Journal of Employee Assistance Vol. 49 no. 3 - 3rd Quarter 2019 by Employee Assistance Professionals Association

The magazine of the Employee Assistance Professionals Association

3rd Quarter 2019 | VOL. 49 NO. 3

Transgender Support Part I

|Page 6

Bonus! Read Cover Story for PDH!

PLUS:

Guidelines for Transgender Employees Page 10

The EAP Role in Fitness for Duty Page 22

Digital Archive Notes 6th Anniversary Page 28

Plan to Attend EAPA 2019 St. Louis Conference & EXPO

St. Louis Union Station Hotel, Curio Collection by Hilton St. Louis, Missouri, USA

Main Conference

Wednesday, September 25 â&#x20AC;&#x201C; Friday, September 27 Pre-Conference Sept 23-24 | EXPO Dates Sept 24-26 eapassn.org

contents EAPA Mission Statement

3RD Quarter 2019 | VOL. 49 NO. 3

cover story

Transgender Support (Part I)

| By Robin Sheridan, JD, MILR; Heather Mogden, JD

No court has definitively held that gender dysphoria (GD)—the diagnosis associated with transgenderism—is a disability under the Americans with Disabilities Act (ADA), but several federal courts have said it could be, which is legally significant. Moreover, when a client suggests that workplace barriers exist due to GD, EA professionals will want to keep a number of things in mind.

features

Best Practice Guidelines for Transgender Employees

| By Carolyn Ruck, LCSW

How should employee assistance professionals respond when an employee requests workplace support while fulfilling the final steps of a gender transition process? EA professionals are able to highlight the importance of organizational inclusiveness, make the business case for it, and find ways to untangle organizational webs of fear and uncertainty.

Conflict Management Services

| By Janeen Haller-Abernethy, LCSW;

Matt Steinkamp, LCSW; & Jeremiah Dahlen, LPC, CEAP

Beginning with a micro-focus on conflict management skills for individuals and expanding the lens to view team strategies for processing conflict, this article will use a case study to demonstrate the efficacy of EAP conflict-focused servicesofor both employees and employers.

features

The EAP Role in Fitness for Duty Determinations

| By Katie E. Connell, PhD, ABPP

Engaging the employer in a dialogue about what employee behaviors they have observed, whether safety concerns are present, and what actions they have taken can assist in navigating an anxiety-provoking situation and clarifying next steps.

Digital Archive Notes 6th Anniversary

| By Jodi Jacobson Frey, PhD, LCSW-C, CEAP; Patricia A. Herlihy, PhD, RN; & Alaina Kahn, BA Having a single, online, free, and permanent public place to store and share historical and current papers, presentations, and other multi-media materials about the EA field generates considerable interest and support. Currently, there are over 3,300 unique submissions from over 400 authors.

departments 4 FRONT DESK 8 TECH TRENDS 20, 21, EA ROUNDUP 32, 34 18 INTEGRATION INSIGHTS 26, 27 LETTERS 34, 35 WEB WATCH

To promote the highest standards of practice and the continuing development of employee assistance professionals and programs. 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 Patt Manda at development@eapassn.org. Send requests for reprints to Debbie Mori at d.mori@eapassn.org. ©2019 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: Patt Manda Designer: Laura J. Miller, Write it Right LLC

Index of Advertisers ASAP....................................................7 EAPA Plan to Attend.........................IFC EAPA Best Value Package................BC Harting EAP..........................................5 KGA, Inc.............................................17 SAPlist.com....................................9, 23 IFC: Inside Front Cover BC: Back Cover

3 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

frontdesk Offering Guidance on Transgender Support Issues | By Maria Lund, LEAP, CEAP

growing number of employees are dealing with transgender issues in the workplace. This provides opportunities for EA practitioners to offer assistance and guidance for both employees and employers as they navigate complex issues that might arise. In the cover story, Robin Sheridan and Heather Mogden discuss the legal ramifications of “gender dysphoria” – also known as GD; the diagnosis associated with transgenderism. In addition to explaining legal aspects of GD that EAPs should be aware of, especially as it pertains to the Americans with Disabilities Act (ADA). This article has important and specific information to use in your practice. By reading it and answering a 5-item multiple choice quiz you can earn one free PDH. View and take the quizt at https://tinyurl.com/y6zysjv2. In a closely related article, Carolyn Ruck describes an EAP response when an employee requests workplace support while undergoing the final stages of a gender transition process. Carolyn illustrates her ideas with a case study that describes how a transgender disclosure was handled in the workplace.

Fitness for Duty Evaluations (FFDEs) are another workplace issue that can be tricky for an EA professional to navigate. Katie Connell provides an indepth framework for identifying when an FFDE is appropriate, situations that may lead to an FFDE, and how to best work through the complex FFD process. Elsewhere in this issue of the JEA, Janeen HallerAbernethy, Matt Steinkamp, and Jeremiah Dahlen discuss the numerous methods EAPs can use for resolving conflicts in the workplace. Conflict is a disruptive and pervasive problem in many workplaces and employers are seeking assistance and relief. Meanwhile, Jodi Jacobson Frey, Patricia A. Herlihy, and Alaina Kahn bring readers up to speed on the International Employee Assistance Digital Archive. This important resource was established in 2013 and functions to store and preserve historical documents, papers, presentations, and other materials related to the EA profession on a publicly accessible website. Technology is an increasingly important element of our EA practices, and Tech Trends columnist

Marina London discusses the opportunities that chatbots present for our profession. Finally, we would love to hear your thoughts about the new, all-digital JEA. Comments are always welcome on EAPA’s LinkedIn page or via email at journal@eapassn.org. As always, 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

Andrea Lardani – Buenos Aires, ARG andreal@grupowellnesslatina.com

Peizhong Li – Beijing, China lipeizhong@eapchina.net

John Maynard – Boulder, CO johnbmaynard8@gmail.com

Bernie McCann – Waltham, MA mccannbag@gmail.com

Igor Moll – Al Den Haag, the Netherlands igormoll@me.com

IS EXCITED TO RELEASE

CHECK OUT OUR NEW WEBSITE! Empowering EAP Professionals with innovative, secure tools that validate their positive impact on employees and their value to the company.

HARTING EAP 4972 Benchmark Centre Drive Suite 200 Swansea, Illinois 62226

SCHEDULE A DEMO Toll Free: 1-800-782-6785 Phone: 618-632-3145 5 Email: sales@hartingeap.com

| W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

HartingEAP.com

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

coverstory Transgender Support (Part I) Is Gender Dysphoria a Disability under the ADA?

| By Robin Sheridan, JD, MILR; & Heather Mogden, JD

o court has definitively held that gender dysphoria—the diagnosis associated with transgenderism—is a disability under the Americans with Disabilities Act (ADA), but two federal courts in Massachusetts and Pennsylvania have said it could be, which is legally significant. The parties in those cases have settled their disputes, so there may not be a final answer in the near future, but the idea that a transgender employee’s ADA claims can survive early dismissal will likely impact how readily employers provide reasonable accommodations on the basis of gender dysphoria. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced the term gender dysphoria (GD) as a diagnosis for people whose gender at birth is contrary to the gender with which they identify. This diagnosis, revised from gender identity disorders in the DSM-IV, requires attendant disabling physical symptoms, in addition to manifestations of clinically significant emotional distress. The ADA defines disability as a physical or mental impairment that substantially limits a major life activity, a record of such an impairment or being regarded as having such an impairment. The ADA specifically excludes from this definition “gender identity disorders not resulting from physical impairments.” (Editor’s note: Discrimination is further defined at the conclusion of this article.)

tions that are not considered disabilities and which shows at least arguable animus toward transgender persons. For instance, rather than grouping gender identity disorders in subpart (a) with homosexuality and bisexuality, the ADA groups gender identity disorders in subpart (b) with pedophilia, voyeurism, kleptomania, pyromania, and illegal drug use. Assuming the exclusion is constitutional, transgender plaintiffs have pointed to physical impairments underlying GD to distinguish the diagnosis from excluded “gender identity disorders not resulting from physical impairments.” For example, the plaintiff in the Massachusetts case mentioned earlier described GD as a physiological disorder or condition affecting the endocrine system because a person born with GD has circulating hormones inconsistent with their gender identity. Transgender persons who transition from their birth gender to their gender identity require lifelong medical treatment, including the administration of male or female hormones, which leaves them incapable of reproduction—a major life activity. The Pennsylvania plaintiff additionally argued that the condition substantially limits other major life activities such as interacting with others and social and occupational functioning. Those courts found that the asserted characteristics of GD could satisfy the ADA definition of a disability and denied the defendants’ motions for dismissal based on the ADA exclusion of gender identity disorders. So far, only an Ohio federal court has disagreed, finding instead that gender dysphoria falls squarely within the ADA’s disability exclusion. In terms of what is trending, it is worth mentioning that the argument that GD is a disability is consistent with the fairly well-known body of case law holding that prison officials engaged in cruel and unusual punishment of transgender prisoners (in violation of their Eighth Amendment rights), when the officials denied them hormone therapy and/or gender reassignment surgery, which the courts interpreted as a denial of necessary medical care to treat a diagnosed condition.

Is Exclusion Constitutional? Notably, there is an open question as to whether this exclusion itself is unconstitutional because it discriminates against transgender persons—a historically marginalized group. Without deciding the issue, courts have noted that “the continuing re-evaluation of GD underway in the relevant sectors of the medical community” is quite different from “gender identity-based disorders as they were understood by Congress twenty-eight years ago,” when the ADA was enacted. The constitutionality argument is based in part on the ADA’s two-part exclusion list, which identifies condi6

Additionally, the U.S. House of Representatives recently passed a bill that would specifically add sexual orientation and gender identity to federal anti-discrimination laws, though the bill is not expected to become law. A change in law may not be necessary, however, as the United States Supreme Court is slated to decide in its 2019-2020 term whether employees are currently protected from discrimination on the basis of sexual orientation and gender identity under existing bans on discrimination on the basis of sex. The point is, the trend, both socially and legally, is leaning toward recognition and resolution of unique transgender issues.

in this regard, helping to build the relationship between the organization and the transgender employee. NEXT TIME: ADA requirements and assisting clients in interactive accommodation discussions. Summary This article is educational in nature and is not intended as legal advice. Always consult your legal counsel with specific legal matters. If you have any questions or would like additional information about this topic, contact Robin Sheridan, (414) 721-0469, rsheridan@hallrender.com; or Heather Mogden, (414) 721-0457, hmogden@hallrender.com. v

When a client suggests that workplace barriers exist due to GD, EA professionals will want to keep a few things in mind:

Editor’s note: This article addresses the question of whether gender dysphoria is a disability under the ADA. The reader should note, however, that discrimination based upon sexual identity, sexual orientation, etc. is prohibited under many states’ fair employment laws, as well as in a growing number of federal jurisdictions.

Maintain Confidentiality Like any other disability-related diagnosis, gender dysphoria is not to be disclosed or discussed by the EA professional or the employer—even when, and regardless of whether, it may seem to be public knowledge within the organization. Situations may arise where employees’ legal, financial, or work documents reflect their birth name, but they prefer to be identified socially by a different name altogether. If an employee requests that his or her file reflect a name different from his or her legal name, the lowest risk option is to accommodate the request and maintain the confidentiality of the discrepant legal and financial documents.

Robin Sheridan and Heather Mogden are attorneys 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.

