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CH-11 Copyright 2008 Werner et al 1
Employee Counseling and Wellness Services
Chapter 11
CH-11 Copyright 2008 Werner et al 2
Learning Objectives
• Explain the need for employee counseling in organizations and why counseling is an HRD activity
• Describe the typical activities included in employee counseling programs
• Describe the focus and effectiveness of three types of employee counseling programs: – employee assistance programs – stress management interventions– employee wellness/health promotion programs
CH-11 Copyright 2008 Werner et al 3
Learning Objectives
• Describe the role of supervisors in the various types of employee counseling programs
• Explain the legal and ethical issues raised by employee counseling, assistance, and health and wellness programs
CH-11 Copyright 2008 Werner et al 4
Questions
• Have you ever witnessed any of the following from someone in a work setting?• Showing up for work under the influence of alcohol or drugs• Struggling to maintain satisfactory job performance because of severe anxiety or depression• Refusing medical or other assistance for a treatable condition • Burnout or fatigue as a response to ongoing work pressures and stress• Involvement (or noninvolvement) in organizational efforts to promote good health (e.g., fitness, nutrition, weight control, or control of high blood pressure)
CH-11 Copyright 2008 Werner et al 5
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
CH-11 Copyright 2008 Werner et al 6
Reasons for Promoting Well-Being
• Rising healthcare costs
• Reduce workers' compensation costs, tardiness, absenteeism, turnover, lost time from work because of illness and injury, and accidents
• Shortage of skilled workers
CH-11 Copyright 2008 Werner et al 7
Employee Counseling Services
• A relationship established between a trained counselor and the employee
• Thoughtful and candid discussion of personal problems experienced by the employee
• An appropriate referral that secures the necessary assistance
• The provision of short-term counseling, when a referral is not necessary
CH-11 Copyright 2008 Werner et al 8
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– They should not try to solve or resolve the
employee’s problem themselves
CH-11 Copyright 2008 Werner et al 9
A Typical Counseling Program
• Problem Identification
• Education
• Referral
• Counseling
• Treatment
• Follow-up
CH-11 Copyright 2008 Werner et al 10
Health Risk Appraisal Concerning Alcohol Use
Table 11-1
• Questions– On average, how often do you drink beer, wine,
liquor, or other beverages containing alcohol?– On days when you drink, how many drinks do you
usually have? (One drink equals a twelve-ounce beer, a four-ounce glass of wine, or a shot of liquor)
– During the past thirty days, on how many days did you have five or more drinks on the same occasion?
– In the next six months, do you want to reduce the amount of alcohol that you drink?
SOURCE: From Lapham, S. C., Chang, I., & Gregory, C. (2000). Substance abuse intervention for health care workers: A preliminary report. Journal of Behavioral Health Services & Research, 27(2), 131–143.
CH-11 Copyright 2008 Werner et al 11
Health Risk Appraisal Concerning Alcohol Use
Table 11-1
• Feedback– Low-risk drinking is using alcohol in a way that does
not harm your health– Research suggests that
• on any one day, more than four drinks for men and more than three for women can cause problems
• having more than twelve drinks a week can cause problems over time
• drinking alcohol every day may cause problems. Unless you limit your intake to one drink each day, you are advised to drink no more than four to five days a week
SOURCE: From Lapham, S. C., Chang, I., & Gregory, C. (2000). Substance abuse intervention for health care workers: A preliminary report. Journal of Behavioral Health Services & Research, 27(2), 131–143.
CH-11 Copyright 2008 Werner et al 12
Health Risk Appraisal Concerning Alcohol Use
Table 11-1
• Risk assessment categories:– a. Low risk—drink less than seven days a
week and no more than one to two drinks per occasion
– b. Moderate risk—drink up to three to four drinks per occasion or drink every day
– c. High risk—usually or occasionally drink five or more drinks per occasion
SOURCE: From Lapham, S. C., Chang, I., & Gregory, C. (2000). Substance abuse intervention for health care workers: A preliminary report. Journal of Behavioral Health Services & Research, 27(2), 131–143.
CH-11 Copyright 2008 Werner et al 13
Who Provides the Service?
