Journal Employee Assistance 2nd Quarter 2018 by Employee Assistance Professionals Association

2nd Quarter 2018 | VOL. 48 NO. 2

The magazine of the Employee Assistance Professionals Association

EA Professionals & Sexual Harassment Part I |Page 10

PLUS:

Project 95-Broadbrush Page 14

Ending Sexual Harassment in the Workplace Page 18

Executive Coaching Page 24

contents EAPA Mission Statement

2ND Quarter 2018 | VOL. 48 NO. 2

cover story

Legal Perspective: EA Professionals & Sexual Harassment – Part I

| By Robin Sheridan, JD, MILR

Depending upon the law of the jurisdiction in which you practice, you may or may not be protected from employer retaliation should they find your advocacy to an employee who was allegedly sexually assaulted, disloyal. Before sharing anything with the employer, get written authorization from the employee client that clearly articulates what information may be shared.

features

Project 95-Broadbrush: Lessons for Today – Part III

|By Jim Wrich

In the last installment of a three-part series, we continue to show the evolution of employee assistance into the EAP of today. The evolution of EAPs has been like any other movement with a mix of positive and negative results. Today, upwards of 200 million Americans have access to assistance through EAPs that didn’t exist when the “Thundering 100” first gathered in 1972.

Ending Sexual Harassment in the Workplace

|By Nancy Board, MSW

EA practitioners can offer tremendous value to companies in ensuring that discussions on workplace culture and appropriate behavior are at the top of everyone’s mind. Make yourself available as a resource on change management and workplace improvement. As HR, EAP, and health & wellness professionals we can and need to be part of the solution.

features

Executive Coaching: The Future of EAPs?

4 FRONT DESK

The Journal of Employee Assistance (ISSN 1544-0893) is published quarterly for $13 per year (from the annual membership fee) by the Employee Assistance Professionals Association, 4350 N. Fairfax Dr., Suite 740, Arlington, VA 22203. Phone: (703) 387-1000. Postage for periodicals is paid at Arlington, VA, and other offices. POSTMASTER: Send address changes to the Journal of Employee Assistance, EAPA, 4350 N. Fairfax Dr., Suite 740, Arlington, VA 22203. Persons interested in submitting articles should contact a member of the EAPA Communications Advisory Panel (see page 4) or the Editor, Mike Jacquart, by calling (715) 445-4386 or sending an e-mail to journal@eapassn.org. To advertise in the Journal of Employee Assistance, contact James B. Printup at development@eapassn.org. Send requests for reprints to Debbie Mori at d.mori@eapassn.org. ©2018 by The Employee Assistance Professionals Association, Inc. Reproduction without written permission is expressly prohibited. Publication of signed articles does not constitute endorsement of personal views of authors. Editor: Mike Jacquart Development & Donor Relations: Jim Printup Designer: Laura J. Miller, Write it Right LLC

5 LETTERS

Index of Advertisers

|By Jason Sackett, LCSW, PCC, CEAP The employee assistance profession has passed through several evolutionary stages since its origins in addiction recovery, including expansion into workplace mental health support, work-life and wellness programs, and management consultation. I believe the next stage, and possibly the future backbone of EAP, involves executive and professional coaching.

To promote the highest standards of practice and the continuing development of employee assistance professionals and programs.

Integrating Mental Health into the Workplace

| By Julie Marshall, PhD, CEAP; and Anna Meiners, MA

Employers need a strategy that proactively integrates mental health into their overall wellness plans. EAPs are uniquely positioned to partner with employers in this endeavor because of the services they provide and the relationship they have with the employer.

departments EFFECTIVE 6 MANAGEMENT CONSULTING 8 TECH TRENDS 13, 21, EA ROUNDUP 27, 33 22 THE WORLD OF EAP 32, 34 WEB WATCH

ASAP....................................................7 EAPA Plan to Attend.........................IFC EAPA Conference on Demand.........IBC KGA, Inc.............................................15 Pinnacle Treatment Centers.................5 SAPlist.com..................................11, 19 IFC: Inside Front Cover IBC: Back Cover

frontdesk Sexual Assault: An Issue EAPs Must Help Address |By Maria Lund, LEAP, CEAP

arvey Weinstein. Jerry Richardson. Steve Wynn. Etc. Accusations of sexual harassment perpetrated by highprofile male executives have dominated the news and garnered the attention of HR professionals. But attention to serious and longstanding cultural and workplace harm also provides an opportunity for positive change. Given the unique role of Certified Employee Assistance Professionals as consultants to both employees and their employers, we are trained and positioned to assist in addressing sexual harassment (and the cultural forces that drive it) in the workplace. In this issue’s cover story, Robin Sheridan, JD, MILR, points out that while reporting the incident is often difficult for the affected employee client, it is crucial that a report be made so the abuse can be addressed. Employer policies and legal issues come into play with these reports. The article describes the legal protections that EA professionals are afforded in this work. Since we are not necessarily “safe” from employer retaliation, Robin urges readers to be aware of policies and laws in their practice locations. Continuing the theme, Nancy Board, MSW, focuses on deeper issues related to sexual assault.

Familiarity with local harassment policies and laws is a vital step for the EAP, but Nancy points out that policies and trainings are not enough. Women and men, alongside their EAP, must work together as allies and not combatants. She states, “We are long overdue for a national conversation about the abuse of power and privilege.” Also popular in the news is the theme of wellness. Many employers are seeking proactive strategies to integrate mental health into their overall wellness plans. As EA professionals, we can help. Julie Marshall and Anna Meiners outline a comprehensive, four-phase program their organization has successfully implemented to create value for their employer clients. What is the difference between coaching and consulting? How should an EAP market a coaching service? Jason Sackett, LCSW, PCC, CEAP, answers these questions and others in a thought-provoking feature article that might inspire more EAPs to provide coaching for their clients. Elsewhere in this issue, Jim Wrich, one of the original “Thundering 100”, concludes his three-part series on some of the more important developments and milestones in EAP history. If you want to read the piece in its entirety, find it on the EAPA website.

Finally, Jeff Harris, Marina London, and John Maynard offer important insights and observations in their respective columns. (Mark Attridge will return in the next JEA.) Happy reading. v

EAPA Communications Advisory Panel Maria Lund, Chair – Columbia, SC maria.lund@firstsuneap.com

Mark Attridge – Minneapolis, MN mark@attridgeconsulting.com

Nancy R. Board – Seattle, WA nrboard@gmail.com

Daniel Boissonneault – Hamden, CT eap700@comcast.net

Mark Cohen – New York, NY mcohenintlcons@aol.com

Donald Jorgensen – Tucson, AZ donjorgensen@comcast.net

Eduardo Lambardi – Buenos Aires, ARG eap@eaplatina.com

Peizhong Li – Beijing, China lipeizhong@eapchina.net

John Maynard – Boulder, CO johnmaynard@spirehealth.com

Bernie McCann – Waltham, MA mccannbag@gmail.com

Igor Moll – Al Den Haag, the Netherlands l.moll@ascender.nl

letters

Point of Clarification on Jim Wrich Series

The assessment process occurred in 1-3 sessions and subsequently referred to the community for treatment. Most of us early on had a strong emphasis on follow-up. This occurred with regular communication with the individual and the treatment community, when appropriate. In this context we were able to develop reports to demonstrate to employers the cost savings in helping people resolve their personal problems.

commend Jim Wrich for the work he’s done in his articles on the history of EAPs. However, after reading the first two articles, I felt it necessary to present a clarification on the early days of the EAP movement before the “Thundering 100”. In any history of the EAP movement it is important to remember the role of the National Council on Alcoholism (NCA), which was started in the 1950s by Marty Mann. The basic rationale for the organization was to present issues related to alcoholism to the public in ways that Alcoholics Anonymous could not. Early on, Marty and others in the organization recognized the need to get information about alcoholism into the business community. She hired a man named Lefty Henderson to be the “evangelist” taking information about alcoholism to the business communities. He traveled by train all over the country presenting the issues and encouraging them to help alcoholics recover and be productive in the organization rather that fire them. Lefty was reasonably successful in this effort. In the 1960s, Marty retained the services of Lew Presnall to be responsible for the Occupational Division of NCA. Lew discovered that to help alcoholics, the focus needed to be related to job performance, rather than alcohol-related. He succeeded in developing a sophisticated method of focusing on job performance. However, Lew also found that in addition to job performance, a wide variety of other problems would surface. Many companies under Lew’s direction began to use this model. Also in the mid-1960s, Lew brought Ross Van Wiegand to NCA. Shortly thereafter Lew left NCA to begin the new EAP at Kennecot Copper. Early in Ross’s experience at NCA he hired Don Phillips to assist him in continuing to develop the model that Lew Presnall started. They called this division of NCA the Labor-Management Department. One of the major problems they discovered was that although the staff was experienced in alcoholism, they had little familiarity in helping people with other kinds of problems. As a result, they established the process of ASSESSMENT, REFERRAL & FOLLOW-UP. This model proved to be very practical and effective.

Continued on page 34

The Journal of Employee Assistance The Journal of Employee Assistance seeks more thought-provoking discourse among EAPA members (and JEA readers) in 2018. One great way of doing that is by submitting a letter to the editor on an article you’ve read in the Journal. For more information, contact the editor. Mike Jacquart, (715) 445-4386 or email journal@eapassn.org

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effectivemanagementconsulting Consulting to Union Officials |By Jeffrey Harris, MFT, CEAP

n our exploration of the many ways in which an EA professional can be an effective management consultant, I felt it was important to include some reflections on how to be an effective union consultant. In fact, EAP core technologies states: “EAP core technology is: Consultation with, training of, and assistance to work organization leadership (managers, supervisors, and union officials) seeking to manage troubled employees, enhance the work environment, and improve employee job performance.” (italics mine) According to the AFL-CIO, “Union members work together to negotiate and enforce a contract with management that guarantees the things you care about like decent raises, affordable health care, job security, and a stable schedule.” It goes on to say that, “Unions don’t protect low-performers or harm the employer.” To explore union services in more depth, visit https://aflcio.org/whatunions-do. Unions: A Culture Within a Culture A union is a brotherhood – and out of their history of struggle, they have become protective, insulated, and careful with their trust. Unions are non-profit entities led by a board of directors who are rotated in/out through elec-

tions. The board must work in the trade or industry represented, and are granted either a full hiatus or limited release time from the job to serve the interests of the union. Most unions have a business agent, an employee of the union who has special training

“One of the many elements that make union consulting unique is that union representatives likely have little management training…” in contracts and negotiation, and who leads collective bargaining on behalf of employees, who are called members. Each work department or division has a shop steward, who helps the union organize and, along with union directors, may represent members in the filing and testimony of grievances on behalf of members, when it is perceived that the supervisor or organization has misinterpreted

or breached the labor stipulations spelled out in the memorandum of understanding (MOU). One of the many elements that make union consulting unique is that union representatives likely have little management training and are often co-workers who may share the same pay grade and supervisor. That is to say, they may have few supervisory skills. What Matters to Union Leadership As EA professionals, we address the needs of the referred individual in order to maximize assistance for this person (union member). It is common for union representatives to mistrust management, so you would be welladvised to avoid the perception that the EAP was a tool of management intending to disadvantage union members. For instance, be sure to avoid the error of arguing for the importance of profits (they know profits are important, but don’t expect them to prioritize it). You’ll have better luck making your arguments to labor leaders if they are built on themes of job retention and job safety because a union rep wants, “union brethren to keep their jobs and I want their jobs to keep them in one piece. Tell me how an EAP helps.” From the start, clarify the role of the EAP, its policies with

Attribution and Gratitude I would like to extend my gratitude to the following EA professionals who leant their expertise to this topic: Takis Bogdanos, LPC-S, CEAP; EAP/ WorkLife Services Advisor at Chevron USA; Jeff Christie, LCSW, CEAP; EAP Manager at JPS Health Network; Sandra Turner, PhD, CEAP; Director, EY Assist at Ernst & Young LLP; and Robin Waterman, MSW, Employee Assistance Specialist at Portland General Electric. v

union representatives, being sure to stay within your boundaries. Offering an “EAP 101” for shop stewards could help clarify things from the get-go. From the beginning, seek to develop shop stewards into EAP ambassadors. Be cognizant of key events, such as contract negotiations or workplace trauma, which might heighten sensitivities in the workplace and temporarily drive labor and management towards polarizing extremes. A short list of “do’s” for the EA professional would include:

Let’s Keep the Discussion Going For more consulting tips on managing union officials, contact me through my LinkedIn profile (linkedin.com/in/jeffharrisceap) and Twitter (@jeffharrisceap).

