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Csiernik, R. & Csiernik, A. (2012). Canadian Employee Assistance Programming: an overview. Journal of Workforce Behavioral Health, 27(2), 200-216.

CANADIAN EMPLOYEE ASSISTANCE PROGRAMMING: AN OVERVIEW

ABSTRACT

A study of 142 Employee Assistance Programs from across Canada found a vibrant range of programming. The focus of programming remained upon the individual provided by professionals but there were a significant minority of EAPs that had branched out and were offering services to enhance organizational wellness. All programs offered voluntary assistance with one third having a formal referral route and one third including mandated counseling for performance issues. The majority of organizations were using third party counseling services external to the workplace though one third of the programs still employed internal counselors while a minority still had active peer components. The study clearly indicated the lack of utility for capping counseling services and found that the average use of uncapped services was less than the artificial ceilings the majority of organizations had placed upon the counseling that was allowed to be provided to employees. There was a lack of uniformity in terms of how utilization rates were calculated underscored by the finding that there were over 20 different definitions in use for what a case was. This is a clear example of the need for the EAP field to come together to develop agreement upon key empirical fundamentals for the profession. The study also discovered a drift away from essential program underpinnings including fewer joint labor-management committees to administer programs, less development of formal EAP policies to govern programs and fewer organizations engaging in new employee orientation and ongoing promotion and staff training.

Key words: Canada, Employee Assistance Program, program development

CANADIAN EMPLOYEE ASSISTANCE PROGRAMMING:

AN OVERVIEW

INTRODUCTION

An examination of Canadian Employee Assistance Programs (EAPs) at the beginning of the 21st century found a solid foundation of programming initiatives though with still much room for growth and development (Csiernik, 2002). In that survey of 154 organizations, it was discovered that half of the EAPs had begun in the ten years prior to the study and that most were developed by a joint labor-management committee. While the majority of programs relied upon external counselors for some portion of clinical services, just under one half were still using volunteers and over one half had some type of professional directly working for the organization responsible for offering EAP services to employees. The majority of organizations were using counselors with Masters level training while 40% had counselors with specialized education in addiction and another third with counselors with specialized EAP education.

Canadian EAPs participating in the study all provided voluntary access to the program to employees, with 93.5% also allowing access by family members. Three quarters of the organizations had informal referral routes with 40.3% having a specified formal referral pathway as part of the program and nearly one third still using mandatory referrals though only eight of the 154 had drug testing programs in place. Arguably the most important finding of the study was that those EAPs with capped sessions averaged 5.1 visits per client while those with no limits on the number of times a client could be seen was actually less, 5.0.

However, slightly less than two-thirds of the programs were being overseen by a committee, one quarter reported no ongoing program promotion of any kind while 40.3% reported no training of any kind for supervisors regarding the EAP while one in five had no policy and thus no formal governance over the program. More problematic in terms of research and evaluation was the lack of consistency in terms of program use data. Nineteen different utilization calculations were being used by the organizations but more troubling was that ten did not calculate utilization, six did not know, 15 relied totally upon their external service provider while 19 did not reply to the question. Compounding this was the fact that there were 16 different definitions of what a case was (Csiernik, 2003).

Much has transpired in the past decade in terms of research in the EAP field (Van Den Berg, 2000) including the use of these findings by many organizations in terms of enhancing their existing programs. However, as Sharar and Hertenstein (2005) found there is still no common definition of what EAPs are suppose to do. There remains a wide variation in practice with accreditation standards not being adhered to uniformly. Thus, the question that needs to be asked is to what extent has our growing knowledge and empirical insights been transferred into direct programming.

METHODOLOGY

In 2001 a four page survey was developed in conjunction with a national advisory committee of 21 persons representing labor, management and service providers. Along with basic demographic information the instrument asked when programs began, who initiated the EAP, who provided services and what the qualifications of the service providers were. Inquiry was made regarding referral routes, utilization, who was eligible to receive assistance, and for what length of time. The instrument concluded with a 15 item list of program options. To this the 2011 survey added one question premised upon the Integrated Model of Occupational Assistance (Csiernik, 2005a) asking participants to indicate what specific programming features their EFAP had in the four quadrants: individual-professional, individual-mutual aid, organizational-professional and organizational, mutual aid.

