Written by: Terry Cahill Vice President of Sales and Marketing, Principal

You might think that it would be hard to find opportunities in this environment.  Though not as highly rated, there were also factors positively impacting Client Retention and New Sales, as follows:

39% – EAP Product Improvements

38% – New Strategic Partnerships

35% – New Product Offerings

35% – Enhanced Broker Engagement

30% – Enhanced Technological Delivery Capability

External EAPs are improving their current service delivery through efforts like SBIRT (Screening, Brief Intervention, Referral to Treatment) which improves clinical intervention with substance abuse cases through motivational interviewing, thus increasing the identification of cases with high impact on the workplace.  Others are creating new products such as those targeting workforce segments which have not traditionally utilized EAP services like physicians.  External EAPs are also integrating their services into their client organizations’ wellness efforts, through both internally developed products and strategic placement of the EAP within a separate wellness vendor’s product.

This wellness integration ranges from EAP seminar attendance counting toward employee wellness requirements to the EAP being used as a front end assessor of high-risk medical cases to determine if any EAP or WorkLife services might help these individuals with comorbid mental health or life cycle issues in order to better prepare them for taking advantage of wellness coaching services.  Enhanced broker engagement has included offering coaching assistance from the EAP to employees attempting to negotiate health care exchanges, allying the EAP more closely with the focus of the broker community.  And technological advances include ecounseling and other employee engagement platforms, including video counseling as discussed by Tom Farris, PhD, of Claremont Partners and Stan Granberry, PhD, of the National Behavioral Consortium in the 4th quarter 2013 issue of The Journal of Employee Assistance.

Not all doom and gloom, but rather signs of healthy entrepreneurship.  Despite the pricing, broker education, outcomes measurement and IT challenges indicated by NBC survey respondents, the following response to the question about whether respondents were pessimistic or optimistic about the future of the EAP field indicates that there are still opportunities for external EAP vendors willing to evolve.

83% of respondents indicated they are Optimistic or Very Optimistic about the future of the EAP field.

Why?  Survey respondents gave the following reasons in the open field provided:

  • Expanding role in psychosocial aspect of behavior change
  • Focus on behavioral risk management
  • Filling the Wellness Gap
  • Technology facilitates EAP reach

To close, I’d like to tie these reasons for optimism to two opportunities for the EAP field that Kathy Mahieu, AON/Hewitt’s Behavioral Health Chief, has challenged us with.  The first is the Wellness Gap.  Per AON/Hewitt’s 2011 Employer Survey, the #1 employer desired benefit-related outcome is to increase the “utilization of wellness and prevention” in order to drive down healthcare costs.  And the #1 challenge to achieving this goal is “motivating (wellness) participants to promote behavior change” (AON Hewitt 2012 Health Care Survey).  This is the Wellness Gap.  And it is creating a focus on behavioral risk management and the psychosocial aspects of behavior change.  And behavior change is the expertise of EAP.  There are many approaches to leveraging EAP behavioral expertise, but the point is EAPs could potentially fill this wellness gap and by virtue of working with customer organizations at one of their main points of pain, extend EAP reach with executives in client organizations, one of the current difficulties identified for external EAP vendors in this survey.

Kathy Mahieu’s second challenge, per her presentation at NBC’s Fall 2012 Conference, is for EAPs to become proactive case finders, to go beyond waiting for cases to come to us in response to program promotion efforts, and actually reach out to potential end users, employees and family members and supervisors, to identify people that need our services.  Key to this proactive case finding is technology.  Technology that enables access to the EAP.  Technology that reaches employee populations with screening tools.  Technology that provides self-service platforms to support behavioral change.  All of these can support the core competencies that have been, and will continue to be, the foundation on which the External EAP industry continues to build. 


 Whether by addressing the Wellness Gap, becoming proactive case finders or through other innovations, the EAP field can and is building on its legacy of assistance to organizations and individuals.  In the meantime, the NBC Industry Profile of EAP Vendors study provides a set of metrics to which purchasers, brokers and vendors can compare their current EAP data.  The study also provides differentiation amongst EAP vendors within the current EAP marketplace, particularly based on variations in dominant pricing model, for purchasers interested in generating EAP utilization and/or integrating the EAP into the workplace.

To get more information regarding the EAP Utilization Data and Trends blog post series, you can email Terry Cahill or visit www.perspectivesltd.com. To read the other parts of the blog post, please visit Part 1, Part 2, Part 3, Part 4, Part 5, or Part 6 now!

