Employee Assistance Programs - Their Development and Benefit
A Paper by Roger F. Peters and Teresa Firth
The Later Years
The EAP Model Today
Issues of Occupational Health & Safety
Implementation of an EAP
Criticisms & Limitations
The Basis For Change
The mental well being of employees is a subject of fundamental importance to all businesses, companies and public services. Leading organisations have become increasingly more aware that mental illness, substance abuse and other employee behaviour problems have a negative impact on the corporate self-interest. The response by many companies both here and overseas has been to initiate employee mental "wellness" programs. One such service, now commonly referred to as an "Employee Assistance Program", (EAP) has proven to be one of the most successful approaches in assisting troubled employees. The following paper follows the developmental path, this type of program has taken, beginning with the early history to the present. The paper discusses the features and functions of EAPs as well as outlining their benefits, limitations and future.
Industrial involvement in mental "wellness" programs has a long history spanning the entire century. The earliest programs were aimed at combating the massive alcohol problem that existed in American industry. During the 18th and 19th centuries, it had been common practice for employers to supply employees with alcohol during working hours as an inducement to work harder. By The 19th century, workers in practically all occupations drank on the job and special alcohol breaks were put aside. It was not until the 1890's that the first formal move to remove alcohol from the workplace took place. This initiative was undertaken by the North American Temperance Movement, who drew employers' attention to the advantages of not allowing the consumption of alcohol while on the job. By the 1940's the first work-based programs had been established mainly as a result of pressure from Alcoholics Anonymous (AA). Companies such as DuPont and Kodak acknowledged that alcohol problems were serious and their action was to introduce alcohol cessation programs during company time (Compton 1988).
It was the policy of those programs that supervisors would look out for symptoms of alcohol use among employees, although supervisors felt uncomfortable with such a task. Other companies employed "expert drunk spotters" who would give employees the option to accept help from the program or lose their jobs. Between 1944 and 1948, several more companies in the United States had adopted similar work-based programs.
The principles of early alcohol programs were as follows:
- Employees' problems that did not affect performance were of no concern to employers;
- Supervisors were only concerned to the extent that employees' problems affected performance;
- Help seeking was on a voluntary basis and occurred professionally and in a confidential way; and
- Drug taking was a symptom of other problems.
However, early drug and alcohol programs failed to meet their objectives. Although they generated many policies and procedures, little action resulted. Many forces arose that pressed for change and the broadening of alcohol programs. Firstly, both unions and management saw the alcohol programs as good ideas then too narrowly based. Secondly, the lack of success of these early programs was partly due to the discomfort many felt in dealing with alcohol problems. Program managers believed that they needed a more euphemistic way to identity and package their efforts in order to reduce the stigma. Thirdly, the basic strategy rested on impaired performance, a condition that could arise from a multitude of factors other than alcohol abuse. Fourthly, waiting for problems to become evident through impaired performance may have disastrous effects, including death or injury through accident. In addition, changes in industry brought a flood of women into the work force. They brought with them traditionally lower incidence of problem drinking, but a higher incidence of other emotional problems. Finally the dramatic increase in marital problems, problems in child rearing, financial problems and the use and abuse of other drugs, all contributed to making a broader concept appropriate (Trice 1983).
During the years that followed, these programs developed substantially, albeit specifically in the area of alcohol and other drugs. Programs included The "Occupational Assistance Program" and The "Occupational Drug and Alcohol Program". However, in 1945 the Kennett Copper Corporation developed a program they called the "Insight Program" which involved social work and staff counselling. This program was better accepted by employees, mainly as it did not label them in any way. This program is regarded as the first EAP (Compton 1980).
The 1960's and 1970's saw a wide development of the employee assistance model. A model that offered a much broader approach to employees' problems including, drugs and alcohol, but also assisting in areas such as financial, emotional, marital and legal difficulties. As a result of this innovation a much wider acceptance of the program occurred and the stigma associated with earlier programs was significantly reduced. By 1973 there were 500 EAPs in North America. This number increased considerably to 2400 in 1977 and in 1980 there were approximately 4400. It was estimated at that time that approximately 60% of the top "Fortune" companies had an EAP. In June 1990 it was reported that, of companies polled in the United States 93%, had an EAP. Incredibly these programs have actually become more prolific than health services which polled 82% (Warshaw 1990). These statistics are important for they indicate the possible level of acceptance of EAPs we may in fact see in this country over the next decade.
