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Between 10-20 percent of the total employee population in any institution of higher education are troubled employees. The lack of visibility and the absence of structure, especially in faculty positions, are risk factors. Higher education has become proactive in developing Employee Assistance Programs (EAPs) in response to organizational personnel problems. A needs assessment survey was conducted to ascertain the need for a university-based EAP in a state university in southern California. The findings suggested that EAP services were needed.

This article suggests there is a lack of a conceptual framework for developing a system of intervention in an Employee Assistance Program (EAP). The author proposes that the development life cycle concept is a framework for planning a case management system of intervention in an EAP. Stages of the life cycle are used to describe the activities in planning and evaluating the activities of a case management system.

The phases in the development of one employee assistance program indicate some of the pitfalls that must be avoided to establish a successful program.

Premenstrual syndrome (PMS) is discussed and defined as a clinical syndrome and the prevalence of PMS among working women is discussed. A review of the clinical history of PMS is provided, along with a description of the growing support for recognizing PMS as a bona fide clinical syndrome. A role for Employee Assistance Program (EAP) specialists in properly assessing PMS and in making an appropriate referral is presented, and review of three levels of interventions-self-help activities, counseling activities and hormonal/drug treatments-identified. The paper notes recent PMS research and closes by identifying a series of paradoxes associated with PMS that serve as a challenge for the EAP specialist.

Most Employee Assistance Programs (EAPs) measure their cost benefit by calculating into their formula equal weight for all problems. However, by examining problems according to degree of severity, different rates of success can be applied accordingly to the seriousness of the problem. Qualitative differentiation between problems would present a more accurate means of measuring cost benefit. This study presents a method of measuring cost benefit in an employee assistance program in higher education by differentiating levels of success depending upon the level of severity of the presented problem and the employee classification.

The National Survey of Work Site Health Promotion Activities established baseline data on the frequency of nine types of health promotion activity at private work sites with more than 50 employees in the United States. Stress management activities were provided at 26.6% of work sites. Types of activities at those work sites with some stress management activity included group counseling (58.5%), individual counseling (39.3%), follow-up counseling (25.9%), special events (11.5%), providing information about stress (80.7%), providing a place to relax (64.8%), and making organizational changes to reduce employee stress (81.2%). Frequency of activities varied by industry type and by region of the country. Incidence of most types of activities did not increase as work site size increased, although the likelihood of having any of these activities did increase with work site size. Stress management activities were more likely to be present at work sites with a medical staff or health educator. An increase in output, productivity, or quality was the most frequently cited benefit (46.5%). Negative effects were reported at 2.6% of the work sites. Other health promotion activities found at the work sites surveyed included smoking cessation (61.8%), treatment and control of high blood pressure (36.7%), and weight control (34.7%). Employee Assistance Programs were responsible for stress management at 62% of the work sites with an Employee Assistance Program.

Historically, Employee Assistance Programs (EAPs) have been viewed as an employee benefit even though there is documented evidence of their cost-effectiveness for the company. This article presents an integration of the Employee Assistance Program and Case Management as a way of providing a proactive method of containing health care costs. Such an integration will expand the focus of the Employee Assistance Program, strengthen our role as an employee advocate, and provide a method of demonstrating to corporations that EAPs do contribute to the "bottom line" profit margin of the company. This article outlines the components of an effective, comprehensive Employee Assistance Program and discusses the process of integrating a Case Management system that emphasizes local demographic control within the EAP.

An employee alcoholism service for hospital workers is described. Sixty-eight alcoholic workers identified over a 3 1/2 year period are assessed for current status as to activity in the service, work status, and drinking status by a chart review. The principle route of referral was via the employee health service (EHS) and a medical problem (63%) versus a supervisor or self-referral. Fifty-three percent of the workers are active in the service, 31% have had no contact, 12% are terminated from the job, and 4% are deceased. Of the active cases, 75% are abstinent. Active status in the service is highly associated with a supervisor or self-referral rather than an EHS referral. Self- and supervisor referrals to the service increased substantially after the initiation of an employee assistance program in the hospital.