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Bernie Dyme on October 15th, 2014

ndsd logoWritten by: Bernie Dyme

Last Thursday, 10/9/2014 was National Depression Screening Day.  It came and it went.  So, what now?  One benefit of a national day like this is that it gains awareness of depression.  The problem however, is that it then recedes back into the shadows.

Unfortunately, in my opinion, this defeats the purpose.  We need to keep the discussion going.  This is not a problem for only one day of the year, but one that is of epidemic proportions. Major depressive disorder (MDD) is the second leading cause of disability worldwide. Furthermore, suicide (which is one of the risks of untreated depression) is the 11th leading cause of death in the U.S., accounting for 30,000 deaths each year.

Tips on treating depression

  1. Encourage your employees to seek and get help.
  2. Talk about mental wellness and health with your employees, family and friends.
  3. If you see someone struggling with sadness, depression or anxiety, go up to them and ask how they are doing. Let them know you care.
  4. Go to the Screening for Mental Health website for more ideas.

Remember that we all can help each other and should.  So I encourage you to keep this conversation going.  Feel free to comment on this post.  The more we can dialogue about this, the more we can help the people who are suffering.

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Kathi Blaszkiewicz on October 14th, 2014

job burnoutWritten by: Kathi Blaszkiewicz, Director Account Management

Were you someone who used to love your job but now find yourself struggling to stay engaged?  Have you shifted from being a workplace cheerleader to a “Debbie downer?”  Are you physically exhausted and weary of the day to day responsibilities of your position?   You may be experiencing a chronic form of stress called job burnout.  Causes of professional burnout can vary but often have to do with lack of control, unclear job expectations, poor workplace communication, difficult managers and/or a mismatch of values between the beliefs of employees and the actions of work organizations. Over time, these occupational factors can take a toll and result in serious chronic stress reactions affecting people’s productivity.

If you recognize yourself in those brief questions it may be time to examine your own situation.  Those of us who have always been “worker bees” and dedicated employees are at greater risk and may find it harder to admit to job burnout.  The best we can do for ourselves is to be mindful that we could be vulnerable and incorporate prevention strategies.

Prevention strategies that might help

  1. Recognize when your passion has turned to poison – Christina Maslach, Ph.D. She states that you might be burned out if the work you were passionate about now feels like a burden.
  2. Honestly evaluate your situation and your options. In this way you increase your empowerment quotient.
  3. Take time for yourself daily. This can range from a 2 minute breathing exercise 3 times per day to a 5 minute walk to going to bed 30 minutes early.
  4. Manage the stressors that are contributing to the work situation. Identify what is fueling the burnout. If you have an EAP, you can use short term counseling to develop strategies to address the issues.
  5. Utilize your support system. Often we are afraid to admit our feelings and this adds to isolation.
  6. Increase your social activities and/or your creative side. In this way you increase work life balance.  The goal is to be mindful that work is only a part of your life and it does not define you as a human being.

Hard workers that, not only come to work every day but show up to work every day, understand that their contribution is part of a greater whole that can “make or break” the success of the organization.  Don’t let yourself be a victim of job burnout. Recognize the signs and take the steps you need to continue to be the best you can be.

To get more information on job burnout email Kathi Blaszkiewicz at kathib@perspectivesltd.com, or visit www.perspectivesltd.com.




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Survey Results – Challenges & Opportunities

Written by: Terry Cahill Vice President of Sales and Marketing, Principal

There are clear challenges for the external EAP industry and the Business Management section of the NBC survey that looked at Most Difficult Internal Operations for external vendors underscores them.  Depicted below are the three main difficulties identified by percentage of respondents indicating High or Very High Difficulty, difficulty defined as high monetary and time commitment.

51% – Educating Brokers on EAP Value

49% – Outcomes Measurement Strategy

47% – Maintaining IT

If it was like a Chicago election, where you vote as often as possible and even from the grave, it might have been me that drove Educating Brokers on the Value of EAP to the top of this list since I am primarily in a sales role.  Suffice to say, there are many brokers who understand that there are different levels of EAP service delivery across varying types of vendors, but there are also brokers who reduce EAP to a spreadsheet that doesn’t necessarily compare the pertinent variables or ask the right questions.  Of course, that second on the list is the EAP industry’s own struggle with proving value doesn’t acquit the field itself on this count.

Maintaining pace with IT, both in support of internal operations and in meeting the growing expectation for use of technology in service delivery, is a challenge.  As EAP end-users become more and more accustomed to simple internet and app access to services, they will expect this from EAP as well.