Australia's EAP history is much shorter. As in the US, early programs focused on alcohol and drugs. Interest in such efforts started in the 1970s. In 1977 the Commonwealth Government funded the National Alcohol and Drug Dependence in Industry Program (NADDIP). Up until 1982 Occupational Drug and Alcohol Programs (ODAPs) developed slowly in Australian Industry. These programs were forerunners and pre-empted the current style of EAPs. A progressive development of the EAP model throughout Australia was seen by 1983. By 1984 the EAP approach had wide based acceptance. Four years of promotion saw 250,000 workers in NSW had access to EAPs in 1988. Roman (1983) says about the early 80s, that in Australia despite the apparently small size of the effort, the Australian endeavour demonstrated substantial enthusiasm and commitment as well as a high degree of organisation and planning as compared with the experience in the US. Part of that no doubt can be attributed to the restrictive practice whereby one organisation in each state was initially given the sole endorsement of the Confederation of Employers, NADDIP and the Australian Union movement. These organisations formed themselves into a co-operative on a national basis and dominated the provision of EAPs in Australia for almost a decade. This was broken in NSW, at least in 1987, (Peters 1989) with the awarding of a substantial contract (BHP - Rod and Bar Division) to a private provider. In 1988 the NSW Labour Council ratified the matter of alternative providers leaving the path open for competition and thus the choice of provider (Tucker in Peters 1990). By 1989-90 several organisations had selected private providers these included Wang, BHP (Slab & Plate) Australian Taxation Office among others. In 1990 in NSW four major providers are available to chose from and that number is expected to at least triple by the end of the century.
The EAP model is widespread throughout the world and it is argued as the most effective way to reach employees with personal or work related problems. Currently, EAPs are defined as "job-based programs operating within a work organisation for purposes of identifying troubled employees, motivating them to resolve their troubles, and providing access to counselling or treatment' (Sonnenstuhl & Trice, in Steele 1988). EAPs have extended services to employees dependents as well.
EAPs operate on a dual strategy of constructive confrontation and counselling (Sonnenstuhl, 1988). The constructive confrontation originally arose from using PA guidelines and industrial and labour relations practices to identify 'and treat employees with drinking and other psychiatric problems. This strategy calls for supervisors to:
- Monitor their employees' job performance;
- Confront them with evidence of their unsatisfactory performance;
- Coach them to improve their performance;
- Urge them to use the EAP's counselling service if they have personal problems; and;
- Emphasise the consequence of poor performance.
Constructive confrontation proceeds in progressive stages.
At each stage employees must decide whether they will accept help from the EAP, manage the problem themselves, or take the consequence of their actions (Sonnenstuhl, Staudenmeier & Trice, 1988).
This method of supervisory referral has been criticised as a difficult strategy to implement because supervisors fear confronting employees and believe that referring their subordinates to EAPs creates more aggravation than relief. Masi (1984) says the system itself can discourage supervisor intervention in a number of ways, these include:
- Complicity of other employees (covering up).
- Peer pressure to "tough it out'.
- The supervisor's reluctance to admit failure.
- A prohibitive maze of rules, regulations and procedures.
- Threat of discrimination, complaints, grievances, or other retaliation.
- The Supervisor's fear of harming an employee's career or "making things worse".
Some authors (e.g. Beyer & Trice, 1984) have suggested that the difficulties related to supervisory compliance can be solved by providing supervisor training. Walker & Shain (1983) have questioned the standard of supervisor training. They believe that a review of supervisor training programs indicated they were very simplistic in nature and generally failed to deal with the day to day realities of supervising the troubled employee. While it is difficult to assess whether this was a problem in Australia, the important role of supervisor training has been recognised, and presently supervisor training is of a high standard being both relevant and appropriate.
