Page 1

1st Quarter 2021 | VOL. 51 NO. 1

The magazine of the Employee Assistance Professionals Association

Adaptive Capacity:

Key EAP Strategies for the New Year |Page 10

Bonus! Read Cover Story for PDH! See page 5.


COVID Lockdown in Spain & Latin America Page 16

Coronavirus Q and A Page 20

Intervention for Executives & Professionals Page 26

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contents EAPA Mission Statement

1ST Quarter 2021 | VOL. 51 NO. 1

cover story


Adaptive Capacity: Key EAP Strategies for the New Year

| By Jeff Gorter, MSW, LCSW …2021 will center on pro-action as business leaders seek to forge ahead and reclaim the momentum they were experiencing prior to the turbulence of 2020. EAPs can support this effort by facilitating adaptive capacity.



Impact of COVID Lockdown in Spain & Latin America

| By Andrea Lardani and

Elena Sánchez Escobar

For the first time, we are receiving calls from employees’ parents, who are an at-risk group because of their age (older than 65). They present issues such as loneliness, sadness, and fears related to COVID-19. As a result, we had to recruit more affiliate psychologists to respond to this increased and specific demand.


Coronavirus Q and A: Practitioners Discuss Pandemic Challenges

The shift to a virtual format provided greater access to services. The visibility of our EAP has increased, and I believe its value has also been reaffirmed. …Remote work has its advantages, but employees who are extroverted hate working from home.



Intervention for C-Suite Executives & High-Level Professionals

| By Linda Fensler, MS, CEAP

To identify an impaired leader, it may be necessary to depend on the people around them to observe and confront the toxic behavior of the individual and build the skills necessary so a trained clinician such as the EAP can step in and intervene before it’s too late.


Video-based Counseling Shifts to the Mainstream

| By Marc Milot, PhD

The pandemic propelled digital counseling services into the mainstream, and they are likely here to stay. Offering the ability to select either EAP in-person or video-counseling is important as it provides the greatest flexibility to employees.

departments 4 FRONT PAGE

To promote the highest standards of practice and the continuing development of employee assistance professionals and programs. The Journal of Employee Assistance (ISSN 1544-0893) is published quarterly for $13 per year (from the annual membership fee) by the Employee Assistance Professionals Association, 4350 N. Fairfax Dr., Suite 740, Arlington, VA 22203. Phone: (703) 387-1000. Postage for periodicals is paid at Arlington, VA, and other offices. POSTMASTER: Send address changes to the Journal of Employee Assistance, EAPA, 4350 N. Fairfax Dr., Suite 740, Arlington, VA 22203. Persons interested in submitting articles should contact a member of the EAPA Communications Advisory Panel (see page 4) or the Editor, Mike Jacquart, by calling (715) 445-4386 or sending an e-mail to To advertise in the Journal of Employee Assistance, contact Cindy Chao at The JEA is published only in digital format since 1st Quarter 2019. Send requests for reprints of issues published BEFORE 2019 to Debbie Mori at ©2021 by The Employee Assistance Professionals Association, Inc. Reproduction without written permission is expressly prohibited. Publication of signed articles does not constitute endorsement of personal views of authors. Editor: Mike Jacquart Development Manager: Cindy Chao Designer: Laura J. Miller, Write it Right LLC

Index of Advertisers


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frontpage Challenges and Opportunities in the (almost) Post-COVID-19 World | By Andrea Lardani and Bernie McCann


s we get ready to release this first issue of Volume 51 of the Journal of Employee Assistance, many of us are continuing to struggle with the myriad of issues that characterized the year 2020. However, as we have always done, our role in the work environment is to offer a sympathetic ear, continued support, relevant information, and ongoing organizational guidance. The articles in this issue are resources to assist us do just that as we head into the New Year with admittedly some uncertainties, but also with renewed hope and optimism for a nascent and healthier 2021! Similar to other seminal events such as terrorism, financial upheavals, and previous disease outbreaks, two things seem evident from our response to the ordeals of 2020: 1) We have gained an advanced awareness of ourselves and our place in the world of work; and 2) We have technological and other tools that are adaptable and capable of meeting these ever-evolving challenges. As EAPs were forced to transition (often overnight) to meet the tectonic shifts in both levels and new modes of service delivery, it is this enhanced visibility and exigency that has once again reaffirmed the value of EAPs. Noting those positives Jeff Gorter, author of this issue’s cover story, explains the aspects of adaptive capacity that will move EAPs and their clients together in the New Year: Resilience, Response, and Resolve.

discuss the positive workplace and professional changes that will arise from this crisis. As Nancy Board states, “We are all much more resilient than we think.” Additionally, readers will find a new “tearout” resource on page 6 – Running the COVID-19 Marathon – Is the End in Sight? designed as employee wellness education, which may be reproduced and distributed freely to employees, family members, and others. We anticipate other one-page wellness handouts in future issues.

EAPA Communications Advisory Panel Andrea Lardani, Co-chair – Buenos Aires, ARG

Bernie McCann, Co-chair – Las Cruces, NM

Mark Attridge – Minneapolis, MN

Nancy Board – Seattle, WA

Daniel Boissonneault – Hamden, CT

Tamara Cagney – Discovery Bay, CA

Peizhong Li – Beijing, China

In another feature article about the impact of the novel coronavirus, my colleague, Elena Sánchez Escobar and I examine the effect of the lockdown on the global sectors of Spain and Latin America. In a review of first-hand experiences, a diverse group of EA practitioners, including Elena, share their thoughts in a question-and-answer article about the lessons learned from the pandemic. Like Jeff, they

Maria Lund – Columbia, SC

Elena Sánchez Escobar – Madrid, Spain

Radhi Vandayar – Johannesburg, South Africa

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and intervention methods are provided. Debuting in this issue of the JEA are two new colAlso, while video-based counseling was an umns. Dirk Antonissen discusses positives resulting emerging trend before the pandemic, EA profesfrom COVID in the Euro Trends column. Recognizing sionals are well aware how the pandemic sped up the importance of the Employee Assistance Certification this process exponentially. Commission (EACC), espeWhat is research showcially in light of changes ing about the differences coming to the CEAP® creGet your free PDH! dential, we introduce the A reminder that by reading this issue’s cover between virtual and inperson counseling? What Spotlight on EACC column. story and answering a 5-item multiple choice are some of the challenges In it, former commissioner quiz at, posed by video counselPaul Fitzgerald brings readyou can earn one free PDH. Upon compleing and how can they be ers up to speed what has been resolved? Marc Milot disgoing on regarding revamption of the quiz, contact Julie Rochester cusses issues important to ing of the CEAP®. ( to notify her that our profession. In another feature article, you have successfully completed the quiz, and Finally, with this issue, Linda Fensler discusses she will forward the earned PDH certificate. please welcome Elena the unique position and Sánchez Escobar to our considerations EA profesgrowing number of Communications Advisory pansionals may find when interventions involve C-Suite elists. She brings extensive experience in the global executives and high-level professionals. Strategies for delivery aspects of EA practice. v preparing, executing, and following up with support

Isn’t it time you earned your CEAP®? The Certified Employee Assistance Professional (CEAP®) certification is the only professional credential denoting mastery of the EAP body of knowledge and commitment to the ethical standards necessary for effective EA practice. For more information, visit

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Running the COVID Marathon: Is the End in Sight…?

Our struggle with the coronavirus pandemic, we’ve been repeatedly told, is a marathon, not a sprint. But marathons have a clearly defined finish line, no matter how distant. Unfortunately, the current state of the pandemic is anything but clearly defined. For many of us it is the unknown endpoint of the pandemic that may be the hardest part of how we are struggling to make it to the end. When the first pandemic measures: sheltering in place, working remotely, school shutdowns were announced, many of us felt we could put life on pause for a few weeks. We hoped those who said the pandemic would someday, like a miracle, just disappear were right. And when the situation seemed to calm down, those measures were often relaxed but then reintroduced as infections surged, still many felt we could do it again. And again. And again. Each time, though, it became harder, with some just giving up and resuming unhealthy, unsafe behaviors instead of hanging tough until this is all over. And more recently as news of promising multiple vaccines might allow us to start fantasizing about an end to the pandemic, then a now huge, fatal resurgence appears, accompanied by the prospect of some more difficult months ahead. Many of us are feeling that we can only hold our breath for so long, but the clear reality is that many vaccine manufacturing and distribution challenges lay ahead, with timelines all over the map. Yes, everyone is waiting for the surge to be over, the vaccine to ramp-up, and for things to go back to normal. But perhaps the best advice is to stay in the moment. For the months ahead at least, we will still be governed by the now familiar public health recommendations designed to avoid becoming infected yourselves and passing along the infection. These remain strict social distancing, stringent mask wearing, and frequent hand washing. It may be helpful to consider these quite necessary efforts as our personal civic duty rather than simply an exercise in freedom. 

    

There is truly one important thought that can help us stay the course and be there for the end. That we can believe eventually the pandemic will become an event that happened, rather than a period of time people struggled to live through. Some additional thoughts to see us through to the end include: Continue to take good care of yourself. Get plenty of rest, stay active, hydrate, and eat a healthy diet. Limit watching or reading the daily pandemic counts, to remain upbeat with a positive view to the future. Count your blessings, literally, the positive mental health benefits of gratitude are well documented. Remind yourself that our best and strongest resources during this time are one another, by looking out for others we ourselves are strengthened. Continue to reach into your personal reservoir of resilience to navigate the days ahead striving to remain vigilant, yet hopeful.

Editor’s note: This wellness article is provided by the Journal of Employee Assistance as a reader service, and may be reproduced freely and distributed to employees, family members, and the general public. 6 | JOURNAL OF EMPLOYEE ASSISTANCE | 1st Quarter 2021 | •• • • • • • • • • • • • • • • • • • • • | W W W . E A PA S S N . O R G |

 We’ve Gone Virtual!  EAPA Introduction to DOT/SAP Role Qualification Training has gone VIRTUAL!! February 9, 11, 16, 18 (4 sessions)

For more details visit 7 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • • • | JOURNAL OF EMPLOYEE ASSISTANCE | 1st Quarter 2021 |

legallines Keeping Up With COVID More Legal Guidance Presented

| By Robin Sheridan


s you may recall from the column in the 4th quarter 2020 Journal of Employee Assistance, the Families First Coronavirus Response Act (FFCRA) has two parts that can impact EA professionals: the Emergency Family and Medical Leave Expansion Act (EFMLEA) and the Emergency Paid Sick Leave Act (EPSLA). In our last issue, we addressed the impact of local/ state COVID-related ordinances, EEOC guidance, and the EFMLEA. Since that time, the US Department of Labor has issued additional FAQs and new regulations for compliance with the FFCRA. Accordingly, while our intent was to address EPSLA and COVID guidance from OSHA in this issue, we have focused instead on the new legal guidance.

participate in remote learning, the newly added FAQs state that parent employees are eligible to take paid leave under the FFCRA on days when their child is not permitted to attend school in-person and must instead engage in remote learning. However, eligibility is limited to times during which the employee needs the leave to actually care for their child and only then if no other suitable person is available. For purposes of the FFCRA, the school is effectively “closed” to the employee’s child on days that he or she cannot attend in person. Therefore, the employee may take paid leave under the FFCRA on each of the child’s remote-learning days (but not for the days in which the child is or could be attending school in-person). That said, if the school is giving parents a choice between having their child attend in-person or participate in a remote learning program, and the parent employee chooses the remote learning option, they are not entitled to take FFCRA paid leave. The DOL explains this is because the school is effectively not “closed” to the child due to COVID-19 related reasons. Of course, if, because of COVID-19, the employee’s child has been advised by a health care provider to quarantine or ordered to quarantine by a government entity, and the employee is needed to care for the child, the employee may be eligible to take EPSLA leave to care for the child even if the school is open.

