Employee Counseling and

Wellness Services
Chapter 11

Werner & DeSimone (2006) 1

The Need for Employee
Counseling
Have you ever seen people:
Struggling due to high levels of
anxiety?
Refusing treatment for a treatable
condition?
Experiencing job burnout?
Involved in efforts to promote good
health?

Werner & DeSimone (2006) 2

The Need for Employee
Counseling – 2
Personal problems are a part of life
Personal problems affect job performance
Healthcare costs continue to rise
Reducing tardiness, absenteeism, lost time
and worker’s compensation saves money
Reducing turnover can improve productivity
and the bottom line

Werner & DeSimone (2006) 3

Addressing Employee Well-
Being
Promotes employee morale
Reduces the impact of external
factors on work
Promotes productivity
 Cheaper to train, treat, and retain
existing workers than to hire new ones

Werner & DeSimone (2006) 4

Employee Counseling as an
HRD Function
Counseling serves the same goal as
other HRD activities
 Improving/maintaining worker
performance
Same techniques are used, especially
coaching
Same kinds of analysis and planning
needed

Werner & DeSimone (2006) 5

Overview of Counseling
Programs
Problem Identification
Education
Counseling
Referral
Treatment
Follow-up

Werner & DeSimone (2006) 6

Problem Identification
Screening device
Absenteeism records
Supervisor’s observations
Referral
Voluntary participation

Werner & DeSimone (2006) 7

Education
Pamphlets
Videos
Lectures
Unsolicited
 Television
 Radio
 Other media

Werner & DeSimone (2006) 8

Counseling
Needs a non-threatening person with
whom the worker can discuss
problems and seek help. Options
include:
 Supervisor/coach
 Ombudsman
 HRD Counselor
 Professional Counselor

Werner & DeSimone (2006) 9

Referral
Directing employee to appropriate
resources for assistance – e.g.,
 Physician
 Substance abuse treatment center
 Marriage counselor
 Alcoholics Anonymous (AA)
 Other options (clergy)

Werner & DeSimone (2006) 10

Treatment
The actual intervention to solve the
problem – e.g.,
 Group therapy
 Medications
 Individual therapy
 Psychological therapy

Werner & DeSimone (2006) 11

Follow-up
Needed to:
 Ensure the employee is indeed carrying
out the treatment
 Obtain information on employee progress
 Ensure that referrals and treatment are
effective

Werner & DeSimone (2006) 12

A Caution About Employee
Counseling
All six approaches are not always
needed
The following issues drive which
approach is taken:
 Type of problem identified
 Appropriate response
 Available resources

Werner & DeSimone (2006) 13

Who Provides Employee
Counseling?
Depends on the organization and
organizational culture
Can be done using:
 Corporate resources (In-house)
 Outside resources (Out-of-house)

Werner & DeSimone (2006) 14

In-House Efforts
Advantages: Disadvantages:
Internal control Confidentiality
Familiarity with Lack of needed
organization resources
Better coordination
of efforts Employee reluctance
to use services
Sense of ownership
Greater internal Limitations in staff
credibility skill and expertise

Werner & DeSimone (2006) 15

Contracting Externally (Out-of-
House)
Advantages: Disadvantages:
Subject matter Lack of on-site
experts services
Confidentiality easier Possible
communications
to maintain problems
Lower cost Lack of
Better identification organizational
and use of resources knowledge

Werner & DeSimone (2006) 16

Characteristics of Effective
Programs
Top management support
Clear policies and procedures
Cooperation with unions and employee
groups
A range of care:
 Referral to community resources
 Follow-up

Werner & DeSimone (2006) 17

Characteristics of Effective
Programs – 2
Policy of guaranteed confidentiality
Maintenance of records for program
evaluation
Health insurance benefit coverage for
services
Family education

Werner & DeSimone (2006) 18

Employee Assistance
Programs (EAPs)
Job-based programs operating within
an organization that:
 Identify troubled employees
 Motivate them to resolve their problems
 Provide access to counseling and
treatment, as appropriate

