Confusion about Alcoholism: When Will It End

Tell me if this makes sense to you:  

The risk of an alcohol use disorder, which includes alcoholism and alcohol abuse is higher among those whose parents had an Alcohol Use Disorder. The increased risk is independent of other major predictors, such as gender, parents' social status and the psychiatric hospitalization of parents. The key message for the general public is that there is an increased risk associated with parental alcoholism, but obviously many other factors determine whether an individual develops an AUD.

This is language from a press release I received today. The only difference is that you are only reading the beginning and the end of it to illustrate my point in this post.

Of course this does not make sense, but it is typical double speak I frequently see in research articles about alcoholism where genetics overwhelmingly is evident as the contributing factor, if not the sole factor evident in  acquired alcoholism. These end of the story caveats that contradict research and alcoholism science are not uncommon. It leaves a wonderful opening to the continued psychological treatment of alcoholics and allows the mental health community analyzing why alcoholics drink to breathe a collective sigh of relief. Now, here is link to the rest of the full press release so you can see it in full.

http://www.healthfinder.gov/news/newsstory.aspx?docID=651844

You may want to see this alcohol in the workplace education and awareness tool.

EAP Marketing Tips: 1 of 10: Talk about Risk Reduction More Deeply

I am going to discuss marketing related issues for EAP providers. Many have complained about low balling, managed care, and "commodization". Commodization is not a problem by the way. It is a symptom of the problem. That problem is lack of definition and codification about what EAPs really are, what they should be, and how they ought to be defined by a nationally recognized organization that both promotes and protects the parameters of the EAP program definition so corporate customers and potential purchasers pull away and are less likely to be attracted to inferior, well marketed knock-offs. (Okay that was a little rough, but this is a blog.)

Back on point. The issue in in free markets is usually also about having a better product and the ability to communicate that. I think a piece of the problem lies here. The problem it seems to me is that EA professionals don't really know their own product very well. Let's discuss this over the next couple weeks and see if my notes transcribed to this blog from the jotted scratches on gum wrappers I possess can assist you with additional insights that will make you better prepared to discuss your program and better able to standou in a crowd because you are able to define a better product.

Issue #1 of 10 for Marketing Discussions with Potential Purchasers of EAP Services:
With the increasing risk to employers of being sued by employees, how does the EAP play a role in reducing this risk beyond simply seeing employees referred for personal problems?


Because CT-EAPs (the CT stands for true core technology-driven programs. Since anyone can call themselves an EAP and get away with it handily, I often like to write "CT-EAP".) deal with troubled employees, many of whom have problems with management, they are frequently the first to learn of an employee’s interest or intention to sue the company. For example, my supervisor did such and such, I am angry, I wonder if I can sue. Such statements, if handled properly, make the EAP an early, front line defense against employment claims and related lawsuits. EA professionals help employees seek solutions to personal problems and will steer employees to more constructive alternatives to meet their needs. In many instances this is accomplished by referring them to human resources, providing conflict resolution assistance, or seeking other alternative dispute resolution channels. Although not researched, EAPs certainly save money by helping ward off lawsuits long before they ever are filed. These are precious dollars recovered from loss. It is more crucial than ever for today’s EA professionals to understand federal laws that govern the employment relationship. EA professionals should know these major laws and have a basic understanding of their tenets. Armed with this knowledge, they can better consult with supervisors in the course of managing troubled employees. Every EAP should respond to an additional question, “How do you respond when an employee comes to your office and states that he or she is interested in suing the company?” Communicating to customers that your EAP is a program of attraction like a magnet for troubled employees and those like to agress against the company financially, where they can get their needs met in "healthier ways" is a huge and attractive marketing point ignored by the most experienced EA professionals and related marketers. A business hearing this may respond very quickly with "where do I sign up!"

EAP Consultancy: Advising Supervisors on How to Investigate Something

Not all supervisors have access to knowledgeable human resource professionals capable giving them instruction on important duties. It all depends on the company's size and its resources and easy access to these resources if they exist. Still, all companies have the same concerns and worries. And meeting the needs of employers should be a key customer service strategy of yours if you are an employee assistance professional. Caveat: If you can justify the activity as falling within the scope of the core technology.

Be creative in your thinking because you may discover new ways of consulting that will prove your value if you think in these dimensions. One of these areas for discussion is giving supervisors basic instruction during consultations with them on investigating employee incidents--serious or not so serious disruptions or violations of company policies or work rules.

Your job is to help protect companies against the impact of troubled employees.

(Digression: Many EA professionals, especially those of yesteryear would argue that this is the most important goal of employee assistance programs. In fact, it is still listed first in the core technology. If you are an "import" to the EAP field and arrived with the idea of only doing mental health counseling in the workplace, you are missing many key aspects of the profession.)

