Everything You Need to Know About Employee Assistance Programmes
What is an EAP?
EAP’s (Employee Assistance Programmes) are an employee benefit that is provided to assist employees with any problems that can impact their work or personal life, which can include (but is not limited to) mental wellbeing, financial wellbeing or their emotional wellbeing.
An EAP can be considered to be a set of professional services specifically designed to improve and/or maintain the productivity and healthy functioning of the workplace and to address a work organisation’s particular business needs through the application of specialised knowledge and expertise about human behaviour and mental health. It is a workplace programme designed to assist work organisations in addressing productivity issues, and supporting employees in identifying and resolving personal concerns, including health, marital, family, financial, alcohol, drug, legal, emotional, stress, or other personal issues that may affect job performance.
What services does an Employee Assistance Programme provide?
EAP’s provide a wide range of assistance programs for employees, the range of services they will be provided depends on the level of cover taken by the employer.
If we look at some of the ten most commonly requested/discussed services, we see under the employee assistance programmes in employee benefit packages.
Face to Face or Telephone Counselling
Cognitive Behavioural Therapy
Mental Health Workshops
Financial Management Help
Critical Incident Management
As we see from the above a comprehensive EAP provides services to support an employee and their employer during the times they need it the most.
Be aware, not every one of the services above are provided by every EAP in the market and certain EAP’s will be limited if they are an add on or taken as a standalone.
Standalone EAP’s you can choose which services are required by your employers and tailor them for your business whereas EAP’s added on to employee benefit products have restricted services as are arranged on bulk deals.
Do employees use these EAPs?
An analysis of the demographics using EAP shows that woman are more likely to reach out for help than men. This coincides with the World Health Order’s (WHO) estimation that men tend to seek help only at a later stage of onset mental health symptoms. This information, combined with the usage demographic data from our audit, should be seriously considered when developing internal communications around mental health and Employee Assistance Programmes.
It highlights the importance of encouragement to reach out for help at the earliest sign of any concerns or symptoms. Our demographic analysis also shows that employees using employee assistance services most frequently are between 31 and 35 years of age. It might be assumed that those in their early 30s are perhaps under more pressure and are more prone to distress, or possibly that they are more likely to be comfortable in reaching out for support.
How do employees use EAP?
From our clinical audit, we can see that face-to-face counselling is the preferred method of engagement, though we know from anecdotal feedback that remote options can help service users overcome some of the barriers to engagement (such as time to travel to sessions.) This highlights a need for organisations to include face-toface counselling in their Employee Assistance Programme, but to ensure remote engagement is also available.
In conjunction with this, we also analysed the most active times for our EAP support line, which is available to employees 24/7. Although the busiest hour of the day for calls to our support line is between 8 and 9pm, 50.1% of the calls are made during traditional working hours, with 11am-12pm being the busiest time in that bracket. This shows us that employees are calling for support in the moment, as opposed to planning time to call. It also reflects that mental health difficulties and stress result in presenteeism, which is defined as the practice of attending work but not being fully productive as a result of external, physical, mental or personal factors. It is estimated that presenteeism costs businesses up to 3 times as much as absences.
What is the impact of EAP?
Spectrum.Life’s Employee Assistance Programme has enabled employees to address areas of distress in their lives. There have been significant improvements in the mental wellbeing of those that have made use of the mental health support services provided by our team. We use a standardised method to assess the level of distress service users are encountering as described below:
Severe psychological distress
Moderately severe psychological distress
Moderate psychological distress
Low level problems
What are the business reasons for an EAP?
The business case for EAP has never been stronger, in fact the Irish government recently called out its crucial importance in supporting employees returning to work during the current epidemic. “Employers should ensure workers are made aware of and have access to any business provided Employee Assistance Programmes or Occupational Health service.” For many businesses this was a timely reminder of the importance of highlighting their EAP to their employees, but for some this was a point of alarm who have yet not even put an EAP in place.
Organisations can’t thrive without dedicated and happy employees at the helm. However, often, the modern workplace can aggravate pre-existing conditions, or be the cause of the problem. With reports such as the UK Government’s mental health review, ‘Thriving at Work’, concluding that the cost of poor mental health among employees is costing employers between £33 and £42 billion each year.