• Conform your consultation style to relate on their level; • From the beginning, work to create a common goal; • Make continual efforts to gain the respect of union members; • Ask relevant questions about union culture; • Strive to be collaborative rather than confrontational; and • Wait for the union member to introduce their readiness to relate to you as a counselor/ social worker.

Jeffrey Harris, MFT, PCC, CEAP has provided management consulting to a wide variety of organizations throughout his 23-year career in employee assistance, including corporate, educational, government and union organizations. The author also has extensive experience as a manager and executive coach, from which he draws insight for his consulting. Jeff currently serves as Program Manager of EAP & WorkLife at the University of Southern California.

Ultimately, remind yourself that you are an outsider looking into their family. Typical Consultation Themes It’s also helpful to keep in mind that the motivation of a union leader can be very different than supervisors or managers in some ways. For example: • Quelling co-worker complaints that this individual is not sharing the workload, or is putting co-workers in danger; • Addressing management threats to sanction, suspend, or terminate a union member if the union doesn’t “fix” him/her; • Restoring the individual’s performance before it progresses to the attention of a supervisor; • Benefiting union members and getting re-elected; • Addressing a performance problem for the company that could become a bargaining point during union/management negotiations in the future; and • Prolonging the tenure of a troubled employee by getting him into a “program” so that he/she is “in treatment.” 7 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • • | JOURNAL OF EMPLOYEE ASSISTANCE | 2nd Quarter 2018 |

techtrends Cybersecurity for Employee Assistance Professionals | By Marina London, LCSW, CEAP

NET (www.cnet.com) is one of the most reliable sites providing hardware and software reviews, as well as important articles about trends in technology. In November 2017, they published an informative article, “How to give your parents the security talk this Thanksgiving.” My experience has been that, just like senior citizens, most employee assistance professionals lack expertise in the fundamentals of cybersecurity, so I have repurposed, summarized, and added to the CNET article for JEA readers. Bear in mind that I almost fell prey to an online scam. Today’s highly sophisticated scammers are capable of generating email correspondence that looks completely authentic, nearly fooling even me. I have received correspondence from Apple, Chase Bank, and other major corporations asking me to verify transactions, or alerting me that my account has been suspended. Only by comparing these emails to actual letters from Apple, etc. could I notice even the tiniest difference between the fake message and the real one. Let’s begin by talking about phishing, in other words, a scammer pretends to be somebody else in an attempt to steal your information, regardless of whether it’s a credit card number, login

password, or any data that can be used in an attack. Phishing attacks often come in the form of an email that contains a link taking you to a website designed to trick you. The easiest way to avoid getting phished is simply to not click on any links in emails. If an email coming from Netflix says your account is going to be canceled, go directly to Netflix’s website to check it out – don’t do it from the link in the email. Tips for spotting a phishing email: Grammar: Bad grammar is a tell-tale sign of an online scam. Check the source: The address the email came from is often a thinly veiled disguise (coming from facebookk.com instead of facebook.com, for example). Weird links: You can hover your mouse over links and see pictures to determine where they’ll lead you. If an email claiming to be from your bank is actually going to a suspicious website, that’s a good sign it’s a scam. My comment: As I wrote earlier, phishers have increasing expertise at sending emails that look official. Many of these emails report that something is being canceled. Automatically be wary of any such email.

Password managers: It is a pain to have to remember different passwords, but it is also a must. Fortunately, there are free services out there that will keep all your passwords in one place. With password managers, you just have to remember one password for the manager. Just log into that service, and the managers sync across your browsers and devices, bringing both security and convenience. Find out more here: https://www.cnet.com/how-to/ how-to-save-and-sync-your-passwords-lastpass-for-free/. HTTPS and SSL: Every time you go on a website, you should check to see if there’s a green lock icon next to the URL. That symbol shows you’re on a page protected by HTTPS, which stands for Hypertext Transfer Protocol Secure. The green lock tells you the website has Secure Sockets Layer (SSL) enabled, meaning there’s a certificate to prove that the website is secure and that your sensitive information can’t be stolen or spied on when you visit that site. Think of it as a virtual Good Housekeeping seal of approval that your secrets are safe. Sometimes going on a nonsecure site can’t be avoided. You should be careful about entering

sensitive information on public Wi-Fi if you have to go on non-HTTPS pages.

months ago, and my ATM account was hacked last week. A useful article, https://www.identity theftlabs.com compares the major players.

Ransomware: This is a type of virus that locks up your important files and sometimes your entire computer, unless you pay a ransom.

Unfortunately, cybersecurity issues are here to stay. It behooves us to stay one step ahead of pirates and hackers. v

You should back up your files regularly in case you ever get hit with ransomware – my favorite utility for this is Carbonite. I connected to it in 2009 and still use it. In computer years, that is a long time. If my laptop crashes and dies, I can buy a replacement, and download all of my files from Carbonite. Now that’s insurance! Plus, they have great tech support.

Marina London is Manager of Web Services for EAPA and author of iWebU, (http://www.iwebu.info,) a weekly blog for mental health and EA professionals who are challenged by social media and Internet technologies. She previously served as an executive for several national EAP and managed mental health care firms. She can be reached at m.london@eapassn.org.

References

https://www.cnet.com/how-to/thanksgiving-parents-cybersecurity-talk-advice-holidays/ https://www.carbonite.com/ https://www.cnet.com/news/the-wannacry-ransom-deadlineis-here-should-you-pay/ https://www.lifelock.com/ https://www.idshield.com

CNET has an entire guide on whether you should pay a ransom. The short answer is – DON’T. Smaller companies and health care organizations such as hospitals are especially vulnerable to attack. Patching: Companies like Microsoft and Apple aren’t sending frequent updates just to annoy you. Most of the time these updates come with patches to fix security flaws that were recently discovered. Yes it may be time consuming, but do it – update all of your devices when necessary.

Advertise in

Two-factor authentication: This is an extra layer of security on top of your password. This type of authentication is around you everywhere you go already: swiping your debit card and then entering your PIN code, or writing a check and showing a driver’s license along with it. The factors are often a combination of something you know (a password, a PIN, answers to a question) with something you have (a thumbprint, a card, a phone).

Contact Jim Printup, Development & Donor Relations: (303) 242-2046, development@eapassn.org

The most common version of two-factor authentication is a code texted to your phone after you enter your password. Warning – this can be more complicated and annoying than it sounds. But understand this process is there to protect you from identity theft. Identity theft: Consider purchasing identity theft protection from companies like Lifelock and ID Shield, which protects you from data breaches even when these occur through no fault of your own. My accountant’s firm was compromised (!) a number of 9

coverstory Legal Perspective: EA Professionals & Sexual Harassment – Part I |By Robin Sheridan, JD, MILR

s the number of celebrity sexual harassment allegations grows, employers across the country are evaluating their policies, trainings, and organizational culture in an effort to avoid being featured in the next headline. While employee assistance (EA) professionals can play a pivotal role in an employer’s fight against workplace harassment, that role must be balanced with the confidentiality obligations owed to the client and understood by all parties, including the employer and the EA professional. Duty to Warn As discussed in my article in the 4th Quarter 2017 JEA, there are limited occasions when an EA professional is permitted to breach his or her duty of confidentiality to the client in order to warn of danger. This standard varies from state to state, but it is generally assumed when an imminent risk of substantial harm exists. It is not difficult to imagine a scenario in which an employee’s experience of sexual harassment leads to fear for the safety of the employee or a third party. In these circumstances, a Duty to Warn analysis should be conducted to determine if, under the relevant state law, confidentiality may be breached and how to do so by

releasing the least amount of confidential information as possible. Duty to Report Most states have laws requiring that an EA professional report the abuse or neglect of a minor, but few impose mandatory reporting for abused or neglected adults other than an adult-at-risk or a

“While always a matter of professional judgment, we recommend that you encourage clients to report the incident. Self-reporting is the first step in resolving the situation, whereas a failure to report likely means that the suffering will continue.” vulnerable adult. In Wisconsin, for example, reporting is required for any adult who has a physical and/ or mental condition that substantially impairs the ability to care for his or her own needs and who has experienced, is currently experiencing, or is at risk of experiencing abuse, neglect, self-neglect, or financial exploitation.

A Duty to Report may also arise if the conduct rises to the level of assault and the state requires reporting of the crime. To the extent that your state requires reporting, it also likely extends immunity to your report so that you may (and indeed must) report and can do so without fear of action for breaching confidentiality. Does the Employer Understand and Acknowledge Your Duties? Although not historically addressed in position descriptions, the national conversation on sexual harassment suggests that we should be calling out expectations in this regard in position requirements. If not, there is a high probability that you, and the employer for which you provide services, will NOT be on the same page. Consider, for example, if you are an internal EA professional employed by the same organization that employs your client. As an employee, you are bound by the employer’s policies. One of those policies likely requires all employees to report harassment. As noted earlier, however, as an EA professional you will not be able to breach confidentiality to report harassment to the employer except in very limited situations. Your employer should acknowledge an exception to the policy

that requires reporting – both in the policy itself and in your position description – both for your protection and the protection of your client. The same principles apply if you are an external EA professional contracted to offer services to the employer. Be sure that your services agreement makes it clear that your confidentiality obligations are to the individual client and you are unable to report violations of the policy (including harassment). Ideally, the agreement contains a provision that clearly delineates your role, such as described in the following two paragraphs. Relationship of the Parties. Nothing in this agreement shall be construed to create a joint venture or partnership between the parties. [EA professional] shall act solely as an independent contractor and not as an agent, servant, employee or representative of [employer]. Consequently, neither party has made, and neither party shall make, any statement or take any action that might cause a third party to believe that it has the authority to transact any business, enter into any agreement, or in any way bind or make any commitment on behalf of the other party unless expressly authorized by a duly authorized officer of the other party. Should You Attempt to Convince the Client to Report to the Employer? While always a matter of professional judgment, we recommend that you encourage clients to report the incident. Self-reporting is the first step in resolving the situation, whereas a failure to report likely means that the suffering will continue.

You can support your client by understanding and educating him or her on the employer’s applicable policies, including, for example, the harassment policy (and duty of the client to report), investigation guidelines (what they can expect post-report), and non-retaliation policy (protecting the client from retribution for reporting). Your knowledge of applicable policies and procedures may also help the client prepare for the next steps. For example, employers are required to complete a thorough investigation – therefore, the client should be made aware that the employer cannot promise complete confidentiality. Should I Advocate on Behalf of the Client? Consider this decision carefully: Depending upon the law of the jurisdiction in which you practice, you may or may not be protected from employer retaliation should they find your advocacy disloyal. Before sharing anything with the employer, get written authorization from the client that clearly articulates what information may be shared.

the employee formulate a plan to report the harassment. Following the employee’s report, the employer investigated and fired the accused harasser. In subsequent counseling sessions, however, the employee reported increasing hostility from co-workers who were friends of the terminated harasser. After obtaining client authorization, DeMasters spoke directly with Human Resources about the increasing hostility and the need for intervention and training. According to the employee, the co-workers’ behavior worsened after that and he feared for his safety. DeMasters then told several Carilion management representatives that they were mishandling the employee’s complaints.