Supervisory referral methods have been in the past inadequate in that they quite often failed to recognise employees' problems before they become serious and the damage done. Supervisory referrals are based on the premise that if an employee's personal problems do not affect performance, then it is of no concern to the employer. However, Wrich (1982) points out that in a number of instances employees still need assistance. For instance some employees have vast experience and have been doing their job well for such a long time that even a serious personal problem will not adversely affect performance. As they are exceptionally talented or experienced, they can operate at a level below their potential while still satisfying the demands of the job. Wrich (1982) emphasises the fact that in some occupations, waiting for the personal problem to develop into a documentable decrease in performance could spell disaster. He gives examples of power linesmen, crane operators, airline pilots just to name a few. Clearly other methods of referral, other than supervisory, are needed. One technique that is growing in acceptance is peer counselling. Here respected members of a work group are given skills to provide "front line" assistance to troubled employees. In 1990 such a scheme was adopted by the NSW Police Department. Such a recommendation was included in a report to the Commissioner of Police in 1986 (Peters & Peters 1986).
When an EAP is properly designed and implemented, self referrals should also be common place. Employees should be encouraged to voluntarily seek assistance through the EAP when they believe that personal problems or problems with a family member pose a threat to their job performance or more simply their own personal well being.
Walker & Shain (1983) believe that the voluntary processes of self and peer referral promises early identification of employee's problems. This would generally mean that the chances for recovery are improved and the process more rapid and less expensive.
Once referred for treatment, the troubled employee receives counselling from a highly qualified and experienced psychologist who is capable of handling a wide range of personal problems. Such a counselling service should at least address the following areas where personal problems are found:
- drugs and alcohol
- work problems
The EAP service is tailored to meet the individual employee's needs and may include: assessment, evaluation, information (education), short term counselling (4 -5 sessions), referral and follow up, (Keifhaber & Goldbeck 1980). Masi (1984) sees the following components as important:
- Information and referral
- Intervention (referral and treatment process)
- After care
- Training and outreach
- Evaluation of information and referral intervention (p70)
Some organisations prefer in-house programs, ones that have been approved by union and management. However it could be argued that if an EAP is to remain truly independent and confidential then it could hardly be offered as an in-house service. Thus external services are quite often preferred for reasons not only of anonymity but cost as well.
Referral to other agencies is an important part of the EAP strategy. Where, for instance, an employee has a serious psychiatric problem, e.g. alcoholism then the EAP psychologist would generally refer on to a community based resource. EAP'S are therefore not only an effective strategy for assisting troubled employees but can relieve managers from the responsibility of diagnosing an employees' problems, a job for which they are rarely qualified (Crisp 1990).
Since the 1940's EAPs have evolved from alcohol specific programs to "broadbrush" programs that target a wide range of problems (Rudd 1988). Programs these days address problems associated with the so called "soft" or "recreational" drugs, such as marijuana. As well as the "harder drugs", such as heroin, amphetamines etc, and prescribed medications, especially the tranquillising sedative group, e.g. Rohlhypnol, Serapax and Valium. However, these programs, as indicated earlier, deal with critical difficulties of a wide and varied nature such as marital or family conflict, legal problems, work stress as well as specific work related problems. In our changing work environment work can be a source of stress. This may be due to the presence of elements such as isolation, tight supervision, inherent stressors at work, e.g. policing, teaching, emergency services etc. Changes too in the workplace practices bring about stress, especially restructuring, technological change, retrenchment and redundancy also provide employees with difficult problems to manage. There is a clear need to have workers better trained and educated (Trice & Sonnenstuhl, 1988). The need to address the problem of work related stress has never been more clearly stated than in a recent article by Parry (1990). He points out that workers compensation claims for mental stress (a mental stimulus on the job resulting in alleged psychological injury without accompanying physical manifestations) increased 630% in California between 1980 and 1988. Mental stress is now California's leading occupational disease. In 1988 that State reported nearly 9400 stress claims; study results indicate there were closer to 35,000. The implications for Australia are thus quite clear.
While EAPs have been criticised in the past for only focusing on alcohol related problems they need to preserve such an interest if the statistics are something to go by. Mannello & Seaman (1979, in Steele 1988) estimated that 19% of railroad employees had drinking problems and that between the period 1975 to 1984 drinking-impaired rail-road workers could be implicated in 48 accidents, or incidents that caused 37 deaths, 80 non-fatal injuries and $34.2 million in damages. The National Institute of Mental Health (Sonnenstuhl, 1988) found that alcohol abuse and dependence was the most prevalent psychiatric disorder in the United States. In Australia where the volume of research is not as great, the problem is none the less fairly similar with Drug & Alcohol Authorities indicating that alcohol is still the preferred drug of choice by the majority and that 20% of all Australians are at risk.
