Medical Family Therapy in Employee Assistance Programs
Companies and industries influence a considerable number of policy changes in the United States, especially when it comes to healthcare. Their influence is grounded in the large number of employees hired and concomitant budget lines that are directed toward employees’ healthcare coverage. Businesses often pay partial or full health insurance on behalf of both the employee and his/her family. Healthcare costs for individuals, families, and employers continue to rise on a yearly basis; these have a “pocketbook impact” on both ordinary families and U.S. businesses alike (National Conference of State Legislators [NCSL], 2017).
Glossary of Important Terms in Employee Assistance Programs
A civil rights law that prohibits discrimination against individuals with disabilities in securing jobs, schools, transportation, and access to public and private places that are otherwise open to the general public.
Assessment and referral are core functions of an EAP. These are not treatment or long-term counseling programs; they are proactive and accessible services for employees and their family to get basic counseling solution or referrals for long-term care. Assessment and referral EAPs also act as navigators through the complex world of behavioral health. Sessions are limited to conducting assessments and determining if the patient can benefit from short-term counseling and if not referring and navigating that member through their health system.
Services provided by the EAP to the employee for 1–6 sessions (some have more sessions). The basis for the number of sessions is determined by the philosophy of the organization and/or in accord with financial considerations.
Consultants who help businesses source the best possible benefits for their employees. Examples of their services include (a) helping business leaders determine what type of health coverage to purchase (e.g., where high-deductible plans would be appropriate for the business and its employees), (b) supporting businesses in establishing a culture of physical, mental, and emotional wellness, (c) advising on ways to increase employee productivity by helping to resolve employee issues that are obvious and relatively undetectable, and (d) offering strategies that may enhance managers’ effectiveness in stimulating workplace performance.
A specially trained and credentialed employee assistance professional who is usually licensed in a mental health or substance abuse counseling field. He or she operates in an occupational setting, and their “clients” may be both management and employees in general.
A person who assists the organization, its employees, and their family members with personal and behavioral problems. Foci of attention include (but are not limited to) health, marital, financial, alcohol, drug, legal, emotional, or other personal concerns that adversely affect employees’ job performance and productivity. The specific activities of this professional may include any of the services described under the definition of EAP. If/When they provide clinical services, these professionals must be licensed or certified in the state that said services are rendered.
A worksite-based program designed to assist in the identification and resolution of work-related and nonwork-related productivity problems associated with employees who are impaired by personal concerns, including (but not limited to) health, marital, family, financial, alcohol, drug, legal, emotional, or other personal concerns which may adversely affect employee job performance. The specific core activities of EAPs include (a) services for individuals (such as identification and resolution of job performance issues related to an employee’s personal concerns and assessment, referral, and follow-up), (b) services for managers and supervisors (such as assistance in referring employees to the EAP, supervisor training, and management consulting, (c) services for organizations (such as violence prevention/crisis management, group intervention, and employee orientation), and (d) administrative services such as the development of EAP policies and procedures, outreach, evaluation, and referral resources development.
The method of delivering EAP services. Typically delivered through one of three basic staffing models; these include (a) internal model, where the EAP staff is comprised of the organization’s employees and there are no contractors involved; (b) external model, where the sponsoring company or organization has entered into a contract for an outside vendor to provide all EAP-related services; and (c) blended model, where both host organizations and contract personnel are involved in the delivery of EAP services.
A labor law requiring qualifying employers to provide employees unpaid leave for serious health conditions, to care for a sick family member, or to care for a newborn or adopted child.
Expert advice given to leaders, supervisors, human resources, and/or union representatives regarding the management of potential or actual performance and conduct concerns. One example is coaching a supervisor on how to refer an employee to the EAP.
An event, usually sudden, unexpected, and potentially life threatening, in which a person experiences a trauma (e.g., feels overwhelmed by a sense of personal vulnerability and/or lack of control). Examples of a need for an on-site incident include a natural disaster, serious workplace accident, hostage situation, or violence in the workplace.
