Each person in the group presents his or her personal experience with alcoholic or addict explaining two experiences directly related to the use of alcohol/drugs and its effects on their life without blaming the addict (it's the disease and drug affected behavior damaging the person and the relationship.) Natural emotional emotional pain will be experienced and demonstrated. That’s appropriate. I statements must be used. Describing experiences their associated emotional pain in the relationship is key. If any participant is so angry that he or she can’t describe their pain and get vulnerable in front of the alcoholic, more work with that person should be considered, or their participation in the intervention should be questioned. Before describing the negative events above, each person affirms how important and valued their relationship is with the addict or how they want to return to what that value relationship once was.
When describing negative events, the key to success is not focusing on the addict's need for treatment. That comes later. Instead, have family/friends focus their experience and feelings associated with hurt and pain caused by the alcohol-affected behavior or its outcomes.
Participants describe in detail two events and their impact. A key element in interventions in having family members acquire the ability to consider within their stories the difference between what the relationship is like now as a result of the use of alcohol or drugs and what a vividly imagined and described picture of what it can and should be if only person's behavior was not affected by alcohol.
This is powerful. No presenter should discuss another participant's experience or attempt to point out what he or she thinks the alcoholic can’t see or doesn't understand. This triggers the use of defense mechanisms and sets the intervention back. The group’s goal with the serial presentations is to create a phenomenon called synergistic remorse.
Each person's presentation causes the alcoholic to re-experience feelings of remorse or guilt--originally felt at the time an incident originally occurred. These feelings of remorse are often short-lived, but they are a open window into which the group will insert a treatment solution later. The goal is to have the addict begin to feel a sense of urgency and determination to deal with the drinking problem/drug problem in some way he or she thinks might be effective. (Willpower is usually what's being silently considered.)
At the end of the last story, the group moves quickly to request admission to an addiction treatment program knowing that at the end of a series of effective presentations the synergistic remorse effect is in play and peaked. An attempt to bargain by the addict is the usual response, and then an gentle persuasion experience on the part of the group begins.
The group asks and presses the addict to enter a treatment program immediately. Each participant presses for this decision.
The goal is to successfully urge the addict's acceptance of the treatment recommendation and reject effectively ideas offered by the addict that will certainly be minimal and half-measured attempts to abstain. Participants MUST be effective with their language at providing non-agitating and non-provocative responses to the addict's "better idea". The following is a resource (sorry it is not well proofed, but I can't edit these blogs and information very effectively so bare with me folks.)
Try this document I wrote to help my own intervention clients: “Effective Responses to Defensive Statements Made By Addicts in Interventions". I think it does a pretty good job at educating participants with “what to say” and “how to say it” in response to twenty classic objections addicts use interventions. Language is disease model based and I think you will get the point of why it is effective to marshal support and confidence in family members prior to an intervention.
Tuesday, March 3, 2009
Thursday, January 22, 2009
Family Empowerment Model Intervention: Part II of V
Part II of IV (See first installment of this article a couple days back)
Family Empowerment: Instruction in the Leverage and Use of Influence.
After instruction in the disease orientation to addiction, participants in
intervention training should be instructed in understanding the use of
influence in the interventions.
Influence is the value or inherent worth that can be subjectively assigned to the relationship a family member or friend has with the addict. All attendees in the intervention should have some influence.
Negative influence equates to provocative relationships of any kind,
including drinking buddies, etc. Such persons should not participate.
Obviously the amount of influence will vary among participants with some, say
a close friend, having a lot, and others say, a cousin or neighbor having
less.
One member of the group must accept responsibility for being
the leader of the intervention group. This person's responsibility is to start the
intervention meeting when it occurs and guide the structure since there
will be no "professional intervention consultant” present.
All members of the group must adhere to strict communication boundaries between training
and the day of the actual intervention. Addicts (as a result of the
disease) become hyper-vigilant and will easily detect subtle mood
differences or behaviors of participants that can tip off to the plan for an
intervention.
The structure of any Family Empowerment Model
intervention includes: Introduction, Use of Influence, Pushing for
Admission, Use of Leverage, Pushing for Admission (second try),
Conclusion, the Admission, and Next Step for a Refusal Outcome.
Eighty percent of interventions that I have arranged never had to use leverage,
but it is critical for it to be present in case it is needed. Leverage
provides intervention teams with psychological power and confidence, which
can be felt by the addict intuitively.
This is the value of leverage. Leverage is something given or taken away from the addict that he or she greatly fears. Next, the group should discuss where they intend to meet the
addict for the intervention.
The group should approach the intervention when the addict is most likely to be least affected by toxcity. Morning hours are frequently better than evenings, for instance, but there is no
hard and fast rule to this step.
