EAP Research Findings: Relevance for Today’s EAPs

Bernie McCann, PhD, CEAPSCEAPA Annual Conference

Charleston, SCFebruary 9, 2016

So are EAPs…?• Successful with troubled employees…?

• Contributing to better work/life balance...?

• Reducing the workforce impact of mental health and substance abuse...?

• Cost-effective…?

• A good return on investment…?

Research DefinitionsProcess vs. Outcome studies: • Descriptive (qualitative) research – tells what, why,

how many, when,…EAPs provide services

• Deductive (quantitative) research – allows analysis of how often, how consistently, how rigorously, how successfully,…EAPs provide services

Randomized research studies - the most rigorous level of experiments which allow specific comparisons

Evolution of EAP Research

Value of EAPs – 2000sEAP Return on

Investment EAP Outcome Studies

Descriptions of EAPs – 1980sTypes/Characteristics of EAPs EAP Process Measures

Numbers of EAPs – 1970sDiffusion of EAPs Prevalence of EAPs

US Prevalence of EAPs: 1970-2014

1970 1985 1995 2002 2005 2008 20140%

20%

40%

60%

80%

100%

US Workforce Access to EAPs: 2010

All worke

rs

Private

Sector

Public Sec

tor

Non-Union

Union0%

20%

40%

60%

80%

100%

EAPs by Employer Size: 2012

Small (1-99) Medium (100-499) Large (500+)0%

20%

40%

60%

80%

100%

Integration of EA & Related Services: 2011

1993 2002 2004 2006 2008 20110%

10%20%30%40%50%60%70%80%90%

100%

Offering Integrated EA + Other Services

Early Representations of EAP Value

Utilization rates Client/case anecdotes User satisfaction surveys Return on investment ratios

EAP Utilization Research Comparisons of EAP utilization rates are nearly

impossible, due to a lack of standardization of utilization measurement practices, although ranges of 2-12% have been reported.

Program utilization also varies by industry, size of employer, and program model. Reports of utilization rates from internal EAPs are typically higher than those reported by externally-provided EA services.

EAP Return on Investment Studies Solid evidence of a positive ROI to make a business

case for providing EAP services can be found in over 45 scientifically-valid published studies.

ROI findings range from $3-10 for every $1 invested. This is consistent with ROI seen in other types of worksite health promotion and wellness programs.

One difficulty in using findings from single case studies of specific organizations, applied studies, or vendor reporting processes is their lack of generalizability.

Reality of Historical EAP “Value” Utilization rates typically reflect providers’ subjective

convenience measures

‘Problem type’ reports not very illustrative

User satisfaction reports typically based on non-representative rates of client satisfaction surveys

Return on investment findings are largely based on projections, single case studies, lacking transparent measures or any universal benchmarking

So what’s missing in EAP Research..?

Scientifically valid experimental designs

Large-scale, multi-site study settings

Demographically & occupationally-diverse populations

Measureable workplace & clinical EAP effects

Studies that can be easily replicated

Contemporary View of EAP Value

EAP VALUE = Measurable, positive client and program outcomes achieved relative to cost incurred.

Remains a black box for many EAPs -- particularly for those programs without a scientifically validated outcome measurement system.

Evidence-based EAP Tools

Screening: Alcohol Use Disorders Identification Test (AUDIT)

Drug Abuse Screening Test (DAST)

Patient Health Questionnaire (PHQ-9)

Generalized Anxiety Disorder (GAD-7)

Workplace Outcomes:Workplace Outcomes Suite (WOS)

Workplace Outcomes Suite

http://chestnutglobalpartners.org/wos

FOH EAP Outcome Study: 2004Federal Occupational Health provides EA services to US federal agencies. This 3 yr. study of 60,000 EAP clients’ EA client overall health & workplace performance used client self-reports & counselor-assessed measures.

EAP users reporting “quite a bit of difficulty” performing their work fell from 15% to 5%.

Significant reduction in absenteeism & tardiness - 30 days before EAP, clients averaged 2.37 days of unscheduled absences or lateness. After EAP use, was reduced to 0.91 days.

Clients’ perception of health status increased significantly after EAP use, evidence for a positive impact of EAPs on employee work productivity, absence and overall health.

