perceptions of affiliate eap counselors: an exploratory study

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Perceptions of Affiliate EAP Counselors:An Exploratory StudyRick Csiernik MSW, PhD, RSW a & Kristi Darnell MSW, RSW aa School of Social Work, King's University College at The University ofWestern Ontario , London, Ontario, CanadaPublished online: 07 May 2010.

To cite this article: Rick Csiernik MSW, PhD, RSW & Kristi Darnell MSW, RSW (2010) Perceptionsof Affiliate EAP Counselors: An Exploratory Study, Journal of Workplace Behavioral Health, 25:2,154-168, DOI: 10.1080/15555240.2010.481277

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Perceptions of Affiliate EAP Counselors: AnExploratory Study

RICK CSIERNIK, MSW, PhD, RSW andKRISTI DARNELL, MSW, RSW

School of Social Work, King’s University College at The University of Western Ontario,

London, Ontario Canada

An exploratory study of Canadian Employee Assistance Program(EAP) affiliates from Saskatchewan and Ontario was undertakenemploying one focus group of four persons, and the completionof 12 open-ended questionnaires. Participants on average had23 years of clinical experience with a mean of 14.6 years ofEAP-specific practice. Participants became external EAP counse-lors through two primary means: being invited, typically via anunsolicited telephone call or letter, or by actively seeking out tobecome an affiliate to supplement their existing private practices.Study participants in general enjoyed their work with thispopulation, particularly the diversity of issues with which clientspresented and felt that providing counselling to this group wascritical. However, they also highlighted several grave issues theyfaced in fulfilling their responsibilities as EAP affiliates. Theprimary clinical and ethical concern was the inability to providesufficient counselling hours to clients in need due to continuouspressure to spend less time with clients from their employers, alongwith a constant need to ask permission from less seasoned clinicaldirectors for extra counselling sessions. There was a feeling amongsome of dishonesty between what organizations were told theiremployees would receive regarding clinical services and whataffiliates were allowed to provide. EAP vendors did not acknowl-edge experience in terms of hourly compensation, and duringthe economic downturn many affiliates had been asked to reducetheir hourly rate. Several of those in the study who had notaccepted were no longer receiving referrals. In general there was

Address correspondence to Rick Csiernik, MSW, PhD, RSW, School of Social Work, King’sUniversity College at The University of Western Ontario, 266 Epworth Avenue, London,Ontario, N6A 2M3, Canada. E-mail: [email protected]

Journal of Workplace Behavioral Health, 25:154–168, 2010Copyright # Taylor & Francis Group, LLCISSN: 1555-5240 print=1555-5259 onlineDOI: 10.1080/15555240.2010.481277

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no training or support provided affiliates other than how tocomplete administrative forms, and little if any input was soughtfrom the affiliates regarding the organizations for which they wereworking.

KEYWORDS affiliate EAP counselors, external EAP counselors

Loyalty is limited. Decisions are made by companies where you have noinfluence. Politics and slick presentations can outweigh simple goodclinical work. (S-8)

Among the range of potential outcomes of an Employee Assistance Program(EAP) is the ability to help create a well workplace, but what of the workingconditions of external Employee Assistance counselors? The ongoing evol-ution of EAP has seen a move from predominantly internal volunteer andprofessional providers to the increasing dominance of external service provi-ders in the form of affiliate networks (Csiernik, 2005a; Sharar, 2008a). AsOccupational Alcoholism Programs evolved into EAPs during the 1970s, asignificant number of private EAP providers began to emerge. What wasonce a profession dominated by addiction counselors and those with arecovery history working for large companies slowly shifted to a field assist-ing with a broad range of mental health and social problems, with this broadbrush approach being staffed by an increasingly diverse assortment of help-ing professionals (Hosie, West, & Mackey, 1993; McClellan, 1982).

The rush to apply the medical treatment model to behavioral problemscontributed to the proliferation of third-party ‘‘helpers’’ particularly in theUnited States. These affiliate counselors external to the workplace began toaddress the vast array of problems being identified by volunteer andprofessional helpers internal to the workplace and rapidly became a viablealternative to the historic model of EAP counselling delivery (Favorini &Spitzer, 1993).