Werner & DeSimone (2006) 19

General Topics that EAPs
Might Address
Alcoholism Compulsive
Drug abuse gambling
Anxiety Marital problems
Depression Financial problems
Eating disorders Personal problems

Werner & DeSimone (2006) 20

Issues/Outcomes Affected by
EAPs
Productivity Accidents
Absenteeism Training
Turnover Replacement costs
Unemployment costs Insurance benefits
Substance abuse Etc.
treatment

Werner & DeSimone (2006) 21

Who Offers EAPs?
62% of medium- and large-sized
companies
33% of companies with 50+
employees
Estimated 82% of large firm
employees have access to an
employee assistance program

Werner & DeSimone (2006) 22

Items of Importance

Extent of substance abuse and

mental health problems faced by
companies
Approaches to employee assistance
Effectiveness of EAPs in treating
substance abuse and mental health
problems
Werner & DeSimone (2006) 23
Substance Abuse
Over 19 million Americans abuse
alcohol or drugs
Alcohol is involved in 47% of industrial
injuries
Substance abuse costs U.S. businesses
over $100 billion per year

Werner & DeSimone (2006) 24

Substance Abuse – 2
6.5% of workers reported going to work
while under the influence of drugs or
alcohol
5%–8% reported being under the
influence of marijuana at work
Companies lose over $7,000/year for
each abuser of alcohol or drugs

Werner & DeSimone (2006) 25

Reasons for Immediate
Concern
Drug and alcohol users are more prone to
accidents, injuries, disciplinary problems,
and “involuntary” turnover
Would you want to fly in a plane with a
drunken pilot?
Do you want to drive a car put together by
someone abusing marijuana or cocaine?

Werner & DeSimone (2006) 26

Drug-Free Workplace Act of
1988
Promotes drug-free awareness
among federal contractors and grant
recipients
Tells employees about:
 Availability of drug counseling
 Availability of rehabilitation programs
 Employee assistance programs

Werner & DeSimone (2006) 27

Mental Health
It is estimated that:
18.8 million Americans suffer from a
depressive illness every year
23% of the American population has
some sort of mental disorder
5.4 % have a serious mental illness

Werner & DeSimone (2006) 28

Results of Serious Mental
Health Problems
Mental health problems can interfere
with major life functions such as:
 Eating
 Managing money
 Functioning in family groups
 Functioning at work
 Functioning in society
 Functioning in educational settings

Werner & DeSimone (2006) 29

Common Mental and
Emotional Health Problems
Individual adjustment
Victim of external factors (rape,
incest, battering, crime)
Sexual problems, including impotence
Divorce and marital problems

Werner & DeSimone (2006) 30

Common Mental and Emotional
Health Problems – 2
Depression and suicide attempts
Difficulties with family and children
Sexual harassment in workplace
Legal and financial problems
Gambling addiction

Werner & DeSimone (2006) 31

Why Care About Mental and
Emotional Problems?
Problems can cause:
 Absenteeism
 Poor performance and work habits
 Low job satisfaction
 Indecisiveness
 Interpersonal conflicts
 Violence and aggressive behaviors at work

Werner & DeSimone (2006) 32

Three Federal Regulatory
Actions

American Disabilities Act of 1990

Mental Health Parity Act of 1996
Executive Directive by President Clinton
(effective January 1, 2001)

Werner & DeSimone (2006) 33

American Disabilities Act
(ADA) of 1990
Who is covered by the ADA? An employee who:
 Has a physical or mental impairment that substantially
limits one or more major life activities,
 Has a record of such impairment, or
 Is regarded as having such an impairment, i.e., an
employer’s perception of a disability would be covered.
Guarantees equal access to jobs for those with
disabilities
Includes mental and emotional disabilities, along
with physical disabilities
How to deal with individuals with such disabilities
(EEOC Guidelines, May, 1997)

Werner & DeSimone (2006) 34

Mental Health Parity Act of
1996
Employers with 50+ employees must
provide mental health coverage equal to
physical coverage
Does NOT include coverage for substance
abuse or chemical dependency
Note: This law has been extended on a
year-by-year basis since September 2001.