A professional process or activity designed to assist an organization, company, or office (department) to move from one level of performance or mode of operation to another in the shortest time possible.
A systemic analysis of an organization done by collecting data through informational interviews, surveys, data, and claims analysis as to the company’s needs in being more productive, safe, functional, and effective.
A systematic process for evaluating and reducing potential harm that may befall personnel, consumers of service, an organization, or a facility.
Workers who are either contracted by an entity embedded in occupational heal th/workers’ compensation service or provided by the company itself when employees get injured in the workplace or while doing their job. It provides wage replacement and extends or contracts out care to employees in exchange for mandatory relinquishment of employee’s rights to sue their employers for negligence.
- Abbasi, M., Dehghani, M., Keefe, F. J., Behtash, H., & Shams, J. (2012). Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: A 1-year randomized controlled trial. European Journal of Pain, 16, 1033–1043. https://doi.org/10.1002/j.1532-2149.2011.00097.x CrossRefPubMedGoogle Scholar
- Attridge, M., Herlihy, P., Sharar, D., Amaral, T., McPherson, T., Stephenson, D., … Routledge, S. (2007). EAP healthier, more productive employees: A report on the real potential of employee assistance programs. Hartford, CT: The Hartford.Google Scholar
- Attridge, M., & Wallace, S. (2010). Able-minded: Return to work and accommodations for workers on disability leave for mental disorders. Vancouver, BC: Human Solutions.Google Scholar
- *Ballus-Creus, C., Penarroya, A., & Leff, J. (2016). How a pain management program for patients and spouses can benefit their lives? International Journal of Social Psychiatry, 62, 496–497. https://doi.org/10.1177/0020764016639340.
- *Bankert, B., Coberley, C., Pope, J. E., & Wells, A. (2014). Regional economic activity and absenteeism: A new approach to estimating the indirect costs of employee productivity loss. Population Health Management, 18, 47–53. https://doi.org/10.1089/pop.2014.0025.
- Baumert, J., Schneider, B., Lukaschek, K., Emeny, R., Meisenger, C., Erazo, N., … Ladgwig, K. (2014). Adverse conditions at the workplace are associated with increased suicide risk. Journal of Psychiatric Research, 57, 90–95. https://doi.org/10.1016/j.jpsychires.2014.06.007.
- Beck, A. T. (1979). Cognitive therapy of depression. New York, NY: Guilford Press.Google Scholar
- Boverie, P. E. (1991). Human systems consultant: Using family therapy in organizations. Family Therapy, 18, 61–71. Retrieved from https://search.proquest.com/docview/1474306108?accountid=14586
- Cagney, T. (2012). Supervisory and management training: Thinking outside the box. Journal of Employee Assistance, 42, 26–27.Google Scholar
- *Cheing, G., Vong, S., Chan, F., Ditchman, N., Brooks, J., & Chan, C. (2014). Testing a path-analytic mediation model of how motivational enhancement physiotherapy improves physical functioning in pain patients. Journal of Occupational Rehabilitation, 24, 798–908. https://doi.org/10.1007/s10926-014-9515-8.
