and family
problems, as well as substance abuse, are a real concern for organizations in the private
sector. Consultation and education services are also offered. Training sessions regarding
problems known to cause stress and impair performance (Gam et al., 1983a) can be held for
all employees or for a selected group. Executive assistance and counselling programs may
represent a new phenomenon which can be included as part of EAPS.
The four basic models of EAP may be characterized as
follows:
1) Alcohol/substance abuse - Programs are located in
corporate medical departments or self reference is made to an external contractual service
centre. Many occupational alcoholism programs rely on staff comprised of recovered
alcoholics (Schmitz, 1983). The current tendency, however, is to shift to expanding the
program to address all substance abuse and to professionalizing these programs through the
addition of licensed mental health staff.
2) Information and referral - The non-professionally
based programs address a variety of employees' concerns such as legal, consumer,
financial, child-care, housing and education matters. Along with personal-problems
services, employees can also be referred to appropriate outside or internal helping
resources or agencies. Professionally based programs, on the other hand, exclude direct
counselling and psychotherapy, while providing diagnostic intake and referral to an
appropriate treatment resource for employees.
3) Executive counselling - These programs address
executive concerns through diagnostic intake, counselling, information and referral
services. They cover all personal problem areas including, but not limited to, marital and
family relations, interpersonal relations, emotional difficulties and career concerns.
Services are provided on-site or off-site, through medical or personnel department
sponsorship, and by in-house staff or external consultants (Schmitz, 1983, p. 77).
4) Comprehensive employee health and counselling -
The comprehensive model, according to Schmitz (1983), provides broadly based, integrated
professional services that emphasize prevention and rehabilitation rather than treatment,
and "wellness" rather than illness. The staff is trained to recognize multiple
problems and is normally equipped to diagnose and deal with them through internal
intervention or through referrals.
In the United States, the public sector seems to be
lagging well behind the private sector in implementing EAPs (Talagrand, 1982). However,
their number has increased in state and local governments (Kemp, 1985) and, since early to
mid 1980s, there is a growing interest on the part of cities and towns in setting up EAPS.
Federal agencies in the United States operate a
variety of EAP models. Some government agencies have their own EAPS, with services
performed by in-house staff or qualified individuals brought in under contract; others use
another federal agency's in-house program or contract, with yet another agency assuming
contract leadership (Fisher, 1983). The selection of the model is mostly guided by the
profile and geographical dispersion of the work population.
Following a survey conducted in Canada and the
United States by Braun and Novak (1986), the following attitudes, beliefs and feelings
were identified by EAP directors as being held by users of program services: (a)
confidence in the services provided by the EAP (20%), (b) openness to change (10%), (c)
desire to seek services because of peer referral (10%), (d) perception of the EAP as free
and convenient (7%), (e) belief that supervisors support EAP use (6%), (f) belief that EAP
use is an alternative to job loss (5%), and (g) perception of a need for help (5%).
As shown in Chapter I, even if the available data is
not conclusive, there exists an important trend towards major growth in volume and
importance for EAPs in the workplace.
The historical background of the Employee Assistance
Programs (EAPS) movement is blurred (Roman, 1988). It may have evolved partly out of
Occupational/industrial Alcohol Programs,13or it may be traced to more
general, job-based programs, e.g., social betterment, personnel counselling and
occupational mental health.14
In the 1930s, the development of Alcoholics
Anonymous (AA) and the beginning of scientific research into alcohol problems were a
definite incentive towards the implementation of format workplace alcoholism programs.15
Moreover, World War II gave a strong impetus to the federal funding of hundreds of mental
and social service programs (Sonnenstuhl & Trice, 1986) so that inexperienced workers
would be able to join the workplace environment. From then on, and especially in the 1950s
and the 1960s, a large number of alcoholism programs which were either management-based or
supported by labour unions emerged (McClellan, 1984). Job-based programs gathered momentum
in the 1950s as private industry came to realize that providing "troubled
employees" with assistance benefitted the company (Stennett-Brewer, 1987). As they
became aware that issues such as drug abuse, domestic violence, depression and divorce
played a major negative role in job performance, companies with alcohol abuse programs
began to offer help to their troubled employees in other areas of mental and emotional
health (BNA, 1987).
The 1970s brought significant changes to the
workplace-programs movement, the main one being a shift in the focus from alcoholism per
se to identifying employees' impaired behaviour and productivity (Masi, 1984). The
introduction of new legislation, as well as incentives to include problems other than
drinking (Wrich, 1974; Roman, 1988), encouraged state and local governments, businesses,
labour organizations and others to establish EAPs to address all problems that interfere
with an employee's job performance (Masi,1984).
The historical background of the EAP movement in
Canada is less dear. EAPs here have not been available as long nor are they as widespread,
but the field is rapidly growing. Roman (1988) considers Canadian EAPs unique: socialized
medical care helps generalize treatment, organized labour is more strongly involved and
there is greater focus on alcoholism.
It is believed that the concept of EAPs in Canada
evolved out of alcohol and drug abuse (especially heroin) programs, as was the case in the
United States16Development was slow and management interest limited. It is
important to note that legislation similar to that in the United States does not exist in
Canada. However, in 1977 the Treasury Board of Canada stimulated the implementation of
EAPs across all federal departments (McGurrin, 1985; Epp, 1988) and the largest single
employee assistance service in Canada is now part of the Department of National Health and
Welfare.
At the provincial level, several alcoholism agencies
in Newfoundland, British Columbia, New Brunswick and Ontario, for instance, have
functioned as catalysts for alcoholism programs in the work setting. In Quebec, there have
been many programs implemented in the para-public sectors, particularly the school boards
and the hospitals in the metropolitan Montreal area.
Many Canadian organizations are renewing interest in
and taking an active part in reviving the EAP movement (MacMaster, 1988), yet "...
there is a long way to go in this field in catalysing the development of EAPs and related
programs in Canadian workplaces" (Epp, 1988, p. 2).
EAPs are complex systems which represent and
influence a large number of people, ranging from employees to management and including,
among others, families, health care networks and even the general public (Ford & Ford,
1986). They cover a wide range of organizations and associations, where management,
labour, or both, may be involved. Programs possess a wide variety of organizational
structures. Yet, regardless of their titles and organizational constitution, all are
concerned with preventing, identifying and treating personal problems that adversely
affect job performance (Sonnenstuhl & Trice, 1986).
The title "Employee Assistance Programs"
was coined by the National Institute of Alcohol Abuse and Alcoholism (NIAAA); according to
Masi (1984), if achieves two major purposes: "(1) It conveys that the program focuses
on assisting employees, regardless of the type of problem from which they may suffer. (2)
It avoids the stigma that may be attached to a more narrow program, specifically
identified as for alcohol or drug problems" (p. 5).
Based on a large number of definitions which began
to appear in the 1980s, three major assumptions distinguish EAPs from other parallel human
resource strategies:
- Employees' problems are private unless they cause job performance to decline.
- The productivity problem resides with the employees and their personal lives.
- It is the role of supervisors to identify deteriorating job performance (without having
to determine the essence of the problem).
Thus, EAPs place the "problem" not within organizational dynamics or
relationships, but rather within the individual. It is expected that through diagnostic,
referral and treatment services provided by EAPS, the "Troubled employee" will
return to reasonably productive performance after alleviating or eradicating the basis of
impairment.