These challenges come at a time when new sales and client retention in EAP are threatened.  According to the NBC Survey, the #1 factor impacting client retention and new sales is Product Pricing.  Survey respondents rated this item High or Very High far more often than any other item.

74% – Product Pricing

39% – next item

And when surveyed about the factors impacting Client Erosion, the two items rated most often as High or Very High were:

45% – Switch to “Free EAP”

44% – Price Competition

To find out why EAP vendors remain optimistic despite these challenges, check out our last blog in the series that will be published next week. Catch up on previous blog posts 1, 2, 3, 4 and 5 now!

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Working World Cafe on October 7th, 2014

Working Mom-worklifeWritten by Lindsey Patrick, Access Center & EAP Counselor Intern

Mindfulness and work/life balance are popular topics these days. Mindfulness can be difficult to achieve and balance is often elusive. I have personally experienced this balancing act as, over the past 1 1/2 years, I have had to balance working full-time, attending graduate school part time and maintaining a household. Here are some things I have learned in my quest to maintain balance.

  • Schedule your time and write it down. Writing down your daily schedule will help you visualize how you parcel out your time. Blocking out space for your daily tasks will help ensure you don’t pack too much into one day. Writing down your schedule will free up mental energy otherwise spent on remembering your tasks. Don’t forget to schedule time to organize your schedule!
  • Create routines within your busy schedule.  Wake up and go to bed at the same time every day. Exercise at the same time every day. Have a bedtime routine.
  • Focus on one task at a time. This is a core concept of mindfulness. When you’re at work, don’t think about how you’re going to make time for dinner. When you’re at home, don’t think about work. When you’re exercising, focus only on muscle movements and breathing.
  • Prioritize tasks. Know which must be completed and which can wait.
  • Listen to your body. Busy schedules cause stress; stress can cause health issues. Know your limits and do not ignore the emergence of a cough, fever, etc. Your body can serve as a signal for when you’re overextending yourself.
  • Know when to cut back, say “no or ask for help. Know your limits and acknowledge when you have to cut back on workloads, course loads, etc. Your priority list will help you identify something you can put off or delegate to somebody else.
  • Prioritize “me time. You cannot take care of others or your tasks if you don’t take care of yourself. Self-care will help build resilience and combat burnout.

Maintaining balance can help make you a better employee, student, partner, friend. Maintaining balance will also help maintain your mental and physical health.

To get more information regarding balance among chaos, email Lindsey Patrick or visit www.perspectivesltd.com.

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Written by: Terry Cahill Vice President of Sales and Marketing, Principal

The comparative analysis also looked at differences based on external EAP vendor size.  Per the study, Dr. Attridge condensed the Local and Regional vendors into the Smaller Market Group and the national, international and global vendors into the Larger Market Group.  As would be expected the Larger Market Group had greater mean averages in certain areas than the Smaller Market Group as indicated in the following chart:


Average total # of client organizations  671 > 191

Average total # of covered employees  15 Million > 93k

Average # of employees per client organization (contract size)  3,539 > 907

Average total # of staff dedicated to EAP (staff size)  215 > 16

However, in the following chart, the data show where the Smaller Market Group had greater mean averages than the Larger Market Group:


EAP counseling Utilization rate 5.6% > 3.5%

% of all counseling sessions provided by EAP staff vs. affiliate counselors 54%  >  34%

Staffing ratio – the average number of EAP staff per 10,000 covered employees 2.20  > 1.54

Again, though further study of these variables across EAP vendor size is required, the idea that an EAP is an EAP is an EAP, regardless of size or pricing model, is not likely a good assumption for a purchaser to make.  But for purchasers to take the time to thoroughly vet EAP vendors there are industry-wide challenges that need to be addressed to reinvigorate the perception of EAP beyond questions of utilization and visibility toward the issue of partnership viability with client organizations.

In Part 6 you will learn about the challenges and opportunities that came with this study. To get more information regarding this blog post, email thc@perspectivesltd.com. Need to catch up? Read Part 1, 2, 3 and 4 now!

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Sara DePasquale on September 30th, 2014

Written by: Sara DePasquale

Each year during Mental Illness Awareness Week, National Depression Screening Day (NDSD) is held. NDSD was established in 1991 by Screening for Mental Health, Inc. (SMH), a non-profit organization. This year on October 9th, NDSD will include local clinicians in all 50 states that volunteer their time to offer free educational and screening programs at health facilities, malls, libraries, colleges, workplaces and senior centers.

