EAPs frequently deal with disgruntled employees. It's a significant part of the job, but the benefit of this activity to the financial world doesn't get a lot of play in the EAP literature. For many of us, well, it simply sounds too self-serving. This is a big problem for many people in the EAP field — viewpoint.
Disgruntled employees are often seen as helpless malcontents, troubled, and expendable. Typically, stories in the EAP literature focus too much on how to help these employees be happy, healthy, and productive, while they omit the real story behind the story.
That story is how this helpful activity keeps employers' financial butts out of the sling. EAPs don't get the credit because we aren’t talking about it, and it is my argument that we should care a lot more about this side of the equation. Why?
There is a new twist in the 21st century that is leveling the playing field and giving an upper hand to disgruntled employees. It is making the importance of having an effective, proactive, well-in-cultured EAP critical and worth every cent it costs.
That new twist is the social media, especially Web 2.0 sites like YouTube.com. These are free, monstrous, broadcast media outlets that take no prisoners.
An EAP that is visible, known, trusted, and has a real face with it can attract employees who may turn to it with the goal of processing their frustrations, complaints about ethics, anger with supervisors, or tales of abuse and harassment.
Effective EAPs work with two hats in these situations empathizing with the employee, and protecting the company financially by helping the employee get their needs met in effective and appropriate ways.
Absent this level of easily accessible and visibly marketed support for employees, companies place themselves at financial risk. This is especially true if they try to get an EAP on the cheap. For most, this is a direct result of naivety or advice from misguided benefits consulting firms.
Employees who are angry and disgruntled have strong impulses to share their story and vent their frustrations. Starting with an empathic listening ear at the EAP is a better channel than YouTube. It would be better to have an employee's story end up in the New York Times than on YouTube. YouTube is forever. A classic and recent example follows:
As I write this column, Bank of America has 300,000,000 shares of stock trading (Dec. 8th). But a YouTube.com video posted by a disgruntled employee only a week ago has received over 146,000 views and counting (Woops! Update - now over 220,000 on 1-10-10. See what I'm saying?).
This growth is the result of word-of-mouth advertising about this video. This is called "viral marketing". It is a powerful force. To wit, mainstream media, without any qualification or fact-checking, has picked up on the video and is using it for its own economic purposes. I have provided the links below.
Not surprisingly, Bank of America's stock price has nose-dived in the same week. It has lost millions.
Is Bank of America's stock price drop the direct result of this video? No one can say for sure. But it is safe to say that it is not helping. And it is more likely that people are looking at this video than press releases about BAC's financial future.
Do you see an argument for having an effective, humanly visible, and appropriately funded employee assistance program that can act as a stop-gap to helping an organization by dealing with and sincerely helping troubled or disgruntled employees?
Can you see the value in making an EAP a benefit to employees and a loss-prevention, management tool for business organizations?
The latter is under-appreciated and it is continually ignored. This is a direct result of a "reformulated" model of EAPs that has been promoted in the health benefits and managed care literature, and has been accelerated by being unchallenged in an organized way.
Whether it is supervisor referral of an employee who may soon lose their job over poor job performance or an EAP being a program of attraction where employees head for coaching, wisdom, and direction, EAPs have unsung potential to be more vital to corporate America's financial security than we are hear about or see.
If EAPs don't toot their own horn to more viable customers, they risk being kicked out of the symphony.
It is my belief that once the property casualty insurance industry (the real stakeholders) make this connection, that is seeing vibrant EAPs as loss prevention mechanisms, the EAP field will experience explosive growth in a new direction that will result in less violence in the workplace, few disasters like the one below, and of course, more helped employees.
To see the video, go to YouTube.com and Search “Why Bank America Fired Me”.
Why Bank of America Fired Me
Media Promotion of This Video
Wednesday, December 9, 2009
Tuesday, December 8, 2009
Do the 2009 EAPA Standards for EAPs Dispose of "800# eaps"?
The EAPA STANDARDS AND PROFESSIONAL GUIDELINES FOR EMPLOYEE ASSISTANCE PROGRAMS (EAPS)were sent to the EAPA membership today. In case you missed them, here they are:
>>> Standards for Employee Assistance Programs
Hats off to the folks that worked so diligently with these standards to help the profession move down the path toward more definition, which of course helps preserve the integrity of the field.
Everyone in the membership--and every corporate customer or those who advise corporate customers in the procurement of employee assistance programs should read these standards. Ditto insurance companies, labor leaders, and students merging into EAP field.