Advocacy: Case Example In DeMasters v. Carilion, 796 F.3d 409 (4th Cir. 2015), an EA professional (DeMasters) worked as a consultant for Carilion Clinic. During a counseling session, an employee/client revealed that his manager had been harassing him. After hearing the employee’s evidence, DeMasters concluded that the employee was a victim of sexual harassment in violation of Carilion’s sexual harassment policy. DeMasters helped 11

coverstory The employee filed a sexual harassment lawsuit against Carilion. The employer settled the claim and, soon after, confronted DeMasters about his involvement. When DeMasters acknowledged that he had expressly confirmed the employee’s belief that he’d been sexually harassed, Carilion asked DeMasters why he had not taken the employer’s side, and whether he understood the magnitude of the potential company liability. The managers also told DeMasters that he had not protected Carilion’s interests and that he had left Carilion “in a compromised position.” Two days after this meeting, Carilion fired DeMasters for failing to “perform or act in a manner that is consistent with the best interests of Carilion Clinic.” In response, DeMasters filed his own lawsuit, claiming that Carilion terminated his employment in violation of Title VII’s anti-retaliation provision. The legal issues in DeMasters’ case revolved around two issues: • Whether an EA professional is protected from retaliation under Title VII; and • If so, whether DeMasters engaged in protected activity necessary to invoke Title VII’s protection? With respect to the first question, some courts have found that when an employee’s job is to communicate employee complaints, that employee cannot later claim retaliation based on the communication. Known as the “manager rule,” the idea is that, if counseling and communicating complaints are a part of a manager’s regular job duties,

then essentially every activity in the normal course of a manager’s job could potentially be protected activity (and management would have no ability to discipline that manager). In DeMasters, the Fourth Circuit found that the manager rule cannot apply to Title VII retaliation cases generally, or to EA professionals specifically, because: “Under the manager rule, the categories of employees best able to assist employees with discrimination claims – the personnel that make up employee assistance programs, Human Resources, and legal departments – would receive no protection from Title VII if they oppose discrimination targeted at the employers they are duty bound to protect.” DeMasters, 796 F.3d at 423. The Court also found that DeMasters’ conduct was protected activity such that he was deserving of protection against retaliation. In addition to the Fourth Circuit, EA professionals should also be protected from retaliation if they advocate for a harassed client in the following jurisdictions: Second Circuit (Vermont, New York and Connecticut); Sixth Circuit (Michigan, Ohio, Kentucky, and Tennessee); Eastern District of Wisconsin; and the Northern District of Illinois. However, other courts have not shared the same findings. For example, in Weeks v. Kansas, 503 Fed. Appx. 781 (11th Cir. 2015); cert. denied, 568 U.S. 1143 (2013), the manager rule barred the claim of an in-house attorney who reported discrimination and advised her employer

to take it seriously. Accordingly, EA professionals in some jurisdictions may not have legal protection from retaliation should they be disciplined or terminated for having advocated for a client victim of sexual harassment. These jurisdictions include: Tenth Circuit (Utah, Wyoming, Colorado, New Mexico, Kansas and Oklahoma); District of South Carolina; Western District North Carolina; and the District of Columbia. Please note: These lists may not be all inclusive and the law is subject to change. Therefore, EA professionals are urged to seek counsel with knowledge of your local employment law. When Your Client is the Accused Cooperate. Be honest. Do not retaliate. This is the best advice you can provide to a client who is accused of sexual harassment. v NEXT ISSUE: In the second installment of this series, we will discuss the employer’s responsibility when harassment is reported and how those responsibilities may impact an accused client. Editor’s note: The recommendations provided in this article are for educational purposes only and are not to be construed as actual legal advice. Always consult with a local attorney. For additional information about this topic, contact Robin Sheridan, (414) 7210469, rsheridan@hallrender.com; Richard Davis, rdavis@hallrender.com; or Kristen Chang, kchange@hallrender.com. Robin Sheridan is an attorney with Hall, Render, Killian, Heath & Lyman, PC. the largest health care-focused law firm in the country. Visit the Hall Render Blog at http://blogs.hallrender.com for more information on topics related to health care law.

earoundup APEAR Conference Set for May 3-4 The 16th International Asia Pacific Employee Assistance Roundtable (APEAR) Conference 2018 will be held in Bangalore, India on May 3rd and 4th 2018 at the Conrad Bengaluru. The theme is “EAP in the Modern Age: Employee Engagement”. APEAR’s EAP Summit is an annual, high-powered, two-day regional forum offering the highest standards of practice and continuing development for employee assistance professionals. In an engaging and intimate setting, expert presentations and plenty of networking opportunities ensure that participants leave with practical tools and key contacts. For more information, check out http://www.apear.org/2018/ index.html.

books have thus far failed to overcome the culture of overwork on a widespread basis. The Japanese government recently increased the number of public holidays in an attempt to force workers to take days off from work. The government also initiated a nationwide campaign — “Premium Fridays”— to encourage workers to leave work by 3 p.m. the last Friday of each month, specifically to engage in recreational activities. In addition, the food and beverage and entertainment industries each started providing happy hourtype discounts on those Fridays in the late afternoons and early evenings. Some regional governments have even encouraged a “lights out” practice where employers turn off office or building lights by a certain time so that employees are forced to leave.

Reducing ‘Death by Overwork’ in Japan

Bullying, Double Standards Plague Working Women

In the wake of increased international focus on karoshi—a Japanese term meaning “death by overwork”—Japan’s business leaders and government alike agree that Japan’s “culture of overwork” is a critical issue in need of a solution, according to JD Supra. Even after acknowledging the seriousness of the problem, curbing the forces underlying karoshi poses a real challenge for leaders. Researchers say that the so-called “culture of overwork” arises from employees’ ingrained drive to seek professional achievement at any cost, placing success above even their own health. Laws on the

Millions of women responded to allegations of sexual harassment against entertainment industry figures, members of Congress, and prominent male journalists through the hashtag #MeToo. Workplace experts say the focus on sexual harassment has yet to spotlight another common problem affecting mostly women: bullying bosses. Experts claim that working women also face a troubling double standard in terms of expectations, reports GLT 89.1, Illinois State University’s NPR station. Workplace bullying is defined in several ways.

“It has to be intentional. It’s not something that accidently happened, or they didn’t mean it. And it’s repeated, it happens more than once, and it causes distress,” said Leandra Parris, an Illinois State University psychology professor. Women also are often held to different standards than their male colleagues, especially in their interactions with male supervisors, Parris added. “It’s almost like, ‘How dare you question my authority or question anything I can say.’ And then there’s this sense of embarrassment that there is this woman who stood up and corrected them,” she said. Parris advises, “Just be honest with them, and do it without emotionality. The minute you start to show any emotion, be it anger or sadness that moment gets undermined. So a woman has to be even more careful than a man when they approach their bosses to say something. Make sure you practice it and that emotionality is taken out of the equation.”

Law Would Ban Confidential Harassment Cases California lawmakers are debating a number of bills to combat sexual harassment in the workplace. One such law would ban confidential settlements of certain claims. Attorneys told SHRM Online that such legislation could result in fewer settlements with employers and more litigation. The proposed bill would protect workers from being victimized and Continued on page 21

featurearticle Project 95 –Broadbrush Lessons for Today Part III |By Jim Wrich

n the final installment of a three-part series, we continue to show the evolution of employee assistance into the EAP of today. The entire series can be read here http://www.eapassn.org/ EAPHistory. Trouble Brewing in Paradise The field of addictions treatment was coming under attack. Free-standing residential programs like Hazelden and the Caron Foundation (Chit Chat Farms) charged between $75 and $100 per day for treatment, or $2,000 to $3,000 for a 30-day stay. However, the hospital-based programs were charging about $250 per day and addictions treatment suddenly became a god-send for hospital administrators. The “Baby Boom” had been followed by a “Baby Bust” and hospitals all around the country had empty maternity wards. An enterprising organization, Comp Care, stepped up to solve two problems: the increasing numbers of empty hospital beds and the insufficient numbers of alcoholism treatment services. They developed a “turn-key” addiction treatment program that they sold to hospitals for $65 per bed per month, including staffing, the treatment protocol, training, supplies, and profit. Within 3 months a hospital could

have a fully operational addictions treatment program that might otherwise take a year or more to develop. Equally important, they could sell a service that cost $65 a day for $250 to $300. And, because they were a hospital, insurance companies readily paid the tab while often denying reimbursement to the free-standing residential programs. As the commercial EAP industry developed, commercial addictions treatment chains also sprang up. In addition to Comp Care, companies such as Parkside Medical Services developed national chains of rehab programs using the Lutheran General program founded by Dr. Bradley in Park Ridge, Illinois. But these companies could not develop new treatment programs fast enough to dominate the industry so they bought up existing free-standing programs and by 1988 grew to more than 2,000 beds nationwide. In the acquisition process layers of bureaucracy were added to what had been reasonably priced services, driving up the cost of care without necessarily adding value or improving outcomes. To their credit, some conducted outcome evaluations on their patients, but the results at $8,000 were about the same as Hazelden had found

under Dan Anderson in the early 1970s. (This was before it had been accredited by JCHA and was charging only $28 per day.) By the late 1980s, many larger employers had become selfinsured, and the benefit managers who had become more directly responsible for containing costs were not happy with the price escalation. With very few reasonably priced free-standing programs still in existence after all the mergers and acquisitions, typical residential addiction treatment costs passed the $10,000 mark and a few soared over $30,000. Benefits managers rebelled. Today, many cost double that amount. In the meantime, residential recovery centers such as the Retreat in Wayzata, Minnesota, were getting comparable outcomes for $5,000 to $7,000. For years overall health care costs had been increasing at 2 to 3 times the rate of inflation and represented an ever-increasing share of the Gross Domestic Product. In 1985, our firm began comparing health care costs to corporate profits and by 1988 the total net income of the Fortune 500 Industrials was eclipsed by their employee health care expenses. Many group insurance plans had only recently begun covering treatment of addictions and mental health and, with a baseline of near

zero, quite naturally these claims increased at the fastest rate. They represented the low-hanging fruit for the cost cutters. Benefit managers began to realize that health insurance companies had a vested interest in cost escalation because their administrative expense and profit margins were pegged as a percentage of claims. Many had already enlisted Health Maintenance Organizations (HMOs), which assumed the risk at a fixed, multi-year fee. But an HMO’s scope was limited to medical-surgical care, and unlike alcoholics or those suffering from depression, beneficiaries complained loudly when the service they needed was cut back. The New Treatment Boss In the early 1990s a counterpart to medical HMOs came on the scene that carved out mental health and addiction treatment: the Managed Behavioral Health Organization (MBHO). MBHOs also accepted contracts at risk. Studying a company’s claims data, they calculated the total cost for mental health and addictions, agreed to a firm fixed priced contract at roughly 70%, and took over the assessment and treatment. With one of the most expensive components being the standard 30-day residential care for addictions, our own retrospective audits disclosed a non-random pattern of denial of treatment for alcoholism and drug addiction. In one case, a large employer was on a path to spending 10% of its total employee health care costs, or $20 million, over the following two years for mental health and addictions treatment. The MBHO accepted a contract

for $14 million and proceeded to spend a little over $5 million for actual care. Virtually no one in a group of 50,000 was referred to residential or inpatient chemical dependency treatment. The outcry from the unions and employees led some employers to conduct audits, but most were satisfied to weather the storm of criticism and enjoy the short-term gains. For a period of time, EAPs and MBHOs competed directly in the workplace, with the MBHO vetoing EAP referral decisions. But that ultimately went by the boards. In building their businesses, MBHOs accelerated growth by rapidly acquiring commercial EAPs, securing their customers, and upselling them managed behavioral health products at a much greater cost but with the promise of reducing overall mental health expenditures. Two of the largest commercial EAP firms — Human Affairs International and PPC – were swallowed up along with several others. In justifying denial of care practices the MBHOs touted studies that purported to prove that outpatient care was as effective as residential care for addictions treatment. This wasn’t what the research of Hoffman and others showed, but it was welcome news to benefit managers and independent practitioners. It was true that few alcoholics needed 30 days in an acute care hospital. More typically, at UAL we found that about 40% of participants suffering from addiction needed primary residential care. Unless there was a serious co-morbid physical or psychiatric issue, the free-standing programs were at

least as effective and cost less than half as much. Of the remaining 60%, intensive outpatient, small group therapy, one-to-one counseling, and sometimes just AA alone secured excellent outcomes, such as: 72% first-time recovery for ground employees; 84% for flight attendants; and better than 90% for pilots and senior management. These recovery rates were far above average and began by providing the right care the first time. Beyond that, the intensity and length of the continuing recovery protocol and family involvement accounted for most of the difference in these outcome rates from the norm. Unfortunately, valid outcome data in the fields of both EAP and treatment began

