An Introduction to Employee Assistance Programs

Course #76253 - $48-


Self-Assessment Questions

    1 . The first employee assistance programs (EAPs) were
    A) industrial social work.
    B) work assistance programs.
    C) occupational alcohol programs.
    D) employee productivity programs.

    HISTORY OF THE EAP

    The first employee assistance programs were known as occupational alcohol programs (OAPs) and began as informal programs created by recovering alcoholics who had overcome drinking problems by attending Alcoholics Anonymous (AA) meetings [2,3]. In the 1940s, many organizations realized that employees with alcohol problems could be treated and returned to work. Employers recognized that as long as employees continued to abstain from drinking, they showed improved work productivity and personal life satisfaction [3].

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    2 . In the 1960s, EAPs shifted from training supervisors to identify symptoms of alcoholism to identifying
    A) signs of domestic violence.
    B) work performance problems.
    C) employee attendance problems.
    D) symptoms of all mental health problems.

    HISTORY OF THE EAP

    In the 1960s, the focus of OAPs shifted from identifying signs and symptoms of alcoholism to identifying job performance problems in general. This transition was welcomed by most because there were fewer stigmas associated with job performance problems than with alcoholism. Supervisors were more comfortable identifying performance problems and were trained to observe and document symptoms (e.g., excessive absenteeism, poor work quality, missed deadlines, poor customer service). By focusing on job performance problems, supervisors were able to contend with an employee's denial of alcohol abuse. The shift in focus to job performance revealed that employees needed assistance for more than problems with alcohol abuse. It was from this realization that modern employee assistance programs were created.

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    3 . The goal of contemporary EAPs is to provide a wide range of services for employee/clients and encourage early use of the program (i.e., before an individual's problems reach a chronic and potentially less manageable stage).
    A) True
    B) False

    HISTORY OF THE EAP

    The contemporary employee assistance approach is comprehensive. EAPs offer assistance with individual psychologic problems (e.g., depression, anxiety), relationship or family troubles, work stress, financial and legal concerns, and more. The goal of EAPs is to provide a wide range of services for employees/clients and encourage early use of the program (i.e., before an individual's problems reach a chronic and potentially less manageable stage). The original focus on alcoholism is not as prevalent but still exists.

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    4 . EAP core technology can be defined as
    A) the computer software used to track an employee during counseling.
    B) essential components creating a unique approach to counseling in a work setting.
    C) the computer software used to track productivity of employees utilizing the EAP.
    D) essential components creating a unique approach to addressing work organization and productivity issues.

    EAP CORE TECHNOLOGY

    The EAP core technology consists of eight components that, when combined, create a unique approach to addressing productivity issues and employee concerns of a work organization. The core technologies include [1]:

    • Consultation to work organizations

    • Promotion of EAP services

    • Assessment

    • Constructive confrontation

    • Referral for treatment

    • Resource development

    • Health insurance advocacy

    • Evaluation

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    5 . Which of the following is NOT one of the EAP core technologies?
    A) Referral
    B) Assessment
    C) Working independently
    D) Health insurance advocacy

    EAP CORE TECHNOLOGY

    The EAP core technology consists of eight components that, when combined, create a unique approach to addressing productivity issues and employee concerns of a work organization. The core technologies include [1]:

    • Consultation to work organizations

    • Promotion of EAP services

    • Assessment

    • Constructive confrontation

    • Referral for treatment

    • Resource development

    • Health insurance advocacy

    • Evaluation

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    6 . Newsletters, health fairs, onsite workshops, and webinars are examples of ineffective promotion techniques for EAPs.
    A) True
    B) False

    EAP CORE TECHNOLOGY

    The promotion of EAP services in an organization involves providing education and outreach to an organization's employees and dependents to facilitate awareness and encourage the use of these services when needed. Newsletters, health fairs, onsite workshops, and webinars are examples of effective promotion techniques [1].

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    7 . Constructive confrontation is a meeting between an employee and
    A) a supervisor to discuss performance concerns and initiate referral to the EAP.
    B) the EAP counselor to discuss personal problems impacting work performance.
    C) the EAP counselor that allows the EAP to confront the employee about their denial.
    D) a supervisor to confront the employee about performance problems and outline possible disciplinary action.

    EAP CORE TECHNOLOGY

    Constructive confrontation is a tool used to facilitate referral of employees to EAP to address problems affecting their work. Constructive confrontation involves a meeting between an employee and a manager/supervisor to discuss work performance concerns and initiate referral to the EAP.