In conclusion, one may retain the most comprehensive
definition of an EAP offered by the Addiction Research Foundation (ARF, 1984b):
- - a framework of specific policy and guidelines that provide fair
and consistent treatment for all workers who need help...
- - it allows employees to seek help confidentially ...
- - it links them with the best help available in the
community...
- - it strives to get them back to productive well-being
and to avoid the need for disciplinary action and ultimate job loss...
- - over the long term, it encourages workers to seek assistance
with stressful personal situations before a problem develops...
- - it "belongs" to everyone: workers and management
in partnership ...
- - it costs a lot less than doing nothing.
If we try to combine the characteristics spelled out
by Hollman (1981) with the dimensions specified by Roman and his associates17
as well as by Trice and his colleagues,18we can sum up the unique features of
EAPs that distinguish them from other workplace interventions:
- The problems encountered by employees must be dealt with
through appropriate professional treatment.
- EAPs favour a "broad brush" approach.
- EAPs have a number of distinguishing policy qualities,
updated on a regular basis and formally communicated to all levels within the
organization.
- EAPs will try to solve problems which affect the employee's
job performance only, following constructive confrontation.
- The responsibilities for EAPs rest upon:
- the personnel or medical department
for managing it;
- the immediate supervisor for identifying and encouraging the
troubled employee; and
- the employee for using the system.
- EAP activities are now moving towards a preventive strategy.
- The focus of EAPs my be extended, especially towards
substance abuse problems.
- All EAPs need professional assistance and expert advice and
guidance especially on emergent behavioral health Issues.
- The time frame for contemporary EAPs tends to be short,
running from an average of 3 months up to a year.
Moreover, based on a number of writings, we can identity the following components as
being imperative to an effective EAP:19
- A company has to establish a clear policy, which describes the responsibilities of both
the organization and its workers, with regard to health and personal problems that affect
job performance. It should include a policy statement, a procedure for ensuring
confidentiality and specific procedures for referral or voluntary use.
- Administrative functions should include the organizational location of EAP, the
recordkeeping system, staffing, the relationship of the EAP to medical and disability
benefit plans and malpractice/liability insurance.
- There should be proper education and training to realize an effective EAP.
- Referral network resources must be adequate and professional.
- It is essential to measure program effectiveness and overall improvement.
The "traditional" EAP package is believed
to contain the following components: assessment, referral, aftercare/follow-up, management
consultation, supervisory training, employee education, motivational counselling and
policy development. However, based on a survey done among a sample of professionals and
practitioners in the EAP field "only 16.8% of the respondents provided all of these
services. Interestingly enough, about 3% of the respondents did not provide any one of
these services" (McClellan & Miller, 1988, p. 31).
A number of classifications of EAPs have been
attempted, based on the source of problems (personal, family, work, etc.), the direction
of services (developmental or remedial) or more general operational concerns
(administration, counselling, education, etc.). While EAPs come in a wide variety of
forms, most of them contain some or all of the following components: referral, training of
managers, employee education, individual counselling, a hot line and group counselling.20
Any company considering the development of an EAP
has to pay great attention to its own unique characteristics. It is believed that factors
such as size of the organization, geographic location and diversity, employee population,
values and goals, as well as other features, must be considered and appraised when
examining the various models.
There are many different ways of administering EAPs
and therefore many different models. Good (1984), for example, believes that "there
are almost as many choices to be made in setting up such a program as there are
companies" (p. 80). In this section we will attempt to summarize six different models
of EAPS. They include: in-house services, external services, internal/external programs,
the consortium model, union-based programs and finally EAP models for small organizations.
These descriptions are derived from a number of sources which have already attempted
numerous classifications.21
It is important to note that EAPs can be classified
along several dimensions. Spicer et al. (1983) identify three of them:
- The focus of the program or what services
are offered:
- Alcohol-only programs--dealing with problems related to
alcohol and drug use.
- Broadbrush programs--dealing with all problems, e.g.,
emotional/psychological problems, marital and family problems, job stress, alcohol and
drug problems, legal problems, financial problems.
- "Wellness" programs--dealing with health promotion
in general, and advocating anticipation and prevention of all problems as well as the
treatment of them.
- The location of the program : EAP models
differ greatly in where employees go to get their services. This source of variability
affects both the operation and the evaluation of the EAP.
- The level of formality which is determined
by the following aspects:
- How was the organization's EAP established?
- How are troubled employees identified?
- How are the employees made aware of the organization's EAP?
- What kinds of records are kept on employees who use the EAP?
There is no single EAP model; each model is most
appropriate for a particular type of client and specific circumstances. It is also
important to recognize that "often the theoretical EAP model that an organization
chooses may differ considerably from how the EAP actually operates" (Spicer et al.
1983, p. 9).
Large organizations tend to have in-house programs
or corporate EAPS. These are administered under the company's auspices by a co-ordinator
with a counselling staff, all of whom are employed by the company. They may be an integral
part of either the personnel/human resources or medical departments or else constitute an
independent service directly responsible to senior management.
In-house programs offer services to all employees
and often to family members as well (Lanier et al, 1987). These may range from simple
diagnosis and referral, to extensive psychotherapeutic treatment of employees. Normally,
they are staffed by mental health professionals (e.g., social workers, psychologists,
certified alcoholism counsellors) with strong clinical backgrounds (Sonnenstuhl &
Trice, 1986).
The advantages of internal programs are diverse.
Expertise is ensured by hiring professionals to develop the program; employers believe it
is a most effective manner to express humanitarian concerns (Sonnenstuhl & Trice,
1986); EAP professionals present at the work site can easily recognize the needs of the
company (BNA, 1987); and, finally, it is believed to be cost-effective over time.
However shortcomings have been pointed out; the main
criticisms concern the confidentiality issue as well as that of conflicts of interest
faced by therapists (Sonnenstuhl & Trice, 1986). Lanier et al. (1987) describe a
special type of internal "informal" program where services are offered on a
part-time basis by special categories of employees (occupational physicians, occupational
health nurses, recovering alcoholics, personnel or industrial relations specialists). The
main problem with this type of service is that the "counsellor" (e.g., a
personnel officer) will in some cases obtain confidential information about an employee.
Nowadays, many businesses, especially medium-sized
companies comprised of fewer than 2,000 employees, contract with profit and non-profit
organizations (e.g., a private consultant, a social service agency, a hospital or a
university) to provide mental health services for their troubled employees.22
These agencies provide a variety of services such as treatment, supervisor training,
diagnosis of employees' problems and referrals to other treatment agencies, which can be
delivered either on-site or off-site.
Companies choose this route for various reasons. It
is a quick and efficient way to implement a program where a manager will simply be
delegated responsibility for co-ordination. Moreover, this model may deal more effectively
with the sensitive issue of confidentiality.
The major drawback to contracted services is
believed to be a lack of experience with the workplace. Dispatching employees to
professional treatment becomes the principal focus and primary organizational prevention
may be forgotten. Moreover it is more difficult to hold accountable and to evaluate those
who provide external services.
A combination of internal and external services is
needed for large corporations situated in various locations. These organizations usually
have a corporation-wide EAP with one or more internal co-ordinators based in one or more
locations. In the other sites, local contractors are often used. Both the co-ordinator and
the contractor provide direct services to employees. The advantage of this mixed approach
is that there is combined knowledge about the internal organizational structure as well as
information about local resources and how to use them.
The community resource network is a
particular example of combined services. "This strategy recognizes that agencies
outside the company already provide a wide range of counselling services that are
available to employees and that the program co-ordinator's function is to direct employees
to those resources" (Sonnenstuhl & Trice, 1986, p. 20).