Discussion will produce the best time and place. The group must buy into making treatment nonnegotiable. This concept refers the absolute belief by the participants that treatment is necessary to save a life and that the status quo with the practicing addict will never
return unless they fail in their determination for change. Any other type of relationship enables the addict to get sicker.
Until the addict is in treatment, the only practical relationship with the addict is the one that facilitates admission to a treatment program as soon as possible. This is particularly true if the intervention is not successful at its conclusion.
Such an understanding will maintain a state of inertia necessary to act at the next opportunity or incidental crisis associated with the drinking or drug use. This is a key point, because such a crisis will come. It is only a matter of time. When this happens, the group will act to encourage admission and will probably be successful.
This is how virtually all interventions successfully occur not led by a professional become successful. A quick attempt to directly facilitate admission will succeed eventually.
Starting an intervention is always a bit difficult, but a plan should be in place for precisely how it is done, and it should practiced. The leader starts by saying something to the effect that "we are all here because there is something very important that we have to tell you. We need you to hear it. This is very personal for each of us and each of us has something we need to say.
There are obviously many variations on this wording. A fair guess, however is that 95% of addicts will cooperate with the intervention at this point. Few guess what is happening and get up and leave. But there is plan in place in the event that happens.
Participants should rehearse their presentation at least twice. Until the day of the intervention, it is important that participants “carry on as usual” and not “alter suspiciously” their relationship with the addict. A crisis caused by drinking or drug using behavior, however, pushes the intervention date forward to NOW.
Prior to the intervention, participants must make preparations for the following: admission after the intervention (or outpatient intake, or evaluation, etc. You can help them decide which is
best.); logistical considerations that could cause the addict to back out -- money, job issues, pets, vacations, bills, child-care, etc. All bases must be covered.
The intervention begins by the leader talking first. Every participant will talk using the following rules: (1) Avoid blaming; (2) Speak only about your own experience; (3) Do not refer to other people in the group; (4) Avoid shaming; (5) Avoid using the terms "you should"
"can't you see what you've done" or other language that moves away from the participants "first-person account of their personal experience associated with the addict's behavior.
The group is also instructed in the "sandwich technique". The sandwiching technique is an interviewing manuever designed to confront a person with negative facts associated with their
problem while blunting the impact with positive statements that validate the person's worth.
In interventions, this means validating how important or how loved the addict
is by each person.
Each person rotates through the confrontation presentation and speaks about their personal experience with the addict. (Next, blog note, I will discuss the outline of this presentation.)
Family Empowerment: Instruction in the Leverage and Use of Influence.
After instruction in the disease orientation to addiction, participants in
intervention training should be instructed in understanding the use of
influence in the interventions.
Influence is the value or inherent worth that can be subjectively assigned to the relationship a family member or friend has with the addict. All attendees in the intervention should have some influence.
Negative influence equates to provocative relationships of any kind,
including drinking buddies, etc. Such persons should not participate.
Obviously the amount of influence will vary among participants with some, say
a close friend, having a lot, and others say, a cousin or neighbor having
less.
One member of the group must accept responsibility for being
the leader of the intervention group. This person's responsibility is to start the
intervention meeting when it occurs and guide the structure since there
will be no "professional intervention consultant” present.
All members of the group must adhere to strict communication boundaries between training
and the day of the actual intervention. Addicts (as a result of the
disease) become hyper-vigilant and will easily detect subtle mood
differences or behaviors of participants that can tip off to the plan for an
intervention.
The structure of any Family Empowerment Model
intervention includes: Introduction, Use of Influence, Pushing for
Admission, Use of Leverage, Pushing for Admission (second try),
Conclusion, the Admission, and Next Step for a Refusal Outcome.
Eighty percent of interventions that I have arranged never had to use leverage,
but it is critical for it to be present in case it is needed. Leverage
provides intervention teams with psychological power and confidence, which
can be felt by the addict intuitively.
This is the value of leverage. Leverage is something given or taken away from the addict that he or she greatly fears. Next, the group should discuss where they intend to meet the
addict for the intervention.
The group should approach the intervention when the addict is most likely to be least affected by toxcity. Morning hours are frequently better than evenings, for instance, but there is no
hard and fast rule to this step.
Discussion will produce the best time and place. The group must buy into making treatment nonnegotiable. This concept refers the absolute belief by the participants that treatment is necessary to save a life and that the status quo with the practicing addict will never
return unless they fail in their determination for change. Any other type of relationship enables the addict to get sicker.
Until the addict is in treatment, the only practical relationship with the addict is the one that facilitates admission to a treatment program as soon as possible. This is particularly true if the intervention is not successful at its conclusion.