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    8 . The mission of an EAP is to
    A) provide therapy to employees.
    B) provide counseling to employees.
    C) improve the health of the workplace.
    D) improve the productivity of the workplace.

    HOW EAPs DIFFER FROM THERAPY

    Employee assistance is a workplace-based program. As discussed, its mission is to improve workplace productivity through the resolution of employees' personal problems and consultation with the work organization. EAP services include assessment, referral, and short-term counseling (i.e., advice or guidance given by a specially trained individual to a person having emotional problems). EAP services do not include treatment or therapy [5]. EAP core technologies specifically state that employee clients are referred from the EAP to treatment and outline that the primary role of an EAP counselor is to complete an assessment and connect employees to appropriate treatment resources.

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    9 . The first sessions with an EAP client should include a comprehensive psychosocial assessment.
    A) True
    B) False

    HOW EAPs DIFFER FROM THERAPY

    The first sessions with an EAP client should include a comprehensive psychosocial assessment. After the assessment, the EAP counselor should determine whether the client should be referred to a therapist, physician, or other specialist, or whether the client's problem can be resolved through short-term EAP counseling. An EAP counselor can offer supportive, skills-building services to individual clients if the assessment shows that such services could help improve the client's work performance. Common services provided by EAP counselors include: counseling for work-related problems, such as stress, that do not require treatment or therapy; teaching communication skills to help the client improve relationships with colleagues and/or supervisors; improving the client's time-management habits; helping the client to establish a better work-life balance; or helping the client adjust to a new work role or environment.

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    10 . EAP counselors provide supportive and skills-building services to employee clients, so diagnosis following assessment is required.
    A) True
    B) False

    HOW EAPs DIFFER FROM THERAPY

    EAP counselors provide supportive and skills-building services to employee clients, but because they do not provide treatment or therapy, no diagnosis following assessment is required. Supportive services may include short-term counseling for personal relationship problems, occupational problems, bereavement, or phase-of-life problems [5].

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    11 . A fundamental difference between an EAP and therapy is that the EAP has a primary focus on
    A) work performance and productivity.
    B) stress management and productivity.
    C) work performance and stress management.
    D) resolving conflicts between employees and supervisors.

    HOW EAPs DIFFER FROM THERAPY

    All assessments performed by an EAP counselor should include an assessment of employee work performance. This is essential because EAPs are work-based programs focused on improving productivity; a therapist or counselor who is not conducting an EAP assessment may not ask questions about work. It is important for an EAP counselor to ask about workplace performance, satisfaction, and attendance. It is also important to include workplace improvement goals in the employee's counseling plan and to ask about work performance during follow-up sessions and telephone calls.

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    12 . Follow-up should include contact with a client to monitor progress and/or the impact of EAP recommendations (including referrals to treatment resources) and to determine the need for additional services.
    A) True
    B) False

    HOW EAPs DIFFER FROM THERAPY

    Follow-up should include contact with a client to monitor progress and/or the impact of EAP recommendations (including referrals to treatment resources) and to determine the need for additional services. Follow-up may include telephone calls, face-to-face meetings, written surveys or questionnaires, or a review of job performance and attendance records. This type of follow-up is different from the therapeutic process of aftercare in that it is a monitoring process. Some EAP networks ask the EAP counselor to make follow-up calls to ensure a successful connection with the referrals provided and to assess additional referral or EAP needs. Other EAPs assign a staff counselor (often located at an EAP call center) to follow up with clients, while still others use a questionnaire or survey as the follow-up method.

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    13 . In the majority of circumstances, the employee pays for EAP services for him- or herself.
    A) True
    B) False

    HOW EAPs DIFFER FROM THERAPY

    The source of payment for services is another difference between EAPs and traditional therapy. In the majority of circumstances, an organization pays for EAP services for its employees (typically included as part of the organization's benefits package). Businesses who outsource EAP services typically pay a fixed price (i.e., a monthly, predetermined, per employee rate) to an EAP vendor. The EAP vendor then performs all EAP functions requested or required during the contract period. The EAP vendor pays the EAP counselor, per the terms of its agreement with the counselor. EAP clients pay nothing, including no co-pay.

