Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of...
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![Page 1: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/1.jpg)
Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice
David A. ShararEAPA 2007 San DiegoOctober 27 Research [email protected]
![Page 2: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/2.jpg)
EAP affiliates
• Available "on demand" and paid fixed fee to see EAP clients on behalf of a vendor
• Most are based in private individual or group practices, or agency/hospital clinics
• Affiliates represent a mix of "helping" professionals
• EAP work likely represents a small portion of the affiliate's caseload
![Page 3: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/3.jpg)
Statement of the problem
• EAP field has identified specific competencies unique to the delivery of "EAP"
• Most prevalent delivery system in EAP is the "Affiliate Network Model"
• Affiliates, as general mental health practitioners, may or may not deliver EAP as conceptualized
• Need to investigate whether affiliates believe they adhere to EAP concepts
![Page 4: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/4.jpg)
Overall design & research questions
• Nation-wide (“one-time”) survey of EAP affiliates using random probability sample
• Goal is to provide a descriptive "portrait" of how affiliates apply EAP concepts in their practices
Two research questions:1.How are EAP concepts understood and
utilized among affiliates? 2.What are the commonalities & differences in
terms of how affiliates treat EAP versus other cases?
![Page 5: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/5.jpg)
Comparison of EAP versus mental health benefits
EAP Mental Health Benefits
Problems in living Diagnosable disorders
Unrestricted access Usually some "gatekeeping"
Rapid resolution or referrals Longer-term or specialized treatment
"Free" to
employees/dependents Co-payments/deductibles
Emphasis on follow-up Emphasis on case closure
Work performance model Medical model
![Page 6: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/6.jpg)
Status of research on EAP affiliates
• Paucity of published scholarly research
• About 10 citations (mostly opinion, anecdotal observation, group consensus)
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Status of research on EAP affiliates
These citations refer to 5 concerns
1.Overlapping EAP and MBHO networks
2.Duplicate purpose with mental health benefits
3.EAP affiliate shortcomings4.Lack of local workplace integration5.Affiliate dissatisfaction
![Page 8: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/8.jpg)
Sampling frame & design
• No resource that covers the "universe" of EAP affiliates
• emindhealth (a provider of network services) appears to be a microcosm of the "universe"
• Random probability sample drawn from emindhealth list of affiliates (3,000)
• 222 completed questionnaires submitted (SE of 3.5)
![Page 9: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/9.jpg)
Administration
• Self-administered over Internet as web-based survey ("Zoomerang" was hosting service)
• Listserv comprised of e-mail addresses of randomized affiliates ("respondents")
• Potential respondents received a pre-notification e-mail from emindhealth
• Pre-notification followed by an invitation with a link to the questionnaire, & up to 4 reminders
• Completed questionnaires submitted to secure server (under control of the investigator)
![Page 10: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/10.jpg)
Questionnaire Construction
• Core components of EAP used to provide conceptual basis (e.g. components "mapped" to questions)
• Uses mostly close-ended questions with scaled responses
• Two open-ended questions allows for some methodological mix
• Six subject matter experts (from Editorial Review Board of a Journal) reviewed the design and content
• Field pretest conducted with 15 actual respondents
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Validity Threats
• Desirability: Respondents may want their answers to be perceived as "correct"
• Memory or unavailable info: Recall of past events is subject to error
• No direct observation: Study measures "perceptions" that may not reflect actual behavior
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Data Analysis Plan
• Data converted into Excel and dumped in SPSSx 14.0.2
• Descriptive statistics show characteristics of sample
• Chi-square used to compare "EAP" cases to "General" cases
• Findings presented with written narrative supported by tabular & graphic results
• Open-ended questions analyzed by content analysis/id of themes
![Page 13: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/13.jpg)
42%
36%
18%
12% 11%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Per
cen
t of R
esp
on
den
ts
ProfessionalCounselor/MH
Counselor
Social Worker Marriage & FamilyTherapist
Psychologist Other
Licensed or certified disciplines (N = 222)
(81% masters level and 19% doctorate level)
![Page 14: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/14.jpg)
General
practice
therapist or
counselor
76%
EAP
practitioner
9%
Specialty in
Marriage/Family
7%
Other specialty
8%
Professional identity
![Page 15: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/15.jpg)
40%
27%
60%
73%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0-50% >50%
Approximate % Clients
General Practice Counseling Employee Assistance Program
% Assessing impact of client problem on job performance
![Page 16: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/16.jpg)
14%11%
86%89%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0-50% >50%
Approximate % Clients
General Practice Counseling Employee Assistance Program
% Cases screened for substance abuse
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57%
47%43%
53%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0-10% >10%
Approximate % Clients
General Practice Counseling Employee Assistance Program
% Referrals to outside practitioners
![Page 18: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/18.jpg)
89% 89%
11% 11%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0-10% >10%
Approximate % Clients Referred
General Practice Counseling Employee Assistance Program
% Referrals to clinical programs
![Page 19: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/19.jpg)
45%
53% 55%
47%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0-10% >10%
Approximate % Clients Referred
General Practice Counseling Employee Assistance Program
% Referrals to “non-clinical” community services
![Page 20: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/20.jpg)
52% 53%48% 47%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0-10% >10%
Approximate % Clients Referred
General Practice Counseling Employee Assistance Program
% Referred to treatment that received follow-up
![Page 21: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/21.jpg)
46%42%
12%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
<10% 11%-50% >50%
Approximate % of Clients Referred to Self
% Referrals beyond EAP to yourself
![Page 22: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/22.jpg)
44%
17%
6%
25%
8%
38%
13%
29%
14%
6%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
Cognitive Behavioral
Eclectic/Integrative/generalist
Solution Focused
Some other Theory
No Particular Theory
General Practice Counseling Employee Assistance Program
% Primary theory or model
Chi-square (df=16)=387.68, p=.000
![Page 23: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/23.jpg)
< 25% 27%
26% - 50% 32%
Greater than 50% 41%
Approximate % of EAP cases where assessed problem was improved or resolved within the EAP:
![Page 24: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/24.jpg)
No way of assessing improvement with in the EAP 1%
Clinical impressions and judgment 57%
Review of the EAP action plan 29%
Formal outcome measurement tool 1%
Other 12%
How is improved/resolved determined for cases that only receive short-term EAP?
![Page 25: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/25.jpg)
0% 22%
Less than 10% 45%
Between 11% and 25% 17%
> 26% 15%
Approximate percent of EAP cases that were formal management or supervisory referrals:
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Not at all 37%
A little familiar 26%
Some knowledge 19%
Very familiar 18%
How familiar are you with EAP “core technology”?
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Never 57%
Rarely (once/twice a year) 15%
Occasionally (3-5 times a year) 15%
Frequently (> 5 times a year) 13%
How often over past year did you provide a direct “ONSITE” service at an employer’s workplace:
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Completely the same 28%
More or less the same 46%
Moderately different 25%
Very differently 2%
In terms of therapeutic approach and selection of interventions, are EAP clients generally treated the same as non-EAP clients:
![Page 29: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory & Practice David A.](https://reader034.fdocuments.us/reader034/viewer/2022051516/56649da15503460f94a8d8a7/html5/thumbnails/29.jpg)
Analysis of open-ended question(183 comments out of 222, or 82% response rate)
Representative themes include: "Less sessions with EAP" "Little difference except EAP has fewer visits" "Only difference is some EAPs require
switching therapists for referrals" "EAP is mainly for 'here & now' issues, not
long-term" "EAP focus is on most pressing problem due to
short # visits"
Describe how your approach to EAP is similar or different from your approach to general practice counseling?"