Implementing EAP Best Practices: Thoughts for Clinicians

Brenda R. Blair, MBA, CEAP

March 1, 2013, Austin, Texas P.O. Box 9927, College Station, TX 77842

email: blairconsultants.com Web information: www.blairconsultants.com

EAP DIRECT SERVICES

•  Services to the individual include:   Assessment   Development of a plan   Motivation   Referral, if needed   Short-term problem resolution, if needed   Follow-up

•  Services to the organization include:   Consultation to managers regarding specific situations

  Consultation regarding organizational strategies for helping employees   Special services, such as critical incident response

KEY CONCEPTS IN EAP

•  A successful EAP maintains a clear focus on the needs of the workplace, both employer and employees.

•  EAPs provide services to individuals and services to the organization.

•  The EAP is always voluntary, even when strongly recommended by management.

•  The EAP is a neutral problem solver.

•  Confidentiality is essential; proper communication is also essential.

•  The EAP simultaneously serves multiple clients, e.g. employee, manager, employer.

EAPs Serve Multiple clients

•  Employee (and/or family member)

•  Sponsoring organization (employer, union)

•  Supervisor / manager

•  HR

•  Occupational Health

•  Labor union

•  Safety / Security

•  Larger community in general

TYPES OF EAP REFERRALS

•  Self referral –  Most common –  No involvement by management

•  Informal management referral –  Employee shares personal problem and manager

encourages use of EAP –  Processed like a self referral

•  Formal management referral –  By manager, due to declining performance or rules violations –  Documentation is key

Looking for Best Practices

•  How is an EAP assessment different from a

general clinical assessment?

Importance of Assessment

•  Client may have never sought counseling before •  Client may not understand what he/she needs •  Workplace issues may be part of the concern •  Multiple people may be involved with this client’s

concerns •  Client may be intimidated by the health care

system •  Client may have concerns about the cost of

treatment •  Solutions may or may not involve counseling

ELEMENTS OF AN EAP ASSESSMENT

•  Client’s statement and history of problem •  Mental status •  Family history •  Level of risk to self or others •  Effect of problem on job performance •  Corroborating data and information •  Assessment of drug and alcohol use •  Initial impressions •  Recommendations

An EAP Assessment….

•  Is usually more directive •  Leads more quickly to a specific action plan •  Must be efficient •  Involves a different kind of therapeutic rapport •  Feels like a triage, more screening questions •  Always considers the workplace •  Requires more analysis of implications

Looking for Best Practices

•  How is an EAP action plan different from a

treatment plan?

DEVELOPING AN ACTION PLAN

•  In partnership with client

•  Identify and prioritize problems

•  Set realistic, attainable goals/timeframes •  Lists all resources to meet goals

-  EAP -  HR -  Occupational Health -  Employee’s supervisor -  Treatment resource -  Community resources/support groups -  Educational resources -  Web-based resources/support groups

POSSIBLE DIFFICULTIES WITH EAP SHORT TERM RESOLUTION

•  EA clinician feels qualified to handle all problems and won’t refer to someone else

•  EA clinician tries to maximize “free” sessions even when clinically inappropriate

•  Client feels "entitled" to EAP and doesn’t want to change counselors, even when clinically necessary

Educating the Client About Short-Term Problem Resolution

•  Important to clarify the EAP role •  Involve the client in the decision-making •  Explain clinical rationale for recommendations

outside of EAP •  Offer follow-up and continuing contact through

EAP

Looking for Best Practices

•  How is a EAP follow-up different and what do

EAP companies expect of network clinicians?

EAP Follow-up

•  Critical to client success •  Involves more communication •  A different view of confidentiality •  Greater collaboration with the EAP company that

made the referral to the clinician •  May last longer or have different content

Looking for Best Practices

•  How are EAP management referrals different?

Management Referrals: High Value Cases

•  Based on a workplace issue, so company is vitally interested in the outcome

•  May be complicated cases involving psychiatric illness, addictions, violence, or fitness issues

•  Will require active communication with the EAP company that made the referral

•  Clinician’s interaction with client may be more assertive and directive

•  Clinician must avoid being an “advocate” for one side but must emphasize problem resolution

Changing your practice…

•  How would you feel about adopting the

strategies and approaches discussed today?

Some obstacles and possible ways to overcome

•  “I’m not comfortable talking directly about certain subjects.”

-- If we can speak comfortably about everything, we give our clients permission to do so.

•  “I believe in letting the client lead the process.” -- If we offer different ways of considering a situation,

we allow the client more choices.

Some obstacles and possible ways to overcome

•  “That’s not how I was trained.”

-- If we ask our clients to change, should we not also be open to change? Especially if it helps our clients!

Creating Best Practices in Your Practice

•  Begin with the needs of clients. (Not what you want to do, but what they need!)

•  Be willing to address hidden problems.

•  Seek consultation when trying new approaches.

•  Follow ethical practice at all times: Something new or unexpected will always happen. If you follow ethical practice, you will be able to decide what to do.

Brenda Blair President, Blair Consulting Group, Inc. PO Box 9927 College Station, TX 77842 979-693-7268 bblair@blairconsultants.com www.blairconsultants.com

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