Here's another point to consider arguing: The customer is the person paying your salary. That isn't the employee client. So always thinking about how to meet their needs with your services raises the value of the profession. Am I wrong?

Continuing........One of the resources you may want to consider helping managers with during consultations is providing guidance to them on conducting investigations. Are there commonly used guidelines for investigating incidents in the workplace associated with disturbing employee conduct? Yes. Most supervisors don't know them.

Rule #1--always tell supervisors that you aren't an attorney and that the supervisor should talk to the human resources manager or other adviser to you cover yourself. That being said, investigations follow a logical path to gather information about an event so that a reliable conclusion about what happened can be drawn. So, get this one down pat, and you will provide a valuable service to reduce risk to the employer. You will really get a "Wow!" out of them. You will be a hero. That's what you want. EA professionals are heroes, remember.

Tell the supervisor that he or she must start of thinking of the process like a hopscotch so they don't go off half-cocked. You're going to take it one square at a time. Many organizations have specific procedures to follow concerning things like sexual harassment and other severe events, so again, remind the supervisor to go looking for this information and inquire about how to conduct these types of investigations.

Still, generally speaking however, go ahead and memorize the following spiel: Consider these steps when investigating other conduct-related incidents: First, notify your supervisor about any incident you think needs investigating. Next, interview parties separately, and in private (ask for all details, and ask for the names of any witnesses). Create a written list of your questions so things stay consistent. Third, keep the information you collect confidential from others you interview - persons involved in an investigation are not entitled to the results of your interviews. Fourth, do not form opinions as you investigate - just write down exactly what is said and move quickly in your investigation; and fifth, arrive at a conclusion - do not disclose the nature of administrative or disciplinary actions, if any, to complainants or witnesses. With this information, discuss your findings with a confidentially approved party. That could be an attorney, but do not forget your employee assistance program professional. Lots of confidentiality there. This might be your final stop before a decision or taking the results to the next level of management.

Now you know a little bit more about this subject and can be a true service to managers who ask you in an EAP appointment--"gee, how do I go about this?" You will no longer have to say. "Gee, I am not sure. Maybe there is a book on it somewhere."

Small Business EAPs: Last Frontier for Employee Assistance?

One of the anomalies characterizing employee assistance services to small business is that, in comparison with large businesses, the small ones may well use those services less frequently. However, the services may nonetheless be immensely more crucial to small business survival. Within this truism is a decades old marketing dilemma for EAPs. Marketing EAPs to small business is not an easy task.

How do you convince a small business of say 40 employees to pay a reasonable fee for a proactive, high-touch EAP when the EAPs success will be likely be unable to demonstrate that disaster X or crisis Y never occurred? It is easier to intuitively convince a company with 5,000 employees that the EAP probably had an impact on X and Y, especially if records of the past can be compared with those going forward. This eap cost-benefit proof is a tougher challenge.

The answer to this problem must lie in a presentation that includes cost-benefits, reduction in financial risks, and removal of stress experienced by the business owner/decision maker all of which are included in a presentation tailored to small businesses. I will begin discussing these factors in this blog and also discuss other "influencers" in the decision-making process toward the goal of motivating the decision maker to invest in effective employee assistance services.

EAPs & Liability Prevention: Someone Please Rebut This...

If you think I am nuts for talking about this, please say so, or I just might continue. Seriously. I think there is a room here for a breakthrough on EAPs getting more attention from stakeholders in the risk management arena. But listen, if you disagree, please tell me to stop kicking this horse and give me a good reason. I might be too close to my own brain to see the opposite argument. So, here it goes.

Although virtually unheard of in the EAP literature (including recent writings on behavioral risk), EAPs may prove their highest value in EPL intervention and loss prevention far exceeding health insurance cost containment. Indeed the average jury award for wrongful termination is over $500,000. Out of court settlements average $100,000. I believe this is a powerful EAP role and one EAPA can use to claim the high ground in the EPL loss prevention frenzy currently being spearheaded by big P-C underwriters.


Here's what I recommend the profession consider:

1. Establish and fund a committee on Employment Practices Liability and Loss Control to study the EAP role in preventing lawsuits related to employment practices. Survey EA professionals and the like. Survey literature to spot unaddressed opportunities and evidence that potentially new constituencies for EAPs are not aware EAPs as a solution to their loss prevention goals.

2. Contact major underwriters to learn of their knowledge current state of knowledge and the deficiencies in that knowledge associated with EAPs.