Such an understanding will maintain a state of inertia necessary to act at the next opportunity or incidental crisis associated with the drinking or drug use. This is a key point, because such a crisis will come. It is only a matter of time. When this happens, the group will act to encourage admission and will probably be successful.
This is how virtually all interventions successfully occur not led by a professional become successful. A quick attempt to directly facilitate admission will succeed eventually.
Starting an intervention is always a bit difficult, but a plan should be in place for precisely how it is done, and it should practiced. The leader starts by saying something to the effect that "we are all here because there is something very important that we have to tell you. We need you to hear it. This is very personal for each of us and each of us has something we need to say.
There are obviously many variations on this wording. A fair guess, however is that 95% of addicts will cooperate with the intervention at this point. Few guess what is happening and get up and leave. But there is plan in place in the event that happens.
Participants should rehearse their presentation at least twice. Until the day of the intervention, it is important that participants “carry on as usual” and not “alter suspiciously” their relationship with the addict. A crisis caused by drinking or drug using behavior, however, pushes the intervention date forward to NOW.
Prior to the intervention, participants must make preparations for the following: admission after the intervention (or outpatient intake, or evaluation, etc. You can help them decide which is
best.); logistical considerations that could cause the addict to back out -- money, job issues, pets, vacations, bills, child-care, etc. All bases must be covered.
The intervention begins by the leader talking first. Every participant will talk using the following rules: (1) Avoid blaming; (2) Speak only about your own experience; (3) Do not refer to other people in the group; (4) Avoid shaming; (5) Avoid using the terms "you should"
"can't you see what you've done" or other language that moves away from the participants "first-person account of their personal experience associated with the addict's behavior.
The group is also instructed in the "sandwich technique". The sandwiching technique is an interviewing manuever designed to confront a person with negative facts associated with their
problem while blunting the impact with positive statements that validate the person's worth.
In interventions, this means validating how important or how loved the addict
is by each person.
Each person rotates through the confrontation presentation and speaks about their personal experience with the addict. (Next, blog note, I will discuss the outline of this presentation.)
Sunday, January 11, 2009
How Complicated Can You Make a Supervisor Referral...Let Me Count the Ways
I have absolute faith in the future of the EAP profession because a great idea will always carry it's weight and move forward, so don't take the following the wrong way. I thought I would just have some fun with creative writing this morning. =======================================
Hey, why is the EAP field and its processes so confusing after over 30 years of being an established and legitimate occupational pursuit?
Answer: A lack of detailed and enforced standards and sanctions for misapplied EAP core technology priniciples that hurt employees, cause loss of jobs, and dismantle the EAP profession. I am convinced, anyone can call anything they want an EAP and recognized associations, even if you are a member of them, won't give a hootily. Just pay your dues on time.
When I get the inkling to discuss this topic, I only have to Google a specific term and up pops a great example of what I am talking about.
Here's today's wonderful (not) illustration. Here is how one HR benefits firm with an "EAP product" discusses their procedure for making what they call a "SUPERVISOR REFERRAL TO THE EAP":
STEP 1: HR (not the supervisor!) calls _________EAP to discuss the purpose for the referral and requests a blank Supervisory Referral Form if needed.
STEP 2: HR and employee discuss Job Performance Problem and determine deadline by which employee must contact ____________EAP and have an initial EAP assessment. Supervisory Referral Form is then signed by both the employee and HR/Supervisory Representative
STEP 3: Supervisory Referral Form is faxed to ______EAP attn: Clinical Manager
STEP 4: Employee calls ________EAP intake operator and requests a referral to a provider
STEP 5: Employee calls provider and schedules an appointment as per agreement
STEP 6: ________EAP Clinical Manager contacts provider and HR/Supervisor to begin the process of mediation between the provider and HR regarding the employee’s treatment plan and progress.
I don't know if you were counting, but there are a total of 8 humans involved in this referral not counting the employee. If you missed the person who is assigned to email or fax the supervisor form, you're simply not on your toes.
How many supervisor referrals to you think this provider receives as a percentage of total referrals to the EAP during the year?
True confession: I worked for a company for 11 months in 1995 (I won't mention the name here, but you can visit my resume to find out.) and they had an almost identical process. That organization's supervisor referrals were close to ZERO!
A supervisor referral is a simple thing. And, it's powerful. But add in bureaucratic hoops and fire rings to create a circus and your utilization rate will flop. Worse still, behavioral risk with the folks that might go "postal" or have other problems that cause financial loss will increase.
Here is what a supervisor referral is (I am going to be a little cynical and expansive in this paragraph to emphasize my point.)
STEP 1: A supervisor referral simply uses the application of authority or leverage of job security to motivate a troubled employee to accept the exciting opportunity to be accommodated and assisted by the EAP to get help for a possible personal problem in lieu of the possibility or immediately pending disciplinary action for documented job performance or conduct problems.