A participant-observer in a qualitative study examined the operation of a consumer's grapevine in an employee assistance program. The study explicates undcrstandings about how the grapevine works and what information it carries. The grapevine was determined to be a powerful source for steering clients into counseling.

This article describes one of the first accounts of an Employee Assistance Program (EAP) staffed by a social worker in industry in the United States. The author was the social worker employed in this EAP (called the Industrial Social Work Project) which was originally motivated by a vice president's concern over employee turnover. The article describes in detail how the EAP was operationalized and used to evaluate the organizational culture by using an organizational development model which involved five overlapping phases. These were: (1) orientation/information gathering; (2) individual treatment; (3) research on cultural change; (4) team building and O.D. projects; and (5) O.D. management training. The main contention of this article is that organizations do in fact contribute to the "professional suicide" of employees, and those who plan to evaluate ENS are remiss not considering the organization context of such programs and their possible impact on employees.

The implementation of the employee assistance program in the New Jersey State Police was studied over a three-year period. Quesionnaires were sent to a stratified random sample of sworn members once each year for three years. The questionnaire contained items to measure the degree of diffusion, receptivity, and the use of the program. The initial hypothesis was that the implementation of the program would follow the three-phase process of diffusion receptivity and use. The result of the first survey indicated the program was in the diffusion stage with more than 69% of the troopers having heard of the employee assistance program. Response to the receptivity items revealed there was an awareness and sensitivity to the need for the program and its potential benefits. The results of the second survey showed that the diffusion stage was strengthened with 78% of the response having heard of the program. Receptivity to the program had not increased significantly and use was minimal. On the basis of these results, recommendations were made to enlarge and enhance certain program elements. The results of the third survey were quite similar to those of the second. The program was largely in the diffusion stage and was little into receptivity and utilization. Innovative procedures were recommended to move the program into an integral part of the Division.

This presentation sets forth a proposal for expanded Employee Assistance Program services when the employee works for an organization that requires repeated geographical transfers and field assignments. Relocating employees and family members are at high risk for developing a range of problems which may show up in the workplace as inefficiency on the job, high absenteeism, reduced productivity and a high turnover rate. The authors conclude that current services do not attend to the pressing need for support, education and problem identification. They suggest preventive strategies which may be utilized to address the needs of the relocating family.

Demonstrating the efficacy of an Employee Assistance Program is an equally important endeavor in public and private sector work organizations. This paper discusses the cost-benefit and cost-effectiveness evaluation that was conducted by the U.S. Department of Health and Human Services Employee Counseling Services program. Further, it details the components of the 30 month project relative to evaluation design, data collection processes, and strategies used to maintain employee privacy while analyzing personnel data. Results of the evaluation are also presented.

A pilot project designed to assess the feasibility and effectiveness of a health-related employee assistance program was implemented at the University of South Carolina. One hundred interested participants were randomly selected from university faculty and administrative staff. The project utilized the following methods: 1) psychophysical tests including health risk appraisals, health knowledge levels, physical activity assessments, psychological batteries of tests, and biophysical data obtained through a treadmill stress test, percent body fat, blood analysis, blood pressure, and pulmonary function; 2) individual health consultants who served to inform, model, and encourage participants to practice healthful behaviors; 3) group programs related to self-care/wellness promotion techniques; 4) mass media contact to repeat and reinforce healthful behaviors; 5) wellness-oriented social activities, such as fun runs, meatless covered dish dinners, etc. Results of the project included statistically sign...

The employee assistance program (EAP) movement has gained strength in recent decades. The goal of the EAP is to work hand in hand with management and labor to increase the productivity of troubled workers by addressing alcohol, drug abuse, or other types of mental health related problems.

