A support mechanism for the worker with a disability.

Employment is key to the establishment of one's identity, self esteem, and quality of life. Labor market trends and government initiatives administratively and legislatively have stimulated increased employment opportunities for persons with disabilities. However, industry faces challenges of matching the worker to the job and assuring that an optimal fit is maintained over time. The Employee Assistance Program (EAP) is a viable mechanism for supporting employees, supervisors and industry in general in resolving issues which affect the productivity of the employee with a disability in the work place. This article reviews an EAP project targeted at enhancing employment outcomes for persons with disabilities, presents data on the utilization of the model, and offers suggestions to industry, counselors and rehabilitation personnel regarding the design and utilization of such a model.

Employment has been viewed not only as a means of realizing economic self-sufficiency but also as a primary mechanism for establishing personal and professional identity (Holland, 1983; Wright, 1980; Super, Starishevsky, Matlin & Jordaan, 1963). Employment, likewise for individuals with disabilities, has been equated with increased quality of life, an indicator of independence, and a measure of self determination (Goode, 1989: Schalock & Harper, 1978). A number of strategies have been implemented to enhance employment opportunities for adults with disabilities (Kiernan & Stark, 1985; Rusch, 1990; Wehman & Moon, 1988). These strategies focus on facilitating an optimal fit between the worker and the work environment through the provision of time-limited and ongoing training and supports.

The emphasis upon support to employees is not new, services such as those available through Employee Assistance Program (EAP) have been used by industry for the past two decades. It is the commitment to employees with substance dependence issues that has made the early EAP programs so successful. Many of these programs were an outgrowth of groups such as the National Council on Alcoholism (NCA). These initial programs had their focus upon training of supervisors to implement constructive confrontation strategies and assist troubled employees on the job (Sonnenstuhl & Trice, 1990). The EAP of today continues to direct its efforts to assisting the troubled employee utilizing supervisory training, peer training, employee education, and counseling supports. The target population has expanded to include not just the substance dependent employee but the troubled employee experiencing stress related to family, work or fiscal issues. The present expansion of the EAP to respond to the needs of the employee with a disability is another logical expansion of the EAP role.

Employee Assistance Programs (EAP) as a Support Option

The expansion of the role of the adult with disabilities in the world of work, and the increased demand for workers in the market place will require an expanded rehabilitation/business partnership (Kiernan & Schalock, 1989). Several industries and businesses have initiated employment programs for individuals with disabilities (Du Pont, 1990:. Hudson Institute, 1990). These, however, have been tied either to a rehabilitation support system external to industry (state and private vocational rehabilitation organizations) or have relied on internal job modifications designed by staff of rehabilitation agencies or organizations (Akabas & Krauskopf, 1989: Judy, 1989).

While such external support designs have proven to contribute to employment success for workers with disabilities, they also contribute to labeling the worker as different from others (Nisbet & Hagner, 1988: Rusch, 1990). Additionally, such approaches do not address the needs of individuals with "hidden" disabilities or of those not connected to a social service system. Finally, the use of external resources to facilitate either placement or job modification may minimize industry's motivation to increase its internal capacity to respond to employees with disabilities.

A strategy for addressing these issues is the establishment of a service employing a wide variety of job support options in a context that is congruent with the work environment, ongoing, and available to all employees. Employee Assistance Programs (EAP) meet these criteria and offer a positive alternative to less intrusive and more customary support services for employees with disabilities (Lake & O'Hair, 1986: Akabas & Krauskopf, 1989).

As noted in the special report of the Institute for Management, How to Establish an Employee Assistance Program, industry views EAPs as part of the employee benefits program. While originally developed as a response to the effects of alcoholism on work, many EAPs have expanded their services to address issues related to work and life adjustment, stress management, family relationships, and management of financial and/or medical problems (Akabas & Krauskopf, 1989: Singer, 1986: Sonnenstuhl & Trice, 1990).

Employers provide EAPs for two major reasons. The first is cost effectiveness. An employee whose production decreases over time because of personal problems or due to such problems is eventually terminated, costs the organization both in terms of lost production and expenses associated with job turnover (Finney, 1985). It is more cost effective in the long run to provide EAP support services to assist employees in resolving life problems which impact work performance than to terminate and hire new and probably less experienced workers. The second justification for EAPs is that employees who view a company as responsive to their needs will be more satisfied with the company (Rodgers & Stieber, 1985). EAP services can provide support to the employee and thus facilitate an optimal fit between the worker and the job.

