David A. Sharar EAPA 2007 San Diego October 27 Research Forum dsharar@chestnut.org

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@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

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 (df=16)=387.68, p=.000

23. Approximate % of EAP cases where assessed problem was improved or resolved within the EAP:

24. How is improved/resolved determined for cases that only receive short-term EAP?

25. Approximate percent of EAP cases that were formal management or supervisory referrals:

26. How familiar are you with EAP “core technology”?

27. How often over past year did you provide a direct “ONSITE” service at an employer’s workplace:

28. In terms of therapeutic approach and selection of interventions, are EAP clients generally treated the same as non-EAP clients:

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"