Almost twenty years ago, in July of 1959, Group Health Insurance, Inc. of New York offered psychiatric benefits to 76,000 people—30,000 GHI subscribers and their 46,000 dependents.

A model intervention to address the needs of female employees with drinking problems was undertaken in several federal agencies participating in an employee assistance program. Supervisors and employees provided information through questionnaires, obtained at the time of the intervention and subsequently, on response to the intervention and later behavior. Further, detailed information was collected on clients entering the employee assistance program. Results indicated a positive increase in knowledge about alcoholism and a willingness to use the program. The intervention resulted in an increase in female referrals and a decrease in the proportion of female clients with prior disciplinary action. There was no significant increase in female alcohol-related referrals. There was a high incidence of alcohol problems among family members and possibly peers of women who attended the intervention programs.

Few readers will question the cost benefits of prevention of alcoholism as compared to its treatment costs. Many, however, might ask why prevention should take place in the workplace. After all, abusive drinking is not a common accompaniment of work (though some employees do drink on the job) and employers are understandably chary of intruding on employees’ rights to privacy. In addition, prevention costs money and businesspeople do not part readily with funds that do not contribute directly to production, distribution, or sale of products. Why prevention in the workplace, then?

The Bell System has been a concerned employer for a long time. We have had a pension plan without employee contributions since, I believe, 1913. And, Illinois Bell’s predecessor, the Chicago Telephone Company, employed their first physician in 1903—and a female at that. The company’s history gives evidence of its attitudes toward health care and employee assistance programs.

The Rock Creek Foundation has served the needs of the dually diagnosed since 1973, offering comprehensive services that include psychiatric day treatment, psychosocial vocational rehabilitation, residential services, and a full outpatient psychiatric clinic. The focus of this chapter is not these particular services but instead the evolution of our system. In terms of the process by which we are now attempting the delivery of our services, I would like to propose that given the opportunity to develop mental health services for mentally retarded individuals, we move toward what I am referring to as a “service model,” and away from “facility-based programs.” This is akin to an employee assistance program for mentally retarded individuals—one that would extend beyond the workplace into the home and other generic environments for the mentally retarded.

Workplace programs make the supervisor responsible for identifying alcoholics through their job performance. However, research indicates that those so identified are a small proportion of the alcoholic employed population and tend to be in the later stages of the disease. This is due in part to the relatively small number of alcoholics who demonstrate performance deterioration in the early stages. In addition, only a few members of the drinking population are responsible for the costs to the organization resulting from poor job performance. The identification rate differs for alcoholics depending on their sex and level in the organization and the supervisory style of their managers. Hiding symptoms and cover-up for others adds to the proportion remaining unidentified.

In June 1977 the Washington Business Group on Health reported the results of its first survey of employee mental wellness programs.1 Although far from comprehensive, that survey established a clear pattern of program growth, sophistication, and concern for the relationship between mental well-being and hospital-surgical-medical utilization. The corporate, professional, and governmental reactions to those findings caused WBGH to undertake a more extensive survey of many more companies.

This study examined characteristics of referrals to employee assistance programs (EAP) associated with subsequent termination of employment. As well, relationships between characteristics of the referrals and program characteristics were explored. Longitudinal data were collected at several time periods for 163 referrals to EAPs from five organizations. Survival analysis was conducted to determine which variables were associated with termination of employment. Females, cohabitating couples, and employees who worked for the organization for 5 or more years were most likely to remain employed. One interesting finding was that people with alcohol problems were significantly more likely to be formal referrals.

Periodic evaluation is necessary to maintain a quality employee assistance program. This survey was undertaken to determine employee awareness of the existing EAP and their satisfaction with the program. Likewise, the survey allowed for employee input on areas of the program they had concerns with that may have caused hesitancy in further use of the program. The survey not only documents to management that the program is of value to employees and identifies areas where changes may be focused in the future to meet employee needs, but actually serves as a communication tool in itself as a reminder of the availability of the Employee Assistance Program.