Employee Assistance Program for Persons with Disabilities (EAP/D)

With the passage of the Americans with Disabilities Act (P.L. 101-336) there will be increasing emphasis upon both the creation of employment options for persons with disabilities as well as the enhancement of opportunities for career advancement through employment for such persons. The realization that persons with disabilities can work has evolved to the point where the capacity to work no longer remains a question but rather the question is what has to be done to maximize the employment skills and abilities of persons with disabilities. We are seeing more and more persons with disabilities enter employment (Kiernan, McGaughey, Lynch, Morganstern & Schalock, 1990: Kregal, Revell & West, 1990)

Given the changes that are occurring the challenge of maintaining employment is now being faced by the employee with a disability. As with all employees, those with disabilities encounter the same stresses, demands, interpersonal challenges and concerns regarding financial and medical problems. The existing resources such as the EAP can play a role in assuring that the employee with disabilities can remain as productive as possible in employment.

In order to test the applicability of the EAP model to the job support needs of employees with disabilities, the Developmental Evaluation Clinic, a University Affiliated Program (UAP) at Children's Hospital, Boston received funds from the Administration on Developmental Disabilities to develop such a model.

The Employee Assistance Program for Persons with Disabilities (EAP/D), utilizing the basic mission of an Employee Assistance Program (EAP), was designed to provide support to employees with disabilities so that maximum productivity on the job could be maintained. Due to the more restrictive focus of the funding agency, in the initial stages of the project, employees with developmental disabilities were targeted as the primary service recipients Thus project activities were directed toward adults having a disability of early onset as opposed to those disabled in later years either through trauma, psychological difficulties, or substance abuse. The limitation in focus differentiated the efforts if this EAP from the more customary EAP in that individuals who were substance dependent were not included in the target population. Such a restriction did limit the total number of individuals who might be eligible for services.

About nine months into the project, an expanded definition of disability was subsequently utilized when it was apparent that supervisors were not able to differentiate a developmental disability from other types of disabilities. Persons who were substance dependent, however, continued to remain outside the definition of disability utilized by this project. Thus, persons served by this demonstration were more narrowly defined than those served by the traditional EAP.

Target Population Served

Three specific groups were targeted: (a) the troubled employee with a disability, (b) the front line supervisor and (c) any employee of the organization needing assistance for a family member who was disabled. It was hoped that problems could be resolved through early intervention in order to minimize their impact on job performance.

Program Design

The program initially focused on employees at a tertiary level pediatric health care facility in Boston employing approximately 3,200 persons. The equivalent of one staff person three quarters time was assigned to this program. A total of thirty staff hours per week was assigned to this effort. The staff involved included two trained rehabilitation counselors who would provide ten to fifteen hours of direct service (orientation to the service, assessment, counseling, referral, and supervisory training) on a weekly basis. Rehabilitation Counselors were employed because of their skills in providing job placement and support services to persons with disabilities. The remaining staff time was utilized in review of literature, data collection, and project evaluation efforts.

The program functioned as a freestanding service. At the time the project was initiated limited counseling and support services were available to the hospital employees through the Department of Human Resources. The hospital did not offer the full range of services available through an employee assistance program.

Employment retention strategies were integrated into program services in a number of ways. Employees with disabilities could request counseling or referral to services for work-related or personal problems. The employee with a disability had the same private, independent access to services as did the typical employee served by an EAP. Supervisors could request services to support employees with disabilities who were having job-related problems or for whom job adjustment problems were anticipated. A referral to the program was required as part of any corrective action process developed by a supervisor. Finally, consultation and referral services were available for employees who needed support when family members with disabilities were having difficulties.

Results

Initial findings

Results of the first 9 months of services showed that of 3,200 employees at Children's Hospital, 20 or .6% of the total number of persons employed used the specialized services for employees with disabilities. Of that group, 6 were employees with family members who were disabled. The remaining 14 were split evenly between supervisory consultation requests and direct intervention with troubled workers.

During this initial nine month period the program eligibility was more restrictive and required that the disability be of a developmental nature having early onset and life long implications. As was noted above after this initial stage the definition of disability became much more inclusive. Though no systematic survey was competed, The Department of Human Resources at the hospital estimated that total number of persons with developmental disabilities employed at the hospital was from 1.5% to 3% or from 48 to 96 employees. This estimate is in concert with the estimated national incidence of 1.49% for adults who are developmentally disabled (Boggs & Henney, 1979: Kiernan & Bruininks, 1986). For purposes of identifying the total populations which might benefit from this service it was further estimated that the incidence of family issues was similar or about 1.8% to 3% or from 57 to 96 employees. The incidence of families with members having a developmental disability reflects the slightly higher incidence of development delay among children as reported by Boggs and Henney (1979).

