Counsellling and Wellness

Werner & DeSimone (2006) 1
EMPLOYEE
COUNSELING AND
WELLNESS SERVICES
Chapter 11
The Need for Employee Counseling

Have you ever seen people:
• Have you ever witnessed any of the following from someone in
a work setting?
• • Showing up for work under the influence of alcohol or drugs
• • Struggling to maintain satisfactory job performance because of
severe anxiety or depression
• • Refusing medical or other assistance for a treatable condition
(e.g., obsessive compulsive disorder, bipolarity, depression)
• • Burnout or fatigue as a response to ongoing work pressures
and stress
• • Involvement (or noninvolvement) in organizational efforts to
promote good health (e.g., fitness, nutrition, weight control, or
control of high blood pressure)
The Need for Employee Counseling – 2
• Personal problems are a part of life. Stress,

alcohol and drug abuse, cardiovascular disease,
obesity, mental illness, and emotional problems
abound in modern society.
• Personal problems affect job performance
• Healthcare costs continue to rise
• Reducing tardiness, absenteeism, lost time and
worker’s compensation saves money
• Reducing turnover can improve productivity and
the bottom line
Addressing Employee Well-Being

• many organizations have adopted the HR strategy
that it is better to retain and help current workers
with problems than to discard them and be faced
with recruiting new ones.
• employee counseling and wellness services as a way to

promote employees’ well-being.
• Counseling has been used to refer to a variety of

activities, from informal discussions with a supervisor to
intensive one-on-one discussions with a trained
professional.
• (1) a relationship established between a trained counselor

and the employee;
• (2) thoughtful and candid discussion of personal problems
• experienced by the employee;
• (3) an appropriate referral that secures the necessary
assistance; and
• (4) the provision of short-term counseling, when a referral
is not necessary.8
Employee Counseling as an HRD

Function
• Counseling serves the same goal as other HRD
activities
• Improving/maintaining worker performance
• Same techniques are used, especially coaching
• Same kinds of analysis and planning needed
Overview of Counseling Programs

• Problem Identification
• Education
• Counseling
• Referral
• Treatment
• Follow-up
Problem Identification
• Screening device
• Absenteeism records
• Supervisor’s observations
• Referral
• Voluntary participation
Education
• Pamphlets
• Videos
• Lectures
• Unsolicited
• Television
• Radio
• Other media
Counseling
• Needs a non-threatening person with whom the
worker can discuss problems and seek help.
Options include:
• Supervisor/coach
• Ombudsman
• HRD Counselor
• Professional Counselor
Referral
• Directing employee to appropriate resources for
assistance – e.g.,
• Physician
• Substance abuse treatment center
• Marriage counselor
• Alcoholics Anonymous (AA)
• Other options (clergy)
Treatment
• The actual intervention to solve the problem – e.g.,
• Group therapy
• Medications
• Individual therapy
• Psychological therapy
Follow-up
• Needed to:
• Ensure the employee is indeed carrying out the treatment
• Obtain information on employee progress
• Ensure that referrals and treatment are effective
A Caution About Employee Counseling
• All six approaches are not always needed

• The following issues drive which approach is taken:
• Type of problem identified
• Appropriate response
• Available resources
Who Provides Employee Counseling?
• Depends on the organization and organizational

culture
• Can be done using:
• Corporate resources (In-house)
• Outside resources (Out-of-house)
In-House Efforts
Advantages: Disadvantages:
• Internal control • Confidentiality
• Familiarity with • Lack of needed
organization resources
• Better coordination of
• Employee reluctance
efforts
• Sense of ownership
to use services
• Limitations in staff skill
• Greater internal
credibility and expertise
Contracting Externally (Out-of-

House)
Advantages: Disadvantages:
• Subject matter experts • Lack of on-site
services
• Confidentiality easier
• Possible
to maintain
communications
• Lower cost problems
• Better identification • Lack of organizational
and use of resources knowledge
Characteristics of Effective
Programs
• Top management support
• Clear policies and procedures
• Cooperation with unions and employee groups
• A range of care:
• Referral to community resources
• Follow-up
Characteristics of Effective Programs –

2
• Policy of guaranteed confidentiality
• Maintenance of records for program evaluation
• Health insurance benefit coverage for services
• Family education
Employee Assistance Programs

