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Chapter 11 Employee Counseling and Wellness Services

Werner

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Learning Objectives

Explain the need for employee counseling in organizations and why counseling is an HRD activity

Describe the focus and effectiveness of three types of employee counseling programs:

Employee assistance programs

Stress management interventions

Employee wellness/health promotion programs

Personal Problems

Personal problems are a part of life

They can affect behavior at work as well as does one’s personal life

Such problems contribute to accidents, absenteeism and turnover, poor decisions, decreases in productivity, and increased costs

Reasons for Promoting Well-Being

Rising healthcare costs

Reduce workers' tardiness, absenteeism, turnover, lost time from work because of illness and injury, and accidents

Link Between Employee Counseling and Coaching

Much of coaching is focused on worker’s performance

Many work performance problems are tied to worker’s personal lives

Employee counseling focuses on these problems

Picture from: https://drseanalexander.org/70-2/

Much of coaching is focused on worker’s performance on job and improving that performance

Many work performance problems are tied to worker’s personal lives

Employee counseling focuses on these problems, especially on how they effect worker performance

Supervisors should not try to solve or resolve the employee’s problem themselves

Employee Counseling as an HRD Activity

Employee counseling is an HRD activity

Coaching and counseling are often intertwined

Supervisors are generally encouraged to provide early identification and referral to a trained professional or counseling service

Supervisors should not try to solve or resolve the employee’s problem themselves

A Typical Counseling Program

Problem Identification

Education

Referral

Counseling

Treatment

Follow-up

Who Provides the Service?

A counseling program in-house

A contracted-out independent service

Employee Assistance Programs (EAP)

EAPs are defined as job-based programs operating within a work organization for the purposes of:

Identifying troubled employees

Motivating them to resolve their troubles

Providing access to counseling or treatment for those employees who need these services

Meet an Employee Assistance Program specialist

Behavioral Problem Indicators

Absenteeism

On-the-job absences

High accident rates

Job performance issues

Poor relationships with coworkers

Absenteeism

Taking many absences without authorization

Using vacation days to cover frequent absences

On-the-job absences

Often away from one’s work area

Frequent tardiness after lunch or breaks

High accident rates

Accidents off the job that affect work performance

Accidents on the job due to carelessness, inattentiveness, etc.

Job performance issues

Complaints from coworkers or clients

Missing deadlines

Frequent shifts between high and low performance

Difficulty understanding instructions or new information

Poor relationships with coworkers

Extreme reactions to real or implied criticism

Large mood swings

Avoiding coworkers and friends

Increasing irritability or argumentativeness

Substance Abuse

Alcohol and drug abuse

Greater risk for accidents, injuries, disciplinary problems, and involuntary turnover

21.8 million Americans are current illicit drug users

47% of industrial injuries are due to alcohol use

Estimated that companies lose over $7,000 per year for every employee who abuses alcohol or drugs

Mental Health

About 21 million adults in the United States experience a depressive illness in any given year

Up to 25 percent of medical claims filed can be tied to mental and emotional illnesses

5.4 percent of American adults have a serious mental illness that substantially interferes with one or more major life activities

Emotional and Mental Health Issues Commonly Seen

Individual adjustment problems

Divorce and marital problems

Difficulties with family or children

Depression and suicide attempts

Problem gambling

Legal and financial problems

Discussion

Suppose you were asked by your employer to develop a proposal for an employee assistance program (EAP). Which approach would you recommend: an in-house program run by employees of your organization or a service provided by an outside contractor? Support your choice.

Suppose financial constraints limited the company to offering only two areas of service (e.g., mental health, substance abuse, gambling, financial problems). Which services do you think are most important? Support your choices. Describe how you would make sure that you select the services that would provide the company and employees with the most benefits.

In-House Service

Advantages

Internal control of the program

Familiarity with the organization

Better coordination of treatment and follow-up

A sense of ownership of the program greater awareness and credibility with supervisors

Disadvantages

Real or perceived problems with confidentiality

Lack of resources needed

Reluctance of some employees to use the service

Possible limitations in staff skills and expertise

Contracting Out

Advantages

Can rely on the services of trained professionals

Confidentiality may be easier to maintain

Cost may be lower

Better identification and use of community resources

Disadvantages

Lack of on-site counseling

Possible communication problems

Lack of knowledge of the organization and its employees by contractor

Stress Management

Stress is a common aspect of the work experience

Expressed as:

Job dissatisfaction

Anger

Frustration

Hostility

Irritation

Categories of Stress Response

Five categories of behavioral responses to stress:

Degradation/disruption of the work role itself (e.g., accidents and errors)

Aggressive behavior at work (e.g., stealing)

Flight from the job (e.g., absenteeism)

Degradation/disruption of other life roles (e.g., spouse abuse)

Self-damaging behaviors (e.g., smoking or alcohol or drug use)

Stress

Includes three main components:

Some environmental force affecting the individual, which is called a stressor

The individual’s psychological or physical response to the stressor

In some cases, an interaction between the stressor and the individual’s response

Stress Management Programs or Interventions (SMIs)