STEP 2: The EAP is notified, preferably, but it won't and can't interfere with the supervisor referral and the employee's responsibility to act. Documentation is given to the employee and the EAP, and a release is requested to be signed by the employee to verify participation and cooperation with whatever is going on at the EAP.
A release is essential to good EAP work, but what if you can't get it? Remember, EAPs are voluntary. Well, answer: It isn't needed or necessary if the employee doesn't want to verify attendance and cooperation (which can easily be explained by the EAP or the supervisor as not a smart choice.) Verifying attendance and cooperation is to the employee's benefit. No organization is handicapped without a release.
That's the sum and substance of a supervisor referral. One human involved, plus the employee being referred will make it work beautifully with an EA professional at the other end.
The key is making the employee responsible for change and accountable for change. Supervisor follow-up is key. A breakdown in communication and bureaucratic snarling in supervisor referral process translates to an erosion of the employee's perception of accountability for change.
Hey, why is the EAP field and its processes so confusing after over 30 years of being an established and legitimate occupational pursuit?
Answer: A lack of detailed and enforced standards and sanctions for misapplied EAP core technology priniciples that hurt employees, cause loss of jobs, and dismantle the EAP profession. I am convinced, anyone can call anything they want an EAP and recognized associations, even if you are a member of them, won't give a hootily. Just pay your dues on time.
When I get the inkling to discuss this topic, I only have to Google a specific term and up pops a great example of what I am talking about.
Here's today's wonderful (not) illustration. Here is how one HR benefits firm with an "EAP product" discusses their procedure for making what they call a "SUPERVISOR REFERRAL TO THE EAP":
STEP 1: HR (not the supervisor!) calls _________EAP to discuss the purpose for the referral and requests a blank Supervisory Referral Form if needed.
STEP 2: HR and employee discuss Job Performance Problem and determine deadline by which employee must contact ____________EAP and have an initial EAP assessment. Supervisory Referral Form is then signed by both the employee and HR/Supervisory Representative
STEP 3: Supervisory Referral Form is faxed to ______EAP attn: Clinical Manager
STEP 4: Employee calls ________EAP intake operator and requests a referral to a provider
STEP 5: Employee calls provider and schedules an appointment as per agreement
STEP 6: ________EAP Clinical Manager contacts provider and HR/Supervisor to begin the process of mediation between the provider and HR regarding the employee’s treatment plan and progress.
I don't know if you were counting, but there are a total of 8 humans involved in this referral not counting the employee. If you missed the person who is assigned to email or fax the supervisor form, you're simply not on your toes.
How many supervisor referrals to you think this provider receives as a percentage of total referrals to the EAP during the year?
True confession: I worked for a company for 11 months in 1995 (I won't mention the name here, but you can visit my resume to find out.) and they had an almost identical process. That organization's supervisor referrals were close to ZERO!
A supervisor referral is a simple thing. And, it's powerful. But add in bureaucratic hoops and fire rings to create a circus and your utilization rate will flop. Worse still, behavioral risk with the folks that might go "postal" or have other problems that cause financial loss will increase.
Here is what a supervisor referral is (I am going to be a little cynical and expansive in this paragraph to emphasize my point.)
STEP 1: A supervisor referral simply uses the application of authority or leverage of job security to motivate a troubled employee to accept the exciting opportunity to be accommodated and assisted by the EAP to get help for a possible personal problem in lieu of the possibility or immediately pending disciplinary action for documented job performance or conduct problems.
STEP 2: The EAP is notified, preferably, but it won't and can't interfere with the supervisor referral and the employee's responsibility to act. Documentation is given to the employee and the EAP, and a release is requested to be signed by the employee to verify participation and cooperation with whatever is going on at the EAP.
A release is essential to good EAP work, but what if you can't get it? Remember, EAPs are voluntary. Well, answer: It isn't needed or necessary if the employee doesn't want to verify attendance and cooperation (which can easily be explained by the EAP or the supervisor as not a smart choice.) Verifying attendance and cooperation is to the employee's benefit. No organization is handicapped without a release.
That's the sum and substance of a supervisor referral. One human involved, plus the employee being referred will make it work beautifully with an EA professional at the other end.
The key is making the employee responsible for change and accountable for change. Supervisor follow-up is key. A breakdown in communication and bureaucratic snarling in supervisor referral process translates to an erosion of the employee's perception of accountability for change.
Wednesday, January 7, 2009
Addiction Intervention Consulting for EAPs
Should you offer intervention consulting to employees who have family members or close friends with alcoholism or drug addiction problems?