In summary, contractual programs tend to be newer,
seem to originate from the broadbrush program, report to senior executives within the
organization, cost more per employee and availability of services is extended beyond
regular working hours. On the other hand, in-house services, having originated as
extensions to alcohol-based programs, are somewhat older and more prevalent. They are
structured in a more traditional manner, cost less and are generally supported by unions.
Moreover they tend to concentrate on medical referrals and on alcohol-related problems,
although various training programs may be linked to them. This comparison between the two
models basically suggests that each tends to serve a different category of workers and
thus, the benefits and limitations of each must be carefully considered in planning a good
and effective EAP (Straussner, 1988a).
An EAP consortium "is a cooperative agreement
among companies and agencies that do not have enough employees to warrant their own EAP.
Instead, they pool their resources and develop a collaborative program to maximize the
individual resources of each company" (Masi, 1984, p. 61). This type of model best
fits organizations with fewer than 2,000 employees.
The advantages of the consortium model
include:
-
The consortium decreases costs for small or medium-size
organizations.
-
Confidentiality is easier to maintain.
-
Often there is better identification of and communication
with community resources.
-
The range of employees served is increased.
-
Usually the ECS (Employee Counselling Services) staff has
greater diversity and better credentials.
The disadvantages include:
- Some supervisory and management staff are reluctant to deal with outsiders.
- The service provider usually knows little about the participating organizations.
- Consortiums are more complex because they include several companies.
- There is some communication difficulty regarding role definition.
- Participating agencies may disagree about the services needed and the apportionment of
costs.
- Some counsellors find it difficult to become a part of the formal and informal work-site
networks.
Over the past five years, unions have been more
active in promoting programs for dealing with occupational alcoholism and other EAP
services.23Labour unions can use different plans to implement and administer
EAPs either directly or through co-operation with management. Several models have been
described:
-
Programs operated under union auspices: they require special
skills and unique techniques enabling union representatives to solve issues related to
conflict of interests.
-
The consortium model: labour and management create a separate
non-profit organization outside the context of collective bargaining agreements. Both
sides are the perceived owners and beneficiaries of the program.
- The union-counsellor model: volunteer labour union members,
specially trained, work independently from management and help convince employees to get
the treatment they need.
- The collective bargaining model.
- Occupational programs initiated in local unions: they usually
become joint labour-management programs through collective bargaining or
institutionalization.
The various EAP models that have been devised to
meet the needs of small organizations are: central diagnostic and referral (CDR) services,
consortiums, independent contracts and clinical liaison personnel (Gray & Lanier,
1985/86).
A diagnostic and referral (CDR) service is an association that provides
assessment and referral services to a number of work places in the same community.
The consortium model is made up of multiple firms that collaborate in sharing an
outside EAP. It covers a wide variety of services ranging from assessment to referral and
follow-up.
Independent contracts represent a straight-forward outside service by a contractor
who covers ail or most areas commonly used by EAP users.
Clinical liaison is a contractual service that provides assessment and referral, as
well as treatment and aftercare and is located in a community.
In sum, all models have some elements in common.
What constitutes an advantage for one model could be regarded as a disadvantage in another
model. The delineating factors are the purpose, the clients, the cost and the efficacy of
the program. The next chapter will examine the criteria for choosing, implementing and
maintaining EAPS.
This chapter will offer some guidelines for
implementing and maintaining an effective EAP. These are based on experience and advice
published by practitioners and scholars about existing programs. However, the measures
suggested here may well vary from one organization to another based on their specific
situation (e.g., size and location, population).
Before setting up a program, top-level support from
senior executives must be ensured.24Shepell (1989) recommends the creation of
a steering committee comprised of representatives from both labour (i.e., employees and
unions where present) and management. This group of individuals should examine the need
for an EAP, propose a practical structure and analyze plans to implement the program.
These plans should identify the assumptions and objectives, in addition to the strategies
and remedies, for attaining the goals. Finally, a survey should be conducted among
employees to ensure that the newly-designed EAP responds to their needs. Pre-program
analysis and assessment is highly recommended, and has proven to be profitable, so that
programs can be better designed and monitored, thereby making it possible to identify
problems, solution/options, impediments and resources more accurately (Sholette, 1983).
The beginning of an EAP deserves special
recognition, yet it is difficult to outline the beginning process because each work
situation is unique. However, both union and management should recognize that this new
method of resolving personal problems is fundamentally different and that the program will
and should evolve over time.
Broadly speaking, some key issues should be
recognized prior to commencement of any EAP program:25
- Commitment: both union and management need to
feel prepared to deal with unexpected problems and they must be able to handle the often
stressful changes that may occur during the initial period, so that the program will be
strongly supported throughout. "Mutual trust and relative power are central b to
this step." (Corneil, 1982, p. 24)
- Communication: a study of existing programs and
close review of existing policies and procedures will illuminate the issues to be served
by the EAP. The best EAPs fit smoothly into existing policies and procedures.
- Structure:
- Select a cross-section of employees to serve on your
committee. This group of employees will represent a wide variety of views and needs, and
therefore will play a major role in formulating the program and its operation. The best
EAPs are "owned" by the employees.
- Develop your EAP policy. This written statement will define,
among other things, the logic behind the program, its objectives and authority, the roles
and responsibilities of the various personnel in the organization (e.g., department heads,
supervisors, employee representatives) and the commitment to confidentiality. The best
EAPs are a benefit that everyone can use confidentially
-
Training: this is a two-step procedure. First, a
selected staff needs to be trained; second, the employees need to be educated and
awareness about the program must be created. The best EAPs are rooted in training and
education.
-
Evaluation: evaluate your program. Re-examining
the program regularly will give some indication as to what aspects need to be tuned up or
changed. The best EAPs become one of the ways an organization emulates itself.
Many organizations prefer to confront issues linked
with developing an EAP by selecting and delegating this task to a consultant (either
internal or external). It is evident that choosing the right person to fill this role is
critical for the success of the program.26Sonnenstuhl & O'Donnell (1980)
as well as Shepell (1989) recommend consideration of a number of issues:27
- availability;
- confidentiality;
- consultant's orientation towards services, education,
training and assessment;
- environment and available resources.
The introductory steps in setting up an EAP are
extremely important. Everything done during the initial phase of a program plays a
significant role in its survivability. The strategies for implementing an EAP, offered by
Maynard and Farmer (1985), can be appropriate for many organizations. These authors
believe that it is essential to study the organization (e.g., players, structure) and find
out its motives and goals for the EAP. Also, the personal involvement of the "right
people" (e.g., the C.E.O. or C.O.O., union representatives, V.P. of Human Resources,
Medical Director) has to be sought. At all times, the EAP should function as consistently
as possible with other company practices and goals. It has to be incorporated into other
company systems and become an integral part of the company's operations.
In order to implement an effective EAP, the
following activities need to be initiated by the EAP coordinator (Maynard & Farmer,
1985):
- meet with company contact person or supervisor;
- meet with C.E.O./C.O.O./union leaders;
- brief managers, supervisors and union representatives;
- meet individually with other key personnel;
- conduct employee orientation meetings;
- assess needs of employees;
- distribute materials;
- orient and train supervisors and managers;
- put out fires.
