Evolution – not revolution... employee assistance programs

by 19 Aug 2009

Having evolved over the past 20 years, offering employee assistance programs (EAPs) to staff and their families is now commonplace. A major bank and two emergency service organisations tell Teresa Russell why trauma counselling is one part of their EAP offering

According to the EAP Association’s web site (www.eapa.org.au), EAPs “are confidential, effective, early and minimum intervention programs operating in the work place. They address work related and personal issues that affect productivity.” Many organisations outsource employee assistance programs.

Benchmark

One of Australia’s largest national EAP providers, Davidson Trahaire Corpsych, has recently analysed 11,000 new counselling referrals from individuals from more than 300 organisations. This represented about 12 months of new referrals. Its clients can now benchmark the results and compare their own EAP referrals. Seventy-one-and-half per cent of people presented for personal issues and 28.5 per cent for work related issues. Fifty-three per cent of the personal issues were family and relationship problems; 40 per cent were emotional wellbeing issues (including anxiety, depression, grief and loss of self-esteem). Only 7 per cent of referrals related to legal, financial, medical or substance abuse concerns.

Some results showed significant gender differences. Interpersonal issues with co-workers are almost twice the rate for females than they are for males. There are higher percentages of males accessing EAP services for marital and separation/divorce issues, while discrimination, harassment and bullying are almost identical for both men and women.

Many organisations and employees view the provision of EAPs as a non-fiscal benefit on top of their salary. However, some EAPs were born out of a duty of care that an employer had for its employees. Trauma counselling, a benefit offered by some organisations, falls more into the occupational health and safety (OHS) category than into employee benefits.

Trauma counselling

Organisations that offer trauma counselling are usually those whose employees are at risk of experiencing violence, armed hold-ups or accidents. These include banking, liquor retailers, transport, mining, construction and emergency services.

Paul Gilmer, head of health and safety at ANZ Bank, says, “Trauma counselling is open to anybody who has experienced a traumatic event. Although this mainly refers to customers and employees who were victims of armed hold-ups, it is also available to any staff member who, for example, may witness an accident or whose close family member attempts suicide.”

Gilmer says that trauma counselling at ANZ has been available for decades, but the rest of the company’s EAPs have grown out of ANZ’s corporate values. The first value says, “We are the bank with the human face.” “People like to work for companies that display values that match their own. If an organisation implements the values it declares, people will stay with the company,’ says Gilmer.

ANZ outsources its trauma counselling to a national EAP consultancy. If a bank branch is held up, the manager of the branch initiates support services, including trauma counselling, by making one phone call to ANZ’s property helpdesk. If it is a metropolitan location, trauma counsellors will arrive at the branch within two hours, do a group debrief that day, return the following day, one week later and one month later. Regional and rural branches can have immediate phone counselling and a consultant will be there as quickly as geographical considerations permit. Counselling is not mandatory.

Paul Flanagan, president of the Employee Assistance Program Association of Australia, says people can experience acute stress reactions, such as anxiety, insomnia and loss of confidence in the first week following a traumatic event. They may become quite fearful and feel unable to face the work situation. “The level of support and interest shown by managers, supervisors and teams after a traumatic incident can greatly minimise the impact of the event. If there is nothing in place, the effect can be four to five times greater,” he says.

Controversy

The benefits of trauma counselling have been widely debated over the past few years. A worldwide systematic review of single-session psychological interventions (debriefing) following trauma, recently concluded “there is no current evidence that psychological debriefing is a useful treatment for prevention of post traumatic stress disorder after traumatic incidents. Compulsory debriefing of victims of trauma should cease.” (Rose, Bisson and Wessely; Psychother Psychosom)

EAPA’s Flanagan agrees with those findings. “The Mitchell model [Critical incident stress debriefing] is a good process that has been poorly applied. It is more important to take a risk assessment approach and focus on individuals, rather than the group. Managers and supervisors also need to be aware of what staff are going through, make adjustments to help people cope and be empathetic,” he believes.

Empathy

Empathy is a key part of both the NSW Police and NSW Ambulance employee assistance programs. Jennifer Lette, chief psychologist for NSW Police says the organisation launched its new EAP model in May 2001. “We appointed an external EAP provider to do general counselling for staff – both sworn and unsworn – and they also do our general critical incident management. Prior to this, we tried to be all things to all people – and it wasn’t working,” Lette says.

The EAP provider NSW Police appointed had worked with the Victorian Police Department, and came with a good understanding of and empathy for the police. Almost 9 per cent of staff per year utilise the external EAP provider services.

If a critical incident is the result of the actions of police, or occurs while someone is in police custody (such as death in custody, pursuit or suicide on duty), mandatory counselling is done by one of the internal team of qualified psychologists, who are also sworn police officers. “Police want to talk to someone who is inside the job,” says Lette. These qualified police psychologists are on call to travel across the state, 24 hours per day, seven days per week, in response to a critical incident involving police.

Ian Johns, a spokesman for Ambulance Service of NSW says that the service has provided trauma counselling for its employees since the early 1980s. Staff can self-refer, or are referred by peer support officers, chaplains or managers. Around 5.9 per cent of employees (excluding family members) utilised the services of an EAP provider in the past year. Ambulance Service NSW puts no limit on the number of sessions an individual can have, but the average number of sessions per individual is 2.76 a year.

Peer support

Part of the empathetic approach to managing people in such high stress jobs as the police and ambulance services, is a strong peer support program. Every large police station in NSW has 10 specially trained peer support officers – more than 500 people across the state. They get three days of initial training in communication skills, record keeping and the police’s referral network. They then update their training every two years. There is also a full-time peer support coordinator, five full-time chaplains and a network of other chaplains state-wide.

Ambulance Service NSW has 80 trained peer support officers who provide initial practical and emotional support, advice and referral. There are also 15 ambulance chaplains available across the state. Johns says, “Counselling is not mandatory. Even if the employee is nominated to attend, the decision to do so is theirs.”

Measuring ROI

Lette explains that the aim is to keep workers well, but EAPs for emergency services are a difficult thing to measure in terms of return on investment. “We’ll wait five years from when the program started and will review the long-term sick/stress leave rates. It is usually not one incident that causes problems, but is more of a cumulative thing,” she says. In the meantime, Lette is satisfied that the new EAP model has been well received, because of the large uptake of the service since its introduction.

Johns says Ambulance Service NSW does not try to measure ROI on its EAP. It reviews usage when it is time to re-tender for an EAP provider, then assess value for money between the bids tendered.

ANZ’s Gilmer says that the bank doesn’t really measure the ROI of trauma counselling either. It believes that if immediate action is taken, longer term issues can be prevented. These might include compensation claims or long-term sick leave. Staff surveys have revealed that employee satisfaction rates have improved significantly (to greater than 80 per cent) in the past three to four years. Gilmer attributes some of that rise to ANZ’s employee assistance program, which it cascades down from its ‘life balance’ corporate value.

EAPA’s Flanagan says that employees measure their own psychological well being following counselling. If the organisation has helped them in a time of need, staff morale will be good. “HR can measure return to work rates, compensation costs and review whether the organisation has fulfilled its OHS obligations,” he said.