Werner & DeSimone (2006) 35

Executive Directive by
President Clinton
Requires equal coverage (parity) for mental
health benefits for those covered by the
Federal Employees Health Benefits Program:
 Federal employees
 Their dependents
 Federal retirees
Also covers substance abuse treatment
Took effect on January 1, 2001
Source: http://www.opm.gov/insure/health/consumers/parity/faq.asp

Werner & DeSimone (2006) 36

Why These Three Federal
Actions?
To require employers to pay
attention to mental health issues
To urge/force employers to carefully
manage and address such problems

Werner & DeSimone (2006) 37

EAP Approach to Resolving
Employee Personal Problems
Basis of the EAP approach:
Work is very important to people
Work performance can help identify
an employee’s personal problems
Employees can be motivated to seek
help

Werner & DeSimone (2006) 38

Characteristics of the EAP
Approach
Problem is defined in terms of job
performance, rather than in clinical
terms
Supervisors monitor employees to
identify changes in workplace
behavior that indicate potential
problems

Werner & DeSimone (2006) 39

Behavior Problems Indicating
Possible Substance Abuse
Absenteeism
On-the-job absences
High accident rate
Poor job performance
Poor relationships with co-workers

Werner & DeSimone (2006) 40

Constructive Confrontation
In this approach, a supervisor:
 monitors performance
 confronts employee on poor performance
 coaches to improve performance
 urges use of EAP’s counseling service
 emphasizes the consequences of
continued poor performance

Werner & DeSimone (2006) 41

The Typical EAP
Clear policies, procedures, and
responsibilities concerning health and
personal problems on the job
Employee education campaigns
Supervisory training program
Clinical services (In- or out-of-house)
Follow-up monitoring

Werner & DeSimone (2006) 42

Effectiveness of EAPs
Effectiveness is “generally accepted”
Estimated 50% to 85% effectiveness
rate
Estimated savings of $2 to $20 per
dollar invested in EAP
However, much EAP evaluation is
subjective, and strongly criticized

Werner & DeSimone (2006) 43

EAPs and the HRD
Professional
EAPs are often housed within the HRD
area of the organization
HRD must determine:
 Costs vs. benefits of the program in dollars
 Whether it’s cheaper to replace an individual
than to successfully treat that person
Healthcare organizations are increasingly
involved in EAPs (behavioral healthcare
management)

Werner & DeSimone (2006) 44

Stress Management
Interventions
“Any activity, program, or
opportunity initiated by an
organization, which focuses on
reducing work-related stressors….”

Werner & DeSimone (2006) 45

What is Stress?
Some environmental force affecting
the individual (a stressor)
Individual’s response to the stressor
Interaction between individual and
the stressor
Individuals react in different ways to
stress

Werner & DeSimone (2006) 46

Organizational Stressors
Factors intrinsic to the job
Organizational structure and control
Rewards systems
Human resource systems
Leadership

Werner & DeSimone (2006) 47

Stress Management
Interventions
Educationally-Oriented Interventions
 Sources or stress, how it feels, how to
avoid it, how to cope with it
Skill-Acquisition Interventions
 Provides new ways to manage stress
such as:
 Time management training
 Assertiveness training

Werner & DeSimone (2006) 48

Stress Management
Intervention Model

By Permission: Ivancevich (1990)

Werner & DeSimone (2006) 49

A Model of SMIs
Focuses on the individual
Helps the individual cope
Perhaps more focus should be
placed on stressors from the work
environment

Werner & DeSimone (2006) 50

Effectiveness of SMIs
Research hasn’t been rigorous
enough to measure effectiveness
accurately
Well-conducted research
demonstrates some success
More research is needed

Werner & DeSimone (2006) 51

Guidance for SMIs
Look for specific issues
Assess and analyze apparent problems
Look for specific and focused solutions
Look at strategic intervention:
 Is problem throughout the organization, or
is it localized?
Ensure evaluation and timely feedback

Werner & DeSimone (2006) 52

Employee Wellness and Health
Promotion
Wellness is more than the absence of
disease
Promotes physical fitness and other
nonstress issues:
 Obesity
 Smoking
Helps control healthcare costs