Use the Right Pronouns A person who was born a man but identifies as a woman is called a transgender woman and goes by “she.” A person who was born a woman but identifies as a man is called a transgender man and goes by “he.” Always use the pronoun for the gender with which the employee identifies. Using the wrong gender pronoun is called misgendering, and, as one expert explained, “misgendering transgender people can be degrading, humiliating, invalidating, and mentally devastating.” Intentional misgendering, and even persistent accidental misgendering, could form a basis for claims of harassment, discrimination, and creation of a hostile work environment. Interactive training, applicable to all levels of employees and managers, can help organizations avoid issues with misgendering. EA professionals can provide critical assistance to an employer’s proactive approach 7 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

techtrends Chatbots: Opportunities for EAPs? | By Marina London, LCSW, CEAP

his past February, I came across an article in Fast Company by Ciara Byrne, “Could talking to a bot help you feel better?” It provided a good summary of the history and current state of the art of chatbots, as well as their promise. Not much about their downside.

in private. This phenomenon became known as “the ELIZA effect.” Today we are surrounded by chatbots and voice analysis apps, a growing number of which are geared toward improving how we feel. Aimed at users who suffer from anxiety, depression, bipolar disorder, PTSD, or simply from stress, chatbots claim to be able to identify the mood or condition of the user, and in many cases can also offer advice or suggest therapeutic exercises.

To summarize the article’s key points: One of the world’s first chatbots was a therapist. Built in 1964, the program, called ELIZA, was designed to mimic techniques from Rogerian psychotherapy where the therapist prompts the patient to examine their own thoughts and feelings. ELIZA had no memory or understanding of the conversation. It merely searched for a keyword in the last sentence typed in by the interviewer and calculated an answer using a rule associated with the keyword.

Chatbots for Substance Use Addicts There are even chatbots for substance use disorders. In 2017, in response to the opioid epidemic, the media conglomerate Viacom launched a corporate responsibility initiative called “Listen,” which aimed to change the national addiction conversation. Kodi Foster, a senior vice president of data strategy at Viacom, thought that “Listen” could do more than make public service announcements.

Here is an example: Well, my boyfriend made me come here. Eliza: YOUR BOYFRIEND MADE YOU COME HERE.

Foster knew that messaging apps were continuously increasing in popularity and that therapy over text message had been shown to encourage people to share uncomfortable information. Research from the University of Southern California’s Institute for Creative Technologies, had found that U.S. veterans returning from Afghanistan were more willing to disclose symptoms of PTSD to a virtual interviewer.

He says I’m depressed much of the time. Eliza: I AM SORRY TO HEAR YOU ARE DEPRESSED. It’s true. I am unhappy. Eliza: DO YOU THINK THAT COMING HERE WILL HELP YOU NOT TO BE UNHAPPY.

So Foster partnered with a tech company called Stndby to build a chatbot for addicts and supporters, accessible via a website. The chatbot, which interacted with users via text message, was designed to detect long-term personality traits, measure short-term psychological states, and offer support and therapeutic exercises accordingly.

I need some help. That much seems certain. Even though Eliza’s responses seem almost comically Rogerian, many users became convinced that ELIZA understood them. Users would often demand to be permitted to converse with the system 8

As with ELIZA, many users had emotional interactions with this chatbot and thanked it for its help. One participant struggling with domestic problems and opioid abuse even sent the bot photos of her vacation at Disneyland with her children. “Hey, I know you are not real but I just wanted to send these pictures of my family out at Disneyland having a great time,” the user told the bot. “I’m doing better now. Thank you.” Rauws Unveils Tess At EAPA’s 2018 Conference and EXPO, Michiel Rauws, the CEO of X2AI, demonstrated “Tess” a chatbot initially created to provide mental health support in parts of the world where professional counselors are in short supply or even nonexistent. Michiel now wants to partner with EAPs to offer “Tess” to employees and their dependents. Tess is not designed to replace EAP counseling but rather to be offered as an adjunct service, whether to tide EAP clients over with support while they wait for their face-to-face sessions or even as they wait for a referral. Tess could even help employees self-identify as needing employee assistance services. For all of the supposed benefits of mental health and counseling bots, critics have questioned their safety and point to a lack of regulation. Others have wondered if a reliance on bots and screens might deprive people of the benefits of real-life communication and connection. The

concerns about connection coincide with a rise in loneliness. Recent research on the placebo effect suggests that the effect may actually be a biological response to an act of caring. A recent study explains that human beings “evolved in an environment which did not require them to distinguish between authentic and simulated relationships.” So when people interact with a nonhuman listener, they may feel as though they are dealing with a sentient being who cares about them. Although Tess users are explicitly reminded that she is not a real person, they act as if she is.

mental health care firms. She can be reached at m.london@eapassn.org.

References

https://www.fastcompany.com/90299135/ mental-health-crisis-robots-chatbotslisteners http://www.iwebu.info/2019/02/web-secret561-talking-to-machines.html. Journal of Employee Assistance Q1 2019 X2 AI Tess: Working with AI Technology Partners, by Michiel Rauws, MscBA; John Quick, PhD; Nancy Spangler, PhD, OTR/L & Angela Joerin, MS, LLP. Breakout session at the 2018 EAP Conference and EXPO: “Artificial Intelligence: Delivering Affordable, On-Demand, and Evidence Based Support to Millions of Employees” parts 1 and 2 can be viewed here: https://eapa.sclivelearningcenter.com/ MVSite/MVStore.aspx?confID=3211

At the end of the Fast Company article, the author notes: “In a society where people seek constant validation via social media, yet feel chronically lonely, can non-human listeners ease our sense of isolation and the problems that result from it, or could these listeners become the ultimate ‘online only’ friend, addressing our basic human need for connection and caring in a way that ultimately leaves us even more alone?” Food for thought given that other forms of artificial reality are right around the corner. v Marina London is the Director of Communications 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

9 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle Best Practice Guidelines for Transgender Employees | By Carolyn Ruck, LCSW

ow should employee assistance professionals respond when an employee requests workplace support while fulfilling the final steps of a gender transition process? In the past decade many organizations have gained a greater understanding of how diversity impacts workplace culture and the financial bottom line. Yet, when employers call for guidance with transgender workplace issues, apprehension remains. When facing gender transition in the workplace, the EAP offers a great resource because employers recognize a critical need for information and collaboration. Most often, it is the lack of clarity that proves problematic for the transitioning employee, and risky for organizational well-being at all levels. Lack of awareness, vague policies, and the absence of diversity programs and management training can be stressful and costly for an employer. An employee’s gender change disclosure, if not handled well, can lead to any combination of complaints, interpersonal conflicts, rumors, or claims of a hostile work environment, harassment or discrimination. Conversely, EAP guidance can enlighten and ease the organizational adjustment process. An experienced consultant can offer understanding and information about the unique personal issues faced by the transitioning employee. EA professionals can coordinate discussions and educational options for top leaders, managers, and staff as well as offer human resource guidance about organizational issues that will likely arise when Jim transitions into Joanne, or vice versa.

until its reclassification as gender dysphoria in 2013, with the release of the DSM-5. The diagnosis was reclassified to better align it with medical understanding of the condition and to remove the stigma associated with the term disorder (Fraser et al, 2010; Bryant, 2018). The American Psychological Association (APA) permits a diagnosis of gender dysphoria if the criteria in the DSM-5 are met. The DSM-5 states that at least two of the following criteria for gender dysphoria must be experienced for at least six months in adolescents or adults for diagnosis (American Psychiatric Association, 2013): • A strong desire to be of a gender other than one’s assigned gender; • A strong desire to be treated as a gender other than one’s assigned gender; • A significant incongruence between one’s experienced or expressed gender and one’s sexual characteristics; • A strong desire for the sexual characteristics of a gender other than one’s assigned gender; • A strong desire to be rid of one’s sexual characteristics due to incongruence with one’s experienced or expressed gender; and • A strong conviction that one has the typical reactions and feelings of a gender other than one’s assigned gender. In addition, the condition must be associated with clinically significant distress or impairment (APA, 2013). A Process That Requires Organizational Attention and Planning Historically, many transgender persons would change jobs rather than staying on a job facing discrimination, harassment or termination due to being non-gender conforming.

Definition In the Diagnostic and Statistical Manual (DSM) used by mental health professionals to diagnose psychological conditions, the diagnostic label gender identity disorder (GID) was used by the DSM 10

However, recent trends suggest that individuals who identify as transgender are increasingly willing to risk “coming out” at work. When a transgender person, usually after years of internal angst, decides to undergo complete gender transition, the results are impossible to conceal at work. Consider how this level of disclosure compares with other employees who choose when and how to reveal personal information at work, including sexual orientation. Transgender persons who plan to remain with their employer while transitioning don’t have that option. A transgender employee is obligated to “come out” to his/her employer in order to comply with treatment requirements to live full-time in his/ her new gender role for at least one year before irreversible surgery. Employers become involved in the gender transition out of necessity. Many workplaces have been emerging from an unspoken “don’t ask don’t tell” culture towards inclusiveness and respect for differences. Misinformation and misperception about transgender persons can cloud effective organizational responses.

transgender persons can be heterosexual, homosexual, bisexual or asexual. Gender identity is who a person is. It is not descriptive of the individual’s sex life. FACT: When a male-to-female transgender person presents as a woman, she should be regarded as a woman, just as a female-to-male transgender person should be regarded as a man. FACT: Genital surgery is one way to align physically on the outside with what has always been felt/ experienced on the inside. The process may include psychotherapy, living as the other gender, taking hormones, re-socialization, and other adjustments. Although there are transgender persons who have surgery and do not take hormones, and vice versa. FACT: Gender and sexuality exist on a spectrum of physiological and psychological characteristics. Research indicates that throughout history there have been people whose internal gender identity was different from their birth gender. Best Practice Guidelines The following are best practice guidelines regarding transgender issues in the workplace. While specifically designed for managers and human resource representatives – they are also recommendations that EA professionals should be aware of.

Facts to be Aware Of The facts in the following section are based on my clinical and consulting experience and the Human Rights Campaign. FACT: Transgender persons experience a significant amount of discrimination because of their gender identity or expression. Some are also targets of homophobia and hate crimes whether they are samesex oriented or not.

 When meeting with the transitioning employee, keep an open mind and acknowledge your own level of experience. Ask questions and express a willingness to learn, adapt, and support.

FACT: Transgender persons who announce their transition at work will generally not be out of work right away if they decide on genital reconstructive surgery. This often comes at a later time when they will be asking to be identified as the new gender and new name, use gender appropriate restroom, etc. when they first come to HR.

 Review current company polices for addressing harassment and discrimination. Should employee relationship issues arise, these documents will help guide your responses.

FACT: A gender transition is a long process with workplace disclosures generally occurring at later stages.

 Include corporate legal counsel throughout the transition process. You’ll need to know which state, county or city laws may apply to employment actions involving the employee. Remember that a transitioning employee needs to provide consent prior to the organization disclosing even limited personal health information.

FACT: Gender identification is NOT the same thing as sexual orientation. Just like anyone else,

 Obtain time frames from the transitioning employee in order to determine company timelines 11

| W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle regarding joint bathroom use. Consider suggesting an EAP referral to help that individual adjust to workplace realities.

for responding to changes (e.g., Jim plans to return as Joanne after medical leave of absence in early October). Most employers coordinate leader and staff trainings prior to the employee’s return to work.

 Remind staff that their transgender co-worker is still essentially the same person. Encourage the same levels of work and social interactions.

 Strive for endorsement of company anti-harassment and respect policies from the top down. Once the tone of acceptance and respect for diversity is established and conveyed by key leaders, front line supervisors are usually motivated to put policies into everyday practice. Unfortunately, even if an organization has specific policies covering protected classes; some claims of harassment and discrimination may bubble up from the front lines. This is why transgender-at-work training for managers and staff can be beneficial.

