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CUTTING EDGE RESEARCH:Two Studies of
the Current State of EAPs
in North America & Europe
Funded with support by the
Today’s PresentersDirk Antonissen, MS
ISW Limits/Leuven University, Kessel-lo, Belgium
Manuel Sommer, PhDClinica CAPA/CIP-UAL, Lisbon, Portugal
Stan Granberry, PhDNational Behavioral Consortium, Baton Rouge, LA
Terry Cahill, LCSW, CEAPPerspectives LTD, Chicago, IL
Moderator: Bernie McCann, PhD, CEAPEmployee Assistance Research Foundation
What is the EARF...?
The EARF was founded as a 501(c)(3)nonprofit foundation to stimulateinnovative, rigorous, and theory-basedresearch activities which demonstrate theability of EAPs to maximize employeecontributions to the success of workorganizations.
…and why now?There is simply not enough existing, credibleresearch to critically demonstrate the valuablecontribution of EAPs and related services toworkplace productivity.
The EARF seeks to advance the quality of EAservices by sponsoring relevant research anddisseminate these findings to employers, laborunions, EAP and HR professionals, and otherstakeholders.
Funded Research Projects to Date
EARF funded its first 2 research projects in 2011:
1) The Eureka Project - EAPs in Continental Europe: State of the Art and Future Challenges, conducted by ISW Limits & Clinica CAPA
2) National Behavioral Consortium Industry Profile of External EAP Vendors conducted by the National Behavioral Consortium
New Research in the Pipeline
• Our next research grant has been awarded to the OMNI Institute in Denver, CO for the study: The Impact of Employee Assistance Services on Workplace Outcomes.
• Study site is the Colorado State EAP, duration is 14 months, and grant amount is $100,000 plus 12% for overhead costs.
• This research effort will be one of the most complete EAP outcome studies ever undertaken, with findings expected in late 2014.
Eureka: An Employee Services Perception Study in Continental Europe
Introduction to the Study
• Are EA needs in Continental Europe different than in the US?– Intervention for prevention & health promotion
– Services are provided for individuals & organizations
• In many countries in Europe EAPs as such are not very well-known, so to investigate, we asked about employee support services at the workplace without using the language “What should an EAP offer?”*
8
*Language similar to that used in Buon & Taylor (2008) A Review of the EAP Market in the United Kingdom and Europe. Journal of Workplace Behavioral Health 23(4): 425-444
Research Questions
1. What type of EA-related services are currently available?
2. What type of services should be made available?
– According to employees
– According to HR managers
9
Methods
Survey Sample
Composed of responses from 6 Eurozone countries:
1) Northern Europe: Belgium, France & The Netherlands
2) Southern Europe: Portugal, Spain & Greece
“Representative” database of respondents from:
• HR and non-HR staff positions
• Companies by size of workforce
• Companies with & without formal EAP services
11
Questionnaire
Based on 2008 Buon & Taylor article*– Content– Delivery mode (website, phone, etc.)?
• Currently present or not?• Satisfaction with?• Externally or internally?• To what extent needed?
*A Review of the Employee Assistance Programme Market in the UK & Europe
12
Description of the Sample(n = 327)
Responses from Six Countries (HR/non-HR)
0
10
20
30
40
50
60
70
80
Belgium TheNetherlands
Greece Spain Portugal France
HR Non-HR
48%
18%
2%5%
26%
0%
10%
20%
30%
40%
50%
60%
White collar workers Executives Other Blue collar workers Management/board
Respondents by Staff Category
Number of Persons Under Supervision
68%
12%
7%5%
8%
41%
28%
9%6%
10%
0%
10%
20%
30%
40%
50%
60%
70%
80%
none 1<5 6<10 11<20 >20
benchmark ISW Limits
our sample
Workforce Size
92%
7%
1% 0%
29%
21%17%
33%
12% 11%
20%
57%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
<10 10<49 50<249 >250
micro small medium large
% of total number of enterprises in EU-27
% of active workforce in EU-27*
our sample
Industry Sector
29%
6%
18%
7%
15%
25%
34%
1%
18%
2%
17%
26%
0%
5%
10%
15%
20%
25%
30%
35%
40%
public admin,education,
health, services
agriculture industry construction finance distribution,horeca, transport
& comm
% of employment EU-27
our sample
Global Results
0% 10% 20% 30% 40% 50% 60% 70% 80%
Internet based (online) counseling
Childcare/eldercare services
Concierge services
Stress management
Other specialist training (healthy lifestyle)
Workplace mediation
Alcohol & other drug
Expatriate support services
Work-life
Critical incident and trauma
Harassment, bullying or grievance investigation
Couns2_stress&motivation
Counseling/advice for employees with depressive, panic or…
Fin/legal
Coaching
Performance management
Management training
HR consultation
Services Present
Type of EA Services Present
20
4.50 4.60 4.70 4.80 4.90 5.00 5.10 5.20 5.30 5.40 5.50
Internet based (online) counseling
Counseling depressive, panic or anxiety
Counseling_stress&motivation
Concierge services
Childcare/eldercare services
Fin/legal
Workplace mediation
Management training
HR consultation
Work-life
Other specialist training (healthy lifestyle)
Expatriate support services
Coaching
Performance management
Harassment, bullying or grievance investigation
Critical incident and trauma
Alcohol & other drug
Stress management
Satisfaction Ratings
Scale: Low need = 1, High need = 7
Satisfaction with EA Services
Couns. Depres/Anxiety
Couns. Stress & Motiv
Alcohol/Drug
CI & trauma
Internet/online
Financial/legal
Work-life
Child/Eldercare
Expatriate
Concierge
Coaching HR cons & infoPerf. Mgt
Mgt training
Spec. Training
Stress Management
Harassment
Mediation
3.60
4.10
4.60
5.10
5.60
10% 20% 30% 40% 50% 60% 70% 80%
Ne
ed =
=>
Presence ==>
Needs x Presence – Gaps?