A combination of mailed and internet surveys were used to collect data from known organizations with an existing Employee Assistance Program. Respondents included Human Resource directors and staff, EAP coordinators and EAP committee chairs. Of the 200 mailed surveys, 91 (45.5%) were returned while of the 200 surveys sent via internet y 51 (25.5%) were returned for a total of 142 responses or 35.5%, 4.2% lower than the previous study. There were two significant differences between the 2011 study and that conducted in 2001. The first was the decision to use both traditional mail as well as electronic surveys to collect the data. The second is that the 2011 survey received much less support from Canadian private service providers with endorsement for the project coming from only two of the seven approached. Data analysis for the study was conducted using IBM SPSS Statistics version19.

RESULTS

Demographics

Table 1 highlights the geographic location of the 142 participating organizations. Responses were received from all provinces as well as two of Canada's three territories, with only Nunavut, with a population of under 30,000, not being represented. The province with the most responses was again Ontario (43.0%) which is not surprising given it has the greatest population and as well as the greatest number of organizations of any of the Canadian provinces and territories. Only one participating organization was located in the Yukon Territory (0.7%) while two responses (1.4%) came from Prince Edward Island, The Northwest Territories and Manitoba. In addition, there were 13 (9.2%) national organizations that returned surveys.

Table 1: Location of Organizations

Location / Frequency / Percent
National / 13 / 9.2
British Columbia / 12 / 8.5
Alberta / 9 / 6.3
Saskatchewan / 15 / 10.6
Manitoba / 2 / 1.4
Ontario / 61 / 43.0
Quebec / 9 / 6.3
New Brunswick / 6 / 4.2
Nova Scotia / 4 / 2.8
Newfoundland / 6 / 4.2
Prince Edward Island / 2 / 1.4
Yukon / 1 / 0.7
North West Territories / 2 / 1.4
Total / 142 / 100

In terms of workplace sector responses, government agencies provided the greatest number of replies (23.2%), followed by education (22.5%), manufacturing (14.1%) and health care (12.7%) (Table 2). Of the 142 responses 83 (58.5%) were from the public sector. In total 122 of 142 (85.9%) of participating organizations had at least one labor union in place.

Table 2: Workplace Sector

Frequency / Percent
Government / 33 / 23.2
Education / 32 / 22.5
Manufacturing / 20 / 14.1
Health Care / 18 / 12.7
Social Services / 8 / 5.6
Transportation / 7 / 4.9
Energy / 6 / 4.2
Law Enforcement / 5 / 3.5
Mining/Forestry / 3 / 2.1
Utilities / 2 / 1.4
Others[1] / 8 / 5.6
Total / 142 / 100

In terms of organization size, the most responses came from organizations with less than 500 employees (33.8%). Thirteen (9.2%) organizations that participated in the study employed between 501-1000 people, 27 organizations replied that had between 1001-2500 (19.0%) employees while 24 (16.9%) organizations in the study had between 2501-5000 employees. Thirteen (9.2 %) organizations replied who have a workplace population between 5001-10000 while 10 (7.0 %) organizations replied who have a workplace population of 10001-25000 with six (4.2 %) having a workplace population of 25001-50000 while one (0.7 %) employing more than 50,000 people. The median workforce size for this study was in the 1001-2500 employee range.

Program Development

The 1990s were the years when the most organizations initiated their EAP with just over one quarter of the organizations beginning in the first ten years of the new millennium (n=37). Most interesting is that four participating organizations had started their EAP within the last two years indicating that this field remains a growing endeavor in Canada (Table 3).

Table 3: Initiation of Program

Year / Frequency / Percent
1970s / 7 / 4.9
1980s / 27 / 19.0
1990s / 49 / 34.5
2000s / 37 / 26.1
2010 > / 4 / 2.8
no response / 18 / 12.7
Total / 142 / 100

Table 4, indicates who in the organization was responsible for beginning the EAP. Not surprisingly, given that nearly 86 percent of organizations in the study were unionized, was that joint labor-management committees were the most common program initiator (n=58) followed by human resources personnel (n=42) and then management (n=25).