The first documented private for-profit consulting company was inaugu-rated by Donald Sandin. Sandin was initially hired as an internal professionalprovider to assist employees of Merrill Lynch in 1971. Three years later he ven-tured forth on his own and within his initial year of operation had five full-timestaff servicing three organizations (Association of Labor-Management Admin-istrators and Consultants [ALMACA], 1983). By 1981 there were more than200 private EAP consulting services, external to the workplace in the UnitedStates, selling employee counselling services to companies (Sonnenstuhl &Trice, 1986). This trend came to Canada in the late 1980s with a proliferationof private practitioners into the field of occupational assistance practice(Addiction Research Foundation, 1992; Gould & Csiernik, 1990). Presently,increasing numbers of individual community-based mental health counselors

Affiliate EAP Counselors’ Perceptions 155

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have entered into subcontracts with EAP vendors to provide services on an‘‘as-needed’’ basis. The majority of these individuals are not full-time EAPcounselors, but rather generalist counselors or psychotherapists who oftenaffiliate themselves with multiple EAP vendors (Sharar, 2008a). In Canadathe exact number of external EAP providers in unknown. There are a handfulof dominant national external providers who use subcontracted affiliates asthe primary service delivery mechanism along with smaller regional and prov-incial providers as well as many local and individual providers scattered acrossCanada.

Although there has been some examination of the differences betweeninternal and external program provision (Brummett, 2000; Csiernik, 1999;Leong & Every, 1997), the integration of the two (Csiernik, Atkinson, Cooper,Devereux, & Young, 2001; Turner, Weiner, & Keegan, 2005), and the nature ofthe work that affiliates perform (Hertz, 2009; Sharar, 2008b), there has beenvery little actually written in the literature about the work experiences of thosewho have become primary providers of EAP services. Cunningham (1992)conducted a qualitative examination of the attitudes, knowledge, and beliefsof EAP counselors. She pointed out the diversity in education and professionalbackgrounds of those who work in this field and also examined the relativeisolation between EAP counselors regardless if they worked for the same orfor different EAP vendors. She found limited vendor support to connect affili-ates with each other or the organization, and the primary focus pertaining tothis group was simply hiring and paying them. This in turn often led EAP affili-ates to find themselves in economic competition rather than collegial relation-ships with fellow counselors. Cunningham also pointedly stated nearly twodecades ago that it was not politically prudent for external EAP counselorsto ‘‘express opinions about the field that run counter to prevailing beliefs’’(p. 14). Her sample of 42 U.S. respondents were predominantly social workers(80.9%) who perceived their EAP work as a process of career developmentand life change rather than as a permanent position. Several study participantsat the time of the study also expressed concern regarding the implications ofmanaged care over their future counselling practice.

Sharar and Masi (2006) wrote of the crisis facing the EAP field becauseof the bundling of EAP services with other employee benefits and offeringEAP as a loss leader or as a free service. Not only does this diminish the entirefield, it also places increasing pressure upon the quality of service counselorscan provide. Masi, Jacobsen, and Cooper (2000) after a formal examination of42 distinct organizational clinical reviews concluded that quality of care was‘‘often over-looked or neglected by mental health companies. The employ-ees or clients and the client companies need to be aware of this unfortunatelack of quality services’’ (p. 16). In an evaluation of a Canadian EAP servicedby an external provider it was reported that though a majority of clientsassisted over a 4-year period were satisfied with the services they received,one in four indicated that the number of sessions they were allocated with

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their counsellor was inadequate and that they felt their sessions had beenterminated prematurely (Macdonald, Wells, Lothian, & Shain, 2000).Although EAP counselors have been reported to be highly committed to ethi-cal practice the Employee Assistance Certification Commission has alsoraised concerns of the trend in the EAP industry away from professionalknowledge with increased outsourcing of services (Sharar & Menco, 2007).

As with too many areas of EAP practice, the lack of research over thepast two decades has limited our knowledge of the working lives of thosewho have become the prominent providers of EAP counselling. This alongwith concerns raised by several EAP affiliates to the authors regarding theirworking lives and dilemmas they regularly faced in their counselling practiceprompted this exploratory study of how EAP affiliates perceive theirvocation.