Each depression screening is free, anonymous and takes less than ten minutes. At the screening, people have the chance to learn more about anxiety and mood disorders, complete a brief questionnaire, and speak with a mental health professional, confidentially.

What to expect during the free screening:

  • A written screening questionnaire
  • Discussion of results with a health professional
  • A referral list of clinicians and treatment facilities in the person’s area
  • The chance to watch an educational video
  • Some pamphlets and brochures
  • The opportunity to fill out a “friends and family questionnaire” for a loved one

If you or someone you know is interested in attending a free screening, locate a site in the area by going online at http://www.mentalhealthscreening.org/. To find out more information on depression, please visit our Working World Cafe Blog, or visit www.perspectivesltd.com to check out our EAP, Managed Behavioral Healthcare & Wellness services.

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Written by: Terry Cahill Vice President of Sales and Marketing, Principal

SURVEY RESULTS – UTILIZATION #3:  An EAP is not an EAP is not an EAP

Thanks to the data analysis conducted by Mark Attridge, PhD, MA, which is summarized in the study, some of the most interesting descriptive findings were the differences in EAP utilization and EAP staffing across pricing models.  A little more than ¾ of the respondents primarily utilized a per employee capitated pricing model, while the remaining quarter primarily used either a fee-for-service pay as you go model or a Free EAP model in which the EAP is embedded in another product (e.g. – Life Insurance, Long Term Disability) and for which the end user customer organization does not pay a fee.  The comparative analysis across these models indicated that:

EAP Counseling utilization rates were respectively 3 and 4 times higher for the Capitated and Fee-for-service models than for the Free EAP model

EAP Organizational Service rates for services such as Supervisory Training, Employee Orientations/Seminars, Critical Incident Response, etc. were respectively 7 and 5.5 times higher for the Capitated and Fee-for-service models than for the Free EAP model

The Embedded Free EAPs had respectively 3.8 and 3.3 times the number of covered employees per EAP staff than the Capitated and Fee-for-service EAP

This has major implications for purchasers in differentiating the various types of vendors in the EAP marketplace.  Those purchasers interested in generating EAP utilization and/or integrating the EAP into the workplace, might do well to consider the aphorism, “you get what you pay for”.  It is important to note that there was no statistically significant difference amongst the three pricing models in average # of sessions per EAP Counseling case.  Another area of further study might be to examine what percentage of these EAP Counseling sessions are delivered in-person or by video as opposed to telephone or LiveChat/email.

Stay tuned for Part 5 of EAP Utilization Date and Trends! Part 5 will bring results on the differences in utilization between larger and smaller EAP vendors. Does size matter? To get more information regarding this blog post, email thc@perspectivesltd.com.

Catch up on Part 1, 2, and 3 now!

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Written by: Terry Cahill Vice President of Sales and Marketing, Principal

UTILIZATION #2:  Is that utilization enough?   Are we reaching our client organizations? Is utilization really the right question?

The NBC study surveyed the participating external EAP vendors about business management issues in addition to utilization data.  Respondents were asked to identify the most difficult objectives in working with their client organizations, difficulty defined by high monetary and time commitment.  Those items ranked most difficult fell into two clusters, the first cluster being the difficulty in getting meaningful opportunities to build relationships with client organizations’ management at levels higher than the organizations’ designated EAP liaison.  The following graphic indicates the percentage of respondents that indicated the item was High or Very High in difficulty:

60% – Getting “face-time” with executives to discuss EAP

51% – Relationship-building activities to renew contract

49% – Opportunities for more proactive/strategic role for EAP

The second cluster was getting the word out about EAP services to the end users – employees and their families, as well as managers.  The following depicts the percentage of respondents that indicated the item was High or Very High in difficulty in this cluster:

52% – Promoting EAP among family members/dependents

47% – Promoting EAP among supervisors/management

45% – Promoting EAP among employees

It would seem from the survey results that there is room for better promotion of EAP services to end users, yet also a lack of access to client organizations’ power structures to cultivate the connections and influence necessary to achieve that end.  This is the utilization dilemma facing EAPs.  And while it is important to attempt to address this, (and a later section of the NBC study does indicate an emerging solution that will be discussed in this paper), it is also important to note that another approach to this issue is to focus not on how many, but on entirely different metrics that support the value of EAP services.  Unfortunately, the final of the 7 most difficult items in working with client organizations based on percentage of High or Very High Difficulty was:

52% – Quantifying and demonstrating the value of EAP

And only 42% of the responding external vendors used validated outcome surveys, the most common of which was Chestnut Global Partners’ Workplace Outcome Suite.  In order to change the conversation with client organizations from raw utilization statistics to the impact EAP services have on client organization performance, much greater use of validated outcomes instruments will be required.  However, even within the quest for greater utilization, there are differences in results across EAP vendors per the next two sections of this paper.