New DOL FAQs Address Leave Due to School Closures Among other things, the EPSLA and EFMLEA provide a leave of absence when an employee is unable to work or telework because they are needed to care for one (or more) children when the child’s school is closed due to COVID-19 related reasons. The leave is only available to care for a nondisabled child if he or she is under the age of 18 or for a child 18 years of age or older with a disability who cannot care for him or herself due to the disability. If the child is over the age of 14 and the private-sector employer intends to claim tax credits for the leave payments, the employee may be required to provide a statement explaining what special circumstances exist that necessitate leave during daylight hours. Accordingly, when the child’s school has implemented a fully remote learning program, employees are generally eligible to take paid leave under the FFCRA while their child’s school remains closed. Similarly, when students alternate between days in which they attend school in-person and days they

New Regulations for FFCRA Given the critical need for patient care during the pandemic, and the fear that healthcare staffing shortages would undermine the country’s fight against COVID-19, the FFCRA provides that “health care providers” (and emergency responders) may be denied leave under the EFMLEA and the EPSLA. Therefore, even if the school of a physician’s child is 8

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closed, the physician is not eligible for leave under EFMLEA or EPSLA. Originally, the definition of “health care provider” was very broad and encompassed anyone employed at a health care employer, anyone employed at an entity that contracted with a health care provider to provide services or to maintain the operation of the facility, and anyone employed at an entity that provided medical services, produced medical products or was involved in making COVID-19 related equipment, tests, drugs, vaccines, diagnostic vehicles or treatments. Accordingly, anyone who worked at a hospital (or doctor’s office or nursing home, etc.), or who worked for the food service provider of a hospital (or nursing home, etc.), or worked for a manufacturer of face masks could be denied, and probably were denied leave under the FFCRA so that the organization could continue to operate at full force in the fight against COVID-19. As of September 11, 2020 the new regulations (known as the Revised Rule) significantly narrowed the definition of “health care provider” and, as a result, employees who do not fall under the new definition are no longer exempted from the EPSLA or the EFMLEA and are eligible for the leaves of absence. Under the Revised Rule, working at a health care facility does not necessarily mean that an employee is a “health care provider.” The revised definition of a “health care provider” is now:

the definition of a “health care provider” even if these employees were employed by a hospital (or other healthcare organization) or supported an EAP or other healthcare program: IT professionals, building maintenance staff, human resources personnel, cooks, food services workers, records managers, consultants and billers. Employees who do not meet the new definition of a “health care provider” are now eligible for leave under the FFCRA, even if their services could detrimentally affect the provision of health care services. Summary EA professionals should continue to stay current with employer policy, public health directives, and changing regulations in order to accurately advise their clients and to ensure that they maintain a safe work/meeting place for themselves and their clients. Our articles and alerts are provided for informational purposes only. For ethical reasons we cannot— outside of an attorney-client relationship—answer specific questions that would be legal advice. For legal advice regarding how the issues in this article relate to your circumstances, we recommend that you seek out your regular counsel who can provide appropriate context and advice for your situation. Robin Sheridan is an attorney with Hall, Render, Killian, Heath & Lyman, P.C., the largest health care-focused law firm in the country. Please visit the Hall Render Blog at for more information on topics related to health care law. She may be reached at

 A “health care provider” as defined by the FMLA’s regulations which includes doctors, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, nurse practitioners, nurse-midwives, clinical social workers, physician assistants, certain Christian Science practitioners and certain other designated health care providers; and  Other employees who are employed to provide diagnostic services, preventive services, treatment services or other services that are integrated with and necessary to the provision of patient care and, if not provided, would adversely impact patient care.

The Journal of Employee Assistance The Journal of Employee Assistance seeks more thought-provoking discourse among EAPA members (and JEA readers). One great way of doing that is by submitting a letter to the editor on an article you’ve read in the Journal. For more information, contact the editor.

While it appears that EA professionals would continue to meet the definition of healthcare provider and, could still be excluded from leave under EPSLA and EFMLEA, the Revised Rule provides examples of many employees that no longer meet

Mike Jacquart, (715) 445-4386 or email 9

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coverstory Adaptive Capacity

Key EAP Strategies for the New Year | By Jeff Gorter, MSW, LCSW


Adaptive Capacity Adaptive capacity (AC) refers to a leader’s ability to respond with a purposefully positive regard to an unexpected shock or challenge, such as the pandemic. It’s grounded in an attitude rather than an action plan in which “if I don’t think about the problem correctly, I’m not likely to arrive at the correct solution.” It needs to be stressed that a “purposefully positive regard” does NOT mean minimizing the challenge or slapping a happy face on a painful situation. Rather, AC is about self-efficacy – the recognition that says, “While I may not have created this problem, where it goes from here is up to me!” There are three aspects to adaptive capacity:

t goes without saying that 2020 was a year like no other. An unprecedented series of challenges included the COVID-19 pandemic, civil unrest, widespread economic distress, catastrophic wildfires, a record-setting hurricane season, and the most divisive election cycle in memory. If it feels like you have been running a marathon, it’s because you have! But employee assistance professionals are no strangers to chaos. Dealing with the unexpected, responding to crisis, and managing the human side of business challenges are core competencies of any top-tier EAP, and EA professionals have

“By intentionally cultivating adaptive capacity, EA professionals position business leaders and their organizations to not just survive, but to thrive in the next normal.”

• Resilience: Absorbing/withstanding the initial impact in a positive fashion (primarily demonstrated in the early stage of the pandemic, Q1 & Q2 of 2020). • Response: Adjusting to the pandemic by mitigating damage and restoring stability (as seen during Q3 & Q4 of 2020) • Resolve: Identifying and seizing opportunities presented by the new dynamic (in planning and strategizing for 2021). By intentionally cultivating adaptive capacity, EA professionals position business leaders and their organizations to not just survive, but to thrive in the next normal.

answered the call in amazing and creative ways, as always. As we move into 2021, it is the right time to consider what course corrections and “lessons learned” we want to apply to the New Year. If 2020 was about reaction, 2021 will center on pro-action as business leaders seek to forge ahead and reclaim the momentum they were experiencing prior to the turbulence of 2020. EAPs can support this effort by facilitating adaptive capacity.

Learning Culture Adaptive capacity embraces a learning culture where creativity, experimentation, and innovation are encouraged. Stressful situations, particularly prolonged ones such as the pandemic, tend to make us rely on the things we are familiar with, the “tried and true” ways we have handled challenges in the past. 10

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While previous experience informs our strategies, doing what we’ve always done will only get us what we’ve always got. Or to put it another way, I don’t want to be well-equipped to survive in a world that no longer exists! A novel virus requires a novel solution. By cultivating a climate of curiosity, EAPs can guide leaders to affirm with their teams that it’s safe:

will help me feel in control again and guide my next decision. But spending too much time on social and other media drains energy and feeds discouragement if left unchecked. Zoom Fatigue: While it may seem minor to some, many leaders report that virtual meetings– while a valuable and necessary adaptation–are physically and emotionally draining in ways that traditional face-to-face meetings are not. It takes more energy and focus to truly engage and connect at a meaningful level. Even simple “glitches” like unmuted participants, barking dogs, or “cute invaders” (i.e. children) can bring a laugh and inspire gentle camaraderie (“I get it…we’ve all been there!”) But they can be subtly exhausting. Face it…when was the last time a toddler wandered through the Board Room during a critical business meeting? Many effective leaders are “people persons” and were energized by the human contact and

• To ask questions; • To “not know;” • To brainstorm; and • To be comfortable with uncertainty as we pursue unique solutions. Now this doesn’t mean lowering of performance standards or accepting something less than excellence, but simply recognizing that you can’t solve a new problem without generating new solutions… and no one hits a home run every time at bat. If your team believes that failure will be punished and risk is too “risky”, the EAP has squandered a key resource. Risk Factors To be sure, creativity and adaptation requires energy, and the extended physical and emotional drain we’ve all experienced can impair a business leader’s adaptive capacity. As a result, EA professionals can support and educate leaders on the four types of fatigue that have commonly been reported in the current environment: Decision Fatigue: The unexpected and unprecedented nature of the COVID-19 pandemic has required leaders to make a host of decisions, personally and professionally, in response to the ongoing crisis. Being decisive is certainly not new territory for a business executive, and many leaders often describe a kind of “rush” when faced with a challenge and then subsequently rising to that challenge. But while solving problems and generating solutions is one of the most affirming aspects of leadership, it can also leave one incredibly weary when each and every day brings a new set of problems and yesterday’s solutions no longer apply. “Doom scrolling” is another related but subtle source of exhaustion – that is, constantly checking and rechecking news and social media reports in a futile attempt to gain “that one morsel of information” that

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coverstory creative energy generated by being in the physical presence of their talented teams. For many, work is being done in isolation and we simply miss our “work family.”

 Be patient with yourself, and others: We have not faced something exactly like this as a nation in over 100 years. We are all doing the best we can in an utterly unfamiliar situation – strive for progress not perfection and give yourself a break. Support and embrace failure – learning and innovation only come in a safe environment where trying…and not success…is encouraged.

Compassion Fatigue: The stress, strain, anger, and grief experienced by so many people during recent months often falls squarely on the shoulders of an Emotionally Intelligent business executive. Engaged leaders know when their teams are hurting, and many tend to take it personally when the pain has no easy or immediate answer. Add to that the fact that they are people too–many have had friends, neighbors and loved ones who have contracted the virus, and many have not recovered. Balancing their personal and professional needs is no easy task. Despite all best efforts, COVID-19 remains a real and unavoidable source of distress for the foreseeable future, both for executives and employees alike. (Editor’s note: If you haven’t already, check out and complete the “Are YOU Suffering from Compassion Fatigue or Burnout?” self-test questionnaire in the third quarter 2020 JEA.)

 Lean into the narrative: While we did not choose this global crisis, we do have to respond to it – this is our moment! Like so many major crises in history the past, how we manage this challenge will define us, both individually and collectively. Effective leaders seek to inspire their teams by affirming the value of their efforts/ contributions in the larger context of COVID-19 response/recovery. For example, many healthcare workers have found their efforts to be personally affirming, recognizing that they are providing frontline care in a national crisis – a worthy and heroic endeavor. This doesn’t negate the very real sacrifices many of them have made, but many report that recognition sustains them during times of discouragement. Finding and attributing meaning – a larger purpose – in a challenge or struggle adds perspective and reframes suffering, leading in many cases to posttraumatic growth.