3. Create a multi-part strategy to educate these underwriters using their economic self-interest to consider effective, core tech-driven, and high-touch EAPs as solutions to problems they face.
3. Seek to establish a national dialogue with P-C insurers and insurance agencies selling EPL products. A labor-management-insurer sponsored joint benchmarking project to demonstrate interface and impact would be ideal.
4. Promote and encourage conferences, papers, and partnering opportunities along with aggressive press coverage for this linkage and by so doing, penetrate the P-C literature base.

5. Encourage the establishment of CT-EAP products offered by property casualty insurance companies as part of their programmatic approach to EPL risk reduction.

Okay, am I crazy?

OSHA Safety and Health Checklist (and No EAP)

You would have to be from another planet to not know that EAPs are cost-beneficial and that when fully implemented have a positive impact on helping reduce accident rates and injury related costs. The research has already been done 30 years ago. And EAPs reduce other behavioral losses in the workplace as well. Somehow however the recommendation to have an EAP is still not listed on OSHA's Safety and Health Management Systems Checklist. This list is no small thing. This is the front line handout OSHA distributes nationwide. It covers many recommended steps that companies should take to reduce accidents and injuries. I think "Establish a Employee Assistance Program" should be on this list. I know probably agree. Think about the lives saved, reduced accidents, and reduced injuries associated with helping troubled employees, particularly alcoholic employees, not to mention reduced property damage and lost time results having an EAP in place. How much pull to you have with OSHA? Do you know anyone there? Are you reading this post from  your desk at OSHA because you work there? (Hi!) The above PDF was last printed in March 2008! The clock is ticking. QUICK! Before this gets re-written without an EAP mention, let's get OSHA to include EAPs as an important part of a Workplace Safety and Health Management System. Right now, I see this as an overlooked and critical component that needs to be on this list. Do you agree? Phone right now while you are thinking about it. This is the office of communications phone number:  202-693-1999. If enough people phone, they will consider adding EAPs. It's the little things folks that promote this profession. Look for more of these gems--things EA professionals can do to promote their craft. Email me and I will post suggestions on this blog. Health and wellness in the workplace is dramatically enhanced when EAPs are in place.

Alcohol in the Workplace: Tinkering with the Employee's Denial

As you become an expert on alcohol in the workplace, you will need to become an expert with assessment and helping an employee-client, who may be diagnosable as alcoholic. Invariably you will bump into your employee-client's "model of denial". This is a critical juncture in your assessment interview. All alcoholics have a model of denial. This is a construct that assists the alcoholic in preventing self-diagnosis. 

It is a myth that denial is absolute in alcoholics. Denial is a defense mechanism and it is therefore employed to do battle against self-diagnosis. Non-alcoholic drinkers deny alcoholism of course, but they do not use denial in the classic psychodynamic sense of the term. It is logical and realistic to view all alcoholics as having--if not the ability to self-diagnose their illness--at a minimum, a fuzzy idea about the nature of their problems and whether drinking is in some way linked to them or associated with them. This is all that is needed to help alcoholic employees examine their "denial construct". 

So where to begin? At an appropriate point in your assessment interview, you should define denial in the following way to make an impact and help the employee move toward self-diagnosis--your goal.

Here is the definition that I finally arrived at using after testing a few other presentations to help employees move past denial. I don't simply rattle this off the tip of my tongue, however.  I piece it out in  my discussion with the employee until he or she finally gets it all. I like this definition because it seriously erodes or creates useful anxiety in the employee-client, enough at least to further the interview to the next step. That next step might be a MAST (Michigan Alcoholism Screening Test) done verbally, or some other next step in the interview and assessment process.

So alcohol and workplace intervention is enabled by the following presentation by the EA professional:

 = = = == = = = = =

Are you familiar with the term denial and how it works with regard to alcoholism? Here's what I have observed in many people over the years. When considering the definition of alcoholism above, many people focus on the symptoms that they do not have more than the ones they do have. Unlike cancer, where any symptom would cause alarm, symptoms of alcoholism often get ignored if other symptoms can be shown to not exist. This process is called “comparing out” of the definition, and it is a natural part of denial.

Here’s a better way to understand denial. Alcoholics usually maintain a definition of alcoholism that serves to exclude them. Alcoholics usually focus on symptoms of addiction that they do not have and use this information to avoid their self-diagnosis. Alcoholics then change their definition over time to exclude symptoms that they begin to experience.

==========

You can hear this definition discussed in the following video. (FYI: This video is available for purchase in several different formats as a useful tool.) It "stirs the juices" in employees, family members, and of course alcoholic employees in denial. It is also embedded in the WorkExcel.com Reasonable Suspicion Training Course for (DOT and non-DOT) Training of Supervisors.