EAP and the Dual Client

The last core efficiency and equally important is the concept of the dual client. EAP's know this well. That is, as an EAP you have to service the needs of the organization who has hired you and/or service the needs of the employee who has contacted you. Sometimes these needs can be at odds.  Let's say you have been brought in to provide onsite services for a bank after they were robbed at gunpoint. One of the bank tellers had a gun placed at her temple and a threat to kill her was made by the robber. You provide an onsite group debriefing and an individual debriefing with the teller. Confidentially, the employee tells you she doesn't think she can continue working at the bank and thinks that some time off to sort this all out is needed. She asks you to intervene on her behalf as she doesn't think she could face her manager.

Hopefully you are beginning to sense the dilemma. If you are just an advocate for the employee, as with most counseling relationships, the answer is easy; you begin to assist the client to move in this direction. In a dual relationship however, you are servicing the organization as well.  The organization needs employees to be able to return to work despite the event. The banking business goes on.  While you consider your options, here is another example.

You have been brought in to do a group bereavement debriefing.  An employee died over the weekend of a heart attack shortly after shoveling snow.  The manager is concerned about how his colleagues will react. He shares with you that the department has been going through multiple reorganizations.  The stress level has been high.  The manager, who works offsite will not be there, but expects that this would likely be a good thing as they see him behind all the changes.  The group starts out with some members very vocal of their anger at the organization and make statements blaming the organization for his death and more specifically, the manager. His not showing up for this debriefing confirms to them that he must be feeling guilty and avoiding them. Others in the group are silent and refusing to participate.  They are gauging you to see who's side your represent- a potential advocate for their ongoing issues or an extension of management sent to show a face of compassion where, they believe, none exists.  As you can imagine, they start off with the latter view.

Now, if this were a firehouse, a similar scenario could be played out. In Mitchell's model however, the use of peers will help quell this. Other firemen (peers) sitting in, have certain trust factors built into the intervention that the mental health provider is likely to lack. In EAP onsite responses, you are likely to be on your own. Let's look at the bank scenario first.

First, above all remember your role. The organization and the employees have been impacted.  The organization has contacted you to help those impacted and get the workplace back on operation. Employees will engage with you to get help with how they have been impacted. If they have been significantly impacted, they generally are not going to care about the needs of the organization. 

The teller's request is perfectly reasonable. It reveals to you the level of impact and her coping mechanisms. It indicates that she needs additional resources. Normalizing, being supportive and identifying those in need of additional resources is your role. There may be similar resources that would achieve the relief that going home would achieve, and understanding this may be of value. This line of discussion may in fact bring a level of settlement to the employee where they then may be receptive to additional coping skills. Remember while it's not your role to evaluate if she is fit for duty, nor would it be the time, it doesn't mean that it shouldn't be considered at some point if the employee does not stabilize. It just needs to be done by the appropriate professional, not EAP.

Many workplaces would allow employees to go home after such an incident. Supporting that would be appropriate, but with a plan for return and the added resources to assist this. We must keep in mind that the longer the employee is away from work, its structure, peers, etc. the harder it is to come back to. Again keeping the dual client perspective.

The second scenario presents other challenges. It is very easy to get sidetracked to the issues they prefer to talk about, but these issues have a history beyond you and have been weaved into a culture that you are not going to affect.  They will need to vent about this, but your goal is to get them back to the loss of their colleague.  Your task is to start the grieving process. Sticking to this, will help clarify your role to them. Tangential issues or beliefs need to be brought back to the grieving process.

Lastly, it is not uncommon that an employee ask to see you privately outside and beyond the onsite intervention. I do not recommend this. Once you do this, you become an advocate for the employee and the boundaries you established during the intervention now do not apply.  This will be confusing and you are not likely to be invited back for onsite services again.