Expanding the role of EAP through peer support.
First responders and hospital personnel are among the occupations that regularly endure high levels of stress, exposure to potentially traumatic events, and an increasing number of critical incidents. When an organization turns to their EAP to add additional support for an employee population such as these, what is a typical suggestion? The usual EAP response is to offer more orientations and trainings to drive greater utilization. However, this is an approach that will likely fall short because it fails to recognize the dynamics of the workplace culture, one that is mission driven and values high levels of commitment and success.
These employees embrace this role, and believe that unless a person has actually done the kind of work they routinely engage in, one cannot fully appreciate or understand it--and thus the emotions they are experiencing. Therefore, delivering an EAP orientation or training as an effort to reach these individuals may actually demonstrate how out of touch the EAP is to their specific needs.
To EAPs: Get Involved in a Peer Approach
The International Critical Incident Stress Foundation (ICISF) was correct in recognizing the need for a peer approach to address the needs of a high energy, mental health services resistant, first responder population (Mitchell, Everly, 1996). Use of the ICISF peer support crisis intervention model addresses the barrier of resistance often seen within these worker populations.
This model capitalizes on the trusting relationships already present among peers (Solomon, 2004; Deegan, 2006). Peers who have similar training, and also find a sense of value in succeeding in their missions, develop trust and compassion for each other (Chinman, 2006).
It should come as no surprise that the ICISF model, similar to its influence in EAP Critical Incident Response (CIR), is also used as a model for peer response outside of the first responder population. It is not unusual that in the absence of an EAP answer to address this unique population, organizations turn to outside vendors to address their needs by using existing, formalized peer-based programs.
EA professionals have been on the outside looking in before, but rather than engaging the "one-shot" trainings provided by third-party vendors and consultants; they need to consider the value that they add since they are already prepared to offer CIR services. This means not only delivering the materials and resources to a formalized peer program, but also the value in creating an extended partnership with the corporate client.
EAPs that are involved throughout the duration of the peer program, as opposed to offering intermittent, third-party trainings, maintain a level of consistency in approach and a growing connection with employees in high-risk professions. When there is a lack of involvement by EAPs, they are left on the sidelines and viewed as only a referral resource.
This is a missed opportunity.
Peer Support is Crucial
How can a fire department benefit from EAP CIR services if the employees fear that by engaging the EAP their job may be negatively impacted? After an adverse incident, how can a hospital access services immediately so that they can move forward in patient care? How can this intervention work alongside the risk management process? Moreover, how can a remote mining operation receive timely support until additional resources become available? These are some of the questions asked by leaders in high-risk organizations. The answer is peer support.
There are great opportunities for EAPs to be on the front lines in coordinating, implementing, training, and supporting the development of peer support teams. An EAP that provides this service gets a seat at the organizational table, further establishing the value of their partnership. They remain an active participant in the peer approach process by being hands-on versus just an 800 number. This active involvement fosters trust within these employee populations, which makes EAPs more accessible. From a business perspective, EAPs have further embedded themselves into the client culture.
EAPs: The Perfect Partner in Peer Support
EAPs are the perfect partner because they are trained in Critical Incident Response. Extending EAP response services to include an early crisis intervention peer process is a natural fit and consistent with the Multi-Systemic Resiliency Approach (MSRA) (Intveld, 2015). Being part of the synergy between an organization and its employees, which the peer team exemplifies, not only supports the resiliency process, but further reduces the barriers a closed culture may have with seeking assistance.
MSRA recognizes that EAPs are not the only response system engaged after an adverse incident. Organizations and their employees are already responding based on a contingency plan that aids in fostering resilience. When EAPs are mobilized, they need to gauge and complement the acts of stabilization and wellness already underway. Research on resilience has demonstrated that these internal actions, delivered by synergistic relations inherent within workplaces, are potentially more powerful than anything an EAP or another outside responder could offer (Kelly, 2007).
Therefore, an important aspect of fostering resilience involves re-engaging the supportive, and significant connections that people already have in the workplace. It is this strength within an organization that offers great potential for early crisis intervention.
Organizations turn to their EAPs for guidance because they have been invited into the fold, albeit contractually, and are viewed by organizations as trusted facilitators of resilience (Kelly, 2007). EAPs are a strength within the organization's internal benefit structure! We should be embracing this challenge.