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    14 . Who are the dual EAP clients?
    A) The employee client and his/her family
    B) The employee client and the organization
    C) The employee client and his/her supervisor
    D) The employee client's supervisor and the organization

    DUAL CLIENTS

    At all times, an EA professional has two clients: the employee client seeking assessment, referral, and short-term counseling, and the company that obtains and pays for the EA program. No matter which client is the primary focus, the EA professional should be cognizant of and give attention to both clients at all times. It is also essential that an EAP counselor remain neutral and maintain confidentiality at all times.

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    15 . Because an EAP counselor has dual EAP clients, he or she should
    A) remain a neutral entity in the workplace.
    B) take the side of the supervisor when a conflict arises.
    C) interview both clients before determining what to do.
    D) take the side of the employee client when a conflict arises.

    DUAL CLIENTS

    At all times, an EA professional has two clients: the employee client seeking assessment, referral, and short-term counseling, and the company that obtains and pays for the EA program. No matter which client is the primary focus, the EA professional should be cognizant of and give attention to both clients at all times. It is also essential that an EAP counselor remain neutral and maintain confidentiality at all times.

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    16 . EAP stakeholders include such entities as individual employees, supervisors and managers, executives, union officials, family members, medical staff, and human resources.
    A) True
    B) False

    STAKEHOLDERS

    EAP stakeholders include such entities as individual employees, supervisors and managers, executives, union officials, family members, medical staff, and human resources.

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    17 . The EAP should coach managers to avoid confronting employees who have work performance problems.
    A) True
    B) False

    STAKEHOLDERS

    Supervisors and managers play an important role in monitoring the work performance and attendance of individual employees, and they are an important link in the early identification of problems and in the problem-resolution process. The EAP should provide supervisors and managers with training to identify problems with work performance (e.g., change in attendance, change in quality of work product, arguments with coworkers, extended lunch breaks). The EAP should also coach managers in how to confront and refer employees who have work performance problems.

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    18 . Wellness staff may collaborate with EAP by providing workshops for employees on such topics as changing health habits and setting goals.
    A) True
    B) False

    STAKEHOLDERS

    Wellness staff includes individuals who provide coaching, exercise programs and instruction, smoking cessation, nutrition education, and other services that promote wellness. Wellness staff should be aware of EAP services to facilitate referrals as needed. They may also collaborate with EAP by providing workshops for employees on such topics as changing health habits and setting goals.

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    19 . A company's drug-free workplace policy can impact the provision of EAP services.
    A) True
    B) False

    STAKEHOLDERS

    There are numerous corporate policies that impact the EAP. For example, a company's drug-free workplace policy may include a referral to the EAP if an employee tests positive on a drug test. A company may also have a formal policy regarding the EAP that assures confidentiality and outlines regulations for administrative or sick leave when an employee seeks EAP counseling. The EAP should be familiar with all workplace policies and ensure that its roles and responsibilities are accurately represented.

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    20 . Formal management referral is the most common type of EAP referral.
    A) True
    B) False

    TYPES OF EAP REFERRALS

    Self-referral is the most common type of EAP referral. It occurs when an employee or family member recognizes a need for counseling help and initiates contact with the EAP. Management and/or the company is not involved.

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    21 . An informal management referral occurs when a manager
    A) calls to schedule an EAP appointment for an employee.
    B) provides an overview of EAP services at a staff meeting.
    C) informally offers an employee counseling and emotional support.
    D) educates an employee about and encourages the use of the EAP.

    TYPES OF EAP REFERRALS

    An informal management referral occurs when a manager becomes aware of an employee's personal problem, has a private discussion with the employee about the problem, informs the employee about the availability of the EAP, and encourages the employee to call EAP for an appointment. Management and/or the company are not involved beyond educating the employee about the EAP.

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    22 . A medical referral occurs when an employee's personal physician recommends counseling and the employee decides either to begin with an EAP assessment or seek EAP help in identifying a therapist.
    A) True
    B) False

    TYPES OF EAP REFERRALS

    A medical referral occurs when an employee's personal physician recommends counseling and the employee decides either to begin with an EAP assessment or seek EAP help in identifying a therapist. This type of referral may also come from a nurse or physician who works for the company's occupational health unit. The referral may be a result of the employee presenting with physical symptoms of stress, anxiety, or depression, or it may be following a physical examination (as is required for many law enforcement agents). In this situation, it is sometimes useful to request that the employee sign a release of information allowing the EAP counselor to consult with medical staff.

