What are the options for psychological therapy and support in workplaces? The arena is complex yet when you boil it down, there are only five broad options you need to consider as you start your search for a perfect service that suits your budget and workers.
An employee assistance programme (EAP) is a work programme that assists productivity and attendance issues within the workplace and supports employees to find and deal with personal concerns that may affect job performance. Things such as health, relationship, family, financial, alcohol, drug, legal, emotional, stress, or other personal issues. Since they were first introduced to the UK in the 1980s, (EAPs) have become an effective way for employers to improve or keep the healthy functioning of the workplace.
What to look for in an EAP
The essential function of a successful EAP is its ability to offer confidential support services, on demand, when needed, and free of charge
to employees. EAPs act as a gateway to a lot of services and support functions.
The use of an EAP service by an employee is voluntary and most employees who use EAP services do so through self-referrals, although many offer options for other people to refer such as line managers or HR. The way of doing this must be discussed with the EAP provider before start-up and should take into account your policies, measures to accommodate data protection, and employee confidentiality.
What does an EAP Offer?
Service usually consist of a blend of the following:
- Short-term psychological services, such as counselling
- Money advice and debt management
- Child and elder care information services
- Legal information and guidance
- Information on emotional, work-life and workplace issues
- Assessment, support, short-term counselling and referral for employee issues
- Management referrals and support
- Usage reports (anonymous)
- Management information on employee and organisational interventions
- Working to the confidentiality and ethical standards
- A website with interactive content and information.
- Consultation and training for managers and supervisors within your organisation
It is important to realise that what distinguishes an EAP from any other form of mental health counselling, coaching or private counselling, is that an EAP
emphasises worker performance as the central theme to guide all programme practices and services.
How an EAP Works
The key elements of a full EAP service are:
- 24-hour telephone support, assessment and counselling services
- Assessment of needs
- Structured short-term psychological interventions delivered both face to face and by telephone
- Case management and management information
- Management consultations
- Website information and services to support the EAP with interactive content, fact sheets and online services.
The elements of the EAP is usually decided by the budget available and the types of issues arising.
Price of EAP’s
There are three main ways to price an EAP:
- Charges are on a ‘per capita’ basis. This rate is calculated on the expected (not real) use of services
- An ‘as used’ pricing method and includes core services, such as telephone counselling, work-life services and web-based services included as a fixed fee. All face-to-face counselling would be paid for as an extra, based on the volume used
- Pricing EAPs ‘per call’ with a set-up fee, and more costs for marketing and account management. On top of this, the purchaser would pay for any calls to the EAP at a set rate.
Other components can be added in too:
- Marketing literature (annually)
- Awareness training
- Management information
- Account management meetings
- Web portal
- Wellbeing portal
Adapted from UK Buyers Guide of EAP, for full details go to http://www.eapa.org.uk/eap-resources/
To see a typical page of an EAP click here – note you have to buy the service to use the information.
Counselling services are included as part of an EAP or may be the only support offered by a business to workers. The British Association of Counselling and Psychotherapy (BACP ) defines ‘counselling’as:
‘Counselling and psychotherapy are umbrella terms that cover a range of talking therapies. They are delivered by trained practitioners who work with people over a short or long term to help them bring about effective change or enhance their wellbeing. Counselling is not about giving advice or directing a client to take a particular course of action. It should not be seen as conditional. That is, attendance should not adversely affect career progression or status at work, counsellors do not judge or exploit their clients in any way.’
How Does Counselling Work?
Workplace counsellors would usually be expected to work within a short-term or time-limited framework, often between two and six sessions. If further support is required, counsellors may refer employees to other interventions, which may not necessarily be funded by the workplace.
