Employee Counseling and          Wellness Services                Chapter 11CH-11          Copyright 2008 Werner et al   1
Learning Objectives• Explain the need for employee counseling in  organizations and why counseling is an HRD  activity• De...
Learning Objectives• Describe the role of supervisors in the  various types of employee counseling  programs• Explain the ...
Questions• Have you ever witnessed any of the following from  someone in a work setting?  • Showing up for work under the ...
Personal Problems• Personal problems are a part of life    – They can affect behavior at work as well as      does one’s p...
Reasons for Promoting Well-Being• Rising healthcare costs• Reduce workers compensation costs,  tardiness, absenteeism, tur...
Employee Counseling Services• A relationship established between a  trained counselor and the employee• Thoughtful and can...
Employee Counseling as an HRD             Activity• Employee counseling is an HRD activity• Coaching and counseling are of...
A Typical Counseling Program•   Problem Identification•   Education•   Referral•   Counseling•   Treatment•   Follow-upCH-...
Health Risk Appraisal ConcerningTable 11-1               Alcohol Use• Questions      – On average, how often do you drink ...
Health Risk Appraisal Concerning             Alcohol UseTable 11-1• Feedback       – Low-risk drinking is using alcohol in...
Health Risk Appraisal Concerning            Alcohol UseTable 11-1• Risk assessment categories:      – a. Low risk—drink le...
Who Provides the Service?• A counseling program in-house• A contracted-out independent serviceCH-11           Copyright 20...
Advantages of In-House Service• Advantages attributed to in-house  programs include    – internal control of the program  ...
Disadvantages of In-House Service• Disadvantages of in-house programs can  include    – real or perceived problems with co...
Advantage of Contracting Out• Advantages can include    – can rely on the services of trained      professionals    – conf...
Disadvantages of Contracting Out• Disadvantages include    – lack of on-site counseling    – possible communication proble...
Effective Employee Counseling               Programs• Must Have    – Top management commitment and support    – A clearly ...
Employee Assistance Programs (EAP)• Employee Assistance Programs (EAPs)  are defined as    – Job-based programs operating ...
EAP Discussion• This section will discuss    – the extent of the problem organizations face      with respect to substance...
Substance Abuse• Alcohol and drug abuse    – Estimated that companies lose over $7,000      per year for every employee wh...
Mental Health• About 21 million adults in the United States  experience a depressive illness in any given  year• Up to 25 ...
Emotional and Mental Health          Issues Commonly Seen• Individual adjustment problems (neurosis  to psychosis)• Extern...
Emotional and Mental Health          Issues Commonly Seen•   Depression and suicide attempts•   Difficulties with family o...
The EAP Approach• Employee problem is operationally defined  in terms of job performance, rather than  clinically defined ...
Constructive Confrontation – 1• Calls for supervisors to    – monitor their employees’ job performance    – confront them ...
Constructive Confrontation – 2• Constructive confrontation proceeds in  progressive stages    – at each stage, employees m...
Conceptual Framework for EAPTable 11-2• EAPs are based on the premise that work is very  important to people; the work its...
Conceptual Framework for EAPTable 11-2• Information about job performance is extremely  important in diagnosis and treatme...
Conceptual Framework for EAPTable 11-2• Job leverage is the key ingredient in  helping an employee      – the counselor mu...
Conceptual Framework for EAPTable 11-2• Cost-effectiveness is an important  consideration and must be addressed with  uppe...
Behavioral Problem IndicatorsTable 11-3• Absenteeism       – Taking many absences without authorization       – Using vaca...
Behavioral Problem IndicatorsTable 11-3• High Accident Rates       – Accidents off the job that affect work         perfor...
Behavioral Problem IndicatorsTable 11-3• Job Performance Issues       – Complaints from coworkers or clients       – Missi...
Behavioral Problem IndicatorsTable 11-3• Poor Relationships with Coworkers       – Extreme reactions to real or implied cr...
Typical EAP Content• Includes    – a policy and procedures statement    – employee education campaigns    – a supervisory ...
Determining EAP Worth• HRD professionals who are considering  adopting an EAP for their organization should    – determine...
Stress Management• Stress is a common aspect of the work  experience• Expressed as    – job dissatisfaction    – anger    ...
Categories of Stress Response• Five categories of behavioral responses to  stress:    – degradation/disruption of the work...
Stress Management Programs or        Interventions (SMIs)• Any activity, program, or opportunity  initiated by an organiza...