22
Harassment & Motiv
Couns. Stress & Motiv
Alcohol/Drug
CI & Trauma
Internet/Online
Financial/legal
Work-lifeChild/
Eldercare
Expatriate
Concierge
CoachingHR Cons & InfoPerf. Mgt
Mgt Training
Spec. Training
Stress Management Harassment
Mediation
3.60
4.10
4.60
5.10
5.60
10% 20% 30% 40% 50% 60% 70% 80%
Ne
ed
==>
Presence ==>
Service Growth Potential
23
Couns. Depres/Anxiety
Couns. Stress & Motiv
Alcohol/Drug
CI & Trauma
Internet/Online
Financial/legal
Work-life
Child/Eldercare
Expatriate
Concierge
Coaching HR cons & infoPerf. Mgt
Mgt training
Spec. Training
Stress Management
Harassment
Mediation
3.60
4.10
4.60
5.10
5.60
10% 20% 30% 40% 50% 60% 70% 80%
Ne
ed =
=>
Presence ==>
?
Future Opportunities...?
24
0% 10% 20% 30% 40% 50% 60% 70% 80%
Couns_depressive, panic or anxiety
Couns_stress&motivation
Alcohol & other drug
Critical incident and trauma
Internet based (online) counseling
Fin/legal
Work-life
Childcare/eldercare services
Expatriate support services
Concierge services
Coaching
HR consultation
Performance management
Management training
Other specialist training (healthy lifestyle)
Stress management
Harassment, bullying or grievance investigation
Workplace mediation
% of service provided by external person/organization
desirable situation
present situation
Potential for External Partnerships
25
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
website
brochure
indiv cc
Hotline
online ass+treatment
Family
Delivery Mode
% desired
% present
Potential Delivery Modes
26
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Phone
Chat
Contact With Counselor
% desired
% present
Preference for Contact
27
0% 10% 20% 30% 40% 50% 60% 70% 80%
comm.
work-life
Stress
Healthy lifestyle
Workplace Training
% desired
% present
Desired Workplace Training Topics
28
Country-Specific Analysis
Services - Comparison by Countries
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
The Netherlands Belgium France spain portugal Greece
Needs - Comparison by Countries
3.00
3.50
4.00
4.50
5.00
5.50
6.00
6.50
The Netherlands Belgium France spain portugal Greece
Belgium
couns. depres/anxiety
Couns. Stress & Motiv
Alcohol/Drug
CI & Trauma
Internet/Online
Financial/legal
Work-life
Child/Eldercare
Expatriate
Concierge
CoachingHR cons & infoperf. mgt
Mgt training
Spec. Training
Stress Management
Harassment
Workplace Mediation
3.00
3.50
4.00
4.50
5.00
5.50
6.00
6.50
10% 20% 30% 40% 50% 60% 70% 80% 90%
Ne
ed =
=>
Presence ==>32
Belgium – Present Services
-15% -10% -5% 0% 5% 10% 15% 20% 25% 30% 35%
Counseling depressive, panic or anxiety
counseling stress/motivation
Alcohol & other drug
Critical incident and trauma
Internet based (online) counseling
Fin/legal
Work-life
Childcare/eldercare services
Expatriate support services
Concierge services
Coaching
HR consultation
Performance management
Management training
Other specialist training (healthy lifestyle)
Stress management
Harassment, bullying or grievance investigation
Workplace mediation
Belgium – Need vs. EU Mean
-0.6 -0.4 -0.2 0 0.2 0.4 0.6
Counseling depressive, panic or anxiety
counseling stress/motivation
Alcohol & other drug
Critical incident and trauma
Internet based (online) counseling
Fin/legal
Work-life
Childcare/eldercare services
Expatriate support services
Concierge services
Coaching
HR consultation
Performance management
Management training
Other specialist training (healthy lifestyle)
Stress management
Harassment, bullying or grievance investigation
Workplace mediation
Belgium: Need vs. EU mean
Portugal
Depres/Anxiety
Couns. Stress & Motiv
Alcohol/Drug
CI & Trauma
Internet/Online
Financial/LegalWork-life
Child/Eldercare
Expatriate
Concierge
Coaching HR cons & info
Perf. Mgt
Mgt Training
Spec. Training
Stress Management
Mediation
3.50
4.00
4.50
5.00
5.50
6.00
6.50
0% 10% 20% 30% 40% 50% 60% 70%
Nee
d =
=>
Presence ==>
Portugal – Present Services
-30% -20% -10% 0% 10% 20%
Counseling depressive, panic or anxiety
counseling stress/motivation
Alcohol & other drug
Critical incident and trauma
Internet based (online) counseling
Fin/legal
Work-life