You may mistakenly believe that intervention consulting requires going to where the intervention is being held, and passively being available in case expert guidance is needed at the event. The intervention industry, which is fraught with rip-off artists has promulgated the belief that intervention requires highly skilled professionals who show up on a Sunday morning after a pancake breakfast to surprise the alcoholic with a loving and supportive surprise meeting.
Nothing could be further from the truth. Intervention guidance does not require "specialists". The evidence for such an observation is in plain site. Addicts are admitted to treatment programs every day with only the hip-shot pressure placed upon them by family members or employers who accidentally, on purpose, said the right thing for the right reasons to motivate an addict to accept help. No intervention expert was present. And, I would imagine 95% of admissions to addiction treatment programs happen just like this--influence and leverage of those in relationships with addicts effectively applied.
Most admissions to chemical dependency treatment programs occur without an interventionist guiding the process, which is usually very expensive. The call to "have an expert" present effectively eliminates many people from the opportunity to ever consider an intervention. This not fair. To say to a family that they can't be just as successful without an intervention is one of the greatest disservices ever to be levied on addicts and family members.
How do you help these people? Despite attempts by interventionists to claim a high levels of artistry and to promulage fear if an expert isn't present, the reality is that the basic principles of successful intervention can be easily taught.
And, my argument is that success rates are higher if this "empowerment model" is used. That's because family members can try again if the first intervention fails, and they can become determined engines of change until it happens.
Most interventions (althought not called that) are completed by insistent family members with no interventionist present. In other words, people do say the right thing, perhaps accidentally, that motivates an addict to enter treatment. Usually these are family members who have decided to make treatment “non-negotiable.” The result is admission.
So, how do you add this expertise to your EAP?
The logistics. Such a meeting to educate an employee should include at the most four or five persons who have significant influence or leverage. More than that, and too much cross talk emerges dragging out the training of these individuals. (From experience and having done as many as 11 trainings in one week, the two major tools of intervention are helping family members IDENTIFY and USE tools of "Influence" and "Leverage".
Influence is the value or weight assigned to the relationship one person has with the addict. Leverage is something that can be given or taken away, which the addict greatly fears. Each of these are crucial tools in interventions, and they are used differently, and at different times, as I will explain. My argument in this blog of course is to argue that addiction intervention training skills should (and I would like to argue must) be a part of your scope of service. It is perfectly within bounds of the EAP Core Technology.
The instructional meeting will last about two hours. (This is not treatment or group therapy, although I know many therapists who have illegally/unethically bill for it through 3rd party reimbursement.)
A person with addictive disease has a medical illness. You are providing common sense principles of constructive confrontation to help family/friends motivate the addict to accept help. This is not therapy.
Your first task is to get information about the addict. Get the family to tell you the whole story. Get a feel for the situation. Next, enter a discussion about addictive disease. You must determine each of the participant’s knowledge about the disease and ensure that each of them understands the biogenic nature of the illness. Educate as you go. Any participants with “psychologically oriented,” or “willpower” models about the disease will sabotage the intervention.
Ultimately exclude such persons if they can’t come around. Coach them out of the intervention. Next, you must deal with guilt. Each of the participants will feel guilty about the intervention to some degree. These persons will also sabotage the intervention if they can't get past it. Help them see that they are not going “behind the addict’s back”.
Most of this guilt is based upon an enabling dynamic fueled by the addict’s direct or implied demands for loyalty in order to avoid confrontation over a period of years. Explain this to erode their mistaken beliefs. My next blog note: The Intervention Training Meeting Part I.
I know this is a bit gutsy, and that I am going against about 30 years of convention, but people need to hear the message. By the way, the movie "I'll Quit Tomorrow" will get your company sued fast if you ever try to duplicate what promotes--bringing the family into the workplace and surprising the employee in the office of the company's president to be confronted about their alcoholism. Burn the film if it is in your midst.
Feel free to e-mail questions or rebuttals as I continue this blog. I would like to respond to your comments: publisher@workexcel.com.
You may mistakenly believe that intervention consulting requires going to where the intervention is being held, and passively being available in case expert guidance is needed at the event. The intervention industry, which is fraught with rip-off artists has promulgated the belief that intervention requires highly skilled professionals who show up on a Sunday morning after a pancake breakfast to surprise the alcoholic with a loving and supportive surprise meeting.
Nothing could be further from the truth. Intervention guidance does not require "specialists". The evidence for such an observation is in plain site. Addicts are admitted to treatment programs every day with only the hip-shot pressure placed upon them by family members or employers who accidentally, on purpose, said the right thing for the right reasons to motivate an addict to accept help. No intervention expert was present. And, I would imagine 95% of admissions to addiction treatment programs happen just like this--influence and leverage of those in relationships with addicts effectively applied.
