Monday, January 16, 2017

Reasonable Suspicion Training, Attendance Patterns, and Intervention

Alcohol and drug using employees who have substance abuse dependencies may in the later stages of their illness demonstrate erratic attendance patterns that lead to their termination. One common pattern that you should discuss in reasonable suspicion training is the problematic performance issues of being absent on Monday, absent on Friday, and absent the day after payday. Alcoholics or drug addicted employees aren’t the only ones who experience this attendance pattern, of course.

Depression affecting employees, for example, can easily contribute to an absenteeism pattern. In fact, oddly, once had an EAP client with attendance pattern caused by her inability to continue on any drive to work because of fear that she had accidentally run over someone when she turned the last corner while driving her car. This necessitated her turning the car around and driving back in the opposite direction to ensure no one was lying in the street injured or dead! This would happen a dozen times on her commute to work.

Despite other personal problems of employees that contribute to absenteeism, the classic pattern above is probably most common among addicts and frequently observed by managers and workforce management professionals with any significant time on the job. Typically when this symptom pattern is discussed in reasonable suspicion training, you will receive a odd chuckle from the crowd because they all know what you are talking about. (Continue to Read More on Reasonable Suspicion Training and Intervention and get the free e-book download PDF on Performance-based Intervention)

Saturday, January 14, 2017

Preventing Caregiver Depression - There Are Employees You Haven't Reached

Caregivers suffer depression at three times the rate of other people. And if you do not think that this affects workplace productivity, you're missing the mark on this problem. When employees leave work at the end of the day, their "second" job begins, and like everyone else, the stress and strain of work, care-giving, and home life begin to form a box from which one feels that their is little escape. Some employees may take it a day at a time. And although few will admit it, some may secretly wish--and feel guilty for it--the natural death of their loved one. Combine this with any substance abuse issues, depression, financial problems, or the IRS bill that wasn't paid last year from a squeezed in part time job, and you risk for a seriously troubled employee. You can only reach these employees with what is an EAP newsletter for employees. I hope you have one, and I hope it is monthly. Because if it is not, you're putting on a nice show, but you're not penetrating what is known as "top of mind awareness." You've seen the stats on how many times we are bombarded by commercials and promotions on a daily basis. As I type this blog note, and glance to the right and left of me, I have count 31 such messages. I mean, it is insane! Your EAP is fighting this clutter, but you still have to figure out how to be not a pest, but a welcomed guest. The strategy is knowing the issues in the workforce, issues SHORT, INTENSE, NO FLUFF SOLUTION-ORIENTED CONTENT employees look forward to getting, and frankly, the rest is waiting for the phone to ring. I would like to add one more key. Add in writing, to the bottom of any newsletter, that the EAP is confidential. You are fighting perceptual erosion of confidentiality on a continual basis because fear of whether a program is confidential is a real energy force that is relentless. You can't fight this with a quarterly newsletter sheepishly and apologetically slipped into an employee's inbox once per month. Use this content in your next newsletter that I wrote - you may do so without attribution.

The following is copyrighted content that may be used by you the reader of this blog post. No attribution required, but you could put a copyright and link to, we would appreciate this very much because it allows us to improve rankings on search engines (and it harder now that ever!) So, you may also edit this article and add your professional expertise to it. However, for an editable, reproducible, web usable, and brand-able EAP Newsletter and articles of this type for your company, EAP, or wellness program, go here.
Since depression is a disease and not a moral or character failing, you must be on-guard for its signs and symptoms exactly like you would for the flu during the wintry months. In your case as a caregiver, this may be periods of time when you are under inordinate stress from sort of responsibility. There are many symptoms of depression, and the EAP is at your disposal for a full assessment, but here are five important rules regarding depression and personal awareness especially for caregivers: 1) Don’t dismiss stress you are experiencing and the symptoms you suspect may be depression by using positive "self-talks” and internal lectures to yourself about “handling it better” or “brushing it off.” Instead, get a quick and easy assessment at the EAP. 2) Understand the difference between “caring” and “doing.” This means being open to help from other people who love and care about you, and from services that can ease your burden or encourage independence by your loved one when appropriate. "Meals Without Wheels" may not be as wonderful as your home cooking, but it can help take the edge off of a bad day for a stressed caregiver. 3) Don’t wait to feel strained before asking for help. Learn to see the strain around the corner. If a tough assignment at work is coming soon and you anticipate conflict and added stress in care-giving, consider your options. The EAP can also help you trouble-shoot solutions. 4) Know what activities rejuvenate you and your spirit, so when you get respite care, (any extended break) you know what to choose that will best retool and re-energize your ability to carry forth. 5) Find another caregiver and develop a friend or buddy in that person, someone you can bond with socially, exercise with, or mutually find shared support.