According to the Mental Health Foundation, “developing mentally healthy workplaces requires employers to protect and improve mental health at the individual, collective and organisational levels”. Therefore, it’s not just about organisations making sure the work environment itself is conducive to optimum health and productivity, but helping employees manage their problems.
One long-established workplace intervention tool aimed at doing just this is the Employee Assistance Programme. Designed to enable organisations to help their employees with personal or work-related problems, EAPs have come a long way since they first took off in the USA in the 1940s as a response to employers’ concerns about the impact of alcohol on job performance and productivity.
Is having an EAP feasible for small businesses?
EAP is not just for big organisations. Supporting mental wellbeing is important for any business, regardless of size. Working for a SME can be exciting, but it can also be challenging. Big rewards are offset by limited resources, heavy workloads and extra responsibilities. And while multi-faceted roles and tight deadlines are commonplace wherever you work, such is the level of personal pressure and unpredictability of the work-life balance, working for a SME is a markedly different experience from that of a larger organisation.
Not only can stress and anxiety take a bigger toll on workplace wellbeing, those conditions can aggravate pre-existing mental health problems. Owners of SMEs are in a better position than most to directly influence their employees. However, the downside to being so visible and familiar is that topics around mental health can’t always be freely talked about. The trouble is that failure to protect and improve employee mental health at the individual level can have negative repercussions on productivity, performance and turnover, not to mention, increase the likelihood of sickness and accidents.
SMEs taking immediate and practical decisions at ‘board level’ to change working practices, in-house communication and the office culture can have a positive impact on employee mental health – as can using the additional support provided by an Employee Assistance Programme (‘EAP’). Despite being the most commonly used workforce health intervention tool in the UK, Employee Assistance Programmes have been traditionally associated with larger organisations. In reality, they offer businesses of any size affordable and long-term access to mental health support 24/7, all year round, enabling them to safeguard their employees’ mental health and provide the necessary duty of care.
In a business sector so dependent on long-term knowledge and in-house experience, good mental health is essential. Having access to an Employee Assistance Programme makes employees feel valued in their role, which in turn boosts morale. Job satisfaction not only enhances employee productivity and performance, but improves business revenue – not least, because it helps to reduce the absenteeism that costs in lost turnover. Furthermore, properly engaging employees also bodes well for long-term staff retention, which in a small business, means everything.
What should I look for in an EAP?
When it comes to procuring an EAP there are a number of options that an organisation can choose from. Regardless of the EAP format that you
decide is right for your organisation, it is important to appreciate the key factors and merits you will find in a quality provider. “The most essential function of a successful EAP is, arguably, its ability to provide confidential support services, on demand, when they are needed, and free of charge to employees.” (EAPA UK)
– Provision of confidential and efficient problem assessment and identification services to employees with personal issues that affect their performance at work.
– Referral of employees for assessment, support and assistance with case management and follow-up services.
– Measurement of the effectiveness of EAP services on the organisation, employee and job performance by both user feedback and formal outcome measurement.
– Staff who are experienced in the delivery of short-term interventions and who are able to work effectively with the dual relationship between the employer or corporate client and the employee.
– An EAP provider who you feel comfortable to work with, and fits your existing culture.
– Provision of/access to additional services that include consultancy and training.
No matter what the specific format or focus of your chosen or preferred EAP, it is important to remember that what ultimately distinguishes an EAP from any other form of mental health counselling, coaching or private counselling, is that an EAP emphasises employee work performance as a central theme that guides all programme practices and services. EAPs are also proactive in helping individuals with their issues, before they might develop into more complex situations, or mental health problems.
Consider your requirements related to geography
Some EAP providers operate beyond the UK, and may have operations in other countries, while others may partner with other in-country providers. When commissioning EAP services where international service is required, it is important to understand what cross-border capability your provider has and how the service is delivered. Equally, it is important to appreciate that many countries outside the UK having varying levels of services and capabilities, and provision is likely to vary from country to country. To address this, ascertain what mediums of access are available in each location, how calls will be handled and by whom, as well as whether the service will be.