• A counseling program in-house
• A contracted-out independent service
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Advantages of In-House Service
• Advantages attributed to in-house programs include – 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
CH-11 Copyright 2008 Werner et al 15
Disadvantages of In-House Service
• Disadvantages of in-house programs can include – real or perceived problems with confidentiality– lack of resources needed– reluctance of some employees to use the
service (e.g., a vice president of finance may be reluctant to go to a lower-level employee to admit a drinking or marital problem)
– possible limitations in staff skills and expertise
CH-11 Copyright 2008 Werner et al 16
Advantage of Contracting Out
• Advantages can include– can rely on the services of trained
professionals– confidentiality may be easier to maintain– cost may be lower, and– better identification and use of community
resources
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Disadvantages of Contracting Out
• Disadvantages include– lack of on-site counseling– possible communication problems– lack of knowledge of the organization and its
employees by contractor
CH-11 Copyright 2008 Werner et al 18
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)– A clear and well-enforced policy concerning employee
confidentiality– Maintenance of records for program evaluation– Health insurance benefit coverage for services– Family education
CH-11 Copyright 2008 Werner et al 19
Employee Assistance Programs (EAP)
• Employee Assistance Programs (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
CH-11 Copyright 2008 Werner et al 20
EAP Discussion
• This section will discuss– the extent of the problem organizations face
with respect to substance abuse and mental health
– describe the approach taken by EAPs, and – discuss the effectiveness of EAPs in dealing
with these problems
CH-11 Copyright 2008 Werner et al 21
Substance Abuse
• Alcohol and drug abuse– Estimated that companies lose over $7,000
per year for every employee who abuses alcohol or drugs
– greater risk for accidents, injuries, disciplinary problems, and involuntary turnover
CH-11 Copyright 2008 Werner et al 22
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
CH-11 Copyright 2008 Werner et al 23
Emotional and Mental Health Issues Commonly Seen
• Individual adjustment problems (neurosis to psychosis)
• External factors such as battering, incest, rape, or crime
• Sexual problems, including impotence
• Divorce and marital problems
CH-11 Copyright 2008 Werner et al 24
Emotional and Mental Health Issues Commonly Seen
• Depression and suicide attempts
• Difficulties with family or children
• Legal and financial problems
• Pathological or problem gambling
CH-11 Copyright 2008 Werner et al 25
The EAP Approach
• Employee problem is operationally defined in terms of job performance, rather than clinically defined in terms of addiction or psychiatric disorder
CH-11 Copyright 2008 Werner et al 26
Constructive Confrontation – 1
• Calls for supervisors to – monitor their employees’ job performance– confront them with evidence of their
unsatisfactory performance – coach them on improving it – urge them to use the EAP’s counseling
service if they have personal problems – emphasize the consequences of continued
poor performance
CH-11 Copyright 2008 Werner et al 27
Constructive Confrontation – 2
• Constructive confrontation proceeds in progressive stages– at each stage, employees must choose
• whether to seek help from the EAP• manage their problems themselves• suffer the consequences of their actions
CH-11 Copyright 2008 Werner et al 28
Conceptual Framework for EAPTable 11-2
• EAPs are based on the premise that work is very important to people; the work itself is not the cause of the employee’s problem– The workplace can be a means to get people help.
• The supervisor plays a key role in getting help for the employee.– The supervisor is critical in the confrontational
process with the troubled employee. – Therefore, education is necessary to eliminate the
supervisor’s tendency to enable the employee by denying the problem.
SOURCE: AMA handbook for developing employee assistance and counseling programs by Masi, Dale A. © 1992 by AM MGMT ASSN/AMACOM (B). Reproduced with permission of AM MGMT ASSN/AMACOM (B) in the format Textbook via Copyright Clearance Center.
CH-11 Copyright 2008 Werner et al 29
Conceptual Framework for EAPTable 11-2
• Information about job performance is extremely important in diagnosis and treatment
• Workplace peers and union stewards are very important – however, they too can deny the problem and enable
the employee to continue the behavior – teaching them to confront and consequently break the
denial barrier is an important element
SOURCE: AMA handbook for developing employee assistance and counseling programs by Masi, Dale A. © 1992 by AM MGMT ASSN/AMACOM (B). Reproduced with permission of AM MGMT ASSN/AMACOM (B) in the format Textbook via Copyright Clearance Center.