The total target population was thus estimated to be between 105 to 192 employees. For the estimated total population the utilization rate of 10.4% to 20% was consistent with the 10% rate reported in the literature for new EAP services (Finney, 1985).

To evaluate effectiveness solely on the number of referrals does not adequately reflect the program's impact, particularly with respect to hospital staff. Project staff met with senior administration staff, department heads, and line supervisors (more than thirty meetings) to share information, identify needs, and develop a liaison with management at all levels. Information sheets, brochures, and internal newsletter articles were developed and disseminated as part of the marketing efforts. These activities most likely increased management awareness of and sensitivity toward the needs of the workers with disabilities. Other similar marketing efforts were initiated for the employee with a disability and the employee having a family member with a disability.

Expansion of the sample size

Given the findings reported above, it became obvious to staff and advisory committee members that a larger employee base was required in order to examine the viability of such a services. The program was thus expanded to include other industries or organizations. In the other organizations, the service was added as a component of existing EAPs. The majority of these companies contracted with an outside EAP, although one company had it's own internal EAP. Thus, the program model shifted away from the free standing design to one which expanded the range of services available through an existing EAP service. This change had positive cost effective implications as well as potential advantages for the contracting EAP, such as an increased capacity to respond to the needs of its contractors.

With this change, the targeted audience for training and consultation shifted from line supervisors to EAP professionals. The training objective was to develop materials to help the EAP provider recognize possible behaviors which might indicate the presence of a disability as well as assist supervisors in more effectively screening for the presence of a disability when a job performance issue was emerging.

A Manager/Line Supervisor checklist was developed as a preliminary screening tool for the EAP professional. The items on this list were identified through the literature as key elements which would indicate the presence of a disabling condition. This check list provides information for the EAP counselor regarding the nature and significance of the problem as viewed by the manager or line supervisor. The EAP counselor can quickly review the indicator check list with the manager and identify critical issues for the worker. If several of the areas are checked as requiring an action, the EAP counselor may use an expanded interview format to explore the possibility of the presence of a disability as part of the employment problem.

Data from the expanded interview should be gathered in an introductory interview with the individual and the EAP professional (Roiter, 1986). Specific information regarding interpersonal relations, learning and adjustment, previous work history, social and leisure activities, financial, and medical will provide the EAP professional with valuable information on early experiences and possible long standing difficulties. These data may confirm the existence of a previously diagnosed disability or identify the presence of a disability not noted prior to the current problem. By alerting the EAP professional to the potential presence of a disability, check lists and expanded interview schedules may allow development of a more appropriate and efficient intervention plan.

Total Program Findings

After 18 months of service, a total of 51 referrals were made to the EAP/D. Of those, 44 followed through and were seen by the staff. The distribution of referrals included: (a) the employee with a disability (45.4%), (b) the front line supervisor (36.4%), and (c) the employee having a family member with a disability (18.2%). The source of the referral was self (52.2%), manager (40.9%) and another EAP counselor (6.9%). The most frequent type of contact was in person (65.9%) followed by telephone (31.8%) and written (2.3%). About one-fifth of the contacts were made within the immediate work area. These contacts typically involved some job modification and were conducted with both the supervisor and the employee present. Four-fifths took place in the company, most often in the EAP counselor's office. The average age of the referred employee with a disability was 33 years. Employees with disabilities had worked an average of 8.7 years, while those requesting assistance for a family member had been employed an average of 9.5 years.

The average time for counseling supports (69 minutes) was twice that spent in management consultation (34 minutes), whereas resource identification required about one-third of the time provided in counseling (26 minutes). A total of 185 units of counseling services, 109 units of management consultation and 45 units of resource identification were provided. Other units of service provided were initial evaluation, supervisory technical assistance, provider consultation, and follow-up. A total of 506 units of service were provided to 44 persons requesting assistance.

Thus, an average of 11 units of service were provided to each individual, with the average unit of service requiring 52 minutes of direct staff time. These statistics do not include staff time involved in documentation, training and project orientation. By far, the most frequently requested service was short term counseling and support. The least amount of time was spent responding to the needs of employees having concerns with a family member who was disabled.