Of course, like anyone else, I have a keyboard to spout my opinion on, but it is my belief after reading these standards that there is no way on earth that an "800#" sold by a managed care company as "EAP" (with a little structure thrown in for good measure) can be an EAP. (I worked for such program for about eleven months, so I have some experience to draw on.)
Believe me, I don't call what I was doing an EAP. However, from my cubicle on the 14th floor, I did a pretty good job servicing seven or eight Fortune 500 companies at once.
(Confession, well, we tried anyway. However, the piled up outpatient treatment reports needing authorization on our desks from therapists around the country, sometimes caused us to miss phone calls.)
I think part A of the Epoxy Cement that stick the EA profession back together is sitting in front of us with this document. Part B is needed. That would be an official position statement by the Association that applies these standards to various EAP models and declares them acceptable or defunct. Why read between the lines. Let's just get it out there.
When Congress passes laws and regulations that govern workplace and workplace employment practices, they have an office down the street that gets a copy of the legislation the next morning after being signed by the President. That organization is the Equal Employment Opportunity Commission (EEOC). They interpret the regs and its nuances and say what's what. That might be a very cool step for EAPA to take as well.
EAPA should take a stand and consider a mechanism that clearly rejects programs and services calling themselves EAPs that don't meet the standards. These are elephants in the EAP living room and they have been smashing the house up for 20 years. We like to ignore, for the sake of "all getting along", these obvious problems.
If this next evolutionary step is taken, a wonderful thing may follow--a profession that roars back to a unified membership of 7000 members, rather than the 3600 it now struggles to keep. And, like 25 years ago, we may hear one voice sharing a common definition and vision of what an EAP really is and should be. As a side benefit, I think EAPs would become more of a "household term" and even my mother might stop calling them an EPA.
>>> Standards for Employee Assistance Programs
>>> Standards for Employee Assistance Programs
Hats off to the folks that worked so diligently with these standards to help the profession move down the path toward more definition, which of course helps preserve the integrity of the field.
Everyone in the membership--and every corporate customer or those who advise corporate customers in the procurement of employee assistance programs should read these standards. Ditto insurance companies, labor leaders, and students merging into EAP field.
Of course, like anyone else, I have a keyboard to spout my opinion on, but it is my belief after reading these standards that there is no way on earth that an "800#" sold by a managed care company as "EAP" (with a little structure thrown in for good measure) can be an EAP. (I worked for such program for about eleven months, so I have some experience to draw on.)
Believe me, I don't call what I was doing an EAP. However, from my cubicle on the 14th floor, I did a pretty good job servicing seven or eight Fortune 500 companies at once.
(Confession, well, we tried anyway. However, the piled up outpatient treatment reports needing authorization on our desks from therapists around the country, sometimes caused us to miss phone calls.)
I think part A of the Epoxy Cement that stick the EA profession back together is sitting in front of us with this document. Part B is needed. That would be an official position statement by the Association that applies these standards to various EAP models and declares them acceptable or defunct. Why read between the lines. Let's just get it out there.
When Congress passes laws and regulations that govern workplace and workplace employment practices, they have an office down the street that gets a copy of the legislation the next morning after being signed by the President. That organization is the Equal Employment Opportunity Commission (EEOC). They interpret the regs and its nuances and say what's what. That might be a very cool step for EAPA to take as well.
EAPA should take a stand and consider a mechanism that clearly rejects programs and services calling themselves EAPs that don't meet the standards. These are elephants in the EAP living room and they have been smashing the house up for 20 years. We like to ignore, for the sake of "all getting along", these obvious problems.
If this next evolutionary step is taken, a wonderful thing may follow--a profession that roars back to a unified membership of 7000 members, rather than the 3600 it now struggles to keep. And, like 25 years ago, we may hear one voice sharing a common definition and vision of what an EAP really is and should be. As a side benefit, I think EAPs would become more of a "household term" and even my mother might stop calling them an EPA.
>>> Standards for Employee Assistance Programs
Sunday, December 6, 2009
Economics and the Management of "Dual-Diagnosis" Alcohol-Drinking Clients: How Murky!
A patient is self-medicating if alcohol is used to reduce symptoms of emotional or physical pain regardless of whether the diagnosis of alcoholism exists. Unfortunately, this definition of self-medication often alters from one clinician to the next. And, of course, we know that some mental health professionals do this for the sake of economics, or maintaining their unshakable model of addiction, regardless of validity.