METHOD

A convenience sample of two groups of EAP providers was used for thisstudy. External providers attending a provincial conference in Regina,Saskatchewan, along with those attending an EAP seminar in London,Ontario, were invited to voluntarily participate. Six persons from WesternCanada (four from Saskatchewan, two from Alberta) along with six fromOntario completed a written open-ended survey instrument (see Appendix)whereas four from the Ontario population also participated in a 90-minutefocus group that used the same questions led by one of the study’s authors.Probing by the group facilitator during the focus group was limited to mini-mize the differences in the two data collection approaches employed. Datacollection occurred over a period of 3 months. Despite the small numbersof participants a degree of triangulation was employed through the use oftwo distinct data collection approaches and the use of two different geo-graphic locations. The focus group was taped with the conversation and tran-scribed verbatim by the focus group facilitator. The study was approved bythe King’s University College Ethics Review Committee.

The original questions for the current study arose from a discussionensuing after a professional development presentation for members of theWestern branch of the Ontario Association of Marriage and Family Therapists(OAMFT) on the state of EAP in Canada. The lead researcher developed adraft instrument that was shared with the executive of the association thatled to further refinement of the questions. A grounded theory approachwas utilized to analyze the data. The current study’s coauthors examinedthe focus group and survey data independently and developed their owncodes. The codes were then grouped into themes and the ideas compared.Concepts that both authors identified were then sought out and confirmedwith specific exemplars. However, as this is a qualitative exploratory study


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with a limited sample size, the results cannot be generalized beyond thegroup who participated. The results are not necessarily the perceptions ofall external Canadian EAP affiliates but rather are restricted to the group thatvoluntarily participated in this study.

RESULTS

Background Information

The 12 survey respondents (S) were knowledgeable clinicians with a mean of24 years of counselling experience, and a mean of 14.5 years of working in anEAP environment. Likewise, the four focus group participants (F) had beencounselors for 21 years on average and had worked with EAPs an averageof just fewer than 15 years. Three of the survey respondents and one focusgroup participant had doctoral degrees whereas the remaining 12 participantshad earned master’s degrees. Eight survey respondents were social workers,two were psychologists with the other two having master’s degrees in counsel-ling. Two of the focus group members were social workers with the other twohaving MEd degrees in counselling. Fifteen of the 16 participants belonged totheir respective professional association colleges though only two surveyrespondents belonged to a formal EAP association. None had taken any spe-cific courses while in university pertaining to EAP other than one surveyrespondent who had completed an independent study course as part of herdoctoral studies. Seven of the survey respondents and one focus group mem-ber indicated that they had never attended an EAP specific course or workshopsince becoming an affiliated EAP counsellor with the remaining seven personsindicating that they regularly attended these types of professional developmentopportunities. The majority of focus group participants and survey respon-dents were affiliated with more than one external EAP provider.

The Experience of Being an External EAP Counsellor

I’m doing less and less EAP work as time goes by. Sometimes, I raise myrates hoping they’ll fire me. Sometimes it works, sometimes, it doesn’t!(S-5)

Our business is too secretive from each other. (F-1)

There are two ways to become an EAP affiliate, ask or be asked, and bothmethods occurred within this study’s population.

I researched EAP companies and applied for the most part. On a coupleoccasions I was approached by employers in my community to provideEAP coverage for their employees. (S-1)


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Participants were approached by national and local providers to sign onas affiliates with many becoming involved in EAP counselling as adjuncts totheir own beginning or established private practice typically with more thanone local and=or national provider. None of the survey respondents or focusgroup participants were full-time EAP counselors with all including their EAPcounselling as part of a larger mental health counselling practice. One focusgroup participant stated that she had been recruited over the years by severalEAP vendors via cold calls asking her to forward a resume, copy of insurance,and indication of membership in a professional college. As expected not allinvitations to become an affiliate were accepted:

Ten years ago I also began a private practice and was recruited throughmy website to work for two other EAPs. I have also received requests toprovide service from other EAPs by being recommended by other profes-sionals who already provided service. Some I have turned down, becauseI did not like their model or they did not pay well enough. Some I [turneddown because I did] not like their ethics. (S-7)

Once becoming an affiliate the type of training and preparation tendedto be minimal as one would expect with part-time, fee-for-service employ-ees. Four survey respondents indicated receiving no training at all, whereasfour others reported simply receiving administrative instruction on how toproperly complete the paperwork:

Training was for two hours, a general orientation to EAP services offeredby the provider, policies to follow and paperwork requirement. (S-5)

Focus group respondents likewise indicated that there was little formalsupport once they were hired:

I can’t say I really had any training in EAP other than the handbooks andthe instructions that periodically [were sent]. (F-1)

Focus group participants also felt that the vendors for whom theyworked had little if any expectation of them to participate in any ongoingprofessional development or follow any specific EAP practice protocol otherthan to adhere to the vendor’s administrative documentation.