Constructive confrontation is a workplace strategy used to identify alcoholic employees and motivate them to change their behavior, either with their own resources or with the counseling services provided by employee assistance programs. This paper describes the strategy’s use by supervisors, peers, unions, and occupational groups, and it reviews the effectiveness of the evaluation research. The paper concludes with a discussion of “self-referral” in employee assistance.

One aspect of successful employee assistance program (EAP) implementation is the adoption of a formal, written policy, reflecting company commitment to EAP guidelines and goals. This study of criteria predictive of such policy adoption was conducted at the occupational alcoholism project of a New England health maintenance organization (HMO). Data on nearly 400 organizations contacted by occupational program consultants (OPCs) over a 20-month period were collected by questionnaire and interview. One third of these organizations adopted employee assistance policies and set about establishing formal programs. Stepwise multiple regression is the principal method used to pinpoint the correlates of policy adoption. Two of the most important of these are the attitudes of contact persons within the organization toward alcoholism and employee assistance programs, particularly their admission of alcohol problems within their social networks; and the consultants' persistence and marketing skills. The adopting organizations also had reputations for being progressive, and actively concerned about employee welfare; they tended to be large, their executives autonomous, and their union membership rates high. Inhibiting policy acceptance were fears that a written policy would jeopardize the reputation and image of the organization, and that an employee assistance program would remove internal control of personal procedures. The adequacy of the evaluative data and methods are discussed, and recommendations are offered in the interests of streamlining the efforts of OPCs and of achieving greater penetration of targeted organizations.

Do employee assistance programs in business have anything in common with deodorants, automobiles, and kids’ cereal? They most certainly do! It is an adage of the American business community that “nothing happens until somebody sells something to somebody.” It is in these terms that I propose those of us who are interested in implementing helping programs in industry must think.

The purpose of an employee assistance program (EAP) is to provide timely, professional help for people whose work performance might otherwise be negatively affected by mental or physical health problems. Many employers have come to recognize that, by offering such services to employees, they can accomplish two purposes: increasing the productivity of their work forces and providing a benefit that employees value.

All businesses are measured by a uniform criterion: profitability. Most industrial resistance to innovation is based on the fear that costs will rise and profits decline. Like everything else in business, employee assistance programs (EAPs) will be evaluated against the yardstick of their contribution to the financial success of the enterprise.

Since 1970 and the passage of a national alcoholism law (PL 91-616) and the creation of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) there has been a flurry of research activity and program development concerned with the prevention of alcohol-related problems (USDHEW, 1971, 1974, 1978, 1981). However, the question of how to measure the incidence of alcoholism and alcohol abuse in a given community has been a serious omission among published reports in the field (Staulcup, Kenward, and Frigo, 1979). Selden Bacon, an internationally recognized expert in studies on alcohol, writes that for “the past 78 years there have been many claims for prevention programs but few people can think of even one such attempt which can provide the slightest evidence that such a prevention in fact incurred” (Bacon, 1978, p. 1143).

The company interested in beginning an employee mental wellness program can benefit from the vast literature that already exists concerning mental wellness efforts, mostly in nonindustrial settings. Because some of the issues are exceedingly complex and because companies’ needs and circumstances vary widely, no effort is made here to provide a formula for program development. Rather, this chapter outlines an initial approach to the task—decisions to be made, some basic definitions—after which a company can pursue the information sources it finds most appropriate.

This report describes the nature, prevalence, and trends of drug and alcohol abuse among members of the US adult population and among personnel in non-nuclear industries. Analogous data specific to the nuclear utility industry are not available, so these data were gathered in order to provide a basis for regulatory planning. The nature, prevalence, and trend inforamtion was gathered using a computerized literature, telephone discussions with experts, and interviews with employee assistance program representatives from the Seattle area. This report also evaluates the possible impacts that drugs and alcohol might have on nuclear-related job performance, based on currently available nuclear utility job descriptions and on the scientific literature regarding the impairing effects of drugs and alcohol on human performance. Employee assistance programs, which can be used to minimize or eliminate job performance decrements resulting from drug or alcohol abuse, are also discussed.