Learn more or see the tip sheet from associated with managing caregiver stress

Saturday, December 31, 2016

After Reasonable Suspicion Training Is Completed, Will Referred Employee Be Sabotaged in Treatment?

 After training managers or supervisors in drug and alcohol awareness, including signs, symptoms, impact, and effect on a worker's psycho-motor skills (all required by the DOT for reasonable suspicion training,) be sure so offer a bit of education to all participants about being careful not sabotage treatment in the event an employee is referred following a positive test and assessment.

The sabotage of addicts in treatment is a common dynamic, and demonstrates unfortunately the natural ignorance most persons have about addictive disease and also the powerful bond of enabling as a dynamic that seeks out the addict like a bloodhound with determination to "help" by saying and doing all the wrong things for the right reasons.

Much of this so called AMA prevention responsibility lies with the treatment program of course and the counselor's ability to educate family members and concerned persons about the role of the family in support of recovery -

Gatekeeping is a critical role but not all treatment programs do it well.  Read More

Thursday, December 1, 2016

The King Has No Clothes: Managed Care's Utter Failure to Harness the Power of EAPs

One of the things I have attempted to do over the past 25 years is help EAPs see themselves as part of the organization's larger risk management strategy. This is no way conflicts with the touchy-feel (aka, program of attraction) model EAPs depend upon. On the contrary it enhances it.

Things like employee newsletters and other utilization and promotion devices are risk management tools and part of the critical continuum of best practices organizations must embrace to reduce loss.

And wow are these tools inexpensive. I would like to see more organizations phoning the EAP and saying, "Hey, make sure your renew the employee newsletter, it is probably saving us thousands or millions by increasing your referrals." 

There are many other tools EAPs can assemble, but this is just one of them. These things are not "nice to haves" as they are often portrayed by uninformed (or misinformed.) Nay, they are essential risk management, and potentially, "going postal" prevention tools.

Until recently, I really could not determine why the value-added argument everyone well-understood in the early 1980's was not working better for EAPs, and why instead EAPs  service vendors and internal programs were closing faster than a creeping forest fire in Gatlinburg.

The idea the EAPs can grow and grow to capture more unmitigated risks associated with human workplace behavior should have overwhelming acceptance by now. I have theory: "The King has No Clothes" . Managed care wants nothing to do with the property-casualty risk market, (which is what we are discussing here), its issues, and the work and integration required to penetrate it. It simple does not meet its business goals of reducing health insurance costs and increasing profits. But EAPs did not start out this way. In yesteryear, they targeted the whole ball of wax of risk in business organizations. If you are retired from the EAP field by now, but as you read this, you know something dramatically degrading has happened to the EAP field.

If a better linkage between EAPs and their powerful risk management reduction capacity where ever truly codified, managed care would risk losing control of EAPs and the simplistic model they depend upon for their uni-polar purpose. Managed care depends on the large majority of EAPs thinking and behaving as they do, and they spend millions on publicity, educational forays, and press releases at every turn to educate the human resources continuum and public at large to buy into their understanding of EAPs as they wish them to be seen. That is, more or less counseling and assessment services with a predominant self-referral path. When the time comes, as  it seems to do almost every day, traditional EAPs bite the dust. Actually, a better way to put it would be that they are more easily assimilated like the Borg in Star Trek. ("resistance is futile.")

I helped secure Arlington County Government's EAP and the School System's EAP against
managed care contagion 15 years ago by capturing the high ground and allowing the EAP core technology to work its magic by reaching out into any area of the organization where human behavior and trouble employees became exposures that threatened the financial well-being of the organization. Arlington County/Public Schools now has a six person staff for 7,500 employees and a very healthy budget. No vendor or managed care organization can touch it (many have tried) with the large swath of EAP services it provides.