It is tempting to use "self-medicating" as an exclusionary term to decide the patient isn't simply an alcoholic or not an alcoholic at all. This helps justify the current course of therapy that may not meet the needs of the patient, especially if he or she continues drink. The incentive is usually preventing the loss of client or patient to a traditional course of treatment for addictive disease.
Alcoholics without dual-diagnoses drink to ward of withdrawal symptoms, however. So, as the AAMCO car transmission spokesman says on TV, "How can you tell which is what without mistaking one for the other?"
Why not use the National Council on Alcoholism and Drug Dependence and the American Society on Addiction Medicine's definition of alcoholism. No less that 20 or so authorities labored for a consensus and have amended the definition at least twice. 1990 was the last - 20 years ago. (Can't believe it, geez, time flies.) If you are not using it, why not? Goodness, I hope you know it! Click here!)
Digression: Many people were upset over the finality of the definition and deliberation of this well-credentialed group. Someone went as far to create a dummy website about the definition to load harmful viruses on people's computers who visit it. Talk about resistence. (Google has a warning on the Internet link to keep people away from it. You'll see it if you surf the web.)
A self-medicating patient is alcoholic if tolerance to alcohol as emerged during the course of the patient's drinking career and symptoms of withdrawal exist (even ones subtle enough to be certainly overlooked by non-medical professionals.)
Pathologic organ changes may be present or may coexist, and some of these may be undetectable without a meaningful liver functions work-up.
Obviously, based upon this description, you would need help in deciding for sure if the patient was only self-medicating, and not alcoholic, right? Definitely, especially if you were seeing adaptive and earliest stages of addictive disease.
Of course, it gets murkier.
There is the possibility that your patient is in the early stages of alcoholism. A dual-diagnosis might exist. (Dual-diagnosis was an behavioral health insurance-saving discovery rapidly popularized by mental health professionals, and very quickly, within few years of the explosive thrust to treat alcoholism as chronic disease in the early 70's.)
But here is the punchline: Regardless of why a patient drinks, abstinence is required to properly treat depression or any mental illness, especially if medication is involved, and even if it is a dual-diagnosis.
So this means the patient needs to acquire motivation and a sense of urgency to remain abstinent if he or she does not have it already. And what if you can't get that from your patient? Any non-alcoholic client wouldn't give it a second thought to acquire better mental health functioning. And, of course, an alcohol-using client wanting to stop drinking would be qualified for AA. (And you should use motivational counseling to help him or her do it.)
Consider the following:
In the end, you may have to fight yourself, the law of economics, and your model of alcoholism at the same time.
A drug and alcohol training program with effective and non-confusing language for use in business and industry can be found here.
It is tempting to use "self-medicating" as an exclusionary term to decide the patient isn't simply an alcoholic or not an alcoholic at all. This helps justify the current course of therapy that may not meet the needs of the patient, especially if he or she continues drink. The incentive is usually preventing the loss of client or patient to a traditional course of treatment for addictive disease.
Alcoholics without dual-diagnoses drink to ward of withdrawal symptoms, however. So, as the AAMCO car transmission spokesman says on TV, "How can you tell which is what without mistaking one for the other?"
Why not use the National Council on Alcoholism and Drug Dependence and the American Society on Addiction Medicine's definition of alcoholism. No less that 20 or so authorities labored for a consensus and have amended the definition at least twice. 1990 was the last - 20 years ago. (Can't believe it, geez, time flies.) If you are not using it, why not? Goodness, I hope you know it! Click here!)
Digression: Many people were upset over the finality of the definition and deliberation of this well-credentialed group. Someone went as far to create a dummy website about the definition to load harmful viruses on people's computers who visit it. Talk about resistence. (Google has a warning on the Internet link to keep people away from it. You'll see it if you surf the web.)
A self-medicating patient is alcoholic if tolerance to alcohol as emerged during the course of the patient's drinking career and symptoms of withdrawal exist (even ones subtle enough to be certainly overlooked by non-medical professionals.)
Pathologic organ changes may be present or may coexist, and some of these may be undetectable without a meaningful liver functions work-up.
Obviously, based upon this description, you would need help in deciding for sure if the patient was only self-medicating, and not alcoholic, right? Definitely, especially if you were seeing adaptive and earliest stages of addictive disease.
Of course, it gets murkier.