Table 4: Initiator of Program

Frequency / Percent
Joint Labor- / 58 / 40.8
Management Committee
Human Resources / 42 / 29.6
Management / 25 / 17.6
Medical Department / 4 / 2.8
Labor / 2 / 1.4
Other / 2 / 1.4
Unknown / 9 / 6.3
Total / 142 / 99.9

SERVICE DELIVERY

Table 5 presents the three primary sources of providing assistance through an EAP and the extent to which each option was used by the survey respondents. What was most surprising was not that the majority of programs (90.1%) used at least one professional counselor outside of the workplace but how many used multiple helping routes. While the most common delivery route were large third party providers (47.2%) many organizations were still contracting with one or more individual private practionners (29.6%) typically is support of internal professionals.

One third of the organizations in the study were using internal professionals to provide EFAP services with social work remaining the most common profession to be employed as an internal counselor. Occupational health professionals were very much a minority (4.9%) as were the use of human resources staff (4.2%) to provide direct EAP services. Twenty-one organizations continued to use peer supports as part of the program though not one was using members of a 12-step fellowship highlighting how the importance of this historic support has waned and been replaced. The range of trained referral agents or union counselors was significant with one organization having only two while another had over 700 trained peer supports. The mean number of peers for the 22 organizations was 73 with a mode of 40 and a median of 19. While 11 organizations did have fewer than 20 trained referral agents or union counselors, four had 100 or more such volunteers as part of their EFAP.

Table 5: Delivery of EAP Services (n=142)

Sub-total / Total / Percent
Internal Volunteers / 21 / 14.8
Referral Agents / 17 / 12.0
Union Counselors / 4 / 2.8
12-Step Members / 0 / 0.0
Internal Professionals / 48 / 33.8
Multidisciplinary Team / 18 / 12.7
Social Workers / 15 / 10.6
Occupational Health / 7 / 4.9
Human Resources / 6 / 4.2
Others / 2 / 1.4
External Professionals / 128 / 90.1
Multidisciplinary Agency / 67 / 47.2
Private Practice / 42 / 29.6
Consortium / 17 / 12.0
Assessment Referral Service / 2 / 1.4

Those providing EAP services to the organizations in the study were well educated. Nearly one half (n=67) were using counselors with a master degree, one third (n=48) had counselors trained at the doctoral level though only four (2.8%) required that their counselors have a specialization in either EAP or addiction. It is also interesting, important and to a small degree alarming to note that 18 (12.7%) respondents were unaware of the academic qualifications of those providing counseling to their workforce.

PROGRAM USE

Each of the 142 organizations in the study promoted voluntary use of EFAP with three quarters (n=106) having multiple access points. Of these the most common were informal referrals followed interesting by mandated referrals which were used by slightly more organizations than were management referrals (Table 6). While only 21 organizations had formal peer support mechanisms in place, 31 (21.8%) indicated that peer and union referrals were an access point into the EAP. Following the findings of Macdonald, Csiernik, Durand, Rylett, Wild and Lloyd, (2006) few organizations committed to providing EAP servicess to their employees had active drug testing initiatives in place.

Table 6: Referral Routes

Frequency / Percent
Voluntary / 142 / 100.0
Informal / 73 / 51.4
Mandatory / 51 / 35.9
Formal/Management / 47 / 33.1
Peer/Union / 31 / 21.8
Drug Testing / 13 / 9.2

Capping of counseling services has been a highly debated issue within the field with the conflict between the business and practice components of Employee Assistance Programming coming to the forefront when this issue is discussed. Table 7 highlights the findings relating to this important aspect of program use. More organizations had placed a formal cap on their counseling services than allowed for the counselor to determine what the client needed in terms of clinical services. In this study the ratio was 1:1.6 whereas in the previous study the ratio had been 1:1. Several organizations were using soft caps or flexible caps which allow the counselor to call a supervisor or program administrator to request and then justify the need for an employee or family member to receive additional counseling sessions. However even this option is still primarily a cost saving measure that serves to diminish a professional's latitude and bring into question the ethics of practice. This in turn has led some counselors to engage in creative record keeping to ethically and professionally serve the needs of their clients (Csiernik & Darnell, 2010).