1. Employees are concerned about confidentiality. That's nothing new. But here's what you might not know: Fear among the workforce that the EAP might not be confidential is a continual and natural force for every EAP and it never goes away. Don't be fooled. Your ethics and confidentiality guidelines are not enough to fight what I call "confidentiality attrition."
2. Confidentiality attrition is the erosion of the "perception of confidentiality" caused by naturally occurring fear and its result: misinformation among employees that the EAP is, or might not be confidential. Confidentiality attrition occurs when EAPs neglect to promote confidentiality frequently, regularly, and non-stop. Confidentiality attrition is a natural phenomenon. The bottom line: Any EAP that does not market and promote its confidentiality boundaries continually will eventually be seen as not confidential by a significant percentage of the workforce -- no matter what the reality.
3. Like a wave coming from the other direction, this perception will overtake your program unless it is fought with marketing techniques that continually communicate confidentiality. To fight the wave you must beat it back, and there is no end to this process. Talk about confidentiality in many different respects - how staff are trained, what laws they follow, discuss informed consent, discuss staff boundaries, releases, and the organization's commitment. Mention confidentiality in your employee newsletter. Look for confidentiality breaches. For example, do your clients meet each other in the main waiting room of an EAP office, or do you have private EAP waiting rooms? Many EAPs are modeled after "therapy offices" but EAPs aren't therapy! Separate entrances and exits help maintain the confidentiality and help market your program by word of mouth. A challenge, true, but do you see the logic in moving toward such a goal?
4. Beyond confidentiality, no EAP staff should socialize with an employee in the host organization who could potentially become an EAP client. This is a critical EAP ethical boundary you won't read about in any EAP manual or book, but you should adopt it. This boundary underscores the unique role of EA professionals in the workplace. Socializing with employees - going to lunch, joining social clubs, attending personal parties and social engagements, hiring blue-collar trade staff from the organization for personal domestic projects, etc. will damage the perception of confidentiality among the workforce. All these things have happened in EAPs we know. These practices alienate employees, disturb the fragile confidentiality boundary, and create dual relationships in conflict with each other that kill EAP utilization. New EA hires should commit to these types of expectations and you should bring them to the attention of other EA professionals to enhance the viability of the EAP profession.
Friday, January 4, 2008
Thursday, December 27, 2007
EAP Skill Builder: Before You Hang Up with the Referring Supervisor
Making an EAP assessment go smoothly and completely is always your goal, so when a supervisor phones to consult with you prior to referring a troubled employee, be sure to ask about or address these six issues that are key to an easier assessment:
1) Ask the supervisor to ask the employee being referred to sign a consent for the release of confidential information. Signing a release is voluntary for the employee, but the employee is more likely to be successful in treatment or counseling if a release exists. An employee assistance professional who pops the question of signing a release during the session usually has to explain why and motivate the employee to understand how signing a release is in his or her best interest. You’ll make this part of your assessment easier and quicker if the employee anticipates signing a release before reaching the end of an assessment.
2) Ask the supervisor if he or she has information about the nature of any personal problems the employee is facing. Firsthand knowledge or information shared by the employee with the supervisor becomes appropriate to share. No, this is not asking the supervisor to be an amateur diagnostician, and it does not encourage getting personally involved with the employee. This can save you untold hours of interviewing time in the pursuit of discovering the nature of the employee’s personal problem. Consider this popular checklist for supervisors.
3) Ask the supervisor if this is the first attempt to refer the employee to the EAP and if not, what happened the first time. Was it an informal referral or an encouraged self-referral? This question can help you understand how supervisors view the EAP and how soon they are likely to consider using it to manage troubled employees.
4) Ask for a complete picture of the performance issues, preferably using a checklist. A checklist helps you better prepare for an assessment. It can help you see patterns associated with the personal problem and will aid you in coming to a diagnostic conclusion. It will also allow you to ask more effective questions during the assessment interview.
5) Ask the supervisor what is planned if the employee’s performance does not improve and whether the employee knows about this next administrative or disciplinary step. Recommend to the supervisor that the employee be told what this next step is. This interrupts an enabling pattern and helps the supervisor commit to change, rather than making hollow threats, which causes employees with behavioral-medical problems to get sicker. Committing to change helps the employee feel motivated to cooperate with the EAP and also make commitments to personal change.
6) Calm the supervisor down. Determine if the supervisor is emotionally charged and “involved” in the pursuit of punishment rather than discipline. There is a difference, and the attitude of the referring supervisor can support or sabotage the employee’s progress and motivation. Don’t let the supervisor undermine the helping process.
1) Ask the supervisor to ask the employee being referred to sign a consent for the release of confidential information. Signing a release is voluntary for the employee, but the employee is more likely to be successful in treatment or counseling if a release exists. An employee assistance professional who pops the question of signing a release during the session usually has to explain why and motivate the employee to understand how signing a release is in his or her best interest. You’ll make this part of your assessment easier and quicker if the employee anticipates signing a release before reaching the end of an assessment.