Most admissions to chemical dependency treatment programs occur without an interventionist guiding the process, which is usually very expensive. The call to "have an expert" present effectively eliminates many people from the opportunity to ever consider an intervention. This not fair. To say to a family that they can't be just as successful without an intervention is one of the greatest disservices ever to be levied on addicts and family members.
How do you help these people? Despite attempts by interventionists to claim a high levels of artistry and to promulage fear if an expert isn't present, the reality is that the basic principles of successful intervention can be easily taught.
And, my argument is that success rates are higher if this "empowerment model" is used. That's because family members can try again if the first intervention fails, and they can become determined engines of change until it happens.
Most interventions (althought not called that) are completed by insistent family members with no interventionist present. In other words, people do say the right thing, perhaps accidentally, that motivates an addict to enter treatment. Usually these are family members who have decided to make treatment “non-negotiable.” The result is admission.
So, how do you add this expertise to your EAP?
The logistics. Such a meeting to educate an employee should include at the most four or five persons who have significant influence or leverage. More than that, and too much cross talk emerges dragging out the training of these individuals. (From experience and having done as many as 11 trainings in one week, the two major tools of intervention are helping family members IDENTIFY and USE tools of "Influence" and "Leverage".
Influence is the value or weight assigned to the relationship one person has with the addict. Leverage is something that can be given or taken away, which the addict greatly fears. Each of these are crucial tools in interventions, and they are used differently, and at different times, as I will explain. My argument in this blog of course is to argue that addiction intervention training skills should (and I would like to argue must) be a part of your scope of service. It is perfectly within bounds of the EAP Core Technology.
The instructional meeting will last about two hours. (This is not treatment or group therapy, although I know many therapists who have illegally/unethically bill for it through 3rd party reimbursement.)
A person with addictive disease has a medical illness. You are providing common sense principles of constructive confrontation to help family/friends motivate the addict to accept help. This is not therapy.
Your first task is to get information about the addict. Get the family to tell you the whole story. Get a feel for the situation. Next, enter a discussion about addictive disease. You must determine each of the participant’s knowledge about the disease and ensure that each of them understands the biogenic nature of the illness. Educate as you go. Any participants with “psychologically oriented,” or “willpower” models about the disease will sabotage the intervention.
Ultimately exclude such persons if they can’t come around. Coach them out of the intervention. Next, you must deal with guilt. Each of the participants will feel guilty about the intervention to some degree. These persons will also sabotage the intervention if they can't get past it. Help them see that they are not going “behind the addict’s back”.
Most of this guilt is based upon an enabling dynamic fueled by the addict’s direct or implied demands for loyalty in order to avoid confrontation over a period of years. Explain this to erode their mistaken beliefs. My next blog note: The Intervention Training Meeting Part I.
I know this is a bit gutsy, and that I am going against about 30 years of convention, but people need to hear the message. By the way, the movie "I'll Quit Tomorrow" will get your company sued fast if you ever try to duplicate what promotes--bringing the family into the workplace and surprising the employee in the office of the company's president to be confronted about their alcoholism. Burn the film if it is in your midst.
Feel free to e-mail questions or rebuttals as I continue this blog. I would like to respond to your comments: publisher@workexcel.com.
Wednesday, December 24, 2008
EAPs and the Great Uncharted Territory of Cost-Benefit
(In this post, I am going to add a bit more to my previous post in November on EAPs and management liability. I see that I missed a couple points.)
The great uncharted territory of cost-benefit for EAPs is the positive impact they have on the bottom line in helping prevent lawsuits brought against companies by their employees for employment practice missteps and wrongdoings.
Did you know that the average out-of-court settlement for wrong discharge is over $100,000? The average jury award is over $500,000, and employers lose over 60% of the time. Health care dollar saved by EAPs do not compare with the size of the awards employers face in the lawsuit arena.
Discrimination, wrongful dismissal, constructive discharge, and dozens of other employment practices violations cost American employers billions in awards. Many of these awards are secretly agreed to by undisclosed out-of-court settlements.
So risky is the employment setting that a new insurance emerged in 1991 called EPL (Employment Practices Liability) insurance. Two companies existed then. Now over 80 insurance companies offer EPL. None of these insurers are using EAPs as cost-containment products like managed care is doing for their products. And, hardly any company is considering how an EAP can help reduce this liability in general.
EAPs are frequently first to learn of an employee's intention to sue. Indeed, how often have you had an employee in your EAP office say, "I think I want to sue?" "Hey, do you think I can sue!?" or a similar statement?
