Human Resources: The Employee Assistance and Work/Life Professional Survey: The Future is already written...

I. Introduction
For the EAP field the events of the past year and a half have brought increased media attention to the work these professionals have been doing for years (Drotos, 2001). Somewhat like the previously unacknowledged, dedicated work of police and firefighters, the work of human service providers, particularly in the workplace, has somehow found itself on the front pages of newspapers and magazines.

How timely then that this particular project, the Employee Assistance and Work/Life Professionals Survey* was being conducted during the month of September 2001.

One will never know for certain, but perhaps the world events of that month had an impact on the response of participants who poured their hearts out to honestly grapple with the issue of whether integration of EAP and Work/Life (W/L) services might be beneficial to employees and their employers.

II. Background
This article presents some of the major findings of this research endeavor. It elaborates with two organizational vignettes that depict how these employers struggled with the issue of collaboration and designed programs that fit their particular cultures. But first some background on how this study evolved.

The Employees Assistance Professionals Association (EAPA) has been tracking the development of the EAP and W/L fields for the last ten years. Due to the New Economy and resulting changes in the workforce, EAPA felt that it was a critical time to revisit the issue of whether some form of collaboration or integration of EAP and W/L benefits might be advantageous for both employers and employees. Thus EAPA began a three-phase project to study in-depth the issue of integration. This article will focus on the key findings of the first phase of this endeavor.

As the research evolved, it became clear that the concept of integration is even more complex than initially thought. EAP and W/L programs may be part of the same department, or report to the same manager, which is one form of integration. But there is a more subtle and perhaps more powerful integration when there is true collaboration of effort... no matter where the programs reside. The research question of attempting to capture the level and type of integration present was a daunting task. We had to rely on self-report of the respondents regarding their perceptions and understandings of the concept of integration.

III. Research
A crucial key to the success of the Employee Assistance and Work/Life Professionals Survey 2001 was the collaboration of the Alliance for Work/Life Professionals (AWLP), and the Employee Assistance Society of North America (EASNA) with EAPA. Members of all three professional organizations were sent an invitation to participate in this survey. It is important to note that, while professionals from all three organizations responded, there were six times as many EAP respondents as W/L practitioners who responded to this survey. Therefore the results may be skewed toward an employee assistance perspective. Figure 1 describes the response rate for these various subsets of the sample population.

Figure 1. Response Rate

In this study, the researchers were interested in exploring the scope of services provided by EAP and W. /L practitioners in the workplace. The study concentrated on the programmatic aspects of both the EAP and W/L fields, as viewed by EAP and W/L practitioners. There was an interest in learning about respondents´ perceptions of integration of EAP and W/L in their workplaces. Integration was defined to the respondents as: " the collaboration among departments to achieve unity of effort".

Research Question
What are the current practices and future directions of the Employee Assistance and Work/Life fields in relationship to the integration of services?

Key Findings
First Key Finding: The Professional Identity Level

Approximately 1 in 6 survey respondents considered themselves both an EA professional and a Work/Life professional, and this finding was consistent across all three associations

Two of the initial questions on the survey asked respondents first, which professional organization they were associated with; and second, how they would primarily identify themselves, i.e. as an EAP professional, a W/L professional, both or other. Table 1 summarizes the results of these two questions about Professional Identity.

Self-Identity	Total Sample	Results Within Each Professional Association
Self-Identity	Total Sample	% of AWLP Members	% of EAPA Members	% of EASNA Members
Work/Life	10%	66	1	0
EAP	62%	4	70	70
Both	17%	16	19	24
Other	11%	14	10	6

Table 1 - Professional Identity

It is here that one can clearly see the greater number of EAP professionals who responded to this survey. The table then breaks down participation by professional association. The interesting fact which leads to the first key finding is that 17% of the entire sample, 16% of AWLP members, 19% of EAPA members, and 24% of EASNA members identify themselves as "primarily Both EAP and W/L professionals".

Second Key Finding: The Service/Provider Level

There is a significant level of collaboration/integration at the service level. The overlap of services in general tends to be in the non-core areas of each profession, except what may be a "New Breed" of professional who seems to provide services across core areas of both professions.

Respondents were given a list of 30 services, based on a complete list of Work/Life Initiatives (Friedman and Wald, 2000) and EAPA´s Core Technologies. They were then given the directive to "check the appropriate box to indicate if the service is provided by the EAP, W/L program, other business unit, or not provided in their organizations.

For those who identified themselves as being primarily an EAP professional (n = 575), each of the 30 services was coded as being offered if "EAP" was part of the responses selected (EAP, EAP & Work/Life, EAP & Other,). Similarly, for those who identified themselves as being primarily a Work/Life professional (n = 92), each of the 30 services was coded as being offered if "W/L" was part of the responses selected. Finally, for those who identified themselves as being "Both an EAP and Work/Life" professional (n = 160) each of the 30 services were coded as being offered if either "EAP" or "W/L" was part of the responses offered.