There is the possibility that your patient is in the early stages of alcoholism. A dual-diagnosis might exist. (Dual-diagnosis was an behavioral health insurance-saving discovery rapidly popularized by mental health professionals, and very quickly, within few years of the explosive thrust to treat alcoholism as chronic disease in the early 70's.)
But here is the punchline: Regardless of why a patient drinks, abstinence is required to properly treat depression or any mental illness, especially if medication is involved, and even if it is a dual-diagnosis.
So this means the patient needs to acquire motivation and a sense of urgency to remain abstinent if he or she does not have it already. And what if you can't get that from your patient? Any non-alcoholic client wouldn't give it a second thought to acquire better mental health functioning. And, of course, an alcohol-using client wanting to stop drinking would be qualified for AA. (And you should use motivational counseling to help him or her do it.)
Consider the following:
- 1) Refer the patient or client to an addiction medicine (certified) physician for the differential diagnosis who will work with the official, and most rigorously formulated understanding of alcoholism that exists.
- 2) Do not accept without question or qualm the patient's explanation for why he or she drinks. I still can't believe how many professionals actually accept a patient's own well-intellectualized conclusions, even as they explain it with alcohol on their breath.
It is natural to begin a diagnostic impression on what is conveyed by patients, but remember, alcoholics are well-practiced at explaining their drinking using the same misconceptions and misunderstandings as the general public. Some may even rely upon explanations provided to them by other health professionals who have attempted to treat in the past. The preferred definition of the actively drinking patient is always the one that will permit continued drinking or offer hope of doing so again one day. - 3) Be prepared to feel anger and resistance at losing your client to traditional alcoholism treatment, because without sobriety, and a stretch of time to overcome protracted withdrawal symptoms and the normal symptoms of recovery (remember those?), you may not be able to determine what you have sitting in front of you in the clinical setting.
In the end, you may have to fight yourself, the law of economics, and your model of alcoholism at the same time.
A drug and alcohol training program with effective and non-confusing language for use in business and industry can be found here.
Tuesday, December 1, 2009
Something's Stirring with Psychologists
Sometimes it is a good idea to know what other occupational groups and professions are planning for the future.
Frequently these decisions are based upon well-researched needs and interests of customers. One such group are Psychologists. They have big plans for reaching out to business and industry in the future. Here's what the Ph.D.s have been focusing on and discussing at their conferences and reporting to their members:
Hey, wait a minute! I thought EAPs dealt with most of these issues? And, hey again, I read recently that there are more EAPs than ever! So, what gives?
One itsy, bitsy, small difference. Managed care now provide most EAPs. The CT (translation - authentic) programs are dwindling. Indeed, manager care 800#'s don't have any practical involvement with the issues discussed above.
Could it be that the decline in the number of solid, core technology-driven, personally visible, and integrated employee assistance programs is causing or allowing to become visible, unmet needs in the workplace? I think they are. I have been observing this trend ever since reading in an HR journal a few year ago that HR managers should start addressing more personal problems of employees when "EAPs" can't do it. Holy cow! You never heard that about the EAPs of the 70's, 80's, or early 90's.
So where do HR managers and customers (decision makers) turn to get these needs met? Themselves? Mental health? Of course, they are turning to mental health professionals. And psychologists are at the waiting--organized, focused, and with clout they have uniformly built for decades.
Frequently these decisions are based upon well-researched needs and interests of customers. One such group are Psychologists. They have big plans for reaching out to business and industry in the future. Here's what the Ph.D.s have been focusing on and discussing at their conferences and reporting to their members:
- Workplace Resilience Training
- Workplace Psychological Well-being
- Military Stress and PTSD/Suicide Prevention (then on to other professions)
- Bullying prevention in workplace
- Presenteeism (employees sick at work and their impact on others/productivity)
- Erratic commuting stress and How It Undermines Productivity.
- Psychological health of untrained disaster responders (as opposed to trained responders)
- Improving personal communication on the job and creating healthier workplaces
- Employees with parental duties and productivity declining while at work, but beginning at the moment school lets out -- i.e. What is Johnny doing? Where's the babysitter?, Etc.
- The study and management of flexible work schedules, employee stress, and related issues.
Hey, wait a minute! I thought EAPs dealt with most of these issues? And, hey again, I read recently that there are more EAPs than ever! So, what gives?
One itsy, bitsy, small difference. Managed care now provide most EAPs. The CT (translation - authentic) programs are dwindling. Indeed, manager care 800#'s don't have any practical involvement with the issues discussed above.