CH-11 Copyright 2008 Werner et al 30
Conceptual Framework for EAPTable 11-2
• Job leverage is the key ingredient in helping an employee – the counselor must be able to use this in
conjunction with the supervisor
• EAPs concentrate on job performance issues – they are not intended to be medical programs
SOURCE: AMA handbook for developing employee assistance and counseling programs by Masi, Dale A. © 1992 by AM MGMT ASSN/AMACOM (B). Reproduced with permission of AM MGMT ASSN/AMACOM (B) in the format Textbook via Copyright Clearance Center.
CH-11 Copyright 2008 Werner et al 31
Conceptual Framework for EAPTable 11-2
• Cost-effectiveness is an important consideration and must be addressed with upper management
• The EAP professional’s knowledge about addiction is paramount – Every EAP should be staffed by licensed
professionals who are familiar with addictions and other employee personal problems
SOURCE: AMA handbook for developing employee assistance and counseling programs by Masi, Dale A. © 1992 by AM MGMT ASSN/AMACOM (B). Reproduced with permission of AM MGMT ASSN/AMACOM (B) in the format Textbook via Copyright Clearance Center.
CH-11 Copyright 2008 Werner et al 32
Behavioral Problem IndicatorsTable 11-3
• 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
SOURCE: Adapted from Campbell, D., & Graham, M. (1988). Drugs and Alcohol in the Workplace: A Guide for Managers. NY: Facts on File, pp. 100–101.
CH-11 Copyright 2008 Werner et al 33
Behavioral Problem IndicatorsTable 11-3
• High Accident Rates– Accidents off the job that affect work
performance– Accidents on the job due to carelessness,
inattentiveness, etc
SOURCE: Adapted from Campbell, D., & Graham, M. (1988). Drugs and Alcohol in the Workplace: A Guide for Managers. NY: Facts on File, pp. 100–101.
CH-11 Copyright 2008 Werner et al 34
Behavioral Problem IndicatorsTable 11-3
• Job Performance Issues– Complaints from coworkers or clients– Missing deadlines– Frequent shifts between high and low
performance– Difficulty understanding instructions or new
information
SOURCE: Adapted from Campbell, D., & Graham, M. (1988). Drugs and Alcohol in the Workplace: A Guide for Managers. NY: Facts on File, pp. 100–101.
CH-11 Copyright 2008 Werner et al 35
Behavioral Problem IndicatorsTable 11-3
• Poor Relationships with Coworkers– Extreme reactions to real or implied criticism– Large mood swings– Avoiding coworkers and friends– Increasing irritability or argumentativeness
SOURCE: Adapted from Campbell, D., & Graham, M. (1988). Drugs and Alcohol in the Workplace: A Guide for Managers. NY: Facts on File, pp. 100–101.
CH-11 Copyright 2008 Werner et al 36
Typical EAP Content
• Includes– a policy and procedures statement– employee education campaigns– a supervisory training program– clinical services– follow-up monitoring
CH-11 Copyright 2008 Werner et al 37
Determining EAP Worth
• HRD professionals who are considering adopting an EAP for their organization should – determine whether it is likely to be a cost-effective
solution for their organization– determine the types of programs needed
• They can make these decisions by– calculating the per-person cost of treating problems to
obtain the desired outcomes– comparing those costs to the cost of replacing the
person rather than offering treatment
CH-11 Copyright 2008 Werner et al 38
Stress Management
• Stress is a common aspect of the work experience
• Expressed as – job dissatisfaction– anger– frustration– hostility– irritation
CH-11 Copyright 2008 Werner et al 39
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)
CH-11 Copyright 2008 Werner et al 40
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
CH-11 Copyright 2008 Werner et al 41
Two Considerations
• Stress management interventions SMI) are popular
• Two important issues have yet to be completely addressed: – the definition of stress – the effectiveness of SMIs
CH-11 Copyright 2008 Werner et al 42
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
CH-11 Copyright 2008 Werner et al 43
Organizational StressorsTable 11-2
• Factors intrinsic to the job– role conflict or ambiguity– workload– insufficient control
• Organizational structure and control– red tape politics – rigid policies
SOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, 254. Copyright 1990 by J.M. Ivancevich. Reprinted by permission.