The third open-ended question asked participants what they liked aboutbeing affiliate EAP counselors. One theme that ran through several respon-dents as well through as the focus group participants was the diversity ofclients and the range of issues referred EAP clients bring. These issues rangedfrom individual counselling including working with teens and children, tofamily and couples counselling, to critical incident stress management.Several respondents viewed their EAP work as a way to establish or sup-plement their private practice caseloads with no additional time spent upon


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marketing. One individual even stated she liked doing the paperwork in that‘‘[it] helps me to keep excellent notes that assist me when working with myprivate clients’’ (S-3). One participant indicated that all her EAP clients camevoluntarily and thus were typically eager to work on issues and therefore lessdevelopmental time was needed, which is critical for those clients who areonly allotted a limited number of counselling sessions. However, oneresponse to this question was less positive:

[I like] very little. Although I look forward to working with EAPclients . . . and I want to be a provider for these services in my communitybecause there is virtually nothing else available, the [EAP] system islacking and in fact I feel it can be abusive. (S-6)

This response led into the next question inquiring about the limitationsof working as a contracted external EAP counsellor. This query had the great-est number and longest responses. Study respondents addressed issues per-taining to clients, the nature of the counselling, and the organizations forwhich they were contracted. Not surprisingly the most common concernrelated to capped sessions and not having enough time to work with clientsin fully resolving issues despite being well aware that EAP counselling is atime-limited practice.

Short-term treatment rarely allows the time for a therapeutic relationshipto be established. In addition, clients are in fact encouraged to disclosevery intimate information under the illusion that the duration of treatmentis not limited when in fact the treatment is very constrained, four to sixsessions at best. This is a tremendous disservice to the client and in factposes an ethical question or concern for me. As well, as a provider ofservice I feel at times as though my professional integrity and clinicalexpertise are questioned—I also feel that we are manipulated to ‘‘con-vince’’ the client to accept the limited scope of treatment—in fact weare instructed not to divulge the number of sessions available to clientsciting that it would only cause them anxiety. This illustrates yet anotherethical dilemma. I could go on. (S-1)

I had a very feisty client who said ‘‘that’s not what I was told’’; I said ‘‘thisis the reality,’’ she went back to her EAP contact person who called [thevendor] well I got a call from the vendor who said, ‘‘oh you told her therewas a limit,’’ and I just said ‘‘ya’’ and I’m looking at the notes I made and[I say] ‘‘you told me it was 3.5 [sessions on average] and this lady’s alreadyhad four,’’ so anyway they said she could have six, so if you rattle thecage they will allow you to have more, but you have to have somebodywho is willing to do that. (F-1)

Any problem we can fix in one to three sessions [laughter]. (F-3)


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Related to this issues was the need and frustration to continually requestpermission for additional sessions, particularly when the clinician had farmore years of practice experience and=or was more knowledgeable aboutthe issue area than the person granting the permission to extend sessions.

The number of sessions is very limiting. Also, with a lot of experience anda prior background in EAP management, I find it frustrating that I mustconsult about extra sessions with someone half my age with one thirdmy experience. They frequently don’t offer suggestions that are new orhelpful. (S-3)

I wish they could be more trusting of us ‘‘oldies’’ (I’m a core provider forseveral companies) and allow us more autonomy in making decisionsabout a few extra cases. (S-5)

I never see clients 3.1 times and every now and again they want to talk tome and chastise me maybe that’s why I’m not getting any referrals. (F-3)

There were also concerns expressed about the ability of an affiliate tohave any influence on company policy, procedures, or interventions as theyare not deemed to be formally part of the EAP organization. There were alsoissues raised regarding the amount of financial compensation EAP providersnow pay affiliates and the time it takes to be paid once an invoice was submit-ted, with an average of 3 months reported by written respondents and focusgroup members. One provider had even been asked to take a pay cut duringthe economic turn down after having worked for the same provider for 6 yearswith no increase in the hourly rate provided. However, perhaps the most tell-ing written comment was one that was capitalized by a survey respondent:

[I have] A FEELING THAT THE PROGRAMS ARE [now] EMPLOYER HELPPROGRAMS RATHER THAN EMPLOYEE HELP PROGRAMS. (S-7)

Remuneration was a topic discussed at length in the focus group. It wasnoted by all participants that there was no acknowledgment for seniority withhourly rates being uniform if you had worked 1 year as an affiliate or 20.Further, several respondents and all the focus group participants discussedhow they had been asked to cut their rates by different organizations at vari-ous times and if they refused the vendor simply stopped referring clients.

They sent a letter out to all their counselors in the summer with a formthat you would sign to say you are agreeing to a rate reduction of $5per session. . . . I didn’t sign it . . . and I have not had a referral since. (F-2)

The assumption among the focus group participants was that this andother companies have turned to affiliates willing to provide counselling for


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lower rates, and that these counselors are generally newer to EAP, overallless experienced, and have less established private practices. The discussionturned to the history of one vendor that had been bought by an income fundand was now being publically traded on the stock market and how the driveto make more profit has had an overall negative effect upon the counsellingoffered, especially when compared to the dwindling number of not-for-profitorganizations still offering EAP counselling.

That sets up an inherent conflict of interest to make a profit for yourshareholders. You’re not going to provide a full measure of service . . .you’re going to limit that as much as you can limit your costs and increaseyour profit. I think that’s where a lot of our fundamental difficulties comein . . . they offer cases to the person who has the lowest fee. (F-1)

Another area of concern was the administrative issues in fulfilling therole of being an EAP affiliate. Foremost is the amount of paperwork affiliatesneed to complete, which differs for each vendor, but with the majorityoffering no compensation for completing—with one large vendor being amajor exception to this trend. Some respondents found it difficult with theirvendors to readily determine eligibility for services without employeelists; however obtaining such lists is fraught with procedural and ethicalissues. Other issues ranged from difficulty in connecting with the EAP advi-sors, to the advisors use of ‘‘bullying’’ techniques to ensure that affiliatesadhere to their policies (S-1). Focus group participants also discussed theisolation that exists in the work with no formal association or interactionbetween affiliates.

One administrative issue reported that segues into a rudimentary ethicalissue involves individuals from the client’s organization who contact affiliatesto obtain specific information regarding an employee, without understandingwhy the counsellor will not provide any. Clarity of roles of the EAP vendor,affiliate provider, and organization paying for the EAP remain unclear withinmany organizations (S-1).

Three of the 12 survey respondents indicated never having had an ethi-cal dilemma during their entire careers as EAP affiliates. The remainder dis-cussed a range of issues any counsellor experiences in practice such asconfidentiality, concerns with informed consent, clients becoming depen-dent upon the counsellor, release of information, and duty to warn. Howeverthere were also issues mentioned unique not only to EAP such as conflict ofinterest regarding who is the client and the dilemma of the for-profit modelwithin counselling, but also to the role of being an external EAP counsellor.One prominent example provided was of an employee seeking assistancewho had been referred by the supervisor because of work performanceissues, with the identifying problem being the psychological abuse of thesupervisor toward the employee (S-2).


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A prominent issue identified as an ethical dilemma by written respon-dents (S-7, S-8, S-9) and focus group participants (F-1, F-2, F-3) was the lackof transparency regarding the limits of the number of sessions an employeecould receive, and simply ‘‘having too few sessions in order to be able totruly engage with the client and offer proper counselling’’ (S-4). Althoughemployees were generally informed that there was a predeterminedmaximum number of allowed visits, affiliates were often told and even pres-sured to limit the number of sessions offered below that level or to refer cli-ents to external resources early in the process and then close the file ascompleted. In one case the client complained to her employer about thisin congruency. The corporate representative in turn chastised the vendorwho in turn ‘‘disciplined’’ the affiliate for limiting the client’s access to ser-vices after being told to do so (S-6). Part of the focus group discussionfocused upon the perceived dishonesty of vendors with the organizationsthey contracted with when selling the virtues of their programs, programsthat are never fully developed or delivered because of profit constraints.