 Recommend education for organizational leaders first – before any training for line staff. Be aware that managers with little exposure to transgender issues may need more time to digest the information.  Determine which customers or vendors need to be updated about the change in gender. This includes “when” and “how.”  Plan for administrative and benefit updates to ensure they are completed by the day the transsexual employee begins appearing at work as their target gender. This includes health insurance and other benefit changes, photo ID, name in company directory, etc.

 Include the transitioning employee in most aspects of organizational planning and response. After all, you’ll be involved in some very personal disclosures. Assure the employee of your support.  Plan to follow up privately and periodically to see how the transitioning employee is doing. This is especially important during the first three months after his or her new gender appearance becomes apparent at work.

Looking Ahead Employers that proactively develop and implement workplace strategies that address harassment and discrimination against all employees have an opportunity to enhance corporate reputation, and increase job satisfaction and employee morale. Results may include greater productivity, less staff turnover, and fewer risks of litigation. Discrimination cases are costly in terms of time, legal fees, and goodwill. Companies with established diversity programs and management systems to address and resolve charges of discrimination and harassment may be at less risk for employment lawsuits. With increasing media attention to LGBTQ individuals and roles, societal exposure to diversity is increasing. This fact, combined with increasing employment protections, means an EA professional is likely to see transgender issues arising in the workplace over the course of a career. The best and brightest young employees will be considering employers based on several factors, including progressive workplace policies. If a company is going to attract these employees, it makes sense to advocate for employment policies that are inclusive of gender identity.

 Avoid focusing on genital surgery vs. the entirety of the transition process at work. Not all transgender individuals have genital or breast reconstructive surgery. Some may have hormone therapy, vocal retraining, and cosmetic or facial treatments. When I first started consulting with organizations, many HR reps seemed fixated on evidence of genital surgery as the marker for when the employee should use new gender-identified bathrooms.  The date the employee presents, as his/her target gender is the day to begin using the restroom that reflects his/her new gender. The employee should not be forced to use the restroom that matches his/her previous gender.  It may be necessary to review your organization’s non-discrimination and anti-harassment policies. For example, if the company receives staff complaints about being uncomfortable working with the transgender employee or there are concerns 12

References

EA professionals are able to highlight the importance of organizational inclusiveness, make the business case for it, and find ways to untangle organizational webs of fear and uncertainty. They are a valuable resource in this regard, so take advantage of it. v

American Psychiatry Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (5th ed.). Washington, DC and London: American Psychiatric Publishing. pp. 451-460. Bryant, K (2018). Gender Dysphoria. Encyclopedia Britannica Online. Retrieved from https://www.britannica. com/science/gender-dysphoria

Carolyn Ruck is an out-patient psychotherapist specializing in LGBTQ issues and previously provided corporate consulting and training for dozens of employers, providers, and colleagues in her role as Consultation Manager at Empathia Inc., EAP. She may be reached at carolyn.ruck@yahoo.com.

Fraser, L; Karasic, D; Meyer, W; Wylie, K (2010). Recommendations for revision of the DSM diagnosis of Gender Identity Disorder in adults. International Journal of Transgenderism. 12(2): 80–85.

Laura’s Management Consultation Regarding a Transgendered Employee

he following consulting case lasted approximately three months from the first call to the final follow-up.

uncomfortable if Bill used the female restrooms. She also knew that several female staff were religious and would use faith as a basis to stir up trouble, even-bad mouthing management if Bill was allowed from their perspective to “wear drag”. Laura was well aware that Fred, the CEO of the company, could be a bit old school and since she remembered he had made homophobic remarks in public, she could only imagine how he would respond when he learned that Bill was transitioning.

EAP Consultation Sought Laura, an HR director at a manufacturing plant called the EAP for a phone consultation. Bill, a product engineer, had just disclosed to Laura that he has been transitioning from male to female and would like her help in announcing his gender change and new name at work. Bill would now be known as Bonnie. Bill told Laura that he has been dressing and appearing as female outside of work. He added that he and his providers agree that he is ready to start living full-time as Bonnie. Laura told the EAP consultant she reassured Bill of the company’s support and that she would do all she could to pave the way for Bonnie to be welcomed as herself in a safe environment. Privately, she saw obstacles and was personally overwhelmed with the reality of having known Bill and his wife for years. She had no idea that Bill was carrying around “this secret.”

Learning More about Transgender Issues from the EAP Laura called the EAP to understand more about transgender issues, to establish an internal plan and timeline for supporting the transition process, and review how current company policies on harassment and discrimination could be the foundation for establishing expected workplace behaviors for the top leaders all the way to front line staff. Laura also needed safe, reassuring guidance to sort out her own feelings about Bonnie. We set up a series of phone consultations through which Laura began to recognize the leverage of her position and her ability to influence and shape the company’s response to welcoming Bonnie. The EA professional suggested that Laura plan a series of follow-up meetings with Bonnie to obtain more information and with Bonnie’s consent, to specify what to disclose, when to disclose, and to whom.

HR Concerns Laura considered herself a seasoned HR professional, yet she had never handled a transgender disclosure in the workplace. She worried about managing harassing behaviors from Bill’s colleagues. She was concerned that certain female staff would be

Continued on page 33 13 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle

| By Janeen Haller-Abernethy, LCSW; Matt Steinkamp, LCSW; & Jeremiah Dahlen, LPC, CEAP

Conflict Management Services

Considerations for the EAP

s EA professionals, we are tasked with developing “a unique approach to addressing work-organization productivity issues” (Employee Assistance Professionals Association [EAPA], 2010, p. 6) and addressing the job performance concerns of the “employee client’” (EAPA, 2010, p. 6). As guided by these EAP competencies, the Colorado State Employee Assistance Program (CSEAP) offers various services to assist employers and employees in mitigating the negative impact of workplace conflict. Beginning with a micro-focus on conflict management skills for individuals and expanding the lens to view team strategies for processing conflict, this article will use a case study to demonstrate the efficacy of EAP conflict-focused services for both employees and employers.

our productivity is dipping and this is keeping me up at night.” Sue and Paula scheduled a consultation with their EAP provider to discuss strategies to assist the team. Ultimately, they decided to implement coaching for Paula and the direct supervisors, mediation for the direct supervisors, and facilitation of team dialogue with the direct-line staff, supervisors, and Paula. Coaching In the case of Paula and her team, CSEAP may start by offering professional coaching services. Using a 360-feedback instrument, like the Goleman and Boyatzis (2016) Emotional and Social Competency Inventory (ESCI), could assist Paula in better understanding how she is perceived by others in the workplace. Paula’s 360 results may show discrepancies between her self-ratings and ratings by others. This variance is used by the coach to encourage employee goal-setting in Goleman’s and Boyatzis’ (2016) four EI competency quadrants:

Paula’s Dilemma Paula is the manager of a project team, which includes two direct supervisors and the front-line employees they both supervise. Paula’s manager, Sue, the agency director, recently called a meeting with Paula to express concern about complaints submitted by front-line staff. The complaints stated that staff received “hostile” and “contradictory” supervision from their direct supervisors. A separate complaint stated a front-line employee witnessed “tense conversations” between Paula and one of the direct supervisors. Paula was known for “marching down the halls” and “slamming her door” when upset with the direct supervisors. In her meeting with Sue, Paula said, “Sometimes I lose my cool but overall everyone seems to like me.” Exasperated, Paula added, “I need my direct supervisors to lead in a way that gets results from their team;

• Self-awareness; • Self-management; • Social awareness; and • Relationship management. In Paula’s situation, increased self-awareness may assist her in understanding how ‘losing her cool’ could lower both team morale and performance. If used with the direct supervisors, the ESCI results and accompanying coaching sessions could prove useful in boosting effective leadership of the front-line employees. The supervisors cited by employees for “hostile and contradictory supervision,” for example, would likely receive low conflict management ratings. 14

Coaching and discussion of ESCI results could elicit supervisor adjustments in communication including “openly talking” or “bringing [conflict] into the open” (Goleman and Boyatzis, 2016, p. 20). ESCI results can also be mapped in a report to demonstrate where leaders, in aggregate, are thriving and falling short in their emotional leadership of the team (Hay Group, 2012). General professional coaching on soft skills like managing emotions, managing conflict, and interpersonal skills for the workplace are also offered by CSEAP to both referred and voluntary coaches. In a 2016 study (Losch, Traut-Mattausch, Muhlberger, & Jonas), professional coaching was found to create “a high degree of satisfaction and was superior in helping participants attain their goals” in comparison to professional group training on a performance-impacting issue (p.1). In the case of Paula’s team, coaching on tweaking default approach to conflict (Thomas & Kilmann, 2007) may elicit more effective management behaviors from direct supervisors. More specifically, if one or both supervisors identifies that they are conflict avoidant or “accommodating,” personalized coaching sessions can assist them in drawing relevant connections between their teams’ lagging productivity and their own conflict-averse supervisory style(s) (Thomas & Kilmann, 2007, p. 7).

According to Schwartz (2002), workplace facilitation seeks to increase “the effectiveness of the group’s process and structure” including “how they handle conflict” (p. 5). Facilitation provided to Paula’s team could assist with their ‘dipping productivity’ by creating a safe structure to discuss team conflict. For Paula’s team, CSEAP would consult with Paula, her agency director Sue, and the direct supervisors. In addition, feedback – via anonymous survey responses from front-line staff, can help uncover maladaptive team behaviors that impact the bottom line. The neutral facilitator then meets with the team to encourage dialogue by first highlighting their aggregate feedback. How this Differs from the 360-Degree Approach While a byproduct of work group facilitation may include individual improvements in conflict communication, this process focuses more on bolstering effective team dynamics to support overall improvements to productivity. This CSEAP team service incorporates team member feedback (vs. individual 360 feedback) in order to reduce maladaptive team behaviors and increase civility in their work-related communication – especially as it pertains to conflict or difficult dialogue. Through multiple facilitated discussions, teams discover workplace-culture concerns, and structural or organizational issues potentially contributing to team conflict. These discoveries lead to increased understanding of workplace conflicts or tensions and the related impact on morale or productivity. Teams then identify goals focused on improved workplace interactions, and strategies for increased team communication or soft skills improvement – all of which could be implemented through the comprehensive EAP offering of coaching, training, and facilitation services.

Mediation & Work Group Facilitation Further opportunities for EAP conflict intervention include addressing workplace disputes between employee dyads and among the team. As indicated in the case study complaints citing that direct supervisors provide “contradictory guidance,” we might infer that these leaders disagree on how to lead their cross-functional team. As mediation has been shown to be an effective tool in addressing conflicts in the workplace, mediation between the direct supervisors could be an appropriate venue to streamline supervisory practices (McKenzie, 2015). From our internal findings, the mediation process serves to de-escalate conflict by offering a neutral setting for employees to present their differing views and also gain an understanding of their colleague’s perspective. For Paula’s dueling supervisors, improved mutual understanding gained through mediation could assist them in presenting as a unified leadership team to their employees.

Considerations The following are considerations for EAP providers, internal or external, aiming to develop or increase conflict-related services.  Coaching vs. counseling. There needs to be a clear understanding of the differences between coaching and counseling. While it may be appropriate for a licensed mental health provider to use 15

| W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle coaching strategies with both trainees and counseling clients, coaches without mental health licensure must understand their limitations should mental healthrelated concerns enter a coaching conversation. CSEAP licensed providers wear both coaching and counseling “hats.” Moreover, the EAP practitioner must be astute in determining the appropriateness of coaching versus counseling, or use of both services. In the case of CSEAP, coaching typically focuses on setting and achieving goals for improvement in professional life while counseling is focused on mental health or personal concerns. When coaching sessions become solely focused on personal or health-related matters, CSEAP pauses on professional coaching and focuses on counseling support or referring the trainee to an additional provider for further counseling sessions.