A threshold of 50% was used to consider that a service was characteristic of the group (offered by a majority). The "Both EAP and W/L" group offered the most services (22), followed by the "EAP" group (17) and then the "W/L" group (12). In general, the "EAP" group and "Both EAP & Work/Life" group had a similar pattern of services offered. The exception was that a higher percentage of respondents who were both EAP and W/L professionals offered services that were also offered by most "W/L" professionals (elder care and child care services in particular).

A Venn Diagram (Figure 2) was created to help visualize the above analysis. This figure shows two overlapping circles. The circle on the left has the 17 services that were provided by the EAP as reported by a majority (50% of more) of EA professionals. The circle on the right has the 12 services that were provided by the W/L program as reported by a majority of W/L professionals. In the middle, where the two circles overlap, are the 6 services that were offered by a majority of both professional groups. All the services in color are the ones that were provided by the Dual Group, those who identified themselves as both an EA and W/L Professional.

The Venn Diagram analysis shows that both groups offer various kinds of training, evaluation, information, and consulting services, but that each group also offers certain services that are unique to their own individual field. These results indicate three kinds of professionals coexisting in today´s marketplace. Two kinds of professionals are focused on providing services specific to one field (the primarily EAP field and the primarily W/L field). The third kind represents a "New Breed" that offers many of the key services associated with the EA field and with the W/L field.

Third Key Finding: The Conceptual Model Level

Respondents´ comments indicated that there is a general consensus that collaboration or some form of integration is better for the employee and the employer than a single focused program. However, they expressed ambivalence about the impact on professional identity, and on the integrity of each practice field.

Respondents were asked five qualitative questions regarding their thoughts and suggestions concerning the issue of integration of EAP and W/L Programs. Despite the extensive variety of EAP and W/L programs at diverse workplaces, as evidenced by the comments of participants, there were some programmatic themes that emerged.

W/L practitioners did not frequently comment that W/L programs were integrated with EAPs. Instead, they indicated that EAP and W/L programs report to different leaders in the workplace, or that the programs are distinct, but overlap to assist employees who have needs in both service areas.

On the other side, EAP practitioners reported that EAP and W/L are equal, though separate, collaborators on behalf of employees in those settings where the programs both exist. But EAPs view integration of W/L and EAP as the expansion of EAPs to incorporate and deliver work/life resource and referral services like child/eldercare, legal services, and financial assistance.

Interestingly, those respondents that offer both EAP and W/L services, while making some of the above comments, more commonly spoke about EAP and W/L as distinct programs. They seemed to use the term "integration" to mean offering different services, such as EAP, W/L, and Wellness under the broader umbrella of corporate health services.

Advantages of Integration
When asked to consider the advantages of integrating W/L and EAP programs, there were two primary beneficiaries reported: the employee, and the sponsoring company. For the employee integration was perceived to allow one-stop shopping, broader, comprehensive services, ease of access, and avoidance of confusion, seamless continuity, quality and effective services for the employee. For the company, respondents felt there was administrative simplicity, greater prevention of problems, cost savings, and consistency of all program efforts

Disadvantages of Integration
The most frequently cited disadvantage of integration was for the professional practitioners. Respondents worried about loss of focus and identity if these programs were integrated. There was also concern about loss of control over the distinct growth of each profession.

For employees, there was a concern about a decrease in quality if so many services were offered together. There was also the fear that there would be a lack of clear communication about services, and that programs would be less effective if they were not staffed by cross-trained and licensed professionals.

Closing Comments and Recommendations
According to economist Roger Cass (2001): "The future is already written. All we need is the confidence to accept it." The results of this study report that integration of EAP and W/L programs has already arrived on some fronts. There appears to be a New Breed of EA and W/L practitioner who identifies themselves as "Both". Then there is the overlap of services that both EAP and Work/Life professionals provide. Finally, in their own words, respondents report a belief that integration is better for both the employee and the employer.

The ambivalence and confusion surface when one asks: how to go about the process of integration, whether integration is an effective model for all organizations, and what are the implications for each of the separate professions. The two organizational vignettes are offered as models of companies that have struggled with these questions and found answers that work in their cultures. Clearly a range of models would be valuable, as well as education between the two professions on their core technologies.

All three professional organizations AWLP, EAPA and EASNA are committed to further exploration of this topic. There are two more phases of this research endeavor. In Phase II we will explore current practices and future directions in the vendor population; and Phase III will involve in-depth surveys of the corporate organizations and their views on the issue of integration of services. This last phase will be a replication of the earlier 1994 National Survey of Employee Assistance and Work/Family Programs conducted by Boston University´s Center on Work and Family.

