Using evidence-based workplace training: research on substance abuse prevention has led to new training programs that can help revitalize EAPs and lead to a new focus within the EAP Core Technology.

Over me past several years, I have listened to many conversations and read several articles discussing the changes and turbulence faced by the employee assistance profession. The issues raised by the speakers and authors often reveal two underlying principles that EA professionals yearn to embrace personally and promote professionally.

First, they want to have a positive influence on individual workers as well as on the overall well-being of work organizations. For example, given the rising level of stress in the workplace, EA professionals want to do more to help employees who labor in hostile, hectic, poorly led, or otherwise unhealthy work environments. This balance of services (individual and organizational, top-down and bottom-up) may be termed integral organizational wellness.

Second, EA professionals want to connect, interface, or establish identity with their client organization(s). They hope to create a sense of what I call reliable intimacy. They want to be more than occasional reporters of utilization rates, conduits for referrals, and (along with their employee clients) passive reactors to the capricious healthcare market and its competitive landscape. EA professionals want to partner with clients and proactively co-create a healthier and more productive workforce; they want to not just meet or get ahead of the curve, but actually shape it.

If, as I believe, integral organizational wellness and reliable intimacy are central to the vitality of the EA field, then EA professionals will be pleased to know that programs drawing on these principles are now available. Research on substance abuse prevention has led to the development of effective classroom training programs in several areas, including stress reduction, work-life balance, and workgroup communication. These programs have been thoroughly researched and are designated "effective" or "model" programs by the National Registry of Effective Programs (NREP) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Each of these evidence-based programs meets the critical EAP goals of enhancing the work environment, motivating performance, and reaching out to workers and encouraging them to seek help. They facilitate social health promotion within the work setting, requiring trainers to interact with workers in ways that are sensitive to the work culture. Such interaction creates a healthy pause, slowing the pace of work just long enough to cut through the very problems of time compression and "presenteesim" that prevent employers and employees from considering such programs in the first place.

APPEALING TO DIVERSE INTERESTS

Four workplace programs that draw on substance abuse prevention have been deemed effective by the NREP (see sidebar). Several things about these programs are worth noting. First, to avoid stigma, they effectively situate substance abuse prevention within the broader framework of employee well-being Second, because they deal with substance abuse, they enhance drug-free workplace educational efforts. Third, because they are grounded in research, the programs come with tools for program evaluation. Fourth, they appeal to diverse interests within the EA profession and address topics of relevance to businesses (e.g., communication).

For example, given the growing overlap between employee assistance and work/life balance services, there should be widespread interest among EA professionals in the program titled "Coping with Work and Family Stress." This multi-session classroom program has been shown to reduce drinking and illicit drug use and help workers establish effective coping strategies for stressors at home and work.

Two other programs can help EA professionals align their interests with behavioral health promotion and healthcare initiatives. "Wellness Outreach," which utilizes one-on-one wellness counseling in the workplace, targets cardiovascular health but also addresses the role alcohol abuse plays in cardiovascular risks relevant to a given client (e.g., obesity, high blood pressure, stress, and so on). "The Healthy Workplace" allows trainers to select from five distinct interventions that are delivered in small group sessions using specially developed videos and print materials. The interventions address topics ranging from stress management to diet and exercise to parenting and have been shown to reduce binge drinking and improve overall health outcomes.

Another program may be particularly useful for EAPs that desire a role in organizational development or are integrated within human resources. This program, "Team Awareness," teaches human resources policy using an interactive board game while also training workers in peer referral to enhance EAP utilization. "Team Awareness" has been shown to reduce problem drinking, improve attitudes toward the EAP, increase supervisory responsiveness to troubled workers, and reduce social climate risks for substance abuse.

CHANGES IN ATTITUDE

Together, these training programs comprise a menu from which an EAR together with an organizational client, can select and shape a substance abuse prevention initiative for the workplace. Whether a customized amalgam or a single training is selected, the research suggests one underlying element needs to be in place: There is no substitute for a facilitator or trainer who is knowledgeable about EAPs and who delivers social health promotion training to employees within work settings.