How do EAP delivery models work?
In order to provide a proactive intervention that best meets each organisation’s requirements to effectively support, educate and embed healthy workplace cultures, providers are able to offer a range of delivery models. Information on the variations within each EAP model can be found below:
All-inclusive EAP service
This model provides support, information and short term solution focused structured counselling as a fully integrated package, providing maximum benefit to organisations and their employees. The key elements of an all-inclusive EAP service can be summarised as:
- 24/7/365 confidential telephone support
- Legal information services
- Debt management services
- Triage and clinical assessment of needs (inclusive of a risk assessment)
- Computerised Cognitive Behaviour Therapy (cCBT)
- Access to limited support for dependants within HMRC guidelines
- Short-term solution focused structured face to face, online and telephonic counselling (session model varies depending on providers and client requirements)
- Case management protocols
- Management information reporting
- Management consultancy and support
- Marketing and promotional materials
- Technological resources such as an online portal website or mobile application
Telephone and online services
EAP providers may also offer a telephone and online services model variation. In this model face-to-face counselling is not inclusive within the core cost. This model may have a reduced cost whilst having the benefits of increased relative anonymity. These mediums may also reduce the stigma commonly associated with confidential presenting issues. The key elements of a telephone or online service can be summarised as:
- 24/7/365 confidential telephone support
- Legal and debt information services
- Triage and clinical assessment of needs (inclusive of a risk assessment)
- Access to limited support for dependants within HMRC guidelines
- 24/7 telephonic critical incident support
- Short-term solution focused structured online or telephonic counselling (session model varies depending on providers and client requirements)
- Case management protocols
- Management information reporting
- Management consultancy and support
- Marketing and promotional materials
- Technological resources including an online portal website and mobile application
Helpline only service
If required, providers may be able to offer a telephone helpline only in which individuals can access 24/7 confidential telephone support on range of issues including personal, financial and legal matters of any reasonable kind. In this model, access to structured counselling is not included within the core cost. If structured counselling is required, this would be charged on ad-hoc per session basis.
An embedded EAP is provided alongside another service or insurance policy such as Group Income Protection, Group Risk Insurance, Cash Plans and Benefits Providers. This EAP model is sometimes presented as being complimentary to the client organisation but in fact the operating costs are embedded within the fees paid for other products purchased as a ‘package deal’. Variations in this model may include but are not limited to; the number of counselling sessions per referral, promotional materials, the level of and/or access to relationship management and management information reporting.
If the service is not promoted to staff, its utilisation level is likely to be poor.
Ensuring a broader, more holistic approach to helping your workforce can effectively manage wellbeing and introduce a visible culture of proactive support. This can be achieved by a range of specialist, added value services alongside the core EAP provision. These services are typically available for an additional cost and include the following:
- Management training, coaching and support – for individuals or in groups
- Training Workshops on a wide range of mental health and wellbeing topics
- Mental Health First Aid
- Critical Incident and Trauma support for individuals and/or group de-briefs
- Executive Coaching
- Consultancy services, for example support on health and wellbeing strategy
- Workplace Mediation
- Specialist psychologist assessments
- Access to specialist therapeutic interventions such as Cognitive Behaviour Therapy (CBT), Eye Movement Desensitising and Reprogramming (EMDR), Trauma Focussed
- On-site promotional support
- Specialist helplines such as whistleblowing
What is EAP counselling?
EAP services provide short-term therapy that aims to assist individuals who are in crisis or who are facing changes in their lives, especially in relation to keeping them productive at work or supporting them return to work. Most EAPs in the UK and Ireland provide evaluation and assessment over the telephone by counsellors, supplemented with short-term interventions by counsellors or psychologists on a face-to-face basis or over the phone. Regardless of the way in which therapy is delivered, it is important that it is done so by professionals who work to recognised standards. All clinicians should be recognised or accredited by their professional bodies. As part of this they will be expected to receive regular supervision of their practice and have training in working within the dual relationship that exists with the client (the employee) and the employer/EAP provider.