Any activity, program, or opportunity initiated by an organization, which focuses on reducing the presence of work-related stressors or on assisting individuals to minimize the negative outcomes of exposure to these stressors

Stress management interventions (SMI) are popular

Two important issues have yet to be completely addressed:

The definition of stress

The effectiveness of SMIs

Organizational Stressors

Factors intrinsic to the job

Organizational structure and control

Reward systems

Human resource systems

Leadership

Factors intrinsic to the job

Role conflict or ambiguity

Workload

Insufficient control

Organizational structure and control

Red tape politics

Rigid policies

Reward systems

Faulty and infrequent feedback

Inequitable rewards

Human resource systems

Inadequate career opportunities

Lack of training

Leadership

Poor relationships

Lack of respect

Stress Management Programs or Interventions

Educational Interventions are designed to inform the employee about:

The sources of stress

What stress feels like

How the individual can better cope with stress

Skill-acquisition interventions are designed to

Provide employees with new ways to cope with stressors

Help keep the effects of stress in check

Issues Guiding SMIs

Look for specific issues with employees—instead of talking generally about “stress,” determine what specifically is going on with employees

Assessment—What evidence is there of a problem, and how widespread is it?

Specific and focused solutions

What will work in a particular organization?

Where should the intervention be targeted?

Strategic intervention

How does this intervention relate to other HR and organizational practices?

Do other things in the organization need to change first?

Evaluation and feedback

What will be evaluated?

How will this guide future actions?

Discussion

Stress management interventions commonly focus on helping employees find ways to deal with the stressors in their lives. But some experts believe organizations should modify jobs or other organizational attributes (e.g., management style) to remove or reduce the impact of such stressors themselves, rather than teaching coping skills alone. What is your opinion on this matter? Support your position.

Exercise: How Are You Dealing with Stress?

Fill out the survey.

Was this survey and the follow-up information helpful to you?

What has worked best for you in dealing with stress in your life?

Employee Wellness Programs (EWPs) or Health Promotion Programs (HPPs)

Encourage individuals to adopt lifestyles that maximize overall well-being

Level I Programs

Primarily cover educational activities

Level II Programs

Attempt to bring about direct behavioral change

Level III Programs

Try to create an organizational environment that helps employees maintain healthy lifestyles

Activities that promote employee behavior

Organizational practices that ensure employee health and fitness

Activities that promote employee behavior

Organizational practices that ensure employee health and fitness

Based on the premise that wellness is more than the mere absence of disease

Encourage individuals to adopt lifestyles that maximize overall well-being

Deal with stress and non-stress issues

Obesity

Nutrition

Smoking cessation

Level I Programs

Primarily cover educational activities and may not attempt to directly change employee behavior

Newsletters, posters, classes, and health screening

Level II Programs

Attempt to bring about direct behavioral change

May include supervised exercise classes, memberships in fitness centers, and classes on how to properly perform physical work tasks, such as lifting

Level III Programs

Try to create an organizational environment that helps employees maintain healthy lifestyles

Ten Dimensions of Employee Wellness Programs (WWPs)

Establishing a constructive policy for wellness

Conducting wellness screening—health risk appraisals

Establishing working relationships with community resources

Referral of employees to treatment and health-improvement interventions

Providing health-improvement interventions using a menu approach

Ten Dimensions of Employee Wellness Programs (WWPs) (cont.)

Outreach and follow-up counseling, done on a regular and ongoing basis

Wellness events done for the entire organization

Consultation on worksite policies and systems, and organizational-level changes

Ongoing evaluation of the process used to carry out the wellness program, as well as any reductions in employees’ health risks

Periodic evaluation based on work performance and benefit use

Four Common Components of Health Promotion Programs

Exercise and fitness

Smoking cessation

Nutrition and weight control

Control of hypertension (high blood pressure)

Exercise and Fitness

Corporate exercise and fitness programs are among the most popular employee well-being interventions

The major obstacle to the effectiveness of fitness and exercise programs may be persuading the employees who would most benefit from them to participate

Smoking Cessation

Smoking is one of the most publicized health risks in society and the workplace

Over eight dollars gained for every one dollar spent on the program

35 percent of private companies have a smoking cessation program

The additional annual cost of employing smokers and allowing smoking in the workplace has been estimated to be $2,853 per smoker

Worksite smoking cessation programs can yield a cost-benefit ratio of 8.75

Over eight dollars gained for every one dollar spent on the program

Reduced health costs

Reduced secondary effects on non-smokers

Reduced facility and cleaning costs

It has been amply demonstrated that smoking is linked to greater incidence of:

Coronary heart disease

Stroke

Cancer

Emphysema

20.9 percent of U.S. adults smoke

Down from 42.4% in 1965

Nutrition and Weight Control Interventions

68 percent of U.S. adults can be considered either overweight or obese

Include educational activities, newsletters, leaflets, cooking demonstrations, weigh-ins, and advice on developing weight-loss programs

Overweight is defined as being 25 to 29.9 percent or more over one’s “ideal” body weight (based on height and gender)