- Chestnut Global Partners. (2013). CGP workplace outcome suite. Retrieved from http://www.eapresearch.com/documents2013/WOS_25-ItemForEAPs_2013-07-02.pdf
- Cole, J. D. (1998). Psychotherapy with the chronic pain patient using coping skills development: Outcome Study. Journal of Occupational Health Psychology, 3, 217–226. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9684213
- Crane, D., & Christenson, J. (2014). A summary report of cost-effectiveness: Recognizing the value of family therapy in health care. In J. Hodgson, A. Lamson, T. Mendenhall, and D. Crane (Eds.), Medical family therapy: Advanced applications (pp. 419–436). New York, NY: Springer.Google Scholar
- De Shazer, S., Dolan, Y., Korman, H., Trepper, T. S., McCollom, E., & Berg, I. K. (2007). More than miracles: The state of the art of solution-focused brief therapy. Binghamton, NY: Haworth Press. https://doi.org/10.1111/j.1467-6427.2008.00419_4.x Google Scholar
- Dewa, C. S., Hoch, J. S., Carmen, G., Guscott, R., & Anderson, C. (2009). Cost, effectiveness, and cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders. Canadian Journal of Psychiatry, 54, 379–388. https://doi.org/10.1177/070674370905400605 CrossRefPubMedGoogle Scholar
- Duncan, B., Miller, S., & Sparks, J. (2011). The heroic client: A revolutionary way to improve effectiveness through client-directed, outcome-informed Therapy. San Francisco, CA: Jossey-Bass.Google Scholar
- Edington, D. W. (2009). Zero trends, health as a serious economic strategy. Ann Arbor, MI: Health Management Research Center.Google Scholar
- Employer Health Asset Management. (2009). A roadmap for improving the health of your employees and your organization . Retrieved from www.ihpm.org
- Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136. https://doi.org/10.1016/b978-0-409-95009-0.50006-1 CrossRefPubMedGoogle Scholar
- Geraedts, A. S., Kleiboer, A. M., Twisk, J., Wiezer, N. M., van Mechelen, W., & Cuijpers, P. (2014). Long-term results of a web-based guided self-help intervention for employees with depressive symptoms: Randomized controlled trial. Journal of Medical Internet Research, 16, 1–15. https://doi.org/10.2196/jmir.3539 CrossRefGoogle Scholar
- Gillard, S. G., Edwards, C., Gibson, S. L., Owen, K., & Wright, C. (2013). Introducing peer worker roles in UK mental health service teams: A qualitative analysis of the organizational benefits and challenges. BMC Health Services Research, 13, 188–201. Retrieved from http://www.biomedcentral.com/1472-6963/13/188
- Goldner, E., Bilsker, D., Gilbert, M., Myette, L., Corbiére, M., & Dewa, C. (2004). Disability management, return to work and treatment. Health Care Papers, 5, 76–90. doi: 10.12927/hcpap.16832
- Gorter, J., Jacobsen Frey, J., & O’Brien, S. (2015). Broadening the value of critical incident response. Journal of Employee Assistance, 45, 10–13. Retrieved from https://archive.hshsl.umaryland.edu/bitstream/10713/5142/1/JEA%20-%20Critical%20Incident%20Response.pdf
- Greenberg, P., Kessler, R., Birnbaum, H., Leong, S., Berglund, P., & Corey-Lisle, P. (2003). The economic burden of depression in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry, 64, 1465–1475. https://doi.org/10.4088/jcp.v64n1211 CrossRefPubMedGoogle Scholar
- Greif, G. L. (1990). Twenty-five basic joining techniques in family therapy. Journal of Psychoactive Drugs, 22, 89–90. Retrieved from http://dx.doi.org/10.1080/02791072.1990.10472203
- *Han, C., & Pae, C. (2015). Pain and depression: A neurobiological perspective of their relationship. Psychiatry Investigation, 12, 1–8. https://doi.org/10.4306/pi.2015.12.1.1.