Cumulative Fatigue: Simply put, this is the previously mentioned types of fatigue (and others), stacked on top of each other. It’s easy to miss – or dismiss – in ourselves. The unprecedented size, scope, and duration of this pandemic is draining everyone, regardless of your specific job or role, and it can be difficult to maintain one’s own morale, much less those who look to you for leadership. And it’s not like the other more “mundane” aspects of life have taken a break – “stuff still happens.” Challenges with parenting, relationships, elder care, finances, etc. continue just as they always have, only now I may have fewer emotional reserves to address them. Unaddressed cumulative fatigue leads to a “settling” or entrenchment into a survival mode (reactive stance) and thus cuts off creativity, necessary for a more proactive stance.

 Seek outside input: Successful business leaders have identified trusted colleagues, mentors, and advisors they can turn to when the creative well runs dry or when energies are running low, and savvy leaders include their EAP in this list EAPs offer a ready resource to leaders for consultation, coaching, and targeted trainings to reduce isolation and enhance a strengthsbased solution focused approach to the challenges ahead. Establishing regular periodic “check-ins” with support networks can offer a fresh perspective and helps hold leaders accountable to selfdetermined goals.

Strategies to Maintain Adaptive Capacity EAPs are uniquely positioned to provide the expert guidance and behavioral health resources needed to move ahead. The following strategies have proven helpful with business leaders and line workers alike:

 Engage your team in the process: In the midst of a crisis, many business leaders tend to isolate, believing the responsibility rests solely with them. EA professionals routinely coach leaders to give up an “I alone must solve this” approach, and 12

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instead embrace an “I have a deep bench” mentality, empowering their teams to participate in the problem-solving process. As mentioned earlier, by actively encouraging a learning culture, leaders tap into the creativity and energy of their teams, who are often equally motivated to see stability and productivity return to their workplace. Even simple strategies like hosting a creative listening session with employees or even having an old fashioned “suggestion box” can generate surprising innovations to meet the current need. Besides giving them ownership and investment in solutions, research shows that employees support initiatives that they had a role in creating (“my voice can be heard and matters”).

Tips for Increasing Use of EAPs


ost organizations are not reaping the full financial benefits of having an EAP. Business Management Daily offers the following suggestions for boosting use of the EAP:  Make it convenient. Employees are more likely to use the EAP if counselors are a short drive from work, or they can access them 24/7 by phone or online.

 Commit to “aggressive” caretaking: For many leaders, taking care of themselves is an afterthought, and only when they have time after the “work is done” (which is to say…never). Running the marathon of pandemic response requires a disciplined, intentional commitment to regular and consistent self-care – pursue this objective with the same intensity you employ in any business initiative. Both EA professionals and business leaders need to put THEMSELVES on the calendar, and hold that time as “sacred”, just like any critical business meeting.

 Emphasize confidentiality. Employees are more likely to use EAP services if they are not concerned about co-workers knowing about it.  Host wellness seminars. For instance, free lunchtime “brown bag” sessions on topics like stress management or time management.  Inform families. Let employees’ families know they can contact you. Offer information about your services, hours, and phone numbers.

Summary Although 2020 brought unexpected challenges and disruption on an unprecedented scale, EA professionals have played a key role in helping organizations weather the storms. As we all look ahead to a new year, EAPs will continue to guide this next phase of recovery. By encouraging and facilitating adaptive capacity, we can all emerge stronger and better positioned for a successful future. v

 Publicize, publicize, publicize. Promote your EAP regularly through emails, website updates, and free posters and refrigerator magnets that list hours and phone numbers.  Remind employees there’s more to EAP than they might think. Stress that the EAP is available for personal reasons such as financial concerns, relationship counseling, and others.

Jeff Gorter, MSW, LCSW, is VP of Crisis Response Services at R3 Continuum. Mr. Gorter brings more than 30 years of clinical experience including consultation and extensive on-site critical incident response to businesses and communities. He has responded directly to the Sept. 11 terrorist attacks, Hurricane Katrina, the Virginia Tech shootings, the Deepwater Horizon Oil spill, the earthquake/tsunami in Japan, the Newtown Tragedy, the Orlando Pulse Nightclub Shooting and the Las Vegas Shooting. He may be reached at

 Encourage staff to bookmark the EAP. Add a link on a company intranet to the EAP site.  Train supervisors. Teach them how to recognize work problems and to recommend using the EAP as an option for improving work performance. v 13

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eurotrends COVID-19 Changes Needn’t be Negative | By Dirk Antonissen


early twenty years ago, former EAPA CEO John Maynard wrote in this magazine: “Employee Assistance is the application of knowledge about behaviour and behavioural health to make accurate assessments, followed by appropriate action to improve the productivity and healthy functioning of the workplace” (Maynard, 2004).

 Employees miss the personal contact and proximity of their colleagues.  Work-life balance can also be affected negatively. For instance, working in the same house with (young) children around can lead to stressful situations. Spending additional time together with spouse and/or children with few variations to usual outside-the-home routines can lead to interpersonal conflicts.

Indeed, two decades later, improving the productivity and healthy functioning of the workplace remains a challenge – even more so in light of COVID-19 restrictions in which remote work (telework) has become the new workplace standard. Telework marks a radical change for many employers and employees, and this certainly includes Europe. But change does not have to be negative. Notwithstanding all the troubles that COVID-19 brought to workplaces, many employees seem to appreciate some of the adaptations that came with lockdown and obligatory home and telework. Pulso Europe conducted some quick informal surveys via social media. Although this was a non-academic survey and the number of responses was limited (+/- 100), it was interesting to see the responses about the lockdown period, some of which were quite positive:

Observations from employees like these aren’t exactly “news” to employers – what has changed most is that for many companies, work in the postCOVID era will not be the same as it was before. Telework and homework will continue to exist. In our survey, most employees consider an ideal work week to be a combination of several workdays at the office and a couple of days at home. Adapting our Approach While the work situation marks changes for the employee and the employer, the challenge for us – as employee assistance professionals – is to adapt our approach to this new reality. Did we, or are we, adapting our approach in such a way that in the words of John Maynard, “the productivity and healthy functioning of the workplace is improved” – knowing that the workplace now is often “home” and the work often became “telework?”? In a certain way I believe it did! In Europe, we observed a radical shift of our counselling approach. Where in many European countries face-to-face counselling was still the pre-COVID standard, telephone or video calling substantially replaced this traditional counselling method. However, is this method sufficient? It’s important to not become too complacent. As Jesuits say to their students: “Plus est en vous.” In English, “There is more in you.”

 Compared to working in an office setting, most employees indicated that they work more efficiently from home.  When asked about the most important work improvement since COVID, most employees mentioned having a referred to greater balance between work and personal life: No traffic time leads to less stress … and more time for family. At the same time, this new way of working has also led to perceived negative effects: 14

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We can do more! And indeed …more is in us. Employee assistance practitioners can do more and better. We need to take advantage of this COVID period and use it as an opportunity to introduce new approaches. In our EAP field, we – as EA professionals – too often behave much like the doctors and the nurses on the work floor. We help individuals and teams when they suffer with psychosocial and work-life issues and are often very successful. This is necessary, but it isn’t enough. We can have greater impact on the individuals that we serve. As it stands, employees often come to us when they have serious complaints or difficult challenges to deal with. In our opinion, EA professionals should not wait for the employees to contact them, they should reach out to employees before difficulties arise. Understanding how employees perceive their work (often home) situation and what motivates them – conversely what causes stress – is crucial to is being more proactive.

The Pandemic Opportunity The current pandemic is an ideal opportunity to address these issues! Indeed, most companies want to help employees at home, they want to know how they’re doing, and they want to know how they can help their employees remain healthy and productive. They will appreciate our advice! We can help by setting up frequent and neutral surveys as a barometer to help maintain this “pulse”. Effective survey tools – the Workplace Outcome Suite being but one example – will help EA professionals monitor crucial indicators like stress, engagement, and absenteeism. But that isn’t enough. It’s also vital to clarify the groups specifically at risk and understand why this is the case. Which are the most impact factors? The Wellbeing and Organisational Dynamics Tool (see ) is such a survey tool that can combine both. Of course, surveys alone are not sufficient. They are important tools, but EA professionals must disseminate, understand, and interpret the results to take appropriate action. Try it! v

Consider and Ask these Important Questions! In an era when the employee is literally out of sight of the employer, many managers do not know what is going on with their colleagues. It’s vital to consider, and ask the following questions:

Dirk Antonissen is Partner of Pulso Europe, a spin-off of the Leuven University with offices in several European countries. Pulso Europe is a reference company in the field of innovative evidence-based tools and services for assessing and impacting psychosocial well-being. In 2019, Dirk received the EAPA Global Champion Award, presented to an individual who has demonstrated outstanding initiative and best practices in growing the employee assistance profession anywhere in the world. He may be reached at

• Does the employee have relevant/ sufficient/ interesting tasks to do? • Is the employee able to work efficiently? • Is the employee’s home environment okay, in fact to work? • Has the employee been able to change an unhealthy lifestyle? • Does the employee have contact with, and/or feel supported by management? • What about teamwork? Is there still social bonding with other colleagues?


Maynard, J.B. (2004), Maintaining our heart, Journal of Employee Assistance 34(2), 36.

Most employees will not reveal answers like this right away. But asking them remains vital as an important step to gauging employees’ work engagement and productivity. Negative responses will lead to complaints of stress and burnout. Employee assistance professionals need to intervene faster. We have the knowledge, skills and (survey) tools to help companies improve engagement and productivity at a time when so much work is not being done at work. 15 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • • • | JOURNAL OF EMPLOYEE ASSISTANCE | 1st Quarter 2021 |

featurearticle Impact of COVID Lockdown in Spain & Latin America

| By Andrea Lardani and Elena Sánchez Escobar


he COVID-19 pandemic has demanded that employee assistance professionals deal with abrupt changes in the workplace, differences that may include the experiencing and managing of new emotions. What is the psychological impact of a worldwide lockdown on workers? How are they coping with remote work? What do they need from their employers? Are there differences between Spanish and Latin-American responses? Our organizations collected and analyzed 693 questionnaires to answer these very questions. This article will present key results analysis as well as discuss how EAPs are responding to this unprecedented time. One point is clear: EAPs need to show companies that well-being policies are more important than ever.

Essential workers indicated high level of anxiety (38% in this group) due to their level of exposure, and yet they reported being very optimistic (30%) about the future. Permanent exposure to risk may increase sense of control and optimism towards being able to change the situation. No statistically significant differences were found regarding gender. Considering age, we have been able to verify how calmness increases with age, which is also true in Latin America. In Spain, 27% of the participants between 18 and 30 reported feeling calm compared to 67% reported by those over 65. In Latin America 60% of this last age group reported feeling calm during lockdown. According to Gooding, Hurst, Johnson & Tarrier (2012) adults are more resilient in emotional regulation and problem solving while young people are more skilled in recovering with social support. The youngest age group (18-30) reported less difficulty in identifying and naming their emotions in both Spain and Latin America.

Survey and Participants The survey was designed and implemented in April 2020 by Yees in Spain and in Latin-American countries by Grupo Wellness Latina in September 2020. We used an online questionnaire that included 15 open and closed questions. We obtained quantitative and qualitative data from participants between 18 and 65 years of age. Open questions allowed participants to express their thoughts freely. Clinical teams in Spain and Argentina – fifteen persons – analyzed answers.