Based on these activities, it can be argued that the
EAP co-ordinator's goals are: "communicating the benefits of the EAP to various
company groups (e.g., executives, supervisors, union representatives, employees, personnel
staff) in terms relevant to each group, developing an understanding of the needs and
concerns of each group, identifying influence networks and potential program supporters or
resisters, and becoming personally visible and known" (Maynard & Farmer, 1985, p.
35).
It is recommended that the various activities be
carried out concurrently with both management and the union throughout the entire process,
in order to avoid labour-management conflicts. It is also suggested that the various
activities be executed in roughly the order in which they are presented in this section,
even though some may be conducted simultaneously. The logic behind the sequence offered by
Maynard and Farmer (1985) is that it starts with individual meetings (where design and
planning take place), then introduces the services to employees (first personally, then
with written materials), and concludes with the orientation and training of management.
However, if must be remembered that it takes time
for the word to spread that counselling is a real help to employees who are having
problems, and for managers to see the increase in productivity, better morale and improved
interpersonal relations. Sheppel (1989) suggests that it takes at least two years for a
company to see a significant increase in cost savings and that the organization that
sticks to its original commitment will retain its EAP and reap long-lasting benefits.28
Maintenance of EAPs is believed to be an autonomous
and self-sufficient function, somewhat abandoned, sandwiched somewhere between
implementation and evaluation (Gumz, 1985). In order to keep an EAP "alive" a
system of maintenance activities is needed that will provide for and encourage a level of
meaningful activity and will permit adjustments on a regular basis (Erfurt & Foote,
1977).
As a result of her work, Gumz (1985) of the Bureau
of Personnel and Employment Relations for the State of Wisconsin's Department of Health
and Social Services, came up with suggestions for maintaining a program in the following
areas: publicity efforts, personnel meetings and briefings, program monitoring and
community resources. These guidelines are supposed to:
- Spread the Word, or Promote the Program through a variety of
methods
- Keep in Touch, or Train Personnel. All resource
co-ordinators, supervisors, union stewards, and in some cases employees, should be kept
aware of the presence of the EAP.
- Track Down the Paperwork, or Pre-Evaluate. In order to
evaluate and then adjust an EAP, information regarding recent performance of the program
is necessary.
- Screen the Community Treatment Resources. Here the focal
point is the treatment agencies that perform a service for the parent organization.
Communications between the EAP and the community treatment agencies have to be examined
regularly.
A "healthy" EAP is a program where all its
components are being cared for and kept in excellent shape. Since developing or purchasing
an EAP involves a major investment, maintaining if is of utmost importance. The guidelines
offered here are only some suggestions that can be used as maintenance activities.
A number of attributes are deemed to be critically
important to ensure an effective, smoothly operating, comprehensive program: top
management support; labour backing; strict confidentiality; a written policy; clear
procedures; organization-wide education and communication; easy access; supervisor
training; insurance involvement; professional leadership; an information assessment and
referral service; a community referral network; follow-up and evaluation.29
Finally, it is worth noting the assertion made by the Addiction Research Foundation, which
claims that a good EAP needs teamwork. This teamwork should include: representation from
management; representation from the union(s) or other employee associations, or a
cross-section of employees; health service personnel (physician, psychologist,
occupational health nurse, etc.); and referral agents, who know what services in the
community will be required in each individual case.
In order to have a reasonable chance to succeed, an
EAP should be designed to include specific evaluation plans (Masi & Teems, 1983a), in
other words a process should be established by which the progress of the program will be
monitored constantly. It has been argued that a program needs to be assessed for its
cost-effectiveness and efficiency, and the results of this exercise should be made known
to all members of the organization. Here, the confidentiality issue may become problematic
and the evaluation must then be conducted by a third party (Masi and Friedland, 1988). The
main reasons to evaluate a program include: the justification of its existence to some
external authority (usually the source of funds and/or support); the verification that its
objectives are being met; and the improvement of its performance (Foote and Erfurt,
1981a).
When appraising EAPS, some unique aspects of the
program need to be taken into account and at least four areas are regarded as problematic:
-
Staffing. Most program administrators are not trained in
conducting a proper evaluation procedure.
- Preparation. Very few programs include an evaluation phase as
part of the initial planning process and many lack measurable goals and objectives.
- Standardization. The great variation in models complicates
the development of standardized, reliable and valid measures and definitions.
- Data Collection. For most organizations available data is
less than adequate for conducting a meaningful evaluation. Employee confidentiality may
limit access to data. The presence of a control group is important.
Evaluating a program can be achieved through a wide
variety of ways and different methods have been proposed. Needs assessment surveys
are used to estimate the number of potential clients and the services required by them. Process
evaluation is used to compare the actual operation of a program with its intended
function. Hence, it alerts staff to operational weaknesses of the program. Outcome
evaluation is used to determine the program impact upon the areas of client
satisfaction, problem resolution and improved quality of life. Impact evaluation is
used to measure the expected changes brought about in those employees and organization
units taking part in the program (Jones, 1983). Cost-effectiveness analysis uses
economic indicators to measure the efficiency of the program.30In summary, the
following evaluation priorities have been cited by EAP counsellors and administrators:
assessing the quality of referral sources, client outcome and satisfaction, employee
awareness, program utilization, job performance changes, supervisory attitudes,
cost-benefit and training effectiveness.31
"In today's competitive business and health
care climate, questions of economic benefit often arise. While statistical significance
and clinical significance are of critical importance for the EAP researcher, decision
makers within a company may be most interested in financial significance" (Owen,
1987, p. 87). Information about this key issue may be obtained through the following
methods:
- Cost-Containment Activities. Strategies used to reduce
expenditures or control rising costs. (Examples: prepaid services, case management.)
- Cost-Offset or Cost-Impact Analysis. Strategies used
to determine the areas where cost savings occur as a result of providing a service.
(Examples: percentage reduction in absenteeism following legal problems, productivity.)
- Cost-Effectiveness Analysis. Strategies used to
calculate the cost of obtaining some desired outcome. (Example: comparing in-patient and
out-patient programs by dividing the real costs of each by the number of improved
clients.)
- Cost-Benefit Analysis. Strategies used to compare the
benefits (tangible and intangible) of a program with its costs (directly and indirectly).
(Example: a comparison of an employee hypertension screening program with an alcoholism
treatment program.)32
Different measures of work performance have been
used by researchers and administrators to assess program impact. They include absenteeism
(lost time in duration and frequency), number of disciplinary actions received, number of
grievances filed, number of on-the-job accidents, number of visits made to the company
medical unit, amount of workers' compensation paid, amount of sickness and accident
benefits paid, health insurance claims and turnover rate.33
A final cautionary note should be sounded on the
problems in conducting a cost-benefit analysis within EAPS. EAP managers are currently
experiencing a major difficulty in attempting to demonstrate the economic feasibility of
their programs. In fact, a number of reports claim that EAPs are not effective in
achieving established goals, whether economic or non-economic. The main reasons are: all
costs are not easily identified, benefits may be difficult to translate into monetary
value and, finally, the methodological quality of the research being conducted is quite
low.34More and better research is needed if the EAP concept is to survive; the
lack of good research or program evaluation data is one of the major ethical issues facing
EAPS.
Policing is an intricate activity in a complicated
world and the stresses and strains facing police officers seem to be on the rise.35
Whether officers are worried about financial affairs, uncertain about their children's
health, the risk of the job, the lack of appreciation of the work they are doing,
distraught about an impending divorce/separation, or generally unhappy about life or about
working conditions such as shift work (to list but a few), the feelings are real and need
to be addressed. Considering that officers' personal problems can have a negative effect
on those around them, or those encountered while on patrol, the personal health and well
being of police force members should be a concern for all members of the police
organization, as well as for the public at large.
