III. DESCRIPTION, SELECTION, ESTABLISHMENT, AND MAINTENANCE OF EMPLOYEE ASSISTANCE PROGRAMS
Struggling with an ever-changing world has often forced organizations to make difficult and painful decisions. The same holds true for employee assistance programs. While some employee assistance professionals view challenges as opportunities, others have found the process of making necessary alterations quite threatening.
Transition periods typically require people to move in directions that conflict with the past. For example, organizations have historically separated employee assistance efforts from disciplinary procedures, making the "helping arm" of the organization and the arm that applied the consequences easily distinguishable. Today, because of legal or security issues, members of some employee assistance programs have found that these distinctions are sometimes blurred. For example, representatives of EAPs in some settings are now asked to refer clients for drug testing and report test results. Similarly, a given EAP might, because of costs, find itself part of a structure that limits or even cuts drug and alcohol benefits. Such a circumstance runs counter to the recognition of relapse as part of the substance abuse picture. Today's EAPs find themselves shaped, defined, and even coerced by external forces which muddy traditional program values and sometimes inhibit proper functioning (Googins, 1990). Such conflicts make establishing, selecting, and/or refining EAP models and functions difficult.
The information provided in this chapter is intended to assist those responsible for establishing or evaluating an ongoing EAP in determining which program approaches best meet a particular organization's needs. Understanding the various program options on the EAP continuum, clarifying responsibilities a program will assume, and determining organizational requirements constitute key elements in the EAP model design and selection process.
The first section of this chapter describes different EAP models typically available to date. The second section reviews various methods of EAP service delivery. The third section covers areas of controversy in the field. The last section discusses a variety of elements common to all EAPS, including: a written policy statement; management endorsement and program placement; union involvement; staffing, licensing, and certification; EAP communication; supervisory training; confidentiality; insurance coverage; and program evaluation (examined further in Chapter VI.
A. An Overview of Current Program Models
HR or personnel managers must make ongoing, crucial decisions regarding the general design of the employee assistance program,? the services it will provide, and its organizational setting. The characteristics of the organization involved, attitudes of supervisors and union representatives where appropriate, and available resources all influence these decisions. An organizational needs assessment that examines behavioral health problems manifested by employees and their families. Studying the nature of job performance issues can provide a useful guide for establishing the kind of program that will best serve all concerned. The needs assessment can be conducted through analyses of psychiatric health care utilization data, employee and supervisor surveys, job performance records, and the organization's existing behavioral health benefit plan. Estimating the potential costs and savings of implementing or modifying an existing EAP should also be done in advance, with the help of a benefit/cost analysis. A variety of organizations provide additional information on this subject, including the Society for Human Resource Management (SHRM--formerly the American Society for Personnel Administration), the Employee Assistance Professionals Association (EAPA), and the Employee Assistance Society of North America (EASNA).
As mentioned, several different design options exist for employee assistance service delivery. Any one of them can work, depending on an organization's particular circumstances and concerns. However, selecting an EAP model should be a dynamic, rather than a once-and-for-all, choice. Given the level of change occurring in all aspects of contemporary life, an attitude of ongoing adjustment will likely prove productive and necessary for optimal program functioning.
Described below are several employee assistance design and service delivery options that have served practitioners and organizations well to date. The labels used here are descriptive; unfortunately, no agreed upon nomenclature consistently applied across program settings exists in the field at this time.
1. Lay Assessment and Referral Approach
A lay assessment and referral model conforms most closely to original employee assistance efforts. It is typically staffed by recovering alcoholics who direct assistance toward other individuals who suffer similar afflictions. This sort of EAP usually operates internally. Personnel often have little or no formal training, although they generally have substantial experience. A portion of these individuals have obtained credentials of some kind in recent years. Referral resources in this approach may be confined to self help or alcohol treatment centers. Such programs have limited scope and have become increasingly rare.
2. Centralized Limited Assessment and Referral Approach
This approach, sometimes called a 'clearinghouse,' characteristically involves a service located off-site which assists one or many different types of organizations simultaneously. Service delivery may occur in person or via the telephone. The individuals providing service may have training as a counselor, but can possess minimal credentials. Knowledge of, and the ability to administer a thorough evaluation of community resources are usually limited as well. The ratio of EAP staff to the size of the organization is usually low. Not surprisingly, therefore, these programs generally have marginal organizational involvement due to their off-site location and lack of intimate knowledge of the organization.