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featurearticle to shrink to nearly nothing as the MBHOs took over. The principal measurement was cost reduction, not recovery, and they certainly achieved that goal largely through denial of appropriate care as the percentage of health care costs represented by substance use disorders and mental health was cut by more than half. This Stuff Should be Easy, Too Compounding the issue further was the Reagan Administration’s response to the growing concern about illegal drug use. At a political rally Nancy Reagan picked up on a placard held by a young school girl that proclaimed, “Just Say No!” When the Reagan Administration turned it into a national mantra to fight addiction, both the disease and its treatment were trivialized. It led many to wonder whether treatment was even necessary. The need for drug testing was also stressed. The message was clear: “Use willpower to solve your alcohol or drug problem, and if you don’t our drug testing will weed you out.” Employers were in a bind: if an employee caused harm or injury in the workplace while under the influence of drugs, the absence of a drug-testing program could be used against the company in a liability suit. Not Only Easy, but it’s Gotta be Cheap Staffing an EAP with Assessment and Referral (A and R) professionals who did face-toface interviews represented a price to employers that generally ranged from $1.50 to $3.00 per employee per month, less than 1% of the cost of health care benefits at that

time. At UAL the preponderance of our assessments were face-toface but because about 10% of our employees worked in remote areas we also needed to conduct some assessments over the phone. Our data showed that about three times as many telephone referrals came back to the program within a year for a different problem than was the case with the face-to-face participants, and a

“But the truth is, the evolution of EAPs has been like any other movement with a mix of positive and negative results. Today, upwards of 200 million Americans have access to assistance through EAPs that didn’t exist when the ‘Thundering 100’ first gathered in 1972.” disproportionate number of these re-entries turned out to be chemically dependent. In the 1990s the “Telephone Model EAP” became popular. One large commercial EAP service built a major part of its business through acquisitions of local and regional EAP providers who conducted face-to-face interviews. After an acquisition, they went to the customers and offered to reduce the price by 50% to 70%, and then converted

the A and R process to a phone model, which yielded much greater profits than the face-toface model. Referrals for alcohol and drugs became rare. But the ability to read body language – something that can only be done in person – is important in differentiating primary from secondary issues. Because addiction will seldom be the presenting issue, it can be difficult to recognize even when the person is sitting in front of the A and R professional. Over the phone, chances are diminished even more. However, when an HR manager was led to believe they could have something at $8 to $10 per year per employee instead of $20 to $30, it seemed like a no-brainer. Besides, no one was keeping score when it came to penetration and recovery rates. And Here We Are There has been an ebb and flow with EAPs over the years, and they did not all end up the same. Some still do outcomes, follow professional standards, and have good utilization rates for addiction. Some try to be “everything to everyone” and have lost sight of the purpose for which EAPs were established. Others offer little more than casual counseling for an array of issues that endear the staff to employees but do not tangibly address the tough issues people face, especially addictions. It would be easy to simply criticize these developments, especially the monetization of EAPs and treatment. But the truth is, the evolution of EAPs has been like any other movement with a mix

of positive and negative results. Today, upwards of 200 million Americans have access to assistance through EAPs that didn’t exist when the “Thundering 100” first gathered in 1972. Millions have received help that they would not have had if not for an EAP. It is highly doubtful this could have happened by serially implementing in-house programs. While far more alcoholics and drug addicts could have been helped – and perhaps should have been had there been better training of staff and fewer compromises in program designs and objectives – the fact is that, all told the results have been significant. What’s Next? The current leaders in the EAP field, especially EAPA and EASNA, need to decide whether or not addiction is still important. If so, there are lessons to be learned and the following points might be considered:  Until health education institutions, especially schools of medicine and social work, get serious about addiction, and include comprehensive instruction for their students in how to recognize the disorder and effectively refer patients for a professional assessment and treatment, latestage identification will continue to be the norm and the personal and public costs will continue to mount unabated.  Until insurance companies acknowledge that effective recovery can be delivered by freestanding recovery programs at less than $7,000 for four weeks, and reimburse for it, treatment costs

will continue to escalate beyond anyone’s ability to pay.  Since few health professionals are ready made for Assessment and Referral positions, appropriate training is essential. If an A and R cannot distinguish between an early to middle stage alcoholic who shows signs of depression due to ingesting a depressant drug, and someone who is clinically depressed and just drinking too much, they cannot competently do the job.  Unless EAP practitioners are trained to effectively inquire about alcohol and drug use with every referral, assess addiction, bring it to the attention of the afflicted and their families, and refer them to the most appropriate care, the penetration rates for addiction will continue to languish at a level that makes a positive benefit to cost ratio nearly impossible.  In moving the needle to improve a person’s life and safeguard the employer’s vested interest, industry standards need to be enforced by employers, audited by qualified representatives of either EASNA and/or EAPA, and an honest outcome evaluation system must be part of any EAP.  The words of Dan Anderson many years ago still hold true: “You have to love alcoholics in order to work effectively with them.” Some EA professionals are capable of this love, but others are not. An honest self-assessment is required.

Addiction is more than just a code in the DSM. Today, as was

the case in 1972, it is a killer that ruins lives, exacerbates a host of other health disorders, fills prison cells, and robs society of its greatest treasure – a fully realized human life. However, as millions of recovering people will attest, addiction can be successfully addressed. An A and R position is more than just a job that offers a clinician a chance to work for an important employer instead of a non-profit social service agency. It is the heart of a life-saving workplace system that can be as lonely as it is rewarding. An EAP is more than just another feel-good HR program. It is often the best hope an employee or family member has of breaking free from a lifedestroying condition. We need not regret the past nor shut the door on it. Conversely, neither does it help to exaggerate our achievements. As always, we need to honestly reflect on where we are, what we have done, who we are, and what will be required of us to do better going forward. Millions are still out there and they need us. v Jim Wrich is one of the pioneers of Employee Assistance Programs (EAPs) - one of the original Thundering 100 who launched the modern EAP movement through Project 95-Broadbrush. In 1972, Jim implemented some of the first EAPs in the country. An early member of ALMACA, (later the Employee Assistance Professionals Association,) he served as First Vice President and was the founding President of the Employee Assistance Society of North America (EASNA). Since 1987 he has managed his own firm, J. Wrich & Associates, LLC. (JWA), a health systems performance company, which provides a broad range of consulting and cost analysis services to businesses and unions.

featurearticle Ending Sexual Harassment in the Workplace | By Nancy Board, MSW

exual harassment in the workplace has been around for as long as men and women have been working together. Many employers have “no-tolerance” policies in place as there are legal consequences for companies that fail to take prompt and appropriate corrective action. However, since nearly every U.S. organization – 94% – (SHRM, 2018) has a sexual harassment policy, clearly the problem is bigger than policy. EAPs have run training programs for years on the legal aspects of sexual harassment. Trainings aren’t Enough Do these trainings actually make a difference? Some studies suggest, no. “Training was least effective with people who equated masculinity with power. In other words, the men who were probably more likely to be harassers were the ones who were least likely to benefit [from the training],” said Eden King, a psychologist at Rice University. And the purpose of the training is to reduce harassment to zero! As a result, while researchers say that training is essential, it clearly is not enough. If employees aren’t reporting harassment because it is “unsafe” to do so, for fear of retribution and retaliation, job loss, etc., then a more deepening lack of trust in the organi-

zation goes untreated and permeates. To actually prevent harassment, companies need to create a culture in which women are treated as equals and all employees treat one another with respect. Professor Kim M. Cobb of the Georgia Institute of Technology, who is active in helping more women advance in the sciences, said recently, “There’s a big gray zone between legal sexual harassment and a culture of inclusion… In that gradient, real damage is done on a daily basis that changes people’s lives and changes people’s careers.” Johnny Taylor, President and CEO at the Society for Human Resource Management (SHRM) recently wrote that, “Cultural change is the most important thing you can do — all of us can do — to make sure that all people in the workplace are respected, valued, and empowered to succeed.” Taylor noted that HR and EAP should work together in addressing this issue. The Power of Power Since most corporations are led by men, white males in particular, there is an inherent privilege, an established pattern of power that awards men in authority with an ease of operating in the world. For those who abuse this power, (e.g. Harvey Weinstein, Roger Ailes, Matt Lauer, Charlie Rose, Steve Wynn, et. al.) the prey often is

more vulnerable and has relatively low status and power. It is not unusual for younger, less powerful female employees to be the targets of harassment and bullying. An anonymous woman shared, “To participate and get ahead I had to act as if the harassment didn’t bother me, or else I would never have gotten ahead. I had to act as if and just move on, so I could hang with the men and not let it bother me.” If toxic masculinity can lead to abuse of power, which leads to abuse of women, how can we as EA professionals impact this dynamic? Can men and women work together to create change? Can we collectively shift the status power differential? In attempting to understand the male point of view on this subject, I suggest reading the work of Marianne Schnall, a widely published writer, interviewer, and founder of the What Will It Take movement, who recently asked a number of men, “Why do you think men don’t speak out?” (Schnall, 2017). Case Study In 2015, a U.S.-based organization, XYZ, with nearly 200 employees in the tech field, hired an “impressive on paper” and verbally astute, white male middle manager “superstar” for a role that had 25 direct reports. Company