CH-11 Copyright 2008 Werner et al 44
Organizational StressorsTable 11-2
• Reward systems– faulty and infrequent feedback– inequitable rewards
• Human resource systems– inadequate career opportunities– lack of training
SOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, 254. Copyright 1990 by J.M. Ivancevich. Reprinted by permission.
CH-11 Copyright 2008 Werner et al 45
Organizational StressorsTable 11-2
• Leadership– poor relationships– lack of respect
SOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, 254. Copyright 1990 by J.M. Ivancevich. Reprinted by permission.
CH-11 Copyright 2008 Werner et al 46
Categories of SMIs
• Educational Interventions are designed to inform the employee about – the sources of stress,– what stress feels like – how stressors can be avoided, and – how the individual can better cope with stress
CH-11 Copyright 2008 Werner et al 47
Categories of SMIs
• Skill-acquisition interventions, such as time management or assertiveness training, are designed to– provide employees with new ways to cope
with stressors affecting their lives and performance
– help keep the effects of stress in check
CH-11 Copyright 2008 Werner et al 48
A Model of Stress Management Interventions
Fig 11-1
SOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, figure 2, 254. Copyright 1990 by American Psychological Association. Reprinted by permission.
Targets ofStress Management
Interventions
Types ofInterventions
Outcomes
SituationalStressors
(1)
Cognitive Appraisalof Stressors
(2)
Coping Strategies(3)
IndividualMeditationExerciseRelaxation techniquesCognitive approachesGoal-settingTime management
OrganizationalOrganizational structureJob designSelection and placement programsWorking conditionsTraining and development
Individual/OrganizationalInterface
Job demands—person style fitParticipation preferences-practicesAutonomy preferences-practicesCoworker relationships
IndividualBlood pressure, heart rate,
cathecholaminesQuality of lifeAnxiety, depressionPsychosomatic complaints
OrganizationalProductivity, quantity, and qualityTurnoverAbsenteeismHealth care costsAccidents
Individual/OrganizationalInterface
Job performanceJob satisfactionBurnoutHealth care utilization
CH-11 Copyright 2008 Werner et al 49
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?
CH-11 Copyright 2008 Werner et al 50
Issues Guiding SMIs
• 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?
CH-11 Copyright 2008 Werner et al 51
Employee Wellness Programs (EWPs) or Health Promotion Programs (HPPs)
• 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
CH-11 Copyright 2008 Werner et al 52
Premise of EWPs and HPPs
• 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
CH-11 Copyright 2008 Werner et al 53
Three Levels
• Level I programs – primarily cover educational activities and may
not attempt to directly change employee behavior
– newsletters, posters, classes, and health screening
CH-11 Copyright 2008 Werner et al 54
Three Levels
• 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
CH-11 Copyright 2008 Werner et al 55
Three Levels
• Level III programs – try to create an organizational environment
that helps employees maintain healthy lifestyles
CH-11 Copyright 2008 Werner et al 56
Ten Dimensions of Worksite 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
CH-11 Copyright 2008 Werner et al 57
Ten Dimensions of Worksite Wellness Programs (WWPs)
• 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
CH-11 Copyright 2008 Werner et al 58
Four Common Components of HPPs
• Exercise and fitness
• Smoking cessation
• Nutrition and weight control
• Control of hypertension (high blood pressure)
CH-11 Copyright 2008 Werner et al 59
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
CH-11 Copyright 2008 Werner et al 60
Activities that May be IncludedTable 11-6
• Screening Programs
– Annual Medical Exam
– Blood Analysis
– Cervical Cancer
– Colon Cancer
– Diabetes
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotionin Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 61
Activities that May Be IncludedTable 11-6
• Screening Programs– Fitness Assessment– Health Fairs– Health-risk Appraisal– Height and Weight– High Blood Pressure
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 62
Activities that May Be IncludedTable 11-6
• Screening Programs– Pre-employment Medical Exams– Pulmonary Function Tests– Screening for Job-specific Health
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 63
Activities that May Be IncludedTable 11-6
• Educational Programs– Alcohol and Drug Use– Breast Self-Exam– Cancer Prevention– Coronary Disease Risk Factors– Cardiopulmonary Resuscitation
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 64