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    23 . An EAP call center provides all of the following services, EXCEPT:
    A) Referral to local counselor
    B) Verification of EAP benefits
    C) Comprehensive psychosocial assessment
    D) Telephonic supportive and problem-solving counseling

    THE EAP CALL CENTER

    Unlike when seeking traditional therapy, an EAP client cannot search through a provider directory and initiate EAP counseling. If a company has an onsite EAP counselor, the client may be able to stop by the company's EAP office, but most clients must first telephone their EAP's call center (usually a toll-free number accessible 24 hours per day, 7 days per week). The call is answered either by a specially trained customer service representative or a Master's level mental health clinician. Customer service representatives are typically college graduates who have been trained regarding the sensitive nature of EAP calls. Customer service representatives verify eligibility for EAP service, educate the client about available benefits, gather basic demographic information (e.g., name, telephone number, address, age, presenting problem), and complete a basic risk assessment for substance abuse, domestic violence, suicide, homicide, and child abuse.

    If no risk is identified, then the customer service representative connects the client with an EAP provider who participates in the network within the client's preferred geographic area. Some EAPs also accommodate other client preferences, including gender, religion, ethnicity, military status, health insurance participation, or evening/weekend hours. The EAP attempts to connect the client to the EAP counselor who is best matched to the client's location and counseling needs. Some EAPs provide the client with the counselor's contact information and instructions about how to set up an appointment. Other EAPs call the counselor directly to set up the appointment for the client. If risk is identified, or if the client is upset or requests to speak with a counselor immediately, the client is transferred to a Master's level mental health clinician immediately. Most EAPs have a Master's level clinician available 24 hours per day.

    In addition to completing the tasks outlined for the customer service representative, the EAP counselor offers telephonic supportive counseling and problem-solving. The counseling may also include creating a safety plan, calling 911 or another mobile crisis unit for immediate support, teaching the client deep breathing or other stress management techniques, or sending the client literature about their topic of concern.

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    24 . A comprehensive EAP assessment includes
    A) presenting problem, symptoms, and diagnosis.
    B) workplace impact, risk evaluation, and diagnosis.
    C) history, symptoms, workplace impact, and diagnosis.
    D) presenting problem, history, symptoms, workplace impact, and risk evaluation.

    ASSESSMENT, REFERRAL, AND SHORT-TERM COUNSELING

    After the client calls the EAP and connects with the EAP counselor, the next step is assessment, followed by either short-term counseling or referral, as outlined in the core technologies. A comprehensive assessment includes consideration of the following elements:

    • Presenting problem and history of the problem (including what, if anything, the client has done to resolve the problem)

    • History (e.g., family, medical, mental health, substance abuse)

    • Current symptoms (e.g., sleep, appetite, concentration, mood)

    • Cognitive functioning (e.g., orientation to date/place, memory, speech/appearance)

    • Workplace impact (e.g., attendance, performance)

    • Relationships and support systems

    • Risk (e.g., violence, substance abuse, child abuse)

    • Strengths

    • Client goals and desired outcomes

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    25 . Short-term EAP counseling is provided if
    A) the client cannot afford therapy through health insurance.
    B) the client requests short-term counseling through the EAP.
    C) the assessment indicates that the problem(s) can be resolved in the remaining EAP sessions.
    D) the counselor does not believe the client's story and needs more time to build rapport and break through denial.

    ASSESSMENT, REFERRAL, AND SHORT-TERM COUNSELING

    After the assessment is completed, the counselor makes recommendations and works with the client to develop and agree upon a plan of action. The action plan may include short-term EAP counseling, a referral to treatment, recommended readings for the client, self-help group participation, and other community resources. The plan should also include measurable outcomes and a follow-up plan. The assessment and development of a plan is typically completed within the first two sessions.

    Short-term EAP counseling is used if the assessed problem and the client's desired goals can be fully addressed and accomplished in the remaining one to six sessions. Short-term counseling may include the following elements:

    • Psycho-education

    • Problem solving

    • Skills building

    • Support

    • Homework between sessions

    • Ongoing measurement of progress and re-evaluation of original plan

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    26 . When an EAP counselor refers a client to a specialist, the counselor should
    A) set up the appointment with the specialist for the employee.
    B) call the employee's health insurance company to get the referral approved.
    C) provide specific names of specialists and education about the referral process.
    D) refer the employee to their health insurance company for help finding a specialist.

