EAP's and their Development (Update 1999)

Roger F. Peters [RFD, BA, BSc, Hon, MSc, Phd, DACPCP, FEAPAA. Director of Clinical Services, HEAS Pty Ltd].

An EAP Defined
A Brief History of EAP's
Providers and Models of Service Delivery in Australia
Implementation of an EAP
The Dynamics of EAP councelling
Evaluation of an EAP
Who Really Benefits from EAP's
The Future of EAP's
Postscript 1999
Crystal Ball gazing the EAP Profession

The aim of this paper is to provide an overview, albeit brief of the development and operation of Employee Assistance Programs (EAPs) in Australia. In researching material for this paper it was clear that there remains a lack of well authored research in Australia in relation to this growing industry, one that sees as many as 4 million Australians covered and one that may generate income for providers, as much as $80 million each year. While the anecdotal evidence is that many undergraduate and graduate students, especially masters and doctoral candidates are presently conducting research, relatively little has been published. This paper aims to provide a current opinion regarding the growth, development and future of EAPs in Australia.

An EAP Defined

The modern EAP has evolved into a work based early intervention program consisting of many integrated services. These services are designed to assist in the identification and resolution of employees who may be experiencing personal or work related problems. Employees can either be self or peer referred (Peters, 1990; McNamara, 1992). In 1995, the internationally accepted definition of an EAP was more eloquently expressed as:

"A work based intervention program aimed at the early identification and or resolution of both work and personal problems that may adversely affect performance. These problems may include, but are not limited to health, marital relationships, family, financial, substance abuse or emotional concerns. The specific core activities of the EAPs include: 1) Expert consultation and training in the resolution of job performance issues related to the aforementioned employee personal concerns; 2) Confidential and timely problem assessment, diagnosis, treatment or referral to an appropriate community resource; 3) The formation of internal and external relationships between the work place and community resources not available within the scope of the EAP" (p25).

Current EAP services are extensive and can range from counselling to outplacement programs all of which assist in the restructuring, downsizing or privatisation of a company. EAPs may also play a major role in services such as: recruitment and training, health promotion, stress management workshops, employee briefings, drug and alcohol policy development and education, organisational development, e.g, outplacement and redundancy counselling. EAPs may provide training in personal development of employees, including quit smoking courses. EAPs' core business, however, remains in counselling - especially marital relationships, alcohol and other drugs, anxiety, grief and assistance in addictive behaviours (e.g., gambling) (Peters 1990; McNamara, 1992).

A Brief History of EAPs

The emergence of the temperance movement in North America in the early 1890's is posited as the stimulus for the establishment of drug and alcohol programs in the work place. By the 1940s, Alcoholics Anonymous had significant input into these programs. These early programs fell short in meeting the needs of troubled employees at work as it was considered that problems not affecting an individual's work performance were not the concern of the employer. Another failure of this approach was that the abuse of alcohol and other drugs is often more a symptom of other underlying problems. Thus in those early days, programs seem to have been narrowly based and were reactive rather than proactive.

Due to some of the shortcomings of these early, solely based alcohol and other drug programs, broader based programs were introduced. These programs were aimed at assisting employees who were experiencing a range of difficulties including, marital, emotional, financial and legal problems. In 1945 the Kennecott Copper Corporation in North America developed the "Insight Program", which is recognised by many EAP professionals as the first EAP program. The Insight Program included the services of social work and staff counselling. Factors, other than drug and alcohol problems, were addressed in this program alongside the stigma previously attached to attending a drug and alcohol program. By 1990, EAPs in North America were ubiquitous and of the US companies polled, 93% had implemented an EAP (Peters & Firth, 1990).

Research has shown that the cost of maintaining employees' physical and mental health is undoubtedly less expensive than recruiting and training new employees. EAPs have also been proven to be a successful and effective strategy in reducing the consequences of a troubled employee.

