Survey shows broad differences in program access and lack of uniform measures
As conspicuous as employee assistance programs are on the Canadian landscape, the programs themselves remain surprisingly unexplored. While there has been extensive research conducted in the EAP field, there has not been a thorough examination of the structure and function of programs.
In 2001, a four-page survey was developed in conjunction with a national advisory committee of labour, management and service providers. In all, 154 organizations took part, with 100 from the public sector. Workforce size ranged from seven employees to 60,000, with an average of 3,144 and a median of 1,350 employees. The majority of the workplaces surveyed (89.6 per cent) were unionized.
The EAP field remains relatively new as only 16 programs in the study were initiated prior to 1980. Nearly half (45.8 per cent) were developed in the 1980s while another 56 (39.4 per cent) were begun in the 1990s. There still also appears to be ongoing growth as 21 (13.6 per cent) were created between 1997 and 2001 with five (3.5 per cent) begun in the new century.
The driving force
More than half of the EAPs were created by a joint labour-management group. Management or HR was responsible for beginning nearly one-third of the programs (31.1 per cent), followed by labour (6.4 per cent) and occupational health (5.8 per cent). While occupational health services were extensively involved in occupational alcoholism programs, as demonstrated by prior research, this latter finding suggests a decreasing importance of health services in EAP program development.
Smaller organizations were more likely to have had their EAP initiated by management while larger organizations were most likely to have a joint labour-management group as the driving force behind program development.
Ways EAPs are delivered
The survey also looked at how EAPs were delivered. What was most surprising was not that the majority of programs (86.4 per cent) used at least one professional counsellor outside of the workplace but how many used a hybrid model. Nearly one-third of the organizations used a combination of internal volunteers, either referral agents, union counsellors or members of a 12-step fellowship, in conjunction with an internal co-ordinator or counsellor and at least one external professional counsellor.
Another 30 (19.5 per cent) organizations used an internal professional supported by a third-party, external counsellor. Only six (3.9 per cent) organizations in the study used internal volunteers alone to provide assistance. It was also interesting to note that while 133 companies used external counsellors or counselling agencies, slightly more than one-quarter used external counselling as their sole mechanism for providing EAP services. The larger an organization, the greater the likelihood that an internal professional would be involved in providing services to the workforce. Labour-initiated programs were also most likely to use internal volunteers to provide assistance.
The amount of education and training provided to internal volunteers varied widely. One organization only provided its internal volunteers with a half day of training after which they were allowed to become part of the EAP, while another required three weeks. One and two weeks of training was not unusual, though nearly 40 per cent of organizations using peer supports reported providing three days or less. Thirty-four organizations reported that their internal volunteers also received annual followup education and training lasting from one half day to two weeks with a mean of four days.
Those providing EAP services are a well-educated group in Canada. Nearly 80 per cent of organizations used at least one counsellor with a master’s degree while slightly more than 40 per cent had at least one counsellor with a doctoral degree. As well, nearly 40 per cent of EAP counsellors had a specialized diploma in addiction studies while one-third had EAP studies certificates. Seventy-six organizations used registered social workers to provide assistance through their EAP, while 56 used certified psychologists, 46 used certified alcohol and drug counsellors, 41 used certified trauma specialists, 33 used certified employee assistance professionals and 22 used certified occupational health nurses.
Expanding access to family members
When workplace-based assistance evolved from occupational alcoholism programs to EAPs, the emphasis remained on the employee. However, in the intervening years there has been acknowledgement that immediate family members should also be counselled through the auspices of these initiatives, which is why many programs are now billed as employee and family assistance plans.
In this survey, 144 of 154 responding organizations allowed family members to use the company program. There were several groups, however, that were not readily allowed access to the EAP by the organization. These included part-time employees (excluded at 27.9 per cent of responding organizations), workers on probation (42.9 per cent), seasonal workers (44.8 per cent), retirees (54.6 per cent) and employees who had been laid off (63 per cent).
Capping of services
The capping of service has always been a contentious issue in EAP. Four organizations did not respond to the question as to whether their program had a maximum number of counselling sessions. Seventy-two (48 per cent) did cap EAP use while 78 (52 per cent) did not. Three organizations (two per cent) had a monetary cap rather than a limit on the actual number of sessions allowed. At the low end, one organization allowed only two sessions, while two allowed for three and four for four.
