preparing marriage and family therapy students to become employee assistance professionals

Journal of Marital and Family Therapy 1989, Vol. 15, No. 4,419-424

PREPARING MARRIAGE AND FAMILY THERAPY STUDENTS TO BECOME EMPLOYEE ASSISTANCE

PROFESSIONALS*

Thomas A. Smith, Jr. Connie J. Salts Auburn University

Craig W. Smith University of Nebraska

While the number of Employee Assistance Programs (EAPs) has grown tremen- dously, opportunities for marriage and family therapists in EAP settings have not been adequately described. This paper addresses issues pertinent to training Marriage and Family Therapy (MFT) students to develop the skills needed to become EAP professionals. Qualifications for becoming an EAP professional are described and suggestions are made as to how these skills may be taught within the framework of an academically based MFT training program.

Employee assistance programs (EAPs) are established by employers to offer help to employees whose work performance is adversely affected by personal problems such as alcoholism, drug abuse, marriage or family problems, financial pressures, and/or other issues. These programs may be found in all types ofbusinesses, government offices, public institutions, and medical facilities. The Association of Labor-Management Administrators and Consultants on Alcoholism (ALMACA) officially estimates that there are approximately 12-14,000 EAPs currently in operation, thus providing tre- mendous job opportunities for mental health professionals (R. Bickerton, personal communication, October 18, 1988). Watkins (1987) noted that the success of marriage and family therapists (MFTs) in becoming EAP vendors will depend on the therapists’ initiative in taking advantage of this expanding opportunity.

Although limited professional literature was found concerning the role of rehabilitation counselors (Desmond, 1985), social workers (Francek, 19851, psychologists (Man- uso, 1985), and psychiatrists (McLean, Ellis, Lipsitich, & Moss, 1985) in EAPs, no professional literature specifically addressing the possible role of marriage and family therapists in EAPs was located by the authors. This lack of recognition of the possible contributions of marriage and family therapists in EAPs is particularly puzzling in light of the view that family systems theory is particularly applicable to EAP develop-

*This article was presented at the 45th Annual American Association for Marriage and Family

Thomas A. Smith, Jr., PhD, is Assistant Professor, Marriage and Family Therapy Program,

Connie J. Salts, PhD, is Associate Professor and Director, Marriage and Family Therapy

Craig W. Smith, PhD, is Associate Professor, Marriage and Family Therapy Program, Depart-

Therapy Conference, Chicago, IL, November, 1987.

Department of Family and Child Development, Auburn University, AL 36849.

Program, Department of Family and Child Development, Auburn University, AL 36849.

ment of Human Development and the Family, University of Nebraska, Lincoln, NB 68583.

October 1989 JOURNAL OF MARITAL AND FAMILY THERAPY 419

ment and operation (Ford & Ford, 1986; Francek, Klarreich & Moore, 1985; Masi, 1983; Shell, 1987).

Marriage and family therapy programs wishing to offer EAP training as an option for some of their students must consider several important issues before developing an EAP emphasis. First, there are various types of EAPs and EAP positions which require different training and expertise. Though Wrich (1982) states that no particular background has been found that seems to be the best preparation for successful EAP work, there does appear to be agreement that people who most often develop EAP programs and negotiate EAP contracts possess extensive business training and experience (Lewis & Lewis, 1986; Masi, 1983; Wrich, 1982). A business background is particularly important when the EAP is located in the private sector, where an ability to operate under the profit motive is essential. Suggesting that an MFT student simultaneously get a Master’s of Business Administration (MBA), if they do not come from an undergraduate business background or possess business experience, is not feasible for most MFT programs or students. Therefore, it seems much more reasonable that MFT programs can consider training students interested in EAPs to either administer EAPs or, even more reasonable, become an EAP service provider.