Two Considerations• Stress management interventions SMI)  are popular• Two important issues have yet to be  completely add...
Stress• Includes three main components:  • some environmental force affecting the  individual, which is called a stressor ...
Organizational StressorsTable 11-2• Factors intrinsic to the job       – role conflict or ambiguity       – workload      ...
Organizational StressorsTable 11-2• Reward systems       – faulty and infrequent feedback       – inequitable rewards• Hum...
Organizational StressorsTable 11-2• Leadership       – poor relationships       – lack of respectSOURCE: From Ivancevich, ...
Categories of SMIs• Educational Interventions are designed to  inform the employee about    – the sources of stress,    – ...
Categories of SMIs• Skill-acquisition interventions, such as  time management or assertiveness  training, are designed to ...
A Model of Stress Management                Interventions                   Targets of                             Types o...
Issues Guiding SMIs• Look for specific issues with employees—    – instead of talking generally about “stress,”      deter...
Issues Guiding SMIs• Specific and focused solutions    – what will work in a particular organization?    – where should th...
Employee Wellness Programs (EWPs) or    Health Promotion Programs (HPPs)• Activities that promote employee behavior• Organ...
Premise of EWPs and HPPs• Based on the premise that wellness is  more than the mere absence of disease• Encourage individu...
Three Levels• Level I programs    – primarily cover educational activities and may      not attempt to directly change emp...
Three Levels• Level II programs    – attempt to bring about direct behavioral      change    – may include supervised exer...
Three Levels• Level III programs    – try to create an organizational environment      that helps employees maintain healt...
Ten Dimensions of Worksite        Wellness Programs (WWPs)• Establishing a constructive policy for wellness• Conducting we...
Ten Dimensions of Worksite        Wellness Programs (WWPs)• Outreach and follow-up counseling, done on a  regular and ongo...
Four Common Components of                 HPPs•   Exercise and fitness•   Smoking cessation•   Nutrition and weight contro...
Exercise and Fitness• Corporate exercise and fitness programs  are among the most popular employee  well-being interventio...
Activities that May be IncludedTable 11-6• Screening Programs  – Annual Medical Exam  – Blood Analysis  – Cervical Cancer ...
Activities that May Be Included Table 11-6 • Screening Programs         – Fitness Assessment         – Health Fairs       ...
Activities that May Be Included Table 11-6 • Screening Programs         – Pre-employment Medical Exams         – Pulmonary...
Activities that May Be Included Table 11-6 • Educational Programs         – Alcohol and Drug Use         – Breast Self-Exa...
Activities that May Be Included Table 11-6 • Educational Programs         – Weight Control         – Health and Fitness   ...
Activities that May Be Included Table 11-6 • Educational Programs         – Nutrition         – Seat-Belt Use         – Sm...
Activities that May Be Included Table 11-6 • Behavioral Change Programs         – Exercise and Fitness                 •  ...
Activities that May Be Included Table 11-6 • Behavioral Change Programs         – EAPs         – Healthy Back         – Se...
Activities that May Be Included Table 11-6 • Behavioral Change Programs         – Stress Management         – Weight Loss ...
Smoking Cessation• Smoking is one of the most publicized  health risks in society and the workplace• It has been amply dem...
Smoking Costs• 20.9 percent of U.S. adults smoke    – Down from 42.4% in 1965• The additional annual cost of employing  sm...
Cost-Benefit of Smoking Cessation• Worksite smoking cessation programs can  yield a cost-benefit ratio of 8.75    – over e...
Nutrition and Weight Control                Interventions• 64 percent of U.S. adults can be  considered either overweight ...
Obesity• Obesity has been causally associated with  musculoskeletal problems, hypertension,  high levels of blood sugar an...
Obesity Programs• Include educational activities    – newsletters, leaflets, cooking demonstrations, weigh-      ins, and ...
A Cautionary Note• Negative attitudes toward overweight  individuals are widespread in our society    – psychological and ...
Control of Hypertension (High              Blood Pressure)• Approximately 29 percent of U.S. adults  suffer from hypertens...
Controlling Hypertension• It can often be controlled through    – Exercise    – Weight reduction    – Medication    – Stre...
Typical Hypertension Program• Typical screening and control program may  include:    – provision of educational materials ...
Cost Benefit of Reducing             Hypertension• Effectiveness of workplace hypertension  programs in reducing blood pre...