3. Professional Assessment, Referral and Situational Counseling Model
This approach offers a wide range of options, generally utilizing a comprehensive range of strategies for tackling human difficulties. Problems dealt with include, but are not limited to: individual psychological problems; marital, family, and child difficulties; substance abuse; work stress; and financial and legal concerns. Professionally trained (licensed or certified) counselors and administrators conduct assessments, refer to appropriate treatment resources, and monitor treatment to some degree. They may also offer some form of short-term counseling, usually for situational disorders or acute crises. Programs like these also assess community resources in some depth.
If benefit plans do not overly restrict resources, the professional assessment, referral and treatment approach typically meets clinical needs. However, follow-up and program evaluation frequently remain limited, since practitioners do not always have the research or statistical skills to fully assess effectiveness. In addition, organizational involvement and responsibility tend to get neglected in favor of meeting clients' clinical needs.
4. Full Service Employee Assistance Model
The full service model represents the most comprehensive employee assistance service, providing a sophisticated approach to dealing with human behavioral problems. It also offers highly developed organizational development resources. Counselors in full service EAPs are usually highly trained: they conduct assessments, make diagnoses, and refer to outside services as appropriate. The program can be located inside or outside the organization. As with the professional assessment, referral, and situational counseling model, the staff often provides short-term counseling. In fact, full service EAPs may offer assistance for a wider range of human difficulties, including clinical areas mentioned under the professional assessment and situational counseling model, but also potentially addressing such subjects as smoking cessation, weight control, managing adolescents, and other educational topics. Such efforts often engage in in-depth assessment of community resources, and options for treatment can extend nationwide.
Full service EAPs become extensively involved in organizational life. Besides training and education, these programs can assist in controlling group health care costs, engaging in case management and/or negotiating for and administering health care costs for mental health, alcohol, and drug abuse problems. Full service EAPs work closely with other organizational entities, such as management development, labor relations, Equal Employment Opportunity (EEO), benefits, and health and safety areas. Tracking of program and treatment effectiveness allows for increased accountability. These EAPs can also act as internal change agents and conduct organizational systems intervention where needed, either through internal resources or through recommendations for the purchase of external services. System interventions of this type can include conflict management, team building, and structural adjustments in the way business tasks get approached and delivered.
Individuals responsible for full service EAPs are often highly placed within the organization, and have access to top management. As mentioned, staff for full service programs usually possess good organizational skills and significant clinical training in addition to professional training and certification.
5. "Mega-Brush" Programs
The so-called "mega-brush" programs are the most recent option to appear on the employee assistance spectrum. These efforts combine full service EAPs and worksite wellness efforts (Erfurt, Foote, and Heirich, 1991). Proponents of the "mega-brush" approach suggest that this combination constitutes a new model of service delivery. The authors of this book believe that the concept of wellness as a component of employee assistance services evolved naturally from the full service model described previously. Regardless of the origins of "mega-brush," the wellness approach offers an emphasis on prevention, reduction, and control of physiological and behavioral health risks before such risks develop into disabilities.
Conventional full service EAPs deal primarily with human problems after they have surfaced and begun affecting overall job performance. Wellness programs target impacting factors that might produce problems before the problems become evident. Wellness efforts address risks for cancer, cardiovascular disease, accidental injuries, AIDS, and other health problems. Screenings offered to employees can examine blood pressure levels, cholesterol levels, the effects of smoking, weight, physical fitness, and stress. After identifying an individual's needs, program staff refer that person to the appropriate resource, such as a medical treatment provider, nutrition counselor, exercise physiologist, general physical fitness program, physical therapist, well-baby care program, and/or educational seminar that discusses risk factors for diseases or problems associated with the individual's personal and family physical histories.
However, wellness programs by themselves do not constitute and can not substitute for an EAP. Where wellness programs focus on the general employee population, EAPs deal primarily with specific employees who have serious, immediate psychological and/or health problems. The two programs require different skills of their respective staffs. Employee assistance counselors must understand alcohol and drug use, addiction, and mental and emotional problems, while those who provide wellness programs emphasize an understanding of physiology and health-related risk factors in general. Where EAPs concentrate on impaired job performance in their promotional strategies, wellness programs rely more heavily on education and prevention. EAP participation is confidential while wellness programs are conducted in the open. Because of these differing skill requirements and approaches, some experts believe the two efforts should remain separate, supported by different personnel (Erfurt, Foote and Heirich, 1991). The authors believe that in an optimal situation, integration between the two efforts can and probably should occur.