Below is an amazing Web site which contains many arguments and appropriate phraseology for EAPs to use in arguing for their larger purpose, value, and ability to manage more behavioral risks within the confines of the EAP core technology. If you face the ever-present jeopardy of closure and takeover by managed care, you may find help here. Delve deep into it, and start identifying unmitigated risks and exposures during the year. Present an annual "risk mapping report" and recommend additional growth for your EAP, not budget cuts.

The successful end result, of course, is more lives saved and more organizational costs contained. Be aggressive with risk management and program growth to help your EAP and the EAP profession itself. It has shrunk 60% in 25 years despite growth in what are called "EAPs."

The real story of successful EAPs is still be written, or re-discovered, but it is not one that will sit well with managed care. When it comes to the "lead, follow or get out of the way" approach to the EAP field (as I heard at a recent EAPA conference), be sure the one you are following has clothes.

Friday, November 18, 2016

Increasing EAP Utilization Hack #16: Use a Good Health Supply Line

I want to share with you an employee assistance program utilization improvement hack I created that will help boost your EAP utilization nearly overnight. It is called the "Good Health Supply Line®". I created this service as part of the EAP program I owned in the early 90's, but since I have never seen it duplicated, I thought I would share it and let you consider it for your EAP. You are welcome to use this idea by changing the name of the service to one you find suitable, but different than mine. The following background and rationale for this utilization hack is obvious. Many employees will never phone the EAP, and so you need to make every reasonable attempt to reach them. This does the trick. Create an order form with a large menu of wellness topics that include handout titles, tip sheet titles, or booklets on workplace wellness topics, such as those distributed by Abbey Press using their product called "CareNotes." Or, you can use the workplace wellness tip sheets from (purchase the entirely library here). On the order form, allow employees to confidentially choose five topics/titles. The form should be mailed via U.S. Postal mail to the EAP office. The EAP then fills the order and mails it back to the employee or family member. Distribute a postpaid envelope with it the order form for best results. Emphasize confidentiality. Only the EAP will receive the order from the employee. Postal mail is confidential of course. The beauty of this outreach technique is the opportunity to promote your EAP with a cover letter designed to encourage the employee or family member to visit the EAP for the issues or problems that concern them, identified in the titles they chose. Do this once per year. Have the employer to reimburse the EAP directly or make it a part of your service. The titles of the booklets distributed to employees are not shared with the employer. This is also an important part of the service and key to its effectiveness.

Saturday, October 29, 2016

Can Mindfulness Help to Intervene with Our National Opioid Epidemic?

A new federally funded research project will attempt over a five-year period to demonstrate that mindfulness  will reduce a person’s craving for opioid painkillers and improve the ability to cope with the intense pain for which these drugs are most often prescribed. There is evidence already that mindfulness can have some impact on managing pain. (Mindfulness is the psychological process of bringing one's attention to the internal and external experiences occurring in the present moment, which can be developed through the practice of meditation and other training.) Here is the essence: The research will attempt to restore restoring brain levels of endorphins in patients with chronic back pain who are being treated with prescription opioids. This, in turn, will make it potentially possible to reduce addiction occurrence rates. The subjects will be military veterans who suffer with more pain, trauma, and serious problems with opioid addiction. The advantage of the research will be to extend its benefits and approach to opioid addiction treatment to other people in the general population. Here's what to do: 1) Check out this news article here. 2) Follow the research 3) Find and find out what they are doing and whether you can apply these techniques to supplement recovery and follow-up work if you are currently working with recovering addicts. This is a non-medical, non-invasive approach, and I would not hesitate to consider whether these approaches might help addicts, frankly, because prior research from the same researcher shows that mindfulness has an impact on some of this stuff. This researcher should be posting a twitter account or updates that can be tracked by the general public. Consider: "Prolonged opioid use changes the way the brain functions, leading to heightened pain sensitivity, insensitivity to natural pleasure, and vulnerability to addiction—factors that may result in opioid dose escalation, which can end in overdose and death. Based on the results of previous research, Eric Garland, Associate Dean at the University of Utah hopes that with this grant he will find evidence that mindfulness meditation training through this research will restore proper function to the brain’s opioid receptors.