Six Steps for Better Health1.      Provide nutritious options in cafeterias and vending machines        and, if possible, ...
Issues in Employee Counseling• Modest number of scientifically sound  studies demonstrating effectiveness• Defining succes...
Strategy for Evaluating Effectiveness• Determine the demographics of the organization (age,  sex, etc.)• Determine expecte...
Legal Issues in Employee          Counseling Programs• Drug-Free Workplace Act requires federal  contract and grant recipi...
Legal Issues• State laws and federal agency rules  require drug testing programs to be  accompanied by EAPs or some other ...
Legal Issues• Rehabilitation Act of 1973• Americans with Disabilities Act of 1990 (ADA)    – prohibit employers from discr...
Legal Issues• Rehabilitation Act• Applies to federal contractors and government  supported organizations• Specifies that e...
Legal Issues• ADA applies to all employers of fifteen or  more employees• ADA broadly defines reasonable  accommodation to...
A Caution• The potential legal advantage of using  counseling programs to comply with  existing laws may be offset to the ...
Whose Responsibility Is Employee         Counseling?• Employees, the organization, supervisors,  and unions all have a rol...
Ethical Issues in Employee                 Counseling• Two ethical issues relating to employee  counseling    – Confidenti...
Supervisory Counseling Training                   Program  Table 11-7  • Identification of the supervisor‘s initial    rea...
Supervisory Counseling Training                   Program  Table 11-7  •         Lecture and discussion of various counsel...
Supervisory Counseling Training                   Program  Table 11-7  • Training in counseling skills, perhaps    using c...
Unintended Negative Outcomes• Workers’ compensation cost increases• Employees participating in fitness  programs may exper...
Closing Comments• Both organizations and employees have  much to gain from workplace counseling  and wellness intervention...
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Employee counseling and wellness services

  1. 1. Employee Counseling and Wellness Services Chapter 11CH-11 Copyright 2008 Werner et al 1
  2. 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 programsCH-11 Copyright 2008 Werner et al 2
  3. 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 programsCH-11 Copyright 2008 Werner et al 3
  4. 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 4
  5. 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 costsCH-11 Copyright 2008 Werner et al 5
  6. 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 workersCH-11 Copyright 2008 Werner et al 6
  7. 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 necessaryCH-11 Copyright 2008 Werner et al 7
  8. 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 themselvesCH-11 Copyright 2008 Werner et al 8
  9. 9. A Typical Counseling Program• Problem Identification• Education• Referral• Counseling• Treatment• Follow-upCH-11 Copyright 2008 Werner et al 9
  10. 10. Health Risk Appraisal ConcerningTable 11-1 Alcohol Use• 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 10
  11. 11. Health Risk Appraisal Concerning Alcohol UseTable 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 11
  12. 12. Health Risk Appraisal Concerning Alcohol UseTable 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 12
  13. 13. Who Provides the Service?• A counseling program in-house• A contracted-out independent serviceCH-11 Copyright 2008 Werner et al 13
  14. 14. 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 supervisorsCH-11 Copyright 2008 Werner et al 14
  15. 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 expertiseCH-11 Copyright 2008 Werner et al 15
  16. 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 resourcesCH-11 Copyright 2008 Werner et al 16
  17. 17. Disadvantages of Contracting Out• Disadvantages include – lack of on-site counseling – possible communication problems – lack of knowledge of the organization and its employees by contractorCH-11 Copyright 2008 Werner et al 17
  18. 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 educationCH-11 Copyright 2008 Werner et al 18
  19. 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 servicesCH-11 Copyright 2008 Werner et al 19
  20. 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 problemsCH-11 Copyright 2008 Werner et al 20
  21. 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 turnoverCH-11 Copyright 2008 Werner et al 21
  22. 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 activitiesCH-11 Copyright 2008 Werner et al 22
  23. 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 problemsCH-11 Copyright 2008 Werner et al 23
  24. 24. Emotional and Mental Health Issues Commonly Seen• Depression and suicide attempts• Difficulties with family or children• Legal and financial problems• Pathological or problem gamblingCH-11 Copyright 2008 Werner et al 24
  25. 25. The EAP Approach• Employee problem is operationally defined in terms of job performance, rather than clinically defined in terms of addiction or psychiatric disorderCH-11 Copyright 2008 Werner et al 25
  26. 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 performanceCH-11 Copyright 2008 Werner et al 26
  27. 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 actionsCH-11 Copyright 2008 Werner et al 27
  28. 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 28
  29. 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 29