The majority of referred employees had a primary diagnosis (determined through interview data) of mental retardation (66%), followed by seizure disorder (17%), and physical disability (17%). Although no specific data were available on secondary diagnoses, staff felt that many of those sweved had a significant secondary disability, the most frequent of which was emotional or psychological. Additionally, five out of eight family referrals involved a family member who had a diagnosis of mental retardation.

The most frequent reason for referral (29.5% of all referrals) was job performance problems (see table 3). The referral reason and the problem identified subsequent to the initial evaluation differed at times. One-fourth of the job performance referrals were found upon completion of an evaluation by the EAP staff to involve issues related to the impact of a disability, i.e. lack of transferable job skills or capacities to accommodate to new tasks. The second most frequent reason for referral (22.7%) was supervisors' difficulties in managing the troubled employee with a disability. Once the initial evaluation was completed, the primary problem in three out of four of the referrals identified initially as managing a troubled employee were felt to be directly related to employee anxiety concerning the impact of the disability on job performance. The third major referral factor was related to the impact of a disabled family member (18.2%) on the employee in the work environment. This generally reflected a child of the employee who was not in a satisfactory academic or work/day program. Other less frequent reasons for referral included personal adjustment issues of the employee with a disability, changes in job expectations and health-related concerns. [TABULAR DATA OMITTED]

Most than one-fifth (22.7%) of the cases involving self or supervisor referral were viewed as potentially resolvable by redesigning job duties. The majority required less change in the actual range of responsibilities, and instead, a variation in how the specific duties were accomplished (i.e. the use of reminder cards, adjustment of work hours). The second most frequent recommendation (18.2%) was for counseling related to personal adjustment or family problems. Fourteen percent were refereed to social service or public service agencies with a few recommendations for job changes. In 40.9% of all referrals (18 cases), a rehabilitational professional from a public or private agency was used as a resource by EAP staff, primarily to assist in locating appropriate referral services.

A review of the 44 persons served following referral and intervention revealed that 43 percent either had improved or resolved issues. For 27 percent, there was no reported change and for 30 percent the situation worsened. In the majority of the situations where there was no change the referral dealt with a complex family issue which required considerable intervention, and more than the information and referral support that the EAP could offer. Situations such as inappropriate school placement, need for specialized home service, and family counseling would require long term intervention and thus not show significant change over the relatively short project period of 18 months. For those where the situation worsened, more than half of the referrals (8 cases) were made after a disciplinary action had been initiated. The relationship between the supervisor and the employee in these cases was already troubled and the performance on the job was impaired. In other instances (3 cases), there was a serious mismatch of the abilities of the individual and the job duties and a lack of capacity for the employee to recognize that even with job modification that the situation would not be resolved.

For the 22 employees who had received services and were no longer followed by the EAP, the final disposition shows that plans of correction were in place which could be utilized by the employee without direct or ongoing assistance. For this group of 22 persons, the employment outcome was somewhat varied. Fifteen employees changed their employment status as part of the plan of correction; ten voluntarily changed jobs (with the majority remaining employed in the same company), two were reassigned, two retired, and one was terminated. Of the remaining seven, five discontinued services and two maintained contact with the EAP staff but refused any direct assistance.

As mentioned, an important function of the project was to provide services to supervisors in responding to the needs of employees with disabilities (10 referrals). These referrals were initiated prior to any disciplinary action being taken. A review of these referrals shows that 80 percent led to continuation of employment for the employee while 20 percent led to terminations. Though the total number of supervisory consultations is small, the data reveal a trend toward positive resolution of problems when identified prior to the initiation of a disciplinary action and support is available.

As important as the actual data on service are, for an effective EAP it is critical that the employee community have knowledge about the existence and types of services offered by the EAP. An analysis of how the employee heard about the services of the EAP was completed. Twenty percent were informed of the service through the Human Resource Department, 30 percent heard from their supervisor, 20 percent were informed through a training session conducted by program staff and the remainder were informed through employee relations, co-workers or promotional materials.

Finally, from a cost effectiveness perspective, although no detailed data on actual dollar savings were available, other measures of impact can be reported. The average hours lost to the company by the employee with a disability the month prior to the referral was 40 hours, with a total of 1,201 hours lost in the month prior to referral by all employees referred. However, data were available on a total of 30 employees; includes troubled employees and employees with family member issues only. For those employees were there was a plan of action in place and for whom follow up data were available (total of 14 employees), the average hours recovered was 35.5 per month following the design and implementation of the plan of correction. A total of 89% of the time lost prior to referral was recovered after the plan of correction was initiated for the employee.