 Costs and pricing. As an internal program, fully-funded in state statute, CSEAP provides all services as a ‘value add’; that is, included at no additional cost for agencies or employees. However, CSEAP does negotiate extraneous expenses – i.e. travel, assessment tools – from agencies that request these services. An external EAP provider would be prudent to consider the market rates for trained facilitators, mediators, coaches, and necessary tools (e.g. 360 assessment) in order to decide on appropriate fee-for service or capitated pricing. Rates will vary significantly depending on the region and the service. For example, a brief Internet search indicates that facilitation services range internationally from $100 to $500 per hour and $2,500+ per day while mediation services range from $75 to $250 per hour per party (Northstarfacilitators.com, 2015; American Arbitration Association, 2017). CSEAP spends about $20 per instrument for a conflict self-assessment tool while state agencies pay $240 per assessment for 360 instruments when they elect Emotional Intelligence coaching for their employees. In addition, a survey from the Conference Board Council on Executive Coaching (2008) finds that coaching services can range from $200 to $500 per hour. Consider contacting your statewide mediation association, organizational development or human resource consultants or consortiums of these providers to inquire about market rates for facilitation, mediation, or 360 assessment services.

 Qualified and trained staff are necessary. Internal and external EAPs must identify the training requirements for various professionals in their state. For example, mediation is not a regulated practice in Colorado; therefore, we defer to national standards which require 40 hours of mediation training. Coaching regulations are also minimal in most states; therefore, EAPs must research established and reputable coach training programs to make available to their staff or seek out providers that have reputable training in the service areas targeted for expansion. External EAPs might also consider providing training or certification to preferred providers vs. seeking agreements with new providers who may have training but don’t have a history with the EAP or its clientele. Suggested resources for vetting providers include the Association of Talent Development (ATD), National Registry of Mediators (NRM); additional mediation resources include adr.org and americanbar.org.

 Data collection and destruction. EAPs would be wise to consult with their legal counsel regarding recordkeeping for conflict services as laws and standards regarding privacy may vary based on locale. Internal and external EAP providers alike must be judicious in their efforts to standardize documentation and retention requirements for these ancillary services.

 Support the multiple “hats” worn by your EAP team. Offer opportunities for external providers or internal team members to discuss the challenges and benefits of conflict-related support offered to your clientele. CSEAP offers quarterly or bi-annual meetings focused on coaching and mediation services to staff working in these roles. These meetings allow for case presentations and discussion, and shared opportunities for case brainstorming or problem-solving related to these services.

Summary While there are numerous considerations that need to be taken into account, EAP conflict-focused services can be very effective for employees and employers alike. v 16

from https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4853380/

Janeen Haller-Abernethy, LCSW, Program Manager for CSEAP, is trained in mediation and holds certifications in Intrinsic Coaching (™) and Emotional Intelligence Coaching. She serves as the primary trainer and facilitator for CSEAP. She may be reached at janeen.hallerabernethy@state.co.us.

McKenzie, D. M. (2015). The role of mediation in resolving workplace relationship conflict. International Journal of Law and Psychiatry, 39, 52-59. Published online 3 February 2015 in ScienceDirect (sciencedirect.com) DOI: 10.1016/J.IJLP.2015.01.021

Matt Steinkamp, LCSW, is the Director of the CSEAP, and is a certified coach and trained mediator. He has significant experience in developing and providing training on conflict.

Sonnentag, S., Unger, D., & Nägel, I.J. (2013). Workplace conflict and employee well‐being: The moderating role of detachment from work during off‐job time [Abstract]. International Journal of Conflict Management, 24(2), 166-183 https://doi.org/10.1108/10444061311316780 Retrieved from http://psycnet.apa.org/ record/2013-19211-004

Jeremiah Dahlen, LPC, CEAP, Program Lead for CSEAP, is a certified Emotional Intelligence coach, trained mediator, and has specialized in EAP since 2006. He has extensive experience providing counseling, coaching, management consultation, and critical incident response.

References

Thomas, K.W. & Kilmann, R.H. (2007). Thomas-Kilmann Conflict Mode Instrument. Mountain View, CA: CPP, Inc. (Original work published 1974)

CPP, Inc. (2008). Workplace conflict and how businesses can harness it to thrive. Mountain View, CA. Retrieved from https://shop.themyersbriggs.com/Pdfs/CPP_Global_ Human_Capital_Report_Workplace_Conflict.pdf

VitalSmarts. (2010, April 6). Cost of conflict: Why silence is killing your bottom line [Press release]. Retrieved from https://www.vitalsmarts.com/press/2010/04/cost-ofconflict-why-silence-is-killing-your-bottom-line/

The Centers for Disease Control and Prevention (n.d). Stress at Work [PDF format]. Retrieved from https://www.cdc. gov/niosh/docs/99-101/pdfs/99-101.pdf?id=10.26616/ NIOSHPUB99101 The Council Board on Executive Coaching (2008). Council Perspective. Retrieved from https://www.conferenceboard.org/pdf_free/councils/TCBCP006.pdf Goleman, D. & Boyatzis R. (2016). Emotional and Social Competency Inventory. Chicago, IL: Hay Group. Hay Group (2012). ESCI talent report. Chicago, IL: Hay Group. International Employee Assistance Professionals Association. (2010). EAPA Standards and professional guidelines for employee assistance programs. Retrieved from http://www.eapassn.org/Portals/11/Docs/ EAPAStandards10.pdf?ver=2014-12-09-124826-483

KGA Life Services

Jacob, L., & Kostev, K. (2017). Conflicts at work are associated with a higher risk of cardiovascular disease. German medical science: GMS e-journal, 15, Doc08. doi:10.3205/000249. Retrieved from https://www.ncbi. nlm.nih.gov/pmc/articles/PMC5406615/

Because when it comes to work-life, experience matters most.

Kilmann Diagnostics (2009 - 2019). An Overview of the Thomas-Kilmann Conflict Mode Instrument (TKI). Retrieved from http://www.kilmanndiagnostics.com/overview-thomas-kilmann-conflict-mode-instrument-tki

800.648.9557 info@kgreer.com kgreer.com

Ask us how we can help enhance your EAP with KGA’s work-life fulfillment services.

Losch, S., Traut-Mattausch, E., Mühlberger, M. D., & Jonas, E. (2016). Comparing the Effectiveness of Individual Coaching, Self-Coaching, and Group Training: How Leadership Makes the Difference. Frontiers in psychology, 7, 629. doi:10.3389/fpsyg.2016.00629. Retrieved

17 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

integrationinsights Psychological Health & Safety in the Workplace |By Mark Attridge, PhD

his column addresses the integration of EAPs with other workplace services. This time I examine the increasing interest of leading employers for including EAP as part of the overarching corporate goal of creating a psychologically healthy and safe workplace. This trend represents tremendous opportunities for EA professionals to better integrate EAPs into various workplace health initiatives.

2018 book – The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth – the meeting featured a dozen presentations and several small group discussion activities. Download the conference proceedings at: https://hero-health.org/wp-content/ uploads/2018/10/HERO_Winter-TT-2019-v3.pdf The two-day conference was filled with inspiring and evidence-based presentations that emphasized the critical role of psychological health and safety to organizational success. It was special to me to see business executives and corporate medical directors recognizing workplace mental health as a leading issue. Highlights most relevant to EAP from several of the presentations appear below.

Psychological Health and Safety A greater focus on what leaders and managers can do to promote workplace mental health is a welcome trend. It demonstrates a more collaborative and realistic mindset compared to the more traditional focus on sponsoring employee benefit services to assist troubled employees and yet at the same time largely ignoring the causal role of organizational-level influences on the psychological health of employees. EAPs historically have been most effective when given the chance to advise and support leadership and managers in addition to their everyday role with assisting individual employees in need.

 Research on EAP Effectiveness and Trends I was one of the presenters at this Think Tank meeting and also helped to summarize the talks for the HERO Proceedings document. My presentation chronicled the substantial research evidence on outcomes of brief counseling in the workplace to answer the basic question: “Do EAPs Work?” I also stressed that the key to having an effective EAP often involves greater integration of the EAP within the workplace and organization and connecting it to larger business goals, which ties in well with the goal of creating psychologically healthy workplaces. Data from largesample global research studies was provided as examples for these main points. The slides are available here: [https://archive.hshsl.umaryland.edu/handle/10713/8869].

HERO 2019 Winter Think Tank & CMO Summit The Health Enhancement Research Organization (HERO) is a nonprofit organization based in Minnesota dedicated to identifying and sharing evidence-based best practices in workplace health and well-being. HERO has over 100 members who represent a mix of employers, wellness providers, and nonprofits. I profiled their Scorecard and its potential for enhancing EAP consulting in my last column (See https://archive. hshsl.umaryland.edu/handle/10713/7397). For the first time in its 20-year history, a HERO members-only conference – called a “Think Tank” – focused solely on the topic of workplace mental health. Psychological Safety at Work was the theme of the February 2019 conference held in San Antonio. Building on key concepts from Harvard University Business School Professor Amy Edmonson, PhD’s

 Guarding Minds at Work [www.guardingmindsatwork.ca] Merv Gilbert, PhD (Director of Vancouver Psychological Safety Consulting and Faculty member at Simon Fraser University) discussed how Canada is at the global forefront in taking action to improve psychological safety in the workplace (See my 2018 review article in the JEA: https://archive.hshsl.umaryland.edu/handle/ 18

10713/7204). A key example is the National Standard of Canada for Psychological Health and Safety in the Workplace, which is being adopted by the International Standards Organization (ISO) as a template for psychological health and safety in the workplace. Gilbert and colleagues created Guarding Minds at Work, which is a no-cost organizational assessment tool and set of self-directed employer action resources. The tool involves collecting a sample of employee ratings of 13 factors of workplace mental health that are then scored, compared to Canadian benchmark data, and summarized. It also includes suggested response documents, action planning worksheets, post-action evaluation worksheets, and links to organizations active in promoting workplace mental health.

campaigns increased use of the EAP. Successful efforts at international corporations Sprint, Ernst & Young, and Kent State University were featured.  WorkPartners – UPMC [http://www.workpartners.com] In closing, I had an illuminating lunch at the conference with James Kinville, MA (Senior Director of EAP, University of Pittsburgh Medical Center. This is both an internal EAP for the 55,000 faculty and staff, and a vendor that serves another 45,000 lives in the local community through direct employer customers and being part of a health plan. They have enacted many of the strategies I have been writing about in this column for integrating the EAP into different parts of the organization. For example, the absence management specialty program uses the EAP to conduct assessments for all employees who request a leave from work for the Family Medical Leave Act (FMLA) benefit. The EAP is also involved with employees who have a workers’ compensation disability claim. Both these efforts have results in documented business cost savings for these allied programs. In 2017, they acquired the HCMS Group, which has sophisticated data warehouse analytic tools that can identify individuals at greatest risk for high utilization and/or low productivity and be used to then provide targeted clinical interventions. This approach allows the EAP to get involved with at-risk cases much earlier than the usual approach of waiting for troubled employees to call the EAP for help.

