The great EAP question — internal or external?

The fundamental purpose of an employee assistance program (EAP) is to help employees and their family members while also helping the organization. Two distinct options have emerged over time: assistance from professionals or volunteers who are part of the organization or aid from professional counsellors who work outside the organization. However, the hybrid or combined internal/external EAP appears to be gaining popularity in Canada.

Internal EAPs are part of the organizational structure of a company and can be a stand-alone department or associated either with the health services or human resources departments. Internal EAPs are staffed by one or more professional counsellors, most commonly social workers, with many organizations using peer referral agents or peer debriefing teams to supplement the program. Internal EAPs usually report to a labour-management committee that oversees the program.

External EAPs are typically fee-for-service providers of counselling that can add a broad range of additional programs, from lunch-and-learn sessions on fitness to disability management services. Most often external providers report directly to HR, although they too can provide quarterly and annual reports to an EAP committee that guides the program’s development.

Hybrid EAPs combine an internal professional who co-ordinates short-term counselling or assessment and referral services with external counselling resources for specialized assistance, such as trauma or substance abuse counselling.

There has been extensive debate in the EAP field about the virtues of internal versus external EAPs since external providers arose in the 1970s to challenge the position of internal counsellors. (See sidebar.)

An examination of peer-¬reviewed articles pertaining to Canadian EAPs reveals counsellors in internal programs see more clients with alcohol- or other drug-related problems than external programs. They also see more employees with work-related problems and have greater annual utilization rates. However, external EAPs see slightly more clients with family, marital and emotional issues.

While proponents of both internal and external programs typically claim financial benefits for the sponsoring organization, the literature has many more examples of studies from internal EAPs than from external programs.

Ultimately the question of which approach is superior depends upon each organization and what it wants from an EAP. If an organization has a small workforce, multiple work sites or opts to outsource any non-mission specific service, an external EAP can be an easy way to begin a program that provides consistent services for all employees.

If an organization wants to have more control over programming and have EAP staff available for informal consultations and be more proactive, along with providing a formal counselling program, an internal EAP should be considered.

The ultimate program would entail on-site professionals co-ordinating the program and responding to ongoing organizational needs as they arise, and before they arise, supported by peers and external counselling supports: the hybrid.

EAPs are much more than a resource to assist employees in crisis so the kind of program selected can have a dramatic impact on the economic health of both organizations and employees.

Rick Csiernik is a professor of social work at King’s University College at the University of Western Ontario in London, Ont., and author of Wellness and Work: EAP in Canada published by Canadian Scholars Press. He can be reached at [email protected].

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STRENGTHS AND WEAKNESSES

Internal EAPS

Strengths

• organizational belongingness and understanding of the dynamic ¬environment of the workplace;

• higher utilization rates than external programs;

• organizational positioning and support;

• long-range perspective;

• immediacy of response to critical incidents;

• quicker response to organizational changes; and

• knowledge of organization policies and procedures.

Weaknesses

• replication of resources available in the community;

• staffing may not be adequate to meet organizational diversity;

• fewer opportunities for ongoing professional development ¬opportunities (for the counsellor); and

• ethical conflict over who the client is and perception of lack of ¬confidentiality.





External EAPS

Strengths

• greater utilization by family members;

• greater utilization by senior management/executives;

• off-site locations promote feelings of confidentiality;

• best option for smaller organizations;

• wider range of clinical resources and greater likelihood to provide longer hours of access;

• consistent service over broad geographic areas;

• provision of additional services at a minimal cost; and

• more emphasis on and experience with marketing of services and self-promotion.

Weaknesses

• necessity of profit margin to maintain operations;

• less awareness of organizational culture;

• fewer informal contacts;

• ethical conflict over who is client (employer or employee);

• fewer supervisor consultations;

• slower response time to immediate crisis or critical incident;

• lower use of services for alcohol and other drug use and for work-related problems;

• capped services;

• fewer core services per employee;

• increased cost if threshold utilization rate is surpassed; and

• lack of consistency between intake and counselling services.