As an employee assistance professional, your task is to help the employee get their needs met in more effective ways. The buzz phrase for thwarting lawsuits and handling disgruntled employees is "alternative dispute resolution." (Yes, I know this is really a term used in labor disputes, but let's broaden this term for a second --- really, to be more precise, this term describes official channels established by management to deal with disputes employees bring, which if not managed effectively, could lead to litigation. Very frequently EAPs work things out and save management and litigation dollars. I see our ability to management conflict in organizations as a form of ADL.
Does the human resource department of the organization understand your ability to align constructively with employees and help them get their needs met without turning to lawyers? The biggest weapon you offer is an empathic listening ear and the most valuable benefit you offer employers is empathy for employees and redirection to constructive help. It’s called “putting out the fire.”
This impact of empathy toward employees that EAPs provide and that cannot be provided by other individuals in the organization who are closely aligned with management (human resources, occupational health, etc.) is under-researched and under-appreciated.
The employer who understands this empathy-redirection-protection paradigm will give you more time to educate managers. They will ask the EAP to be involved in providing management consultation. And your influence will expand as an EA professional beyond the limited role many HR managers mistakenly believe you only fill now.
The great uncharted territory of cost-benefit for EAPs is the positive impact they have on the bottom line in helping prevent lawsuits brought against companies by their employees for employment practice missteps and wrongdoings.
Did you know that the average out-of-court settlement for wrong discharge is over $100,000? The average jury award is over $500,000, and employers lose over 60% of the time. Health care dollar saved by EAPs do not compare with the size of the awards employers face in the lawsuit arena.
Discrimination, wrongful dismissal, constructive discharge, and dozens of other employment practices violations cost American employers billions in awards. Many of these awards are secretly agreed to by undisclosed out-of-court settlements.
So risky is the employment setting that a new insurance emerged in 1991 called EPL (Employment Practices Liability) insurance. Two companies existed then. Now over 80 insurance companies offer EPL. None of these insurers are using EAPs as cost-containment products like managed care is doing for their products. And, hardly any company is considering how an EAP can help reduce this liability in general.
EAPs are frequently first to learn of an employee's intention to sue. Indeed, how often have you had an employee in your EAP office say, "I think I want to sue?" "Hey, do you think I can sue!?" or a similar statement?
As an employee assistance professional, your task is to help the employee get their needs met in more effective ways. The buzz phrase for thwarting lawsuits and handling disgruntled employees is "alternative dispute resolution." (Yes, I know this is really a term used in labor disputes, but let's broaden this term for a second --- really, to be more precise, this term describes official channels established by management to deal with disputes employees bring, which if not managed effectively, could lead to litigation. Very frequently EAPs work things out and save management and litigation dollars. I see our ability to management conflict in organizations as a form of ADL.
Does the human resource department of the organization understand your ability to align constructively with employees and help them get their needs met without turning to lawyers? The biggest weapon you offer is an empathic listening ear and the most valuable benefit you offer employers is empathy for employees and redirection to constructive help. It’s called “putting out the fire.”
This impact of empathy toward employees that EAPs provide and that cannot be provided by other individuals in the organization who are closely aligned with management (human resources, occupational health, etc.) is under-researched and under-appreciated.
The employer who understands this empathy-redirection-protection paradigm will give you more time to educate managers. They will ask the EAP to be involved in providing management consultation. And your influence will expand as an EA professional beyond the limited role many HR managers mistakenly believe you only fill now.
Sunday, December 14, 2008
You Gotta Get Out More
If you have a huge organization with multiple sites, consider assigning one of your EAP staff to that location for training, communication, and relationship-building.
Other work sites make it less appropriate to just show up and do a walk through. In such instances, you’ll need to consider a specific reason to show up. Perhaps your moving posters, dropping of cards someplace, or simply having a monthly meeting with the site manager on what needs might exist for the organization's work unit.
Why does this external rubbing of elbows work? Employees see you, consider their personal problem (remember 12-18% of the workforce has one right now) and think about calling. Then, some do. Visit again in three months and different employees will phone. The key low-dose frequency of contact with these potential clients.
Employees are also reminded about the company’s investment in them. This is appreciated and the reputation of the EAP as “being available” grows. Hint: 800#'s don't have legs.
Tuesday, November 25, 2008
1991-- the Pivotal Year for EAPs that Wasn't
What were you doing in 1991 when the U.S. Congress passed the 1991 Amendment to the U.S. Civil Rights Act? If you were like me, you were oblivious to its implications for the employee assistance field, but it was earth shattering and monstrous.
The only reason the EAP field didn't feel the 9.0 quake rumble under its feet was because all of us, or nearly so, were on the wrong side of the mountain mining what little gold there is in the Managed Care industry. We were trying to understand it, team with it, fight it, and for some surrender to it. Some really famous EAPs sold themselves completely--and vanished.