Although I understand that there may be a role for managed care (let’scall it what it is) I believe that we need to be open and honest about whatwe are providing for our communities. I believe that we are participatingin a subversive process otherwise and I feel this undermines the integrityof our profession. (S-1)

DISCUSSION

I think that clearly for me [EAP counselling] is more positive than negativeor I wouldn’t keep doing it. I deal with the frustrations with a lot ofhumor. (F-1)

The backbone of the EAP field is the counselling offered to anxious, con-cerned, and distressed employees and their families. If this foundation uponwhich contemporary EAP practice has been built are affiliate networks, and ifthe responses of this small sample in any way reflects the larger sentiment ofthis population, then far more support and attention needs to be offered tothis seemingly underappreciated and undersupported sector of the field.Within this exploratory study the vast majority of participants were seniorcounselors with an average of more than 20 years of clinical experienceand over a decade of direct EAP practice. However, participants felt that theirseniority and practice wisdom were not valued rather that they were merelycommodities of a larger corporate process. EAP affiliates in this Canadianstudy reported being offered virtually no professional development, no net-working opportunities, and no acknowledgement of their experience. Hertz(2009), in her discussion of developing a new affiliate network in Chilestressed the importance of creating a sense of belongingness among affiliates


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and how proper training was integral. Unfortunately this message does notappear to have been heard in North America, as little has changed in theworking lives of affiliates since Cunningham’s (1992) examination of externalproviders nearly two decades ago. At that time there was concern regardingthe negative impact managed care in the United States would have on thefield and that same concern was being expressed nearly 20 years later bythese Canadian respondents. This sentiment may even be greater in Canadawith its tradition of socialized health care and an expectation by its citizens oftimely and complete service provision.

As indicated by the majority of participants, the role of an affiliate EAPcounsellor does provide the opportunity for a wide range of clients, withvery differing issues. Although this was identified as a positive to the roleof affiliate, it does not appear to be enough to balance out the limitationsof the role the participants identified. The isolation experienced by affiliatesin the current study and which is further exacerbated by the competing inter-ests of the vendors to find a counsellor willing to offer the lowest rateappears to be diminishing the quality of service that can be offered to clients.Affiliates reported being asked to reduce their hourly rates and if unwilling todo so than clients were being referred to less experienced counselors whowere willing to take a lesser rate of remuneration.

Although fair compensation for their labor was a prominent issue raisedby respondents it was still not as crucial a concern as the restrictions placedupon their practice by the EAP vendors for whom they worked. EAP counsel-ling since its inception has been intended as a time-limited intervention, andrespondents were aware of this distinction of EAP practice in comparison toprivate mental health counselling. However, as Csiernik (2005b) empiricallydemonstrated in his study of Canadian EAPs the idea of forced capping inEAP is not necessary. In a direct comparison of 72 EAPs that capped their ser-vices versus 78 that did not the difference in average number of sessions was0.1. Organizations where EAP counselors had latitude in the number ofsessions granted employees or family members averaged 5.0 counselling ses-sions whereas those who worked under a cap system averaged 5.1. The studyfurther found that capping did not provide any real savings, and in fact whenservices were capped at 8, 10, or 12, average use by employees and familymembers was greater than in instances when no formal cap was in place.

Also for the study participants the theme of not being allowed to usetheir clinical judgement to provide the best service to clients was a prominentconcern. Professional practice was perceived as being diminished by thevendors’ needs to increase their profit through a limited number of sessions.As professional counselors, this lack of control over using clinical judgmentappears to create another divide between those that are new to the fieldand have less experience with those who are more seasoned professionals.Trepidation was also reported regarding deceptive practices pertainingto how much counselling employees were actually entitled to and what


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affiliates could offer and what they were allowed to say they could offer.Some participants even alluded to the lack of integrity by some EAP vendorswith regards to the contracts between the vendors and the organizations andthe vendors and their affiliates.

