Behavioral risk: a systemic approach: understanding that behavioral risks are interconnected can help EAPs better address challenges to human assets and convince employers of their value to work organizations.

The effectiveness of human assets may be the single most important determinant of a work organization's success. The behavioral risks that can compromise the effectiveness of human assets are well known (see Figure 1), but frequently they are identified and addressed individually rather than as parts of a whole.

On a philosophical level, employee assistance professionals see employee problems in the workplace holistically, but practically speaking they tend to approach problems individually and find individual solutions. Managers and human resources practitioners, for their part, tend to view EA professionals as individual-problem solvers.

Peter Senge, in his book "The Fifth Discipline" (1990), encourages companies to think in terms of wholes rather than parts. "Business and other human endeavors are systems," he writes. "They are bound by invisible fabrics of interrelated actions, which often take years to fully play out their effects on each other. Since we are part of that lacework ourselves, it's doubly hard to see the whole pattern of change. Instead, we tend to focus on snapshots of isolated parts of the system and wonder why our deepest problems never seem to get solved."

Thinking in terms of wholes rather than parts, or "systems thinking," provides a conceptual framework that allows us to see overall patterns more clearly and helps us understand how to support or change them effectively. This requires us to look at the interrelationships among all human asset risks. An intervention into any one of these risks becomes an intervention into the whole. Like a mobile hanging over a baby's crib, when one part is disturbed, the whole mobile mores and all the interrelationships change.

MOVING FROM PARTS TO WHOLES

The research literature is replete with examples of efforts to recognize and capitalize on the interaction of human behavioral risks (HBRs). These efforts usually focus on the effect of two risks upon each other, and data are seldom coordinated or shared to demonstrate this interaction or the cost-effectiveness of managing cause and effect or the synergy between the two.

For example, the Lawrence Berkeley Laboratory at the University of California developed an integrated protocol to prevent and manage workplace mental stress injuries, claims, and associated costs. This approach was developed in response to a catastrophic workplace stress claim and a charge to the internal EAP to integrate its functions with those of occupational health, human resources, and risk management. According to Kathleen Handron (1994), manager of the employee assistance and vocational rehabilitation programs at the laboratory, this coordinated effort reduced stress claims costs from $192,000 (paid for a single 1981 stress claim) to an average of $11,500 over a five-year period. During the same time frame, California experienced a 700 percent increase in stress claims costs.

In 1989, Conoco, Inc. chose to take a systemic approach to escalating healthcare costs by creating integrated healthcare teams at its major sites. The teams included a physician, a wellness professional, and an EA professional. Conoco's behavioral health benefits costs for its U.S. employees had been escalating at rates of between 18 percent and 27 percent annually, about double that of overall healthcare inflation.

The EAP worked closely with the human resources and benefits departments to design user-friendly, cost-effective mental healthcare benefits. The EAP then developed and managed the network providing services and coordinated access to the network and the claims process. Over a five-year period, the EAP helped save more than $12 million in behavioral healthcare costs.

The EAP was careful to not function alone but to act as part of the organizational team and coordinate a systemic approach to healthcare costs. The EAP's efforts included the following:

* Designing mental health benefits;

* Managing utilization of mental health benefits;

* Participating in the company's Corporate Substance Abuse Task Force;

* Developing critical incident response capability as part of the company's Significant Incident Umbrella Plan;

* Developing a family and employee assessment process for all expatriate foreign assignments;

* Developing concepts, practices, and tools to address and support corporate downsizing efforts;

* Developing a consultation process for management, human resources, work groups, and supervision; and

* Participating in a Human Resource Natural Work Team (NWT).

Notwithstanding these examples and other research data supporting the financial effectiveness of EAP intervention with the troubled employee, there is still substantial evidence of EAPs moving from internal or small external settings, where they are part of the fabric of the work organization, to large external managed care companies, when a minimal EAP is offered at bargain rates. Without a people-based information management system to acknowledge and support the interrelatedness of all areas of behavioral risk, the movement from internal to external models will continue. As Harold Gardner (1993) emphasizes, there is a critical need for integrated data collection in all human behavioral risk areas. Gardner's research identified the Pareto Effect in benefits utilization, whereby 20 percent of employees account for 80 percent of corporate health benefit expenditures.

RE-ENGINEERING THE EAP FUNCTION

We have identified the whole of human behavioral risk as greater than the sum of its parts. In order for a corporation to support its human assets needs and address potential human behavioral risks, it must take a holistic approach, addressing the whole of human behavioral risk in a way that is human value driven, not dollar value driven.

Yandrick (1996) proposed a strategy for managing behavioral problems at work by identifying how individual and organizational behaviors can affect each other. "Designing a behavioral risk management strategy requires an understanding of how and why behavioral problems manifest themselves in work organizations," he reported. "Effective solutions to diminish risk exposures are ones that conform to the contours of the organizations. There is no such thing as a 'typical' company when it comes to behavioral risk, because even companies in the same industry can vary greatly in production methods of service delivery, reward systems, marketplace positioning, culture and other organizational characteristics that can be risk factors. Behavioral risk management, therefore, is not a template process."

When employees feel their job options are restricted, as in our current economic climate, they may stay in jobs they dislike or for which they are ill-suited and tolerate management and work practices that are unhealthy. The costs to the company stemming from these situations manifest themselves in behavioral risk problems such as increased safety infractions, greater drug and alcohol use, increased mental health and physical health benefits claims, and so forth. All of these behavioral risks diminish partnering among employees and between employees and management and reduce the synergy that is developed through working together.

Wojcik (1997) suggested integrating risk management principles into human resources responsibilities, noting that the human resources budget is generally larger and receives more attention from senior management. EAPs can add value and credibility to the human resources function by becoming behavioral risk experts. EAPs hold a broad view of employee problems and are in an ideal position to provide leadership in behavioral risk management.