Another issue that programs should consider involves whether interest is in industrial alcoholism programs or “broad b r u s h comprehensive EAPs. Training for employment in industrial alcoholism programs would naturally focus on alcoholism and chem- ical dependency assessment and treatment. The advantage of narrowly specializing in this area is that most EAP programs began as alcoholism programs and many still retain this focus (R. Bickerton, personal communication, October 18,1988). On the other hand, since most MFT programs are systemically based and train students to address many different problems in a wide variety of settings, students would more naturally be prepared for the “broad brush” EAPs. This focus would also appear to provide for a wider array of different job opportunities.

A final issue that interested programs and, subsequently, their students will need to consider involves whether working in a n in-house EAP or functioning as a subcontracting, consulting, fee-for-service provider is the goal. Working in an in-house EAP probably makes the marriage and family therapist a full-time employee of the parent company, functioning clearly within the organizational hierarchy. A marriage and family therapist choosing the subcontractor option will most likely be primarily employed elsewhere or be self-employed and involved in any number of other professional activities, with EAP work accounting for only a portion of his or her time. In-house versus subcontracting and EAP provider versus director are both decisions that will probably be affected by issues such as salary, prestige, and opportunity. Beginning salaries in EAPs are usually in the $20,000 range with some EAP directors making as much as $100,000 per year (Desmond, 1985). EAP directors are probably in a more influential, powerful position in the parent company, with more opportunity for advancement. Subcontractors may not be in as strong of a position within the parent company, but, as previously noted, they may be involved in other influential andlor financially rewarding endeavors. Though there is much similarity between the skill required to direct EAPs and provide EAP services, there are significant differences that are more a matter of degree than kind. An EAP director must possess business acumen, while the EAP provider should. For the service provider, the most important qualification is being an effective helper. For the EAP director, being a therapist may not be required, but being able to be an effective manager and provider of assessment and referral services is. It is important that interested MFT programs acknowledge and consider all of these issues both among the MFT faculty when determining program objectives and while training the students. Which options are most attractive lie in the eye of the beholder.

420 JOURNAL OF MARITAL AND FAMILY THERAPY October 1989

Marriage and family therapy programs wishing to offer EAP training as an option for some of their students can provide students the opportunity to develop skills that prepare them to administer andlor provide EAP services. The literature suggests that the following qualifications are needed in order to be a provider of EAP services: (a) an advanced degree in a mental health discipline (Wrich, 1982); (b) expertise in short term treatment, assessment, and crisis intervention (Lewis & Lewis, 1986; Masi, 1983); (c) knowledge, expertise, and experience working with alcohol and drug problems (Fran- cek, 1985; Wrich, 1982); (d) skills in designing and administering training and educational programs (Lewis & Lewis 1986); and (e) knowledge of organizations, management theory, labor relations, and human resource management (Masi, 1983; Myers, 1984).

The purpose of this paper is to describe how university-based marriage and family therapy programs can most effectively provide the basic knowledge, training and experiences that marriage and family therapists need to function effectively in an EAP environment. It is not the purpose of this paper to describe, in-depth, the various types of EAP programs or to describe how to establish EAPs within an organization. The reader may refer to other sources for such information (Gam, Sauser, Evans, & Lair, 1983; Lewis & Lewis, 1986; Masi, 1983; Myers, 1984; Wrich, 1982).

Training programs, especially those accredited by the Commission on Accreditation for Marriage and Family Therapy Education, already require a rigorous plan of study for students. Developing a formal EAP option, requiring a new sequence of business courses and practicums would be impractical in most cases. It is the authors’ position that existing marriage and family therapy training programs, following the Commission on Accreditation’s model curriculum, provide most of the basic training that is needed by a therapist to function as an EAP service provider. Specifically, preparing interested trainees to become EAP professionals may be accomplished through the purposeful integration of several significant components of the previously presented EAP provider qualifications into existing coursework. Strategies as to how this may be accomplished, covering each of the suggested qualifications, will follow.

