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Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory

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Title: Do Employee Assistance Program (EAP) Affiliate Providers Adhere to EAP Concepts? An Examination of Affiliate Fidelity to EAP Theory


1
Do Employee Assistance Program (EAP) Affiliate
Providers Adhere to EAP Concepts? An Examination
of Affiliate Fidelity to EAP Theory Practice  
  • David A. Sharar
  • EAPA 2007 San Diego
  • October 27 Research Forum
  • dsharar_at_chestnut.org

2
EAP affiliates
  • Available "on demand" and paid fixed fee to see
    EAP clients on behalf of a vendor
  • Most are based in private individual or group
    practices, or agency/hospital clinics
  • Affiliates represent a mix of "helping"
    professionals
  • EAP work likely represents a small portion of the
    affiliate's caseload
  •  

3
Statement of the problem
  • EAP field has identified specific competencies
    unique to the delivery of "EAP"
  • Most prevalent delivery system in EAP is the
    "Affiliate Network Model"
  • Affiliates, as general mental health
    practitioners, may or may not deliver EAP as
    conceptualized
  • Need to investigate whether affiliates believe
    they adhere to EAP concepts

4
Overall design research questions
  • Nation-wide (one-time) survey of EAP affiliates
    using random probability sample
  • Goal is to provide a descriptive "portrait"
    of how affiliates apply EAP concepts in their
    practices
  • Two research questions
  • How are EAP concepts understood and utilized
    among affiliates?
  • What are the commonalities differences in terms
    of how affiliates treat EAP versus other cases?

5
Comparison of EAP versus mental health benefits
EAP      Mental Health Benefits
Problems in living  Diagnosable disorders
Unrestricted access Usually some "gatekeeping"
Rapid resolution or referrals  Longer-term or specialized treatment
"Free" to employees/dependents Co-payments/deductibles
Emphasis on follow-up Emphasis on case closure
Work performance model  Medical model 
6
Status of research on EAP affiliates
  • Paucity of published scholarly research
  • About 10 citations (mostly opinion, anecdotal
    observation, group consensus)

7
Status of research on EAP affiliates
  • These citations refer to 5 concerns
  • Overlapping EAP and MBHO networks
  • Duplicate purpose with mental health benefits
  • EAP affiliate shortcomings
  • Lack of local workplace integration
  • Affiliate dissatisfaction

8
Sampling frame  design
  • No resource that covers the "universe" of EAP
    affiliates
  • emindhealth (a provider of network services)
    appears to be a microcosm of the "universe"
  • Random probability sample drawn from emindhealth
    list of affiliates (3,000)
  • 222 completed questionnaires submitted (SE of
    3.5)

9
Administration
  • Self-administered over Internet as web-based
    survey ("Zoomerang" was hosting service)
  • Listserv comprised of e-mail addresses of
    randomized affiliates ("respondents")
  • Potential respondents received a pre-notification
    e-mail from emindhealth
  • Pre-notification followed by an invitation with a
    link to the questionnaire, up to 4 reminders
  • Completed questionnaires submitted to secure
    server (under control of the investigator)  

10
Questionnaire Construction
  • Core components of EAP used to provide conceptual
    basis (e.g. components "mapped" to questions)
  • Uses mostly close-ended questions with scaled
    responses
  • Two open-ended questions allows for some
    methodological mix
  • Six subject matter experts (from Editorial Review
    Board of a Journal) reviewed the design and
    content
  • Field pretest conducted with 15 actual
    respondents

11
Validity Threats
  • Desirability Respondents may want their answers
    to be perceived as "correct"
  • Memory or unavailable info  Recall of past
    events is subject to error
  • No direct observation Study measures
    "perceptions" that may not reflect actual
    behavior

12
Data Analysis Plan
  • Data converted into Excel and dumped in SPSSx
    14.0.2
  • Descriptive statistics show characteristics of
    sample
  • Chi-square used to compare "EAP" cases to
    "General" cases
  • Findings presented with written narrative
    supported by tabular graphic results
  • Open-ended questions analyzed by content
    analysis/id of themes

13
Licensed or certified disciplines (N 222) (81
masters level and 19 doctorate level)
14
Professional identity
15
Assessing impact of client problem on job
performance
16
Cases screened for substance abuse
17
Referrals to outside practitioners
18
Referrals to clinical programs
19
Referrals to non-clinical community services
20
Referred to treatment that received follow-up
21
Referrals beyond EAP to yourself
22
Primary theory or model
Chi-square (df16)387.68, p.000
23
Approximate of EAP cases where assessed problem
was improved or resolved within the EAP
lt 25 27
26 - 50 32
Greater than 50 41
24
How is improved/resolved determined for cases
that only receive short-term EAP?
No way of assessing improvement with in the EAP 1
Clinical impressions and judgment 57
Review of the EAP action plan 29
Formal outcome measurement tool 1
Other 12
25
Approximate percent of EAP cases that were formal
management or supervisory referrals
0 22
Less than 10 45
Between 11 and 25 17
gt 26 15
26
How familiar are you with EAP core technology?
Not at all 37
A little familiar 26
Some knowledge 19
Very familiar 18
27
How often over past year did you provide a direct
ONSITE service at an employers workplace
Never 57
Rarely (once/twice a year) 15
Occasionally (3-5 times a year) 15
Frequently (gt 5 times a year) 13
28
In terms of therapeutic approach and selection of
interventions, are EAP clients generally treated
the same as non-EAP clients
Completely the same 28
More or less the same 46
Moderately different 25
Very differently 2
29
Analysis of open-ended question (183 comments out
of 222, or 82 response rate)
Describe how your approach to EAP is similar or
different from your approach to general practice
counseling?" 
  • Representative themes include
  •  "Less sessions with EAP"
  • "Little difference except EAP has fewer visits"
  • "Only difference is some EAPs require switching
    therapists for referrals"
  • "EAP is mainly for 'here now' issues, not
    long-term"
  • "EAP focus is on most pressing problem due to
    short visits"
  •  
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