  30. 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 programsSOURCE: AMA handbook for developing employee assistance and counseling programs by Masi, Dale A. © 1992 by AM MGMTASSN/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
  31. 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 problemsSOURCE: AMA handbook for developing employee assistance and counseling programs by Masi, Dale A. © 1992 by AM MGMTASSN/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
  32. 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 breaksSOURCE: 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 32
  33. 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, etcSOURCE: 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
  34. 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 informationSOURCE: 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
  35. 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 argumentativenessSOURCE: 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
  36. 36. Typical EAP Content• Includes – a policy and procedures statement – employee education campaigns – a supervisory training program – clinical services – follow-up monitoringCH-11 Copyright 2008 Werner et al 36
  37. 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 treatmentCH-11 Copyright 2008 Werner et al 37
  38. 38. Stress Management• Stress is a common aspect of the work experience• Expressed as – job dissatisfaction – anger – frustration – hostility – irritationCH-11 Copyright 2008 Werner et al 38
  39. 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 39
  40. 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 stressorsCH-11 Copyright 2008 Werner et al 40
  41. 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 SMIsCH-11 Copyright 2008 Werner et al 41
  42. 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 responseCH-11 Copyright 2008 Werner et al 42
  43. 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 policiesSOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, 254. Copyright 1990 byJ.M. Ivancevich. Reprinted by permission.CH-11 Copyright 2008 Werner et al 43
  44. 44. Organizational StressorsTable 11-2• Reward systems – faulty and infrequent feedback – inequitable rewards• Human resource systems – inadequate career opportunities – lack of trainingSOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, 254. Copyright 1990 byJ.M. Ivancevich. Reprinted by permission.CH-11 Copyright 2008 Werner et al 44
  45. 45. Organizational StressorsTable 11-2• Leadership – poor relationships – lack of respectSOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, 254. Copyright 1990 byJ.M. Ivancevich. Reprinted by permission.CH-11 Copyright 2008 Werner et al 45
  46. 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 stressCH-11 Copyright 2008 Werner et al 46
  47. 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 checkCH-11 Copyright 2008 Werner et al 47
  48. 48. A Model of Stress Management Interventions Targets of Types of OutcomesFig 11-1 Stress Management Interventions Interventions Individual Individual Meditation Blood pressure, heart rate, Exercise cathecholamines Relaxation techniques Quality of life Cognitive approaches Anxiety, depression Goal-setting Psychosomatic complaints Situational Time management Stressors Organizational (1) Organizational Productivity, quantity, and quality Organizational structure Turnover Cognitive Appraisal Job design Absenteeism of Stressors Selection and placement programs Health care costs (2) Working conditions Accidents Training and development Coping Strategies Individual/Organizational (3) Individual/Organizational Interface Interface Job performance Job demands—person style fit Job satisfaction Participation preferences-practices Burnout Autonomy preferences-practices Health care utilization Coworker relationshipsSOURCE: From Ivancevich, J.M. (1990). Worksite stress management interventions. American Psychologist, 45, figure 2, 254. Copyright 1990by American Psychological Association. Reprinted by permission.CH-11 Copyright 2008 Werner et al 48
  49. 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 49
  50. 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 50
  51. 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 fitnessCH-11 Copyright 2008 Werner et al 51
  52. 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 cessationCH-11 Copyright 2008 Werner et al 52
  53. 53. Three Levels• Level I programs – primarily cover educational activities and may not attempt to directly change employee behavior – newsletters, posters, classes, and health screeningCH-11 Copyright 2008 Werner et al 53
  54. 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 liftingCH-11 Copyright 2008 Werner et al 54
  55. 55. Three Levels• Level III programs – try to create an organizational environment that helps employees maintain healthy lifestylesCH-11 Copyright 2008 Werner et al 55
  56. 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 approachCH-11 Copyright 2008 Werner et al 56
  57. 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 useCH-11 Copyright 2008 Werner et al 57
  58. 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 58
  59. 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 participateCH-11 Copyright 2008 Werner et al 59
  60. 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 promotion in Colorado. Public Health Reports, 99, 2.CH-11 Copyright 2008 Werner et al 60