- Harris, J. (2011). Effective management consulting: Defining management consulting in employee assistance. Journal of Employee Assistance, 41, 20–21.Google Scholar
- Henderson, R. M., & Bacon, S. D. (1953). Problem drinking: The Yale plan for drinking and industry. Quarterly Studies Alcoholism., 14, 247–262. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/?term=Problem+drinking%3A+The+Yale+plan+for+drinking+and+industry
- *Hodgkin, D., Merrick, E. L., Hiatt, D., Constance, H. M., & McGuire, T. G. (2010). The effect of employee assistance plan benefits on the use of outpatient behavioral health care. Journal of Mental Health Policy and Economics, 13, 167–174. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/?term=The+effect++of+employee+assistance+plan+benefits+on+the+use+of+outpatient+behavioral+health+care
- Hodgson, J., Lamson, A., Mendenhall, T., & Tyndall, L. (2014). Introduction to medical family therapy: Advanced applications. In J. Hodgson, A. Lamson, T. Mendenhall, and D. Crane (Eds.), Medical family therapy: Advanced applications (pp. 1–9). New York, NY: Springer.Google Scholar
- *Hogh, A., Hansen, A. M., Mikkelsen, E. G., & Persson, R. (2012). Exposure to negative acts at work, psychological stress reactions and physiological stress response. Journal of Psychosomatic Research, 73, 47–52. https://doi.org/10.1016/j.psychores.2012.04.004.
- International Employee Assistance Professionals Association (IEAPA). (2011). Definitions of an employee assistance program (EAP) and EAP core technology. Retrieved from http://www.eapassn.org/about/about-employee-assistance/eap-definitions-and-core-technology
- *Intveld, R. (2013). EAP critical incident response: A multi-systemic resiliency approach. Journal of Employee Assistance, 43, 20–23. https://doi.org/10.1080/15555240.2015.1119655.
- Joseph, B., & Walker, A. (2016). Employee assistance programs in Australia: The perspectives of organisational leaders. Asia Pacific Journal of Human Resources, 55, 177-191. doi http://dx.doi.org.jproxy.lib.ecu.edu/10.1111/1744-7941.12124
- *Karatepe, O., & Karadas, G. (2014). The effect of psychological capital on conflicts in the work-family interface, turnover and absence intentions. International Journal of Hospitality Management, 43, 132–143. https://doi.org/10.1108/IJCHM-01-2014-0028.
- Korner, S. (1986). The family therapist as systems therapist: Treating the workplace. Psychotherapy in Private Practice, 4, 63–76. Retrieved from http://www.tandfonline.com/doi/abs/10.1300/J294v04n02_11
- Kroenke, K., Spitzer, R., & Williams, J. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x CrossRefPubMedPubMedCentralGoogle Scholar
- Lamson, A. L., Hodgson, J., Goodman, J. & Lewis, F. (2017). Integrated behavioral healthcare in employee assistance programs . Unpublished manuscript, Department of Human Development and Family Science, East Carolina University, Greenville, NC.Google Scholar
- Linton, S. J., Boersma, K., Traczyk, M., Shaw, W., & Nicholas, M. (2016). Early workplace communication and problem solving to prevent back disability: Results of a randomized control trial among high-risk workers and their supervisors. Journal of Occupational Rehabilitation, 26, 150–159. https://doi.org/10.1007/s10926-015-9596-z CrossRefPubMedGoogle Scholar
- *Lund, M. (2016). How to start, sell, and grow an EAP . Retrieved from https://issuu.com/eapa/docs/jea_vol47no1_1stqtr2017
- Macy, G., Watkins, C., Lartey, G., & Golla, V. (2017). Depression screening, education, and treatment at the workplace: A pilot study utilizing the CDC health scorecard. Journal of Workplace Behavioral Health, 32, 3–13. http://dx.doi.org.jproxy.lib.ecu.edu/10.1080/15555240.2017.1282826 CrossRefGoogle Scholar
- Marsh, R. (2014). How healthcare strategies impact the employer’s bottom line . Retrieved from http://inbusinessmag.com/healthcare/healthcare-strategies-impact-employers-bottom-line#.WQqrpfnyu70
- Mcpherson, T. L., Goplerud, E., Derr, D., Mickenberg, J., & Courtemanche, S. (2010). Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study. Drug and Alcohol Review, 29, 641–646. https://doi.org/10.1111/j.1465-3362.2010.00249.x CrossRefPubMedGoogle Scholar
- Morledge, T. J., Allexandre, D., Fox, E., Fu, A. Z., Higashi, M. K., Kruzikas, D. T., … Reese, P. R. (2013). Feasibility of an online mindfulness program for stress management: A randomized, controlled trial. Annals of Behavioral Medicine, 46, 137–148. https://doi.org/10.1007/s12160-013-9490-x.