XYZ had a C-suite consisting of three women and nine men, all Caucasian. Initially this middle manager was seen as a change maker, action-oriented, outspoken and well-liked by most of the senior team. After a few months, several female employees reported that the manager’s behavior at times made them feel “uncomfortable.” The recently hired manager was witnessed to have stepped into a “gray” area, in which nothing completely tangible could be seen, and yet subtle hints and messages were being noticed as he spent a good deal of time with the youngest women on the team, and typically after 5 p.m. He soon arranged frequent social gatherings after hours with staff mostly 15-20 years younger than him. Once revelations of more specific incidents were shared with HR, it was clear that there was a pattern developing of inappropriate behavior, particularly for an organization that touted itself as an employer of choice and a best place to work for women. Within a matter of weeks, nine resignations became public knowledge, all from women only. It was later revealed that the CEO supported this manager, wanted him on his team, and that he would be “coached” by a female HR leader to change his behavior. In other words, he kept his job, despite a “no jerks are allowed to work here” practice. In discussions with the women who left, every one of them revealed that this manager and the leadership’s lack of reigning in his behavior, was a big part of their decision to leave. Some had spoken out to HR against him and

some did not. Many shared they did not feel the culture matched a level of trust they thought they had when they joined the company. Some said it was not worth it to stay – they did not feel safe there. Not only did they not trust the manager, but they lost trust for HR and the leadership team as well. The women did not take legal action, but they vented their experiences online (on Glassdoor), actions that can be quite damaging for a company’s reputation. Men and Women Engaged as Allies and Partners Conversations with men about men need to occur to analyze, assess, and discuss various behaviors of men and how men need to engage and speak out. Organizations such as A Call to Men, The ManKind Project, and #HowIWillChange Twitter campaign are just a few examples of change solutions. I would argue that men:

mainly men are in these top positions, it means that men must work together with women to build a better culture for everyone. What Can EA Practitioners Do?  Learn how to assess for harassment in the workplace and recognize how it impacts the individual as well as the organization. According to University of Oregon psychology professor Jennifer Freyd, “Few people know how to recognize the mental health issues that happen after harassment. Pretty much any common form of emotional or psychological distress can be experienced after sexual harassment. People may suffer from anxiety or depressive issues. Some can even be diag-

• Should hold themselves and other men accountable for their behaviors. They must stop choosing “peer pressure” over women’s rights. • Need to admit the ways in which they are complicit – both directly and indirectly – in harmful actions. • Should be at the forefront of change, alongside women, in building solutions. • Really listen to women as they share stories of facing harassment, assault, and other forms of discrimination Culture change starts at the top – who is in the C-suite and who we bring into the C-suite – and who we promote matters. Since 19

featurearticle nosed with post-traumatic stress disorder, and the effects may not show up for years.”  Make yourself available as a resource on change management and workplace improvement. EA practitioners can offer tremendous value to companies in ensuring that discussions on workplace culture and appropriate behavior are at the top of everyone’s mind. Are you seated at the table with the C-suite in these talks? What about HR? You need to step in and address how workplace culture impacts engagement and employee performance.  Review EEOC guidance and updated policies. Understand how laws are designed to create better conditions in the workplace. New guidance is issued in a 95-page report assembled by a task force focused on harassment prevention (EEOC, 2016).  Review your organization’s harassment policies and training materials. Revisit this discussion with your HR partners. Have the harassment policies and trainings changed over the past year? Is the information offered impacting the workplace enough? Have you added bystander additions such as, “If you see something, say something.”? Do you have other content that would be helpful to add to existing training materials? Are you a trusted consultant and advisor to the organizations you work with? How does HR handle complaints and policy violations? What is the EAP’s role in these violations?  Recognize that sexual harassment not only causes emotional and psychological

pain, but it can also threaten an individual’s financial wellbeing. Many women say that they cannot afford to lose their job, so they put up with and remain silent. What resources are at your disposal when considering the overall impact of harassment on an employee’s well-being? Summary Solutions to these complex problems of gender inequality and harassment cannot be found by men and women working in siloes or be kept undercover any longer. As HR, EAP, and health & wellness professionals we can and need to be part of the solution. But short-term therapy is arguably not enough. These are deepseeded issues that warrant much introspection and inner work. An EAP can provide a window of trust, support, and resources for further actions to take root. A person full of shame and self-hatred is only going to hurt more people if left untreated. We are long overdue for a national conversation about the abuse of power and privilege, the socialization of men and boys, the objectification of women, and workplace cultures of toxic masculinity. Healthy leadership demands that we uncover and shed our own biases and prejudices in order to be compassionate, productive servant leaders. Ending sexual harassment in the workplace is at a watershed moment. The most successful companies understand that investing in women’s health, well-being, and leadership impacts the bottom line. The best workplaces of tomorrow depend on our action today. v Nancy Board is a long-time international EA professional and co-founder of Women

4 Wellbeing (GW 4W), a 501 (c) (3) nonprofit dedicated to empowering healthy female leaders for a more sustainable world. She leads powerful transition programs for women on four continents. Nancy can be reached at nancy.board@gw4w.org.

References

Fox Rothschild, LLP. (2014, August 19). “Third-party sexual harassment” – What every employer must know. [Blog post]. Retrieved from https:// employmentdiscrimination.foxrothschild.com/tags/low-status-andpower-differential-in-the-workplace/ Miller, C. (2017, December 11). Sexual harassment training doesn’t work. But some things do. New York Times (online version). Retrieved from https://www. nytimes.com/2017/12/11/upshot/ sexual-harassment-workplace-prevention-effective.html Schnall, M. (2017, November 13). #MeToo to men too: How men can prevent harassment and abuse. Huffington Post. Retrieved from https:// www.huffingtonpost.com/entry/ from-metoo-to-men-too-howmen-can-prevent-harassment_ us_5a05e669e4b0f1dc729a6a91 Society of Human Resource Management. (2018, January 31). SHRM research finds some employees unaware of company sexual harassment policies. [Press release]. Retrieved from https:// www.shrm.org/about-shrm/pressroom/press-releases/pages/sexualharassment-survey.aspx Toxic Masculinity. (n.d.). In Wikipedia retrieved February 15, 2018, from https://en.wikipedia.org/wiki/ Toxic_masculinity United States Equal Employment Opportunity Commission. (2016, June). Select task for on the study of harassment in the workplace: Report of Co-Chairs Chai R. Feldblum & Victoria A. Lipnic. Washington, DC. Retrieved from https://www.eeoc.gov/eeoc/task_ force/harassment/report.cfm

earoundup ban secret settlements in cases of sexual assault, sexual harassment, and discrimination. “As we have clearly seen over the last few months, secret settlements serve one primary purpose: to keep sexual predators away from the public eye and continuing to torment and hurt innocent victims,” said Sen. Connie Leyva in a press statement. Prohibiting confidentiality provisions would keep claimants from being forced to stay silent about sexual assault and harassment if they want to resolve their claims, wrote Kate Gold and Philippe Lebel, attorneys with Drinker Biddle & Reath in Los Angeles, in an e-mail to SHRM Online. “I think we will see a lot more jury trials with this type of law in place,” added an attorney in Newport Beach, Calif.

Correct JEA Text Listed An article on page 7 in the 1st Quarter 2018 JEA stated that, “Differences do occur substantially within age, gender, referral type, presenting concern, industry of the employer, and the delivery model of EAP.” According to Mark Attridge, co-presenter of the “Workplace Impact of EAP” session at EAPA 2017 Conference & Expo – Los Angeles, the text should have read, “Only very small differences in the five Workplace Outcome Suite (WOS) measures were found for client age, gender, referral type, presenting concern, industry of the employer, and the delivery model of EAP. Thus, EAP outcomes were similar across a range of clinical and contextual factors.”

Continued from page 13

See slides of the full presentation at the EA Archive, http://hdl. handle.net/10713/7231.

Some Opioid Addiction Cures aren’t Legit So-called natural addiction “cures” have surfaced to take advantage of people struggling with an opioid addiction. The US federal government is trying to eliminate the fraudulent products. The targeted products claim to provide a natural alternative or booster to legitimate drugs that reduce craving and withdrawal symptoms (“Soothedrawal, “Nofeel,” “Calmsupport,”), with listed ingredients like chamomile to relieve stress or amur cork bark to lower blood pressure, according to the website Gizmodo. Still others go one step further with names that look similar to real medications, like methadone (“Mitadone”, “Naturcet”).Taglines include: “#1 Selling Opiate Withdrawal Brand,” “Break the pain killer habit,” and “Safe and effective natural supplements that work to ease many physical symptoms of opiate withdrawal.” As if that isn’t enough, many websites, Facebook pages, and YouTube videos are selling the products – some even with alleged testimonials. “We’ll continue to work with our partners at the Federal Trade Commission to step up our actions against unapproved products being marketed for the treatment of opioid addiction and withdrawal,” said Food and Drug Administration (FDA) chief Scott Gottlieb in a prepared statement.

Should Marijuana be Removed from Screenings? Employers are facing a real quandary: Should they stop testing job applicants for marijuana use now that more states have legalized it for medicinal or recreational purposes and popular acceptance of the substance has spread? Twenty-eight states and the District of Columbia have legalized medical marijuana. Eight of those states (Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington) and the District of Columbia have also legalized marijuana for recreational use. However, the drug remains illegal under federal law, and employers have the right to test for it, even in states where the substance is legal, according to the Society for Human Resource Management (SHRM). Moreover, not only does federal law conflict with some states’ laws, but these laws also vary, which is burdensome on employers operating in multiple states. Surveys are showing that employers in states that have legalized the recreational use of marijuana are gradually removing the substance from pre-employment drug testing panels. Experts concurred that HR should consider the nature of the job and the industry when contemplating whether to continue testing candidates for marijuana. For example, if an applicant is applying for a dangerous job such as driving a forklift, it’s Continued on page 27

theworldofeap EAP in France – Growing Savoir Faire | By John Maynard, PhD, CEAP

enowned for its cuisine, cultural history, and physical beauty, France is ranked among the world’s leaders in education, health care, and life expectancy. It has the 5th-largest economy in the world and is the 4th-wealthiest nation. Economically, culturally, and politically, it has long been among the most influential countries on both the European and world stage. France is also the world’s most popular tourist destination. My wife and I added our names to the other 83 million or so annual foreign visitors, when we spent several days in and around Paris in December 2017. While there, we also had the opportunity to visit several French EAP firms and talk with leading EA professionals about the state of the profession in France. EAP Begins Slowly The first EAPs in France appeared in the early 2000s. Prior to that, in the 1980s and 1990s, a few psychological support phone services had been established by companies or insurance plans, but they weren’t called EAPs, nor did they provide more than limited support or brief counseling for individual callers. In 2002-2004, with impetus from new European Union regulations, the French government

began holding workplaces more accountable for prevention and mitigation of psychosocial risks, including stress and interpersonal conflicts. By 2005, when the first book about EAP in France (Angel et al., 2005) appeared, the authors noted that EAPs were beginning to emerge, but were still limited to a few large public sector companies, in addition to the French divisions of multinational companies that already had EAPs in their other locations. Suicides Quicken the Pace EAP awareness and growth accelerated in 2008, following a series of suicides at prominent French companies, including France Télécom (now called “Orange”), Renault, and others. These highly publicized suicides shocked the country. Within the next two years, the French government passed legislation requiring that companies with more than 1,000 employees develop and implement specific plans to identify and manage psychosocial risks, including stress and harassment. To help define and maintain the professionalism of the rapidly growing market for psychosocial risk intervention, including psychological support, several psychosocial risk-related firms created, in 2011, a professional association

called Fédération des Intervenants en Risques Psychosociaux (FIRPS). Today, FIRPS has 18 member firms and focuses on developing professional guidelines and providing a forum for sharing information. Some, but not all, of the founding and current member firms provide EAP services. Between 2008 and 2012, many companies in France conducted psychosocial risk assessments and began to implement EAPs as part of their mitigation plans. The demand for company risk analysis and assessment has declined since then; however, the interest and demand for EAP services have continued to fuel the growth of the profession in France. Although statistics are hard to come by, the general consensus of French professionals is that most of the largest French companies today have functioning EAPs. Smaller companies are less likely to have implemented a program, but interest in EAP is continuing to grow at all company-size levels. Vive la Différence A few interesting differences emerged between EAP firms in France and those in most of the other countries I’ve written about in this column. Whereas in many countries, much of the local EAP business is still subcontracted from