    REFERRALS AND THE REFERRAL DATABASE

    When a referral is needed, the EAP counselor provides the client with treatment and therapy options, including the names of providers, providers' contact information, and an overview of each provider's services and credentials. The counselor should consider the clinical needs of the client and the client's preferences for location, insurance, cost, and other specifications. If the counselor is not familiar with an appropriate referral source, it may be necessary to telephone several providers in order to prescreen them and find suitable resources for the client.

    In addition to providing the referral information to the client, the counselor should coach clients about how to contact referrals and initiate treatment. The counselor also should educate the client about the treatment process and what to expect from the treatment program. The counselor should discuss a follow-up plan and explore the client's motivation to follow through on contacting the referral. Motivational interviewing techniques can be useful strategies for increasing a client's commitment to follow through. The job of an EAP counselor is most successful when the client adheres to the plan and contacts the referral.

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    27 . Case monitoring and follow-up are included in the EAP service model, which differentiates EAP from the traditional therapy model in which the client is responsible for initiating any desired follow-up.
    A) True
    B) False

    REFERRALS AND THE REFERRAL DATABASE

    Referrals are a fundamental part of EAPs, however, case monitoring and follow-up are also included in the EAP service model. This differentiates EAP from the traditional therapy model in which the client is responsible for initiating any desired follow-up. EAP follow-up is typically achieved by telephoning the employee, but it may also be achieved with either a face-to-face session or via a survey in the mail. Typically, follow-up assesses whether the client accessed referral resources and whether the referral was a good fit. Follow-up may also assess current work performance and any other additional needs. If the client is complying with the agreed-upon plan, finding the plan to be helpful, and has no new work performance problems, the case is normally closed. If the client is not complying with the plan and/or has not contacted the referrals, then the counselor engages in additional motivational work to help the client break down barriers that are preventing compliance and follow through. If the client cannot be reached, the EAP counselor often documents three attempts to contact for follow-up before closing the case.

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    28 . According to the 2020 National Survey on Drug Use and Health, the population of adults with substance use disorder included
    A) 3.9% of full-time workers and 5.9% of part-time workers.
    B) 5.9% of full-time workers and 3.9% of part-time workers.
    C) 16.9% of full-time workers and 16.7% of part-time workers.
    D) 17.4% of full-time workers and 8.9% of part-time workers.

    SUBSTANCE ABUSE

    Assisting employees with substance abuse problems is fundamental to EAPs. As discussed, OAPs were the original model. According to the 2020 National Survey on Drug Use and Health, the rate of substance use disorder was 16.9% among full-time workers and 16.7% among part-time workers. In addition, of the 54.1 million adults with alcohol use disorder, 71% were employed either full or part time [6]. Substance abusers have been shown to have higher rates of absenteeism, workplace accidents, disability claims, healthcare claims, and conflicts with coworkers, thus the continued emphasis by EAPs to screen all clients for substance dependence or abuse.

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    29 . Which of the following is NOT a role of the EAP in enforcing the Drug-Free Workplace Act?
    A) Administering random drug tests and ensuring compliance with all regulations
    B) Providing case monitoring and follow-up to an employee in treatment after a positive drug test
    C) Providing employees who test positive on a drug test with assistance in finding and obtaining treatment
    D) Providing supervisory training to assist in identifying and addressing illegal drug use by agency employees

    SUBSTANCE ABUSE

    In 1986, President Reagan signed Executive Order 12564 for the Drug-Free Federal Workplace, which mandates that federal employees refrain from illegal drug use and that each agency establish a plan for obtaining a drug-free workplace and establish a drug testing program [7]. The order specifies that each agency's plan should include EAPs that emphasize "high-level direction, education, counseling, referral to rehabilitation, and coordination with available community resources" [7]. The Order also requires that supervisors be trained to help identify and address illegal drug use by employees, which is often a role that an EAP counselor is asked to perform. In 1988, the Drug-Free Workplace Act (Public Law 100-690, Title V, Subtitle D) required certain federal contractors and all federal grantees to agree to provide drug-free workplaces as a precondition of receiving federal grants or contracts [8]. These actions by the federal government increased the demand for EAPs and emphasized the need to continue to assess for and provide treatment resources to employees with substance abuse problems.