Where we should have been was digging for the mother lode was on the other side of the mountain. We should have been teaming up with the Property-Casualty insurance industry. That's because the property-casualty insurance industry is not interested in keeping employees from accessing their behavioral health insurance benefits and using EAPs as gate-keeping devices to save health insurance dollars--what little there is to be saved.
These big boys want everything an EAP can throw at a company to reduce behavioral risk exposures. They want--they need the core technology. Why? They pay for the lawsuits that were made possible by the 1991 Civil Rights Act. They are the insurers for damages caused by bad employee/manager/management behavior.
Are you beginning to see the picture?
So what happened in 1991? You will answer this question for yourself in just a minute.
Let me ask: Are you aware that a corporation like Denny's, Toyota, or any business entity can be sued for unlimited punitive damages for sexual harassment and racial discrimination?
Did you know that 10 years ago the average out-of-court settlement for a wrongful discharge claim was $100,000. Even better, did you know that the average jury award for wrongful termination/discharge is $500,000?
So how expensive, or better said, how cheap is an EAP that can help prevent these payouts using its tools and resources so problems never become problems? Call it "dollars recovered from loss."
Ask yourself: How many times have you, as an employee assistance professional sat in your office and had an employee grumble, "I'm going to sue this place." If your experience has been similar to mine, you will probably say, "quite a few times." Of course, if you're a pro, your approach is to help such an employee get their needs met in more effective ways than suing the employer. Unfortunately, these vital successes probably aren't statistics in your annual reports.
The 1991 Civil Rights Act relates to behavioral risk exposures of employees and managers--ones that EAPs deal with all the time. But here is the kicker: Insurance policies were developed in 1992 to protect these companies. But who is protecting the insurers? Enter EAPs.
EAPs, with their education, intervention, assessment, proactive program development, supervisor training, and effective follow up can reduce these exposures. Are you aware of the psychomedical aspects of worker injury and recovery? I would suggest you investigate it. It is rich territory for EAP application. The goal: reducing Workers Comp payouts.
EAPs haven't seen their best days yet. They're ahead. They lie in protecting companies against financial loss associated with human behavior. But these programs can't be watered down. They need to represent the robust approach that the core technology suggests.
Head for the other side of the mountain--and bring a shovel.
The only reason the EAP field didn't feel the 9.0 quake rumble under its feet was because all of us, or nearly so, were on the wrong side of the mountain mining what little gold there is in the Managed Care industry. We were trying to understand it, team with it, fight it, and for some surrender to it. Some really famous EAPs sold themselves completely--and vanished.
Where we should have been was digging for the mother lode was on the other side of the mountain. We should have been teaming up with the Property-Casualty insurance industry. That's because the property-casualty insurance industry is not interested in keeping employees from accessing their behavioral health insurance benefits and using EAPs as gate-keeping devices to save health insurance dollars--what little there is to be saved.
These big boys want everything an EAP can throw at a company to reduce behavioral risk exposures. They want--they need the core technology. Why? They pay for the lawsuits that were made possible by the 1991 Civil Rights Act. They are the insurers for damages caused by bad employee/manager/management behavior.
Are you beginning to see the picture?
So what happened in 1991? You will answer this question for yourself in just a minute.
Let me ask: Are you aware that a corporation like Denny's, Toyota, or any business entity can be sued for unlimited punitive damages for sexual harassment and racial discrimination?
Did you know that 10 years ago the average out-of-court settlement for a wrongful discharge claim was $100,000. Even better, did you know that the average jury award for wrongful termination/discharge is $500,000?
So how expensive, or better said, how cheap is an EAP that can help prevent these payouts using its tools and resources so problems never become problems? Call it "dollars recovered from loss."
Ask yourself: How many times have you, as an employee assistance professional sat in your office and had an employee grumble, "I'm going to sue this place." If your experience has been similar to mine, you will probably say, "quite a few times." Of course, if you're a pro, your approach is to help such an employee get their needs met in more effective ways than suing the employer. Unfortunately, these vital successes probably aren't statistics in your annual reports.
The 1991 Civil Rights Act relates to behavioral risk exposures of employees and managers--ones that EAPs deal with all the time. But here is the kicker: Insurance policies were developed in 1992 to protect these companies. But who is protecting the insurers? Enter EAPs.
EAPs, with their education, intervention, assessment, proactive program development, supervisor training, and effective follow up can reduce these exposures. Are you aware of the psychomedical aspects of worker injury and recovery? I would suggest you investigate it. It is rich territory for EAP application. The goal: reducing Workers Comp payouts.
EAPs haven't seen their best days yet. They're ahead. They lie in protecting companies against financial loss associated with human behavior. But these programs can't be watered down. They need to represent the robust approach that the core technology suggests.
Head for the other side of the mountain--and bring a shovel.
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