Latin-American respondents – from Argentina, Chile, Venezuela, Costa Rica, Mexico, Colombia, and Peru – reported predominantly experiencing anxiety (46%) and stress (39%). Anxiety was higher in individuals between 18 and 30 (67%), which may be related to uncertainty about their future and less experience in coping with crisis as opposed to the over 65 age group, who reported predominantly feeling calm. Conversely, nearly half (48%) of respondents ages 31-45 felt overwhelmed by stress. This age group is likely to be coping with additional family demands, such as helping their children with classes, taking care of toddlers, and even supporting elder parents.

Emotions Different emotions and feelings were experienced during lockdowns in Spain and Latin America. In Spain, respondents indicated a parity of conflicting emotions. That is, the simultaneous coexistence of apparently contradictory emotions, such as anxiety and calmness, or optimism and sadness. At almost 40%, calmness was the most frequently mentioned emotion. The imposition of telework and “stay at home” to avoid contagion implies an emotional reaction of security, which is tarnished, however, by strong anxiety (33.5 %) when returning to the office.

Anxiety is higher in teleworkers (54%) than in essential workers and employees who are in their usual work environments. This might be related to uncertainty about returning to their usual workplaces 16

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and greater difficulties in work/life balances when working from home. Managers and directors reported more optimism (40%) and less fear (5%) than other workers. This may be useful in designing well-being plans with managers taking the lead in teaching other groups how to cope with adversity with optimism. Conversely, fear was highest in essential workers (25%), which may be due to the level of adapting they’ve had to do to protect themselves from the risk of contracting the coronavirus.

“I am concerned about my elderly relatives’ health and guaranteeing my family the necessary resources.” (Latin America) “I feel overwhelmed having to work, take care of the children, help them with school, housework, everything at the same time.” (Latin America) Work and Coping Strategies During Times of Crisis What areas in life were most affected during lockdown? We asked participants which of the following aspects impacted them the most: a) keeping pace with work, b) exercise, c) sleep, d) time management, e) balanced diet, f) relationship with friends and family and g) other.

Latin-American respondents reported experiencing less sadness and fear than in Spain (15 and 12% versus 30 and 24% respectively). This may be because COVID19 arrived and spread later in Latin America, so sadness related to losses and fear toward re-opening are still not significant. On the other hand, anxiety and stress are higher in Latin America than in Spain (see Table 1).

Table 2: Most difficult areas to manage during lockdown in Spain and Latin America. Most difficult to manage

Table 1: Most frequent emotions during lockdown in Spain and Latin America. Emotions


455 respondents

Latin America 238 respondents

Spain 455 respondents

Latin America 238 respondents

Keeping pace with work









Time management



Balanced diet






















Relationship with friends & family











Don´t know how to express them



* Most difficult for Spain ** Most difficult for Latin America

Difficulty keep pacing with work was the highest for respondents in Spain with exercising in second place. The lockdown has not reduced job demands; the same levels of performance are expected, and family lives may have higher demands with children at home. This stressful situation combined with reduction in physical exercise may enhance sleeping difficulties.

* Most frequent in Spain ** Most frequent in Latin America

Examples of phrases shared by respondents: “I have contradictory sensations, although there are days I feel overwhelmed, I also feel it was good to reduce speed.” (Spain) “I feel uncertain and I have some fears about possible consequences, but I also feel optimistic and responsible for staying home.” (Spain)

In Latin America exercising (45%) was the most frequent difficulty mentioned, closely followed by time management (41%). Lockdown, with closure of gyms and sports, has significantly reduced options for 17

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featurearticle physical exercise in spite of its necessary for mental and physical health. The abrupt reduction of physical activity combined with the difficult challenge of balancing work, family demands, and increased housework may well explain the high levels of anxiety and stress mentioned by Latin-American respondents. In spite of the obstacles, 66% of participants in Spain and 76% in Latin America perceive themselves managing lockdown positively. This demonstrates how human beings from different continents react with resiliency towards this world pandemic. Some textual phrases expressed by participants:

of their age (older than 65). They present issues such as loneliness, sadness, and fears related to COVID-19. As a result, we had to recruit more affiliate psychologists to respond to this increased and specific demand. We also incorporated new webinars with specific tools to support employees and their family members during the pandemic. Utilization of these webinars and our wellbeing platform have increased during lockdown. One company client in Argentina had half (50%) of its employees infected with COVID-19. Human Resources asked their EAP provider if psychologists could call each of these employees, find out how they are doing, inform them about the EAP, and offer counselling sessions. Another company in Mexico asked their EAP to coordinate focus groups for employees to discuss possible work changes after lockdown and how to cope with them. These are new and atypical requests that were provoked by this pandemic.

“I feel hopeful that all this will end.” “I try to stay calm and keep going.” “I feel tired but grateful that my family is healthy and that I have a job.” “I try to value simple things, I miss hugs.” “I live one day at a time, trying not to break the routine both at home and at work, connecting with nature and looking for pleasant family activities that allow us to cope with lockdown.”

Summary EAPs need to be flexible and adapt to the new reality of COVID-19. We need to listen not only to the decision makers in our client companies, but also to end users. We should be aware that mental health symptoms may have late onset (six months after the end of lockdown). Training in emotional self-knowledge (“Which are my emotions? How may I regulate them? When should I ask for help and where?”) will help workers identify signs of potential risk and take responsibility for their vigilance and self-care. Expanding services to provide broader health care coverage may be a path worth exploring. Musculoskeletal disorders, eating disorders, and substance abuse may have increased during lockdown as well as after re-opening. Stress can be reflected in muscle tension or related illnesses such as headaches. There is also evidence about the relationship between anxiety, anguish, stress, and substance abuse (Alexander, 2012). The pandemic has also increased the risk toward different addictions such as drugs, video games, internet and food (Rojas-Jara, C. 2020). In Latin America, both before and during COVID19 lockdown, companies began requesting EAPs to include other services as nutritional consultations, ergonomic professional advice, online stretching classes, and specific hotline assistance for gender violence. Gender violence, including femicides, has increased due to lockdown (Lardani, 2020).

How are EAPs Responding? Telephonic assistance and digitalization of services were already present before the pandemic. COVID-19 has done nothing more – nor less – than to increase visibility of the value of having an EAP as a preventive and assistance tool. In Spain, the number of calls decreased at the beginning of the pandemic to our surprise. We realized that employees did not have an intimate place at home to talk about their problems. Therefore, we launched e-mail counseling, which had not been implemented in Spain before, and it was very well received, increasing utilization. For return-to-work offices, Yees created the Welcome Back Program with self-care guidelines for employees and managers that included recommendations and an activities calendar. This program, along with emotional support, was the most requested EAP service. At Grupo Wellness Latina in Latin America, online and telephonic psychological utilization increased 45% compared with the same quarter in 2019 (July, August, and September). Consultations related to anxiety, stress, fears and work-life balance during home office were the most frequent complaints. For the first time, we are receiving calls from employees’ parents, who are an at-risk group because 18

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In Spain and in many Latin American countries, mental health assistance remains a stigma, but the pandemic crisis has accelerated this shift in paradigm. Organizations are now placing emotional care and mental health of employees as a greater priority. Yees has developed a program that is supporting 10,000 workers of an important insurance group. The program includes a complete assessment of needs, psychological assistance, emotional debriefing groups for workers on the front line, grief support groups for workers who have lost family members due to the pandemic, training in coping skills, and a strong communication campaign to help strengthen the sense of belonging (minimizing the impact of emotional burnout). All told, there is no question the COVID-19 pandemic has been a challenging time for EA professionals, employees, and employers alike. But the crisis has also brought to light a number of opportunities for EAPs, some of which are presented in this article. The keys lie in being flexible, adaptable, and taking advantage of these possibilities when they arise! v

OPS/OMS (2020). Consideraciones psicosociales y de salud mental durante el brote de COVID-19. consideracionespsicosociales-salud-mental-durante-brote-covid-19. Gooding, P.A., Hurst, A., Johnson, J. & Tarrier, N. (2012). Psychological resilience in young and older adults. Journal of Geriatric Psychiatry, 27(3), 262-270. Alexander, B. K. (2012). Addiction: the urgent need for a paradigm shift. Substance Use & Misuse, 47, 1475-1482. .3109/10826084.2012.705681. Lardani, A. (2020). How Covid-19, gender violence and femicide intersect in Latin America. Journal of Employee Assistance, 50(3), 18-21.

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Contact Cindy Chao, Development Manager: (303) 242-2046,

Andrea Lardani is the Director at Grupo Wellness Latina. She has extensive experience in developing and managing EAPs and wellbeing programs for multinational companies, as well as in training and leading affiliate networks and teams in Latin America. She may be reached at Elena Sánchez Escobar is Clinical & Operation Director at Yees. She has over 12 years’ experience in global healthcare, wellness and EAP operations, and account management. She may be reached at


Brooks, S. K., Webster, R. K., Louise, •, Smith, E., Woodland, L., Prof, •, Wessely, S., Prof, F. •, & Greenberg, N. (s. f.). EL IMPACTO PSICOLÓGICO DE LA CUARENTENA Y CÓMO REDUCIRLA: REVISIÓN RÁPIDA DE LA EVIDENCIA. Recuperado 13 de noviembre de 2020, de https://www.thelancet. com/journals/lancet/article/piis0140-6736. Rojas-Jara, C. (2020). Cuarentena, aislamiento forzado y uso de drogas. Cuadernos de Neuropsicología/Panamerican Journal of Neuropsychology, 14(1), 24-28. CNPS/14.1.203. Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi. org/10.1177/1745691614568352. Facultad de Psicología de la Universidad de la República (2020). Cuidado comunitario Subtítulo Frente al Coronavirus COVID19.

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featurearticle Coronavirus Q and A

Practitioners Discuss Pandemic Challenges


HR teams regarding the reality of the employees’ situation (especially during confinement). An indirect consequence of this challenge is that it reinforces the idea of the EAP as a tool limited in time and only for the most challenging moments, rather than as a preventive health and safety tool. In addition, our counsellors were addressing complex emotional issues, and the volume of calls or other contacts grew significantly. Stress increased, so we had to put support in place for our practitioners.

he Journal of Employee Assistance had the opportunity recently to ask EA practitioners about the impact of the COVID-19 pandemic on their professional and personal lives. (Respondents were given the option of remaining anonymous as noted *) The following is an edited summary of those responses: Q: What is the biggest challenge the pandemic has posed in terms of your personal practice (EAP) and what have been a few of your most important responses to these challenges?

Nancy Board: Pivoting on a dime to stay ahead of anxiety and unknowns. Proud that my EAP quickly came together to offer our first webinar on self-care March 17th and we’ve since offered over 145 webinars and have had more than 21,000 employees attend various webinars on different aspects of coping.

A: Bryan McNutt: Remote work, certainly, but the shift to a virtual format also provided an opportunity to increase access to services. Our internal EAP escalated the number of workshops, groups, and trainings, which have also seen higher utilization rates as well as overall. The visibility of our EAP has increased, and I believe its value has also been reaffirmed.

Peizhong Li: The biggest challenge has been not having enough tools and resources to help the organizations and employees in need. This has made referral more difficult.