- Morneau Shepell. (2014). The integration of EAP with DM . Retrieved from http://www.morneaushepell.com/ca-en/insights/integration-eap-disability-management-programs-fosters-better-disability-outcomes-and
- Mulligan, P. M. (2007). The prevalence of employee assistance programs and the employee participation rates of Long Island companies. Proceedings of the Northeast Business & Economics Association, pp. 68–71. Retrieved from http://eds.b.ebscohost.com/eds/detail/detail?vid=0&sid=61551c52-5413-4cac-80de-da961e476ebd%40sessionmgr4006&bdata=JnNpdGU9ZWRzLWxpdmU%3d#AN=27535391&db=buhGoogle Scholar
- Open Minds. (2000). Yearbook of managed behavioral health market share in the United States. Gettysburg, PA: Open Minds.Google Scholar
- Oss, M. and Clary, J. (1998). The evolving world of employee assistance. Behavioral Health Management, July/August, pp. 20–27. Google Scholar
- Parry, T., & William, M. (2009). Depression: A lot bigger than you think: The absenteeism and presenteeism- related costs of depression outweigh the medical and pharmaceutical costs and make a strong case for EAP intervention against this condition. Journal of Employee Assistance, 39, 18–19. Retrieved from http://directionseap.com/wp-content/uploads/2012/06/Depression-A-Lot-Bigger-Than-You-Think1.pdf
- Pompe, J. C., & Sharar, D. (2014). Technology & EAP: Engaging and motivating the new workforce. Journal of Employee Assistance, 44, 22–24. Retrieved from https://www.highbeam.com/doc/1G1-435717807.html
- Presnall, L. (1981). Occupational counseling and referral systems. Salt Lake City, UT: Utah Alcoholism Foundation.Google Scholar
- *Price, J. W. (2014). Alcohol, drugs, and the U.S. workplace: A guide for healthcare providers, safety officers, and human resource managers. London, England: Nova Science Publishing, Inc.Google Scholar
- *Richard, M. A., Emener, W. G., & Hutchison, W. S. (2009). Employee assistance programs: Wellness/enhancement Programming (4th ed.). Springfield, IL: Charles C. Thomas Publishing, Ltd.Google Scholar
- Rollnick, S., Miller, W. R., & Butler, C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York, NY: Guilford Press.Google Scholar
- Roman, P. (1988). From employee alcoholism to employee assistance. Journal of Studies of Alcohol, 42, 244–272. Retrieved from http://www.jsad.com/doi/pdf/10.15288/jsa.1981.42.244
- *Roman, P. M. (2011). Definitions of an employee assistance program EAP and EAP core technology . Retrieved from http://www.eapassn.org/About/About-Employee-Assistance/EAP-Definitions-and-Core Technology
- Samra, J., & Gilbert, M. (2009). Guarding minds @ work: A new guide to psychological safety and health. Visions: BC’s Mental Health and Addictions Journal, 5, 22–23. Retrieved from https://www.workplacestrategiesformentalhealth.com/pdf/EE015-035_Update%20Guarding%20Minds%20at%20Work%20Brochure_English.pdf
- Sanders, M. R., Stallman, H. M., & Mchale, M. (2011). Workplace Triple P: A controlled evaluation of a parenting intervention for working parents. Journal of Family Psychology, 25(4), 581–590. https://doi.org/10.1037/a0024148
- Sharar, D. A., & DeLapp, G. P. (2016). Follow the data: New study correlates EAP to positive workplace outcomes. Employee Assistant Advisor. Retrieved from http://www.umaryland.edu
- Shi, Y., Sears, L., Coberley, C. R., & Pope, L. E. (2013). The association between modifiable well-being risk and productivity. A longitudinal study in pooled employer sample. Journal of Occupational and Environmental Medicine, 55, 353–364. https://doi.org/10.1097/jom.ob013e3182851923 CrossRefPubMedGoogle Scholar
