By Corporate Relations and Business Strategy Staff
Working with Employee Assistance Programs (EAPs) is one way for psychologists to diversify their practices, meet emerging needs and reach new clients who could benefit from their services. This article provides a brief introduction to EAPs, describes some of the opportunities that exist for integrating EAP work into your practice and offers suggestions for identifying and connecting with high-quality EAPs in your community.
EAPs are employer-funded programs created to help employees and their families cope with personal issues that can affect job performance and overall health and well-being. EAPs developed in the early 1970s, evolving out of Occupational Alcohol Programs that were first started in 1939. In the 1980s and 1990s, many EAPs broadened their focus to address personal and family concerns, in addition to substance abuse problems.
Today, EAPs still vary in the depth and breadth of the services they offer, with some still limiting coverage to substance abuse problems. Others address a wider range of issues, but provide only basic assessment and referrals. “Full service” EAPs include an array of services, such as proactive outreach and prevention efforts, educational resources related to health and wellness, stress management, family concerns and legal and financial issues, as well as problem identification, brief counseling and referrals for more extensive help with mental health, legal or financial concerns.
EAPs can be connected to the employee health benefit structure. However, unlike health plans, EAPs typically offer employees a specific number of brief counseling sessions with no co-payment or deductible. The goal is to either resolve the identified issue in the specified number of sessions or refer the person to another mental health professional to continue the work.
In recent years, increased globalization, technological advances, and changes in the nature and structure of work have all contributed to a more competitive business environment. This has put pressure on workers to be more productive than ever before. In addition, employees must increasingly juggle personal and work demands. The bottom-line: more workers need help managing job and personal stress. At the same time, employers are increasingly recognizing the link between employee health and well-being and organizational performance. Providing high-quality EAP services is one way to create a psychologically healthy workplace that benefits both employees and the organization.
EAPs are becoming increasingly common in the American workplace. In 2000, more than 62 million employees were enrolled in EAPs and 76 percent of U.S. companies with more than 1,000 employees had an EAP in their benefit portfolio (Simmons, 2004).
Assessment. Psychologists can function in a triage role, briefly assessing severity and appropriate level of care when a problem arises, making treatment recommendations and referring for more extensive treatment, as appropriate. Psychologists’ expertise in assessment, diagnosis and treatment planning make them particularly well-suited to serving in this assessment role.
Treatment. Working within a brief therapy model, psychologists can apply many of their therapeutic skills, including identifying treatment needs, building rapport and helping clients achieve and maintain positive behavior changes, to the counseling services offered through an EAP. Many EAPs cover brief counseling to address the following issues:
Conflict resolution (e.g., personal, family or work situations)
Stress management
Substance abuse prevention and treatment
Health concerns
Grief and loss
Program development. Psychologists interested in program development and organizational consultation can work more directly with EAPs to create prevention programs tailored to the specific organization or in designing a knowledge management strategy for the distribution of wellness information throughout the organization.
Administration and evaluation. Psychologists with experience and interest working in human resources, health care administration and program evaluation could use those skills in helping organizations or EAPs with management and administrative decisions and evaluation of new services.
Potential for referrals. When an employee’s problem cannot be resolved within the identified time frame of EAP services, referrals are made to outside mental health professionals. Connecting with EAPs can be an excellent way to expand your network of referral sources. If you are interested in the possibility of gaining referrals by working with an EAP, it is important to know what health plans are affiliated with the companies that the EAP serves. Your prospects for referrals may depend in part on whether you have provider contracts with these health plans.
At present, several large, national EAP providers exist, along with a number of specialized regional and local EAP providers. Some states have established guidelines for EAPs, and national organizations such as the Employee Assistance Society of North America (EASNA) accredit EAPs based upon ratings in categories such as administration, program design and implementation, record keeping, confidentiality procedures, case management, staffing and staff development, evaluation and research.
Some factors you may want to consider when choosing an EAP to work with include:
Accreditation (e.g., EASNA or other national accrediting organizations)
Experience (e.g., years in business, types of organizations served, specific services provided)
Reputation (e.g., public perception as reflected by press coverage, employee satisfaction with services received, recommendations from colleagues)
Accessibility (e.g., number of locations, frequency of programming at organizations, 24-hour service)
Data collection (e.g., regularity of performance evaluations, quality and style of feedback to contracted organizations, quality improvement efforts)
Non-restrictive services (e.g., thorough assessments, adequate number of sessions to address emotional and personal issues, appropriate referrals to qualified professionals for necessary treatment)
Learning emphasis (e.g., focus on prevention, health and wellness, continuous improvement model)
Licensure and education level of staff (e.g., are all of their professionals licensed, what types of credential and qualifications do they require)
Like any new business opportunity, diversifying your practice through involvement with an EAP should be systematically evaluated. While the specifics of a new practice opportunity may change, using a consistent framework can help you examine important factors that may not be readily apparent. Refer to "A framework for evaluating new practice opportunities" for one approach to making this type of business decision.
The following questions may also be helpful in considering whether to integrate EAP work into your practice:
How much of your time do you want to commit to EAP work?
Would this amount of time be personally and financially worthwhile to you?
How can you market your strengths and areas of expertise to an EAP?
What experience do you have working in organizational settings and are you comfortable in the business world?
Do you know a colleague who works with EAPs and could serve as a mentor for you throughout this process?
Opportunities to network with major employers in your community
Steady referral stream
Diversified source of revenue
Variety of potential practice activities (e.g., program development and evaluation, short-term therapy, grief work, stress management)
Growth area for the future
Assessment and counseling provided through an EAP may be less comprehensive than psychologists are accustomed to in other settings
There is a risk of employers using EAP services as a demand management tool to limit use of more extensive services
Payment structures and reimbursement rates vary by EAP and employer contract, and some rates may be lower than those of other payers.
Psychologists used to the freedom of independent practice may not be accustomed to the politics and complexities of a corporate environment
Call the human resources departments of the major employers in your community to find out which EAPs they contract with. Contact the EAPs you identified to discuss their needs and potential opportunities for involvement. Be sure to ask questions that will help you evaluate the quality of the EAP and its services (see above).
There are a variety of approaches to working with an EAP, including accepting a full or part-time position as a staff psychologist for the EAP, functioning as an independent contractor, or simply being part of the EAP’s referral network. If you decide to add EAP work to your menu of professional activities, be sure to choose the approach that is the best fit for you, your practice and your goals for the future.