Australian Developments

The history of the Australian EAP is considerably shorter than their US counterparts. Similar to the US EAPs, Australian EAPs were initially developed as Occupational Drug and Alcohol Programs. In Australia, EAPs have been largely developed by a high degree of organisation and planning (Roman, 1983). In fact, Australia was unique in accelerating a "broad brush" approach, which quickly replaced an alcohol and other drug focus when compared to EAP evolvement in North America. Australian EAPs had to also overcome the reluctance of Australians (when say compared to Americans) to seek psychological help (McNamara, 1992).

In 1976, the National Alcohol and Drug Dependence Industry Committee (NADDIC) was formed by the Alcohol and Drug Foundation of Australia. This committee was made up of representatives of the Australian Council of Trade Unions, the Confederation of Australian Industry, the Alcohol and Drug Foundation of Australia, and the Federal Government. During this time, Government funding was made available for full time providers of alcohol and drug programs. These Australian programs acknowledged the failure of Alcohol and other Drug programs in the past to address the wider issues and problems that confronted employees, and thus adopted a more broad brush in approach. This modification and emphasis in program delivery, within the EAP, was one reason that the then National Alcohol and Drug Dependence Industry Committee changed it's name to the National EAP Executive (Compton & Buon, 1990).

EAPs in the 1980's were partly funded by drug and alcohol grants from the Australian Government. This funding resulted in one organisation alone in each state being given the endorsement of the Confederation of Employers, NADDIC and the Australian Union Movement. In 1988, this problem was recognised and the NSW Labour Council opted to remove the limitations of this endorsement. This resulted in the move towards privatisation by 1992, with many private businesses contracting the delivery of EAP services (Mosher, 1993). The following year Government funding, via drug and alcohol grants, was seen as no longer justified and was withdrawn in 1993. In accord, the "Keys Report" found the number of referrals relating specifically to drug and alcohol issues were as low as 6 per cent. As privatisation continued to expand, the union involvement in Australian EAPs has become less evident and can presently be best described as "lukewarm". Likewise, the National EAP Executive was disbanded, although many of the old executives now form a network of state providers, which has been described by Mosher (1993) as "a supportive network".

Providers and Models of Service Delivery in Australia

In exploring the evolvement of the EAP, some recognition should be given to two particular providers who acted as the vanguard of modern EAPs in Australia. The first of these are the previously government funded agencies who were the first to work directly under the EAP banner. As indicated above, since cessation of funding these agencies, located in each state, have acted as a collective and claim national coverage. The second group who have been providing work based programs for decades is the Inter Trade Industry Mission (ITIIM), also referred on work sites as the "chaplaincy". This later group has become increasingly active in the provision of EAPs.

However, since the mid-1980's, two further groups have taken an active role in the provision of EAPs. The first of these groups are normally regarded as more generalist welfare agencies but who have a corporate shop front and are gaining a good market share. These agencies often have connection with religious organisations or hospitals. The second group include the specialist consultancies that have taken a large market share.

Likewise since the mid 1980's but more so in the 90's, individual psychology practises have entered into the provision of Australian EAPs, and although smaller than the above groups, still have a commanding share of the market. Statistics in the area of market share is a little difficult to judge, but there is now clearly a plethora of providers offering EAP services throughout Australia. Other providers have attempted to join this growing market, including accounting firms and health funds.

EAP Models of Service

The Australian EAP exists in various forms. To determine the suitability of a particular model, a number of factors are addressed including: the size of the company, it's available budget, resources available, geographic location, values and goals, and in addition the skills of the provider (Masi, 1992; McNamara, 1992).

An EAP may fall into four general categories including: an in-house model, an out of house model (contracted out), a consortium (collaboration between several companies pooling their resources) and an affiliate (vendor subcontracts) (Masi, 1992). McNamara (1992) and Peters (1995a) have further expanded these categories, following a more detailed analysis of the different models peculiar to Australia. As a result, six EAP models have emerged which range from solely internally or externally provided, to a combination of both.

1. The Internal EAP with no Internal Resources
This EAP is made up of qualified professionals employed by the company who are predominantly involved in problem assessment, referral and case management. The benefits of this EAP lie in it's ability of greater control and a reduction in costs. Problems within this form of program include the greater risk of corruption of confidentiality. Control is also lost over the actual treatment of the employee and an increased burden is placed on community resources.