Employee problems, whether personal or work related, drug or non drug related have a detrimental affect on performance and ultimately effect the success of the organisation. The symptoms of a troubled employee in an organisation may be measured by:
- impaired performance
- decreased productivity
- decline in quality of work
- poor working relationships
- high absenteeism
- missed deadlines
- errors in judgment
- higher use of medical assistance
- low morale
- poor safety
- poor morale, lacking motivation
- deteriorated client service
- high staff turn-over (Compton (1988))
The incidence of impaired workers is surprisingly high. Usinger (1987) estimates that greater than half of Americans work, and of these at least 10-15 % may be considered "troubled". This means that too high costs and additional charges are carried by the organisation and ultimately added to the cost of the product. In Australia Norington (1990) reports that absenteeism is running so high in the motor industry that $850.00 can be added to the cost of the family car. He says that studies have shown that both trade and non-trade employment turnover rate is at 35% and rate of absenteeism is 10% (see point v & xv above).
Substance abuse is a growing problem in Australia and mentioned several times so far in this report. At the time of writing this paper, by way of example, an interstate bus driver had been arrested in Northern NSW for driving his bus (despite the epidemic of fatal bus crashes) at a level of .15 or three times the permissible level. It is our suggestion that the situation is far more chronic in the Australian work force, especially heavy industry. It has been estimated by Harwood that between 6- 20% of the work force abuses substances at a level to hinder job performance, which in terms of lost productivity and lost employment was calculated to have cost American industry approximately $80.7 billion in 1980 and $104.6 billion in 1983. While statistics are not readily available in Australia it is anticipated that this would be in excess of $10 billion a year. Certainly it is not only alcohol that presents industry with a problem but other drugs as well. This includes the extensive use of amphetamines, currently the number one drug of choice outside of alcohol.
EAPs have proven to be very successful in improving productivity and efficiency through rehabilitation of employees. Organisations, which have used EAPs, report decrease in staff turnover, absenteeism and grievances, increase in morale and improved interpersonal relations (Hickox 1989). In the US a survey of 50 companies reported the significant impact EAPs had on employee performance. The survey found that EAPs had partially solved the problem of alcohol related absenteeism, with the amount of hours absent being reduced in one company from 488 to 168. It was found that EAPs were responsible for substantial cost reductions, including declines of 33% in the use of sickness benefits, 65% in work related accidents, 30% in workers' compensation claims and 74% in time spent on supervisor reprimands. In Australia an evaluation of EAPs by the Confederation of Australian Industry found that they were instrumental in reducing accidents from 40%-80% and a 30 - 50% decrease in sick leave. One leading NSW Organisation, BHP (slab and Plate) at Port Kembla found that their EAP was so successful that they increased the contact by 50% in 1990.
Naturally there are further implications for organisations with troubled employees, the least of which is not the affect they may have on others, including questions of safety and morale. EAPs are aimed to assist these troubled employees, bring back their work performance to an acceptable standard, thereby reducing possible damages and costs both in personal and practical terms.
EAPs are a cost-effective strategy and while economic reasons are important, they are not the sole reason why companies have decided to address the mental health issue. None the less in promoting the EAP concept in Australia cost effectiveness as a criteria is important and inevitably raised. It was indicated earlier in this report that approximately 90% of US companies polled have an EAP.
Thus, it makes sense to examine the question of cost effectiveness based on the long-term record of the American experience. It is reported that US business and industry invest between $204 and $798 million per year in EAPs. Importantly they estimate that for every dollar employers invest, it is estimated that between $3 and $5 are saved or $600 million and $3.9 billion per year. Compton 1990). The Kennecott Copper Corporation has estimated a 6-1 benefit to cost ratio per year for its "Insight Program". Similarly the Equitable Life Assurance Society found that for every dollar of treatment cost incurred by their EAP, there was a fivefold return in increased productivity. In Australia the findings are similar. Crisp (1990) suggests that for every dollar spent rehabilitating workers, four are saved. Kodak (Australia) reports close to $1 million saving annually from reduced absenteeism as a result of tackling its employee problems. Thus at the very least, by implementing an EAP savings can be expected of $3 for every dollar spent.