Even though the hegemonic culture in North America rigidly separates welfare from the workplace, there is a fairly widespread example in North America of workplace welfare in which unions participate. This is a programme of referral services and some personal counselling usually called ‘Employee Assistance Program’. In this chapter we shall examine workers’ participation in EAPs, and contrast this experience with a newer programme, called ‘Union Counsellor Program’.

The modern employee assistance program straddles the two worlds of business and health services, and its staff must be well-versed in both. Unfortunately, most EAPs in corporations do not fill this double bill. They are sorely lacking in appropriately qualified staff, and, as a result, they provide only piecemeal assistance in limited areas. Companies eventually wind up dropping the entire service in the light of its remote or nonexistent benefits. Improper staffing has thus instigated a negative chain reaction: EAPs die because they’re ineffective; they’re ineffective because they’re inadequately staffed; they’re inadequately staffed because of naive ideas relating to the functions and objectives of the modern EAP. This chapter addresses that problem by identifying the five essential components of an EAP and the kind of staffing each requires to operate effectively.

EAPs increased from approximately five in 1945 to more than 5,000 in 1980. EAPs derive their mandate to assist employees in avoiding the negative impact of personal problems on job performance. Occupational health nurses must be familiar with the treatment resources in the community and the company's benefit programs. An occupational health nurse with good diagnostic and interviewing skills may find it possible to intervene with troubled employees before their job performance is impaired.

Public understanding and professional treatment of mental illness has a history of which we can only be embarrassed. For reasons steeped in myth, fear, confusion, and ignorance, illness of the mind has frequently been viewed as a category of disease separate from that affecting any other part of the human body. It is all right to break an arm, have a kidney fail, succumb courageously to cancer, or use the ears and nose to support a strange apparatus designed to assist our eyes. But the mind, that is different. That we were all supposed to totally control—by ourselves. And, if something should be a bit abnormal, therapy often entails more ostracism than rehabilitation. With such a history, it is little wonder that the evolution of employee health benefits offered coverage for nearly every other human organ and disease before including the mind and its problems.

Throughout this volume the contributors have provided a thorough overview of current thinking regarding alcohol abuse prevention. Available techniques and a state-of-the-art summary of policies, programs, and practices have been reviewed. It is apparent that prevention of alcohol problems is in its infancy from both a technological and a methodological standpoint. The information presented in this book, therefore, can serve as an excellent base upon which to build future prevention efforts.

“It is a physician’s ethical responsibility to take cognizance of a colleague’s inability to practice medicine adequately by reason of physical or mental illness including alcoholism and drug dependence.” In 1972, this statement from the Report of the Council of Mental Health of the American Medical Association (AMA) emphasized that a national effort was necessary (1) to help impaired physicians return to optimal professional functioning and (2) to safeguard the health of patients from the care rendered by these impaired physicians. Subsequently, medical societies of all 50 states developed procedures to identify and bring into treatment those physicians who were alcohol and drug dependent.1 Thirty-five states have enacted laws to amend legislation concerned with the practice of medicine so that treatment alternatives are available for impaired physicians involved in disciplinary proceedings.

The federal government expended $584.1 million on alcohol-related actions in 1980 (the latest year for which these figures are available). Only $24.4 million (4%) of this figure was allocated to prevention efforts, which were largely restricted to the three federal agencies for whom alcoholism is a central concern—the National Institute on Alcohol Abuse and Alcoholism, the Department of Defense (which must provide prevention and treatment services for members of the Armed Forces), and the National Highway Safety Administration.