To address these issues many forces across Canada36
and the United States37started to develop officer assistance programs.
"The ultimate objectives of these programs are to re-establish officers as effective
members of the police community" (Hodson & Fallon, 1989b, p. 18).
Besner (1985), a psychologist in the private sector
who has been involved in counselling police officers and their families for many years,
argues that an employee assistance program can benefit a police department in many ways.
For instance:
-
It can be used to assist the alcoholic or troubled employee,
serving as a preventive and intervention mechanism.
-
The EAP counsellor can develop a screening instrument and
train supervisory personnel to identity problem employees. Absenteeism rates, decreased
work performance, sloppy appearance, tardiness and increased letters of complaints are a
few of the areas that could be explored.
-
The counsellor can assist the officer who has been involved
with excessive-use-of-force incidents, automobile accidents, shooting incidents or
fatalities. A few counselling sessions can greatly benefit the officer's emotional well
being.
-
The counsellor can implement a stress management program.
Studies have indicated an increased incidence of stress-related health problems, such as
ulcers and heart disease, among police officers. The suicide rate is also considered
relatively high.
-
The counsellor can provide a training forum for work and
non-work related issues.
-
The counsellor can help boost department and employee morale
by showing staff that the department cares about their well being and is looking out for
their needs.
-
The counsellor can also develop a spouse program with
emphasis on family-related issues and how work can affect the officer's home life.
-
Finally, this program promotes mental health. By providing
the employee with easier access to help, if reduces the time between the initial
appearance of a problem and treatment. The earlier the intervention occurs, the greater
the return to the department in terms of cost, productivity and community safety.
Unfortunately, programs are sometimes difficult to
implement in this sector for a variety of reasons. Police departments are set up in a
quasi-military fashion and often constitute a 'closed society' (BNA, 1987, p. 93).
Accordingly, the belief held by most police officers that admitting to problems and
seeking help is a weakness--the "John Wayne Syndrome"--survives. Moreover,
confidentiality within the system is viewed with skepticism by many police officers
(Brennan et al., 1987). Similar conclusions were drawn by Dolan (1989a) when
recommendations were made based on the impact on changes in patrol systems (e.g., oneman
vs. two-man ) for the Montreal Urban Community police force.
Usually, "people don't request police
assistance when their lives are orderly and proper. The police become involved when life's
activities are in serious disarray and lives are in jeopardy" (Bratz, 1986, p. 2).
Many researchers suggest that psychological
stressors often become more chronic and disruptive to officers' professional and personal
lives than physical stress.38Based on a recent summary of the literature by
Brennan et al. (1987), the following description can characterize police officers'
confrontation with psychological stress factors: facing the responsibility for other
peoples' lives (Duncan et al., 1979); the frustration that accompanies working with the
court system and police administration (Kahn and French, 1970); ambiguity in the role of
the police officer in today's complex society and having to adapt to a work environment
which includes sub-cultures, ethnic groups, or lifestyles different from one's own;
conflict in separating on-duty activities from personal life and maintaining a balance in
allocating time to both (Capps, 1984); and the strain of having to deal with the ambiguous
nature of many laws (Wilson, 1968).
Police officers are often required to perform tasks
that are inconsistent with their own values, and they often face a negative public image
(Brown, 1984). They must also adapt to the inconsistency of having long hours of
inactivity and yet being expected to respond to sudden, unpredictable crises (Margolis et
al., 1974). In addition, training for some job duties is often not sufficient to allow
officers to feel comfortable in performing them, and officers are often placed in
situations for which there are no performance criteria (Bard, 1976).
Having to cope with poor equipment, lack of
administrative support and departmental disciplinary action adds to the numerous stresses
mentioned above, without forgetting exposure to death, near-death experiences and
accidents (Daviss, 1982), as well as family disruption caused by an officer's changes in
shifts, internalized feelings and displaced anger.
Finally Tipps (1984) identified specific job-induced
problems, rooted in the earliest stage of a police officer's career at the police academy,
namely: work schedules, emotional exhaustion, negative public image, overprotecting the
spouse and family, hardening of emotions, identity problems and problems with children.
In sum, one of the main incentives for police forces
to implement an EAP is stress reduction and stress management. While some stressors,
especially the long-term ones, could be handled through organizational changes and
interventions (see Dolan, 1989), the role of counselling services for individual police
officers is crucial in alleviating stress and remedying its consequences. This role would
encompass the provision of stress management training, career and more general counselling
services (Dolan, 1989).
The stresses and strains in police work are often
compounded by problems that arise from daily functioning "off the job", and the
emotional turmoil can be excessive, resulting in a variety of "escapist
behaviour" which could be manifested in abusing alcohol and/or drugs.
Establishing an EAP to deal with alcohol abuse and
other problems is considered to be a sensible and effective solution; it has been adopted
by various forces, one of which is the Lincoln (Nebraska) Police Department. The Lincoln
EAP39is a free-standing, non-profit service centre and, as such, is not a
formal part of the organizations it serves (i.e., all city departments). A broadbrush
program, it provides a variety of counselling services to employees and their families.
The professional staff offers help for marital, family, substance abuse, emotional, legal,
financial and vocational problems. The Lincoln EAP also provides management consultation
and training to help managers and supervisors encourage employees to use the counselling
program when work performance has declined because of personal reasons. Employees who come
to the Lincoln EAP receive assessment, short-term motivational counselling, referral to
the appropriate agency or practitioner, and follow-up.
Although the EAP had proved successful for Lincoln's
other city departments, it became apparent that the police department was under-utilizing
ft. Consequently, remedial action was undertaken. The main thrust of the remedy included
the assignment of internal resource officers (IRDs) composed of four police department
members: a sergeant, a detective, a police officer and a representative from the police
department's personnel office. These "insiders" benefitted from a higher level
of trust and bridged the gap between the police department and the EAP. The four IRDs
received special training, especially on how to facilitate referrals to the EAP. Their
function was to provide support for officers who were apprehensive about seeking outside
help, to act as trouble shooters and, generally, to provide information to fellow officers
about the EAP process.
The first department in North America to develop and
implement an integrated and fully department supported peer counselling program using
regularly employed officers and civilians on a large scale was the Los Angeles Police
Department (Capps, 1984).
A peer counselling program can play an important
frontline role in providing timely and effective assistance to police personnel whose
personal lives and effectiveness on the job are being adversely affected (Schaer, 1986).
Such help, while not designed as a substitute for professional services, has nevertheless
been found to be a particularly effective means of providing assistance, as demonstrated
by the rapid growth of self-help groups.
Peer counsellors in the police force are normally
volunteer policemen, from a cross-section of the work force, who are trained to assist
their fellow employees. These individuals possess some skills and sensitivity to the
personal and emotional problems encountered by their colleagues. They are sometimes drawn
from committees which oversee health and safety or educational issues. One of the most
important responsibilities of a peer counsellor is the promotion of trust, anonymity and
confidentiality for policemen who seek the assistance.
In Canada, many peer counselling groups exist among
police forces. Although data on the success of these programs is scanty, proponents seem
reasonably content. In Quebec, for example, a major proponent of this model is M. Olieny,
a former policeman turned psychologist, who is at present working at the police academy.