*Magellan Behavioral Health Care and Lifecare. Inc sponsored the Employee Assistance and Work/Life Professionals Survey. A special thanks to Sandy Burud, AWLP President, for reviewing the final drafts of this article! Bibliography

Drotos, J. Chip. (2001). Hats Off to Behavioral Health´s Heroes. Behavioral Health Management. Vol21. Number 6. p48.

Friedman, Dana and Wald, Richard. (2000). Work/Life Intitiatives 2000. Survey Report by William M. Mercer and Bright Horizons.

Rubin, Harriet. (2001). Roger Cass: The Last Optimist. Fast Company. July. Pp.88-98.

Separate but Coordinated Approach

The University of California at Berkeley is the largest employer in the East Bay of the San Francisco Bay Area. Â The population of this academic institution includes approximately 15,000 faculty and staff, and another 35,000 students. Â At UC Berkeley, the EAP and Work/Life programs are located in the University Health Services, which is the primary medical, and mental health provider for students. This facility also provides an array of services, which are specifically targeted for faculty and staff.

Â Â Â Faculty/Staff services include: Â Wellness, Ergonomics, Vocational Rehabilitation, Workers'' compensation and Occupational Health in addition to EAP and Work/Life. Â The managers of these programs report to the Assistant Vice Chancellor, University Health and Counseling Services.

Â Â Â All of these internal programs are separate but coordinated units. Each program maintains its own identity but all program planning and development are complementary within the faculty/staff health services. Program coordination is accomplished through a management team structure. While intake for all of these programs and their components are separate, publicity for workshops, brown bag presentations, and all other offerings are integrated into one flyer.

This model of "separated but coordinated services" is designed to preserve the integrity of each program, promote trust in the confidentiality of the EAP, allow for increased awareness and support of all of the programs by a larger group of people, and help to prevent overlap and gaps in services, which in turn has significant financial savings.

External Model of Integration

Humana is one of the nation´s largest publicly traded health benefits companies, with approximately 6.4 million medical members. Humana´s products and services are designed to help consumers take charge of their own health by connecting them and their doctors to customized, medical and life-enhancing information.

In the Fall of 2001 Humana decided to integrate its EAP and Work/Life programs to help associates maximize their effectiveness both on and off the job. To raise awareness and encourage associates to use Ceridian´s LifeWorks Product, Humana promoted the program to two distinct audiences: employees who were looking for EAP services, and those who were looking for assistance with the everyday life challenges. Prior to the October 1st launch date, popular songs about finance, childcare, and home repair were featured along with traditional EAP articles on the Intranet. The week the program launched, and the web sit went live, there were more than 1200 web hits. By offering EAP and W/L in a single program the stigma attached to EAP has virtually been eliminated at Humana. Associates perception of this program shifted from "help for an emotional crisis" to a "resource for anything to help you make life easier."

Combined on-line and telephonic access for the first two months resulted in a five-fold increase over our previous EAP utilization. Todate, we have received enthusiastic feedback from our associates and are very pleased with the results. The integrated program resulted in a 35% savings over the cost of the two separate programs.

About The Authors

Patricia A. Herlihy Ph.D., RN is a Psychiatric Clinical Nurse Specialist with over 25 years of psychiatric experience. Her range of experience includes Charge Nurse on an Inpatient Adult Psychiatric care unit, Family Therapist in an outpatient child guidance center; Director of an Adolescent Substance Abuse Program; Assistant Professor at Boston University''s Graduate Psychiatric Nursing Program; System´s Manager for Digital Equipment Corporations'' EAP; and Principal Investigator for the National Study of EAP and Work/Family Programs out of Boston University''s Center on Work and Family. She received her Doctorate from the Florence Heller Graduate School, Brandeis University in social policy and has published numerous articles on the topic of Integration of EAP and Work/Family Programs. Currently, she is the Principal Investigator in the International Survey of Employee Assistance and Work/Life Vendors. You can reach her at HerlihyPA[at]aol.com.

Dr. Mark Attridge is a Principal for Optum in the area of Research and Analysis. He received his Doctorate in Social Psychology from the University of Minnesota and a Master in Communication from the University of Wisconsin-Milwaukee. Dr. Attridge is the Chair of the Research Committee for the international Employee Assistance Professionals Association and is a liaison to the EAPA Work/Life Committee. He has published many research articles in scientific journals and regularly presents findings at national trade and academic conferences, including EASNA and EAPA. Mark can be contacted by email at mattridg[at]uhc.com.

Sandra P. Turner, MSW, CEAP, CCDC III-E is the Director of Ernst & Young''s EY/Assist, the firm''s integrated EAP and work/life resource and referral service. Previously Sandra worked with companies as an EAP consultant and an organizational change agent. Sandra is the Past President of the International Employee Assistance Professionals Association. She is a founding member and former Chairperson of the Employee Assistance Certification Commission. Sandra is a Ph.D. candidate at Case Western Reserve University''s Mandel School of Applied Social Services. Email Sandra at Sandra.turner04[at]ey.com.