Behavioral risk management, as Yandrick (1996) has described, is an applied risk management strategy that affects all risks connected with workplace behaviors that have a negative impact on the productivity of an organization. To prevent such losses, the organization needs a holistic strategy and an integrated approach to planning, implementing, collecting data, and reporting. For this strategy to have legitimacy, it must have senior management support, centralized reporting and early intervention, coordination of all corporate areas of human behavioral risk, and centralized data management, tracking, and performance metrics.

EA professionals must stay well informed on holistic behavioral risk management and be aware of the unique risks of the organizations they serve. Just as EAP clients (both employees and managers) are the best sources of behavioral risk information, they are also the best resources for developing strategies to meet human needs and manage human risks. When employees assist in designing solutions to behavioral risks, they invest themselves in the success and own the outcome.

A behavioral-based paradigm for helping EAP clients understand and begin to intervene against ineffective personal behavior is as follows:

[ILLUSTRATION OMITTED]

According to this paradigm, an individual interprets events in his or her life, leading to internalized thoughts. These thoughts generate "feeling states" that ultimately can lead to some behavioral action. To change the outcome of this progression, one can intervene at any step along the way. Events can be acknowledged, predicted, altered, or eliminated. Interpretations of the events can be re-examined and re-framed, leading to different internalized thoughts. The existence of a feeling state can trigger the individual to re-examine thoughts or events, and the resultant behaviors can be supported, treated, disciplined, and/or used as information to allow re-examination.

The model for human behavioral risk management in an organization provides similar opportunities for identification, examination, alteration, and intervention.

[ILLUSTRATION OMITTED]

Just as an individual addresses personal behavioral issues, an EAP can help an organization address and intervene in areas of human behavioral risk. EA professionals must seek to be "invited to the table" with management as value-adding partners and leaders rather than as primarily crisis repair personnel.

CHANGING OUR EAP PARADIGM

Positioned as leaders in human behavioral risk management, EA professionals can become a primary visionary, and implementing force to empower employees as well as organizations and workgroups to address their human behavioral risks together. Empowered employees and organizations are proactive, creative, flexible, responsible, accountable, healthy, safe, and productive.

The technology is readily available to gather, interpret, and manage the data and interactions among the various areas of human risk. With this data we can identify needs, design interventions, evaluate outcomes, and demonstrate a positive impact on employers' profits.

The real challenge is changing our EAP paradigm, letting go of some of the ways we have typically done things and leaving turf issues behind. Let's get on with it. There are great and useful contributions to be made through our "reengineered" EAP.

FIGURE 1

Behavioral Risks Affecting
Human Capital

Physical health
Emotional/behavioral health
Threat of violence
Safety infractions on the job
Critical incident stress
Bullying
Conflict with supervisor
Sexual harassment
Discrimination
Marital/family issues
Drug/alcohol abuse
Family health issues
Conflict with co-worker
Work/life balance

References

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Cooper, Cary L., and Sharon G Clarke. 2000 "The risk management of occupational stress." Health, Risk & Society, November (25): 173-187.

Feerst, Daniel A. 2002. "EAPs help limit behavioral exposures." National Underwriter, August: 18.

Gardner, Harold H. 1993. "Integration of safety and health, workers' compensation and health care to reduce total losses." Presentation to National Safety Council.

Handron, Kathleen 1994. "An employee assistance program approach to the prevention of workplace mental injury." Behavioral Healthcare Tomorrow, November/December: 21-24.

Harlow, Kirk, Robert B. Johnson, and Paul Callen. 1993. "Comparison of physical health benefits utilization among mental health and physical health climants, 1989 and 1990." Journal of Occupational Medicine, 35 (3): 275-281.

Harlow, Kirk, Robert B. Johnson, Paul Callen, and Donald Young. 1991. Presentation at EAPA Annual Conference.

Imlab, David 2003. "Happy, healthy and here." The Safety & Health Practitioner, July (21): 54.

Johnson, Robert B. 1983. "Troubled employees are high risk for on-the-job accidents." Unpublished study.

--. 1993. "Mental health and substance abuse managed care from an internal EAP perspective: A review of the first three years at Conoco." Presentation at EAPA Annual Conference.

--. 1993. "Industry Statistics: Conoco." Open Minds, November,.

Jorgensen, Don. 2003. "Why use an employee assistance program?" Employee Benefits, August: 5B.

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Paul, Robert J. 2003. "Managing employee depression in the workplace." Review of Business, Winter (24): 31-52.

Quinley, Kevin M. 2003 "EAPs: A benefit that can trim your disability and absenteeism costs." Compensation & Benefits Report, February, 17 (2): 6-7.

Senge, Peter M. 1990. The Fifth Discipline: The art and practice of the learning organization. Doubleday: New York.

Vorachek, Darlene. 2002. "EAPs: They're well intentioned, but also risky." HRBriefing, May (3009): 2-3.

Wojcik, Joanne. 1997. "Managing risks of human resources." Business Insurance, July, 31 (27): 2-3.

Yandrick, Rudy M. 1994. "Conoco's Behavioral-health-benefits plan." HR, January, 50.

--. 1996. "A strategy for managing behavioral problems at work." HR, June, 41 (6): 150-157.

--. 1996. Behavioral risk management: How to avoid preventable losses from mental health problems at work. Jossey-Bass: San Francisco.

Zolkos, Rodd. 1998. "Human resources exposures create need for risk management." Business Insurance, June, 32 (26): 3-4.

Bob Johnson is principal consultant of SOS Consultants in Salt Lake City, Utah. He can be reached by phone at [phone] or by e-mail at [e-mail]