Activities that May Be IncludedTable 11-6
• Educational Programs– Weight Control– Health and Fitness– First Aid– Cancer Detection– Low Back Pain
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 65
Activities that May Be IncludedTable 11-6
• Educational Programs– Nutrition– Seat-Belt Use– Smoking Cessation– Stress
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 66
Activities that May Be IncludedTable 11-6
• Behavioral Change Programs– Exercise and Fitness
• Aerobics• Calisthenics• Recreational Sports• Competitive Sports• Weight Training• Exercise Instruction
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 67
Activities that May Be IncludedTable 11-6
• Behavioral Change Programs– EAPs– Healthy Back– Self Defense– Smoking Cessation
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 68
Activities that May Be IncludedTable 11-6
• Behavioral Change Programs– Stress Management– Weight Loss– Cooking Classes
SOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. Public Health Reports, 99, 2.
CH-11 Copyright 2008 Werner et al 69
Smoking Cessation
• Smoking is one of the most publicized health risks in society and the workplace
• It has been amply demonstrated that smoking is linked to greater incidence of – Coronary heart disease– Stroke– Cancer– Emphysema
CH-11 Copyright 2008 Werner et al 70
Smoking Costs
• 20.9 percent of U.S. adults smoke– Down from 42.4% in 1965
• The additional annual cost of employing smokers and allowing smoking in the workplace has been estimated to be $2,853 per smoker
• 35 percent of private companies have a smoking cessation program
CH-11 Copyright 2008 Werner et al 71
Cost-Benefit of Smoking Cessation
• 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 & cleaning costs
CH-11 Copyright 2008 Werner et al 72
Nutrition and Weight Control Interventions
• 64 percent of U.S. adults can be considered either overweight or obese
• 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
CH-11 Copyright 2008 Werner et al 73
Obesity
• Obesity has been causally associated with musculoskeletal problems, hypertension, high levels of blood sugar and cholesterol, and some forms of cancer
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Obesity Programs
• Include educational activities – newsletters, leaflets, cooking demonstrations, weigh-
ins, and advice on developing weight-loss programs
• 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
CH-11 Copyright 2008 Werner et al 75
A Cautionary Note
• Negative attitudes toward overweightindividuals are widespread in our society– psychological and economic implications here 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
CH-11 Copyright 2008 Werner et al 76
Control of Hypertension (High Blood Pressure)
• Approximately 29 percent of U.S. adults suffer from hypertension– with 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
CH-11 Copyright 2008 Werner et al 77
Controlling Hypertension
• It can often be controlled through – Exercise– Weight reduction– Medication– Stress reduction– A low-salt diet
CH-11 Copyright 2008 Werner et al 78
Typical Hypertension Program
• Typical screening and control program may include:– provision of educational materials– blood pressure screenings to identify hypertensive
employees– 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
CH-11 Copyright 2008 Werner et al 79
Cost Benefit of Reducing Hypertension
• Effectiveness of workplace hypertension programs in reducing blood pressureand 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
CH-11 Copyright 2008 Werner et al 80
Six Steps for Better Health1. Provide nutritious options in cafeterias and vending machines
and, if possible, subsidize the purchase of them2. Make the workplace smoke free and help employees kick the
habit outside of work3. Encourage exercise by offering employees free use of a fitness
center or subsidizing employees ’memberships to offsite facilities4. Offer on-site health education and screening for conditions like
high blood pressure and cholesterol5. Share with employees who take care of themselves some of the
savings they generate6. Design healthcare programs with a component that extends to
employees’ families
CH-11 Copyright 2008 Werner et al 81
Issues in Employee Counseling
• Modest number of scientifically sound studies demonstrating effectiveness
• Defining success and effectiveness for many of these problems is a difficult task
• Reasons an organization has begun an intervention in the first place may affect whether research is done and how effectiveness is defined
CH-11 Copyright 2008 Werner et al 82
Strategy for Evaluating Effectiveness
• Determine the demographics of the organization (age, sex, etc.)