Workplace counsellors need to have an understanding of organisational cultures and workplace factors that might have an impact on the psychological health of people at work. Furthermore, workplace counsellors will need to be mindful of the different stakeholders involved, and be aware of a possible tension between the needs of the client, the organisation, the counselling provision and other parties. Service providers might also conduct routine stress audits to help purchasing organisations meet their ‘duty of care’ obligations. They also need to be proactive in enabling employees to increase their coping resources through stress management and mental health awareness or well-being training.
Counselling support can also be brought in after a critical incident or work-related trauma. Counsellors with specialised trauma training can offer support to employees immediately involved, those who have seen the event, or concerned colleagues. Having a crisis management plan helps to prepare for such an eventuality.
Models of Counselling Service
The organisation employs counsellors, therefore, understands the organisation and culture. The potential disadvantage with this model of psychological therapy is that some clients may prefer a completely separate organisation due to concerns about confidentiality.
An external organisation (e.g. Employee Assistance Programme, see above,) provides the service. The advantage is that it is usually available for 24/7. The potential disadvantage is its remoteness from the organisation, meaning it does not fully understand the culture.
A mix of internal and external services, such as where an external provider carries out telephone support but refers to internal counsellors to give
face to face counselling. The advantage is that a joint service builds a better understanding of the organisational culture, whilst bringing flexibility and
Innovation. The disadvantages lie in that the two sides need to fully cooperate to make sure they can integrate properly.
4. Ad hoc
Engaging the services of a suitably qualified freelance or self-employed workplace counsellor on an ‘ad hoc’ basis. This provides a resource for smaller organisations or small numbers of referrals.
Adapted from British Association for Counselling and Psychotherapy copy of “Counselling in the Workplace” 2016 (paywall to access)
3. Cognitive Behaviour Therapy (CBT)
CBT is one of many therapies available and recommended by NICE1 as being the most effective; with the rider that “it is not effective for everyone”. The idea is that CBT is based on the concept that thoughts, feelings, physical sensations and actions are connected, also, negative thoughts and feelings trap you in a vicious cycle. Participants are shown how to change those bad patterns so they feel better. Unlike some other talking treatments, CBT deals with current problems, rather than focusing on issues from the past. It looks to improve your state of mind.
You can do CBT individually or with a group of people, or even a self-help book or computer programme which makes this psychological therapy one of the most flexible.
What Happens During a CBT Session?
Sessions are usually once a week or once every two weeks, and lasts between five and 20 sessions, with each session lasting 30-60 minutes. During the sessions, the therapist breaks down problems into their separate parts – such as thoughts, physical feelings and actions to see if they’re unrealistic or unhelpful. What effect is it producing? Therapists help work out how to change unhelpful thoughts and behaviours; then ask you to practice these changes in your daily life. You’re asked to bring the outcomes to the next session for discussion.
The aim of therapy is to teach the client how to apply the skills to daily life and stop having negative impacts on their life – even after the course of treatment finishes.
See leaflet from the Royal College of Psychiatrists on CBT or bit.ly/2pKQab3
4. Mental Health First Aid
Just as accidents have first aid to deal with the aftermath; so too does mental health issues in the workplace.
Mental Health First Aid (MHFA) is an educational course which teaches people how to find, understand and help a person who may be developing a mental health issue. In the same way, as we learn ordinary first aid, Mental Health First Aid teaches how to recognise the crucial warning signs of mental ill health.
MHFA courses also teach how to recognise the signs and symptoms of common mental health issues, provide help on a first aid basis and effectively guides someone towards the right support.
Some people prefer to help themselves so try these two sites as a starter:
Which Psychological Therapy will you Choose?
As you can see there are many different models and approaches to psychological therapy in the UK Workplace. If you are an employer thinking about providing support for your workers, this is the starting point for your research. But it’s important to realise that all of this comes at a cost so, before you sign on the dotted line, consider what your workers will feel confident enough to use and not just opting for the most or least expensive.
1 Depression in adults: recognition and management | Guidance and guidelines | NICE
Nice.org.uk. (2009). [online] [Accessed 17 May 2017]