 Center for Organizational Excellence [http://www. apaexcellence.org/resources/creatingahealthyworkplace/] David Ballard, PsyD (American Psychological Association) noted that addressing these issues requires a broad, multi-level approach, which includes organizational factors and not just individual interventions. He reviewed the APA’s research-based conceptual model of a psychologically healthy workplace and how multiple factors (health and safety, work-life balance, employee involvement, employee recognition, employee growth and development) are enacted through organization-wide communication practices. The Center’s website offers many resources available and is now part of a new emphasis at the APA on applied psychology. It also presents annual Psychological Healthy Workplace awards – many that emphasize the important role of EAPs. See a short video on 2018 award winners here: http://www.apaexcellence.org/awards/

Summary The HERO meetings demonstrated the larger trend of increasing interest among leading employers in promoting workplace mental health. The many resources noted in this column also illustrate a growing number of tools and resources (most at no cost) that EA professionals can utilize to promote use of the EAP as part of their customer’s overarching business goals and initiatives concerning workplace culture and psychological health and safety. v

 Center for Workplace Mental Health [http://workplacementalhealth.org] Darcy Gruttadaro, JD (Director of the Center, American Psychiatric Association Foundation) described the mission and resources of her nonprofit, which since 2005 has provided free resources, services, and consultation to more than 10,000 employers. For example, two of the more popular mental health awareness and anti-stigma programs for employers are the “Right Direction” program on depression and the “ICU” program (Identify – Connect – Understand) developed by DuPont. She also described employer case examples that demonstrated how worksite social awareness communication

Dr. Mark Attridge is an independent research scholar as President of Attridge Consulting, Inc., based in Minneapolis. He has created over 200 papers and conference presentations on various topics in workplace mental health, EAP, psychology and communication. He has delivered three keynote presentations at EAPA World Conferences and is past Chair of the EAPA Research Committee. He can be reached at: mark@attridgeconsulting.com.

19 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

earoundup WOS Annual Report Finds EAPs Boost Employee Well-Being

Nolo.com noted there are numerous strategies that employers can use to prevent sexual harassment at work. They cited employee handbooks as a good place to lay down the law early and to make rules as clear as possible to avoid any misunderstandings.

The Employee Assistance Professionals Association (EAPA) in partnership with Morneau Shepell, recently announced the publication of the 2018 Workplace Outcome Suite (WOS) Report. More than 24,000 cases were analyzed in a study conducted by EAPA and other stakeholders. The report examines the outcomes of 24,363 completed employee cases compiled from more than 30 different employee assistance programs (EAPs) across 28 countries. The 2018 study introduced a new combined SuperScore measure that demonstrated a 16 percent level of improvement across the five outcomes measured. To read the press release and download the 2018 report, go to http://www.eapassn.org/WOS.

Read JEA Cover Story, Earn Free PDH! EAPA will offer a free PDH for reading the cover story of each issue of the JEA and answering a 5-item multiple choice quiz. Read “Transgender Support: Part I” by Robin Sheridan and Heather Mogden in this issue and answer the multiple choice questions here https://tinyurl.com/y6zysjv2 Instructions are provided at the end of the quiz on how to get your free PDH.

Mental Health Toolkit is New Resource

68% of LGBT+ Employees Report Sexual Harassment

The Mental Health Toolkit helps employers learn more about mental health issues and create a supportive work environment for employees with mental health conditions. The toolkit, available from the Department of Labor-funded Employer Assistance Resource Network on Disability Inclusion offers tools and resources for enhancing mental health-friendly workplaces while presenting an easy-to-follow employer network referred to as the “4 A’s”: • Awareness; • Accommodations; • Assistance; and • Access. Learn more here http://www.askearn.org/mental health

Nearly seven in ten (68%) lesbian, gay, bisexual and trans (LGBT+) people have reported being sexually harassed at work, according to research published by the Trades Union Congress (TUC) as reported by HR Grapevine. The study revealed that more than two in five (42%) of the LGBT+ people polled said that colleagues had made unwelcome comments or asked unwarranted questions about their sex life. The report – which is the first major study into LGBT+ workplace sexual harassment in Great Britain – revealed that 27% of respondents had received unwanted verbal sexual advances. While these alarming figures indicate a high prevalence of sexual harassment toward LGBT+ people, TUC’s report found that 66% of sexual harassment victims didn’t tell their employer over fears of being “outed” at work. The survey revealed LGBT+ women as more likely to experience undesired touching at work, such as someone placing hands on their knee or lower back, while 21% reported experiencing sexual assault, which included touching of the breasts, buttocks or genitals or efforts made to kiss them. Additionally, one in eight LGBT+ women reported being seriously sexually assaulted at work.

Solutions to a Masculinity Contest Culture If you’ve ever wondered why bullying, harassment, and toxic leadership are tolerated, a revealing new research study by psychologists from Lawrence University and the University of British Columbia, puts a three-word label on the root of the problem: masculinity contest culture. 20

guistic cues that might predict depression. It turns out that those suffering from depression express themselves on social media in ways that those dealing with other chronic conditions do not such as mentions of loneliness and using words such as “feelings,” “I” and “me.” After examining 500,000 Facebook posts from people who consented to provide their Facebook status updates and medical records, they were able to identify depression-associated language markers. What the researchers found was that linguistic markers could predict depression up to three months before the person receives a formal diagnosis. As reported by Bernard Marr on LinkedIn, there are numerous benefits to using AI to help solve the mental health crisis. They include:  Supporting mental health professionals. AI algorithms can analyze data much faster than humans, can suggest possible treatments, monitor a patient’s progress, and alert the human professional to any concerns. In many instances, AI and a human clinician would work together.  Encouraging comfort in talking to a bot. While it might take some people time to feel comfortable talking to a bot, the anonymity of an AI algorithm can be positive. What might be difficult to share with a therapist in person is easier for some to disclose to a bot.

As reported in Harvard Business Review, the researchers assessed workplace cultures across two studies involving thousands of workers. They found that bullies are tolerated and even, at times, highly praised. Sabotage was common and illness, burnout, and sexual harassment were prevalent. The researchers suggest several recommendations to address a masculinity contest culture. They include:  Generate awareness of a masculinity culture and its role in creating organizational problems. Researchers stress that sexual harassment is falsely attributed to a “few bad apples,” when, in fact, the current culture is responsible for allowing, even rewarding the misconduct. “When organizations do not tolerate bullying and harassment, the bad apples are kept in check and good apples do not go bad,” the report states.  Leaders must publicly reject masculinity contest norms. Research has shown that people in masculinity contest cultures think their co-workers embrace these norms when in fact they do not.

New EAPA Webinar Series Slated The EAPA Summer Specialty Series includes three webinars “Understanding the Context of Military Culture in Treating Veterans”, “Building Cultural Competence to Serve Fire-Rescue Personnel” and “Understanding Law Enforcement: The Culture and All that Comes with It.” Presenters are all internationally and nationally renowned experts. These archived (recorded) presentations are being offered at a special discounted rate for both members and non-members alike. Go to http:// eapassn.org/Conf-Ed/Webinars to register.

Next EAPA Town Hall Meeting Set The next EAPA Town Hall meeting is scheduled for Thursday, August 22, 2019, from 3-4 p.m. (US, EDT). The meeting will be hosted by the EAPA Board of Directors. To participate, navigate to the online meeting room at https://eapa.adobeconnect.com/_a773917115/ town-hall. Choose the “guest” option, and enter your name in the text box. What you enter appears on the attendee list in the meeting room. Audio is available through your device speakers, or you may dial in to the audio line at 1-888-619-1583, PIN: 7998-68-5263#. (Editor’s note: An agenda was not available at press time of this issue.)

AI Seen as Important Mental Health Resource Approximately 15.5% of the global population is affected by mental illnesses, and those numbers are rising. As a result, researchers are testing different ways that artificial intelligence (AI) can help screen, diagnose, and treat mental illness. The World Well-Being Project (WWBP) analyzed social media with an AI algorithm to seek out lin-

Continued on page 32 21

| W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle The EAP Role in Fitness for Duty Determinations | By Katie E. Connell, PhD, ABPP

mployers have an obligation to their employees and the public to ensure their employees are fit to safely perform their essential job duties. When concerns arise regarding an employee’s behavioral health and its impact on safety, the Fitness for Duty Evaluation (FFDE) is a valuable tool. This article will provide a framework for identifying when an FFDE is appropriate, scenarios that may lead to an FFDE, and how to best navigate the Fitness for Duty (FFD) process. It will also explore how employers can utilize their EAPs as a resource to help facilitate an FFDE.

employee and employer. The identified employee often fears losing their job and/or is angry about having to undergo an evaluation. This can make the navigation of FFD issues particularly stressful for employers and employees. Consistent with EAP Core Technology, defined by EAPA at http://www.eapassn.org/About/AboutEmployee-Assistance/EAP-Definitions-and-CoreTechnology, the EAP can provide consultation to workplace leaders about the unique practices of an FFD process Generally speaking, an FFDE is a medical-legal examination of a current employee to determine if the employee is physically or psychologically able to perform his/her job. The purpose is to obtain concrete information about an employee’s functioning and ability to safely be in the work environment. (Editor’s note: See the sidebar on page 31.)

A Look at Employee Fitness An employee who is fit for duty is able to go to work in a physical, mental, and emotional state in which he/she is able to perform essential work responsibilities in a manner that does not threaten the safety of oneself, co-workers or property. Many behaviors can lead to an employee appearing psychologically unstable or unsafe. Some of the most concerning behaviors employers may observe include but are not limited to: • Confusion; • Forgetfulness; • Unexplainable errors; • Slurred speech; • Sleepiness; • Glazed eyes; and • Anger – such as kicking, throwing or destruction of property.

ADA Guidance According to the Equal Employment Opportunity Commission (EEOC) guidance regarding the Americans with Disabilities Act (ADA): Applying Performance and Conduct Standards to Employees with Disabilities at https://www.eeoc.gov/facts/performance-conduct.html, the ADA allows an employer to request medical information or order a medical examination when it is job-related and consistent with business necessity. Generally, to be job related and consistent with business necessity, the employer should have a reasonable belief, based on objective evidence, that an employee may have difficulty performing one or more essential job functions or may pose a direct threat to their own safety or the safety of others because of a medical condition. To determine whether a medical exam is job-related and consistent with business necessity, the employer

Often a sudden change in behavior leads to coworkers complaining about another employee not performing their job; or feeling afraid or anxious around another employee. Such concerns often cause heightened anxiety among co-workers and management, along with disagreement between the 22

should not make general assumptions but rely on direct observations or reliable information from a credible third party. Determining Whether a Direct Threat Exists Under the ADA, an employer may lawfully exclude an individual from employment for safety reasons if the employer can show that employment of the individual would pose a “direct threat.” A direct threat may be defined as “a significant risk of substantial harm to the health or safety of the individual or others that cannot be eliminated or reduced by reasonable accommodation.” A determination that an individual poses a direct threat must be based on an individualized assessment of the employee’s current ability to safely perform the essential functions of their job. This assessment is based on a reasonable medical judgment relying on the most current medical knowledge and/or on the best available objective evidence. In determining whether an individual would pose a direct threat, the factors to be considered include: duration of the risk; nature and severity of the potential harm; likelihood that the potential harm will occur; and imminence of the potential harm. When employees make threats, employers are often unsure if these threats are idle or if they represent significant danger. This is why FFDEs include violence risk assessment as a component of the evaluation. Some think that screening for violence is only important

when employees present with certain “danger signs,” such as talking about violence, having been violent in the past, or bringing weapons to the workplace. Consequently, some view screening for violence as an optional add-on product, to be reserved for times when employees show at least hints of dangerous behavior. However, there are many reasons to screen for violence in virtually all FFD evaluations. Employers are not experts in identifying risk and are not trained to know when risk is present. Leaving the decision whether a violence screen should occur to an untrained person could have catastrophic consequences. Also, employers are often reluctant to ask about violence, so a potentially violent employee might escape notice. Consequently, including violence screening only when an employer sees indications of potential violence would be irresponsible because they are not experts in identifying risk. Even worse, if a case isn’t designated as needing screening for violence, the evaluation could be sent to a professional who is not qualified to assess risk. Violence screening is therefore critical in nearly every evaluation.