6. Future Directions for EAP Model Development
Given emerging trends, it seems unlikely that any of the program models on the employee assistance continuum will remain exactly as currently constituted. Elements of each may survive, but changing times and needs will require variations in emphasis and structure. The success of employee assistance efforts may well be gauged according to how effectively personnel adjust to new requirements brought about by new realities. Chapter VI discusses possible future directions for EAPS.
B. Program Service Delivery
Program models define the structure and goals of an EAP. Service delivery addresses the process of realizing services and goals. Organizations desiring to establish or currently operating an EAP must decide what kind of service delivery best meets organizational needs. options include in-house employee assistance efforts, contractual arrangements with an external EAP, or a combination of both. Sound decisions will reflect consideration of a variety of variables, including: the organization's size, geographic distribution and dispersion of employees, labor management relations, use already made of contract services in other areas, and resources available for an EAP. Legal concerns about liability and confidentiality, financial concerns about return on investment, and projected utilization should also be taken into account.
Each form of service delivery has advantages and disadvantages. A brief discussion of different service delivery strategies for employee assistance programs follows.
1. Internal Employee Assistance Programs
Internal EAP services generally provide full and comprehensive service. Staff consists of trained professionals with strong clinical backgrounds, including social workers, psychologists, and certified alcoholism counselors. Organizations with large employee populations are most likely to provide internal service.
Because external EAPs expose human resource decision-makers to extensive marketing, some managers may overlook the advantages of internally staffed efforts that external providers cannot match. Foremost amongst these is that internal practitioners have greater access to and more effectively understand the workings and culture of their organization. Outside contractors with limited organizational contact simply cannot duplicate the amount of information available to the internal EAP provider. As discussed in Chapter II, an EAP's organizational responsibilities have historically matched its clinical responsibilities in importance. The loss of organizational input through employment of outside contracting deprives an EAP of one of its essential components.
Further, internal EAP services provide easy access to employees during working hours. Availability encourages utilization. Having the program so readily accessible, however, creates one serious problem: employees sometimes fear that such close proximity to the organization might jeopardize confidentiality of services, and render the EAP more susceptible to management discovery and manipulation. If management becomes aware of personal problems, employees assume, they then run the risk of some form of punishment or loss of opportunity (Sonnenstuhl and Trice, 1990).
2. Externally Contracted Programs
EAP services can also be obtained through contracts with external for-profit or nonprofit organizations. Besides mental health referral services, these outside "service centers" (EAPA, 1990) sometimes provide diagnoses and referrals to other treatment centers and training for their client populations, as well as a hotline employees can use in emergencies.
Organizations often view contract services as a quick and efficient way to establish and maintain an EAP. Managers also apparently believe that utilizing outside contracting shifts EAP liability away from the organization (Sonnenstuhl, 1990). The truth of this assumption remains unclear. Some contend that organizations remain just as liable for the agents they select to assist them as they are for the actions of their employees.
As discussed previously, one major drawback of external EAP services is their more limited workplace knowledge and experience. Regardless of a provider's clinical experience, the lack of a regular, extended on-site presence prevents an intimate understanding of the organization. Outside contractors, therefore, frequently emphasize counseling and de-emphasize the organizational opportunities and interactions displayed by their internal counterparts (Sonnenstuhl and Trice, 1990).
3. Combined Programs
Use of in-house services and external contractors or community resources constitutes yet another strategy for delivering an EAP service. An organization desiring this type of effort would employ EAP personnel to deliver certain services themselves, and then contract with external vendors for other services as needed. The in-house EAP coordinator might assess employee difficulties and educate the workforce in general, but then assign placement for treatment and surveys of community resources to contractors outside the organization. The EAP's internal component might also provide training to supervisors and union officials regarding program utilization, policies, and procedures. One such combined delivery program is the UAW/GM EAP-Central Diagnostic and Referral (CDR) center system.
4. Consortia
Smaller businesses which cannot afford extensive employee assistance efforts independently sometimes unite, forming a consortium to secure service delivery. Under such a model, businesses contract jointly with independent EAP vendors to provide coverage at a shared cost (EAPA, 1990).
C. Typical Elements of Employee Assistance Programs
Certain elements have emerged as core ingredients for successful employee assistance program operations. These include a written policy statement, top management endorsement, union involvement where possible, program coordination, communication, trained supervisors, confidentiality, insurance coverage, and program evaluation.