Could it be that the decline in the number of solid, core technology-driven, personally visible, and integrated employee assistance programs is causing or allowing to become visible, unmet needs in the workplace? I think they are. I have been observing this trend ever since reading in an HR journal a few year ago that HR managers should start addressing more personal problems of employees when "EAPs" can't do it. Holy cow! You never heard that about the EAPs of the 70's, 80's, or early 90's.
So where do HR managers and customers (decision makers) turn to get these needs met? Themselves? Mental health? Of course, they are turning to mental health professionals. And psychologists are at the waiting--organized, focused, and with clout they have uniformly built for decades.
Thursday, November 12, 2009
"We have an expert on that subject!"
Throughout the year the major media will visit health related subjects that have broad appeal to the public. They will also report on major calamities and news stories like the recent massacre at Fort Hood.
The media needs mental health experts when these events occur. Who do they call? The answer is whoever comes to mind. That could be you if you know what to do, and first step you should take is to believe that they want you instead of the same old warm body that calls them every time.
There is one national managed care organization that hogs the spotlight on these events. They have a well funded pubic relations arm and they consitently show up in the media, the New York Times, ann Washington Post. There is another large corporate EAP that does the same thing. I am amazed at their prowess, but they deserve the attention if no one else is seeking.
Hey, were talking about capitalizing on tragedy here. The Fort Hood massacre was beyond belief horrible, but the media will pursue experts to help the public cope with these events, and it might as well be you. This is especially important because the some organizations have completely misguided ideas about employees assistance programs and they don't have any resistance to sharing the view to match their economic pursuits, regardless of its grander impact on the profession.
You will notice that specific topics appear in the news periodically, but predictably. For example, you can predict that approximately once a year the topic of alcoholism will emerge. It might be a news event on the cause, a new drug to fight cravings, or some other related topic. Many other topics related social problems will emerge in the mass media.
Pay attention. You will see that this is the case. Your local television station is not the "major media" in our definition. We are referring to AP news wires, and other major media outlets that sell news to the major networks, principally ABC, CBS, and NBC. However, pay attention to enormously important local news, specifically news events that relate to a subject about which you are an expert.
Now, here is what you should do: Listen attentively to the news. When you hear news that relates to your field of expertise, immediately fax to the local television stations your biography (a half page) and call the news room to say that you are an expert on that subject, and that you are faxing a bio. This is a great way to get publicity and to get on TV or the radio. And, it will make you instantly visible to your potential clients and EAP customers. (It's also a rush.)
Television and news stations scramble to find experts on subjects when the news hits. You are doing them a big favor.
If it is national news, you will have a few hours to respond because it will take longer for local stations to run "local expert" interviews. And it could be day later. If it is local news, your window of opportunity is much shorter, about an hour. Obviously you need to prepare ahead of time by getting phone and fax numbers, and contacts lined up. Then, wait for the "big one"--well hopefully not THE big one, but you get the idea.
The scramble for an expert kicks into gear quickly. That's you. Be there.
The media needs mental health experts when these events occur. Who do they call? The answer is whoever comes to mind. That could be you if you know what to do, and first step you should take is to believe that they want you instead of the same old warm body that calls them every time.
There is one national managed care organization that hogs the spotlight on these events. They have a well funded pubic relations arm and they consitently show up in the media, the New York Times, ann Washington Post. There is another large corporate EAP that does the same thing. I am amazed at their prowess, but they deserve the attention if no one else is seeking.
Hey, were talking about capitalizing on tragedy here. The Fort Hood massacre was beyond belief horrible, but the media will pursue experts to help the public cope with these events, and it might as well be you. This is especially important because the some organizations have completely misguided ideas about employees assistance programs and they don't have any resistance to sharing the view to match their economic pursuits, regardless of its grander impact on the profession.
You will notice that specific topics appear in the news periodically, but predictably. For example, you can predict that approximately once a year the topic of alcoholism will emerge. It might be a news event on the cause, a new drug to fight cravings, or some other related topic. Many other topics related social problems will emerge in the mass media.
Pay attention. You will see that this is the case. Your local television station is not the "major media" in our definition. We are referring to AP news wires, and other major media outlets that sell news to the major networks, principally ABC, CBS, and NBC. However, pay attention to enormously important local news, specifically news events that relate to a subject about which you are an expert.