Advanced Mental Health Degree The M.S. or Ph.D. in marriage and family therapy fulfills the requirement of an

advanced mental health degree. In addition, a degree in marriage and family therapy generally involves solid grounding in systems theory which is not only applicable to families, but is also applicable to addressing employee problems. An employee with a problem must return to his existing work and family system after treatment; therefore, the various systems in which the employee functions should be included in the treatment (Lewis & Lewis, 1986). Marriage and family therapists, who are systemically oriented, look first to the context in which the presented problem resides for effective assessment and treatment goal determination. Although most marriage and family therapists do not receive any formal management or organizational behavior training, family systems training is significantly similar in theory as to provide MFTs with a model directly applicable to understanding business systems and employer-employee relations (Masi, 1983; Shell, 1987). Consequently, creation of an awareness among MFT trainees of the applicability of family systems theory to business systems and employer-employee relations is an important first step in EAP training. The most natural place for this awareness to be introduced is in the initial course on systems theory.

For MFT students to make an informed decision as to whether EAP employment is of interest to them, the topic must be introduced early in their program of studies. Many training units already have avenues which could serve this purpose, such as orientation or professional seminars required of new students, professional issues courses offered early in the sequence of courses or active student professional organizations which offer career programs.


Therapy Skills It is important that EAP professionals have skills in making assessments, providing

crisis intervention, and providing short term treatment (Lewis & Lewis, 1986). One of the major tasks of MFT programs is to train students in assessment and diagnostic issues through formal coursework and the various supervised practicum experiences. Particular emphasis, for those students interested in EAP work, should be directed toward the assessment of drug and alcohol abuse and use ofthe DSM-111-R (1987) system. Training in crisis intervention methods is important to any competent therapist and is generally provided to MFT students through coursework and practicum experience. Systemically-based therapy training prepares students to be able to effectively intervene at an individual, marital, family, or broader system level-all potentially important in effective treatment of EAP clients referred for evaluation andior treatment. Particularly important for EAP providers is training in short term, problem solving approaches to treatment. Marriage and family therapy trainees typically receive varying degrees of exposure to these approaches. In fact, short-term problem solving approaches serve as the foundation of many MFT programs. Competently trained marriage and family therapists have received clinical training that, typically, is well suited to an EAP setting.

Expertise in Alcohol and Drug Abuse Treatment Training students to assess and treat alcohol and drug abuse is one of the essential

duties of an MFT program preparing students to become EAP service providers (Myers, 1984). This goal is best accomplished by offering a course that exposes students to a variety of treatment strategies encompassing the range of behavioral and medical treatments. If a separate course dealing with alcohol and drug treatment cannot be provided within the program of studies, units on alcohol and drug etiology, assessment, and treatment may be included in other existing courses, such as family dysfunctions. Students serious about EAP employment can be encouraged to focus term papers, theses, or other assignments on alcohol and drug treatment.

Exposure to alcohol and drug treatment facilities is also important for the EAP service provider. Interested students should experience working in an internship placement which provides alcohol and drug treatment, if a t all possible. Therefore, to support an EAP emphasis, an MFT program is well advised to arrange placement options with agencies that provide alcohol and drug treatment services.

Educational and Training Program Development Part of the comprehensive professional development of any marriage and family

therapy program should be providing the student with skills, training, and experience in designing and implementing educational programs. Students may be required to design and implement educational programs for specific audiences or the general public on such topics as stress management, communication skills, or family life issues. This requirement can be part of existing courses such as professional issues or practicum, and, often, may be part of the effort to publicize marriage and family therapy. These efforts may be as diverse as an 8-week relocation adjustment program or a talk for a local civic organization’s luncheon.

Business KnowledgelExperience It is not unusual to find students returning to school to study marriage and family

therapy after having had a variety of previous experiences, including various business experiences. Marriage and family therapy students with business experience may be in particularly strong positions to develop an EAP specialization. Students declaring an EAP interest, who do not already have this experience, will need to gain some knowledge of organizations, management theory, labor relations, and human resource manage-


ment. Many academic MFT programs require, or encourage, students to have a minor or outside concentration. In such programs, students declaring an EAP interest could enroll in business school classes or special study courses designed by clinical faculty, working with business school faculty, to provide MFTs with a business background. As an alternative, students might audit appropriate undergraduate business courses, or choose to focus their projects, papers, or research for various classes on application of systems theory to business systems or on EAPs. Non-therapy practicums in human resources, or personnel departments of large companies might well enable students to gain the knowledge and experience they need.