A further important consideration involving EAPs are issues of occupational health and safety. Companies recognise that they have a definite responsibility to protect both the physiological and psychological health of their employees. An important assumption underpinning an EAP is that the organisation does not in one sense only employ part of a person for part of the time. It does in fact employ the total person and for a period longer than simply that for which they get paid (Compton 1988). Employees do not leave their problems at the door. In fact employees' whole lives have to be organised around the demands of work. Employees' problems invariably affect their performance at work. Conversely, their problems at work have a significant impact on their private lives and upon their physical and mental health. The work setting is often a scene of great stress and where conflicts can emerge in the form of work related problems. If work contributes to a person's stress then the organisation is responsible for caring for and rehabilitating that employee. Importantly requirements under several Occupational Health & Safety Acts protect the employee ruling that their wellbeing both physically and psychologically must be preserved.
Osborne (1990) examines the legal dangers employers face in placing their employees under stress at work. He reports that employers are legally liable to pay expenses to their employees who have been exposed to work related stress and trauma. This often amounts to high compensation costs. So too Dawson (1987) in "Stress - the Employers Liability" reminds employers and enunciates such a position.
Roman (1983) suggests that apart from realising that they have a legal responsibility, employers should recognise that there is in fact an interdependence between management and worker alike in organisational goal achievement. Employers are realising that they must come to grips with perplexing problems that adversely affect their employees. EAPs are more likely to be found in organisations which have a genuine concern for their employees. The answer to poor performance is not simply termination. The employee is often worth saving, and sacking a once worthwhile team member may have an affect on team synergy and morale. It can also prove to be a costly exercise, thus rehabilitation provides a real alternative.
Such effort, aside from creating a sense of loyalty and morale, offsets the high costs of recruitment and training incurred when replacement is necessary. It is important here to make some comment regarding the cost of poor screening at the time of recruitment. Peters & Jay (1990) indicate that there is a measurable cost saving by simply implementing proper and effective recruitment strategies which necessarily includes psychological appraisal. There are two views, the first is the idea that the person should fit the job and second that the job should fit the person. The latter is the predominant philosophy of unions but the two are not incompatible with each other. In fact appropriate and validated psychological appraisals like EAPs have been shown to save approximately four for every one dollar spent. The huge Westpac Corporation assesses 20,000 applicants a year for 5000 jobs and believes they save $10 million by using an effective psychological strategy at the time of recruitment. Recruitment is also a sensible time to evaluate the employees' psychological temperament for the job and their potential to suffer unduly from stress. Thus an EAP when "synergised" with a modern selection plan can give the best possible opportunity for recruiting and maintaining a healthy work force.
It should be understood that management's acceptance of an EAP is wasted unless the workers are willing to participate. Harris & Fennell (1988) found the most important factors influencing employees' willingness to participate in an EAP are the respondents' familiarity with the program, together with perceptions of its trustworthiness and opportunities for personal attention. Perhaps the most effective way to gain familiarity is through word of mouth from manager to worker. The mere fact that the EAP has been established indicates a concrete commitment by management to employee well being. This helps instil a positive attitude of the program from the onset. However to gain acceptance of the program as one that is trustworthy is more difficult to accomplish, although it is unarguably the key to an EAP's success. This takes time, the most important element is personal testimony. This may seem at odds with questions of confidentiality but experience indicates that people do tell others of their experience and this naturally enough will cause others to utilise the service but obviously only if the testimony is positive.
Confidentiality is a central issue in the success of any EAP. Any breach of trust may destroy the credibility of the entire program. Confidentiality has long been of concern to people involved with the identification, treatment and rehabilitation of persons having serious problems. This is especially true in alcohol and drug fields where a stigma is often associated. In addition, concerns for the individual's rights give some practical reasons for maintaining confidentiality. Programs that do not guarantee the protection of confidentiality only gain forced referrals. Without employee support, supervisors too are less likely to refer. Thirdly, and as indicated earlier, non-referral means that the troubled employees' problems become more entrenched and thus difficult to treat.
The implementation of any EAP is normally a shared commitment and initiative by both management and union. A steering committee in most cases is formed after initial acceptance and this committee formulates the EAP guidelines and policy. The EAP is indeed dependent on acceptance by all groups within an organisation. However the EAP should be seen as supplementing the chaplaincy, welfare and other "help" agencies within the organisation, not replacing them.