to return to work after time off for a serious illness or injury. For example, an employee who inflicted knife wounds to their arm at work and was psychiatrically hospitalized may have to undergo an FFDE to ensure they are now ready to return to work. A FFDE may also be required when an employee makes threats of violence to specific or nonspecific targets in the workplace, displays emotional threats or inappropriate outbursts, or makes threats of self-harm. Helping Employers Understand Options When employers contact EAPs with concerns about an employee’s performance and conduct, EA professionals can assist the

Scenarios that May Lead to an FFDE A machine operator who displays rapid speech, erratic behavior and inability to follow directions might be required to undergo an FFDE to ensure they can safely perform their job tasks. An employer may also require an FFDE when an employee is ready 23

| W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle employer in determining next steps. Engaging the employer in a dialogue about what employee behaviors they have observed, whether safety concerns are present, and what actions they have taken can assist in navigating an anxiety-provoking situation and clarifying next steps.

a medical condition impairing the employee’s ability to perform essential job functions, an FFDE may be required. Who Should Perform the Evaluation? FFDEs are forensic, not treatment related, assessments. Their primary purpose is to help employers make managerial decisions. No treatment relationship is established with the employee. They require a doctoral level professional trained in forensic ethics, violence risk, objective testing, employment law, and other relevant state and federal laws. Also, it is critical to have a professional who does not have an allegiance to the employer, EAP, or employee. This neutrality will be scrutinized should the situation end up in a court of law. Evaluators must be specially trained professionals familiar with specific occupational duties and relevant legal requirements. This provides the employer with confidence that the FFD is defensible, objective and of the highest quality. Utilization of a neutral third-party facilitator protects both the employer and the EAP. They are expensive and the employer will almost always need to be educated as to why an expert is needed and the fact that this expertise comes at a price not covered by the cost of EAP services.

 For example, the EA professional should ask the employer if they are continuing to allow the employee to work when they have safety concerns about their ability to perform essential job tasks. If the person has not been placed on an administrative leave and continues to perform their job, this would call into question whether the employer has sufficient objective evidence to require an FFDE.  A valuable place for the EA professional to start is to talk to the employer about the least intrusive measures available and if these are inappropriate or inadequate for the identified employee. Some options an employer may consider include:

3 Asking the employee to produce medical documentation that they are fit to continue working; such documentation should clearly demonstrate the employee can perform their essential job tasks. 3 If this has been attempted and the information is vague or insufficient to demonstrate the ability to safely perform essential job tasks, an evaluation by an independent FFD professional may be warranted. Whether a physician or psychologist, the important caveat is that the individual performing the FFDE must have specific training as this is a highly specialized task.

What are the Components of an FFD Evaluation? Although it is ideal that FFD evaluation occurs relatively quickly after identification of the referral need, it is more important the employer gathers and provides supporting documentation, follows internal processes, consults legal representatives, when needed, and identifies a qualified doctor who follows a data driven process to perform the evaluation.

3 A referral to an EAP may be an option when there is a performance improvement plan, or an employee violates a company policy such as one related to substance use, harassment, or unprofessional conduct. Consistent with EAP Core Technology, the EA professional can provide confidential assessment services to address problems that affect job performance. In addition, the EA professional may provide consultation services to the employer regarding when an FFDE is the most appropriate choice. When there are concerns about safety, violence, or

Every referral must be evaluated on an individual basis. The employer should communicate the reason for referral to the employee along with requiring the employee to sign any necessary authorization forms, which will permit the FFD doctor to communicate the findings to the employer. Included in this documentation should be a statement regarding what will happen if the employee refuses to cooperate. The actual evaluation of the employee typically takes about four hours, on average, with additional hours needed when the referral includes neuropsychological issues. 24

During the evaluation, the doctor will ask the employee questions about the behaviors that led to the referral. They will also attain relevant background information; assess for current medical, psychiatric or substance use problems that are impacting the employee’s ability to perform their job; evaluate their ability to perform their job tasks and assess for violence/suicide risk. A mental status exam will likely be performed along with objective psychological testing. Such testing often includes paper and pencil or electronic tests that the employee is asked to complete.

is presently impairing their ability to perform essential job functions. Employers need to understand there are limits to the information they will be provided. An employer is only entitled to information necessary to determine if the employee can perform essential job functions without posing a direct threat and is not entitled to the employee’s entire medical record.

Records and third-party interviews are critical components of the FFD evaluation that are often overlooked. An evaluation is only as good as the information it has to rely on. The employer must provide a copy of the employee’s job description, along with supporting documentation regarding the behaviors of concern or the reasons for the referral.

 Employee is fit for all aspects of duty. No presence of illness exists that interferes with the employee’s ability to safely perform the duties of their job. Specific information will likely be provided documenting why

Report Findings The findings help the employer make one of the following determinations:

continued on page 31

Practical Tips for the EA Professional

It is often critical for the doctor to obtain proper authorization to review relevant medical records and conduct collateral calls with the employee’s treating doctor so they can fully assess the employee’s condition and determine if they present any type of violence risk.

 Know what it means to be fit/not fit and that context matters.  Help employers understand that not all behaviors should lead to an FFDE.

Collateral calls with individuals at the place of employment who can provide information about the behaviors of concern is another crucial source of information in conducting a thorough FFDE.

 Know what it means to be job-related and consistent with business necessity.  Violence/direct threat are primary reasons for an FFDE referral; violence should be screened for in each and every case.

It is critical employers understand that Fitness for Duty results are time limited and speak to the employee’s functioning and violence risk at the time of the evaluation. Just because an employee is found to not be a threat to self or others at the time of the FFD evaluation, does not mean they would not be a danger down the road.

 Offer consultation services to employers about their options when they encounter a troubled employee.  Avoid liability, utilize a third-party facilitator to select a credentialed forensic expert.

What will the Employer Learn from the Evaluation? The FFD report determines the employee’s status and next steps. Following the FFDE, the doctor prepares a report that includes an opinion regarding whether the employee currently presents a significant risk of harm to themselves or others, and whether the employee has a psychiatric or cognitive problem that

 Understand what you will learn from the FFD report, who is privy to the results, and how to communicate the findings. v - Katie Connell

25 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

letters Enjoyed Sharar Article

Sharar Article a Must Read

nce again, Dave Sharar has written an outstanding review of the evolving crisis in the EAP field around marginal vendors being able to “compete” with optimal ones based on price. (“Where Do We Go From Here?” JEA 2nd Quarter 2019, VOL. 49 NO. 2). The emphasis on driving fees lower and lower has led many of the nation’s EAPs to purposefully limit meaningful interaction with the same “at risk” employees that they are contracted to help. Many low-cost EAP platforms operate without measuring – let alone improving – their outcomes. Indeed, the emphasis on utilization rather than on outcomes is easy to “game.” EAP vendors are free to define utilization to their advantage – where a website visit, administrative telephone inquiry or downloaded help-sheet counts toward “utilization.” It is therefore no surprise that many benefits consultants have come to the conclusion that EAPs don’t do much so they shouldn’t cost much. The time has come for us to get our message into the purchasers’ world that the “EAP service” platforms provided by the least expensive or “free” (embedded) products only perpetuate the alienation, loneliness, and isolation that contribute to the emotional and social distress of today’s workforce. Thanks to the many science-based thought leaders in our field who have been published in JEA, we have the tools and body of evidence to do a much better job of identifying and treating human problems. It’s imperative we spend time and effort in getting the word out that the true value of EAP is tied to an employee’s improvement and its impact on retention, engagement, and healthcare costs. Purchasers need us to demonstrate that it is about the measurable money we save organizations, and not just the cost of our EAP services. Thank you for publishing Dr. Sharar’s article.

ongratulations to Dave Sharar for identifying several challenges confronting the EAP field and recommending a way forward. This article is a must read for all EA professionals. For 20+years, Dave has been a constant voice promoting the development of tools and methods to improve the effectiveness of EAP measurements about the services they provide to employees. This article diagnoses key stumbling blocks vendors face in growing and sustaining how employee assistance services are delivered. With an increasing number of employees across the globe dealing with some form of mental illness, there is a real need to support all employees in a personalized manner so they can live more productive lives at home and at work. Due to service delivery being highly variable and not easily visible, Sharar argues that innovation has been hobbled while pseudo-measures have prevailed. In addition, confusion and lack of consistency with the term “utilization” has misled many in assessing the true benefit of a particular EAP’s performance. Many agree with Sharar . We do need common and agreed-upon standards for defining what constitutes a “case”, calculating proper “utilization” levels, and describing the specific service modalities offered to the individual employee or “user” to help companies make good choices and justifications for the particular needs of their workforce. The key takeaway from this article is Sharar’s recommendation to combine proper and credible measurement outcomes with an appropriate pricing model as the key lever in improving the value proposition of EAPs. The article points out that if employers, EA vendors, benefit consultants, and other stakeholders were to embrace outcome performance measurement as a central goal, our field could move beyond sustainability and thrive instead of merely surviving. Sharar’s message to focus on measuring employee outcomes and actual documentable results rather than just the volume of service delivery is an important one for all to heed.

– Susan Skinner President, Personal Assistance Services (PAS)

– Patricia Herlihy PhD, RN 26

Employers Needed In Discussion

n an open and straight forward cover story in the 2nd quarter 2019 Journal of Employee Assistance, Dr. David Sharar summarized the plight that a commodity model has brought upon the EAP field. The urgent need for change is clear; EA providers and professionals should be better paid for the value they create for employers and employees, instead of having to compete on low price at the expense of utilization and effectiveness. However in my opinion, the direction and steps of change that will create a sustainable future for the EA field need more development and elaboration than are available in current discussions. In particular, I would like to invite employers to engage more fully in the discussion. As Dr. Sharar points out, senior management of employers are disengaging from EA providers, leaving decisions to purchasing departments to a large degree, resulting in a focus on low price. This situation also leaves EAPs more separated from the workplace. While I agree with Dr. Sharar that EA providers overestimate employers’ ability to understand our value propositions, I would like to add that as EA providers and professionals, we may also overestimate our ability to understand the needs and conditions of the employers, the employees and the workplace. Do we really know what a valuable EAP would look like from employers’ and employees’ perspectives? As a small step toward becoming more relevant to the workplace, we may need to take stock of how employers are responding to current EA initiatives. For instance, EAPA has worked consistently to promote the Workplace Outcome Suite (WOS). An impressive database has been accumulated with the publication of annual reports since 2015. It has been a great tool for demonstrating statistically significant improvements to employee performance that result from using the EAP. However, what are the reactions from employers? We need to ask some bottom-line questions: Armed with consistent assessment data (e.g. WOS results), are providers winning more contracts or getting paid compared to those who do not have such data? Are they gaining more favorable

reviews from potential corporate clients as a result of this data? Are we impressing potential clients with this step in particular, and the direction our field wishes to pursue? If not, what are THEIR (e.g. employers’) needs? I would love to learn more about what it will take for us to engage the employers in this discussion. In particular, would love to read an article in JEA on this topic by employers who purchase EAPs for their employees. v – Peizhong Li

Tips for raising awareness of your EAP: Get on a local speaking circuit. Don’t get pigeonholed into only hanging out with EA colleagues or just networking at EAP events. Utilize or join Chamber of Commerce, civic groups (think Lions, Rotary, etc.) and others to raise awareness of an issue or about EAP in general. Joining a business association related to EAP, such as the Society for Human Resource Management (SHRM) is another possibility. Have an elevator speech ready. If someone asked, “What does your EAP do?” would you know what to say in roughly 30 seconds? The following is an idea that one EA professional has used: “Anything worth losing sleep about, is worth coming in for.” Utilize social media. Some people are intimidated about getting involved in social media, but don’t underestimate how much Millennials use these platforms to communicate. If you are on social media, how often? It should be on a regular basis to remain current.v

27 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle Digital Archive Notes 6th Anniversary Preserving Our Past to Protect Our Future

| By Jodi Jacobson Frey, PhD, LCSW-C, CEAP; Patricia A. Herlihy, PhD, RN; & Alaina Kahn, BA

t is hard to believe that six years have passed since the International Employee Assistance Digital Archive was unveiled in 2013 by Drs. Jodi Frey and Patricia Herlihy. Initially, it developed out of a need for the EA field to preserve its history on a free and publicly accessible website where historical documents, current papers, presentations, and other multimedia EA-related materials could be preserved and shared on a global level (Frey & Herlihy, 2017). Since the initial launch, the EA Archive has grown by leaps and bounds; expanding to include both past and current articles, webinars, and presentations from around the world. Currently, there are over 3,300 unique submissions from over 400 authors. In addition, there have been approximately 4,500 visits to the Archive during the last six years.

ideas, concepts,�� and actions, �� as well as current findings. Looking back, we are thrilled that so many academic leaders and practitioners in the EA field have joined the process of contributing to and using the Archive. Starting with just a few submissions in 2013, there has been strong enthusiasm and commitment, particularly by the EA research community. Our contributors understand the benefit of having their publications in one place easily accessible by others coming up in the field. In addition, many of the icons in our employee assistance field have graciously offered their advice and support, as well as numerous historical documents that have led to the inclusion of many unique documents.