Forming a Peer Support Program
According to The Defense Centers of Excellence's paper, Best Practices Identified for Peer Support Programs (2011), a summary of the most important areas to address when forming a peer program lies in guiding leadership through the buy-in process with all stakeholders. For instance:
* Planning and identifying areas for policy development and operational procedures begins to lay the foundation of a peer response operation;
* Determining the criteria for peer selection, based on unique cultural needs, which includes access, experience, role-modeling capabilities, as well as communication, ethical and other skills are important in facilitating a compassionate response; and
* Developing an atmosphere for peer supporters to learn and practice these skills offers ongoing support.
The Strength Within
MSRA also recognizes the personal strengths within individuals. Tried and true attributes help employees rebound from adversity. These are the strengths within ourselves that serve as a guide and resource during troubling, yet temporary times. Helping affected individuals to reconnect to these sources of strength is often best facilitated by the trusting relationships found with peers. (As noted earlier, organizations themselves, as well as individuals, also have strength from within.)
An EAP that implements and provides peer team training offers a front-line crisis intervention approach that is consistent with the EAP mission and CIR approach--that is, a front-line approach integrated with the EAP's CIR services. Having EA professionals and the peer team utilizing the same response approach reduces confusion, creates common language, and further delineates roles and boundaries.
The focus of this type of training is peer delivered, crisis intervention skill development. This training will build skills that restore a sense of safety, foster resilience through MSRA, and allow for further training on recognition and referral as highlighted in Mental Health First Aid (MHFA).
EAPs should review the types of clients they serve to identify the high-risk clients where absenteeism, presenteeism, disability claims and threat of personal risk may be greater. Start a meaningful dialogue that looks for solutions by building resilient workforces and restoring resilience in the aftermath of an adverse incident. This is in our mission. It is proactive, collaborative, and consistent with EAP core technology: Consultation with, training of, and assistance to work organization leadership (managers, supervisors, and union officials) seeking to manage troubled employees, enhance the work environment, and improve employee job performance.
For clients who are not considered "high risk," consider offering Mental Health First Aid training to educate and destigmatize mental illness. MHFA empowers colleagues to intervene, instead of ignore, when someone in the workplace is struggling with mental health related issues. This is yet another example of the potential power of peer connections, and it utilizes the strengths already within an organization.
By Robert Intveld, LCSW, CEAP
Robert Intveld, LCSW, CEAP, is the owner of Robert Douglas and Associates, author of "EAP Critical Incident Response--A Multi-Systemic Resiliency Approach", and developer of the Strength Within--An EAP RALLI Support System. Robert trains and provides resources for EAPs to coordinate and train peer teams utilizing the RALLI support process: R--Recognize and approach: A--Assess for Risk; L--Listen Nonjudgmentally; L--Learn the sources of resilience: 1--Identify next steps. Robert is also a nationally recognized corporate trainer in Mental Health First Aid. More information can be found at www.eap-rda.com.
Chinman, M., Young, A.S., et al, (2006). Toward the implementation of mental health consumer provider services. Journal of Behavioral Health Services cfe Research. 33 (2) 176-195.
Daniels, A., Grant, E., et al, (2010). Pillars of Peer Support: Transforming Mental Health Systems of Care through Peer Support Services, www.pillarsolpeersupport.org.
Deegan, P. E. (2006). The legacy of peer support. Retrieved from http://www.patdeegan/blog/archives/000018.php.
Intveld, R. D. (2015) EAP Critical Incident Response--A Multi-Systemic Resiliency Approach. Printed by Createspace, Charleston, SC.
Mitchell, J.M., Everly, G.S. (1996). Critical Incident Stress Debriefing: An Operations Manual for the Prevention of Traumatic Stress among Emergency Services and Disaster Workers', Second Edition. Chevron Publishing Corp. Elliot City, MD.
Solomon P. (2004). Peer support/peer provided services: Underlying processes, benefits, and critical ingredients. Psychiatric Rehabilitation Journal', 27: 392-401.
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|Title Annotation:||Feature article|
|Publication:||The Journal of Employee Assistance|
|Date:||Oct 1, 2016|
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