Obesity is defined by a body mass index (BMI) of thirty or more

Approx Weight/7.37 for Males

Approx Weight/6.96 for Females

Obesity has been causally associated with musculoskeletal problems, hypertension, high levels of blood sugar and cholesterol, and some forms of cancer

Organizations may also stock cafeterias and vending machines with healthy, low-fat foods

Post nutritional information concerning food sold in cafeteria

Provide a “health coach” to assist employees with issues such as obesity and smoking

Negative attitudes toward overweight individuals are widespread in our society

Psychological and economic implications for overweight individuals

Potential legal implications for employers

Organizations must ensure that interventions are kept free of negative stereotypes and negative job outcomes for participants unless the participant’s weight is truly related to their ability to perform a given job

Control of Hypertension (High Blood Pressure)

It can often be controlled through:

Exercise

Weight reduction

Medication

Stress reduction

A low-salt diet

Typical screening and control program may include:

Provision of educational materials

Blood pressure screenings to identify hypertensive employees

Approximately 29 percent of U.S. adults suffer from hypertension

An additional 31 percent classified as pre-hypertensive (i.e., at risk for hypertension)

Hypertension causes a significantly greater incidence of heart disease and stroke

Typical Hypertension Program

Referral of such employees for treatment

Installation of blood pressure screening equipment for employees to use to monitor their own blood pressure

Low-salt foods available in both cafeteria and vending machines

Periodic monitoring of employee progress

Cost Benefit of Reducing Hypertension

Effectiveness of workplace hypertension programs in reducing blood pressure and increasing participant knowledge appears to be well established

Benefit of $1.89 to $2.72 in reduced healthcare claims per dollar spent on running a hypertension control program

Six Steps for Better Health

Provide nutritious options in cafeterias and vending machines

Make the workplace smoke free

Encourage exercise by offering employees free use of a fitness center

Offer on-site health education and screening

Share with employees who take care of themselves some of the savings they generate

Design healthcare programs with a component that extends to employees’ families

Provide nutritious options in cafeterias and vending machines and, if possible, subsidize the purchase of them

Make the workplace smoke free and help employees kick the habit outside of work

Encourage exercise by offering employees free use of a fitness center or subsidizing employees ’memberships to offsite facilities

Offer on-site health education and screening for conditions like high blood pressure and cholesterol

Share with employees who take care of themselves some of the savings they generate

Design healthcare programs with a component that extends to employees’ families

Legal Issues

Rehabilitation Act of 1973

Applies to federal contractors and government supported organizations

Specifies that employees with disabilities may be discharged only for job-performance reasons

Americans with Disabilities Act of 1990 (ADA)

Both laws cover employees with alcohol and drug problems

Rehabilitation Act

Applies to federal contractors and government supported organizations

Specifies that employees with disabilities may be discharged only for job-performance reasons

An alcoholic employee may not be fired because of his or her alcoholism

Only fired for the negative effects the alcoholism has had on work performance

Employer must make reasonable accommodations that help the employee resolve the problem and improve performance

Americans with Disabilities Act (ADA)

Applies to all employers of fifteen or more employees

ADA broadly defines reasonable accommodation to include modification of facilities, materials, procedures, and jobs

Employers must take such action provided these modifications do not create an “undue hardship” on the organization (e.g., significant difficulty or expense)

Whose Responsibility Is Employee Counseling?

Employees, the organization, supervisors, and unions all have a role to play in employee well-being

The individual bears primary responsibility for his or her own well-being

Ethical Issues in Employee Counseling

Confidentiality

Voluntary or mandatory

Unintended Negative Outcomes

Workers’ compensation cost increases

Employees participating in fitness programs may experience scheduling problems, increased fatigue and accidents, and lower performance

Smoking bans may lead to conflicts between smokers and nonsmokers

Two ethical issues relating to employee counseling

Confidentiality; all records of program utilization should be:

Held in the strictest confidence

Maintained separately

Released only with the express permission of the employee

Voluntary or mandatory

Debate

Some people believe that wellness programs infringe on an individual’s right to choose his or her own lifestyle, maintaining that an individual has the right to smoke cigarettes, eat junk food, and avoid exercise if he or she wants to.

What argument can you make to support the use of workplace wellness and health promotion programs?

What argument would support the critics of workplace wellness programs?

If you were a director of a workplace wellness program at a large banking firm, for example, how would you balance the needs of the company with the rights of individuals? Support your position.

Effective Employee Counseling Programs

Must have:

Top management commitment and support

A clearly written set of policies and procedures

Cooperation with local union(s), if they are present in the organization

A range of care (e.g., referral to community resources, follow-up)

Maintenance of records for program evaluation

Health insurance benefit coverage for services

Family education

Closing Comments

Both organizations and employees have much to gain from workplace counseling and wellness interventions

Healthy work environments cannot be expected to occur without healthy employees

Homework (Due by Nov midnight of 20th)

Watch the Ted video (How to make stress your friend), summarize the speaker’s speech, and answer the following questions in a one-page paper:

Have you, your family, or friends ever experienced the problem the speaker mentioned? Describe what happened.

What do you think might be the causes of the problem?

What solutions could a person do on their own? What solutions could people do together? Would one be better than the other? Why or why not?