Implementation is fairly straight forward but it should be remembered that the initial choice of a provider is a critically important one. This not only includes capability and accent on confidentiality and neutrality, but also expertise in provision, service delivery and access are important pre-requisites in competent provision.
In the present era of rapid changes to work practices and 'evolving cultural changes there has been an increase in demand for EAPs. This has been relatively slow in Australia with barely 10 % of the work force covered by an EAP . This is somewhat surprising as management is certainly being confronted daily by the serious increases in problem employees, stress claims and compensation. Madonia (1985) interviewed 75 businesses and companies: corporate personnel were interviewed to learn the extent to which they thought emotional problems were manifest in the workplace. Of the companies studied 59% reported that 10% of employees experienced emotional problems that interfered with job productivity, 28% reported that 20% of their workers experienced such problems and 13% reported that 30% of their workers experienced job impairing problems. So why has there not been a more general acceptance of EAPs? In short, why have providers not been "rushed off their feet'? The answer probably lies in the fact that in the early days EAPs only received minimal support and were considered to be "meddling" or a waste of time (Compton 1988). The early programs were severely limited in their scope, focusing on alcohol and other drug problems, thus many non - alcohol related problems were left untreated. Although these programs have broadened their approach, they are often seen as primarily drug and alcohol strategies. In addition, the strategy of constructive confrontation, mentioned earlier, has been only begrudgingly been accepted by both supervisors and employees. However recent developments in intervention have changed so that the supervisor is more appropriately a work evaluator rather than a diagnostician who offers help to all employees whose work is effected. There has been some reticence by employers to accept that such EAPs would be accepted and used by their employees, a problem that held back acceptance in America for many years (Wrich 1982). Today however the "broadbrush" EAPs de-emphasise constructive confrontation in favour of self-referral, peer referral and referral through increased program awareness (Walker & Shain 1983). In fact in a program provided by the author in the Australian Taxation Office, rejected supervisor referral as a component when they developed their EAP policy and guidelines. Their program depends entirely upon self-referral and increased awareness of the program.
While some criticisms were raised earlier within the context of development, this section deals more specifically with criticisms and the strategies that have been implemented to counter them. Although the expansion of the EAP model has eliminated many of its criticisms, there still exist some limitations to the effectiveness of the program. For instance, it has been claimed in the past that EAPs merely treat the symptoms of the problem, rather than the actual problem itself, (Compton 1988). The cause of an employees' decreased performance may not be a lack of motivation, but rather a difficult supervisor or the boring nature of the work. That is, the root of the employees' problem often lies within the organisation. However, at times due to confidentiality , the problem can not be resolved and continues to be difficult to remedy. In addition, because of confidentiality the effectiveness of the program is not readily observable. EAPs have a "down the road" validation in that the nature of their outputs is usually confidential and thus their outputs might not be evident for lengthy periods of time (Roman & Blum 1988).
This also makes an evaluation of the cost effectiveness difficult, nevertheless employers that have an EAP almost unanimously agree that the program is worth having (Wrich 1982). While few programs have an objective evaluation system, employers point to a number of successful examples, such as employees whose personal and job performance problems were resolved through use of the EAP. Others point to "before" and "after" absenteeism. Still others cite the extent to which the program is used as an indication of success.
Perhaps the most valid of all EAP criticisms has been that programs have followed traditionally a reactive strategy (Compton, (1988). Supervisors only refer employees to the program after their performance has reached an unacceptable level. However, an employee's problems may go unnoticed until they meet an irreversible state. This may be especially so if employees are good at disguising their inefficiency or if supervisors are not very perceptive of employees' problems.