    Most drug-free workplace plans and regulations require that companies offer assistance to any employee who tests positive for substance use. (The company is not required to pay for treatment or to retain the employee; it is only required to offer the employee assistance in finding and obtaining treatment.) This is typically achieved by referring the employee to an EAP counselor who completes an assessment and refers the employee to appropriate treatment resources. If the employee continues to be employed during treatment, the EAP counselor may be asked to provide case monitoring and follow-up to ensure that the client is receiving treatment and complying with treatment recommendations. The EAP is not responsible for releasing the client to return to work or determining appropriate disciplinary action.

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    30 . It is important for the EAP to build a good working relationship with the union because
    A) the union can protect the EAP counselor's job.
    B) the EAP may need the union to assist them on a case.
    C) employees expect their union to provide emotional support.
    D) it is often the first place many employees turn to when they are dealing with work stress.

    UNIONS

    Unions provided support, assistance, and counseling programs before EAPs existed. Unions are stakeholders in current EAPs, and EAPs should look to collaborate with unions. When employees are dealing with stress and other problems that affect their work, they often turn to their fellow union members for support. Building collaborative relationships with union leaders can position EAPs as a resource for additional support. The union also plays a role in the perception and the acceptance of an EAP within an organization.

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    31 . Consultation with work organization leadership (e.g., managers, supervisors, union officials) is typically initiated by an employee who contacts an EAP counselor to discuss concerns about a supervisor.
    A) True
    B) False

    OTHER EAP SERVICES

    Consultation with work organization leadership (e.g., managers, supervisors, union officials) seeking to manage the troubled employee, enhance the work environment, and improve employee job performance is a part of the EAP core technology component 1 [1]. This service is typically initiated by a supervisor who contacts an EAP counselor to discuss concerns about an employee. The EAP counselor's responsibilities are to listen, build rapport with the manager, validate the manager's experience, and begin to assess the problem. It is common for a manager to telephone, give the EAP counselor a brief description of the area(s) of concern, and then ask: "So what do I do?" Often, an EAP counselor's next step is to slow the manager down and gather additional information so the counselor has a comprehensive understanding of the problem and the history. The skills required for a successful management consultation are transferable and similar (if not the same) to the skills used when working with an individual employee client.

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    32 . Which of the following is an example of a manager's enabling behavior?
    A) Cutting the employee slack when problems start
    B) Talking with employees as soon as a performance problem begins
    C) Talking with human resources about handling a problem employee
    D) Holding the employee accountable for work performance at all times

    OTHER EAP SERVICES

    Many managers enable their employees and then problems worsen. It is not uncommon for a manager to make excuses or cut the employee slack when problems start. Managers often believe that they are protecting and/or helping employees by not holding them accountable. The EAP should help managers learn the importance of holding employees accountable. This in turn helps prevent problem escalation and encourages problem resolution. Educating managers about enabling behaviors is a key part of the management consultation process.

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    33 . Which of the following is NOT part of an EAP orientation?
    A) Services offered
    B) Contact information
    C) Review of confidentiality
    D) Testimonials from employees

    OTHER EAP SERVICES

    Orientations are typically offered either when a new EAP is contracted to provide services to an organization or at new employee orientations sponsored by the organization. However, employee orientations may be included in town hall meetings held by executives, in staff meetings, or during other events, and are good ways of reminding employees about the availability of EAP services. Typical orientations educate employees about the services offered by the EAP, the number of counseling sessions available to them, the confidentiality for employees who meet with the EAP, and contact information and the location of the EAP.

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    34 . The purpose of EAP supervisory training is to teach supervisors
    A) how to identify mental illness.
    B) fundamental supervisory skills.
    C) how to document performance problems.
    D) how to work with different personality types.

    OTHER EAP SERVICES

    Supervisory training is a formal training session for supervisors and managers to orient them to EAP activities and benefits and to educate them about their role in the identification of work performance problems and EAP referral. Trainings will typically include an overview of EAP services, a thorough review of confidentiality policies, indicators of a problem employee (e.g., performance, attendance, conduct), types of EAP referrals (informal vs. formal), and how to discuss and refer an employee to the EAP (constructive confrontation). Trainings also provide supervisors with education about how to document work performance deficiencies, and they differentiate the roles played by the supervisor, union, human resources, and EAP.