  61. 61. Activities that May Be Included Table 11-6 • Screening Programs – Fitness Assessment – Health Fairs – Health-risk Appraisal – Height and Weight – High Blood PressureSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 61
  62. 62. Activities that May Be Included Table 11-6 • Screening Programs – Pre-employment Medical Exams – Pulmonary Function Tests – Screening for Job-specific HealthSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 62
  63. 63. Activities that May Be Included Table 11-6 • Educational Programs – Alcohol and Drug Use – Breast Self-Exam – Cancer Prevention – Coronary Disease Risk Factors – Cardiopulmonary ResuscitationSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 63
  64. 64. Activities that May Be Included Table 11-6 • Educational Programs – Weight Control – Health and Fitness – First Aid – Cancer Detection – Low Back PainSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 64
  65. 65. Activities that May Be Included Table 11-6 • Educational Programs – Nutrition – Seat-Belt Use – Smoking Cessation – StressSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 65
  66. 66. Activities that May Be Included Table 11-6 • Behavioral Change Programs – Exercise and Fitness • Aerobics • Calisthenics • Recreational Sports • Competitive Sports • Weight Training • Exercise InstructionSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 66
  67. 67. Activities that May Be Included Table 11-6 • Behavioral Change Programs – EAPs – Healthy Back – Self Defense – Smoking CessationSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 67
  68. 68. Activities that May Be Included Table 11-6 • Behavioral Change Programs – Stress Management – Weight Loss – Cooking ClassesSOURCE: From Davis, M.F., Rosenberg, K., Iverson, D.C., Vernon, T.M., & Bauer, J. (1984). Worksite health promotion in Colorado. PublicHealth Reports, 99, 2. CH-11 Copyright 2008 Werner et al 68
  69. 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 – EmphysemaCH-11 Copyright 2008 Werner et al 69
  70. 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 programCH-11 Copyright 2008 Werner et al 70
  71. 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 costsCH-11 Copyright 2008 Werner et al 71
  72. 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 FemalesCH-11 Copyright 2008 Werner et al 72
  73. 73. Obesity• Obesity has been causally associated with musculoskeletal problems, hypertension, high levels of blood sugar and cholesterol, and some forms of cancerCH-11 Copyright 2008 Werner et al 73
  74. 74. 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 smokingCH-11 Copyright 2008 Werner et al 74
  75. 75. A Cautionary Note• Negative attitudes toward overweight individuals 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 jobCH-11 Copyright 2008 Werner et al 75
  76. 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 strokeCH-11 Copyright 2008 Werner et al 76
  77. 77. Controlling Hypertension• It can often be controlled through – Exercise – Weight reduction – Medication – Stress reduction – A low-salt dietCH-11 Copyright 2008 Werner et al 77
  78. 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 progressCH-11 Copyright 2008 Werner et al 78
  79. 79. 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 programCH-11 Copyright 2008 Werner et al 79
  80. 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’ familiesCH-11 Copyright 2008 Werner et al 80
  81. 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 definedCH-11 Copyright 2008 Werner et al 81
  82. 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 valueCH-11 Copyright 2008 Werner et al 82
  83. 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 programsCH-11 Copyright 2008 Werner et al 83
  84. 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 fairlyCH-11 Copyright 2008 Werner et al 84
  85. 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 problemsCH-11 Copyright 2008 Werner et al 85
  86. 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 performanceCH-11 Copyright 2008 Werner et al 86
  87. 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 87
  88. 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 treatmentCH-11 Copyright 2008 Werner et al 88
  89. 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-beingCH-11 Copyright 2008 Werner et al 89
  90. 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 mandatoryCH-11 Copyright 2008 Werner et al 90
  91. 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 questionnaireSOURCE: From Ramsey, K.B. (1985). Counseling employees. In W.R. Tracey (Ed.), Handbook of human resource management anddevelopment (pp. 829, 832). New York: AMACOM. CH-11 Copyright 2008 Werner et al 91
  92. 92. Supervisory Counseling Training Program Table 11-7 • Lecture and discussion of various counseling topics, which may include: 1. emotional needs of individuals 2. potential signs of employee problems 3. 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 anddevelopment (pp. 829, 832). New York: AMACOM. CH-11 Copyright 2008 Werner et al 92
  93. 93. 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 availableSOURCE: From Ramsey, K.B. (1985). Counseling employees. In W.R. Tracey (Ed.), Handbook of human resource management anddevelopment (pp. 829, 832). New York: AMACOM. CH-11 Copyright 2008 Werner et al 93
  94. 94. 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 nonsmokersCH-11 Copyright 2008 Werner et al 94
  95. 95. 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 employeesCH-11 Copyright 2008 Werner et al 95
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