As should already be clear, "training" in this context does not refer to standard EAP orientations or one-hour programs on workplace violence, sexual harassment, or job stress. (I personally have trained several hundred employees who had forgotten about their company's EAP or--because of the stigma associated with an EAP or its lack of relevance to them--had never even encoded information about it in the first place.) This training should be interpersonal, pro-active, and engaging. The facilitator must be familiar with the work setting and speak to issues relevant to the specific work culture, then take time to really listen to workers and help address their individual concerns.

Even though these training programs are relatively new and more research on their effectiveness in different settings is needed, I would venture to say that they point the way to a revitalization of the EA profession and perhaps even suggest an additional focus--substance abuse prevention--for the EAP Core Technology. Interactive face-to-face training or coaching can re-establish the EAP as a partner on the path to overall organizational health. This goal has led my firm to begin experimenting with NREP training programs in an effort to extend the reach of EAPs to those who may need substance abuse prevention outreach most--employees of small businesses in the construction, transportation, and hospitality/service industries.

During the past year, with support from SAMHSA, my firm has partnered with three organizations--the Small Business Development Center of North Texas, the Tarrant Council on Alcoholism and Drug Abuse, and MenningerCare EAP--to deliver training and employee assistance services to small businesses (usually with fewer than 100 workers) that did not know such a thing as an EAP existed. Through our efforts, 28 businesses were randomly assigned to receive either a version of "Team Awareness" or a customized training that incorporates elements from both "The Healthy Workplace" and "Team Awareness." Other businesses were assigned to a control group and received no training. Employees receiving training were informed about the EAP and also given access to counseling for six months following the training. All employees completed questionnaires two weeks before and after the trainings.

Results showed that both the "Team Awareness" and customized programs were effective in increasing employees' willingness to seek help for problems that affected their work and/or personal lives. Specifically, workers who received the trainings indicated they were more likely to utilize a counselor, EAP, or support group if they felt depressed, overwhelmed, or stressed (see Figure 1), while the control group showed no changes in attitude. In addition, utilization records suggest that more than 20 workers actually sought help from the EAP following training.

[FIGURE 1 OMITTED]

These results represent an extension and replication of the NREP research results. More importantly, the findings indicate that such programs can be effective tools for EAPs. In the hands of EA professionals, prevention programming can contribute to the aforementioned goals of integral organizational wellness and reliable intimacy.

Critics may caution that organizations will spend neither time nor effort on classroom training, or that market forces within healthcare will limit services for troubled workers who are able to break through the denial, stigma, or fear of confidentiality that has prevented them from taking action in the past. With scientific proof in hand and continued program evaluation, it is possible to address these criticisms directly.

Interactive trainings can assist EAPs as they strive to reduce workplace risks that contribute to productivity problems. They can also help remove psychosocial barriers that hinder employees from seeking help sooner. The training may be in work/life balance, health promotion, stress management, or team building, or some combination of the four. Through the use of such evidence-based prevention programs, EAPs can contribute to employee health and productivity and burnish their image as a reliable partner in organizational health.

There are several ways to learn more about science-based prevention programs for the workplace. One way is to visit the Web site for SAMHSA Model Programs and the National Registry of Effective Programs (NREP) at www.modelprograms.samhsa.gov. The specific programs and developers are also high-lightened in Preventing Workplace Substances Abuse: Beyond Drug Testing to Wellness, published by the American Psychological Association (2003). Alternatively, you can contact the program developers directly.

Coping with Work and Family Stress

David Snow, Ph.D.

Yale University 

Phone: [phone]

e-mail: [e-mail]

Wellness Outreach

Max Heirich, Ph.D.

University of Michigan 

Phone: [phone]

e-mail: [e-mail]

The Healthy Workplace

Royer Cook, Ph.D.

ISA Associates

Phone: [phone]

e-mail: [e-mail]

Team Awareness

Joel Bennett, Ph.D.

Organizational Wellness & Learning Systems

(Developed at Texas Christian University)

Phone: [phone]

e-mail: [e-mail].

Joel Bennett is president of Organizational Wellness & Learning Systems (OWLS) in Fort Worth, Texas. He is the author of Time and Intimacy (Lawrence Earlbaum) and co-author of Heart-Centered Leadership, to be published this fall. The author wishes to thank Camille Patterson, Ph.D., and Wyndy Wiitala, M.S., for their help in preparing this article.