Now, here is what you should do: Listen attentively to the news. When you hear news that relates to your field of expertise, immediately fax to the local television stations your biography (a half page) and call the news room to say that you are an expert on that subject, and that you are faxing a bio. This is a great way to get publicity and to get on TV or the radio. And, it will make you instantly visible to your potential clients and EAP customers. (It's also a rush.)
Television and news stations scramble to find experts on subjects when the news hits. You are doing them a big favor.
If it is national news, you will have a few hours to respond because it will take longer for local stations to run "local expert" interviews. And it could be day later. If it is local news, your window of opportunity is much shorter, about an hour. Obviously you need to prepare ahead of time by getting phone and fax numbers, and contacts lined up. Then, wait for the "big one"--well hopefully not THE big one, but you get the idea.
The scramble for an expert kicks into gear quickly. That's you. Be there.
Monday, November 2, 2009
Workers' Comp: Getting the EAP Involved
Most organizations of any appreciable size pay workers' compensation premiums, and for the biggest companies, they are self-insured. Companies want to keep their premiums as low and self-insureds try to reduce their costs, as well.
A CT-EAP (CT=Core Technology) can play a major cost-beneficial role in helping achieve these goals, but it takes education of human resource managers and those who control referrals after injury to pull the EAP into the picture.
This is a utilization improvement link EAPs.
Research supports the argument that empathic contact and support for injured employees received from the organization, plays a role in helping employees return to work more quickly. This saves money, and therefore a rationale exists to include the EAP in the continuum of care after injuries occur. Beyond coordinating the nuts and bolts of medical service and follow-up, figure out how to get your EAP into the care huddle and you will increase your EAP's utilization and influence by offering employees support for issues that nearly always associate themselves with injury and recovery.
Workers' comp claims are higher for addicts—five times that of non-addicted workers-is the commonly cited figure. NIAAA includes this in much of its literature, so there isn’t much argument about its validity. But this only a small piece of the EAP rationale. There is much more that EAPs can do vis-a-vis Workers' Comp.
While there has been solid promotion of EAPs using this alcoholic employee angle as a rationale to promote them, EAPs can also help injured workers no matter what the cause—alcohol, drugs, stress, absent mindedness, back luck, or mental distraction of any kind. After the injury occurs, employees often need support they aren't getting, and the EAP can fill the void.
Unfortunately NIAAA, and many other stakeholder organizations have not promoted EAPs in this way. If they had done so over the past 25 years, EAPs would be in a completely different place in their evolution. They would be household terms, and your mother would still not be calling an EAP an EPA.
Hundreds of property casualty insurers would be acquiring EAPs by now I think if this linkage were more well established. The direct role of EAPs in the workers comp cost-containment fight would have been identified and popularized.
Post-injury, some of the needs employee have to arrange are home health aides, companionship services, shopping assistance, transportation, and an empathic listening ear. Many injured workers need financial counseling and problem-solving for family problems and communication issues. EAPs are particularly adept at arranging the coordination of services or offer emotional support, and it is here they have no occupational match by another profession in the workplace. Few HR managers understand how to quickly obtain the resources above, and even fewer are want to get involved with these issues.
Workers' comp managed care firms can partner with EAPs for the intervention opportunities that exist with worker injuries. But they are not like to take the first step.
Work toward having your HR representatives or managed care companies that process workers' comp claims include EAP literature, the things EAPs can do, and other types of very direct communication with injured workers. Encourage the referral of the injured worker to the EAP for an assessment after the medical crisis and acute care period ends.
You will add points to your utilization rate by way of these referrals and improve your value as a service to employees and the organization's bottom line.
A CT-EAP (CT=Core Technology) can play a major cost-beneficial role in helping achieve these goals, but it takes education of human resource managers and those who control referrals after injury to pull the EAP into the picture.
This is a utilization improvement link EAPs.
Research supports the argument that empathic contact and support for injured employees received from the organization, plays a role in helping employees return to work more quickly. This saves money, and therefore a rationale exists to include the EAP in the continuum of care after injuries occur. Beyond coordinating the nuts and bolts of medical service and follow-up, figure out how to get your EAP into the care huddle and you will increase your EAP's utilization and influence by offering employees support for issues that nearly always associate themselves with injury and recovery.
Workers' comp claims are higher for addicts—five times that of non-addicted workers-is the commonly cited figure. NIAAA includes this in much of its literature, so there isn’t much argument about its validity. But this only a small piece of the EAP rationale. There is much more that EAPs can do vis-a-vis Workers' Comp.