“Archives are witnesses to the past. They provide evidence, explanation, and justification for historical ideas, concepts, and actions, as well as current findings.”

Background The field of archival digital preservation is complex and growing among librarians, computer scientists, and information technology professionals. The International Council on Archives was established in 1948 and currently has approximately 1,400 members from 199 countries. Since 1990, the evolution of digital Archives has gained attention and fostered experiments on a broad array of issues and methods (Coalition for Networked Information, 2017; Reiger, 2018). The EA Archive is somewhat unique in that it is contributing to digitizing material that had previously only been available in published form. Marketing is an ongoing struggle, a challenge faced by many archives�� . Without continual outreach and use, archive�� s lose their living, breathing existence, something that is necessary for its document collection to remain relevant for the field (Owens, 2014).

An original member of the Thundering Hundred captured the heart of what we are working to accomplish in the following comment: “As the EAP field evolves and grows to meet the challenges of the worldwide 21st century work forces; program administrators, practitioners, and researchers increasingly require archival resources to learn of the variety of models across cultures and consumers. So too, do policy makers and consumers. Archives are also essential for the development of robust and accurate academic and technical literature. The University of

Why Archives are Important Archives are witnesses to the past. They provide evidence, explanation, and justification for historical 28

Maryland has stepped up to the challenge of providing these services via the EA Archive.”

-Tom Delaney, MPA, MSW, March 2016

As a leader in EA education and research, it is fitting for the University of Maryland to host the Archive. Best of all, anyone can become an Archive submitter from anywhere in the world without having to have any relationship to the university. In-kind contributions from the school and university library, in addition to funds raised through the EAP fund and financial contributions to Rocky Mountain Research help keep the lights on for managing and growing the Archive. Next Generation of EA Professionals One benefit of working with the university is the opportunity to engage with the next generation of EA professionals as they enter the field. Dr. Frey’s graduate social work students, following an EA specialization track, work on the Archive – meeting leaders who submit materials, curating content, and designing an engaging website. This work often sparks interest in learning more about EAP. Many of these students eventually become members of EAPA and participate in local chapters. Engaging these future leaders of the EAP field is only one small way in which the Archive is not only preserving the rich history of the field, but connecting it to the future as we move into areas such as artificial intelligence, opioid and other substance use and misuse, workplace violence prevention and response, and a host of other yet unimaginable related topics.

From this partnership, the Archive has gained access to full issues of the Journal of Employee Assistance and related historical versions of the journal, as well as EASNA Source newsletters, and EASNA Research Notes. A relatively new partnership has evolved with the Employee Assistance Report (EAR), edited by Mike Jacquart, resulting in full copies of the EAR now being available in the Archive. George Watkins, editor of the EAP Digest, has also donated copies of this nowdefunct publication to the Archive. The Archive has also started to include audio and videotaped keynote presentations from EAPA’s annual EAP Conference and EXPO. continued on page 30

Get Involved! Many people have asked how they can best support the Archive. Below are six simple ways that individuals and organizations can both utilize this resource as well as build it to be the best possible repository of knowledge for future generations of EA professionals. • Visit the Archive and search one of your favorite authors or topics; • Encourage others in your network to check out the Archive; • Email the EA Archive Flyer to your distribution list & participate in our Social Media; • Submit articles, books, presentations, webinars, videos and related EA-related current and historical documents; • Submit relevant photos to the Archive Photo Gallery; and • Consider donating to the EAP Fund (tax deductible through the University of Maryland Baltimore Foundation) which supports the Archive among other EAP-related work and projects, including EAP students. Alternatively, make a financial contribution directly to Rocky Mountain Research to support Dr. Herlihy’s time spent on Archive marketing and gathering of historical documents. v

Appropriate Items for Submission As mentioned earlier, the Archive accepts articles, books, presentations, webinars, letters, videos, and photographs. A new feature is our photo gallery. This photo gallery highlights the professional achievements of EAPA chapters and EAP leaders, in addition to memorable moments in time. As the Archive continues to grow, we encourage EA professionals to visit the Archive website, explore information on topics you want to learn more about, or that you might need to write RFPs, responding to customer requests, or learning cutting-edge trends. In addition to submissions, we also encourage feedback and questions. Archive Collaborators Both EAPA and EASNA have been strong collaborators with the Archive over the last six years. 29 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

featurearticle

Continued from page 29

New Direction – Connections with Well-Known Archives Another new initiative of the Archive has been the development of relationships with other archival holdings. This includes the Kheel Center for LaborManagement Documentation and Archives at Cornell University, which houses works by Dr. Harrison Trice, father to the Occupational Alcoholism Field, which was the precursor to the EAP field. More recently, we have forged a relationship with Wayne State’s Reuther Library, which houses most of the archival work on unions. This is important as unions have had an historically strong impact on the development and proliferation of EAPs within the U.S. We are also in discussion with leaders from EAPASouth Africa (EAPA-SA) to include material from their informative monthly newsletter and will be linking soon to research from the Archives at the University of Pretoria on EAPs and workplace behavioral health.

Patricia A. Herlihy, PhD, RN is the CEO and Founder of Rocky Mountain Research and co-founder of the EA Digital Archive. Her research and consulting focuses on delivery benefits models around integration of EAP, work/life and wellness programs. She may be contacted at pherlihy@rockymountainresearch.us. Alaina Kahn, BA is a MSW student at the University of Maryland and works closely on the EA Digital Archive. Her graduate studies focus on providing trauma-focused clinical treatment.

References

Coalition for Networked Information. (2017). Rethinking Institutional Repository Strategies. Retrieved from https://www.cni.org/wp-content/uploads/2017/05/CNIrethinking-irs-exec-rndtbl.report.S17.v1.pdf Frey, J. J. & Herlihy, P. (2017). EA Digital Archive: Virtually weaving past, present and future. Employee Assistance Report, 20(12), 1-4. Owens, T. (2014, February 27). What do you mean by archive? Genres of Usage for Digital Preservers [Blog post]. Retrieved from https://blogs.loc.gov/thesignal/2014/02/what-do-you-meanby-archive-genres-of-usage-for-digital-preservers/

University of Maryland’s SSW 40th Anniversary As the University of Maryland’s School of Social Work celebrates its 40-year anniversary of EAP education and research with a year of celebration running March 2019 – March 2020, we are proud to house the final collection of video interviews conducted by Dr. Dale Masi comprising the EARF-funded history project that documents the history of EAP in the U.S and Canada. All interviews are with leaders from the EA and Work/ Life fields including: John Burke, MA; Dale Masi, PhD; Fran Rodgers, MA; Dave Sharar, PhD; Carl Tisone, MS; Jim Wrich; Rick Csiernik, PhD; and Rita Fridella, MBA. All eight videos can be streamed online from the Archive and can be located using the search terms: “History video.”

Rieger, O. Y. (2018, October 29). The State of Digital Preservation in 2018: A Snapshot of Challenges and Gaps. https://doi. org/10.18665/sr.310626

Advertise in Email Blast!

The Future Looks Bright Having a single, online, free, and permanent public place to store and share historical and current papers, presentations, and other multi-media materials about the EA field generates considerable interest and support. We want to send heartfelt thanks to the many organizations and individuals who have been so supportive in helping to both populate and increase awareness of the Archive as a resource for EA research and knowledge building. v

Each issue of the JEA is released to members via an email that includes space to advertise your EAP!

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

Jodi Jacobson Frey, PhD, LCSW-C, CEAP is an Associate Professor at the University of Maryland, Baltimore and co-founder of the EA Archive. Her research focuses on workplace behavioral health, with expertise in depression, suicide and substance use, and she chairs the University’s EAP sub-specialization. She may be reached at jfrey@ssw.umaryland.edu

featurearticle

Continued from page 25

the person is able to safely perform job duties and/or does not present any type of risk.

results directly to the employee, who communicates to supervisors, and who involves disability accommodations or security when needed.

 Employee is fit for some duties but not others. Presence of illness exists that interferes with the employee’s ability to safely perform some but not all duties. Recommendations will be provided, and the employer can determine if any accommodations are appropriate.

Summary There are limitations to the information that can be communicated to an employee’s supervisors and the minimum necessary rule should be followed with a strict focus on the employee’s ability to perform their essential job tasks with or without accommodations. EA professionals often play a vital role at this juncture and can assist employers in understanding the FFD results, supporting management, or working directly with the employee regarding recommendations and finding treatment referrals when needed. Finally, employers must treat the FFD report as a confidential medical record and store results separate from the employee’s personal file. Information should only be shared on a strict need to know basis. v

 Employee is unfit for duty. Presence of illness exists that interferes with their ability to safely perform their job or the employee presents a safety risk to self or others. Information will be presented to explain rationale about the risk or inability to perform job tasks. Often the result is that the employee cannot return to work and needs treatment or must follow some other recommendation before a re-evaluation for return to work can be considered.

Katie Connell, Ph.D., ABPP, serves as the Chief Clinical Officer of PsyBar, LLC. She oversees PsyBar’s quality assurance department, which includes psychiatrist and psychological fitness for duty evaluations. She is an expert educator and travels nationally on behalf of PsyBar, lecturing on mental health issues in the workplace, fitness for duty evaluations, and risk assessment. Katie may be reached at katiec@psybar.com.

Although the FFD report provides recommendations, the final determination on the employee’s fitness for duty status is the purview of the employer. The FFD report is often provided directly to the requesting body at the employer. The employer should have a clear plan in place of who receives the results, who communicates the

Should All Concerning Behaviors Lead to an FFDE? A Fitness for Duty Evaluation (FFDE) is a medical-legal examination of a current employee to determine if the employee is physically or psychologically able to perform his/her job. The purpose is to obtain concrete information about an employee’s functioning and ability to safely be in the work environment.

FFDEs should not be used as a substitute for managing performance deficiencies that warrant corrective action or conduct problems that require discipline. Behavior that is simply annoying, inefficient, or argumentative would likely not be sufficient to require an FFDE.