*Christine Chapel: The biggest challenge is that people are taking a long time to make decisions because no one knows when the pandemic will be over, so EAP buyers sit on the fence. The way to respond is to get creative. Offer services you have never previously offered: “Pandemic Support Groups,” “Life Coaching”, lunch-and-learn offerings focused on anxiety reduction, support for parents of school aged children, etc.

Q: What is the biggest challenge the pandemic has posed in terms of your own life, and, if applicable, the impact that has had on your practice? A: Bryan: I have been faced with the challenges of emotional fatigue, low morale, and hampered motivation, as well as a general sense of grief due to the collective trauma and loss that many people are experiencing. I’ve had to adjust my expectations of performance and be creative with self-care.

Dan Boissonneault: The company to its credit had a comprehensive COVID action plan, but it took a lot of time to get employees to focus on it. I instructed my EA direct reports to monitor the plan and repeat it, on script, to maintain one voice.

*Christine: My position was eliminated, and I had to reinvent myself. I now provide life coaching, EAP consulting services, and create training programs on the cutting edge Gnowbe platform.

Elena Sánchez Escobar: We had to address the immediate needs of our clients at a time when our team was hardly getting proper feedback from clients’ 20

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Dan: Social isolation due to working from home dulled my ability to pick up on the non-verbal as well as I used to. The dynamic of the domestic relationship changed with both of us working from home. In addition, the office protocol of not “bothering” one another during the workday bled over into the off hours, and we became a lot more formal than we normally were. Formality felt like distance.

accustomed to remote work and were able to transition well. Others, such as lab-based research, were significantly challenged. Some employees have valued the fringe benefits of remote work, while others have been overwhelmed by the simultaneous demands of work and parenting. *Christine: We discovered that doing one’s job at home is different than the workplace. Some employees are distracted by their children at home. Zoom calls are fatiguing and not the same as in-person meetings. Remote work has its advantages, but employees who are extroverted hate working from home. It is definitely not for everyone. Many companies have reported that their workers are “checked out.” Everyone is worried about the pandemic and wondering when a vaccine will be viable. There is uncertainty in every direction. It makes it hard to focus. In terms of engagement, I have seen a rise in company virtual “Happy Hours,” and Trivia Nights. Time will tell if these were effective.

Elena: Serving as clinical director, wife, mother, and newly appointed “teacher” of my three children at home has been challenging and involved astronomical multitasking. I believe I’ve managed to minimize the impact on my practice. Nancy: The day-to-day impact of COVID touched me quite personally. My father died in April, and I navigated his healthcare challenges remotely for six weeks. He was hospitalized twice in six weeks and had emergency surgery. I could not be there in person to properly support nor hold a proper funeral, service or burial. Then my developmentally disabled brother tested positive for COVID 19. It felt like a punch in the gut. His entire home of 10 residents tested positive, including 50% of the staff. I have had three friends with COVID, two were hospitalized and one had to have open heart surgery. Two other friends’ fathers died of COVID-19. The silver lining in it all has been daily hikes and walks in nature to stay sane, calm, and grounded through it all. My gratitude has grown, my resilience is greater, and my love for humanity and the simplest gifts in life have been enriched.

Dan: I believe that the longer this lasts the more like gig workers many people will feel. The sense of community is lessened. A small group of people continued to work in my office since their jobs necessitated it but mine could be done from home. The first time that I needed to return to do an SAP evaluation after a few months, I felt disconnected from the daily goings on. In terms of EAP, it’s harder to observe changes that normally would prompt an intervention. My fear is that issues may be unrecoverable before an EAP referral is made.

Peizhong: The restrictions on travel and social activities. Travel for family and business purposes has been impossible for months. Many social services such as childcare and libraries have been closed also.

Elena: The disappearance of informal interactions between co-workers is a reality for remote workers, and the emotional bond to the company is weakening. I do believe that employees’ engagement can be positively affected if organisations invest in promoting all employees (not only remote workers) health care. Many organisations still have to demonstrate genuinely they participate in the well-being of their employees and not delegate it to National Health Systems when these authorities are already under tremendous pressure. This is particularly true for European organisations.

Q: In terms of the increased numbers of remote workers, do you see employee engagement with their employers as a problem going forward? If so, what can employees and/or employers do about it? Regardless, what do you see as some pros and cons of remote work? A: Bryan: In the diverse university setting that I work at, the change to remote work has affected each department differently. Some units were much more

Nancy: Companies that could not possibly consider a remote workplace pre-COVID 19, now see 21

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featurearticle that remote work creates greater flexibility. Of course. there are always challenges, but workplaces committed to authentic connections with employees will come out stronger in the long run in terms of employee engagement, productivity, and satisfaction. My workplace made the decision months ago that we would work from home until at least June 2021. This created a sense of relief of not guessing each month what the next “normal” would look like.

identity as an EAP is stronger than ever with utilization at 25% + of our employee population. Unheard of pre-pandemic. Peizhong: Easy question! I have worked with Shengxin International EAP Institute in collaboration with EAPA to introduce an intensive four-day certificate course on Emotional First Support Training to Chinese managers and EA professionals. This course is designed to prepare both clinicians and managers on best practices when responding to an unexpected event in the workplace.

Peizhong: The cost of office rental has come down significantly in most cities where we have offices. The drawbacks of remote work include difficulties in maintaining team cohesion and client relations. Video conferencing is not the same as face-to-face meetings.

Q: No one has a crystal ball, but looking ahead to 2021, what are some important best practices / lessons learned thus far that will help mitigate COVIDrelated problems in 2021?

Q: On an optimistic note, what has been the most pleasant, unexpected surprise in terms of your EA practice that you have witnessed in a pandemic society?

A: Bryan: At the university I work at, our internal EAP is fortunate to have a well-established and trusting relationship with each of the units within our broader Human Resources department. We have benefited from leaning upon these relationships as a source of creative collaboration to help better serve the diverse needs of our faculty and staff. It will be critical for our EAP to continue nurturing these collegial relationships to meet the complex needs of our client community in the year ahead.

A: Bryan: The shift to a virtual format provided greater access to services. The visibility of our EAP has increased, and I believe its value has also been reaffirmed. *Christine: More than ever, EAP services are seen as important and essential to meeting employee needs for emotional support during difficult times. Dan: Happily, the incidence of employee to employee interpersonal conflicts have drastically reduced in my world. The protocol of social distancing has made person-to-person interactions only about work itself. Break rooms, cafeterias, and onsite gyms are closed. I’m looking forward to reminding everyone how great they did during the pandemic so there’s no reason not to do so post-COVID.

*Christine: Because we have never been faced with a worldwide pandemic like this one, we are literally reinventing the wheel. So, it is hard to judge what worked best because we are still in it. I do think this is something we will be able to evaluate retrospectively. I do not think the workplace will return to its pre-COVID state. I think that there will be many more workers working remotely and much more reliance on Zoom. I think that everyone is going to want to take vacation at the same time – that will have to be managed!

Elena: For the first time in my career as a counsellor, I heard a business leader saying: “We have to help our employees to overcome the health crisis, tell us whatever is needed to do to provide support to each of them.”

Dan: Collectively, we can contain most things with mutual respect. Be it masks, social distancing, hand washing or contact tracing the synergy of the group effort pays dividends. When we acknowledge others’ fear or their hope, we open the channel to receive it ourselves.

Nancy: Our team pulling together to build education and support that could reach as many people as possible. We held numerous listening sessions, and as a nimble team, we increased utilization in ways we never could have imagined pre-pandemic. Our 22

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Elena: In Europe, health and safety will become a strategic pillar of HR management and development. Health and safety are very regulated, so European companies traditionally do whatever is needed to adapt to local county labour laws. In 2021, corporations will continue to invest as they are learning from their employees how helpful an EAP can be. I would like to reinforce the urgency of giving employees a voice when implementing an EAP. Each employee has adapted to the pandemic as best they could. So, any EAP should include several lines of specific lines of actions to address the needs of many different groups.

passionate, more grounded and determined. We have plans for continued and successful remote working and are all more skilled in digital tools than before. Lessons learned: get out in front and help people, meeting them where they are. Be bold. Be creative. Be pro-active. Be compassionate. Be kind. Peizhong: For both employers and EAPs, it is imperative to have protocols, training, and competent personnel to handle unexpected events like COVID-19. The workplace and the background of global environment are becoming more unpredictable. Collaboration among multi-national teams at multi-national companies is an issue that needs more attention. With so many uncertainties, the mental and behavioral needs of international employees need attention. v

Nancy: We are all much more resilient than we think. We can come together as a collective and support one another, listen to one another and deal with challenges effectively. We are wiser and more com-

earoundup EAPA Selects New Board, EACC Members

Ian Quamina, North Miami Beach, FL; and Andrea Stidsen, Andover, MA.

The Employee Assistance Professionals Association (EAPA) recently announced new officers, board members, and EACC commissioners (Employee Assistance Certification Commission). They are as follows: Kristin Rantala, Cedar, MN, President; Dan Boissonneault, Hamden, CT, President Elect; Libby Timmons, Tucson, AZ, Immediate Past President; Patrick Williams, Desert Hot Springs, CA, Secretary/Treasurer; Greg DeLapp, CEO. Director(s) at Large: Sherry Courtemanche, Riverton, CT; Renee’ Evans, Cary, NC; Lauren Garnier, New Orleans, LA; Michele Grow, Sydney, Australia; Daryl Joseph, Port of Spain, Trinidad & Tobago; Hunny Powell, San Francisco, CA; EACC Chair Laura Jacobson, Sudbury, MA; EACC: Chair, Laura Jacobson; Commissioners: Amy Friedling, North Ridgeville, OH; Bryan Hutchinson, Highlands Ranch, CO: Patricia Meissner, Anchorage, AK; Craig Mills, Chandler, AZ; Abena Noel-Branker, Trinidad & Tobago;

Paper Presents Comprehensive Look at Digital Solutions Employers are the largest purchaser of health care services, yet there is minimal research on employer use of digital solutions. This report, compiled by the Pacific Business Group on Health, summarizes qualitative research on the use of digital tools for mental health. Interviews were conducted with 10 large employers who represent over 1 million employees, and 22 mental health vendors. Read more here file:///C:/Users/Mike/AppData/ Local/Microsoft/Windows/INetCache/Content. Outlook/XID4WQ5L/London%202020%20 WHITEPAPER%20Digital_Tools_Employee_Mental_ Health_Report_PBGH.pdf. continued on page 29 23

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spotlightoneacc EACC Revamps the CEAP® | By Paul Fitzgerald, PsyD, CEAP, MAC, SAP


ince its inception, the Employee Assistance Certification Commission (EACC) has been responsible for the development and maintenance of the only recognized credential for advanced practice in employee assistance, the Certified Employee Assistance Professional (CEAP®). The CEAP® was conceived in 1985, with the first exam held in 1987. The goal has always been to set a standard for EA knowledge and practice, and to help assure consumers and employers that the certificate holder is a knowledgeable professional with specific expertise in employee assistance core technologies, including program design, operations, and practice. The EACC is also responsible for adjudicating and enforcing the comprehensive ethical standards for advanced EAP practice.