In each of these cases the average number of sessions was the cap. For organizations that capped service from five to 12 sessions, the average number of counselling sessions was 5.1. For organizations with no cap, the average was five. This means there was no difference in the average number of sessions between the two groups. Capping did not provide any real savings and in fact, where services were capped at eight, 10 or 12, average use was greater than in instances where no formal cap was in place.
Usage rates
Organizations regularly rely on usage rates to assess the program’s ability to assist employees, what model of assistance should be used and whether more program promotion or development is needed. However, this survey confirms there is no uniform formula for determining usage.
Ten organizations did not calculate a usage rate, six reported they did not know how the usage rate they were reporting was calculated, while 15 relied exclusively on their external service provider. Of the 102 companies that did report a usage rate there were 19 different formulas used. The most commonly used formula was number of new files per year divided by the number of employees. Another common formula was number of family members plus employees using the EAP divided by the total number of employees. Some used total number of employees accessing the EAP divided by total number of employees in the workforce and omitted the count of family members who accessed the program.
Further complicating this is the lack of a common definition for a case. For some organizations, a phone intake was equivalent to a visit and would trigger the opening of a case while for others, a case necessitated an actual face-to-face counselling session. For some, if a person accesses the service twice in a year, each time with a different problem, it would constitute two cases. Another organization reported that after a person has used up 12 hours of counselling, he’s considered a new case. In the last two examples, the method of defining a case may be a creative way to circumvent the capping of services for clients who are still in need of counselling.
Employee assistance programs are a growing enterprise in Canada and while third-party professionals are a prominent mechanism through which assistance is provided, peers and internal professionals remain important within many programs. Differences in EAPs arise depending upon who initiates the program, who provides the service, the size of the organization and the presence of a union in the work environment. There remains many areas that require continued program development, including policies, promotion, orientation, supervisory and peer education and training. Perhaps most importantly, uniform definitions of critical terms, such as what a case is and how usage should be calculated, need to be developed.
Rick Csiernik is a professor and graduate studies co-ordinator at the School of Social Work, King’s University College at the University of Western Ontario in London. His new book is entitled, Wellness and Work: Occupational Assistance in the Canadian Context. He can be reached at [email protected].
In 2001, a four-page survey was developed in conjunction with a national advisory committee of labour, management and service providers. In all, 154 organizations took part, with 100 from the public sector. Workforce size ranged from seven employees to 60,000, with an average of 3,144 and a median of 1,350 employees. The majority of the workplaces surveyed (89.6 per cent) were unionized.
The EAP field remains relatively new as only 16 programs in the study were initiated prior to 1980. Nearly half (45.8 per cent) were developed in the 1980s while another 56 (39.4 per cent) were begun in the 1990s. There still also appears to be ongoing growth as 21 (13.6 per cent) were created between 1997 and 2001 with five (3.5 per cent) begun in the new century.
The driving force
More than half of the EAPs were created by a joint labour-management group. Management or HR was responsible for beginning nearly one-third of the programs (31.1 per cent), followed by labour (6.4 per cent) and occupational health (5.8 per cent). While occupational health services were extensively involved in occupational alcoholism programs, as demonstrated by prior research, this latter finding suggests a decreasing importance of health services in EAP program development.
Smaller organizations were more likely to have had their EAP initiated by management while larger organizations were most likely to have a joint labour-management group as the driving force behind program development.
Ways EAPs are delivered
The survey also looked at how EAPs were delivered. What was most surprising was not that the majority of programs (86.4 per cent) used at least one professional counsellor outside of the workplace but how many used a hybrid model. Nearly one-third of the organizations used a combination of internal volunteers, either referral agents, union counsellors or members of a 12-step fellowship, in conjunction with an internal co-ordinator or counsellor and at least one external professional counsellor.
Another 30 (19.5 per cent) organizations used an internal professional supported by a third-party, external counsellor. Only six (3.9 per cent) organizations in the study used internal volunteers alone to provide assistance. It was also interesting to note that while 133 companies used external counsellors or counselling agencies, slightly more than one-quarter used external counselling as their sole mechanism for providing EAP services. The larger an organization, the greater the likelihood that an internal professional would be involved in providing services to the workforce. Labour-initiated programs were also most likely to use internal volunteers to provide assistance.