He believes in early education and sensitivity to stress related problems during the
initial training of policemen. Because of his background as a policemen, he enjoys more
credibility and trust when he consults his peers.
In Ontario, the Metropolitan Toronto Police Force
has a peer counselling program headed by its EAP co-ordinator. The program is composed of
18 peer counsellors serving more than 7000 uniformed and civilian employees (Schaer,
1986). They are specially trained to develop specific interviewing, communication and
counselling skills; to identify the causes of personal problems or job-related
difficulties; to understand psychological stress and how it can affect the work and life
of police personnel; and to make client referrals to available community resources.
Another success story regarding the use and
application of a peer counselling program has been recently reported by MacKillop (1990).
Sgt. MacKillop discussed with much enthusiasm the continued success of a stress management
program involving peers in the Waterloo Regional Police Force. According to his testimony,
this is the only kind of program regarded as being credible and confidential by members of
the police force.40
In August 1984, the Police Research Unit of
South Australia held a seminar on occupational stress, which was attended by police
psychologists and welfare officers. The following recommendations were made by the seminar
leaders (Olekanus, 1985, p. 115):
- A centralized welfare agency, comprised of
psychologists, medical officers and chaplains, with close liaison between the various
specialists. Staffing levels between 1:2000 to 1:1000 were recommended for each of the
services.
- In cases of acute stress, such as shooting
incidents or disasters, that there be:
- a mandatory interview/debriefing with a psychologist, with
the possibility for further follow-up interviews;
- referral to a peer counsellor;
- some level of counselling be provided to spouses.
- A general occupational health scheme, which
should include regular medical checks, a means for improving health and fitness and
monitoring for stress symptoms.
- Increased and maintained training at all levels
on stress awareness and management.
Bratz (1986) offers several constructive options to
stress management. He believes that these approaches may be utilized separately or in
various combinations to combat stress in law enforcement:
- Establish a special unit with the primary responsibility for
counselling and conferring with members in need.
- Acquire the services of a local psychologist or psychiatrist.
- Establish a routine psychological testing process at
predetermined Intervals.
- Design a stress training program for all departmental
officers.
- Encourage personnel to get involved in physical exercise.
A unique approach was adopted by the Metro-Dade
Police Department, Dade County, Florida. The department's basic training staff, working at
the Southeast Florida Institute of Criminal Justice, established the Spouse Awareness
Program. It is offered to the spouses of trainees to provide them with information
regarding the true nature of police work. Spouses participate in activities normally
reserved for trainees; this allows them to appreciate, to a limited extent, the degree of
stress that trainees experience (Tipps, 1984).
Two other programs worth looking into are: the Home
Visit Program (Petrone & Reiser, 1985) and the Critical Incident Program (Wagner,
1983). The goal of the first program is to determine whether an outreach approach by
in-house mental health specialists for distressed officers will positively affect morale
and productivity and significantly reduce sick time, medical costs and civil liability.
The results led to a recommendation to expand the Home Visit Program in order to enable
all officers who are on long-term sick or IOD leave for more than 30 days to have the
benefit of support and remedies. The program appears to establish rapport, provide vital
support to the department and facilitate more positive communications with distressed
officers (Petrone & Reiser, 1985, p. 37).
The second program deals with trauma counselling.
Due to the nature of police work, such incidents as accidents, shootings and hostage
takings are frequent, and might have a grave impact in early intervention is not provided.
Individuals who experience a trauma can benefit from a psychological support service.
Although the symptoms of distress in response to a trauma vary from officer to officer,
and often personal vulnerability due to "off work" problems might significantly
enhance the after-shock, an effective emotional assistance can prove to be most valuable
for the officer. Some specialists share the belief that experiencing emotions at a high
intensity with proper professional assistance might prove to be a beneficial learning
experience as if provides an optimal opportunity for officers to learn about the way they
respond to stressful situations (Wagner, 1983). The learning takes place, in a supportive
atmosphere, during a focused counselling interview. The reassurance and support officers
receive serve to debrief the experience. The opportunity to look at the situation will
enable the officers to put the pieces of the experience together, an essential
psychological task following a trauma. They will feel better and calmer. The initial
"stress signs", which are anxiety symptoms, will lessen or go away. More
important, the debriefing and the subsequent integration will prevent the development of
delayed symptoms or lessen those that do occur.41
To summarize, here are some practical suggestions
which a police department could implement in order to help its troubled officers:
-
Put more emphasis on how an officer can deal with the
personal stresses and strains of being human in the police force. This issue must be
confronted at a very early stage of police training.
-
Use an internal program. Many police officers are distrustful
of "outsiders"--those who are not part of the police system. They also believe
that outsiders simply cannot understand or help them (Brennan et al., 1987).
-
Use officer-counselling. While the officers assigned to a
"stress unit" need not be certified psychologists or psychiatrists, they must be
aware of counselling procedures and techniques and have sufficient knowledge to recognize
potentially serious problems (Bratz, 1986).
-
Build a program to be utilized by families of law officers.
Police officers' families often feel isolated and in need of a support system. At the same
time, the officers require the love and listening ear of their families (Tipps, 1984; BNA,
1987; Hodson & Fallon, 1989a).
-
Adopt a more pro-active role, namely, focus on prevention.
In sum, the implementation of an EAP in police
forces requires some special considerations. Policemen seem to be more sensitive to issues
of confidentiality and trust in the system; reports also suggest that they trust
peers/colleagues more than other, professional, service providers. Consequently, before
implementing an EAP within a police force, careful consideration of the credibility and
confidentiality of the system is needed. In relative terms, a mixed approach of using
resources from within the force (peers or buddy system), along with professional
expertise, seems to be the more effective approach for this sector.
Because EAP is a relative newcomer in the work
world, there are still many questions and issues that remain controversial. With the
increase in concern about health care costs, the first significant question that many ask
is: who should bear the responsibility for employees' care: the employees themselves, the
employer, or perhaps the various levels of government through their extensive health
delivery system? In retrospect, the emergence of EAPs suggests indirectly that neither the
individual worker nor the government should bear the entire responsibility for caring for
the emotional and behavioural problems of employees. Because it affects performance
(directly or indirectly), many companies should assume some responsibility by providing
EAPS.
Data regarding EAP coverage in Canadian
organizations suggests that although the programs are well promoted, most businesses are
ill-informed or uninterested in their creation. Those that become involved are generally
large, private sector corporations (1000 or more employees) or public and para-public
sector employers of similar, and sometimes, smaller size.
In Canada, EAPs seem to be needed more than in other
countries, given the alarming statistics on the consumption and impact of alcohol on
Canadians. It has been estimated that 3.5 to 7 per cent of the active work force,
amounting to between 350 000 and 700 000 of Canada's 10 000 000 employed individuals,
experience severe alcohol-related problems. These contribute to lower productivity,
absenteeism, lowered worker morale and accidents at work, and have been estimated to cost
Canadian industry about $21 million per day. Alcohol intake is believed to exacerbate
child abuse, marital disruption, social aggression and violent crimes (cited in Dolan
& Schuler, 1987, p. 279).
Adding to this phenomenon is the impression that
more and more Canadians are suffering from stress-related physical and mental problems. A
national committee of the Canadian Mental Health Association estimated that 15 to 30 per
cent of the work force is believed to be seriously handicapped by emotional problems at
any time (cited in Dolan & Schuler, 1987, p. 280).