Werner & DeSimone (2006) 53

Three Levels of Fitness and
Wellness Programs
Level 1 – primarily educational
without interventions
Level 2 – seeks to bring about direct
change:
 Supervised exercise, fitness centers,
etc.
Level 3 – institutionalized wellness

Werner & DeSimone (2006) 54

Ten Dimensions of Work Site
Wellness
Constructive wellness policy
Wellness screening
Working with community resources
Employee referrals to professionals
Menu-approach to health
improvement

Werner & DeSimone (2006) 55

Ten Dimensions of Work Site
Wellness – 2
Outreach and follow-up counseling
Plant-wide wellness events
Worksite policies and systems
Ongoing evaluation of wellness
process
Periodic evaluation of cost-benefits of
wellness programs

Werner & DeSimone (2006) 56

Exercise and Fitness
Interventions
Most popular interventions
Even modest exercise helps prevent
disease
Research shows effectiveness
Problem: Getting those who would
benefit the most to exercise

Werner & DeSimone (2006) 57

Smoking Cessation Programs
Smoking: most publicized health risk
Cost per smoking employee: $2,853
per year more than nonsmokers
Measuring effectiveness:
 Quit rate
 Percentage of smokers in program
Cost Benefit: $8 saved for $1 spent

Werner & DeSimone (2006) 58

Nutrition and Weight Control
Obesity: 30% or more over one’s “ideal”
weight
30% of Americans are obese; another 34%
are overweight
Obesity causes hypertension,
musculoskeletal problems, high blood
sugar, and cholesterol levels
Competition helps program effectiveness

Werner & DeSimone (2006) 59

Control of Hypertension
Hypertension – blood pressure greater than
140/90 repeatedly over time
Greater incidence of heart disease and
stroke
 Control through, exercise, weight loss,
medication, stress reduction and low salt diet
Benefit: $1.89 to $2.72 reduction in health
claims per dollar spent on program

Werner & DeSimone (2006) 60

Issues in Employee
Counseling
Effectiveness of programs
Legal issues
Who is responsible for counseling?
Ethical issues
Unintended negative outcomes

Werner & DeSimone (2006) 61

Effectiveness of Counseling
Determine organizational demographics
Determine expected participation rates
Estimate start-up and maintenance costs
Implement test and tracking system
Measure pre- and postprogram
Analyze results for users and non-users
Do present and future cost-benefit
analyses

Werner & DeSimone (2006) 62

Legal Issues
Using counseling programs to comply
with legislation may increase liability
to lawsuits:
 Must be equally available to all
 Erroneous assessments are made
Injuries in wellness/fitness programs
can lead to lawsuits

Werner & DeSimone (2006) 63

Responsibility for Employee
Counseling
HRD Professionals?
Supervisors?
Unions?
Management?
Individuals?
What are your thoughts?

Werner & DeSimone (2006) 64

Ethical Issues
Confidentiality:
 Records should be held in strictest
confidence, and kept separate from the
employee’s regular personnel file
 Release only with specific employee
permission
Nature of Participation:
 Mandatory versus voluntary

Werner & DeSimone (2006) 65

Question
Should participation be mandatory or
voluntary?
Why?

Werner & DeSimone (2006) 66

Potential Unintended Negative
Outcomes
Increased worker’s compensation costs
Employee scheduling problems,
increased fatigue, lower performance
Conflicts at work over smoking bans

Werner & DeSimone (2006) 67

Closing Thoughts
EAPs show that companies care
HRD professionals have the skills
and expertise to provide EAP
information
Promoting employee health and
well-being can contributes positively
to an organization’s bottom line.

Werner & DeSimone (2006) 68

Summary
Employee well-being affects ability,
availability, and readiness to perform a job
Employee counseling encompasses a lot of
areas
It is an HRD function that:
 Ensures that employees are now effective
contributors to the organization, and that they
will continue to be in the future
 Needs professionals who are qualified to deal
with the difficult issues involved with this topic

Werner & DeSimone (2006) 69