When it comes to counselling sessions, a number of different models are available, some of which are required by the organisation as part of the contract, while others depend on the standard put in place by the provider. In most cases an EAP provider will offer anything from three to eight sessions of face-to-face or telephone counselling; the exact number will depend on the individual EAP provider and the terms of your EAP. Regardless of the specific number of counselling sessions, it is important for employees and employers to appreciate that this is a very brief therapeutic intervention and is focused on the presenting issue. Before counselling services are offered, an assessment of risk and need must be undertaken. This assessment must take into account:
- The client’s history
- Previous psychological treatment
- Current treatment
- Prevalent risks
The assessment must be undertaken by an EAP clinician, whether this is a counsellor or psychologist. Prospective EAP purchasers should take time to understand the counselling model in place and how it is priced. Providers’ pricing will take into account the level of usage of counselling and the average number of sessions delivered. This is important when comparing one provider with another.
EAPs generally provide short-term counselling that is centred on the person and focussed on helping with the particular presenting issue by talking about the issue with a counsellor the individual can focus on ways forward for them. Sometimes counsellors can combine different approaches and use their skills to help the individual reach their goals. CBT is not usually included within an EAP model, however you should check if it is. Although some CBT tools and approaches can be combined into the therapy this is not the same as receiving formalised and specialist CBT treatment from a specifically qualified CBT therapist. You should check if specialist CBT is being provided or if CBT is being integrated into normal counselling. In general CBT specialists offering more long-term therapy for the more complex cases are more expensive and this can affect the pricing of your EAP.
Which type of counselling is best?
Telephone counselling is normally provided 24/7 upon initial contact with the EAP service. It can also be provided in scheduled sessions.
Face-to-face counselling is typically provided through a nationwide network of affiliates; in most instances the EAP provider will ask the employee if they wish to have counselling near to where they work or live. What happens from this point onwards depends on the specific EAP provider. Some will make all the necessary arrangements, including billing, directly with the counsellor. Others will do some of the set-up work and then provide the employee with the counsellor’s phone number and expect them to make the appointment themselves, as they feel this ensures commitment by the employee.
Web-based counselling is offered by a number of EAP providers, for example in a live ‘chat room’ where both parties interact using a text dialogue. Web-based counselling can also refer to video conferencing or a ‘virtual world’ environment where the client and therapist interact through avatar representations. It is important to check availability and security encryption to ensure any web-based method is appropriate for your employees. There are also on offer a variety of different cCBT courses. These are computer programmes which help the client run through various Cognitive Behavioural Therapy modules with questions asked along the way to help the client check their understanding. Videos, clinical questionnaires and podcasts help retain the client’s interest and it has been established that the best outcomes are achieved when there are regular reviews with a counsellor either on-line or by phone as this helps maintain the client’s motivation.
Counselling can also be provided by an App, which may possibly provide access to a number of modalities directly from the App, such as text based, cCBT, voice or video.
How does account management of EAP work?
The level of EAP account management will vary according to the type and scale of the programme and you should investigate the structure of account management within a particular provider organisation so that you know what to expect.
You should ask about the level of support available during the implementation phase, and what on-going support you can expect to help you get maximum benefit from the programme once it’s established. As part of account management some providers may offer regular monthly meetings to review management information and discuss promotional activity, whereas others may offer quarterly or bi-annual meetings.
Where your provider offers more services such as Private Medical Insurance or Occupational Health, you may have a single account manager across these services, or sometimes and account manager for each service.
Your account manager should become a trusted advisor and consultant and be the first port of call to support your organisation through change, redundancy and crisis. As such, they should be experienced in understanding the delivery of EAP services and, perhaps more importantly, they should appreciate the strategic aims of an EAP within an organisational context. They may offer a very consultative approach as part of the management information review, and work with you to manage and develop the EAP within your organisation.
Account managers are often supported by a back office coordinator who will become part of your account management team. Usually they will provide day to day support on administration and finance matters. They can also act as back up if your account manager is unavailable or on annual leave.
If you have a broker, they too may offer support to you for administrative actions and more consultative work.
