When I joined the employee assistance field in the 1970s, with a graduate degree and a background as a therapist, I was in a distinct minority. At that time, most EA professionals had backgrounds of personal recovery from alcoholism or addiction, not particular educational credentials. Those early practitioners designed programs that thrived because they were addressing a significant workplace need--to reduce the absenteeism, productivity costs, and accident risks associated with employees with substance problems. The growth of our profession coincided with growing employer attention to the business costs of substance abuse.
As the years passed, the EA profession evolved to meet the changing needs of the workplace and the changing focus of attention of organizational leaders and decision makers. The workplace became more sophisticated in its human resources policies and, at the same time, more demanding of its people, asking employees to work longer hours at a faster pace. In response, EAPs became more sophisticated in the problem resolution services they offered and the scope of concerns they covered. The profession continued to grow.
With the advent of managed behavioral healthcare, EAPs evolved again, moving toward an arena that was capturing more and more attention from organizational leaders--the quest to control spiraling healthcare costs. As before, EAP growth escalated. The profession, however, was falling into a trap, with EA professionals beginning to see themselves as part of the healthcare world instead of the work world.
When positioned as part of the world of healthcare, employee assistance loses its ability to stay in the forefront of helping solve workplace concerns. Instead, the profession limits itself to helping address only those concerns that have a healthcare solution. Because employee assistance doesn't involve the "big" healthcare dollars, EAPs inevitably become more marginalized and commoditized.
The "tug-of-war" between identifying employee assistance as essentially a healthcare solution or a workplace solution is …