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    35 . All of the following are goals of a critical incident stress management (CISM) response, EXCEPT:
    A) To provide support to employees
    B) To provide employees with coping resources
    C) To assess which employees need time off to recover
    D) To educate supervisors about how to support and monitor their employees

    OTHER EAP SERVICES

    The goals of CISM services are to provide support to employees, to provide education to supervisors about how to support and monitor their employees, and to provide employees with coping resources. EAP counselors may be asked to provide onsite CISM services following, for example, the death or terminal illness diagnosis of an employee, a robbery, workplace violence accident, industrial accident, or other trauma impacting employees. The EAP counselor should be specifically trained in CISM response before performing this type of service.

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    36 . Which of the following does NOT require a CISM response by the EAP?
    A) A robbery
    B) An employee's death
    C) An industrial accident
    D) An employee's spouse's death

    OTHER EAP SERVICES

    The goals of CISM services are to provide support to employees, to provide education to supervisors about how to support and monitor their employees, and to provide employees with coping resources. EAP counselors may be asked to provide onsite CISM services following, for example, the death or terminal illness diagnosis of an employee, a robbery, workplace violence accident, industrial accident, or other trauma impacting employees. The EAP counselor should be specifically trained in CISM response before performing this type of service.

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    37 . Which of the following is an example of an internal EAP?
    A) Company employees must call an outside EAP toll-free number.
    B) A counselor provides EAP to all companies within a certain building.
    C) The counselor providing EAP counseling is an employee of the company, not an outside vendor.
    D) An EAP employee sits onsite in a company building and provides EAP services to the company's employees.

    PROGRAM VARIATIONS

    An internal EAP is a "company" EAP, meaning the EAP and its services are part of the company's structure, not provided by an outside vendor. Internal EAP counselors are employees of the company.

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    38 . The Hughes Act
    A) specifies that EAP records are confidential.
    B) protects the security clearance of individuals seeking counseling.
    C) protects the confidentiality of clients seeking mental health treatment.
    D) protects the confidentiality of clients seeking treatment for alcoholism.

    CONFIDENTIALITY

    Also known as the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act Amendments or the Hughes Act, this law protects the confidentiality of patients seeking treatment for alcoholism or alcohol abuse education, training, treatment, rehabilitation, or research. Protected records include the identity, diagnosis, prognosis, and treatment of the patient [12]. As a result of this Act, all EAP records are considered confidential.

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    39 . In addition to giving individuals the right to understand and control how their health information is used, HIPAA's Privacy Rule
    A) establishes standards for notes kept by employers.
    B) prevents disclosure of individuals' protected health information.
    C) prevents disclosure of clinical notes by therapists and psychiatrists in any circumstance.
    D) establishes standards regarding the use and disclosure of individuals' protected health information.

    CONFIDENTIALITY

    The HIPAA Privacy Rule establishes national standards regarding the use and disclosure of individuals' health information, called protected health information (PHI), as well as standards for individuals' privacy rights to understand and control how their health information is used. A major goal of the Privacy Rule is to protect individuals' health information while also allowing the flow of that information as needed to provide and promote high-quality health care. The Privacy Rule establishes requirements of providers to notify patients regarding their privacy practices, to obtain written authorization for disclosure, and to disclose only minimally necessary amounts of information. The Privacy Rule also outlines individual patient rights, such as a right to access records, to request amendments, to request an accounting of disclosures, and to file a complaint [14].

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    40 . Seeking EAP counseling does not impact one's ability to retain employment or be promoted; however, failure to seek counseling may cause problems on the job because
    A) EAP counseling is mandatory when performance problems exist.
    B) unresolved problems typically lead to inpatient hospitalization.
    C) unresolved problems can escalate and create further job strain.
    D) supervisors are allowed to discriminate against mentally ill employees who are not in counseling.

    CONFIDENTIALITY

    Employees with a security clearance are often concerned that seeking EAP counseling will result in the loss of their clearance and then loss of their job. It is often best to refer these employees back to the EAP program manager or to their security office for clarification about these concerns. Regulations of the U.S. Office of Personnel Management (OPM) and the U.S. Department of Defense (DOD) state that security clearance will not be revoked or denied solely on the basis of seeking mental health counseling. It can be useful to remind employees that resolving personal problems can protect their security clearances and jobs by promoting personal and professional performance. Employees who need counseling and who fail to seek counseling will likely, over time, find problems escalating, symptoms worsening, and work performance declining, which puts their security clearance at risk.