2) Ask the supervisor if he or she has information about the nature of any personal problems the employee is facing. Firsthand knowledge or information shared by the employee with the supervisor becomes appropriate to share. No, this is not asking the supervisor to be an amateur diagnostician, and it does not encourage getting personally involved with the employee. This can save you untold hours of interviewing time in the pursuit of discovering the nature of the employee’s personal problem. Consider this popular checklist for supervisors.
3) Ask the supervisor if this is the first attempt to refer the employee to the EAP and if not, what happened the first time. Was it an informal referral or an encouraged self-referral? This question can help you understand how supervisors view the EAP and how soon they are likely to consider using it to manage troubled employees.
4) Ask for a complete picture of the performance issues, preferably using a checklist. A checklist helps you better prepare for an assessment. It can help you see patterns associated with the personal problem and will aid you in coming to a diagnostic conclusion. It will also allow you to ask more effective questions during the assessment interview.
5) Ask the supervisor what is planned if the employee’s performance does not improve and whether the employee knows about this next administrative or disciplinary step. Recommend to the supervisor that the employee be told what this next step is. This interrupts an enabling pattern and helps the supervisor commit to change, rather than making hollow threats, which causes employees with behavioral-medical problems to get sicker. Committing to change helps the employee feel motivated to cooperate with the EAP and also make commitments to personal change.
6) Calm the supervisor down. Determine if the supervisor is emotionally charged and “involved” in the pursuit of punishment rather than discipline. There is a difference, and the attitude of the referring supervisor can support or sabotage the employee’s progress and motivation. Don’t let the supervisor undermine the helping process.
Wednesday, December 12, 2007
Musings on Mandatory EAP Referrals
Mandatory referrals indeed do have leverage, but it clearly appears that they are unethical and in violation of EAP practice standards despite their wide-spread use. It is an "elephant in the room" of the EAP field. Although I have not seen EAPA take a stand on this issue (someone correct me if I am wrong) mandatory referrals appear to violate a key principle in the helping professions--client self-determination. EAPs are voluntary in the EAPA standards. A mandatory referral is coercive and contrary to the spirit and intent of the standards it seems to me. Many of my core technologist colleagues agree. I first mentioned this dilemma at the 2002 Boston EAPA Conference. I had no one walk up and disagree. There is a better way to go, and a more powerful approach to motivating a troubled employee to voluntariy accept help.
Forcing an employee to the EAP by stating they have no choice (mandatory) disregards self-determination and it is unethical practice. It is also unethical for clinical social workers to cooperate or promote such a practice—according to the General Counsel of the National Association of Social Workers (NASW). (Based upon a personal conversation I had with her several years ago regarding this practice.)
A firm choice agreement maintains the ethical boundary, yet creates a sense of urgency equal to a mandatory referral--perhaps more--yet it is distinctly different and conforms not only with the core technology but the historical foundation of supervisor referrals as designed originally in occupational alcoholism programs. Firm choice agreements cause employees to act on their own behalf and seek help from the EAP or face consequences for legitimate job performance problems or rule violations--not because of failure to attend the EAP as in the case of mandatory referral. The agreement by the employee to attend the EAP while discipline is held in abeyance, in accompanied by the requirement to participate fully in its recommendations. The quality of the EAP interview with firm choice referrals is infinitely more productive. For these reasons, mandatory referrals are no longer permitted by the U.S. Department of Personnel in civilian government agencies according to its well-followed Federal Personnel Management Directives.
The result of a mandatory referral for an employee is "resentment" and sluggish cooperation at best. At worst, an uncooperative client is created and hate of the EAP is engendered. Use of the mandatory referral also harms and erodes the effectiveness of EAPs and their natural ability to attract employees and remain apart from the disciplinary process. Feel free to have your web site link to this free explanation on mandatory referrals to the EAP that brilliant explains all.
Forcing an employee to the EAP by stating they have no choice (mandatory) disregards self-determination and it is unethical practice. It is also unethical for clinical social workers to cooperate or promote such a practice—according to the General Counsel of the National Association of Social Workers (NASW). (Based upon a personal conversation I had with her several years ago regarding this practice.)
A firm choice agreement maintains the ethical boundary, yet creates a sense of urgency equal to a mandatory referral--perhaps more--yet it is distinctly different and conforms not only with the core technology but the historical foundation of supervisor referrals as designed originally in occupational alcoholism programs. Firm choice agreements cause employees to act on their own behalf and seek help from the EAP or face consequences for legitimate job performance problems or rule violations--not because of failure to attend the EAP as in the case of mandatory referral. The agreement by the employee to attend the EAP while discipline is held in abeyance, in accompanied by the requirement to participate fully in its recommendations. The quality of the EAP interview with firm choice referrals is infinitely more productive. For these reasons, mandatory referrals are no longer permitted by the U.S. Department of Personnel in civilian government agencies according to its well-followed Federal Personnel Management Directives.
The result of a mandatory referral for an employee is "resentment" and sluggish cooperation at best. At worst, an uncooperative client is created and hate of the EAP is engendered. Use of the mandatory referral also harms and erodes the effectiveness of EAPs and their natural ability to attract employees and remain apart from the disciplinary process. Feel free to have your web site link to this free explanation on mandatory referrals to the EAP that brilliant explains all.
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