Although none of the survey respondents were full-time EAP providersand most did offer EAP services to supplement their private practices therewas a general sense of what they were doing was important; the clients them-selves were important, the work they were doing with the clients was impor-tant, and the target population, the workplace, was very important. Sharar(2008a), Sharar and Masi (2006), Sharar and Menco (2007), among othershave recently raised a range of concerns about the future of EAP as we moveforward into the 21st century: the third century of workplace-based assist-ance. Making EAP a loss leader in selling integrated health benefit packages,cutting the fees charged organizations for this service, and even offering EAPas a free benefit have distinct ramifications one of which may be on thosewho are the foundation of service provision, the affiliate counselors. WithEAP generating less revenue it is even less likely that funds will be madeavailable for professional development for those who are not full-timeemployees than has been in the past. Likewise, outreach and networkingbecome lower priorities as the realm of EAP becomes commoditized on alllevels. It is not surprising that affiliate counselors that do not have regularcontact with their various EAP vendors can feel adrift and disconnected interms of roles and function. This level of isolation makes it easier to focusonly upon the negative aspects of the relationship and to minimize theunique aspects of EAP that make working in this field meaningful.

It is worthwhile to also note what was not discussed in the focus groupsor recorded in the returned surveys. No mention was made by any study par-ticipant of any vendors stressing the importance of the core technologies oreven inquiring if the affiliate was a member of or had any interest in joining aprofessional EAP association. If the only contact EAP affiliates have with oneor more vendors for whom they work is asking for more counselling time,then it is easy to understand why affiliates in a single point in time surveyor focus group would target that as a primary concern. However, it wouldalso be worthwhile to discover what the perceptions of EAP vendors areregarding their affiliates. How important are having senior counselors?How is the quality of service appraised? Do vendors look at average counsel-ling hours per organization and compare affiliates upon time spent or uponoutcomes or upon client satisfaction data quantified by affiliate and com-munity? How is effective counselling to maximize worker and workplacewellness being measured by EAP vendors?

If the views of the participants of this small study in any way representthe realities of the larger body of EAP affiliates then this is another area oflegitimate concern that further attention, study, and targeted responses arerequired. EAP vendors need to engage their affiliates in ways so that these


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senior counselling professionals no longer feel minimized. This concern wasraised by Cunningham in 1992 and does not seem to have been addressed, atleast not with this group, to any degree. When one examines all the themesdiscussed, the unifying idea is one of respect. The affiliates in the currentstudy did not perceive that their clinical judgment was respected and thatthey were competent enough to determine if one or two additional sessionswere necessary to meet the client’s goals without seeking permission from asupervisor who tended to be less experienced than they were. Affiliates per-ceived that their input was not welcomed or needed and thus spent littletime, energy, or money engaging with their vendor partners. However, thereis a mutual onus on both parties to develop and establish closer workingrelationships to enhance the primary function of EAP to enhance the work-place through enhancing worker and family lives as despite the limitationsand critiques reported by these participants EAP remains

a wonderful benefit for people who would normally never see a counse-lor, would normally never even think that that is something that wouldbe possible for them. (F-1)

REFERENCES

Addiction Research Foundation. (1992). Resource directory to Employee AssistancePrograms. Toronto, Canada: Author.

Association of Labor-Management Administrators and Consultants [ALMACA]. (1983).Pioneer of the private consultants. Labour-Management Alcoholism Journal,12(6), 181–205.

Brummett, P. (2000). A comparison of Employee Assistance Programs providinginternal versus external treatment services: A research note. Employee AssistanceQuarterly, 15(4), 19–28.

Csiernik, R. (1999). Internal versus external Employee Assistance Programs: What theCanadian data adds to the debate. Employee Assistance Quarterly, 15(2), 1–12.

Csiernik, R. (2005a). The evolution of occupational assistance: From social control tohealth promotion. In R. Csiernik (Ed.), Wellness and work: Employee AssistanceProgramming in Canada (pp. 17–43). Toronto, Canada: Canadian ScholarsPress.

Csiernik, R. (2005b). What are we doing? The nature and structure of Canadian EAPsand EFAPs. In R. Csiernik (Ed.), Wellness and work: Employee Assistance Pro-gramming in Canada (pp. 101–115). Toronto, Canada: Canadian ScholarsPress.

Csiernik, R., Atkinson, B., Cooper, R., Devereux, J., & Young, M. (2001). An exam-ination of a combined internal-external program: The St. Joseph’s Health CentreEmployee Counselling Service. Employee Assistance Quarterly, 16(3), 37–48.