If the total savings to the company is to be estimated, subsequent savings per month should also be calculated based upon increased attendance and productivity for the employee sample. Simply estimating the reduction in the utilization of sick time from 40 hours to less than 5 hours once a plan of correction was in place is a way of estimating some of the company savings. Other savings associated with an effective plan of correction can be realized through reduced job turnover. Estimates of from two to six months of salary can be lost with each turnover (Teel, 1983). These types of savings can be incorporated into the calculation of the return on investment that the company will realize through such an employee support program.

Discussion

EAPs are naturally occurring industry support resources which can play a role in assisting the employee with a disability in maintaining a productive employer-employee relationship over time. The continuing emphasis upon creation of employment options for persons with disabilities will most assuredly increase the number of persons with disabilities entering the labor market. The passage of the Americans with Disabilities Act will likewise increase the need for industry to respond not only to the issues of access but also career advancement and job supports for persons with disabilities. The present study identifies some clinical and structural factors which must be considered if EAPs are to assume a more aggressive role in enhancing the independence, productivity, and integration of employees with disabilities into and through the world of work.

The present study does document that the EAP mechanism can play a role in responding to the needs of the troubled employee with a disability and the troubled employee with a family member having a disability. The typical services of counseling, supervisor training and consultation, and referral offered by the EAP were those most often required for the troubled employees with a disability. The services provided which differed from the typical services offered by an EAP were those of redesigning job duties and restructuring work environments (22.7% of the service units offered were in these areas).

For persons with disabilities initially job accommodation strategies are utilized such that the individual can be hired. Once employed if there is a job change or a change in the particular duties or ways in which the job tasks are performed specific job modifications may be necessary. The earlier such changes can be anticipated the more natural the accommodation can be. The role of the EAP in responding to the employee with a disability is thus one of not only early intervention but anticipation and/or early identification of potential problems in the work area. For some EAPs identification of potential problems or the anticipation of an issue may be a new role.

Once a problem is identified the solution may not always lead to remaining in the same job. Job restructuring or job modification and in some cases job separation will be the outcome. For the current EAP demonstration program after 18 months of operation less than half had shown signs of improvement. A partial explanation of this may be that eight of the employee referrals were received subsequent to the initiation of a disciplinary action. In cases such as these the issues are already at a crisis stage. Positive outcomes are much more difficult to achieve when there is an existing adversarial relationship between the supervisor and the employee. On the other hand, for the supervisory originated referrals (10 in total) where no disciplinary action was initiated, 80 percent lead to a positive outcome.

These findings serve to highlight the need for early identification. One aspect of early identification is employee awareness, thus, a continuous marketing effort is necessary. This marketing effort must address the issues of early identification by supervisors of troubled employees with and without disabilities as well as general awareness of EAP resources among all employees. A full functioning EAP must take into consideration the active roles of all of the stakeholders: supervisors, union stewards, and coworkers in the prevention, identification, and implementation of corrective plans for the troubled employee.

The issue of early identification as well as the type of services required suggests that the existing EAP services will need to consider modifying some of the ways that they provide services. The incorporation of questions at the time of the initial data gathering or first interview which would highlight the presence of a disabling condition may assist the EAP professional in more efficiently identifying the problem and subsequently developing the plan of action for the employee. The presence of a disability which impedes production, as was the case in one out of five of the employees referred in this project, may call for a very different response. What may appear as an unhappy or unmotivated employee could be an indication of an employee who has sequencing problems, short or long term memory deficits, or other job skill limitations which could be responded to by job accommodation or job modification strategies. Lists, charts, color coding of materials, reminder cards, audio tapes or specific task training may be the answer to what presents itself as a motivational problem. EAP professionals will want to be able to accurately identify such situations such that the optimal plan of correction can be implemented.

With counseling as one of the primary services offered by the EAP, it is significant to note that of those plans of correction developed more than 40% called for the use of an outside rehabilitation professional. This finding would imply that if the EAP is to respond to the needs of the employee with a disability that they should have in house or consultative resources knowledgeable of disabilities and the relationship of such disabilities to the work place available. Developing this capacity can make the free standing EAP vendor more capable of responding to its customers. By having some knowledge of disabilities, and thus the capacity to respond in a cost effective and timely fashion to the needs of the employee with a disability and of the industry, new markets for EAP vendors may open.