1. The Written Policy Statement
The development of a policy statement should precede any EAP implementation. When clearly written and widely publicized, the statement serves as a guide to supervisors and managers regarding constructive handling of an employee's personal problems. It also prescribes ways of balancing organizational needs with the needs of the individual employee and the employee assistance program itself. In addition, the policy should explain to employees that the EAP is a mechanism for providing confidential access to counseling and services, as well as reassuring them that using the program will not jeopardize their current or future position with the company. Detailed examples of EAP policy statements can be obtained through EAPA or EASNA.
2. Top Management Endorsement and Program Placement
Top management endorsement is critical for insuring an EAP's acceptance and protection. Internal and external programs alike appear to require access to the highest levels of management for optimum success. Unfortunately, many organizations have not granted their EAPs the necessary visibility and top-level commitment. Organizational placement also has an apparent impact on the kinds of clients who utilize the program. organizations assigning responsibility for such efforts to high level managers see more executive level clients. Those EAPs assigned to middle level managers usually wind up perceived as a resource for blue collar workers.
3. Union Involvement
Depending on the circumstances, union support and involvement can also dramatically increase program acceptance and efficiently. EAPA recommends the formation of an advisory committee that includes labor representatives where possible to maximize potential for success (EAPA, 1990).
EAPs and labor unions share many common goals, including preserving jobs, furthering individual performance, providing assistance for troubled employees, and addressing situations that might otherwise result in formal grievance procedures (Bickerton, 1990). In recent times, unions have often initiated the establishment of EAPs through collective bargaining agreements with their organization's management.
4. Staffing, Licensing, and Certification
Organizations must carefully examine professional credentials when establishing an EAP, whether internal or external, to ensure that the prospective program's staff is trained in assessment and diagnosis, and can provide a wide range of mental health recommendations. As noted, alcohol and drug dependencies exist in virtually all workforces, but EAPs encounter many other types of human problems with employees as well. Recent trends in government indicate a shift toward requiring a mental health license for employee assistance practitioners, but many states still do not. Applying the following guidelines may prove useful in selecting staff and treatment providers. A proper EAP provider should have:
A state license where required, in a recognized mental health discipline (psychiatry, clinical psychology, clinical social work);
Considerable controversy has raged in the past between recovering individuals who act as counselors and mental health professionals concerning ideal qualifications for delivering employee assistance services. The success of self-help groups such as Alcoholics Anonymous and Narcotics Anonymous in assisting people who want to overcome their substance abuse difficulties initially fueled the debate. The fact that professionals in the mental health field did not generally exhibit much interest in addressing such issues before funds became available fanned the flames. Throw in the fact that narrowly defined medical treatment frequently winds up ineffective or even counter-productive, and it seems hardly surprising that many in the recovering community regard mental health practitioners through a smokescreen of suspicion and resentment.
The controversy has diminished somewhat in recent times. Some recovering individuals still believe mental health professionals have little to offer others in need. Some mental health practitioners still believe that those with first-hand experience with substance abuse, but no license, have no place in the service delivery system. However, the majority of employee assistance professionals recognize that both groups can play important roles, while most recovering individuals understand that "having been there" alone does not qualify someone to handle the variety and complexity of demands professionals face in today's work place. Practitioners of various backgrounds now agree that at least some formal training and certification of personnel heightens the potential for any EAP's success.
In addition, organizations offering EAPs have become increasingly concerned about liability issues. They have consequently looked toward professionally licensed personnel to at least direct their delivery system. Experts continue to disagree about who should coordinate an EAP, but people with a wide range of backgrounds (psychologists, social workers, nurses, human resource administrators, AA members, or individuals with first-hand experience and/or knowledge or substance abuse and recovery) have performed this job successfully.
Attempts have been made to regulate EAP staffs and programs. EAPA has established and developed an independent commission to administer procedures for the credentialing of EAP counselors as Certified Employee Assistance Professionals (CEAP), thereby professionalizing the field. A person gains EAP certification by passing an examination in six areas: work organizations, HR management, EAP policy and administration, EAP direct services, chemical dependency and addictions, and personal and psychological problems. To qualify for the examination, a person must log three years of work experience that includes a minimum of 3000 hours in employee assistance programming. The CEAP certificate remains valid for five years, after which a person may obtain re-certification by passing another exam or completing 60 hours of commission-approved training (EACC, 1992).
Both EAPA and EASNA have developed codes of ethics and also published standards defining what constitutes an acceptable, appropriate, and optimal functioning EAP. Despite these efforts, though, no effective enforcement of national standards or credentialing of EAP providers in the private sector has yet taken place (Dixon, 1988). A brief outline of the UAW/GM program standards has been appended to this book. For more information on certification and program standards, contact EAPA and EASNA.