Cunningham, G. (1992). The EAP counsellor: Attitudes, knowledge and beliefs.Employee Assistance Quarterly, 8(1), 13–25.


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Favorini, A., & Spitzer, K. (1993). The emergence of external Employee AssistancePrograms: Report of a survey and identification of trends. Journal of EmployeeAssistance Research, 2(1), 23–35.

Gould, A., & Csiernik, R. (1990). EAP service providers guide. Hamilton, Canada:Employee Assistance Program Council of Hamilton-Wentworth.

Hertz, P. (2009). Providing training for EAP affiliates. Journal of Employee Assistance,39(1). Retrieved April 12, 2010, from http://www.thefreelibrary.com/Providingtraining for EAP affiliates: continuous training network . . . -a0193405804

Hosie, T., West, J., & Mackey, J. (1993). Employment and roles of counselors in Emp-loyee Assistance Programs. Journal of Counseling & Development, 71(3), 355–359.

Leong, D., & Every, D. (1997). Internal and external EAPs: Is one better than theother? Employee Assistance Quarterly, 12(3), 47–62.

Masi, D., Jacobsen, J., & Cooper, A. (2000). Quantifying quality: Findings from clini-cal reviews. Employee Assistance Quarterly, 15(4), 1–17.

Macdonald, S., Wells, S., Lothian, S., & Shain, M. (2000). Absenteeism and otherworkplace indicators of Employee Assistance Program clients and matchedcontrols. Employee Assistance Quarterly, 15(3), 41–57.

McClellan, K. (1982). An overview of occupational alcoholism issues for the 80s.Journal of Drug Education, 12(1), 1–27.

Sharar, D. (2008a). General mental health practitioners as EAP affiliates: Do theymake referrals beyond the EAP? Journal of Workplace Behavioral Health,23(4), 337–358.

Sharar, D. (2008b). General mental health practitioners as EAP network affiliates:Does EAP short-term counseling overlap with general practice psychotherapy?Brief Treatment and Crisis Intervention, 8(4), 358–369.

Sharar, D., & Masi, D. (2006). Crisis facing the EAP field. Journal of Employee Assist-ance, 36(4), 7–9.

Sharar, D., & Menco, H. (2007). EAP ethics: The field speaks. Journal of EmployeeAssistance, 37(2). Retrieved April 12, 2010, from http://www.thefreelibrary.com/EAP Ethics: the field speaks: survey of EA professionals shows that...-a0189703687

Sonnenstuhl, W., & Trice, H. (1986). Strategies for Employee Assistance Programs:The crucial balance. New York: ILR Press.

Turner, S., Weiner, M., & Keegan, K. (2005). Ernst & Young’s assist: How internal andexternal service integration created a ‘‘single source solution.’’ Journal of Work-place Behavioral Health, 20(3–4), 243–262.

APPENDIX A: SEMISTRUCTURED INTERVIEW INSTRUMENT

EXTERNAL EAP COUNSELORS SURVEY

PART I: BACKGROUND INFORMATION

1. Please list your academic degree(s):2. If you took any EAP specific course(s) as part of your education please list

them and indicate for which degree:


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3. Please list any professional college(s) or association(s) that you belong to:4. Please list any EAP specific professional development courses or work-

shops that you have taken on your own initiative:5. Number of years that you have worked as a counsellor:6. Number of years that you have worked as an external EAP service provider:7. Province you live in:

PART 2: THE EXPERIENCE OF BEING AN EXTERNAL EAP COUNSELLOR

1. How did you come to be an external EAP counsellor?2. What training=preparation=professional development did you receive

when you were hired as an EAP counsellor?3. What do you like about the role?4. What are the limitations of working as a contracted external EAP

counsellor?5. What administrative issues arise in fulfilling the role?6. Have you ever had any ethical dilemmas arise in your role?

( ) Yes ( ) No

If Yes could what was the dilemma (confidentiality, client care, conflict ofinterest . . . you do not have to provide any type of specific examples butare welcome to do so)

7.Do you have any concerns in being able to fulfill your role?8.Please use the back of the page if there are any other issues that you wouldlike to discuss in terms of being an external EAP counsellor


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perceptions of affiliate eap counselors: an exploratory study

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