An account manager does not have to be a clinician; however they should be supported by experienced EAP clinicians who can offer support and advice to you when needed.
How to implement and promote EAP
The effective and visible implementation of an EAP provision is fundamental to the success of the service. This process should be systematic in approach and should identify key EAP stakeholders, including but not limited to senior managers across your organisation and other wellbeing providers to ensure high levels of engagement from the outset.
Most providers will have a template implementation plan that you can adapt to suit the individual needs of your organisation, it is good practice to work collaboratively with your EAP provider to develop a tailored plan with agreed timescales and milestones ahead of the service commencement date.
A comprehensive launch is key to ensure clear communication of the EAP service throughout your organisation. Effective and regular promotion can increase awareness of and utilisation of the EAP service. Ensuring staff and managers understand the wide range of independent, confidential services available will help to reduce any stigma associated with seeking support.
If your EAP has an App for access or information, you will need to communicate to employees how to download the App and the username and password. If this App is to be allowed to be used on company mobile devices, you may need to enable its installation.
If your EAP service offers web access to a portal, web chat or web based counselling you will need to communicate the user name and password to employees. If access is allowed on company desktop machines or laptops, you may need to enable this via your IT department.
Consider doing the following:
- Create a positioning statement for the EAP to define how it sits within the business, highlighting the proactive nature of the services
- Ensure a comprehensive and clear understanding of the range of services available – particularly at line management level
- Use the implementation process to generate interest in all aspects of the programme for example the technology resources available
- Review internal communication channels and work with existing support structures to ensure increased awareness and understanding of the service
- Utilise a range of electronic and hard copy materials to create optimum visibility of the service
- Consider the range of job roles in your organisation and how these may require variations in service accessibility and promotion
- Secure senior management support: it is essential to show employees that the business is serious about their health and wellbeing
- If your EAP is integral to a wellbeing program, you should use the wellbeing brand and communications to position the EAP correctly
- If you have changed EAP provider, this is a good time to re-promote the program and remind staff about the range of services
- Confidentiality is a key promotional aspect of an EAP and should always be emphasised
To ensure that promotion of the service is continuous and varied throughout the life of the contract, it is good practice to ensure that you work with your chosen provider to ensure the development of a tailored communication plan to instil a supportive culture and to enable ongoing effective communication of the service.
Questions to ask before buying an EAP
- What is your organisational structure?
- How many counsellors do you employ?
- Can they describe escalation points for complaints and issues?
- What parts of your EAP service are outsourced to other providers?
- How does the EAP link to other services, such as occupational health and private medical insurance?
Telephone access, intervention and intake:
- Describe your telephone answering process, including how you handle calls after regular business hours and at weekends
- What are the role and qualifications of the typical person who answers the initial call?
- What are your average timeframes for scheduling routine counselling appointments?
- Describe what would happen if one of our employees accessed the EAP at 3am with an urgent problem
- What is your process for providing short-term counselling?
- What types of personal and behavioural health problems do your EAP clinicians handle?
- What specialised EAP counselling services do you offer?
- Describe your handling of clients in crisis such as self-harm or child abuse
- How do you assess who gets face to face counselling?
- How many sessions of face-to-face counselling do you offer per case?
- What is your average number of face-to-face sessions delivered?
- What percentage of telephone cases go on to face-to-face counselling?
- Is specialist cognitive behavioural therapy (CBT) counselling or Eye Movement Desensitisation and Processing (EMDR) included, and how many sessions?
- How are outcome measured in face-to-face interventions?
- Describe the services offered to help managers improve employees’ performance
- How do you support employees after a critical incident?
- Describe your current network of EAP affiliates and the method used to control the network
- List the criteria for EAP affiliates to be included in your network
- How are their credentials verified?
- How do you check affiliates premises?
- Do you have coverage outside the UK/Ireland?
Reporting and management information:
- What utilisation measure do you use?
- What is the frequency of management information, and does it vary by monthly, quarterly annually?
- What is included in management information?
- Is management information available online?
- How many account management visits do you provide annually?
- Do you have demo logins?
