Essential Skills for EAP Providers
Transcription
Essential Skills for EAP Providers
Welcome to this course for Magellan EAP providers. When you finish, please see the attachments in this document to access the course post-test and other documents. Essential Skills for EAP Providers Welcome! This course is for outpatient Mental Health Providers who want to learn about the EAP provider role and function in Magellan’s Employee Assistance Program (EAP). An EAP is a worksite-based program designed to assist work organizations in addressing productivity issues and to assist the individual client in identifying and resolving personal concerns across a broad spectrum including financial, legal, emotional, substance abuse, family/marital, health, and dependent care problems. This training program provides the Mental Health Professional with essential knowledge to enhance understanding and skills when functioning as an EAP provider. Upon completion of this training, participants should be able to: 1. 2. 3. 4. 5. 6. Identify three different types of management referrals to EAP Distinguish between routine and crisis referrals to EAP Recognize the importance of the dual client relationship when providing EAP services Determine whether a client is a candidate for resolution of the presenting problem within the EAP Include substance abuse screening and assessment as an essential element of a comprehensive assessment Recognize when and how to make a referral if a client needs services beyond the scope of the EAP The course takes about two hours to complete and offers two (2.0) continuing education (CE) credits/ hours. To obtain CE credits you must 1) Complete the course in its entirety; 2) Complete the post-test with a passing score; and 3) Complete the course evaluation. Click here for additional details about this training program. To navigate, use the links in the footer on each page. Click ‘Next’ below to begin. EAP Vignette Essential Skills for EAP Providers EAP Vignette You are an EAP provider, sitting in your office after a busy day of conducting back-to-back client sessions. You feel pretty good about your day, but you are also tired. Looking at the blinking light on your answering machine reminds you that there are messages waiting, with work still to attend to. Click on the name of each caller to listen to your messages. A transcript for each caller appears below. John Templeton Jack Striker Whose call should you return first? Click ‘Next’ below for more about this client referral. file:///U|/Desktop/EAPEssentials/Intro1.html [11/9/2010 1:06:14 PM] Maggie Carter EAP Vignette Essential Skills for EAP Providers EAP Vignette You are an EAP provider, sitting in your office after a busy day of conducting back-to-back client sessions. You feel pretty good about your day, but you are also tired. Looking at the blinking light on your answering machine reminds you that there are messages waiting, with work still to attend to. Click on the name of each caller to listen to your messages. A transcript for each caller appears below. John Templeton Jack Striker Maggie Carter “Hi, Dr. Smith? This is John Templeton with the Big Box Company. I need to come and see you right away. My boss thinks I have a drinking problem so he sent me home. I swear it was just the new mouthwash I used this morning. I really need your help! I can’t go back to work until I see an EAP counselor. Can I stop by in about an hour? Please get back in touch. Thanks.” Whose call should you return first? Click ‘Next’ below for more about this client referral. file:///U|/Desktop/EAPEssentials_Providers/Intro1.html#[9/29/2011 1:11:05 PM] EAP Vignette Essential Skills for EAP Providers EAP Vignette You are an EAP provider, sitting in your office after a busy day of conducting back-to-back client sessions. You feel pretty good about your day, but you are also tired. Looking at the blinking light on your answering machine reminds you that there are messages waiting, with work still to attend to. Click on the name of each caller to listen to your messages. A transcript for each caller appears below. John Templeton Jack Striker Maggie Carter “This is Jack Striker down at the Big Box Company near the mall. I’m sending one of my guys over. I sure hope you can straighten him out. I know all about drinking from my ex-wife’s family, and I certainly don’t need that aggravation again. John’s an okay guy, but I won’t cover for him. I need to know if you can help him as soon as possible. Otherwise, I have to kick this thing upstairs.” Whose call should you return first? Click ‘Next’ below for more about this client referral. file:///U|/Desktop/EAPEssentials_Providers/Intro1.html#[9/29/2011 1:12:45 PM] EAP Vignette Essential Skills for EAP Providers EAP Vignette You are an EAP provider, sitting in your office after a busy day of conducting back-to-back client sessions. You feel pretty good about your day, but you are also tired. Looking at the blinking light on your answering machine reminds you that there are messages waiting, with work still to attend to. Click on the name of each caller to listen to your messages. A transcript for each caller appears below. John Templeton Jack Striker Maggie Carter “Hello, this is Maggie Carter. I’m a Care Manager with Magellan’s EAP. I’m calling about a client we need you to see. He had an incident at work today and the situation is escalating fast. We’d like your help to address it. Maybe you could see him this evening after you finish up with your clients? Please call me back as soon as you can. Oh, and please don’t call his boss or have any contact with his workplace before we get a chance to talk.” Whose call should you return first? Click ‘Next’ below for more about this client referral. file:///U|/Desktop/EAPEssentials_Providers/Intro1.html#[9/29/2011 1:13:40 PM] EAP Questions Essential Skills for EAP Providers EAP Questions You have a new client