Childcare/eldercare services
Expatriate support services
Concierge services
Coaching
HR consultation
Performance management
Management training
Other specialist training (healthy lifestyle)
Stress management
Harassment, bullying or grievance investigation
Workplace mediation
-0.6 -0.4 -0.2 0 0.2 0.4 0.6
Counseling depressive, panic or anxiety
counseling stress/motivation
Alcohol & other drug
Critical incident and trauma
Internet based (online) counseling
Fin/legal
Work-life
Childcare/eldercare services
Expatriate support services
Concierge services
Coaching
HR consultation
Performance management
Management training
Other specialist training (healthy lifestyle)
Stress management
Harassment, bullying or grievance investigation
Workplace mediation
Portugal - Need vs. EU Mean
Major Conclusions
• HR Managers (‘buyers’) report higher needs, more presence and better quality of services than employees (‘end-users’)
Often employees are not well informed of available services
Communication about EA-services towards employees is an important area for improvement of the services
• The need for EA services reported in different countries are much less diverse than the availability of services –this indicates possibilities for global expansion
38
Opportunities and Challenges for EAPs in Europe
Challenges & Opportunities for EAPs
Opportunities
– Other motives for employers (see Buon & Taylor, 2007):
• External & internal image of “caring company” (perception)
• To support employees suffering from stress (reactivity)
• To promote work-life balance & well-being (proactivity)
• To cut costs & increase performance (economic motives)
– Accent on primary prevention to broaden scope for EAPs with risk assessments, programs/tools for higher uptake
– Evolution from negative to positive outcomes (from stress and harassment to satisfaction and engagement) and etc.
Challenges…how to turn them into Opportunities
– Cultural diversity & different stories = innovation
– Other criteria /arguments when answering to RFP = creative thinking about marketing strategies
– Internal key roles for prevention within companies (HR, prevention advisors, company doctors)
• EAP providers can profile themselves as complementary services, providing support to key people
• More referral models for EAP: direct or indirect
• Internal key people as promoters for EA services
• Collaborating towards more integrated support systems41
Challenges & Opportunities for EAPs
Challenges & Opportunities for EAPs
Challenges, continued– External organizations that offer similar services to companies
• the case for Belgium: ESPP
• sickness insurance companies (‘mutualities’)
When evidence-based approach & best practices permit, shift from competitors to promoters/partners
– Social dialogue in work organizations cannot be bypassed;
Union representatives may be suspicious, need to be convinced of the value of EA services
EAP providers should present themselves as a neutral partner; Employee representatives can be involved as referral agents
© N
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avio
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on
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Stanford W. Granberry, PhD
Primary Investigator
Mark Attridge, PhD, MA
Terry Cahill, MSW, LCSW, CSADC
Patricia Herlihy, PhD, RN
Co-Authors
2013
www.nbcgroup.org
NATIONAL BEHAVIORAL
CONSORTIUM
INDUSTRY PROFILE OF
EXTERNAL EAP VENDORS
The NBC study was supported by a $40,000 grant from the Employee Assistance Research Foundation
(EARF).
The Foundation exists to stimulate innovative, rigorous, and theory-based research activities in the
field of EAP.
www.eapfoundation.org
44
The NBC study shines a flashlight
in a dark closet, it does not
turn on all the lights in the house.
46
Terry Cahill created the first version of
the NBC EAP Vendor Survey 5 years
ago.
47
Actual pictures of Terry Cahill
taken before and after the Survey
This is the first study to provide
publicly available, comparative
information based on such a large and diverse
set of External EAP providers.