5. Employee and Family Communication and Education
An EAP must communicate its availability and services to employees and their families, if covered, in order to function effectively. Verbal announcements, newsletters, brochures, posters, and payroll envelope stuffers can all be used to reach members of the workforce. At a minimum, employees must know about a company's EAP policy and understand what the program can and can not do. Unfamiliarity with the policy and scope of program efforts could keep employees from using the EAP, or at the very least lead to inappropriate and disappointing expectations. Education programs also make employees aware of the organization's commitment to helping those in need. Providing proper information encourages people to step forward when necessary and to seek help themselves (Sonnenstuhl and Trice, 1990).
6. The Role of the Supervisor
Supervisors have traditionally played a major role in the carrying out of EAP policies. The responsibility for training and educating supervisors to perform necessary functions usually rests with the employee assistance program.
As discussed earlier, employee assistance professionals can train supervisors to identify troubled employees through deteriorating job performance, and to motivate these individuals to resolve their problems and improve performance either on their own or through the EAP. When using intervention strategies, supervisors confront employees with evidence of declining work effectiveness, providing suggestions about how to improve. Prompted by this advice, employees sometimes face difficulties, enter treatment, or utilize everyday problem-solving techniques to eliminate the trouble on their own. Research reveals that supervisor interventions often provide employees with all the incentive necessary to address the problems at hand (Sonnenstuhl, Trice and Hathaway, 1989; Sonnenstuhl, 1990; Sonnenstuhl and Trice, 1990).
Today, the supervisor's role in employee assistance has become more complex than ever. Modern-day employees face more pervasive and multi-faceted problems than their predecessors did during the era of occupational alcoholism programs. As a result, supervisors must now act as professional mentors across a wide range of organizational activities and take a human interest in the people who work for them as well.
7. Confidentiality, Ethics and Recordkeeping
Many EAP administrators believe their programs cannot function without an absolute commitment to confidentiality. Without the assurance of confidentiality, employees will not use an EAP. Confidentiality guidelines afford EAP professionals a measure of privacy as well.
At the same time, program administrators recognize the potential for conflict where organizational responsibilities and confidentiality issues collide. Conflicts of interest become particularly likely in organizational settings dominated by safety and security concerns, such as the defense industry, the nuclear power industry, public transportation, health care, and manufacturing.
A properly functioning EAP requires the ability to balance the employee's right to privacy with management's need to know. Therefore, the concept of confidentiality must be clearly defined in each organizational setting. Because state laws vary widely, developing confidentiality policies and procedures may require legal consultation (Nye, 1990).
In the private sector, EAP confidentiality often constitutes a more ethical than legal issue. Employee assistance professionals are bound ethically to confidentiality, whether or not a client specifically requests it. Every health and social service profession has imposed the obligation of confidentiality on its members based on the adoption of the Hippocratic Oath by physicians in the early days of medicine (Nye, 1990).
Because of the importance of confidentiality as a legal issue -- especially in the not-for-profit sector--federal laws and the regulations implementing them offer guidelines for weighing the needs of employers, employees, and counseling staff. The 1970 Alcohol Abuse, Alcoholism Prevention, Treatment, and Rehabilitation Act, as amended and implemented by regulations, specifies comprehensive federal requirements. These laws apply to any EAP operated by a federal government agency or receiving federal funding, directly or indirectly [42 CFR Ch.1 paragraphs 2.12 (a) and 2.12 (b) I . While the Act does not cover EAPs operated by unions, private sector companies, or external for-profit EAPs providing services to for-profit companies (Nye, 1990), all EAPs can use these laws as signposts when formulating their own confidentiality policies.
The key provisions of these laws, with respect to confidentiality, are:
Developing an employee assistance policy that clearly defines the degree of confidentiality promised by the program provides organizations and EAP professionals with one method of handling the problem of potential liability. It also informs the employee of what he or she can expect, and helps safeguard the effectiveness of the operation.
Some organizations have chosen a two-tiered system of confidentiality to differentiate between supervisory and self-referrals. An employee's self-referral generally results in a level of confidentiality comparable to that found in private mental health practice. A supervisory referral may result in the confirming of a client's appointment by the employee assistance provider, as well as some generally minimal, agreed upon feedback between client and counselor about what the counselor discovers. Moreover, federal law permits consensual disclosure when there is a "need to know." Such disclosure must be limited, however, to specific details related to job conditions, and may not include information about the nature of the problem itself. This two tiered approach to confidentiality has been well received, in general, by employers and employees alike, as long as each group understands, in advance, the limits of confidentiality related to these circumstances.