Part 4 coming shortly on the differences in utilization between Capitated, Fee-For-Service and Free Embedded EAP models. To get more information regarding this blog post, email thc@perspectivesltd.com.

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Survey Results: Utilization#1: What is typical EAP Counseling utilization?

Written by: Terry Cahill, Vice President of Sales and Marketing, Principal

To reiterate, all data was reported anonymously so those participating had no competitive advantage to consider when filling out the survey.  This may account for the lower utilization numbers than seen in previous reports of EAP utilization such as AON/Hewitt’s Study of their Request For Information (RFI) data from 2009-10 which indicated the average EAP Counseling rate to across vendors submitting response to their RFI as 5.7% and 6.0% respectively for 2009 and 2010.  (External Employee Assistance Program Vendors: A Study of RFI Data from 2009-2010; EASNA Research Notes, Kathleen Mahieu and Chet Taranowski; Volume 3, Number 3, April 2013).

What should our EAP utilization be?  How many counseling sessions should be built into our model?  What percentage of cases should an EAP refer into the healthcare benefit? 

Another way to ask these questions is how does our utilization stack up against others?  For the utilization rate data item, the survey asked for the number of unique individuals receiving EAP assessment/counseling services, (not WorkLife or LegalFinancial services), annually divided by the total number of covered employees.  Good arguments can be made to calculate this number differently.  However, this was the definition settled upon for this survey as it was the one in most common usage and so easiest for respondents to retrieve and report for purposes of comparison.

The average reported EAP Counseling annual utilization was 4.5% with the median at 3.6%.

This is a far cry from some of the marketing claims made by EAP vendors.  Of course, when utilization of WorkLife, Legal/Financial and online services are added, utilization is higher, but even then, are EAPs reaching enough individuals?  The next subsection of this paper will look at that question.  What about the average number of sessions per EAP Counseling case?

The average number of sessions per EAP Counseling case was 2.47, the median 2.36.

This survey result is especially interesting in that the 82 EAP companies surveyed had models that included from 3 to 12 counseling sessions per case.  There are EAP vendors that market “unlimited” counseling sessions though their contracts often clarify that cases needing mental health or substance abuse services will be referred into the healthcare benefit without receiving unlimited counseling.  This data makes the discussion about what are the actual differences between a 5 and an 8 and an unlimited counseling session model quite interesting.  How much more service is an employer actually buying once they get past a 5 or 6 session model?  As studies of this kind always generate more questions, one excellent question to research in this area is what percentage of EAP Counseling sessions are delivered by phone versus in person?  The current study, in order to get the survey down to a manageable time allotment for participants, pulled this particular question from the original survey draft.

If the typical EAP case averages under 3 sessions, what percentage of the EAP Counseling cases are NOT referred into the mental health and substance abuse benefit?

82% of EAP Counseling cases are not referred into the mental health/substance abuse benefit.

This speaks to a huge shift in EAP service delivery in that most EAP cases well into the 1980s were “Assessment & Referral”, the premise of EAP work being to get the client to the help that best matched their EAP-assessed need.  The EAPs role was to provide a comprehensive assessment and then find a resource to fit the assessed need, often, though not always, within the mental health portion of the healthcare benefit.  Clearly, the EAP field has evolved to a more of a brief counseling model in which cases are not referred nearly as frequently into the benefit plan.  This shift does speak to a challenge for today’s EAP, which is how to deliver both the brief goal-focused counseling in keeping with the repositioning of EAPs as a resource for everyday living while also still providing a comprehensive assessment in order to identify high workplace impact issues like substance abuse.  These two ends of the service delivery continuum speak to the pull for EAPs to both increase utilization and prove their value.  While EAP vendors struggle to increase utilization, can they also set aside resources to deliver services that demonstrate the workplace impact of their services?  The next set of survey results addresses that question.

Stay tuned for Part 3 where we ask the questions, Is that utilization enough?   Are we reaching our client organizations? Is utilization really the right question? To get more information regarding this blog post, email thc@perspectivesltd.com.

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