• Determine expected participation rates• Estimate program start-up and maintenance costs • Implement a testing and tracking system to quantify
program outcomes• Measure pre- and post-program changes for relevant
outcomes• Analyze program variables separately by relevant
demographic groups and by measuring participation versus nonparticipation in the program
• Perform cost-benefit analyses of present and future benefits, expressed in current-dollar value
CH-11 Copyright 2008 Werner et al 83
Legal Issues in Employee Counseling Programs
• Drug-Free Workplace Act requires federal contract and grant recipients of more than $100,000 to have a written policy regarding drug use in the workplace and to notify employees of the availability of related counseling, rehabilitation, and employee assistance programs
CH-11 Copyright 2008 Werner et al 84
Legal Issues
• State laws and federal agency rules require drug testing programs to be accompanied by EAPs or some other form of rehabilitation counseling
• Equal Employment Opportunity has listed having an EAP in place as a “best practice” for employers to ensure that employees are treated fairly
CH-11 Copyright 2008 Werner et al 85
Legal Issues
• Rehabilitation Act of 1973 • Americans with Disabilities Act of 1990 (ADA)
– prohibit employers from discriminating against individuals with disabilities
– require that employers make “reasonable accommodations” to help such employees perform their job functions
• Both of these laws cover employees with alcohol and drug problems
CH-11 Copyright 2008 Werner et al 86
Legal Issues
• 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 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
CH-11 Copyright 2008 Werner et al 87
Legal Issues
• 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)
CH-11 Copyright 2008 Werner et al 88
A Caution
• The potential legal advantage of using counseling programs to comply with existing laws may be offset to the extent that the counseling program exposes employers to lawsuits charging erroneous assessment for failure to refer either to appropriate treatment or to any treatment
CH-11 Copyright 2008 Werner et al 89
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
CH-11 Copyright 2008 Werner et al 90
Ethical Issues in Employee Counseling
• 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
CH-11 Copyright 2008 Werner et al 91
Supervisory Counseling Training Program
Table 11-7
• Identification of the supervisor‘s initial reactions to the prospect of counseling e.g., using comfort reaction questionnaire
SOURCE: From Ramsey, K.B. (1985). Counseling employees. In W.R. Tracey (Ed.), Handbook of human resource management and development (pp. 829, 832). New York: AMACOM.
CH-11 Copyright 2008 Werner et al 92
Supervisory Counseling Training Program
Table 11-7
• Lecture and discussion of various counseling topics, which may include:
1. emotional needs of individuals2. potential signs of employee problems3. signs of over-involvement in counseling (e.g., loss
of objectivity, focusing beyond job performance, guidelines for giving advice)
4. structure of a counseling session, including decisions to be made therein
5. counseling terminology to facilitate discussion of feelings, reactions, and behaviors
6. nonverbal communicationSOURCE: From Ramsey, K.B. (1985). Counseling employees. In W.R. Tracey (Ed.), Handbook of human resource management and development (pp. 829, 832). New York: AMACOM.
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Supervisory Counseling Training Program
Table 11-7
• Training in counseling skills, perhaps using case studies and behavior modeling
• Role play of counseling sessions• Discussion of the relationship between
counseling and coaching/performance management
• Evaluation of counseling options and resources available
SOURCE: From Ramsey, K.B. (1985). Counseling employees. In W.R. Tracey (Ed.), Handbook of human resource management and development (pp. 829, 832). New York: AMACOM.
CH-11 Copyright 2008 Werner et al 94
Unintended Negative Outcomes
• Workers’ compensation cost increases
• Employees participating in fitness programs may experience schedulingproblems, increased fatigue and accidents, and lower performance
• Smoking bans may lead to conflicts between smokers and nonsmokers
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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
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