Though cost effectiveness or dollar savings are not the sole reason for developing an EAP, they are often two of the reasons for establishing and continuing such a service. One finding of the present demonstration was the considerable reduction in lost time. For the month prior to the intervention the employee with a disability used 40 hours of sick or leave time. Subsequent to the development and implementation of the plan of correction, the amount of lost time was reduced by more than 89%. Though the total number of persons from which follow up data were collected was small (N = 14), this finding is significant. There was clear documentation that the troubled employee who had a plan of correction in placed did increase his/her work hours. The authors would advise the reader to exercise caution in interpreting these cost data due to limitations in the sample size and the fact that an increase in the number of hours does not necessarily mean an increase in productivity on the job. Productivity data were not collected in this demonstration program.

A much more detailed analysis of benefit and cost for EAPs responding to the needs of the troubled employee with a disabled is necessary. Information on variables such as increased productivity, hours on the job, reduction in accidents on and off the job, number of disciplinary actions and changes in insurance costs (injury payouts and policy premiums paid) will need to be collected. Additionally, it must also be kept in mind that EAP programs are adopted not solely on the basis of cost savings but because employers believe that helping employees solve their personal problems is good business and demonstrates social responsibility. Measurement in changes in the quality of work life and increased levels of job satisfaction will need to be made if the full impact of the EAP is to be documented (Schalock, 1990). Future research in program evaluation, as noted by Sonnenstuhl and Trice (1990) is essential.

The current project did examine the various structures which could be utilized; the free standing EAP for persons with disabilities and the incorporation of the disability service into an existing EAP. By virtue of the number of persons with disabilities and the employees having family members with disabilities being limited, the idea of a free standing specialized EAP does not appear to be feasible. Additionally, since there are many parallels to the nature of the services required, the incorporation of the support services for the troubled employee with a disability into an existing EAP seems reasonable. This incorporation would require that existing EAPs develop capacity to identify and respond to the needs of the employee with a disability. Such an activity can be accomplished by assuring that all EAP professionals have some orientation to the issues relating to disabilities in the work place or that the EAP hire a specialist knowledgeable in disability management. The former is an inservice training issues which can be responded to by professionals in the field of rehabilitation counseling. The rehabilitation counselor could also serve as an EAP professional having a disability specialty. Either way the rehabilitation professional seems to be uniquely qualified to join with other professionals to form a comprehensive EAP team.

From an organizational design perspective, it can be concluded that the optimal administrative structure for such a support system would be part of an existing EAP. For an employee base of about 11,000 persons, about 5 hours per week of direct service from an EAP specialist (FTE .125) was required to respond to the needs of troubled employees with disabilities. Training and related services may require an additional 3 to 7 hours of staff time per week. Replication efforts may use more or less time depending upon the degree of interest in training and related services. Thus, for the current project, direct service and training efforts called for an investment of 8 to 12 hours per week (FTE .2 to .3). Depending upon how much time is devoted to training front line supervisors and other employees in the industry, replication efforts may require greater staff investment during the initial phase.

It may be assumed that as more persons with disabilities fill positions in industry, the need for such support strategies may increase. Thus, staff effort in responding to the needs of the troubled employee with a disability, assisting supervisors of such employees, and serving as an information and referral resource for employees with family members with disabilities could be and most likely will be even greater.

Conclusion

As the role of the EAP has expanded the skills of the EAP professional have likewise diversified. The findings of the present study raise some points of consideration for EAP as they again expand their roles. The EAP professional is expected to be a jack of all trades: teacher, counselor, information and referral resource, job engineer, and marketer. The experiences of the current project show that professionals such as rehabilitation counselors in many ways are uniquely suited to fill the role of an EAP professional. The rehabilitation counselor brings to the EAP a knowledge of disability and its influence in the work place, knowledge of community resources, counseling skills, and an orientation to job accommodation and job modification.

With the continuing shortage of workers and the growing emphasis upon employment for people with disabilities, industry is likely to become increasingly invested in hiring and maintaining adults with disabilities. The EAP is a familiar and viable mechanism for assuring that industry is able to maintain the optimal job match for all employees (i.e. both persons with and without disabilities). Existing EAP resources offer great potential to meet the needs of employees with disabilities, yet, they have hardly been tapped at present. It is incumbent upon rehabilitation professionals and industry representatives to find creative ways to utilize these resources more effectively to increase the opportunities for access and advancement for people with disabilities in the work place.

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Wright, G. (1980). Total rehabilitation. Boston: Little Brown and Co. For reprints of this article contact:

William E. Kiernan Training and Research Institute for People with Disabilities Children's Hospital 300 Longwood Ave., Gardner 6 Boston, MA. 02115