Impact of Employee Assistance Services on Workplace Outcomes: 2014

Purpose: This study seeks causal evidence of the impact of EAPs on clinical and workplace outcomes by quantifying EAP impact; identifying conditions under which EAP is most effective; and estimating cost-savings in absenteeism

Site/Population: 27,000 CO State Government employees in diverse job categories and work settings

Method: Quasi-experimental design with an intervention group of EAP users and a matched comparison group of non-EAP users

Measures: AUDIT-10, PHQ-8, DAST-10, GAD-2, WOS-5

Funded by: Employee Assistance Research Foundation

Pre-publication Results: Clinical Measures

Depression (PHQ-8)

Anxiety (GAD-2)

Alcohol (AUDIT)

Pre-publication Results: Workplace Outcomes

Absenteeism (WOS)

Presenteeism (WOS)

Workplace Distress (WOS)

Implications for EAP Effectiveness

“These study findings demonstrate strong quantifiable evidence of EAP impact on both clinical and workplace outcomes – and are the first major study to compare outcomes to similar employees who did not receive EA services.”*

*Article in press – Journal of Occupational Health Psychology

Implications for EAP Value

“Findings support the value of EAPs to improve and maintain productivity and healthy functioning of the workplace …through their application of specialized knowledge and expertise about human behavior and mental health.”*

*Article in press – Journal of Occupational Health Psychology

Created as a non-profit foundation, the Employee Assistance Research Foundation was formed to stimulate innovative, rigorous and evidence-based research activities which demonstrate the ability of EAPs and related workplace efforts to maximize employee contributions to organizational success.

What is the EARF...?

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.The EARF is incorporated as a 501(c)(3) nonprofit foundation EIN #26-2443117

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Our Mission Promote excellence in the design

and delivery of Employee Assistance services worldwide.

Support effective measurement practices, performance tools, and outcome criteria.

Bridge the gap between EA knowledge and practice by translating valid research findings to contemporary EA services.

Dissemination of EARF Research Peer-reviewed articles published with results of EARF-funded studiesMore scholarly articles in preparation Conference sessions by researchers to present EARF-funded study resultsFree webinars of EARF-funded studiesNumerous additional mentions in trade publications and on various websites

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EAPs in Continental Europe: State of the Art & Future Challenges

PI: Debora Vansteenwegen, PhD, ISW Limits

• Multi-national research team surveyed HR managers, employers and employees in six Western European countries, examining characteristics of existing EAP and workplace services and investigating the future potential for service delivery.

• Results published in Journal of Workplace Behavioral Health, 2015.

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• Research study on the characteristics of external EAP providers and EAP utilization patterns. Also gathered benchmarking data on EAP use of technology, aging of the EA provider population, and future of EAPs.

• First peer-reviewed article published in Journal of Workplace Behavioral Health, 2013. Second article on EAP market published in Journal of Workplace Behavioral Health, 2014.

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Comparative Metrics for the External EAP Field PI: Stanford Granberry, PhD, National Behavioral Consortium

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Research Contributions

Available matching funds = $830,000

Contributions= $170,000

Tisone FoundationMatching

Pledge

$0 $1,000,000$170,000 $500,000

FoundationGoal

EARF contributions + Tisone Foundation matching funds received to date have totaled approximately $340,000.

Cost of previous research and commitment to funding current study total over $350,000.

EARF’s future capacity for funding EAP research studies are unsustainable without additional financial support.

The Bottom Line…

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Value Proposition for EARF Support

Visibility for your organization as a advocate for EAP efficacy, viability, and sustainability.

Tangible business benefits of better data on EAP contributions to workplace productivity.

Demonstrate leadership and commitment to advancing the EAP field.

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EARF’s Chapter ChallengeTo fully fund the EARF’s latest effort – The EAP History Project, we have initiated an EAPA Chapter Challenge. The following Chapters have contributed at the $500 level:

South Carolina Chapter North Carolina Chapter Northern Illinois Chapter Philadelphia Chapter Upper Midwest Chapter Houston Chapter

The following Chapters have contributed at the $1000 level:

San Francisco Bay Chapter Colorado Chapter

How You Can Help

1. Facilitate a contribution from your organization to fund EARF’s research efforts.

2. Make a personal tax-deductible contribution.

3. Make an in-kind contribution to assist with dissemination of research findings or fundraising efforts.

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Contact information:

Bernie McCann, PhD, CEAPDevelopment Consultant, EARF

mccannbag@gmail.comWebsite: www.eapfoundation.org

Mobile: 781.264.6211www.linkedin.com/in/berniemccannphd

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