CEAP® credential, that some of the requirements – especially the one about experience – was frequently an obstacle to applicants since employers often look for the credential in making hiring decisions. At the same time, the Commission wanted to preserve an option for those who came into the profession through our longstanding pathways of labor assistance and peer assistance. This meant preserving a path for those who did not have graduate degrees in one of the behavioral health fields, or who came into the EA field from human resources and related fields. One additional challenge that the Commission faced was to preserve the value and knowledge base of the existing credential without “watering down” the value of the certification through the existing method of work experience, professional development, and examination. In addition, the value of mentoring and advising was kept as a consideration, although it had been removed as a requirement.

Survey First Step in Revamping CEAP® Five years ago, the EACC began collecting data to assess the viewpoints of current certificate holders about their CEAP® certification and its role in their professional work. The goals of the survey were both to determine satisfaction with the credential, and to seek feedback in shaping the future direction of the CEAP®. The survey was an important step in revamping the CEAP®. Since that time, the EACC has been busy disseminating this information, as well as gathering information from our field and from other fields that have advanced certification, in order to create an improved pathway to certification for the EA profession. EACC commissioners have played an important role in compiling standards, processes, and teaching materials, creating a process that will allow a less burdensome path to certification without diluting the value of the CEAP®.

Shrinking Pool of CEAPs; Change in Delivery Drive Changes The EACC has been concerned that the pool of CEAP® holders has been shrinking as current CEAP® holders retire, and the pool of new applicants has not been sufficient to replace them. The Commission heard that the 1,000-hour EAP experience requirement has been a factor in this reduction. On the other hand, those who have had the 1,000 hours of EA experience had been finding that accumulating the required Professional Development Hours (PDHs) often took longer than it should have, presenting an additional obstacle. Additional impetus for looking at the credential came from the changing nature of EA service delivery, which has moved from a primarily internal program model in the 1980s to the current widespread use of external programs, including those provided by affiliate networks and/or bundled with benefit

Feedback next Step This ambitious undertaking was prompted by feedback from respondents interested in obtaining the 24

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plans. The Commission also made use of feedback and wisdom from the global EA community, including the challenges of creating and maintaining an examination that was reliable and valid for global use in multiple languages. Changes being Planned The plan as it is being developed now is to create multiple entry points for different types of candidates, with or without graduate degrees in a clinical behavioral health field, and with or without employee assistance experience. Experience and a graduate degree in a clinical behavioral health field will now allow the applicant to bypass a significant portion of the PDH requirement, while still requiring online coursework and modular examination format to confirm knowledge and skill development. Realizing the value of sharing the experience and guidance of existing CEAP® holders, the EACC has been considering mentoring or advisement as a possible route or option for candidates, in place of or along with other requirements. The Commission has been working to replace the single examination with a set of educational training modules that cover all the domains and content areas important to EA practice. The goal is to include material adapted and developed from existing content, new content, and material from labor assistance programs. The EACC has been preparing this content for loading into a learning management system (LMS) with an assessment for each module, in place of the previous comprehensive, professionally managed examination. We are hopeful the CEAP® revamp will be completed by March 2021. A Look Back at a Lengthy Process All told, the goal in thoroughly reviewing exam content is to assure candidates that all of the content is current and applicable to the practice of employee assistance in the year 2020, eliminating outdated or irrelevant content while adding material relevant to the current EA world. The EACC sought to do this while preserving the knowledge and practice areas that have traditionally been the backbone of the profession, particularly drug and alcohol and mental health assessment and referral. The Commissioners are confident that this hard look at the skills and knowledge needed for employee assis-

tance will service EAPA in maintaining a credential that maintains and enhances its role as “the world’s largest, oldest, and most respected membership organization for employee assistance professionals.” With members in over 40 countries around the globe, EAPA is the world’s most relied-upon source of information and support for and about the employee assistance profession; so a truly global and current method of certifying our practice is essential, no matter what the entry point (labor, HR, call center staff, affiliates, or program administrators) may be. EAPA members are encouraged to contact the EACC commissioners with questions, suggestions, and feedback on the “CEAP® Refresh” process. (Editor’s note: See Certified-Employee-Assistance-Professional-CEAP/ EACC as well as roundup item elsewhere in this issue.) v Paul Fitzgerald is president of the Northern Illinois EAPA Chapter and a former EACC commissioner. He may be reached at paul@

KGA Life Services Because when it comes to work-life, experience matters most. Ask us how we can help enhance your EAP with KGA’s work-life fulfillment services. 800.648.9557

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featurearticle Intervention for C-Suite Executives & High-Level Professionals

| By Linda Fensler, MS, CEAP


he road to success isn’t always a smooth one. No one knew this better than Michael Snyder, a former CEO of Red Robin Gourmet Burgers and Brews. In 1979, Michael and his brother Steve opened their first store. In 2018, Michael was 68 years old. On December 2nd he walked into his front yard, put a gun to his head and ended his life. Michael never reached out for help; he suffered in silence. He did not leave a note. No one knew the depth of his despair. Could a trained mental health professional have recognized Michael’s cry for help? Mental health professionals know that the end stage of addiction and mental illness often leads to suicide. They recognize the need to identify behavioral changes early, to find a way to intervene before it’s too late. That said, identifying the impaired professional is difficult to do in a timely manner. Professionals, executives, CEOs, and entertainers are often isolated by the nature of their work and insulated by those around them. Death by suicide or overdose does not discriminate; it affects everyone. Due to the COVID pandemic, we have seen an increase in mental health concerns while people are isolated in their homes. Medical professionals, too, have been reported to have significantly higher suicide rates than the general population. According to an article published in 2016, “Medicine has been the deadliest profession in the United States for decades as physicians continue dying from suicide rates twice that of the general population” (Gunter, 2016). Another article published in Lifestyle/Health & Wellness in 2018 shares data collected by Dianna Kenny from a University of Sydney study. In the article, she shares observations from a clinical psychologist who founded an organization that treats celebrities in Hong Kong and China. While maintaining their confidentiality, she indicated half of the clinician’s patients are either celebrities, bank CEOs, or movers and shakers in the political world.

The clinician shared observations that “… under more pressure than ordinary people, my patients suffer from a range of mental disorders – like panic attacks, insomnia, violent outbursts, substance abuse, eating disorders, suicidal thoughts, sex addictions and deviant sexual behaviors” (Yau, 2018). Identifying Problem Behaviors EAP counselors are often the first to identify impaired executives and other professionals. If the EAP becomes aware of an impaired executive and is not high enough in the organizational hierarchy, it will be necessary to report the findings to a supervisor or a workplace consultant within the system. Larger companies could have healthcare coaches or may be willing to pay for an external interventionist. In any case, getting the person to the right source is important. This means healthcare workers and HR executives must know what resources are available to them prior to devising a plan to intervene. Observations of an EAP In my work as an EAP counselor since 1989, I’ve observed not only the array of mental health disorders that plague C-level executives and professionals, but also the levels of isolation, loneliness, and mistrust they experience. Many have trouble trusting those around them because of hidden agendas. Furthermore, they fear being misrepresented or harshly judged. One CEO told me, “I’m afraid to say anything when employees ask questions. My words are taken out of context exaggerated and downright misrepresented. A simple statement can be taken out of context, or totally changed, causing mass hysteria for thousands of employees. Sometimes it’s better to say nothing!” Suppressed Dopamine Can Fuel Addiction Some people surmise that the very traits required to get to the top are the same ones we see in the path to addiction. David J. Linden, a professor of neurosci26

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ence at John Hopkins University School of Medicine, found that certain people possess a genetic variant that leads to suppressed dopamine signaling in the brain. As a result of this decrease in dopamine they are compelled to seek unusually high levels of stimulation or thrill-seeking behaviors, in order to give them the same level of pleasure that others achieve without the need for thrill-seeking behaviors. Not coincidentally, these characteristics are consistent with the same ones needed for success; risktaking, a competitive nature, an ability to handle disappointments, dedication, and the ability to initiate new concepts. Unfortunately, highly successful people often become accustomed to greater levels of anxiety as the result of strong competition and high expectations. These traits may develop into mental health concerns for the individual. Leaders with these traits may show signs of impairment. This is when someone needs to identify the problem – and in the beginning. And yet, this is when people are often afraid to confront the individual needing help and the problem is left to grow and fester. Think about how difficult it would have been to identify and address a concern with someone like Sigmund Freud or Winston Churchill, both of whom were heavy drinkers. In an article published in The New York Times, Linden states “ … in fact, the psychological profile of a compelling leader – think of tech pioneers like Jeff Bezos, Larry Ellison and Steve P. Jobs – is also that of the compulsive risktaker, someone with a high degree of novelty-seeking behavior. In short, what we seek in leaders is often the same kind of personality type that is found in addicts, whether they are dependent on gambling, alcohol, sex or drugs” (Linden, 2011).

• Poor decisions; • Erratic mood swings, including manic behaviors and temper tantrums; • Disappearing acts; • Changes in staffing; • Sudden weight loss or gain; • Broken promises; • Excessive rumors surrounding the person and, in later stages of impairment, psychosis, dependency or paranoia. Identify the Problem and Offer Help! After the signs of impairment have been identified and are shared with a professional, whether it’s an EAP or another mental health professional, a strategy to confront the individual must be developed. As stated, it may be difficult to develop a working relationship with an executive in the C-Suite. It may be necessary to consult a trusted friend, relative or partner of the impaired person. In such cases, plan to meet several times with the person who has the greatest influence with the impaired executive or professional.

Signs of Impairment So, how do we get help for thigh achievers? First, we must identify the signs of impairment. If someone is impaired by a behavioral problem or a substance, those around him or her will notice changes in daily mood and functioning. My counseling experience spans corporate and educational settings in Chicago, Las Vegas, Florida, and Indiana, where I have observed the following behaviors: • Inappropriate or broken communication; • Poor hygiene; 27 | W W W . E A PA S S N . O R G | •• • • • • • • • • • • • • • • • • • • • | JOURNAL OF EMPLOYEE ASSISTANCE | 1st Quarter 2021 |

featurearticle You may need to teach the principle influencer about areas such as effective communication, documentation, constructive confrontation, and motivational interviewing. The idea is to coach the person how to begin making headway with the impaired individual before the affected person is ready for clinical intervention and support. I cannot overstate how important it is to “get the ball rolling” by first working with the person who has the most rapport and trust with the impaired individual. As a trained professional, you can guide the influencer, rather than insisting on handing the case yourself and risking pushback by the impaired professional, who may not know or trust you. As a professional, you need to put your ego aside and keep your eye on the ball, so to speak.

easier and more direct. In this case, the EAP will notice the impaired behaviors first-hand. If the EAP is not part of the executive team, then establishing rapport with the VP of HR is an important step. This provides a connection to the executive team and anyone else strongly affiliated with the impaired, top-level executive. Another option would be for the EAP to connect with a board member, colleague or friend of the executive or other professional. Whoever it is, the idea is anyone who will advocate for the EAP and help make the necessary connection to the impaired professional. When Making the Referral After identifying the impaired executive and providing the number of sessions allowed by the company’s contract with the EAP provider, the best longterm treatment provider or treatment center will need to be identified. In some cases, the EAP will refer out immediately to maintain consistency in treatment and to give the “free EAP session” to family members of the impaired. When the EAP makes a referral to a treatment center or a clinical professional, they will require ongoing communication with the facility or counselor to follow the case. This will help the EAP manage re-entry and develop a return-to-work plan. Confidentiality, always important, is even more crucial if the impaired person is a CEO, surgeon or celebrity. Certain in-home programs will allow a high-level person to recover at home while making use of digital options. With the rise of COVID-19 remote work recommendations, it’s even more important to find digital tools and programs to ensure both confidentiality and immediate access. These types of services are rapidly surfacing to meet the 24/7 needs of those suffering from potential relapse while recovering at home.