Context matters. For example, an employee with some concentration difficulties might be fit to continue stocking shelves at a grocery store but would not be fit for the job duties of a police officer or airline pilot. Thus, the employer must always couch fitness in terms of the employee’s specific job duties. It is important for employers to understand that not all problematic employee behavior should lead to an FFDE.

EAPs can identify potential avenues for dealing with problematic employees, including active promotion of EA services, last chance agreements, or management training in dealing with troubled employees. Furthermore, EAPs should remind employers that concerns must be related to the employee’s job performance and the functioning of the business. v - Katie Connell

31 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

earoundup

Continued from page 21

Employee Happiness Emerging as Key Workplace Trend

 Most people opt for same-sex mentors (69% women, 82% men).  People with mentors are happier at their current jobs than those without.  Only 14% of mentor relationships started by asking someone to be their mentor – 61% of those relationships developed naturally. Read the full report at https://online.olivet.edu/ research-statistics-on-professional-mentors

In the changing world of work, businesses are revamping their approach to HR and are working towards creating a culture that revolves around employee happiness. As reported by HR Technologist, Hani Goldstein, the CEO and co-founder of Snappy, explains that leading companies have created positions specifically dedicated to improving employees’ work experience and company culture. Why? A recent CareerBuilder survey found 50% of HR managers have open positions they cannot fill due to a lack of qualified applicants, while more than 70% of workers say they don’t feel satisfied in their career and are actively hunting for a new job. As a result, in order to attract and retain top talent, businesses are starting to revamp their approach to HR and are working towards creating a culture that truly revolves around employee happiness and employees’ day-to-day experience. According to Goldstein, companies like Google, Zappos, Airbnb, Charity Water, Salesforce, and Chefs Club have created positions specifically dedicated to maintaining and improving employees’ experience and company culture— everything from Chief Happiness Officer to Global Head of Employee Experience and Vice President of Global Employee Success. Essentially, Goldstein said, these leaders are in charge of managing the strategy and processes related to building and retaining an exceptional team of professionals. Their job is to optimize people-centered activities such as hiring, training, professional development, performance management, and recognition while ensuring these efforts support the company’s growth and bottom line.

Why Trust at Work is Vital When executive coach Vicki Bradley talks to clients about trust, she says they rarely talk about what trust is, but rather about what trust does. Consider: A trusting environment allows people to be themselves; Trust builds safety; Trust creates non-judgmental relationships. What happens without trust? We’re suffocated by fear of losing what we’ve got and we’re on guard all the time. Too often, we wonder, “Who’s out to get me?” At work, this shows up as an inability to work well with other people, constant worry about past interactions and a tendency to take things personally instead of dismissing them. The following are several suggestions for adding more trust to your life:  Surround yourself with a support network. These are people who “have your back.”  Give trust first because it’ll not only make you happier, it doesn’t breed distrust like an “earn trust first” philosophy.  Give people the benefit of the doubt, even when they leave a poor first impression.  Give feedback only to help someone else succeed. continued on page 34

More People Want Mentors Many successful people attribute part of their professional success to having a mentor. To learn more about why this is, Olivet Nazarene University recently surveyed 3,000 people about professional mentor-mentee relationships to see what they look like in 2019. Here is what they found:  76% of people think mentors are important, however only 37% of people currently have one. 32

featurearticle

Continued from page 13

She recommended that Laura review her current company policies on non-discrimination and harassment before meeting with the CEO, then lay out her hope for how Fred the CEO would set the tone.

Transitioning employees should use the restroom that matches his/her target gender. The workplace should not put the burden on the transitioning employee to use a restroom that no longer fits and there is legal precedent to affirm this position. If the employee feels more comfortable using the unisex bathroom (as was in this case) there was no reason for staff to complain. However, it was important that Laura explained to the female staff members that under company policy, Bonnie IS female and should be treated with the gender respect afforded to all staff. Laura and I reviewed differences between gender and sexual identity. We thought that the concerned female staff were likely making false assumptions. I explained that Bonnie, having gone through a long process of medical treatments, would NOT be wanting to use the women’s restroom for inappropriate behavior. I sometimes use metaphors to illustrate. If lesbian staff are attracted to females should they be forced to use the men’s restroom? If gay staff are sexually attracted to men, should they be using the women’s restroom, and my favorite, how does anyone really know what sort of sexual equipment anyone else possesses when they are in a restroom stall?

Transgender Training & Flyers She suggested that after Bonnie provided specific consent for disclosure, that managers and then staff members receive transgender at work training through the EAP. She personally screened a local EAP trainer with this type of expertise. She also created EAP informational flyers for co-workers and for managers. I helped develop the flyers and the trainings during my employment at Empathia Inc EAP so this info would be proprietary. There were manager and E-versions of each. The training materials highlighted factual information vs. myths about the transgender change process. It relayed general information about medical treatments and length of time before full transition may be achieved. The training materials also provided guidance for co-workers about helpful responses to a transitioning individual, including making a concerted effort to use correct gender pronouns and name. The flyers were brief and offered the EAP 800 phone number if staff needed to talk privately with an EA professional.

Conclusions Ultimately, Bonnie and Laura agreed upon a plan that consisted of a target date for the CEO’s announcement to take place, followed by mandatory EAP trainings on transgender issues for applicable managers and staff. Bill then presented as Bonnie after taking two days off of work during the EAP trainings. I kept in touch with Laura before and after Bonnie transitioned and encouraged her to check in with Bonnie every few weeks. In those check ins, I recommended that Laura sift out whether there were signs of workplace bullying or conduct toward Bonnie that needed HR intervention. Fortunately there were not. I believe that the on-site training that the EAP provided in addition to the CEO announcement went a long way toward ensuring a peaceful transition for all involved. v

Next Steps; Reviewing Policies Over the next few weeks, Bonnie disclosed her transgender status to a select group of engineering coworkers ahead of the company announcement. Bonnie felt they handled it better than she expected. Some co-workers needed time to digest the news and came to her later with questions, which she was comfortable answering. Other colleagues didn’t seem phased by the news. Once a general announcement from the CEO was made as to Bill’s gender identity and name, two female staff members came to HR about Bonnie using the women’s restroom. Since there were nongender specific restroom options and Bonnie felt comfortable using a unisex bathroom, the initial bathroom complaint never came to fruition.

- Carolyn Ruck

33 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

earoundup

Continued from page 32

Tips for Coping with Depression in the Workplace

 Break assignments or tasks into small chunks. The employee client with depression needs to ask, “What is the first thing I need to do for this project?” Work with a manager to break the assignment into small pieces and set reasonable deadlines for each piece. Working in small chunks feels more manageable and less overwhelming than looking at a massive project the employee may be facing.  Allow extra time to complete job-related tasks. Brain fog is real. It takes extra time to cut through the fog and complete a task. It’s important for the employee to acknowledge that he is moving a little slow and allow more time to complete each task. The client is recovering from an illness and needs to give himself a break. Read more here https://bluesagecareers.com/blog/ 2019/5/22/tips-for-coping-with-depression-at-work v

Do any of your employee clients with depression struggle to make it through their workday? As well as the obvious – help from the EAP – the following are some additional coping strategies from Blue Sage Career Strategies:  Start with small changes at work. Is it the employee’s job that’s actually making him depressed? Both internal and external factors in the workplace can contribute to depression. Ask the client to take a look at the reasons their job may be making them depressed and identify some small changes that might make a big difference. Sometimes, even a change as simple as making taking a 30-minute lunch break out of the office can do a world of good.

webwatch Cannabis The Health Effects of Cannabis and Cannabinoids http://bit.ly/healtheffectsofcannabis In one of the most comprehensive studies of recent research on the health effects of recreational and therapeutic cannabis use, this report from the National Academies of Sciences, Engineering, and Medicine offers a rigorous review of relevant scientific research.

Disability Inclusion Job Accommodation Network https://askjan.org Do you have questions about the Americans with Disabilities Act? Job Accommodation Network (JAN) is a leading resource on the ADA, including a comprehensive list of various disabilities and suggestions for workplace accommodations, which the EAP can help devise.

Cannabis EAPA Cannabis@Work Toolkits http://www.eapassn.org/CannabisatWork Major societal trends are converging to make cannabis in the workplace one of the biggest challenges facing employers and EA professionals. The toolkits are intended to give EA professionals information to assist their companies and clients. Both kits can be downloaded at this link.

Employee Assistance EAP Institute https://www.eapinstitute.com/index.php The EAP Institute will hold one-day seminars on “Drugs and Alcohol at Work: Managing Reasonable Suspicion” 18th September and 14th November. The site features these and other Institute seminars and related information.

webwatch Expatriates Relocating Partner Survey Report http://bit.ly/2018RelocatingPartnerSurvey According to NetExpat’s Relocating Partner Survey Report, employers confirm that the number-one reason for employees not accepting an international assignment is the potential disruption of the career of their relocating spouse or partner. Read more at this site.

Mental Health Family Guide to Mental Illness and the Law https://pitt.co1.qualtrics.com/jfe/form/ SV_3fsw6FhODHyA29L A new online self-assessment can help people identify their most comfortable supportive role when interacting with someone with a mental illness. The self-assessment tool presents five scenarios and, for each scenario, asks users to check the response that best matches the way they are inclined to respond. This tool does not collect any identifying information and is located on a secure server at the University of Pittsburgh.

Financial Resources CareConnect USA https://careconnectusa.org/ Established in 2005, the North Carolina-based firm publishes reputable helplines for financially stressed employees and their families. The vetting process of service providers is extensive and ongoing, which means the EAP is referring the troubled employee to information they can trust.

Technology Appmkr https://www.appmakr.com/ Everybody is downloading apps these days, but maybe you’d like to create your own app. Doing so is neither complicated nor costly. Learn more at this site.

Human Resources Human Resource Executive http://hrexecutive.com/leading-the-pack/ Human Resource Executive® recently released what they consider to be the best HR and training introduced to the market during the past 12 months. The awards spotlight innovative new solutions that are helping business leaders meet the HR needs of their organizations. The winners also illustrate the increasing prominence of artificial intelligence in emerging HR technologies.

Technology PsyberGuide https://psyberguide.org/ This non-profit website is dedicated to helping individuals seeking to make responsible and informed decisions about computer and device-assisted therapies for mental illnesses Workplace Conflict CPP Global Human Capital Report http://bit.ly/globalhumancapitalreport “Workplace Conflict and How Businesses can Harness it to Thrive” was commissioned by CPP, Inc. in partnership with OPP, Ltd., to shed light on the nature of conflict – defined as any workplace disagreement that disrupts the flow of work. The research project analyzed the workplace attitudes about conflict from 5,000 full-time employees in Europe and the Americas. v

Inclusion Human Rights Campaign Foundation https://www.hrc.org/campaigns/corporate-equality-index The Human Rights Campaign (HRC) invites US-based companies to participate in an annual Corporate Equality Index (CEI). The CEI is a benchmarking tool on policies and practices pertinent to LGBT+ employees. In the 2018 CEI report, 609 major businesses earned a top score of 100 percent.

Advertise in

Inclusion World Professional Association of Transgender Health https://wpath.org This 501(c) (3) non-profit, interdisciplinary professional and educational organization has been devoted to transgender health since 1979.

Contact Patt Manda, Development & Donor Relations: (303) 242-2046, development@eapassn.org 35

| W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • •

| JOURNAL OF EMPLOYEE ASSISTANCE | 3rd Quarter 2019 |

UPGRADE TO THE 2018

Unlimited

ACCESS PACKAGE The Unlimited Access Package provides online access to conference sessions recorded during the EAPA 2017 & 2018 Conferences. CE credit is still available for the most recent conference year. Enjoy unlimited access to EAPA Conference Recordings through October 31, 2019.

Purchase online today! www.eapassn.org