(EAPs)
• Job-based programs operating within an
organization that:
• Identify troubled employees
• Motivate them to resolve their problems
• Provide access to counseling and treatment, as
appropriate
General Topics that EAPs Might

Address
• Alcoholism • Compulsive gambling
• Drug abuse • Marital problems
• Anxiety • Financial problems
• Depression • Personal problems
• Eating disorders
Issues/Outcomes Affected by EAPs

• Productivity • Accidents
• Absenteeism • Training
• Turnover • Replacement costs
• Unemployment costs • Insurance benefits
• Substance abuse • Etc.
treatment
Who Offers EAPs?

• 62% of medium- and large-sized companies
• 33% of companies with 50+ employees
• Estimated 82% of large firm employees have access
to an employee assistance program
Items of Importance
• Extent of substance abuse and mental health

problems faced by companies
• Approaches to employee assistance
• Effectiveness of EAPs in treating substance abuse
and mental health problems
Substance Abuse
• Over 19 million Americans abuse alcohol or drugs
• Alcohol is involved in 47% of industrial injuries
• Substance abuse costs U.S. businesses over $100 billion
per year
Substance Abuse – 2
• 6.5% of workers reported going to work while under the
influence of drugs or alcohol
• 5%–8% reported being under the influence of marijuana
at work
• Companies lose over $7,000/year for each abuser of
alcohol or drugs
Reasons for Immediate Concern
• Drug and alcohol users are more prone to

accidents, injuries, disciplinary problems,
and “involuntary” turnover
• Would you want to fly in a plane with a
drunken pilot?
• Do you want to drive a car put together by
someone abusing marijuana or cocaine?
Drug-Free Workplace Act of 1988

• Promotes drug-free awareness among federal
contractors and grant recipients
• Tells employees about:
• Availability of drug counseling
• Availability of rehabilitation programs
• Employee assistance programs
Mental Health
It is estimated that:
• 18.8 million Americans suffer from a depressive illness
every year
• 23% of the American population has some sort of mental
disorder
• 5.4 % have a serious mental illness
Results of Serious Mental Health

Problems
• Mental health problems can interfere with major life
functions such as:
• Eating
• Managing money
• Functioning in family groups
• Functioning at work
• Functioning in society
• Functioning in educational settings
Common Mental and Emotional Health

Problems
• Individual adjustment
• Victim of external factors (rape, incest, battering,
crime)
• Sexual problems, including impotence
• Divorce and marital problems
Common Mental and Emotional

Health Problems – 2
• Depression and suicide attempts
• Difficulties with family and children
• Sexual harassment in workplace
• Legal and financial problems
• Gambling addiction
Why Care About Mental and Emotional

Problems?
• Problems can cause:
• Absenteeism
• Poor performance and work habits
• Low job satisfaction
• Indecisiveness
• Interpersonal conflicts
• Violence and aggressive behaviors at work
Three Federal Regulatory Actions

• American Disabilities Act of 1990
• Mental Health Parity Act of 1996
• Executive Directive by President Clinton
(effective January 1, 2001)

American Disabilities Act (ADA) of

1990
• Who is covered by the ADA? An employee who:
• Has a physical or mental impairment that substantially
limits one or more major life activities,
• Has a record of such impairment, or
• Is regarded as having such an impairment, i.e., an
employer’s perception of a disability would be covered.
• Guarantees equal access to jobs for those with
disabilities
• Includes mental and emotional disabilities, along
with physical disabilities
• How to deal with individuals with such disabilities
(EEOC Guidelines, May, 1997)
Mental Health Parity Act of 1996
• Employers with 50+ employees must

provide mental health coverage equal to
physical coverage
• Does NOT include coverage for substance
abuse or chemical dependency
• Note: This law has been extended on a
year-by-year basis since September 2001.
Executive Directive by President

Clinton
• Requires equal coverage (parity) for mental
health benefits for those covered by the Federal
Employees Health Benefits Program:
• Federal employees
• Their dependents
• Federal retirees
• Also covers substance abuse treatment
• Took effect on January 1, 2001
Source: http://www.opm.gov/insure/health/consumers/parity/faq.asp
Why These Three Federal Actions?

