CASE STUDY 1

An EAP is asked to work with the Strategic Human Capital Committee of a company. The Committee asks the EAP to monitor the assessed problems, by department, and report back observed trends and recommendations for management development or needed organizational changes. As the EAP explores this request it realizes that there are several very small departments in which there are only a few employees and that disclosing any information about such small groups might compromise the confidentiality of the individual employee/clients. The EAP helps the Committee identify alternative organizational management strategies that would not create a potential conflict of interest for the EAP, allowing the EAP to remain a neutral entity in the organization.

CASE STUDY 2

The EAP is asked to provide a stress management workshop for a particular department that has had a lot of turnover the past year. Despite conducting a thorough needs assessment prior to the workshop, the EAP counselor quickly realizes that the employees believe their supervisor and the company are responsible for their high levels of stress. The employees use the workshop as an opportunity to vent their frustration and anger about their work loads and company expectations. The EAP counselor serving the employees allows them to feel heard and helps them learn how to take control of their stress levels. The counselor completes the training and helps the employees focus on maximizing their productivity at work. It is important that the counselor shows sufficient empathy to build rapport and gain the trust of the employees, but also remains neutral. The counselor can serve both clients by giving the employees the opportunity to express frustration then refocusing them on finding healthy ways to manage anger and stress.

CASE STUDY 3

An employee is seeking counseling for "work stress." The employee reports that he feels his supervisor is discriminating against him and tells the counselor he plans to hire a lawyer and sue the company. Again, it is important for the EAP counselor to remain neutral in this situation. The EAP counselor connects enough with the client in order to complete the assessment and make a plan of action to address the employee client's needs but does not take sides with either the company or the employee client. It is not the counselor's job to conduct an investigation of the discrimination, to make a determination of fact, or to be involved in the disciplinary process. He stays neutral and focused on supporting the emotional needs of the employee client and connecting the employee client to problem-solving resources, which can involve empathizing with the employee client, helping him identify resources for emotional support, and creating a self-care plan. The counselor is also aware of the internal resources of the company and encourages the employee client to seek additional problem resolution through the equal employment office (EEO), human resources office, and union. Connecting an employee with internal company resources helps the employee and the organization resolve the problem more quickly and typically with less financial cost to both the employee client and the organizational client.

CASE STUDY 4

An EAP counselor is asked to be onsite following the murder of an employee. (The murder occurred after work hours and away from the worksite.) During the group intervention, an employee (and good friend of the deceased) reports that he does not see a point in living in a world where good people are murdered and murderers roam freely. The employee goes on to say that he plans to drink himself to death that night. After concluding the group intervention session, the counselor follows up with this employee to complete an assessment, including a risk assessment.

CASE STUDY 5

An employee walks into her supervisor's office, hands her supervisor her ID badge, and says: "I won't be needing this after tonight." The supervisor knows that the employee has been counseled for work performance problems and that she is going through a divorce. The supervisor immediately calls security. She also alerts the EAP that she has an employee who needs immediate attention. The company has an onsite EAP counselor who handles this crisis-initiated case. The counselor's job is to complete an assessment, including a risk assessment.

In both examples, the counselor takes immediate action, helps the employees identify supportive resources, establishes a safety plan with the employees, and facilitates a referral for medical evaluation and therapy. (If needed, the counselor may call 911 so an ambulance can take the employee to the hospital to ensure his or her safety.)

CASE STUDY 6

A client contacts the EAP following his supervisor's retirement and recent problems with his new supervisor. The client reports that his new supervisor is unresponsive to emails containing questions about draft work products, but then expects him to work evenings and weekends to make last-minute corrections. The client reports a disruption to his work-life balance. No current symptoms are assessed—no problems with sleep, appetite, mood, or concentration and no risk of substance abuse. The EAP counselor employs short-term counseling to help the client develop alternate communication strategies to use when talking to his new supervisor about concerns and needs; learn stress management skills such as deep breathing and journaling; and develop assertiveness skills to set limits with his new supervisor.

A different approach would be needed if, for example, the assessment had revealed that the client has a history of clinical depression; averages only four hours of sleep each night; has gained weight in the past two weeks; or is drinking four glasses of wine each work night. In this case, due to the client's history of depression and current symptoms, he would be referred to a therapist with experience working with depression and substance abuse. He would also be encouraged to abstain from alcohol use and attend AA for additional support regarding his use of alcohol. The EAP counselor may provide SAMHSA literature about unhealthy drinking behaviors and alcohol abuse and encourage the client to consider the consequences and problems associated with using alcohol as a stress management tool.