This chapter is not a comprehensive review of the research literature relevant to personnel selection and training research. Rather it attempts to place the subjects of selection and training in perspective--that is, in terms of their partial contribution to employee productivity, quality of work life, and profits. Then we will present examples of the contribution of four types of behavioral science interventions: an absenteeism control program, an employee assistance program, a goal setting and feedback program, and an assessment center selection program. Let us begin by defining our terms.

Background Internet-based cognitive behavioral therapy (ICBT) for mental health issues has been successfully implemented in routine health care settings, and research indicates that ICBT can also be applied to decrease problematic alcohol use in workplace settings. However, studies investigating the feasibility of implementing ICBT in a workplace setting have been lacking. Objective The current study aims to investigate the feasibility of delivering ICBT for problematic alcohol use within an employee assistance program (EAP). Methods The study has a quantitative naturalistic design, quantitively comparing ICBT and face-to-face treatment, and allowing for qualitative interviews with employees and employers. Recruitment of participants follows a five-session in-person psychological assessment at an EAP regarding an employee’s presumed problematic alcohol consumption. All assessed employees referred to ICBT or face-to-face treatment will be offered participation in the study. Interviews will be held with employees and their employer representatives following ICBT to elucidate both stakeholders’ experience and perception of ICBT and its context. Outcome comparisons between ICBT and face-to-face treatment will be assessed quantitatively using a Reliable Change Index and analysis of variance. Thematic analysis and Grounded Theory will be used to analyze the interview material. Results The study is set to begin in April 2020 and to end in September 2021. The aim is to recruit up to 150 participants to the quantitative part of the study and 45 participants (15 employees and 30 employer representatives) to the qualitative part of the study. Conclusions The current study will provide knowledge that is lacking and urgently needed on how to implement ICBT for problematic alcohol use in a workplace setting. International Registered Report Identifier (IRRID) PRR1-10.2196/18693

From a qualitative study of flight attendants volunteering as support providers in a peer-based employee assistance program, a typology of the boundary management tactics used by peer-support providers to maintain a comfortable distance from help recipients is derived and a grounded theory explaining providers' selection of tactics is proposed. After identifying 2 factors associated with tactic selection (personal experience and social structure), it is demonstrated that support providers' cognitive orientations, or logics of action, mediate the relationship between these factors and tactic selection. There are 4 types of support providers' logics of action identified and it is shown how a provider's logic may predict his or her preference for a particular boundary management tactic.

It is almost commonplace today to read front-page stories of damage done by substance abuse to professional careers of athletes, entertainers, and public officials. It is estimated that 10 percent of the nation's work force struggles with alcoholism, 2 percent with drug addiction, and another 6 percent with emotional problems. ' Many public managers may be aware of employees whose personal problems adversely affect job performance. It is debatable, however, whether many are knowledgeable about their organization's policy toward troubled employees, aware of what can be done for them, or are informed about employees' legal rights. A 1978 U.S. General Accounting Office survey of 81 federal installations confirmed this; it also found that top management officials possessed negative feelings about their organizations' rehabilitative programs.2 Some did not believe they were in the "hand-holding business," and others were concerned with the cost of social actions such as alcohol and drug counseling relative to the resources invested in the installation's primary mission. This latter feeling was articulated despite the GAO's finding that funding and office space devoted to such programs were often limited and inadequate. 3 The most common approach to managing troubled employees, that of employee assistance programs (EAPs), evolved from industrial alcoholism programs. Consequently, the EAP literature (and practice) is dominated by a concern with alcoholism and alcoholrelated issues, and, with very few exceptions, draws from private sector experience.4 Differences exist, however, between public and private sector personnel rules, employment practices, and legal obligations to employees. Differences may even exist between those who seek public sector employment and those who seek work in the private sector.5 The EAP literature provides inadequate information about the likely incidence of troubled employees in the public work force, the identification and counseling of public employees, and the problems of EAP implementation in public organizations. This article seeks to sensitize public managers to the issue of troubled employees, and discusses the employee assistance program as one approach to managing this type of employee. Although one must be cautious in extending findings reported in this article to other cities