With regard to a police force, stress seems also to
be on the increase (Arsenault et at., 1987). It has been estimated that among all factors
contributing to health and safety problems, stress and burnout are among the top-ranked,
leading to a sharp rise in suicides. Although suicide statistics for police officers are
not readily available (they are often disguised as work accidents), interviews conducted
by the authors in several police forces indicate otherwise. Consequently, some sort of
program intervention and stress management is called for before the situation becomes a
"real epidemic".
Despite a consensus regarding their value,
EAPs are facing some major problems and obstacles on conceptual as well as on practical
grounds. While EAP advocates regard these obstacles as quite natural, given the evolution
of the field, opponents suggest that the problems are serious enough to suggest that EAPs
represent just another fad in organizational life.
There is no single way to classify the many issues
and obstacles to EAPS. Nevertheless, an attempt was made by Hollmann (1981) to classify
current deficiencies in EAPS:
- Most EAPs tend to be treatment-oriented (i.e., they deal with
symptoms of the problem) rather than the cause of the problem (e.g., boring job, unfair
supervisor, overburden of responsibility).
- Most EAPs tend to be reactive rather than pro-active. In
other words, "EAP occurs after the fact, namely, attention is directed to the past
instead of the future" (p. 38).
- Most EAPs tend to be fragmented. Hollmann (1981) concludes
that the majority of the programs fail to:
- recognize the possible interdependence between multiple problem areas (e.g., family
problems, lack of support);
- consider the possible interdependence between the problem and
internal organizational conditions (e.g., insensitive superior); and
- integrate with other
human-resource management activities (e.g., staffing, promotion, performance appraisal,
training)
Another way to tackle the current challenges to EAPs
is to recognize some of the limitations of most programs. It is important to note that an
EAP should not be regarded as a panacea to solve all performance problems in an
organization, nor should it be regarded as an exact science designed to solve all human
misery. In fact, if any program is perceived as such, it is bound to fail. in addition,
some objective limitations characterize, to some degree, many EAPs and thus contribute to
their "non-success". For example, an absence of the following might all
contribute to a failure of the program and should guide any potential client organization
in attempting to purchase or implement a program:
-
precise definition and clear mission for the EAP (Diesenhaus,
1985/86);
-
benchmark data (Jones, 1983; Santa Barbara, 1984b; Albert et
al., 1985);
-
precise implementing procedures (Diesenhaus, 1985/86), or
lack of established policy and procedural methods (Madonia, 1985);
-
standards and ethical principles (BNA, 1987; Penzer, 1987;
Roman & Blum, 1987);
-
sufficient dissemination of information (Steele &
Hubbard, 1985);
-
evaluative systems (Penzer, 1987; Gerstein & Bayer,
1988);
-
training for supervisory personnel and counsellors (Googins
& Kurtz, 1980; Masi, 1982);
-
top-level support (Witte & Cannon, 1979; Maynard &
Farmer, 1985);
-
competent staff (Nahrwold, 1983);
-
preventive dimension (Hollman, 1981; Beale, 1984; Delaney,
1987).
Finally, a major vacuum in the field of EAPs is the
lack of systematic information about what works and what does not work. Too often,
according to Epp (1988), organizations are "in the dark" in making decisions
regarding an EAP's implementation or modification. Since scholarly research on EAPs is
largely unavailable to consumers, it is most important for potential buyers of the service
to be involved in self-education, in information gathering and in internal discussions
prior to making a decision.
Although EAPs have some limits and unresolved
issues, this should not deter organizations from using them. One of the assets of EAPs
"lies in the fact that each EAP may be tailored to meet the specific need of
employees at a specific company, industry, institution, or government unit"
(Appelbaum & Shapiro, 1989, p. 42). That is to say that the available data on models
and approaches and on scope and limitations is useful in the sense that it provides a menu
of available services, their pros and cons and permits the more sophisticated user to make
an intelligent decision regarding the segment(s) it wishes to adopt and implement. It also
provide the user with a realistic assessment concerning chances for success.
In order to increase the chance for success in
implementing an EAP program, Hollmann (1981) pinpoints a number of issues that need to be
addressed:
- The Integrative and Preventive Dimensions
- The following should be included:
- Integration of the problem area to include the possibility
that a troubled employee might have multiple problems that should be treated in a
co-ordinated manner.
- Integration of the EAP activity with other human resource
activities; for most companies, various activities conducted by the personnel/human
resource office is done independently of the EAP, health or medical department; more
coordination between these units is called for.
- Quality Assurance Procedures - in order to
protect EAP consumers and to provide guidelines for EAP practice, it is essential to use
definitions and practice standards that are carefully and precisely drawn. The EAP
movement can learn in this regard from the mistakes and errors committed earlier by other
professionals such as physicians and psychologists. An interesting example of quality
assurance procedures is offered by McClellan (1985/86).
- The confidentiality issue - This issue has
to be treated with extra care in accordance with strict professional ethics.
- The location issue - Most EAP experts warn
against placing the program in the personnel/human resource department.
- Continuous training of supervisory personnel
and counsellors - initial training should be followed up. Continuing education of
counsellors is also essential.
- Staffing - Foote, Erfurt and Austin (1980)
argue, based on their experience at General Motors, that at least one full-time staffer is
needed. Further, research indicates that even external services are not used to the full
extent if a permanent liaison person in the organization is not at hand (Blum and Roman,
1987; BNA, 1987).
- Promotion/Education - Braun and Novak
(1986) conclude that EAPs must be engaged in promoting their service. Pamphlets, training
sessions and other media should be used for such promotion.
- Evaluation - The more data available for
evaluation purposes, the easier if is to demonstrate the tangibility of the service.
EAPs have traditionally proven their effectiveness
in "secondary prevention", which involves early detection of a problem and
prompt intervention or treatment. What is generally missing in EAPs is a "primary
prevention" which would decrease the incidence of problems that might otherwise
become severe.
In the future, primary prevention will become
effective as EAP professionals recognize the active role they need to assume. One EAP
expert (interviewed for this project) stated: "My real test of effectiveness will be
materialized at the point where I will run myself out of business". Two approaches
are commonly used in primary prevention: (a) educational approaches and (b) improvements
in instruments/tools permitting early (or very early) diagnosis.
Educational approaches, according to Lewis
and Lewis (1986), will be used more and more in the future for preventing the incidence of
problems most frequently seen among the employees of a given organization. A variety of
methods, including role simulations, workshops, seminars and film presentations, should be
used to educate employees about potential problems and teach them how to self-diagnose the
early signs and symptoms of a problem. Some examples of popular workshops sponsored by
many EAPs include: stress management; preventing burnout at work; effective parenting;
improving communication skills; assertiveness training; marriage enrichment; increasing
social support systems.
Another developing area is the improvement of
tools/instruments available for the organization and the EAP specialist. The new
family of diagnostic tools utilize state-of-the-art technology such as computer-assisted
diagnosis and computerized files enabling systematic follow-up and assessment of
intervention success. These tools are perceived by most users as being more credible. As
stated by one physician-turned-EAP-specialist: "Because we live in a technological
society it seems that gadgets and computerized equipment improve the credibility of the
service, as it boosts the image of the field being more precise and more scientific".42
One of the sophisticated programs currently
available is called SDI (Stress Diagnostic Inventory) . The software package was
developed by researchers at the University of Montreal for use on a personal computer and
it can be tailored for any given client.