2. The Internal EAP with Internal Resources
In accord with Model 1 above, this program consists of qualified professionals who are employed by the company for problem assessment and case management. This model includes internal resources that employees can be referred to, or they can be referred to an appropriate community resource. This EAP provides greater control over the treatment of employees, but still exhibits similar problems as seen in Model 1.

3. Internal EAP with Gate Control
Similar to the first two models, the EAP assuming this model ascertains whether the problem is serious enough for a referral to an external EAP. While this approach can control costs, it may also result in employees feeling devalued.

4. External EAP (Assessment and Referral)
This model differs from the ones above, in so far that it is staffed by professionally qualified counsellors (not employees of the organisation) with the predominant role of problem assessment and/or diagnosis. Following this assessment, clients are then referred to a community resource. Again, this may result in clients feeling devalued and an increased burden is placed on community resources. Benefits within this form of EAP include: the problems of confidentiality are addressed, a wider range of professionals are available, diversity of employees reached is increased, and off-site counselling is provided.

5. External EAP (Assessment and Treatment)
Similar to Model 4 above, this model differentiates itself by offering counselling to the client by the EAP provider. In limited cases, clients are referred on to specialist services. This EAP model addresses many of the limitations of the above models by enhancing the confidentiality and value of the client, as well as reducing the burden on community resources. Despite these advantages, greater reliance is placed on the expertise of the provider.

6. Mixed External/Internal EAP
This form of EAP places the decision of whether to seek help from an internal or an external provider on the client. Both internal and external EAPs assess and/or diagnose and either provide treatment or further referral. Unfortunately this form of EAP can be costly, communication problems may occur and a hierarchical discrimination exists. This discrimination often results in staff choosing external services and employers choosing internal services.

In relation to the models discussed above, currently ninety five per cent of EAPs are outserviced and are provided off-site. This high number is mainly due to cost effectiveness, but also with some consideration for the critical issue of confidentiality.

It is not possible to say with assurance that there is one best model. As mentioned earlier, the form of the EAP is largely dependent upon the needs and abilities of the company and provider. The 4th Model tends to be the type most prevalent when EAPs were operating within a government funded climate (McNamara, 1992). In accord, Model 5 has grown in prevalence since privatisation, whilst Model 6 appears to be a good option for larger companies. There is also a growing tendency for companies to opt for a "one stop provider". This has resulted in organisations seeking out providers that can provide at least on a statewide, often national, even international level.

Implementation of an EAP

Success in implementing an EAP is contingent upon a number of factors. Before implementing the EAP in an organisation, policy and procedures should be publicised, senior management must be committed and endorse the EAP, and managers should be trained and staff briefed. Once these steps have been satisfied it is necessary to actively promote the EAP, to create awareness and to educate staff. The EAP should also integrate effectively with the existing organisational systems and procedures, e.g, Occupational Health and Safety, disciplinary procedures, and can even be included within enterprise bargaining processes. There are a number of impediments in the implementation of the EAP that need to be addressed. These include employee resistance, misunderstanding about counselling, adaptability of the program to the target audience and the question of whether to promote the EAP's features or benefits (Flanagan, 1993).

Psychological injuries in the work place account for a disproportionate amount of total rehabilitation costs. An interactive and targeted intervention EAP (proactive) as opposed to a generic counselling based EAP (reactive) can assist in reducing these costs. Key factors in a proactive response are the identification of at-risk employees, tailored active psychosocial interventions and brief therapy strategies, skilled providers who can educate and train, and non-privileged reporting on organisational issues (Davis, 1995).

The Dynamics of EAP Counselling

When this paper was just a first draft, the comments and opinion of an industrial psychologist were sought with regard to it's content. She posed the question, "But what happens when someone attends an EAP counselling session?" It was apparent from her question that for non-practitioners and those who have not been a client, this is a relevant question. An EAP doesn't normally provide therapy, as participating in therapy usually needs a considerable period of commitment by both patient and therapist. EAPs do provide general counselling, whereas therapy means to heal and counselling means to guide. This is often described in EAP brochures as "Where are we now - where do we want to go - and how are we going to get there?" EAPs are designed to offer brief intervention only. For this reason the cognitive approach or solution based interventions have proven to be the most common approaches used.