“After the signs of impairment have been identified and are shared with a professional, whether it’s an EAP or another mental health professional, a strategy to confront the individual must be developed. As stated, it may be difficult to develop a working relationship with an executive in the C-Suite.” The outcome of health and wellness for the impaired person is always the main goal. How you get there is to develop a plan, stick to it, and alter it as needed. The ultimate goal is to connect the person with the best counseling plan, psychiatric care or inpatient treatment needed, then maintain good follow-up. Of course, it’s always easier and faster when the EAP can identify and directly confront the impaired leader, if in fact a relationship and the trust is already there.

Summary Identifying impaired professionals in our fastpaced, competitive work environment is necessary but as stated, it’s not easy to identify a C-level executive, professional or a top performer and get them help in a timely fashion. There are barriers that include the reclusive lifestyle of high-level leaders and the protected work environment that insulates them from recognizing a problem. These individuals often enable their toxic actions and protect them from the consequences of their behaviors.

Become Part of the Team Whenever Possible The CEO or any other organizational leader shoulders the responsibility of creating a vision for the company’s future growth. If the EAP is involved in leadership decisions, and if the EAP is part of this process, confronting the impaired executive will be 28

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The high-level executive has a level of freedom and protection that exceeds the general working population. On the one hand, these individuals are often risk-takers and innovators, the very traits needed in our leaders to move us forward, especially in light of COVID-19. To identify an impaired leader, it may be necessary to depend on the people around them to observe and confront the toxic behavior of the individual and build the skills necessary so a trained clinician such as the EAP can then step in and intervene before it’s too late. v

current development of a digital, in-home, two-year Aftercare Program for people in recovery and those who love them: www. Linda may be reached at

Linda Fensler, MS, CEAP is the owner of FLEXIBLE EA Services, LLC. She has operated EAPs throughout the U.S. and has maintained EAP Certification since 1992. Linda is a partner in the

Yau, Elaine, (2018, June 22). Why suicide is more common among celebrities, CEOs and creatives, and how therapy helps, Lifestyle/Health & Wellness.



Gunter, Tracy, (2016, May). Physician death by suicide: Problems seeking stakeholder solutions, Indiana University Robert H. McKinney School of Law Research Paper No. 2016-23, Available at SSRN: or http:// Linden, David, J., (2011, July 23). Addictive personality? You might be a leader, The New York Times. Retrieved from Nytimes. com/2011/07/24/opinion/Sunday/24addicts.html

Continued from page 23

Remote Work: Relationships Matter

about their weekend, family or hobbies. Follow up on their comments from previous calls.

Due to the coronavirus pandemic, more people than ever are working remotely. Employees like the greater flexibility over their work schedules and are often more productive with no long commutes. But people are also social creatures and are missing on-site time in which they would be more engaged with co-workers and managers alike. Building a good relationship with remote employees ensures that they don’t feel isolated from the team. But without physical proximity, new avenues for relationship-building are needed. Courtesy of executive coach and speaker Jan Makela, the following are tips for the EAP to share with managers and supervisors:  Managers should use instant messaging for the types of interactions you have in the hallways with office-based staff. Ask how their day is going, send a link to a helpful article or share a joke.  Managers are not going to just “run into” remote employees, so connections require deliberate effort. Set reminders in your calendar to make sure informal check-ins don’t get overlooked.  Managers should encourage a couple of minutes of personal chit-chat at the beginning of calls. Ask

Mobile Apps: Effective Treatment Option? Are mobile apps an effective option in treating illicit drug use? That question was addressed in a recent white paper conducted by the Journal of Medical Internet Research, with Petra Karin Staiger, PhD, and with the School of Psychology at Deakin University in Australia serving as lead author of: “Mobile Apps to Reduce Tobacco, Alcohol, and Illicit Drug Use: Systematic Review of the First Decade”. Ten years following the release of the first app targeting problematic tobacco, alcohol, and illicit drug use, their effectiveness, use, and acceptability remains unclear. Although most app interventions were associated with reductions in problematic substance use, less than one-third were significantly better than the comparison conditions at post treatment. Read more at continued on page 30 29

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Continued from page 29

Digital Health Access Alone isn’t Enough

additional half-day of poor mental health in the month following election (December) compared with the month before (October). A survey conducted by The Harris Poll on behalf of the American Psychological Association (APA) reported that 68 percent of adults in the United States said that the 2020 election is a significant source of stress in their lives. Only 52 percent said the same about the 2016 election.

Due to the coronavirus outbreak, increase in digital mental health services has exploded. That’s the good news. The bad part is that an increase in access alone isn’t sufficient. There is growing concern that many digital mental health firms are marketing products that lack clinical pilots to demonstrate that their solutions actually work, as reported in an online article “The hazards of digital mental health.” Additionally, many of these same companies may claim they are evidence-based when they are based off of vague translations of existing clinical models. There are numerous reasons why these hazards are prevalent – suffice it to say that academic medicine would clearly benefit from partnering with digital health companies either to assist with clinical research or help develop new research frameworks specifically for digital health. Slowly but surely, progress is being made. Germany recently published the Digital Healthcare Act, which offers a national framework for reimbursement, prescription, and regulation of digital health apps. Moreover, the American Psychiatric Association recently launched an app advisor to help psychiatrists navigate the digital world. But many more efforts like these are needed to address the disconnect between mental healthcare and technology. Read more here

Empathy is Crucial in Return to Work As employees return to the workplace, mental health and well-being rank high on their lists of concerns. Some workers have been fearful to return because they have no idea what will meet them at the door. Will their job responsibilities be the same? What new procedures will they have to observe? What if some employees don’t wear a mask? Will social distancing change their relationship with co-workers or customers? This new normal is stressful, but experts say that difficult situations can be managed with appropriate support, empathy, flexibility, and sufficient time to adjust – help the EAP is well positioned to help provide. The good news is that employers now know which jobs can be successfully performed remotely. Their fear of lost productivity among remote workers or that collaboration or teamwork would be compromised has not materialized in many cases. Flexibility is key: For employers that can’t offer remote options but have workers who are exhibiting mental health issues, they need to demonstrate flexibility. Change employees’ job or job responsibilities. Relocate them to a more isolated workspace. Alter their work schedule. Recommend they stay unplugged during breaks. Create separate office spaces for prayer or meditation. Enable them to work from both home and the office, although office settings provide more human contact and opportunities for empathy, states Kris Meade, chair of the labor and employment practice at Crowell & Moring. Some employees may become emotionally distraught and act out by being disruptive around coworkers. HR can step in and suggest mental health counseling from the EAP.

Post-Election Anxiety is Real: Report Post-election anxiety can be particularly difficult for people when the candidate they supported doesn’t win. In fact, they may face even more strain on their mental health if they live in a state that supported their candidate. Additionally, the more the candidate loses by, the greater the number of days of stress and depression for residents in those states, Healthline reported. According to a study by the University of California, San Francisco (UCSF) and Duke University, researchers analyzed data from nearly 500,000 adults, looking at mental health indicators during the 2016 general election. They found that people who lived in states with a Hillary Clinton majority experienced on average an 30

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Promote learning: Business leaders need to move employees from being in a fearful zone to one of learning, according to Chuck Gillespie, CEO at the National Wellness Institute. If the organization supports a wellness committee, Gillespie says its members can help managers assess situations, engage with managers in staff conversations, and identify triggers that cause emotional behaviors: Is this individual truly fearful of COVID19 or simply abusing company policies or benefits? Again, the EAP is in a perfect position to help.

addressing mental health in the workplace, reports EHS Today. According to a recent study by the American Psychiatric Association (APA), more than one-third of Americans (36%) say coronavirus is having a serious impact on their mental health and most (59%) feel coronavirus is having a serious impact on their day-to-day lives. A good first step to helping employees deal with this issue is to expand the current employee assistance programs that most companies already have. “Employers have come a long way in the benefits they are now offering,” says Darcy Gruttadaro with the APA Foundation. “The EAPs are now being strengthened to provide better service. In addition to these formal benefits, we are seeing companies offering informal assistance in the form of peer support. This way employees can connect with others who are dealing with the same issues.” The need to deal with these mental health issues now is of utmost importance. The problem with ignoring these issues, officials said, and as EAPs are well aware, is that they can lead to chronic levels of mental illness such as anxiety, depression, and other serious mental health problems. v

Mental Health Days are Crucial Many employees are afraid to admit to feeling emotionally ill when mental health should be treated with as much importance as physical health. If an employee would call in sick because of a fever, why not for a panic attack? Here’s how employees can benefit from mental health days. Recognize thoughts and emotions. By taking a mental health day, the employee is choosing to get better, according to Vicki Salemi, a career expert at Monster. It’s unlikely anyone who woke up with a migraine would force him or herself to go to work, so why not treat mental health the same way? Acknowledge feeling “down.” The employee needs to admit he/she is struggling, and being aware of your struggle is the first step. From there, the employees need to do what will ease the emotional strain. Don’t worry about judgment. Would colleagues think the worker used a mental health day as an excuse to skip work? Additionally, no one need label a day off. The employee should simply tell the employer he/she is feeling under the weather (because you are!) and treat it like any physical illness. Implement a mental health policy. Many of us spend more time at work than we do with our loved ones. Workplaces with mental health policies care for everyone’s well-being and provide a place where everyone feels supported. The EAP can be of great assistance in this area.

Upcoming features include:  Secrets of Working with Law Enforcement  Racial Bias in the Workplace  History of EAP in US

Pandemic Fallout: STRESS Acknowledging the emotional aspect of coping with the coronavirus outbreak offers a huge stepping stone to 31

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featurearticle Video-based Counseling Shifts to the Mainstream | By Marc Milot, PhD


hile video-based counseling (or teletherapy) was already growing in popularity in the last decade, the COVID-19 pandemic shifted these trends into overdrive. Now even more EA professionals provide online services to stay in line with public health guidelines, social distancing measures, or the needs of clients. For employers, employees or purchasers of EAPs, greater reliance on video counseling may lead to questions about its effectiveness and value versus traditional in-person EAP counseling. These concerns, while valid, are generally not supported by the findings of past studies comparing outcomes of video-based to in-person therapy. (More EAP-specific studies are needed.) A number of research-informed practices for video-based counseling may also help EA professionals optimize service delivery for this modality.

worsen them. For example, there have been reports of greater client participation, spontaneity and disinhibition during video-based sessions. This may be the result of the more informal setting of video, which can influence social dynamics and client perceptions. What about EAP video-based Counseling? An earlier EAP study compared the two modalities in an industry paper (Morneau ���������������������������������� Shepell, 2013)����������� . The findings indicated comparability on a number of outcomes but also that self-rated mental health improvements were greater for in-person versus video-based therapy. In the 4th Quarter 2020 Journal of Employee Assistance, the authors (Veder, Steenstra, and Beaudoin) also reported on findings from a more recent Morneau Shepell study that showed counseling outcomes were positive across in-person, telephone, and video counselling. More research is needed, however, to confirm the value of EAP video-based counseling, including longitudinal studies accounting for potential baseline differences between users of the different modalities, taking into consideration counselor characteristics, and using validated measures of mental health designed to detect clinical changes. Advancements in online streaming technology and tools can also influence experiences and outcomes with video-based counseling as can the many differences across EAP vendors and their programs.

