Employee Assistance Professionals and Corporate/Organizational Onsite Interventions.

Having completed the core competencies- Stress, Basic CISM, Psychological First Aid, and the dual relationship within EAPs, a solid foundation has been developed to integrate the best practices and apply them to onsite corporate interventions for the non first responder employee.

Let's review some of the differences in the population you'll be providing services for.

Civilians vs. First Responders.

First, let's look at some common patterns in emergency personnel. The characteristics and personalities of a first responder are somewhat different then the population at large. What makes someone want to be, and enjoy this kind of work? "At-risk" professions like emergency service professions, are highly stressful careers.  They must make life and death decisions on short notice.  They are expected to perform well, they are expected to save and rescue lives, and they are expected to be the watchdogs over a community's safety, health and well being. It is of no surprise that their levels of divorce, alcoholism and suicide rates are higher than the general population. Other characteristics of at-risk occupations include:

People who chose at-risk professions accept the dangers, pressure and unpredictability of at-risk jobs; in fact studies indicate that certain personalities are likely to be more attracted to these kinds of professions.  At-risk professionals tend to:

As we delve further into the personality structure of "emergency helpers", there is another commonly reported characteristic.  That is, early experience with chaos, under-parenting, or some level of family dysfunction in their youth.  Growing up with an impaired parent or chaotic household can provide a child with "early training" in crisis intervention, rescuing, taking care of, and other "adult" responsibilities.  Completing these "services" becomes a child's source of self esteem and can establish patterns of similar interactions in the future. So, as there is a job for everyone, someone with these attributes can have great attraction to the at-risk career. This is not to say that because of these childhood experiences, front-line workers are more dysfunctional, nor does one have to have a level of dysfunction in their youth to find this kind of work appealing, their simply is data that has been done over the years that explore types of individuals and their choice for their profession.

Emergency personnel are trained, proven, and well-defended (psychologically). Through their training, life experience, and job experience, they have seen, felt, smelled and interfaced with the faces of death and near death. Experiences where grotesque scenes, hysterical survivors, twisted vehicles, ruined buildings, lost or dead children and pets, provide a commonality through experience that bonds emergency workers together.  This much protected union may isolate them from the general public, but serves as a synergistic mechanism adding strength and cohesiveness to the entire team. This is also common in the military. The emergency professional or first responders have developed a psychological protective armor that hardens with experience and protects their soft underbelly from harm.  Powerful events, however, can crack the armor.  When going to provide CISM services to a group of individuals of similar experience, drive, and needs, the approach should reflect this.

Now consider the mixed bag of individuals in a corporation that may gather together and form a group for a critical incident stress debriefing. Personalities, life experiences, coping skills, all vary greatly. The general working population for the most part, does not have familiarity beyond a cognitive level of the experiences emergency personnel have. Media, both through fact and fiction has enabled the working population/citizens to get closer to "seeing" trauma producing events, and their impact, but without experience, there is no comparison. Jobs that the general public have are indeed stressful, time sensitive, and at times unstable, but these are not life and death matters.  There is an end to the day, a "punching out",  and generally effective stress management techniques that one turns to. Jobs and job sites are perceived to be safe from deadly catastrophes and function with minimal security, if any at all. In fact people develop a working life and a personal life and try to keep them separate.  This is good stress management. 

In comparison to the first responder, the employee population is less psychologically defended and more vulnerable to critical incidents.  The group will likely experience critical incidents with greater degree of severity and present this differently during the intervention.  The 24-72 hour time frame for responding to emergency personnel for CISM, does not apply with the general population. Consider responding earlier with PFA techniques as the average population does not have a protective armor to shield itself against the impact of CIS. 

Healthy employees at a "healthy" company will have fewer personality structures similar to the emergency worker.  While their certainly is overlap, employees are less cognitively defended to tragedy, and risk greater impact and trauma when a tragedy occurs.  The working employee's corporate environment brings its own culture, roles, rules, identities and hierarchy.   Add to this elements of power, influence, competition and a wide variety of personalities, the intervention model used needs flexibility, creativity and knowledge of organizational behavior for it to be successful.

Environmental Differences

The EAP professional has greater understanding and impact of the corporate environment upon its employees. This advanced training is relevant when providing onsite services. How an organization functions and the role of its employees are crucial to be effective counselors. This skillset can and will enhance the onsite intervention.

The Organization

Providing Onsite Services to employees of any corporation, the EAP has advanced training with the number of variables that are present and relative. One must consider the environment they work in and all its influences on people.  The Organization in which one works in can strongly influence participation levels and outcomes.  The structure of organization itself can become fragile and unsafe both physically and emotionally.

While the purpose is not to go into detail about organizations, interventions do not happen in a vacuum.  The process is not pure.  The variables at play can reveal themselves in dramatic ways when there is a crisis. For employees at corporations, they spend a great deal of time within this structure, and thus integrate it into the lives.  They learn the culture, the rules and the hidden rules. Some have more power then others, and some are more favored than others.  There are perceptions of and acts of prejudice and harassment despite efforts to educate and initiate no tolerance policies. The employee may derive their identity, find sources of positive self esteem, and replay family of origin issues.  It may be their only source for socializing or escape from personal issues. They may have had a history of positive or negative experiences with management.  The organization itself may not be people friendly, it may be over litigious or may be going through a reorganizing.  There are politics, agendas, criminal activity, celebrations, and issues of fairness. All of which, for many, take precedent over issues related to mental health.

An EAP counselor entering into a corporation may not be forewarned, or aware of how such factors come into play.  Such factors may not be interfering or relevant either. As an interventionist though, there needs to be awareness that these influences do exist and may reveal themselves during the intervention.

External EAPs are by themselves, their own organization.  The business of EAPs are to make money like all businesses. Extending the scope of services outside of the traditional or contracted services, is a decision that primarily external EAP's are faced with especially when a crisis exists.  We would like to believe that financial concerns are dropped in the face of "doing the right thing" and EAP decisions are based purely on the well-being of those impacted.  This generally is the instinct of the mental health provider.   After-all what would it look like to quibble about contracted services when a crisis is present. Nonetheless it is a consideration for decision makers on the type of response that is provided. Internal EAPs also have difficult choices to make. Internally EAPs are basically housed in larger corporations and may need to travel to reach their population. It costs money to travel and for room and board.  Has money been budgeted for this? For both internal and external EAPs, when a critical incident occurs requiring EAP intervention, everything is not dropped to respond.  While the organization or department in crisis may drop everything to respond, the EAP has other contracts or employees not part of this event and expect, and have the right to, uninterrupted services.  Decisions about allocating resources to attend to the crisis have to be made.

While population, locations and organizational considerations may be different, the overall goals of Onsite Services remain the same. That is,

	Prevention of traumatic stress
	Mitigation of traumatic stress
	Intervention to assist in recovery from traumatic stress
	Acceleration of recovery whenever possible
	Restoration to function
	Maintenance of worker health and welfare

What is important to remember, that while there are differences, the theoretical construct used in the Mitchell Model and in Crisis Intervention remain the same when working with the general employee population and emergency workers. What is different and where adaptation takes place is the delivery of the process, the population receiving the services and the organizational variables that come into play during the intervention.