large multinational EAP firms, in France the majority of EAP business is generated by direct contracts with French companies. For the portion of the French EAP market that is subcontracted from the global EAP vendors, there appear to be far fewer exclusive agreements. In other words, in most countries a global vendor will identify a particular local EA provider to handle its EA business in that country or region. In France, several of the local EA providers mentioned subcontracting with the same global EA firms. This means that those global providers are working with multiple local firms in the same geographical area. Challenges and Opportunities Culturally, the French tend to maintain a clear distinction between work and personal life. This mindset creates reluctance on the part of many employers to address personal issues with workplace programs. EAP and related services continue to be driven forward more by legislation and the after-the-fact need for response to critical incidents, than by employer understanding of the potential return on investment they might achieve from a full suite of EA services. From an employee perspective, the distinction between work and personal life can increase people’s reluctance to use services offered through the workplace. This is compounded by the still prominent association of counseling and therapy with psychoanalysis in France. Although awareness is growing of brief, more

practical-oriented counseling and therapy approaches, psychological help for the wealthy is still associated with analysis, while most other people depend on medication. In fact, France is one of the world’s largest consumers of psychotropic medication. The challenge most often mentioned by EA professionals in France is the pressure toward lower prices, even though the market remains far from saturated. The vicious cycle of lower prices leading to lower employer expectations and ultimately to commodification of a professional service is, of course, not unique to France. However, it can be particularly damaging when it occurs so early in the development phase of EAP within a given country. On the other hand, the fact that the market still has so much room to grow offers great opportunity for EAP in France. The psychosocial risk legislation that helped jump-start EAP awareness and development ten years ago continues to evolve and support strong EAP market momentum. The sad reality of the increasing need for critical incident preparation and response in France, as in other countries, is also contributing to the growing awareness and perception of EAP value. Simultaneously, technology is improving EAPs’ ability to deliver services outside Paris and making individual access to services more convenient and potentially more confidential. Taken together, changing environmental factors, such as legis-

lation and highly visible critical incidents, along with gradually shifting public attitudes toward accepting psychological support, as well as evolving technological abilities to deliver services, have set the stage for significant growth of the EAP field in France. This trend is likely to continue and even accelerate. v Let’s Continue the Discussion My thanks to the following individuals for taking the time to meet with me as I was preparing this column: Brigitte Vaudolon of Be Positive; Patrick Amar of AxisMundi; Clement Allanic & Richard Lavergne of Psya; Emmanuel Charlot of Simulus; and Christian Mainguy of Rihalto. Let’s continue the discussion of EAP in France and elsewhere around the world! If you have comments about this article or ideas for other countries we should explore in future issues, please send them in. You’re welcome to contact me directly anytime or to post your feedback, questions, or suggestions on EAPA’s LinkedIn group. Dr. John Maynard served as CEO of EAPA from 2004 through 2015. Prior to that, he was President of SPIRE Health Consultants, Inc., a global consulting firm specializing in EA strategic planning, program design, and quality improvement. In both roles, he had the opportunity to observe, meet, and exchange ideas with EA professionals in countries around the world. He currently accepts speaking engagements and consulting projects where he can make a positive difference. He can be reached at johnmaynard@ spirehealth.com.

References

Angel, P., Gava, M-J., Amar, P., & Vaudolon, B. (2005). Développer le bien-être au travail. Paris: Dunod.

featurearticle Executive Coaching: The Future of EAPs? | By Jason Sackett, LCSW, PCC, CEAP

he employee assistance profession has passed through several evolutionary stages since its origins in addiction recovery, including expansion into workplace mental health support, work-life and wellness programs, and management consultation. I believe the next stage, and possibly the future backbone of EAP, involves executive and professional coaching. What Coaching Isn’t To better understand the concept of coaching, it’s necessary to first explain what coaching isn’t. Coaching is not: • A form of counseling for people who don’t want to bother with clinical education and training; • Consulting, but with a title that sounds friendly and hip; • A specialized advisor role requiring expertise in the client’s profession; and • A completely unregulated and loosely defined service not bound to a code of ethics. Coaching vs. Counseling When addressing employees with substandard performance or behavioral issues, some programs use the terms counseling and coaching interchangeably. Coaching, by definition, is not a remedial service, and therefore using that term to describe a service primarily aimed

at correcting problem behaviors mislabels that service and misrepresents true coaching. This will ultimately lead to confusion and mistrust for consumers, and create marketing and program evaluation problems for EAPs. The potential benefits of branding performance improvement counseling as coaching— namely, to lower client resistance by avoiding stigma associated with counseling—are not worth the consequences for a program’s coaching services that this practice will bring. If a manager calls me requesting coaching for an underperforming or problem employee, I correct that manager, and recommend employee assistance counseling. If the employee in question is of high rank, and will not accept counseling, then I will offer “consultation,” but never coaching. What Coaching IS Coaching involves a collaborative partnership between coach and client that supports action toward a desired outcome. Coaching strives to help clients overcome obstacles, maximize potential, and stay accountable to the actions they have designed to realize goals. Although coaches help create the plan, clients ultimately set their own agenda and responsibility for outcomes.

This point is crucial as its nondirective style makes coaching an empowering experience for clients. Unlike consultants, teachers, or mentors, coaches are facilitators, not providers. This is a key part of what makes coaching distinct from other forms of counseling. Coaching is fundamentally a process of facilitation. A coach’s job primarily involves prompting clients to explore their goals, develop clarity about their motivations for those goals, and brainstorm actions that ultimately help the client reach the desired outcome. Rather than creating a power dynamic in which the coach is viewed as an expert or advisor to be heeded, coaches work to promote a productive thinking environment for clients, in which they generate the insight, creativity, and tasks to support their agenda. According to the International Coach Federation’s (ICF) core coaching competencies, coaching does not involve persuasion, advising, counseling, or mentoring (ICF, 2009). Although the coaching industry is not subject to government regulation, coaching does have several prominent professional organizations that set professional and ethical standards for training, practice, credentialing, supervision, and continuing education. The oldest, largest, and most influential of these are the

ICF and the European Mentoring and Coaching Council (EMCC). Marketing the Coaching Service One strategy is to target underserved, high-value employees, identifying potential outcomes they would find attractive, shaping the message to address those outcomes, and delivering the message directly to those individuals and their close colleagues.

“Coaching strives to help clients overcome obstacles, maximize potential, and stay accountable to the actions they have designed to realize goals. Although coaches help create the plan, clients ultimately set their own agenda and responsibility for outcomes.” For example, an EAP could promote coaching to help executives increase employee confidence in uncertain economic times, help team leaders leverage the strengths of an increasingly diverse workforce, assist physicians in balancing research activities with patient care, or helping faculty position themselves for tenure and promotion. Coaching Sessions In terms of mechanics and structure, a coaching session might look like the following:

 The coach and client cocreate goals and desired outcomes, ultimately reaching a contract or coaching agreement in which the client explicitly states what he/she wants to achieve during that session that supports the desired outcome.  Next, the coach and client enter an exploration phase, in which the coach relies on four core competencies to facilitate discovery and awareness for the client: 1) Coaching presence; 2) Active listening; 3) Powerful questioning; and 4) Reflective observations (also referred to as direct communication). Coaching emphasizes exploration and creation of awareness because it views these as essential to clients creating agendas and outcomes that resonate with their values and motivations. Without this congruence between motivations and goals, clients are less likely to follow through with action plans or feel satisfied with outcomes.  Building on the awareness developed through the exploration phase, the coach prompts the client to design a specific, measurable plan that is consistent with the coaching agreement. After discovery occurs, the client may develop a new coaching agreement based on a new, desired outcome.  The coach provides accountability to sustain commitment, and at times tracks back to key points of awareness (e.g. of motivations and values) discovered in past sessions to reinforce a client’s drive to continue taking action.

Employee assistance professionals and others with clinical backgrounds often have a great foundation for coaching, and conversely, training and practice in coaching often complements and enhances clinical and EA work. Case Example Tina, a mid-level executive, is engaged in coaching for career enhancement purposes. Ultimately, she wants a more fulfilling role that incorporates most of her strengths, but in the short term, she wants to improve her effectiveness in her current job and relationship with her boss. During a current coaching session, she expresses wanting to be optimally prepared for her upcoming performance review, and articulates to her coach what optimal preparation would look like, and how she would measure successful attainment of that goal. However, during the session’s exploration phase, Tina realizes that based on recent statements and interactions, her supervisor does not fully trust her. She also recognizes that she accepted her position with the presumption that she was trusted, based on her resume and stellar reputation. Then, Tina discovers a critical insight: that presumed trust is a non-negotiable standard for her, and without it, performance feedback is irrelevant, and trying to enhance that job is pointless. This dramatically changes Tina’s approach to action planning. Instead of finding ways to be optimally prepared for her review, she focuses on using the meeting to discuss trust issues with her boss, and designs action steps to create that conversation.

featurearticle What Else Makes Coaching Distinct? Another distinction of coaching lies in its purpose: to help clients achieve ambitious goals, through a strengths-based, developmental approach in which individuals design their own agendas and actions and decide who can be trusted to realize their desired outcomes. Since coaching is growthfocused rather than problemfocused, it is a more accessible, desired, and relevant to a larger pool of potential clients, especially compared to counseling (Steele, 2011). Utilization rates for counseling frequently drop as employee ranks increase. This has been historically true and is consistent at my university EAP, where until recently, the majority of clients consisted of lower-level staff and junior faculty. However, senior managers and executives often don’t merely accept coaching — they expect it. This represents a potential “ace up the sleeve” for EAPs: offering coaching services engages historically underserved, often high-value employees such as executives, emerging leaders, high performers, tenured or tenure-track faculty (in academic settings), and physicians, many of whom would rarely contact an EAP for other services. At the University of Southern California (USC), staff from USC’s internal EAP, the Center for Work and Family Life (CWFL), coached 110 physicians at our academic medical center in six years between 2011 and October 2017. In the six years prior to 2011—and prior to the introduction of coaching services—the center opened just 23 total cases for physicians.

This represents a significant increase, and the number of persons seeking coaching continues to grow as individuals refer their colleagues for coaching. This finding is consistent with ICF research, in which managers were cited by survey respondents as the group most often seeking coaching (mentioned by 29% of participants). Almost one in four respondents (23%) said they mainly coached executives (ICF, 2016). How Do I “Press Play”? Technically, you can brand yourself as a coach—or offer coaching services through your EAP—immediately. However, this approach will create two problems. First, if clients ask about your credentials or training, you will have no real coach-specific training to cite. Coaching does overlap with counseling and other services, and EA professionals can be quick studies, but without training in coaching competencies and practice in keeping your professional roles distinct, you will be using the label of coaching inaccurately. Instead, I suggest following these steps:  Obtain training. If you are based in the U.K. or elsewhere in Europe, you might want to take a look at the EMCC (http:// www.emccouncil.org/). It is a long-standing professional organization with high standards. For the U.S. and most anywhere else, ICF is the leading organization, and lists many accredited coaching training programs on their website (https://www. coachfederation.org). Some programs allow participants to complete training

quickly, while others are highly flexible and accommodating. One valuable factor of ICF-based training is mentor coaching, in which a trained and credentialed coach directly observes the work of trainees (through audio or video recordings) and follows up with the trainee for point-bypoint feedback.  Get credentialed. Credentialing is becoming increasingly more important in the coaching industry, with more clients and corporate sponsors starting to demand certification. ICF offers three levels of credentials with their respective requirements listed on the ICF website.  Build a program. Client selectivity is crucial to staffing and managing demand. One approach is to prioritize eligibility for the highest-ranking members of the organization, while another is to offer coaching to those with the potential to make the greatest impact (who may not be the highest-ranking employees). If your EAP has enough staff, you can broaden eligibility on a case-by-case basis to include clients in middle management and people with leadership or high-performance potential. Given limited eligibility, marketing of EAP-based coaching services must be targeted. You would not want to mass market services for which only a small population of employees will qualify.  Track your program. To thoroughly narrate the value of your EAP to stakeholders, you will need to track utilization and outcomes of coaching services.