Recordkeeping also will differ according to the needs of the EAP staff and the organization. EAP records should be kept separately from personnel files and medical records, and all involved parties should decide at the outset to whom those files belong (i.e., are they the property of the counselor or the organization?). Management and EAP staff should also determine how much information the program should gather and keep on file, since access to records can be compromised, despite the best intentions. As a minimum precaution, assigning case numbers with a cross reference system to all records can prevent easy access to clients' names. Most importantly, EAP files should be stored in a locked file, safe from unauthorized inquiries (Starr, 1987).
8. Appropriate Insurance Coverage
EAPs also need proper benefit support to operate effectively. Unfortunately, most organizations do not include such support in their standard benefit plans. Worse, organizations faced with economic difficulties might well reduce in the future the benefits they do provide today.
History suggests several ways of addressing insufficient and inappropriate benefits:
Each organization must decide how much responsibility it will assume for the welfare of its employees with respect to the treatment of mental health, alcohol, and drug abuse problems. Unlimited access to benefits, however, is actually not in the best interests of employees or management and organizations have been curtailing such access at a rapid rate. The extent of benefit coverage should reflect the scope of problems covered by the EAP. However, as noted, economic constraints may force the reduction or elimination of options previously taken for granted.
An inability to utilize the highest quality resources for the particular problems it faces can also constrict an EAP's operations. In accordance with EAPA standards, EAPS should therefore regularly identify, foster, create, utilize, and evaluate community resources that provide the best quality care at the most reasonable cost. Such monitoring will permit delivery of prime services responsive to the individual needs of both employees and the organization.
9. Program Evaluation
Like all organizational undertakings, an EAP should be required to evaluate its appropriateness, effectiveness, and efficiency. Measurable program objectives and data collection mechanisms greatly assist in conducting meaningful evaluations. This vitally important subject is addressed further in Chapter V.
REFERENCES
Bickerton, Richard L. (1990), "Employee Assistance: A History in Progress," EAP Digest, November/December, p. 34.
Dixon, Keith (1988), "Employee Assistance Programs: A Primer for Buyer and Seller," Hospital and Community Psychiatry, Vol. 39, No. 6, June, pp. 623-627.
Employee Assistance Certification Commission (EACC, 1992), "Attention: CEAPs Recertifying March 31, 1992," Employee Assistance Professional Association, Inc., March 3.
Employee Assistance Professionals Association, Inc. (EAPA, 1990), EA Program Standards, Arlington, Virginia.
Erfurt, John C., Andrea Foote, and Max A. Heirich (1991), "The Core Technology of 'Megabrush' -- Employee Assistance and Wellness Programs Combined," The University of Michigan, Institute of Labor and Industrial Relations, Ann Arbor, Michigan, September.
Googins, Bradley K. (1990), "Strengthening the Mission: We Need to Strongly Say Who We Are, What We Stand For and What Our Values Are," Employee Assistance, Vol. 2, No. 12, July, pp. 29-30.
Nye, Sandra G. , (1990), Employee Assistance Answer Book, Panel Publisher, Inc., New York, New York.
Sonnenstuhl, William J. (1990), "Help-Seeking and Helping Processes Within the Workplace: Assisting Alcoholic and Other Troubled Employees, " Chapter 16 in Alcohol Problem Intervention in the Workplace: Assessing Strategic Alternatives, Paul Roman (editor), pp. 237-259.
Sonnenstuhl, William J., and Harrison M. Trice (1990), Strategies for Employee Assistance Programs: The Crucial Balance, second edition, revised, ILR Press, Cornell University, Ithaca, New York.
Sonnenstuhl, William J., Harrison M. Trice, and Barbara L. Hathaway (1989), "The Supervisor: Key Player in EAPs," Journal of Job Placement, Vol. 5, No. 2, pp. 11-15.
Starr, Ann (1987), Establishing a Foundation for Effective Employee Assistance Programs, prepared on behalf of the Occupational Health, Safety and Security Committee of the American Society of Personnel Administration, Alexandria, Virginia.
Swanson, Robert C. (1984), "Legal Issues Affecting Employee Assistance Programs," presented at the 1984 National ALMACA Conference, Denver, Colorado.
Continue to: EAP Handbook - Chapter 4 - THE RELATIONSHIP BETWEEN EMPLOYEE ASSISTANCE PROGRAMS AND MANAGED CARE
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