Depending on the scope of the EAP, the number of sessions may vary, with some programs only allowing clients to attend one session, while for others these may be unlimited. Incidentally, the average number of visits is about 3-4 and most organisations allow at least that number. Some practitioners refer to this type of counselling as "brief intervention therapy".

The other important role that an EAP has is to ensure that clients, if necessary, are referred to the appropriate expert agencies, especially if the client's problem falls outside the scope of the counsellor. For those that are research minded, from this description of EAP intervention it is reasonable to expect that methodological problems will be substantial. Indeed, this more than anything else probably also accounts for the problems encountered in evaluation, the subject of the next section of this paper.

Evaluation of an EAP

There is an obvious lack of validated research on the effectiveness of an EAP, which is due to the inherent difficulty in measuring EAP outcomes. McNamara (1993) highlights this problem and suggests that in the last decade the difficulties of evaluation have largely been ignored. The general consensus emerging from the field is that while there may be some valid criticisms, EAPs are well worth their while. It has also been suggested that perhaps EAPs, like the current debate surrounding Critical Incident Stress Debriefing, do not particularly lend themselves to empirical evaluation. Improvements due to the implementation of an EAP may be seen in the increase in productivity and decrease in absenteeism, but it is difficult to assess success in achieving employee well being (Toohey, 1993). While qualitative research may be able to show improvements in relation to the morale of employees and their dedication to their job, quantitative results are difficult to acquire. Perhaps because of the lack of validated research evidence, some organisations are still hesitant in implementing an EAP. In support, Carless (1995) states the lack of hard data regarding cost benefits was one of the reasons the Commonwealth Government ceased subsidising EAPs. Peters (1996) asserts that EAPs, in addressing alcohol problems were excessively expensive. However, in accord with Carless, Peters agrees the lack of hard evidence based on credible research is a substantial hurdle for EAPs in Australia.

Long term gains for employees are difficult to ascertain, however for employers, short term decreases in absenteeism, compensation, stress, accident rates, increases in worker morale, work climate and consequential worker productivity may be evident. In addition the effectiveness of the counselling process must be likewise carefully scrutinised. Masi (1992) views this a little differently and provides the following table in which she argues that an evaluation should include how an EAP contains measurable losses, hidden losses and losses due to legal claims, the latter is of significant interest given the burgeoning cost of workers compensation.

Table 1. Losses Addressed by EAPs

Measurable Losses Hidden Losses Losses due to Legal Claims
Absenteeism Diverted supervisory managerial time Workers compensation
Overtime pay Friction among workers Equal employment opportunity
Tardiness Damage to equipment Disciplinary actions
Sick Pay Poor decisions Grievance procedures/other legal actions
Health insurance claims Damage to public image Threat to public safety
Disability payments Personnel turnover Illegal drug trafficking on the job
Premature death Security issues  

(Masi, 1992).

Evaluation by survey and organisational records should regularly take place (McNamara, 1993). In the process of evaluation it is necessary to maintain confidentiality, therefore, Masi (1992) recommends the use of an independent third party.

Program evaluation should include both process evaluation and outcome evaluation. The process evaluation is quantitative research that monitors the implementation of the program and ensures the EAP reaches an appropriate representation of a diversified workforce (Masi, 1992).

Who Really Benefits from EAPs?

A study by Ramanathan (1992) assessing an EAP at both a two month and four month follow-up period, found personal stress and productivity to be related. Ramanathan also concluded that while EAPs improved productivity they did not reduce employee stress. This finding raises questions regarding whom the EAP is actually benefiting - the employee or the organisation? A competent EAP would be expected to be of assistance, in the short and long term, to both the employee and the organisation. This study highlights that for an EAP to be regarded as successful and justified it must intervene at both the individual and organisational level. Obviously, employee problems such as reduced productivity may stem from difficulties in the organisational structure. To be effective in treatment, the EAP must recognise this fact. As such, it is necessary for the role of the EAP and it's corresponding objectives to be defined before implementation.