 Expand your repertoire. Once your program is firmly established, you can expand your career with activities such as mentor coaching, coaching supervision, coach-as-manager training, etc. Since the industry has embraced services by phone and video conference, you can also try coaching in different settings, locations, and populations—without leaving your day job.

Summary If you remain unconvinced of the fit between EAP and coaching, here is a definition from EAPA’s website (EAPA, 2011): “In general, an EAP is a set of professional services specifi-

earoundup highly unlikely that an employer would be okay with a recreational marijuana user. Experts also agree that whether or not employers decide to test for marijuana prior to employment, having a clear, well-thought-out drug-testing policy addressing marijuana is a good idea.

More Mental Health Care Needed It is clear that there are many facets to the violence plaguing American society. One of them is undoubtedly the treatment of mental health and mental illness.

cally designed to improve and/ or maintain the productivity and healthy functioning of the workplace and to address a work organization’s particular business needs through the application of specialized knowledge and expertise about human behavior and mental health.” v Jason Sackett, LCSW, PCC, CEAP, regularly speaks to EA professionals about adding coaching to their skill set, and about increasing their program’s value with expansion into coaching services. He also serves as an internal coach and senior employee assistance professional for the University of Southern California, USC’s Keck Medical Center, and Children’s Hospital Los Angeles. He can be reached at jason@ solutionsmine.com.

References

Employee Assistance Professionals Association (2011). Definitions of an employee assistance program (EAP) and EAP core technology. Retrieved from http://www.eapassn.org/About/ About-Employee-Assistance/EAPDefinitions-and-Core-Technology International Coach Federation (2009). ICF global coaching client study: Executive summary April 2009. Retrieved from https://www.coachfederation.org/files/includes/media/docs/ ExecutiveSummary.pdf International Coach Federation (2016). 2016 ICF global coaching study. Retrieved from https://coachfederation. org/files/FileDownloads/2016ICFGlobal CoachingStudy_ExecutiveSummary.pdf Steele, D. (2011). From therapist to coach: How to leverage your clinical expertise to build a thriving coaching practice. Hoboken, NJ: John Wiley & Sons, Inc.

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The 2016 21st Century Cures Act made mental health services more affordable for families and provided new funding for research programs to develop best practices in mental health treatment. The law also includes key federal grants to increase the number of mental health providers nationwide and dramatically increases funding for suicide prevention programs, Fox News reports. But it is not enough. According to the Washington Post, there is only one psychiatrist per 1,807 children who need mental health services in this country. More than half of the counties nationwide do not have a practicing

psychiatrist, psychologist, or social worker. In addition to increasing the number of qualified mental health professionals to help students, parents, families, and those struggling with addiction or homelessness, funding Assertive Community Treatment (ACT) programs is also important, the Fox News report adds. ACT builds a network of staff, services, and treatment plans to care for individuals in need. Professionals trained in ACT specialize in psychiatry, social work, nursing, substance abuse treatment, and vocational rehabilitation. continued on page 33

featurearticle Integrating Mental Health into the Workplace |By Julie Marshall, PhD, CEAP; and Anna Meiners, MA

ne in six U.S. adults lives with a mental illness (National Institute of Mental Health). As a result, employers need a strategy that proactively integrates mental health into their overall wellness plans. EAPs are uniquely positioned to partner with employers in this endeavor because of the services they provide and the relationship they have with the employer. Simple interventions, which are typically already part of basic EAP services, can be implemented to normalize, educate, and increase awareness of mental health issues. This involves changing the dialogue to present mental health in relatable language and offering interventions for life experiences such as divorce, grief, or stress. For example, people are more willing to engage in the workplace on topics of managing change, resilience, self-care, and positive relationships than “coping with loss” or “depression”. EAP interventions such as on-site trainings (i.e. stress management or conflict resolution), introduction of promotional campaigns (i.e. sleep hygiene or resiliency), and supervisor support, further reduce stigma associated with a mental health issue. Beginnings In 2016, Cascade Centers decided to help our client compa-

nies proactively assist individuals who needed assistance but who were not engaging with the EAP or other mental health treatment. It was recognized that in most health promotion programs, a first step to individual healthy behavior is a risk appraisal. The barrier Cascade faced was that the tool needed was not available. Typically, assessing mental health has required taking multiple, time-consuming assessments. Not only is this cumbersome for the individual it does not provide employers a way to assess the aggregate mental health needs of their population. In response to this need Cascade developed the WholeLife Directions program and the WholeLife Scale™.

 Consultation with the employer to decide how they can include mental health into their overall wellness approach. It is helpful to explore ways the employer currently encourages people to stay healthy, what may have worked for them in the past, and their goals for participation.

Assessment and Intervention The WholeLife Directions program is comprised of four phases. Each phase focuses on a specific topic and has a three-month duration. The entire program lasts one year, with each year building on previous outcomes and experiences.

 A focused anti-stigma campaign, “Mental Health Isn’t a Choice”, is delivered. This campaign uses humor to educate employees on ways we’ve historically treated mental illness differently than physical health issues. For example, if someone breaks their arm they get immediate medical attention. However, if someone is depressed they may be told to “cheer up” or “snap out of it”.

Phase 1: Decrease Stigma and Assess Needs of the Population The introduction of the program focuses on decreasing stigma, increasing awareness of mental health issues, and assessment. The key components of this phase include:

 Engagement with leaders, who are encouraged to communicate their commitment and support for employees with mental health issues. Cascade provides customized messages that leadership can use to acknowledge the relationship between physical health and emotional well-being, encourage help-seeking behavior, and communicate EAP benefits.

 Administration of the WholeLife Scale™ (WLS), an easily accessible, reliable, and valid behavioral health risk assessment.

The WLS is a complete mental health appraisal that measures nine mental health domains: Anger, Stress, Depression, Anxiety, Relationship, Post-Traumatic Stress, Sleep, Substance Abuse, and Work Engagement. Cascade developed a 47-item assessment, which has been validated to measure each of the nine domains and asks users to answer the questions based on the last 30 days. Examples of questions include: “I thought I should cut down on my drinking or drug use”; “Stressful issues (family illness, financial setbacks, accidents) occurred in my life”; or “I woke up too early, or had trouble staying asleep”. The assessment takes 5-8 minutes to complete, is delivered through a user-friendly online HIPAA compliant platform, and is accessible online or through a mobile app.  A robust intervention following the assessment. Upon completion of the assessment, users are given an individual summary of their results. This provides a score for each mental health domain, an explanation of the score, and direction to recommended next steps. The next steps are determined based on the individual score and risk stratification (high, medium, and low). Those with high distress are directed to contact the EAP for intervention and counseling. Those with medium and low scores are guided to specific programs in Phase 2 of the WholeLife Directions campaign.  Aggregate data is used to understand the key mental health issues impacting the workforce. Once the employee population

has taken the WLS, data is compiled into an executive summary. This provides a snapshot for each domain, which identifies the most prevalent mental issues within the employee population. The role of the EAP is then to provide consultation and guidance for the remaining three phases (or nine months) of the campaign. Targeted interventions for specific mental health domains are outlined based on the aggregate data.

“What will motivate your client’s employees? In addition to traditional financial incentives, consider intangibles like celebrations, employee recognition, or extra paid time off. The goal is to reach as many employees as possible …”

 Web-based Cognitive Behavioral Therapy (CBT) programs are available to the individual user for each goal or domain identified in their WLS summary report. Each CBT program is broken into 5-10-minute sessions, which contain engaging, short, and accessible content. Tools include skill building, mindfulness techniques, and direction to EAP resources.  Resilience is targeted as an intervention during this phase. Webinars, interactive programs, and promotional materials are offered to the employer. Employees are encouraged to develop a personal resilience map and are offered interactive exercises through a module called “Resilience Journey”.  Resources are provided to employers based on areas of highest needs within the population. For example, if a significant percentage of the WLS scores indicated high distress in the depression domain, information would be shared about apps, podcasts, and treatment resources for depression.

The next three phases of the WholeLife Directions Program have an overall theme, in addition to highlighting one of the identified domains (listed previously as Anger, Stress, etc.).

Phase 3: Care for Others The next phase of the WholeLife Directions campaign focuses on caring for others, more specifically skill building for supervisors who are working directly with employees experiencing mental health issues.

Phase 2: Self Care This phase encourages individuals to utilize the EAPs recommended in their WLS summary report. The employer is also provided with tools that encourage selfcare and domain-specific resources.

 Supervisor support is crucial in supporting the needs of employees. Supervisors are sometimes the first in the organization to be aware of employee mental health issues. It is important that they receive training to recognize mental health issues

featurearticle in employees, and connect people with resources and response strategies in times of employee crisis.  Continued focus on stigma reduction is important. Employers are provided with a menu of promotional flyers to share, reducing myths associated with mental health treatment. The goal is to communicate treatment effectiveness, minimize shame, and reduce fears around help-seeking behavior. Domain-specific materials are also available, again focusing on areas of high distress within the overall population.  Users monitor their progress within the web-based CBT programs initiated in Phase 2. Individuals are encouraged to complete the programs through push notifications or emails. This is a proactive approach that enables the EAP to reach out to individuals who might not otherwise seek EAP services.

Phase 4: Maintaining Healthy Changes The fourth and final phase encourages continued healthy behavior change, ways for dealing with setbacks, and ideas for helping the employer in the future.  Employees are encouraged to maintain improvement. They are invited to attend a webinar about stages of change and how to cope with barriers that may arise. For example, people using new skills to manage depression may experience a setback due to life changes, unexpected financial stress, or health issues. The goal is to offer EAP resources when barriers to sustained change occur.

 Organizational support is provided to maintain momentum around the topic of holistic health. The EAP provides consultation and a menu of promotional flyers focused on continuous selfassessment and engagement with web-based CBT programs.

access during their work day to a computer? If so, electronic communication will fit nicely within their structure. If not, using other communication channels such as print media (posters, flyers, etc.), staff meetings, and on-site training will be important avenues to consider.

 Population-specific needs continue to be addressed. Meaningful reporting on employee engagement allows for adjustment or continued focus of domainspecific interventions. For example, if users are not accessing anxiety self-use programs on an individual level, yet an organizational (e.g. aggregate) report shows that anxiety is high within the employee population, we may implement renewed attention and additional promotional materials focused on anxiety.

 Overall wellness strategy. Have you reviewed your claims data, absenteeism/presenteeism rates, and current wellness program utilization and outcomes? Is there an issue in your population you are concerned about? What barriers to access exist? What current wellness vendors are you working with? How can the EAP partner, supplement or replace what you’re currently using? Helping employers understand their preferences, needs, and goals allows for a holistic approach. Mental health should be prioritized as part of an overall wellness plan. An assessment such as the WLS will provide the employer with thorough baseline data that can identify issues for employer intervention and help inform coordination with wellness and other vendors.