While there has been solid promotion of EAPs using this alcoholic employee angle as a rationale to promote them, EAPs can also help injured workers no matter what the cause—alcohol, drugs, stress, absent mindedness, back luck, or mental distraction of any kind. After the injury occurs, employees often need support they aren't getting, and the EAP can fill the void.
Unfortunately NIAAA, and many other stakeholder organizations have not promoted EAPs in this way. If they had done so over the past 25 years, EAPs would be in a completely different place in their evolution. They would be household terms, and your mother would still not be calling an EAP an EPA.
Hundreds of property casualty insurers would be acquiring EAPs by now I think if this linkage were more well established. The direct role of EAPs in the workers comp cost-containment fight would have been identified and popularized.
Post-injury, some of the needs employee have to arrange are home health aides, companionship services, shopping assistance, transportation, and an empathic listening ear. Many injured workers need financial counseling and problem-solving for family problems and communication issues. EAPs are particularly adept at arranging the coordination of services or offer emotional support, and it is here they have no occupational match by another profession in the workplace. Few HR managers understand how to quickly obtain the resources above, and even fewer are want to get involved with these issues.
Workers' comp managed care firms can partner with EAPs for the intervention opportunities that exist with worker injuries. But they are not like to take the first step.
Work toward having your HR representatives or managed care companies that process workers' comp claims include EAP literature, the things EAPs can do, and other types of very direct communication with injured workers. Encourage the referral of the injured worker to the EAP for an assessment after the medical crisis and acute care period ends.
You will add points to your utilization rate by way of these referrals and improve your value as a service to employees and the organization's bottom line.
Thursday, October 22, 2009
Part V of V - What If the Addict Says, "No!"
(Note, this post has four previous parts.) I will make all parts available in a downloadable document (grammatically proofed) at a later date.)
If the addict says no, intervention participants should be ready to act on the leverage they have previously decided to use. However, it is extremely effective to give a deadline for the addict to accept the offer of help if he or she says "no."
The recommendation is no more than one day. This gives the addict time to think about treatment and feel in control of the decision to accept it.
Many people argue only for an immediate transport to the treatment facility. I disagree from personal experience. Addicts babies. Don't treat them as such. You must guess that the addict is motivated and willing to follow through.
As a director of a 25-bed adolescent drug and alcohol treatment unit in 1982, I once convinced a teenager to enter treatment after attending an Ozzie Osbourne concert. This kid never would have entered treatment. I guessed I could make the deal. He shook on it and entered treatment two days later.
The desperate act of “forcing” the addict to decide upon admission within minutes of the intervention is linked to the intervention consultant’s role and the implication that the intervention can’t be repeated later when the interventionist does not come back.
Using an intervention consultants is almost entirely viewed as a “one shot” opportunity. It is a disservice to families and the patient to view interventions in this manner.
Virtually all interventions will succeed. That's a bold statement isn’t it? But if you understand the nature of addictive disease and its progression, you know that this statement is essentially true.
Helping intervention clients understand this reality is essential because it provides motivation to practice new behaviors that stop enabling and facilitate crises that can lead to admissions. The goal is for co-addicts (persons in relationships with addicts) to act in tireless and aggressive ways against disease until the addict accepts help at a future point, if not right now. That day will come with a new attitude and a watchful approach to stopping enabling. Alanon is extremely useful for this purpose, but the Alanon sponsor must not be a individual who sends the message of "do nothing", simply live detached. Alanon's message is powerful, but some individuals interpret Alanon principles as avoiding intervention--forever. So, be careful of this message.
There are essentially three reasons all interventions will eventually succeed, particularly if they are "family-managed” rather than intervention consultant-driven. (Family-managed means that the intervention becomes a process, not a one time shot event that is declared a failure on the first try if does not work.) Again, no intervention consultant is used with the family empowerment model.
Reason #1: The reality of the progression of incidental, serial crises until death or sobriety. As the disease worsens, crises continue unabated with only an unpredictable amount of time that separates them. Each one becomes an opportunity to initiate an intervention.
Reason #2: Denial and alibis of the addict diminish and this leads to a rapid progression of the illness’s symptoms. Addicts practice defensive mechanisms to avoid confrontation and consequences for their behavior. If an intervention at first does not succeed, drinking or drug use will increase, although there may be a short-term attempt to reduce consumption in a vein attempt to demonstrate control over the illness by practicing abstinence or moderation. As drinking continues or resumes, problems increase and interventionists (family and friends) need only await for the opportunity to try again. The mission: Make acceptance of treatment non-negotiable as before.