• To require employers to pay attention to mental
health issues
• To urge/force employers to carefully manage and
address such problems
EAP Approach to Resolving Employee

Personal Problems
Basis of the EAP approach:
• Work is very important to people
• Work performance can help identify an employee’s
personal problems
• Employees can be motivated to seek help
Characteristics of the EAP

Approach
• Problem is defined in terms of job performance,
rather than in clinical terms
• Supervisors monitor employees to identify changes
in workplace behavior that indicate potential
problems
Behavior Problems Indicating Possible

Substance Abuse
• Absenteeism
• On-the-job absences
• High accident rate
• Poor job performance
• Poor relationships with co-workers
Constructive Confrontation
• In this approach, a supervisor:
• monitors performance
• confronts employee on poor performance
• coaches to improve performance
• urges use of EAP’s counseling service
• emphasizes the consequences of continued poor
performance
The Typical EAP

• Clear policies, procedures, and responsibilities concerning
health and personal problems on the job
• Employee education campaigns
• Supervisory training program
• Clinical services (In- or out-of-house)
• Follow-up monitoring
Effectiveness of EAPs
• Effectiveness is “generally accepted”
• Estimated 50% to 85% effectiveness rate
• Estimated savings of $2 to $20 per dollar invested in
EAP
• However, much EAP evaluation is subjective, and
strongly criticized
EAPs and the HRD Professional
• EAPs are often housed within the HRD

area of the organization
• HRD must determine:
• Costs vs. benefits of the program in dollars
• Whether it’s cheaper to replace an individual
than to successfully treat that person
• Healthcare organizations are increasingly
involved in EAPs (behavioral healthcare
management)
Stress Management Interventions

• “Any activity, program, or opportunity initiated by
an organization, which focuses on reducing work-
related stressors….”
What is Stress?
• Some environmental force affecting the individual (a
stressor)
• Individual’s response to the stressor
• Interaction between individual and the stressor
• Individuals react in different ways to stress
Organizational Stressors
• Factors intrinsic to the job
• Organizational structure and control
• Rewards systems
• Human resource systems
• Leadership
Stress Management Interventions

• Educationally-Oriented Interventions
• Sources or stress, how it feels, how to avoid it, how to cope
with it
• Skill-Acquisition Interventions
• Provides new ways to manage stress such as:
• Time management training
• Assertiveness training
Stress Management Intervention

Model
By Permission: Ivancevich (1990)

A Model of SMIs
• Focuses on the individual
• Helps the individual cope
• Perhaps more focus should be placed on
stressors from the work environment
Effectiveness of SMIs
• Research hasn’t been rigorous enough to measure
effectiveness accurately
• Well-conducted research demonstrates some
success
• More research is needed
Guidance for SMIs

• Look for specific issues
• Assess and analyze apparent problems
• Look for specific and focused solutions
• Look at strategic intervention:
• Is problem throughout the organization, or is it localized?
• Ensure evaluation and timely feedback
Employee Wellness and Health

Promotion
• Wellness is more than the absence of disease
• Promotes physical fitness and other nonstress issues:
• Obesity
• Smoking
• Helps control healthcare costs
Three Levels of Fitness and

Wellness Programs
• Level 1 – primarily educational without
interventions
• Level 2 – seeks to bring about direct change:
• Supervised exercise, fitness centers, etc.
• Level 3 – institutionalized wellness
Ten Dimensions of Work Site

Wellness
• Constructive wellness policy
• Wellness screening
• Working with community resources
• Employee referrals to professionals
• Menu-approach to health improvement
Ten Dimensions of Work Site

Wellness – 2
• Outreach and follow-up counseling
• Plant-wide wellness events
• Worksite policies and systems
• Ongoing evaluation of wellness process
• Periodic evaluation of cost-benefits of wellness
programs
Exercise and Fitness Interventions

• Most popular interventions
• Even modest exercise helps prevent disease
• Research shows effectiveness
• Problem: Getting those who would benefit the most to
exercise
Smoking Cessation Programs

• Smoking: most publicized health risk
• Cost per smoking employee: $2,853 per year more
than nonsmokers
• Measuring effectiveness:
• Quit rate
• Percentage of smokers in program
• Cost Benefit: $8 saved for $1 spent
Nutrition and Weight Control
• Obesity: 30% or more over one’s “ideal”

weight
• 30% of Americans are obese; another 34%
are overweight
• Obesity causes hypertension,
musculoskeletal problems, high blood sugar,
and cholesterol levels
• Competition helps program effectiveness
Control of Hypertension
• Hypertension – blood pressure greater than