Originally US Centric
Canada added
Then Global
52
Panel of Industry Experts
Generated 71 items
That was pared down to 44 Items
Pilot tested & revised
53
1. Corporate Structure
2. Staffing
3. Client Companies
4. Utilization Metrics
5. Survey Tools & Outcomes
6. Business Management
7. Business Development
8. Forecasting the Future of EAP 54
157 total unique data
points if all 44 items are
fully answered
Survey participants primarily: US and Canada
• Included 12 other countries
• Respondents included local to global providers.
130 visitors accessed the online survey
48 responses rejected as invalid
• 40 incomplete questionnaires rejected
• 8 duplicate responses identified & rejected
82 EAP companies provided valid questionnaires
55
1. Over 29,000 customer organizations
2. Over 62 million employees
3. Over 146 million covered lives
56
STEP 1
Targeted large EAP carriers in US and Canada
Sampling frame based on number of covered lives
US vendors > 2 million covered lives
Canadian vendors > 1 million covered lives
57
Targeted 16 large EA providers in US & Canada to
participate.
US: 8 of 11 (72%) > 2 Million covered lives
CA: 5 of 5 (100%) > 1 Million covered lives
58
STEP 2
Multi-stage snowball sampling method
Press Releases and targeted email invitations
Two recruitment waves during 2012
May-July = 66 / October-November = 16
Article
o Scholarly: Peer Reviewed
o JWBH Volume 28, Number 4, Nov/Dec 2013
o 119 pages and 29,251 words
Slide Deck
o Applied: For EAP Vendors
o Companion resource to the article
o www.nbcgroup.org/home.html
1. Greying effect of external EAP owners
2. Mergers and Acquisitions
3. Staying ahead of the technology
61
Issue #1- Marketing claims vs. actual industry
metrics
o NBC Study Data
• Average EAP Counseling utilization rate
• Median 3.6%, Mean 4.5%, Range 0.1 - 15.6%
• Average # of sessions per EAP Counseling case
• Median 2.36, Mean 2.47, Range 1.15 - 4.68
• Percentage of EAP Counseling cases that do not
access the mental health/substance abuse benefit
• 82%
Issue #2 – Is that level of utilization enough OR Are we reaching our client companies?
o NBC Study Response to Areas of Client Company Difficulty –6 of 7 areas identified as “most difficult” relate to this question:
• Face time with client company management, Relationship building activity with client company, Opportunities for a proactive strategic role with client companies (3)
• Promoting the program to family, managers, employees (3)
o The other main identified area of difficulty with client companies was “Quantifying the value of EAP”:
• At current utilization levels, need either another metric or to boost utilization. Only 42% of surveyed EAP orgs used a validated outcome survey tool (Chestnut Global Partners’ Workplace Outcome Suite was the most often utilized)
Issue #3 – Regarding utilization, an EAP is not an EAP is not an EAP
o NBC Study Data – Comparative Metrics Across Dominant Pricing Models (Capitated vs. Fee for Service vs. Embedded “Free” EAP)
• EAP Counseling Utilization Rate:
• Capitated 4.7%, Fee For Service 6.0%, Embedded “Free” EAP
1.6%
• EAP Organizational Service rates for Capitated and Fee for
Service were respectively 7x & 5.5x those of Embedded “Free”
EAP rates
• Embedded “Free” EAPs had 3.8x & 3.3x the number of covered
employees per EAP staff than Capitated and Fee for Service
EAPs
NBC Study Response to Most Difficult Internal
Operations
o Educating Brokers on EAP Value
o Outcomes Measurement Strategy
o Maintaining Information Technology
NBC Study Response to Factors Impacting
Client Renewal, New Sales & Client Erosion
o Product Pricing almost 2x any other variable
o Switch to “Free” EAP
NBC Study Response to Factors Impacting Client
Renewal and New Sales
o EAP Product Improvements
o New Strategic Partnerships
o Enhanced Broker Engagement
o Enhanced technological delivery capabilities
NBC Study Response to Level of Optimism For
External EAP Industry
o 83% Optimistic or very Optimistic. Why?
• Expanding role in psychosocial aspect of behavior change
• Focus on behavioral risk management
• Filling the Wellness Gap
• Technology facilitates EAP reach
Audience Questions
• Any questions for our presenters to clarify any information from their studies?
• Any questions about the EARF?
• Any recommendations for EARF-funded research in the future?
For further information about the EARF, please visit our website:
How You Can Help
There are multiple ways you can support the Foundation:
1. Facilitate a contribution from your organization
2. Make a personal contribution
3. Designate a planned contribution or behest
4. Make an in-kind contribution
5. Assist in fundraising and/or publicity efforts
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