The self-referral component is one approach to combat this problem. In spite of this though it is highly possible that some employees will deny, cover up, or simply ignore their problems, which in the long term reduces their levels of performance, their own health and their relationship with their family. For these reasons EAPs have moved to proactive strategies. These efforts have included the screening of applicants for employment, establishing education and preventative health care programs so that employees may be less vulnerable to personal and work related problems (Steele 1988). An EAP model that is more proactive by nature will also assist in the early intervention of employee problems. In order to provide consistent and complete cover EAPs should interface with existing health care service such as the health service itself, rehabilitation, occupational health and safety groups, the chaplaincy and welfare. The EAP should advise on matters psychological, promotion of employee "wellness" programs and employee development programs. Employee health promotion programs are generally a combination of educational, organisational and environmental activities designed to promote behaviour conducive to the health of employees and their families (Sonnenstuhl, 1988). These include, smoking cessation ,drug and alcohol programs, fitness, nutrition and stress courses. In fact all forms of information and approaches that increase the employee's level of consciousness and promote their physical and psychological wellbeing while at work should be an extension of the EAP. (Roman & Blum 1988). Employee development programs, on the other hand, consist of courses devised to meet the specific needs of the organisation and may include, training in trauma counselling, communication, organisational change, redundancy and retirement. The extent to which EAP providers are involved in preventative services varies quite considerably. In fact with some these services are not provided at all. Obviously the exclusion of preventative services clearly has a disadvantage. Sonnenstuhl (1988) regards the provision of such services as essential in improving employee morale , loyalty and increasing workplace productivity. Just as important it should be understood it is these services that will promote a climate in which the EAP is more likely to be successful.
It is probably the failure by many EAPs in the past to address the issue of employee "wellness" from a holistic approach that has attracted the most criticism. Yosi Berger (in Crisp 1990) referred to EAPs as a "band aid effect'. EAPs he suggests had become inadequate for dealing with the often serious , complex and dysfunctional, psychological and emotional problems of the work force. They had failed to keep pace with the changing Australian work environment. Peters (1990) develops the concept of the EAP and broadens it to include all aspects of occupational health, human resource management and the understanding of interpersonal conflict at work. This development has been called the Personnel Support Program (PSP) and provides all the support elements of an EAP with the addition of several other key components which ensures that the program remains relevant and effective in dealing with today's problems. Peters (1990) notes that: "PSPs are intended to enhance productivity in organisations by pre-emptorially and actively removing barriers to increased productivity". PSPs offer the standard components that most EAPs offer but also provide trauma counselling, retrenchment, redundancy training, psychological assessments and advice to organisational groups, such as rehabilitation & Occupational Health & Safety. In Australia and more specifically in NSW, there have emerged a number of EAP providers challenging the established territory of what has been provided by a single organisation. As indicated earlier it is estimated that there are four organisations that can legitimately claim to be providing EAPs in NSW. These organisations fulfil the National Guidelines for EAPs.
In this paper, an attempt has been made to follow the historical development of EAPs, indicate benefits, counter criticism and forecast the path ahead. EAPs in Australia have emerged from a role of singularly addressing issues of drugs and alcohol to a broadbrush strategy assisting troubled employees, irrelevant of the problem and its source. In the latter part of the last decade, it became abundantly clear that EAPs needed to keep pace with the changing work environment and while major modifications had improved their capability, further changes were still required. This has been done and importantly the issue of prevention has become central to any improvement and development. It has been argued that these should not be just add-on training components but involve an integrated approach to employee health. Credible EAPs today involve a holistic approach. EAPs that do not, represent only a tokenistic effort and are ultimately ineffective.
Understandably in the current economic climate EAPs have to be proven as cost effective. In this paper, we have argued that while the long-term gains are in fact more important, significant short-term savings in areas such as absenteeism and compensation can be demonstrated . As far as "set up" and running costs are concerned, despite various formulas used in calculation, The end result is that most programs cost about the same. In this paper we have suggested that certain issues such as quality of preventative programs, access and service delivery are ultimately important. In fact it is recommended that aside from cost the quality of any program should be evaluated with the following six factors in mind:
- Service delivery - quality.
- Record of service - experience
- Training - credibility and competence.
- Access - availability
- Accountability - stewardship
- Capability to offer mutual support to other human resource areas.
In Australia, should we only partially follow the North American trend, the next decade should see 50% of all medium to large organisations with access to an EAP. As such there will be a corresponding increase in provider organisations. However, like the introduction of rehabilitation legislation in both NSW and Victoria, after a period of rationalisation and adjustment, a solid core of competent providers should emerge. The actual impact in the longer term that EAPs will have in Australia is unknown. Research clearly indicates that EAPs will take on a significant role in the developing workplace climate during the next 10 years.
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