- Do you have a dedicated website for the EAP? Please describe its content
- Does it contain cCBT? (computerised cognitive behaviour therapy)
- What CBT model is delivered and what evidence base is being used to support it?
- How do you comply with GDPR
Quality improvement and evaluation:
- How do you measure and evaluate service quality?
- What professional standards, if any, does your EAP adhere to?
- Are you members of any professional bodies such as UK EAPA or BACP Workplace?
- Are you accredited by any professional bodies?
- What training and CPD do you provide to staff?
- What values do you operate as a company?
- What policies do you have for health and safety, wellbeing and engagement?
- What policies do you have for diversity, and bullying and harassment?
- Do you have any other accreditations such as ISO?
- What is your plan for EAP promotion and employee communications?
- Please provide examples of printed communication, if available.
- Who will deliver the implementation sessions?
- What is the cost for additional promotions?
- What pricing assumptions are being made around utilisation of services?
- What counselling session model is being proposed?
- What is included within the price?
- How many sessions of face-to-face counselling are expected?
- What is the price for extra sessions of counselling?
- Are awareness-training sessions included?
- Is web-based/online counselling included?
How do I prepare an EAP Tender?
EAP tenders are much the same as any other tender but it is important to specify if, for example, you require any of the following as part of your EAP:
- Telephone service 24/7
- Management consultancy
- Legal information
- Child or elder health and support services
- Referral pathways
- Face-to-face counselling network
- Web-based counselling
- Face-to-face model type (3/5/7 sessions)
- Management information reports
- Account management
- Promotional activity and materials
- Awareness training
- Crisis Support
As part of the tender submission process you may wish to visit a provider to observe their operational capability. This would be an opportunity to see where and how calls are handled and who answers them, and to gain some insight into their business continuity, data handling and storage, and case management. You would be able to establish which services are provided in-house and which are outsourced. Typically, EAP providers welcome visitors and want to demonstrate their capability.
What is a good EAP utilisation rate?
As part of their management information EAP providers will show a figure for the utilisation of the programme. There are several ways that utilisation can be measured and you should be clear about which method your provider is using.
Some providers measure cases, which is the number of employees using the EAP as a percentage of the total employees. This figure is regardless of the number of services used. So if an employee used telephone counselling, legal information and face to face counselling this would be counted as one user. A provider may count all services used, which may generate a higher utilisation level. Where employees have access to a web portal, the provider may count the number of hits that the portal receives and include this within utilisation count.
The above three methods would provide very different utilisation figures because some individuals may use several services within a single case. There is also the possibility for double counting where web hits are counted alongside clinical and practical services.
It is important when comparing one provider with another to look at how utilisation is being counted.
What are important EAP quality markers and accreditations?
EAP providers may vary in the standards they operate to. Some may use programmes such as Investors in People while others may use ISO or other standards of accreditation. Regardless of the programme, it is important to recognise that these schemes provide a measure of quality that provider organisations have invested in and operate from.
UK EAPA, for example, has a published Standards Framework for its members, to which all of its Registered EAP Providers adhere. These outline the minimum operating level purchasers can be assured that Registered EAP Providers should meet, as well as a set of ethical standards they uphold. In addition to organisational accreditation, professionals within the EAP service, such as therapists, will adhere to their own professional standards and code of ethics. These operate hand in hand with the EAP Standards Framework and can be a valuable benchmark when selecting an EAP provider.
Why use a UK EAPA member?
EAPA is the largest global professional body for employee assistance professionals and sets its own standards for EAP service and delivery. The delivery of an EAP may vary slightly in different countries but a set of core services and standards exists. All UK EAPA members agree to abide by the Standards Framework and code of ethics, set out by UK EAPA. As a buyer, this means that the UK EAPA member provider you select is working to a quality and operational standard. You can be confident of a reliable, safe and high quality service for your employees when they need it most. All current UK Registered Providers of EAPs are listed on the UK EAPA website. If you wish to audit the operation of your provider you should discuss this with them. You may wish to build this into your tender document. Providers welcome audit, whether undertaken by existing or potential clients or by a specialised consultant, but it must be remembered that the data they hold about employees is strictly confidential.