Googins and Davidson (1993) have also addressed the concept of who actually benefits from the EAP and suggests that EAPs must broaden their function to not only address the employees' problems, but also the changing social and human issues of the environments in which they operate. EAPs must consider the organisation, as well as the individual, as their client. While the benefits of such an approach are obvious, it must be implemented with caution and deliberation due to the possible risks that may occur. Increasing the focus of the EAP may potentially tarnish the image of EAPs if they become identified with adverse business decisions and may result in a diminished effort from both the organisation and the individual. Employees may also become confused as to the role and boundaries of the EAP. Ethical considerations also need to be addressed as the EAP may become involved in issues that they are not qualified to deal with.

The Future of EAPs

Two important developments that have occurred in Australia over the last decade have been: the privatisation of previously government funded EAP providers, and secondly, the establishment of a Professional Association.

The trend appears to indicate that in the next decade there may be an increase in the actual number of EAPs, however, a restriction in service delivery and the number of sessions provided. Australia has certainly taken the lead where only professionally qualified counsellors are able to provide legitimate EAP services. North America have generally rejected such criteria and regard formal tertiary qualifications as an imposition. Thus it is reasonable to expect that in Australia, EAPs will provide both assessment and treatment, (even if only brief intervention and referral), whilst in North America EAPs will continue to provide assessment and referral only.

For EAPs to continue to evolve, the industry will have to address the problems of program evaluation, research and more generally be far more accountable to their organisational clients. This will of course include the controversial question of auditing, which for the most part is discussed but rarely conducted.


EAP providers would no doubt argue that EAPs must prove to be integral to the cost-effective operation of an organisation. Not only do these programs increase productivity and decrease absenteeism, they must show how they improve worker morale and satisfaction. There is some evidence for this, but most of this has been based on North American research, anecdotal evidence, or the promotional material of providers. One exception was the research work of Blaze-Temple (1994) in Western Australia who up until 1994 was making some significant gains. Her unfortunate death has had a significant impact on research in this country. In a society where health costs are increasing, providing a readily available EAP is at least, most beneficial to employees. Implementing an EAP that simply provides counselling is probably not sufficient. EAP's continued evolvement and growth in Australia will no doubt be dependent on thorough and reviewed research of existing programs.

Postscript 1999

Since writing this review some 18 months ago, there has been little change in the provision of, or research into EAPs. Worthy of mention however, is work by Andrea Kirk-Brown of Griffith University, Queensland, which has highlighted some common misconceptions with respect to EAPs.

Kirk-Brown's first study, "A Profile of Current EAP Practice in Australia", was rather descriptive of the industry and said very little about usage or, more importantly effectiveness of EAPs. Her second 1999 paper, "Comparison of Internal and External EAP Provision in Australia", was presented at the EAPAA Conference in Sydney on the 22-23 July, 1999. This was a comparative study which again did little to add to the much needed research on cost benefit, effectiveness, etc of EAPs. This second paper also seems inconclusive because of her failure to use homogenous groups, ie, internal EAPs were not controlled for; capability of delivery of the service along with the research qualifications were not accounted for, and included welfare as well as any, counselling provided by occupational health and safety staff, with less than 50% of internal providers surveyed registered psychologists. Her evaluation of external providers similarly failed to control important independent variables, with no consideration given to the differences in contractual arrangements, e.g., number of permitted sessions, fee base (per capita, annual fee, or fee for service etc), all of which can affect usage or take up rates. For instance, in 'per capita' base programs there is no incentive to promote return counselling as this is an added provider expense, while for the service provider there is an incentive to prolong engagement with clients. Kirk-Brown's observation that "they would cancel each other out", is somewhat reflective of an inappropriate methodology, which in fact may betray a lack of understanding on her part about EAPs.