140/90 repeatedly over time
• Greater incidence of heart disease and
stroke
• Control through, exercise, weight loss,
medication, stress reduction and low salt diet
• Benefit: $1.89 to $2.72 reduction in health
claims per dollar spent on program
Issues in Employee Counseling

• Effectiveness of programs
• Legal issues
• Who is responsible for counseling?
• Ethical issues
• Unintended negative outcomes
Effectiveness of Counseling
• Determine organizational demographics

• Determine expected participation rates
• Estimate start-up and maintenance costs
• Implement test and tracking system
• Measure pre- and postprogram
• Analyze results for users and non-users
• Do present and future cost-benefit analyses
Legal Issues
• Using counseling programs to comply with
legislation may increase liability to lawsuits:
• Must be equally available to all
• Erroneous assessments are made
• Injuries in wellness/fitness programs can lead to
lawsuits
Responsibility for Employee

Counseling
• HRD Professionals?
• Supervisors?
• Unions?
• Management?
• Individuals?
• What are your thoughts?
Ethical Issues
• Confidentiality:
• Records should be held in strictest confidence, and kept separate
from the employee’s regular personnel file
• Release only with specific employee permission
• Nature of Participation:
• Mandatory versus voluntary
Question
• Should participation be mandatory or voluntary?
• Why?
Potential Unintended Negative

Outcomes
• Increased worker’s compensation costs
• Employee scheduling problems, increased fatigue, lower
performance
• Conflicts at work over smoking bans
Closing Thoughts
• EAPs show that companies care
• HRD professionals have the skills and expertise to
provide EAP information
• Promoting employee health and well-being can
contributes positively to an organization’s bottom
line.
Summary
• Employee well-being affects ability,
availability, and readiness to perform a job
• Employee counseling encompasses a lot of
areas
• It is an HRD function that:
• Ensures that employees are now effective
contributors to the organization, and that they will
continue to be in the future
• Needs professionals who are qualified to deal with
the difficult issues involved with this topic

Counsellling and Wellness

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Werner & DeSimone (2006) 1

The Need for Employee Counseling

The Need for Employee Counseling – 2

• Personal problems are a part of life. Stress,

Addressing Employee Well-Being

• employee counseling and wellness services as a way to

• Counseling has been used to refer to a variety of

• (1) a relationship established between a trained counselor

Employee Counseling as an HRD

Overview of Counseling Programs

A Caution About Employee Counseling

• All six approaches are not always needed

Who Provides Employee Counseling?

• Depends on the organization and organizational

Contracting Externally (Out-of-

Characteristics of Effective Programs –

Employee Assistance Programs

General Topics that EAPs Might

Issues/Outcomes Affected by EAPs

Who Offers EAPs?

• Extent of substance abuse and mental health

Reasons for Immediate Concern

• Drug and alcohol users are more prone to

Drug-Free Workplace Act of 1988

Results of Serious Mental Health

Common Mental and Emotional Health

Common Mental and Emotional

Why Care About Mental and Emotional

Three Federal Regulatory Actions

(effective January 1, 2001)

American Disabilities Act (ADA) of

Mental Health Parity Act of 1996

• Employers with 50+ employees must

Executive Directive by President

Why These Three Federal Actions?

EAP Approach to Resolving Employee

Characteristics of the EAP

Behavior Problems Indicating Possible

The Typical EAP

EAPs and the HRD Professional

• EAPs are often housed within the HRD

Stress Management Interventions

Stress Management Interventions

Stress Management Intervention

By Permission: Ivancevich (1990)

Guidance for SMIs

Employee Wellness and Health

Three Levels of Fitness and

Ten Dimensions of Work Site

Ten Dimensions of Work Site

Exercise and Fitness Interventions

Smoking Cessation Programs

Nutrition and Weight Control

• Obesity: 30% or more over one’s “ideal”

• Hypertension – blood pressure greater than

Issues in Employee Counseling

• Determine organizational demographics

Responsibility for Employee

Potential Unintended Negative

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