The amount of education and training provided to internal volunteers varied widely. One organization only provided its internal volunteers with a half day of training after which they were allowed to become part of the EAP, while another required three weeks. One and two weeks of training was not unusual, though nearly 40 per cent of organizations using peer supports reported providing three days or less. Thirty-four organizations reported that their internal volunteers also received annual followup education and training lasting from one half day to two weeks with a mean of four days.
Those providing EAP services are a well-educated group in Canada. Nearly 80 per cent of organizations used at least one counsellor with a master’s degree while slightly more than 40 per cent had at least one counsellor with a doctoral degree. As well, nearly 40 per cent of EAP counsellors had a specialized diploma in addiction studies while one-third had EAP studies certificates. Seventy-six organizations used registered social workers to provide assistance through their EAP, while 56 used certified psychologists, 46 used certified alcohol and drug counsellors, 41 used certified trauma specialists, 33 used certified employee assistance professionals and 22 used certified occupational health nurses.
Expanding access to family members
When workplace-based assistance evolved from occupational alcoholism programs to EAPs, the emphasis remained on the employee. However, in the intervening years there has been acknowledgement that immediate family members should also be counselled through the auspices of these initiatives, which is why many programs are now billed as employee and family assistance plans.
In this survey, 144 of 154 responding organizations allowed family members to use the company program. There were several groups, however, that were not readily allowed access to the EAP by the organization. These included part-time employees (excluded at 27.9 per cent of responding organizations), workers on probation (42.9 per cent), seasonal workers (44.8 per cent), retirees (54.6 per cent) and employees who had been laid off (63 per cent).
Capping of services
The capping of service has always been a contentious issue in EAP. Four organizations did not respond to the question as to whether their program had a maximum number of counselling sessions. Seventy-two (48 per cent) did cap EAP use while 78 (52 per cent) did not. Three organizations (two per cent) had a monetary cap rather than a limit on the actual number of sessions allowed. At the low end, one organization allowed only two sessions, while two allowed for three and four for four.
In each of these cases the average number of sessions was the cap. For organizations that capped service from five to 12 sessions, the average number of counselling sessions was 5.1. For organizations with no cap, the average was five. This means there was no difference in the average number of sessions between the two groups. Capping did not provide any real savings and in fact, where services were capped at eight, 10 or 12, average use was greater than in instances where no formal cap was in place.
Usage rates
Organizations regularly rely on usage rates to assess the program’s ability to assist employees, what model of assistance should be used and whether more program promotion or development is needed. However, this survey confirms there is no uniform formula for determining usage.
Ten organizations did not calculate a usage rate, six reported they did not know how the usage rate they were reporting was calculated, while 15 relied exclusively on their external service provider. Of the 102 companies that did report a usage rate there were 19 different formulas used. The most commonly used formula was number of new files per year divided by the number of employees. Another common formula was number of family members plus employees using the EAP divided by the total number of employees. Some used total number of employees accessing the EAP divided by total number of employees in the workforce and omitted the count of family members who accessed the program.
Further complicating this is the lack of a common definition for a case. For some organizations, a phone intake was equivalent to a visit and would trigger the opening of a case while for others, a case necessitated an actual face-to-face counselling session. For some, if a person accesses the service twice in a year, each time with a different problem, it would constitute two cases. Another organization reported that after a person has used up 12 hours of counselling, he’s considered a new case. In the last two examples, the method of defining a case may be a creative way to circumvent the capping of services for clients who are still in need of counselling.
Employee assistance programs are a growing enterprise in Canada and while third-party professionals are a prominent mechanism through which assistance is provided, peers and internal professionals remain important within many programs. Differences in EAPs arise depending upon who initiates the program, who provides the service, the size of the organization and the presence of a union in the work environment. There remains many areas that require continued program development, including policies, promotion, orientation, supervisory and peer education and training. Perhaps most importantly, uniform definitions of critical terms, such as what a case is and how usage should be calculated, need to be developed.
Rick Csiernik is a professor and graduate studies co-ordinator at the School of Social Work, King’s University College at the University of Western Ontario in London. His new book is entitled, Wellness and Work: Occupational Assistance in the Canadian Context. He can be reached at [email protected].