Comparability between Modalities Findings from studies and systematic reviews have provided strong evidence of comparability between video-based and in-person counseling in a number of relevant outcomes. In brief, there are similar retention rates for videobased and in-person counseling, and in therapeutic effectiveness both modalities have been found equally effective at significantly reducing symptoms of depression, anxiety and stress, and increasing quality of life. General satisfaction is also comparable to traditional in-person counseling. The therapeutic alliance, otherwise known as the working alliance, can develop even in the absence of face-to-face interactions, with some reports of comparability between the two modalities. However, differences have been reported, including both an enhanced and diminished alliance in video-based counseling. Some of the unique aspects of video-based counseling might be expected to improve outcomes, not

Research Project on EAP Video-based Counseling With these considerations in mind, and as a response to the pandemic, a research project supported by Canadian EAP provider Arete was developed and led by this author to determine the comparability of the two modalities on a number of relevant outcomes. The findings reported in this article are preliminary and based only on self-reported outcomes of EAP users on a follow-up survey deployed after case close in the second and third quarter of 2020. The EAP 32

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users accessed the same program providing up to 12 hours of counseling per year, with an average of ~7 hours accessed per case. The final findings from the study will be based on a more robust research methodology (pre-test-post-test) with a wider range of outcomes, including validated measures of mental health and work functioning, and accounting for counselor characteristics. Three groups of EAP users were included:

ity between this vendor’s two EAP counseling modalities on a number of outcomes. Research-informed Practices for Video-based Counseling Best practices for video-based counseling can include those related to 1) overcoming technological challenges, 2) optimizing the delivery of video counseling, and 3) addressing the unique ethical and safety issues of this modality. Video-based counseling presents a number of technological challenges that could disrupt clinical services. In a recent research paper, a number of common technological challenges of telehealth counseling were identified as well as corresponding recommendations (see bulleted points below) based on the experiences of clinicians with the Zoom videoconferencing platform during the course of a clinical trial (Wooton, McCuistian, Legnitto Packard, Gruber, & Saberi, 2019).

• One choosing to access only video-based counseling (n=45); • One that was only in-person counseling (n=64); and • A group that contained a mix of both video and in-person (n=43). The self-reported outcome measures included the degree of: problem resolution (0-3 scale), counselor focus on providing concrete solutions (0-3 scale), mental health improvement in relation to before EAP use (0-5 scale), and satisfaction with the overall EAP (0-10 scale). Linear modeling analyses controlling for demographics (gender, age, language, education) ensured that any differences between the groups were not explained by these factors. Finally, as a research and data psychologist, one area of interest was the development of the therapeutic alliance across the two modalities. The therapeutic alliance is central to the manifestation of positive client outcomes, and it can be influenced by nonverbal cues such as eye contact and even therapist trunk movements (Dowell & Berman, 2013) in ways that theoretically could be impaired in EAP video counseling. The five-item Workreach Brief Therapeutic Alliance Scale (BTAS-5) was used to assess this outcome. This is a validated scale designed for use in an EAP setting that is completed by the counseling client after close of the case, assessing (for example) feelings of connection and trust with the assigned therapist.

 The challenge of managing EAP client expectations about video counseling. This aspect can be addressed by systematically informing clients before or early during the first session that technological issues will likely occur at least once during the course of counseling. This could help reduce feelings of disappointment and frustration in EAP users when such challenges invariably emerge.  The challenge of EAP clients being unable to participate in the first session due to an inadequate internet connection. This can potentially be avoided by suggesting the client conduct an internet speed test on their device before the first session to ensure they meet the bandwidth requirements, which can vary across different streaming platforms. For Zoom the bandwidth requirements are 2 Mpbs (both download and upload speeds) for highest quality, 1.2 for medium quality, and 0.6 for lower (non-HD) quality. In the event of an inability to secure enough bandwidth to meet the requirements of streaming and/or therapy (i.e., non-HD quality may not be acceptable for some EAP service providers), alternative modalities can be considered to avoid an unsuccessful first EAP session.

Preliminary Findings The findings revealed an absence of statistically significant differences between the three groups on any of the outcome measures. In fact, and despite not reaching statistical significance, there was a tendency towards a higher (12%) degree of therapeutic alliance reported by the video-based versus in-person counseling group. This provided initial support of comparabil-

 The challenge of certain EAP clients repeatedly having difficulties using video technology. This can be addressed through systematic logging of issues encountered on calls (e.g., client location, device used, type of internet connection) and the identification of 33

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featurearticle potential causes of recurring issues to suggest ways these can be avoided in the future (such as excluding certain devices or locations). As for delivery, use of video can influence perceptions of making eye contact, and reduce the visibility of nonverbal cues making it more challenging to assess a client’s breathing or perceive body gestures and facial expressions from which emotional states can be inferred.

video-counseling is important as it provides the greatest flexibility to employees, taking into consideration needs and preferences of users to maximize satisfaction and the manifestation of positive outcomes. Since EAPs are not the same, providers should consider conducting evaluations to ensure comparability of video-based versus in-person EAP services. Organizational clients will then be more confident that they are getting the same return and value from their EAP irrespective of the modality used for clinical service delivery. Finally, as more people turn to mental health professionals due to the pandemic, many therapists may find themselves experiencing new levels of stress and pressure as they take on additional clients and roles as caregivers in these challenging times. That said, self-care must also be taken (including by EAPs) to prevent counselor burnout and to reduce the risk of developing mental health issues or disability; therapists are just as overwhelmed as the rest of us by the pandemic, if not more. v

 Because the camera is often positioned above the center of the screen, looking at the middle of the screen (i.e., at the client) can give the impression you (the therapist) are looking down, which may adversely affect client experiences.  One possibility is to increase the distance between yourself and the device camera to at least one meter. This is a research-supported approach that can heighten a client’s perception of making eye contact by attenuating your eye gaze angle (Tam, Cafazzo, Seto, Salenieks, & Rossos, 2007) and it also increases visibility of body gestures.  For smaller screened devices, such as phones and small tablets, being closer to the camera may be more appropriate (even if eye gaze may not be optimal) so as to not appear distanced, bringing your hands into view and using them as body language indicators.  While more research is needed in this area, ultimately it is a matter of taste and preference, and weight should be given to checking in with the client about their preferences and needs to feel safe and supported during a session.

Marc Milot is a research and data psychologist based in Montreal, Quebec. He is Managing Director and Consultant at Workreach Lab, assisting with research, analytics, and technology in employee assistance and mental health. For more information, including additional references used in this article, contact Marc at


Dowell, N. M., & Berman, J. S. (2013). Therapist nonverbal behavior and perceptions of empathy, alliance, and treatment credibility. Journal of Psychotherapy Integration, 23(2), 158. Morneau Shepell. (2013). The effectiveness of video counselling for EFAP support. London, M., Nagel, D., & Anthony, K. (2011). An ethical framework for the use of technology in EAPs. Therapeutic Innovations in Light of Technology, I (6), 26-33. Docs/Tech%20Resources/EthicalFrameworkTechEAP.pdf

There are also unique ethical and safety issues that can arise from the use of video-based counseling (Shaw & Shaw, 2006) and a number of resources are available for online mental health services, such as guidelines by the American Telemedicine Association (Turvey et al., 2013) to help practitioners provide safe, effective care when treating patients through computers and mobile devices. An ethical framework for the use of technology published by EAPA is also available (London, Nagel, & Anthony, 2011).

Shaw, H. E., & Shaw, S. F. (2006). Critical ethical issues in online counseling: Assessing current practices with an ethical intent checklist. Journal of Counseling & Development, 84(1), 41-53. Tam, T., Cafazzo, J. A., Seto, E., Salenieks, M. E., & Rossos, P. G. (2007). Perception of eye contact in video teleconsultation. Journal of Telemedicine and Telecare, 13(1), 35-39. Turvey, C., Coleman, M., Dennison, O., Drude, K., Goldenson, M., Hirsch, P., & Maheu, M. (2013). ATA practice guidelines for video-based online mental health services. Telemedicine and e-Health, 19(9), 722-730.

Summary The pandemic propelled digital counseling services into the mainstream, and they are likely here to stay. Offering the ability to select either EAP in-person or

Wootton, A. R., McCuistian, C., Legnitto Packard, D. A., Gruber, V. A., & Saberi, P. (2019). Overcoming Technological Challenges: Lessons Learned from a Telehealth Counseling Study. Telemedicine and e-Health.

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webwatch Mental Health Fresh Hope Fresh Hope is based upon six tenets/principles seen as a foundation for living well in spite of a mental health diagnosis. The tenets/principles are for both the person who has a diagnosis as well as for the loved ones of those who have a diagnosis.

Coronavirus Benefits Pro: Legal Questions In light of the coronavirus pandemic, employers want to know the answers to dozens of legal questions, such as can they ask to check employees’ temperatures, pay older and more vulnerable employees to stay home, and many more. (Editor’s note: This topic is also addressed in this issue’s Legal Lines column.)

Sexual Assault National Sexual Violence Resource Center The NSVRC believes in the power of information, tools, and people. Links include e-learning, library, projects and more.

Coronavirus CareConnect USA: Helplines CareConnect USA, a publisher of free helplines since 2005, maintains a state-by-state list of coronavirus hotlines. In addition to hotlines, the site also includes information about financial stress and disaster relief. The SAMHA Disaster Distress helpline is 800-985-5990.

Technology Appmkr Everybody is downloading apps these days, but maybe you’d like to create your own app. Doing so is neither complicated nor costly. Learn more at this site.

Coronavirus HR Executive: Employer Mental Health Guide A new tool from the Business Group on Health aims to help HR and benefit leaders at global organizations develop and implement mental health programs.

Technology One Mind PsyberGuide There are so many apps out there these days! But which ones are effective? Apps and digital health resources are reviewed at this site, which includes its criteria for determining its ratings. Understanding and managing mental health are among other useful links.

Coronavirus Johns Hopkins: Resource Center Johns Hopkins, experts in global public health, infectious disease, and emergency preparedness have been at the forefront of the international response to the coronavirus pandemic.

Technology World Well-Being Project The WWBP is pioneering scientific techniques for measuring psychological well-being and physical health based on the analysis of language in social media. The Project is based out of the University of Pennsylvania’s Positive Psychology Center and Stony Brook University’s Human Language Analysis Lab.

Disability Inclusion Job Accommodation Network Do you have questions about the Americans with Disabilities Act? Job Accommodation Network (JAN) is a leading resource on the ADA, including a comprehensive list of various disabilities and suggestions for workplace accommodations, which the EAP can help devise.

Workplace Wellness Who isn’t affected by cancer today? This site, formerly known as Cancer and Careers, helps patients, survivors, healthcare professionals, and employers navigate the practical and legal issues common after a cancer diagnosis. v

Employee Benefits Employee Benefit Adviser This site features workplace benefit news for advisers, brokers, and consultants, as well as tools for business growth and development. 35

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