CASE EXAMPLE

The accredited MFT program at Auburn University will serve as an example of how the suggested EAP training can be implemented in a MFT program. Auburn’s program has an ongoing internship placement in the EAP program of one of the country’s largest textile manufacturers. Potential MFT students learn about the various possibilities for internships that will be available to them when inquiring about the program. Internship possibilities are discussed at the orientation activities of the MFT program’s Student-Associate Organization, exposing all new MFT students to EAPs as one of several career options very early in the program. The training that first year students receive in systems theory emphasizes application to all systems, including the work world. Students are taught that a client’s work life is a very important component of his or her well being and often crucial to problem formation and resolution. Students who display an interest in EAPs are encouraged to focus this interest by researching the area for class assignments and papers. All MFT students are provided intensive training in short-term problem solving therapy, crisis intervention, assessment and diagnosis, and substance abuse etiology and treatment as part of the first year clinical training sequence. Clinical faculty members have developed relationships with several business faculty members so that students interested in auditing or completing appropriate business courses may develop individualized programs to meet their needs. Interdisci- plinary consultation has also been helpful in developing other EAP contacts. For example, consultation with business faculty led to contact with the EAP of another manu- facturer in the area that agreed to serve as a resource for students regarding issues of organized labor since the program’s other EAP involvement is in non-union facilities.

The Auburn University Marriage and Family Therapy Center, which the Auburn MFT program administers, is a designated provider for the Auburn University EAP. All MFT students, as part of their first practicum experience, provide services to EAP- referred clients. All MFT students also develop and present educational programs in the university community for the University’s EAP, as partial fulfillment of the require- ments for the course in professional issues and development.

Probably the most important experience that an MFT program can provide interested students is an internship within a n existing EAP. The learning experience that an EAP internship provides allows MFT students to integrate their training and academic knowledge in a business setting. It also provides them with marketable experience as EAP providers. Auburn’s EAP internship placement allows students to experience working in a self contained, in-house EAP that provides a variety of services to the corporation it serves. Interns are initially provided a thorough orientation to the corporation, its history, facilities, employees, management system, organization, policies and procedures. Not only do students provide the full range of therapy services, but they are also given the opportunity to participate in various educational and training programs for management, employees and their families. Students in this placement also


work closely with several substance abuse facilities and gain experience in facilitating the transition of employees back into the workplace after inpatient treatment.

The Auburn University MFT program serves as an example of how a degree of awareness and experience in EAP service provision can be integrated into the training of students in an existing MFT program without reorganizing the curriculum. Auburn's program further illustrates how students interested in EAP service provision as a career may be trained within an existing program, through the development of appropriate internship placements.

CONCLUSION

The preceding discussion of qualifications for EAP employment are based on EAP literature. In reality, there are far too few professionals with all of the desired qualifications. Candidates frequently have either the business background or the clinical qualifications, but not both (Erfurt & Foote, 1977). Professionals with the human service background are often hired to direct EAPs and then must flounder to pick up the management-organizational background necessary. Marriage and family therapy programs which put forth the extra effort to provide the experiences and knowledge described in this paper should be graduating therapists qualified to compete for EAP jobs and to function effectively in those positions.

REFERENCES

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Desmond, R. E. (1985). Careers in employee assistance programs. Journal ofApplied Rehabilitation Counseling, 16, 26-30.

Erfurt, J. C. & Foote, A. (1977). Occupational employee assistance programs for substance abuse and mental health problems. Ann Arbor, MI: University of Michigan Press.

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Francek, J. L., Klarreich, S. H. & Moore, C. E. (1985). Toward a systems approach to EAPs. In S. H. Klarreich, J. L. Francek & C. E. Moore (Eds.), The human resources management handbook. New York: Praeger.

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