There is a continuing and fallacious belief by many that any service that provides assistance to employees is an Employee Assistance Program. However, the use of upper case in EAPs is to suggest that an EAP, whether internal or external should meet particular criteria. Firstly, EAPs should follow the internationally recognised definition and criteria of provision. In Australia, it is recommended by EAPAA that only qualified practitioners should provide EAP services, i.e., registered psychologists or clinical social workers. Secondly, that EAP counselling is based on recognised theories of intervention and professional engagement. An EAP intervention is not a "chat" with the OH&S nurse over coffee, nor an on-site conversation with a chaplain. While the importance of this type of assistance should be recognised, they remain informal, uncontrolled and unvalidated interventions and as such should not be lumped together with more formal, structured and professional interventions provided through a formal EAP. These issues are critical when conducting research into the effectiveness of EAPs.

Some current research into EAPs may prove to be an important step in validating EAPs, at least on a therapeutic level. This is presently being undertaken in NSW, by several of the major providers. The study involves a pre and post entry psychometric evaluation of clients who have received counselling, hopefully answering the rather self-evident question, "Does counselling help?".

There remains however, far more fundamental questions for organisations who contract EAP providers, e.g., "How does an EAP benefit an organisation?" While in the past we have been dependent on North American research, Australian providers must be able to not only clearly demonstrate the efficacy of intervention, but also its value to the organisation and its potential to improve the organisations performance.

Crystal Ball Gazing the EAP Profession

As a final comment in relation to the development of EAPs as a profession, it is clear that there is emerging a group of "super" providers. The impetus for this has been due to the requirement by many organisations to have either national or, at least state wide provision. The next decade should see the decrease in internal provision (Area Health Services may be an exception) and a decrease in providers (except country and certainly remote areas). Indications are that this may involve six major providers. Somewhat like the National Rugby League (NRL), there will be a rationalisation of teams, with takeovers and partnerships being forged. Like the NRL at present, there will be providers who will dominate. The first of these are the previously Government funded providers who were part of the National Council of EAPs, who now act as a "consortium". The second group will be those who have historically a predominantly Catholic church background. The third the chaplains, (ITIM) who will develop an increased professional qualified base. The fourth, probably Davidson Trahaire, and the remaining two groups that will take fifth and sixth position remain unclear, although Melbourne based OSA seem to be accelerating growth and consequently their market share. While competition will see a fairly cutthroat policy on fees, eventually, like the banking industry, some sensible and consistent policy in relation to recommended fees will emerge. There will no doubt be an increase interest in fee for service based contracts (invoiced monthly), at the expense of per capita based fees.

Finally, the professional bodies EAPA (Australian chapter of the North American based group) and EAPAA will continue to be in conflict and there will remain continued division. Obviously, this will only reduce the lack of credibility of our profession among organisational clients. Without continuing strong leadership, EAPAA will collapse. On the other hand, because of the dynamic and strength of EAPA in the US, its Australian chapter will survive. Of course, in the event that EAPAA collapsed or simple became impotent, then EAPA in Australia would strengthen its position and of course, their memberships share. It would seem that despite EAPA's original alliance with EAPAA, under the current EAPA leadership in Australia that once carefully established relationship would, if not already come to an end.

Accreditation will not be an issue as the Certified Employee Assistance Professional (CEAP) exams will not be seen as an attractive or necessary option. This prediction is based on the substantial difference in basic qualifications between US and Australia EAP providers. Certainly, almost all external providers in Australia are, at a minimum, registered psychologists, thus the need for any further recognition is absent. CEAP's in part was an attempt to fill the gap in the absence of qualifications among North American practitioners. In this way, the time, the expense, and perhaps irrelevance of this certification will see it as being of little importance to Australian providers.


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Brown-Kirk, Andrea (1998) A Profile of Current External EAP Practice in Australia, Report for EAPAA Conference July 98, Griffith University QLD.

Brown-Kirk, Andrea (1999) Comparison of Internal and External EAP Provision in Australia, Report for EAPAA Conference July 99, Griffith University QLD.

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Toohey, J. (1993). Government Funded EAPs, the Past, the Present and the Future. A conference paper presented at the 2nd National EAPAA Conference, Sydney, Australia.

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