Reason #3: Addicts will sicken as their illness grows worse, making sudden medical crisis an eventual certainty if they do not kill themselves first either by accident, medical event, or suicide. This may take weeks or years, but medical symptoms will almost certainly emerge requiring sudden and acute intervention. Again, this is an incidental crisis as I have defined it earlier, and it is therefore another opportunity to make another move to intervene.
It is a medical fact that two-thirds of addicts die of the medical consequences of alcoholism left untreated. One-third die of calamities of one sort or another. Before death, intervention opportunities are numerous, not one shot. Obviously, no intervention consultant can return for a second, third, and fourth try at the intervention. Subsequent interventions do not require much planning. The addict is "directed" to treatment in the aftermath of each crisis.
If the addict says no, intervention participants should be ready to act on the leverage they have previously decided to use. However, it is extremely effective to give a deadline for the addict to accept the offer of help if he or she says "no."
The recommendation is no more than one day. This gives the addict time to think about treatment and feel in control of the decision to accept it.
Many people argue only for an immediate transport to the treatment facility. I disagree from personal experience. Addicts babies. Don't treat them as such. You must guess that the addict is motivated and willing to follow through.
As a director of a 25-bed adolescent drug and alcohol treatment unit in 1982, I once convinced a teenager to enter treatment after attending an Ozzie Osbourne concert. This kid never would have entered treatment. I guessed I could make the deal. He shook on it and entered treatment two days later.
The desperate act of “forcing” the addict to decide upon admission within minutes of the intervention is linked to the intervention consultant’s role and the implication that the intervention can’t be repeated later when the interventionist does not come back.
Using an intervention consultants is almost entirely viewed as a “one shot” opportunity. It is a disservice to families and the patient to view interventions in this manner.
Virtually all interventions will succeed. That's a bold statement isn’t it? But if you understand the nature of addictive disease and its progression, you know that this statement is essentially true.
Helping intervention clients understand this reality is essential because it provides motivation to practice new behaviors that stop enabling and facilitate crises that can lead to admissions. The goal is for co-addicts (persons in relationships with addicts) to act in tireless and aggressive ways against disease until the addict accepts help at a future point, if not right now. That day will come with a new attitude and a watchful approach to stopping enabling. Alanon is extremely useful for this purpose, but the Alanon sponsor must not be a individual who sends the message of "do nothing", simply live detached. Alanon's message is powerful, but some individuals interpret Alanon principles as avoiding intervention--forever. So, be careful of this message.
There are essentially three reasons all interventions will eventually succeed, particularly if they are "family-managed” rather than intervention consultant-driven. (Family-managed means that the intervention becomes a process, not a one time shot event that is declared a failure on the first try if does not work.) Again, no intervention consultant is used with the family empowerment model.
Reason #1: The reality of the progression of incidental, serial crises until death or sobriety. As the disease worsens, crises continue unabated with only an unpredictable amount of time that separates them. Each one becomes an opportunity to initiate an intervention.
Reason #2: Denial and alibis of the addict diminish and this leads to a rapid progression of the illness’s symptoms. Addicts practice defensive mechanisms to avoid confrontation and consequences for their behavior. If an intervention at first does not succeed, drinking or drug use will increase, although there may be a short-term attempt to reduce consumption in a vein attempt to demonstrate control over the illness by practicing abstinence or moderation. As drinking continues or resumes, problems increase and interventionists (family and friends) need only await for the opportunity to try again. The mission: Make acceptance of treatment non-negotiable as before.
Reason #3: Addicts will sicken as their illness grows worse, making sudden medical crisis an eventual certainty if they do not kill themselves first either by accident, medical event, or suicide. This may take weeks or years, but medical symptoms will almost certainly emerge requiring sudden and acute intervention. Again, this is an incidental crisis as I have defined it earlier, and it is therefore another opportunity to make another move to intervene.
It is a medical fact that two-thirds of addicts die of the medical consequences of alcoholism left untreated. One-third die of calamities of one sort or another. Before death, intervention opportunities are numerous, not one shot. Obviously, no intervention consultant can return for a second, third, and fourth try at the intervention. Subsequent interventions do not require much planning. The addict is "directed" to treatment in the aftermath of each crisis.
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