The WholeLife Directions program is designed to be easy to implement and take a minimal investment of time from employers. Employers are encouraged to use the program over multiple years to track progress through a year-to-year comparison. Designing a Program Whether EAPs implement a program like the WholeLife Directions or design one of their own, there are specific elements to analyze for successful implementation:  Company environment and culture. What are the business’s needs? What are the employee demographics? What are successful communication channels used by the employer? Collecting this information will help prioritize specific areas. For example, does most of the employee population have

 Organizational support and engagement with leadership is key. Is there a personal or organizational connection to this topic? Who can serve as a champion to encourage participation, communicate benefits, and reinforce efforts towards positive change? Leadership buy-in is essential to help decrease stigma and increase engagement in EA programs. Ask a leader in the company if they are willing to lend their endorsement or share why the topic of mental health is important to them. Maybe it is a brief description of

their own journey, how they have supported a friend or family member who has struggled with mental health issues, or simply what motivates them to live a holistic healthy life.

before they receive an accurate diagnosis and many never receiving treatment (Kohn, Saxena, Levav, & Saraceno, 2004). Utilizing new EAP tools for assessment and intervention can shift this paradigm. Prevention and early intervention is now possible. v

 Provide incentives. What will motivate your client’s employees? In addition to traditional financial incentives, consider intangibles like celebrations, employee recognition, or extra paid time off. The goal is to reach as many employees as possible and incentives help give that extra push to encourage participation. Cascade has found that providing even small incentives to participants significantly increased utilization of the WLS.

Julie Marshall, Ph.D., CEAP, oversees the administrative operations of Cascade and guides new product development in the area of behavioral health. In addition, she provides consultation to organizations in the areas of crisis management, behavioral health wellness, and organizational development. She can be reached at jmarshall@cascadecenters.com. Anna Meiners, MA, is currently the Director of Account Services at Cascade. Her experience in the mental health field includes provision of direct clinical services, wellness program development and consultation in all areas of Employee Assistance Services. Anna is an experienced presenter on the topic of mental health integration into the workplace.

 Emphasize confidentiality. A big concern with EAP participation in mental health treatment involves concerns about privacy. As a result, communicating the steps that are in place to protect personal health information is crucial. This can include distributing FAQ documents, and educating employees interested in serving as mental health advocates within the employee population.

References

Any mental illness (AMI) among adults. (n.d.) National Institute of Mental Health. Kohn, R., Saxena, S., Levav, I., Saraceno, B. (2004). The treatment gap in mental health care; Bulletin of the World Health Organization, 82; 858-866.

Summary Employee Assistance Programs are in a unique position to help employers integrate mental health into workplace wellness programs and safety initiatives. EAP services go beyond crisis, and low utilization does not have to be the norm. Partnering with employers to increase awareness of mental health issues, normalize help-seeking behavior, and reduce stigma is a crucial step in improving employee quality of life. The research is clear that mental health issues are costly to employers. It is important that organizations recognize that with the involvement of the EAP, support and intervention is available to reduce these costs. Customized programming, consultation, and organizational support are essential elements. Providing reports to demonstrate value is also key. This includes not only traditional utilization reports, but also measures on outcomes (such as the Workplace Outcome Suite, which we use), engagement with population-specific programming, and yearto-year comparisons. When it comes to employee health, the need to address wellness holistically has never been so important. Mental health issues are highly prevalent, with most people experiencing symptoms for years

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webwatch Disability Inclusion Job Accommodation Network Webcasts https://askjan.org/webcast Available at no cost, JAN webcasts educate managers, employees, and others on disability etiquette, technologies, management techniques, and the latest on accommodations and employment provisions of the Americans with Disabilities Act (ADA). Employee Benefits Employee Benefit Adviser www.employeebenefitadviser.com Workplace benefit news for advisers, brokers, and consultants – also tools for business growth and development. Mental Health Getting Started with Mindfulness https://www.mindful.org/meditation/mindfulness-getting-started/ You want to try mindfulness meditation but don’t know where to start? This site shows you how. Mental Health Mental Health By The Numbers https://www.nami.org/learn-more/ mental-health-by-the-numbers A statistical service of the National Alliance on Mental Illness (NAMI), this site contains quick, easy-toread stats and infographics about the prevalence of mental illness. Mental Health Psych Central https://psychcentral.com/ Since 1995, this award-winning website has been run by mental health professionals offering reliable, trusted information and over 250 support groups to consumers. Mental Health Speaking About Depression Community Blog

https://speakingaboutdepression. wordpress.com Established by Patricia and John Gallagher, this blog is a safe community where anyone can talk about the effects of depression on their lives. Links include a depression FAQ, lifting the spirits of the elderly, and share your story. Sexual Assault A Call to Men http://www.acalltomen.org/aboutus/our-vision/ A Call to Men is a violence prevention organization and respected leader on issues of manhood, male socialization and its intersection with violence, and preventing violence against all women and girls. Sexual Assault National Sexual Violence Resource Center https://www.nsvrc.org/ The NSVRC believes in the power of information, tools, and people. Links include e-learning, library, projects, and more. Sexual Assault RAINN https://www.rainn.org/articles/ sexual-harassment Where can users learn more about sexual assault? What public policy and action is available? What about safety and prevention? This site includes links like these, and others. Sexual Assault Select Task Force on the Study of Harassment in the Workplace https://www.eeoc.gov/eeoc/task_ force/harassment/report.cfm This comprehensive report, released in 2016, presents information on areas such as employee responses to harassment, risk factors for harassment, and many more.

Stress Management American Institute of Stress https://www.stress.org/workplacestress/ Numerous studies show that job stress is far and away the major source of stress for American adults and that it has escalated progressively over the past few decades. This site includes surveys, reports, and findings. Substance Abuse The Fix https://www.thefix.com The Fix is a leading website about addiction and recovery, featuring breaking news, exclusive interviews, investigative reports, essays, blogs on sober living, and more. Technology The AI Revolution: The Road to Superintelligence https://waitbutwhy.com/2015/01/artificial-intelligence-revolution-1.html This site takes an interesting look at time and progress. Technology PsyberGuide https://psyberguide.org There are thousands of mental health apps. This site helps users choose the right ones. The site features a product guide. Technology Internet World Health Research Center http://health.ucsf.edu The mission of this organization is to harness the power of technology to reach those most in need of effective interventions that can be administered via the Internet or a mobile device. continued on page 34

earoundup Fewer Refills, Higher Doses Recommended A recent study published in the BMJ (British Medical Journal) suggests that the key to decreasing rates of addiction causes by prescribed painkiller medications may be to provide fewer refills, and offer higher dosages of the painkiller. The study suggests that by ensuring the individual experiences less pain early on, they can overcome the need to continue taking the painkillers sooner than they would otherwise. According to the study, ensuring the individual did not need to be on the medication for too long would decrease the likelihood that they engage in substance abuse or become addicted. The study revealed that when a patient was prescribed an opioid painkiller medication, the likelihood that they would engage in abuse of that substance increased by 20% for each additional week of taking the medication. Furthermore, each time an opioid painkiller medication prescription was filled, the likelihood that the individual would engage in abuse increased by 40%.

Many Firms Expanding Wellness Benefits Companies that aren’t focusing on employee health and wellness should make a point of doing so. In a recent survey from staffing firm OfficeTeam, two-thirds of HR managers (66%) reported their organization has expanded

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their health and wellness offerings in the past five years. And these efforts haven’t gone unnoticed: 89% of workers said their company is supportive of their wellness goals. Some additional findings from the survey: Employees cited food at office celebrations (30%) and snacks brought in by colleagues (22%) as the biggest obstacles to meeting health and wellness goals. HR managers were also asked to name the most innovative thing they’ve heard of a company doing to support employee health and wellness. Here are some of their responses: • Paying employees extra money if they don’t check work email while on vacation; • Offering on-site exercise, meditation, yoga, and healthy cooking classes; • Providing free massages; • Having a nurse’s department in the office; • Giving workers fitness tracking devices; and • Offering on-site personal trainers.

Certain Environments Lead to Substance Abuse The use of cocaine and other drugs has been called the hospitality industry’s “dirty little secret.” However, restaurants and hotels aren’t the only ones with a substance problem, nor is it limited to Europe or the U.S. For instance, in South Africa, there are numerous industries that are synonymous with frequent and

regular use of mood and mindaltering substances, such as alcohol and other drugs, reports the Cape Argus. Other industries that display a tendency toward substance abuse include the financial sector, which includes banks, insurance companies, investment houses, and call centers. The common link is that each of these fields requires a high degree of customer service, which can be incredibly stressful for employees due to customer dissatisfaction, complaints, and rudeness. This creates an unpleasant environment in which employees just have to “take it” and placate customers who might be unreasonable. As a result, workers might be tempted to turn to mood-enhancing drugs to boost their confidence and help them cope with stress. Long hours are another contributing factor, as many employees in the hospitality and call center professions work long, monotonous shifts, sometimes well into the early hours of the morning. To fight drowsiness, substances such as methamphetamine, cocaine, and energy drinks spiked with vodka are popular. Many businesses address this problem through effective policy enforcement, frequent drug testing, and adjusting the environment in which employees are required to work. For example, some workers benefit from rehabilitation, therapy, or even a lighter, less stressful workload. In such instances, the employee is often able to perform better, knowing that they have the support of their employer. v

letters Therefore we could show to the company a “return on investment”. So, the Job Performance model accompanied by the Assessment, Referral, and Follow-up process began with NCA. Next came the establishment of ALMACA under the promotional efforts of Ross Von Wiegand and the NCA. Ross invited several people to attend a meeting, which preceded the NCA convention at Los Angeles in June 1971. It was my privilege to attend this meeting with 23 other men. During the first day we were asked if we would like to form an organization – separate from NCA. The answer was a resounding, “Yes”. At the end of that day it was suggested that we spend some time in the evening (not in the group) trying to come up with a name. After dinner Ed Johnson,

webwatch Coaching International Coach Federation https://coachfederation.org/ ICF is advancing the coaching profession so coaching becomes an integral part of society. Members lead this journey by representing the highest quality in professional coaching. Mental Health Fresh Hope https://freshhope.us/ Fresh Hope is based upon six tenets/principles seen as a foundation for living well in spite of a mental health diagnosis. The

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of Firestone, and I spent an hour or so working on a name. (We enjoyed the process.) The next morning the group unanimously chose the ALMACA name. We then elected Frank Huddleston of Hughes Aircraft as our first president. Of the 22 attendees, 18 of us became the inaugural members. Many of the programs operated by the founders of ALMACA used the Job Performance model, which was presented at all early meetings of this new organization as the only practical, viable, method of operating a corporate program. On a personal basis I was hired by Merrill Lynch In January of 1971. I had been under the tutelage of Ross and Don Phillips. I have a profound sense of gratitude to both of them. That put me in a position to become one of the founders of ALMACA (EAPA today).

Also in 1971, Don left NCA to join Will Foster at NIAAA. Don brought all the information that had been developed at NCA on the Job Performance model. When they were making preparations for the “Thundering 100” they were trying to give the model some “sizzle”. (I was fortunate to be asked to attend one of the preparatory meetings of their efforts to plan out the activities of this new venture.) They called this new effort, “the Broadbrush” method. However, everything they used came from NCA. Credit then, at least in the context of the process followed by NIAAA should be given to Lew Presnall, Don Phillips, and NCA. v Don Sandin, EAPA member Emeritus

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tenets/principles are for both the person who has a diagnosis as well as for the loved ones of those who have a diagnosis. Sexual Assault The ManKind Project https://mankindproject.org The ManKind Project (MKP) is a global brotherhood of nonprofit charitable organizations [501 (c) (3) in the US. It supports a global network of over 1,000 peer-facilitated men’s groups serving close to 10,000 men each week. In an MKP men’s group, men mentor men through the passages of their lives.

Workplace Bullying Civility Partners http://civilitypartners.com Civility Partners offers a variety of civility consulting services in order to effectively eradicate workplace bullying and create a positive workplace. v

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