SDI was developed following 10 years of research on
stress and burnout and their consequences on individual and organizational health.43
It is intended to assist diagnosis at both the individual and the organizational or unit
levels. The user simply replies to a series of questions on a computer screen, and
diagnosis (in either English or French) is displayed or printed immediately following the
completion of the battery of tests. Because the computer is programmed with norms for
different occupations, the diagnosis includes a reference for establishing the severity of
the problem. The computer is capable of assembling any paper and pencil inventory/test
currently used by EAP experts for the purposes of assessment.
The beauty of the program is that, in addition to
individual analysis, it performs aggregate analyses, thereby identifying epidemiological
trends and consequently providing an early warning for a given problem that seems to be
apparent in a specific location or in some categories of employees. The potential uses for
instruments of this kind are enormous as they permit the simultaneous analysis of
individual and group data. This permits a more balanced and holistic approach to
organizational intervention (i.e. for both treatment and prevention), as well as
individual treatment.
Most employers and employees who have experienced
EAPs view them quite positively. Decision-makers in the corporate world must become
convinced that investing in EAPs leads to a double-winning position: furthering
organizational effectiveness and enhancing employees' well being. Nonetheless, an EAP is
not a panacea. While it will provide assistance for personal problems it will not
eliminate all tardiness, absenteeism, accidents or morale problems. Also, it will not
solve union-management or other organizational malaise.
A comprehensive EAP has a two-fold function:
correction and prevention. While the area of correction has received ample attention and
various models of service delivery are used in many organizations, the area of prevention
is still in its infancy. Because of the fact that most organizations operate with limited
resources, EAPs need to demonstrate tangible results, as well as indications of
cost-effectiveness in the long run, in order to prosper in organizations. While if is
widely recognized that not all results of EAP intervention can be measured precisely, if
is generally agreed that the benefits outweigh the costs, assuming that the program is
properly implemented and managed.
The major drawback of many EAPs is that they are
geared towards microscopic intervention, after the fact. Their preventive role should be
the trend for the future where the traditional, individual assessment will be coupled with
educational efforts and will be expanded to include organizational diagnosis, thereby
permitting a new array of organizational, microscopic interventions. The notion that some
organizations, or some units within an organization, might be breeding grounds for
generating and fostering employees' problems is beginning to be recognized. It is for
these reasons that a number of recent cases of employee burnout have been recognized by
workers compensation boards in Ontario and in Quebec, as well as in several arbitral
awards. Thus, if individual treatment is performed in isolation from the unit/department,
it might be nothing more (in some cases) than an exercise in futility. This calls for
increased collaboration between the traditional EAP professional and the human resources
expert and between the physician and the supervisor. The new EAP will represent this
eclectic and multi-disciplinary approach. One final conclusion seems to be evident:
regardless of the approach chosen, regardless of the scope and technology used, EAPs are
here to stay.
- Googins, 1975; Hollmann, 1981; Masi, 1982; Jones, 1983; Trice
& Beyer, 1984; Roman & Blum, 1987a; Straussner, 1988; Appelbaum & Shapiro,
1989.
-
Levine, 1985; Steele, 1982; Masi & Teems, 1983a.
-
Roy-Brisbois, 1983; Santa-Barbara, 1983a; Canadian Mental
Health Association, 1984.
-
Bilik, 1987.
-
Whitbread's, 1989.
-
Johnson & Black, 1985.
-
Carmody-Sheehan, 1983; Roman, 1983a; Terry, 1987.
-
Alcohol and Drug Addiction Foundation, 1978; Albert et al.,
1985; Klarreich et al. 1985; MacMaster, 1988; MacDonald & Dooley, 1989a.
-
Sonnenstuhl & O'Donnell, 1980; Dickman & Emener,
1982b; Ray, 1982; Gerstein & Bayer, 1988.
-
Johnson, 1985; Levine, 1985; Appelbaum & Shapiro, 1989.
-
McClellan, 1983; Delaney, 1987.
-
McClellan & Miller, 1988a; Spicer, 1987; Kim, 1988.
-
Presnall, 1981; Trice & Schonbrunn, 1981; Trice &
Beyer, 1984; Masi, 1986; Brock, 1987; Masi & Goff, 1987.
-
Roman, 1983; Sonnenstuhl, 1986; Sonnenstuhl & Trice,
1986; Roman & Blum, 1987a.
-
Trice & Schonbrunn, 1981; Roman, 1988.
-
Shain & Groeneveld, 1980; Shain, Suurvali &
Boutilier, 1986.
-
Roman & Blum, 1985; Roman et al., 1987.
-
Sonnenstuhl & Trice, 1986; Trice & Sonnenstuhl, 1988.
-
More specific information and details can be obtained from
the full length report mentioned at the beginning of this paper.
-
Jones, 1983; Kemp, 1985; Levine, 1985; Lanier et al., 1987.
-
Gray & Lanier, 1985-86; Lanier et al., 1987; Masi &
Friedland, 1988 and Appelbaum & Shapiro, 1989.
-
Addiction Research Foundation, 1984a; Lanier et al, 1987.
-
More information and examples about union-based models and/or
labour involvement can be found in: Pedis (1980); Putnam & Stout (1982); Trice &
Beyer (1982); Hudson (1983); Lynch (1983); Cohen-Rosenthal (1985); MacDonald & Albert
(1985); Riediger (1985); Tramm, (1985); Stennett-Brewer (1986); BNA (1987) and Wilcott
(1987).
-
Erfurt & Foote, 1977; Barrie et al., 1980; Masi and Teems
(1983a).
-
Corneil, 1982; Addiction Research Foundation, 1984b.
-
Hellan & Campbell, 1981; Corneil, 1982; BNA, 1987.
-
More detailed information about these is elaborated in the
original report (Dolan and Wolpin, 1990).
-
Other more detailed Information on implementation and the
specific functions performed by EAP practitioners and supervisors can be obtained from the
detailed report by Dolan and Wolpin (1990).
-
Dickman & Emener, 1982a; Masi, 1984; Appelbaum and
Shapiro, 1989.
-
Kim, 1988; Masi and Friedland, 1988. More detailed
information on different evaluation methods and on the specific type of questions to be
asked when evaluating a program can be found in the detailed report by Dolan and Wolpin
(1990).
-
Jones, 1987; Balgopal & Patchner, 1988.
-
A number of cost-benefit analysis models have been described
in Shain et al. (1986) and several practical examples in both the public and private
sectors in Canada and the U.S. are described in Dolan and Wolpin (1990).
-
Foote et al, 1978; Gam et al., 1983b; Nadolski and Sandonato,
1987.
-
Jerrell & Rightmyer, 1982; Myers, 1984; Starr and Byram,
1985.
-
Dolan et al., 1988; Dolan, 1989.
-
Metro Toronto Police Force - Schaer, 1986; Ottawa Police
Force -Welsh & Westwick, 1984.
-
Los Angeles Police Force - Petrone & Reiser, 1985;
Metro-Dade Police Department, Dade County, FL. - Tipps, 1984; Chicago Police Department -
Wagner, 1983; Cleveland, OH, Police Department Bratz, 1986.
-
Singleton and Teahan, 1978; Dolan, 1989.
-
As cited in Brennan et al., 1987.
-
Additional information on peer counselling can be found in
Capps (1984) and Hodson & Fallon (1989a)
-
For more information about post trauma counselling see:
Roy-Brisebois, 1983; Welsh & Westwick, 1984; Gwaltney, 1987.
-
Source: interview conducted with the medical/EAP team of the
Royal Victoria Hospital in Montreal.
-
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NOTES