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    41 . Which of the following is an example of time off covered by the Family Medical Leave Act (FMLA)?
    A) An employee staying in bed for one week because of the flu
    B) An employee taking a vacation because he/she feels overwhelmed
    C) An employee unable to work for four weeks due to a serious medical condition
    D) An employee going to kick-boxing classes twice as part of a stress management plan

    LAWS IMPACTING EMPLOYEES IN THE WORKPLACE

    The Family and Medical Leave Act (FMLA) of 1993 entitles eligible employees to take up to 12 weeks of unpaid, job-protected leave in a 12-month period for specified family and medical reasons [17]. Reasons for taking FMLA may include birth and care of the newborn child of the employee; for placement with the employee of a son or daughter for adoption or foster care; to care for an immediate family member (i.e., spouse, child, parent) with a serious health condition; or to take medical leave when the employee is unable to work due to a serious medical condition. In 2008, the first-ever amendments to FMLA were signed into law. They provide new military family leave entitlements, including leave for a qualifying exigency arising out of the fact that an immediate family member (i.e., spouse, child, parent) is a covered military member on covered active duty. Up to 26 weeks of leave in a single 12-month period may also be granted to care for a covered service member with a serious injury or illness if the eligible employee is the service member's spouse, son, daughter, parent, or next of kin [17]. In some cases, leave may be taken intermittently. FMLA applies to both public-sector employers and private-sector employers who employed 50 or more employees in 20 or more workweeks in the current or preceding calendar year. To be eligible for FMLA, an employee must work for a covered employer; have worked for the employer for a total of 12 months; have worked at least 1,250 hours over the previous 12 months; and work at a location in the United States or a U.S. territory.

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    42 . Workers' compensation laws are designed to ensure that employees who are injured or disabled on the job are provided with fixed monetary awards, eliminating the need for litigation.
    A) True
    B) False

    LAWS IMPACTING EMPLOYEES IN THE WORKPLACE

    Workers' compensation, sometimes referred to as "workman's compensation" or "workers' comp," is the name given to a system of laws meant to protect injured workers. Workers' compensation laws are designed to ensure that employees who are injured or disabled on the job are provided with fixed monetary awards, eliminating the need for litigation. These laws also provide benefits for dependents of workers who are killed because of work-related accidents or illnesses. Each state has its own workers' compensation laws. Most laws provide for partial pay of an employee's salary following a workplace accident and coverage of medical expenses [18].

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    43 . Which of the following is NOT a covered disability according to the Americans with Disabilities Act?
    A) An employee who is an alcoholic
    B) An employee who is currently using illegal drugs
    C) An employee who has been diagnosed with multiple sclerosis
    D) An employee who has been diagnosed with major depression

    LAWS IMPACTING EMPLOYEES IN THE WORKPLACE

    Individuals who currently engage in the illegal use of drugs are specifically excluded from coverage under the ADA when the employer takes action on the basis of the drug use. Testing applicants for the use of illegal drugs is not subject to the ADA's restrictions on medical examinations. But, a person who currently uses alcohol is not automatically denied protection. An alcoholic is a person with a disability and is protected by the ADA if she or he is qualified to perform the essential functions of the job, and an employer may be required to provide an accommodation to an alcoholic. However, an employer can discipline, discharge, or deny employment to an alcoholic whose use of alcohol adversely affects job performance or conduct. Employers may hold alcoholics to the same performance standards as other employees [14]. An employer also may prohibit the use of alcohol in the workplace and can require that employees not be under the influence of alcohol.

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    44 . When explaining EAP, all of the following terms should be emphasized, EXCEPT:
    A) Free
    B) Voluntary
    C) Mandatory
    D) Confidential

    EXPLAINING EAP

    When discussing EAPs, it is important to mention that they are confidential, free, and voluntary, and that they provide assessment, referral, and short-term counseling to employees who have personal problems. Mentioning that EAPs have been proven to help individual employees enhance their work and personal lives while simultaneously improving the overall productivity of the individual's employer can be helpful. This helps reinforce the business model of an EAP. Emphasizing the words confidential, free, and voluntary is critical.

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    45 . In the United States, certified employee assistance professionals (CEAPs) are credentialed by the
    A) Employee Assistance Certification Commission.
    B) Employee Assistance Society of North America.
    C) International Association of Employee Assistance Professionals in Education.
    D) All of the above

    EAP CREDENTIALING

    The Certified Employee Assistance Professional (CEAP) program is administered by the Employee Assistance Certification Commission (EACC), an autonomous credentialing body established in 1986 by the EAPA. The CEAP program is recognized worldwide and was the first credential to represent the EA profession [22].

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