If the counselor's assessment indicates that a client's problem requires more sessions than allotted by the EAP for resolution, or if a specialist is needed for diagnosis and treatment of a mental health disorder, a referral to treatment resources is included in the action plan. Referrals to treatment resources should be made after the first or second session, before the client gets too connected or goes too deeply into the problem with the EAP counselor.

CASE STUDY 7

Employees report to management that they often smell alcohol on their supervisor's breath and that sometimes the supervisor disappears after lunch. Management talks with the supervisor who assures them that she is not drinking. She says that she often has meetings in the afternoon and that she will do a better job of communicating her schedule to her team and to other departments who may need her. Later the same month, the cleaning crew supervisor reports finding several empty single-serving wine bottles in the supervisor's trash can. (This is a mandatory reporting as outlined in the company's drug-free workplace manual.) Management discusses the matter and decides to formally refer the supervisor to the EAP but to take no additional disciplinary action. Management reports to EAP that the supervisor has been with the company for more than 30 years and that she is close to retirement, so they do not want to tarnish the supervisor's employment record or jeopardize her retirement. The EAP coaches management on how to confront and refer the supervisor. The supervisor comes to the EAP, which assesses her problems as depression and alcohol dependence. The EAP strongly recommends an outpatient substance abuse treatment program as well as therapy with a local provider who has experience with addiction and depression. The supervisor rejects the recommendations and instead prefers to attend Self-Management and Recovery Training (SMART) meetings and see her former therapist. The EAP continues to follow up with the supervisor to ensure compliance with the two-prong plan. About one month later, the supervisor is found passed out in the office building lobby and is taken to a hospital for treatment. Management then gives the supervisor three choices: resign from the company; work with the EAP and comply with all EAP recommendations; or do nothing and be fired for violation of several company policies. The employee chooses the second option and begins outpatient treatment and therapy. The EAP will continue to monitor her compliance and will report results to management.

CASE STUDY 8

While working with a client, an EAP counselor asks why the client did not seek assistance earlier, before the issue became a crisis. The client responds that "my union representative told me the EAP is the devil." The EAP counselor then reaches out to the union representative and learns that the union had experienced problems with the EAP about 10 years ago. Through numerous conversations and collaborations, the EAP counselor and the union representative are able to build a good working relationship; the union soon becomes one of the biggest referral sources for the EAP.

CASE STUDY 9

An employee contacts her union because she is unhappy with the performance evaluation she recently received from her supervisor. The employee is seeking the union's assistance in obtaining an extension on the evaluation period and a re-evaluation after three months. The employee reports to the union that she is dealing with her son's recent suicide attempt and may, therefore, have fallen behind at work. She believes that she can be back on track in three months and would like a new performance evaluation at that time. The union recommends that she contact the EAP and then explains that setting up an appointment with EAP would be good for two reasons: the EAP can provide support and additional resources to ensure that the employee can focus on work for the next three months, and letting management know that she is seeking EAP support shows that she is taking action to resolve the personal problems that are impacting her work performance. (Note: This is not a violation of confidentiality. The client can tell anyone she wants that she is seeking counseling; it is the EAP counselor who needs a signed release of information in order to disclose information about EAP participation.)

CASE STUDY 10

Human resources (HR) conducts a benefits fair and invites the EAP manager to participate as an outreach effort. HR provides the EAP manager (and all HR representatives) with a t-shirt labeled with "HR" and the company's name. To preserve the appearance of confidentiality, however, the EAP manager decides to wear professional attire rather than the company t-shirt. It is key that the EAP remain a neutral entity in the organization.

CASE STUDY 11

An EAP manager and counselor are standing in the hallway openly venting frustrations with their boss. An EAP client walks by and overhears their conversation. Later, the client does not show up for a scheduled appointment. The EAP counselor calls to follow-up with the client and discovers that the client is concerned about confidentiality based on the discussion he overheard in the hallway. Although the EAP manager and counselor were not discussing client information, the perception of confidentiality has been violated.

CASE STUDY 12

An EAP counselor is invited to play on the company's kickball team. The counselor wants to play, but declines the offer in order to preserve the appearance of confidentiality. She decides it is best for EAP counselors to maintain professional boundaries at all times with all employees.