- Shumway, S. T., Wampler, R. S., & Arredondo, R. (2004). A place for marriage and family services: A survey of employee assistance program client problems and needs. Employee Assistance Quarterly, 19, 61–71. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/?term=A+need+for+marriage+and+family++%09services%3A+A+survey+of+employee+assistance+program+client+problems+and+needs
- Shumway, S. T., Wampler, R. S., Dersch, C., & Arrendondo, R. (2004). A place for marriage and family services in employee assistance programs (EAPs): A survey of EAP client problems and needs. Journal of Marital and Family Therapy, 30, 71–79. https://doi.org/10.1111/j.1752-0606.2004.tb01223.x CrossRefPubMedGoogle Scholar
- Skidmore, R. A., & Skidmore, C. J. (1975). Marriage and family counseling in industry. Journal of Marriage and Family Counseling, 1, 135–144. https://doi.org/10.1111/j.1752-0606.1975.tb00077.x CrossRefGoogle Scholar
- Slawinski, T. (2005b). Crisis response for business: More than an intervention. Behavioral Healthcare Tomorrow, 14, 40–41. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15887607
- Slawinski, T. (2012). Saying goodbye to the Mitchell model. Journal of Employee Assistance, 42, 10–13. Retrieved from https://www.highbeam.com/doc/1G1-352492037.html
- Smith, T., Salts, C. J., & Smith, C. W. (1989). Preparing marriage and family therapy students to become employee assistance professionals. Journal of Marital and Family Therapy, 15, 419–424. https://doi.org/10.1111/j.1752-0606.1989.tb00828.x CrossRefPubMedGoogle Scholar
- Steenstra, I. A., Busse, J. W., Tolusso, D., Davilmar, A., Lee, H., Furlan, A. D., … Hogg Johnson, S. (2015). Predicting time on prolonged benefits for injured workers with acute back pain. Journal of Occupational Rehabilitation, 25, 267–278. https://doi.org/10.1007/s10926-014-9534-5.
- Sumiec, J. (2016). Is that an elephant in the room? Journal of Employee Assistance, 46, 26–27. Retrieved from http://www.eapassn.org/Is-that-an-Elephant-in-the-Room
- Twemlow, S. W., & Harvey, E. (2010). Power issues and power struggles in mental illness and everyday life. International Journal of Applied Psychoanalytic Studies, 74, 307–328. http://dx.doi.org.jproxy.lib.ecu.edu/10.1002/aps.262 CrossRefGoogle Scholar
- Willis Tower Watson (2017, January 4). Full report: 2016 21st annual Willis Towers Watson best practices in health care employer survey. Retrieved from http://www.willistowerswatson.com
- Wrich, J. (1974). The employee assistance program. Center City, MN: Hazelden.Google Scholar
- Wrich, J. (1980). The employee assistance program: Updated for the 1980s. Center City, MN: Hazleden.Google Scholar
- Wright, L. M., Watson, W. L., & Bell, J. M. (1996). Beliefs: The heart of healing in families and illness. New York, NY: Basic Books.Google Scholar
- Wynne, L. C., Weber, T. T., & McDaniel, S. H. (1986). The road from family therapy to systems consultation. In L. C. Wynne, S. H. McDaniel, and T. T. Weber (Eds.), Systems consultation: A new perspective for family therapy. New York, NY: Guildford Press.Google Scholar
- York, D. R. (1985). The private sector: Revenue source of the 80s. Community Mental Health Journal, 21, 252–263. http://dx.doi.org.jproxy.lib.ecu.edu/10.1007/BF00758144 CrossRefPubMedGoogle Scholar