referral, with three different requests for return phone calls. In addition to figuring out which call to return first, you’re faced with many questions, such as: ● How do you deal with the dilemma you face between the boss who’s requesting feedback, and the request from the EAP Care Manager not to call him? ● How do you balance the request to see this new referral with the reality of your existing clientele and a busy practice? ● How do you assess John’s drinking? ● Can John’s problem be addressed within the EAP service delivery model? This training program has the information you need to answer these and other questions about the provision of EAP services. The goal of Essential Skills for EAP Providers is for you to learn how to: ● ● ● Respond appropriately to management referrals Determine whether a referred client is a candidate for EAP services Intervene effectively within the EAP service delivery model Click ‘Next’ below for perspectives on EAP services. file:///U|/Desktop/EAPEssentials/Intro2.html [11/9/2010 1:06:15 PM] Perspectives on EAP Services Essential Skills for EAP Providers Perspectives on EAP Services Compare the employee's perspective of EAP services on the left with the perspective of the referring employer on the right. The employee’s perspective on EAP services Recall John Templeton, the employee from the Big Box Co. In the vignette, John was sent home by his boss and can't return to work until he sees a Provider at the EAP. ● The EAP provides a way for John to get help in dealing with issues affecting his work performance. ● An EAP can provide referral recommendations and often solutions to a variety of work/life problems. ● John is eager to make an appointment because he is motivated to save his job. The employer’s perspective on EAP services Recall Jack Striker, the Manager from the Big Box Co. In the vignette, Jack referred his employee to the EAP because of suspected substance use. ● The EAP provides a way for Jack to address workplace issues that affect productivity caused by employee absences and interpersonal problems. ● An EAP provides assessment, brief counseling, and referral and follow-up services to help in maintaining or restoring workplace performance. ● The employer is giving John an alternative to disciplinary action. Click ‘Next’ below for an overview of the course contents. The rest of this program focuses on EAP services from the perspective of the EAP provider. file:///U|/Desktop/EAPEssentials/Intro3.html [11/9/2010 1:06:15 PM] EAP Course Contents Essential Skills for EAP Providers Course Contents Menu The three parts of the course are summarized below. You can link to each part via the Menu provided at the top right of every page. Part 1: Handling EAP Referrals This section describes three different types of management referrals that EAPs receive from employer organizations. You will learn about responding to these referral requests as well as how to distinguish between a routine referral and a crisis referral. Part 2: Guidelines for EAP Providers This section will help you understand the dual client relationship inherent in providing EAP services. This knowledge will help you determine whether a referred client is an appropriate candidate for resolution of the presenting problem within the EAP. Part 3: EAP Service Delivery In this section, you will learn about essential elements of a comprehensive assessment, including the particular importance of substance abuse screening. This information will help you recognize when to make an outside referral for a client versus resolving the client's issue through EAP services. Click ‘Next’ below to proceed to Part 1: Handling EAP Referrals. file:///U|/Desktop/EAPEssentials/Contents.html [11/9/2010 1:06:16 PM] Part 1: Handling EAP Referrals Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu Handling client referrals appropriately is an essential skill when functioning as an EAP provider. The role of the EAP provider is to conduct precise assessments of all individuals, couples, or family members referred for EAP services. This function requires that you respond appropriately to various types of requests for EAP services, including how to handle both routine and crisis situations. In Part 1, you will learn how to: 1. Identify three different types of management referrals to EAP 2. Distinguish between routine and crisis referrals to EAP Click ‘Next’ below to learn about management referrals to the EAP. file:///U|/Desktop/EAPEssentials/Part1Start.html [11/9/2010 1:06:17 PM] Types of Management Referrals Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu There are three types of management referrals that EAPs receive from employer organizations. Click on the name of each type of referral type to read the description. Informal Formal Mandatory In the vignette, what type of a management referral was Jack making for his employee John Templeton? Type the correct answer in the space provided. Submit Reset Click ‘Next’ below to make a decision about whose call to return first. file:///U|/Desktop/EAPEssentials/Part1A.html [11/9/2010 1:06:18 PM] Types of Management Referrals Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu Menu There are three types of management referrals that EAPs receive from employer organizations. Click on the name of each type of referral type to read the description. Informal Management Referral Informal Formal When an employer observes that an employee may be experiencing emotional difficulties that affect job performance, or if the employee requests assistance, the employer can informally recommend EAP participation to the employee. With an informal referral, the employer may or may not contact the EAP to facilitate the referral. The EAP Provider does not provide any information or feedback to the employer about the referred employee. Mandatory In the vignette, what type of a management referral was Jack making for his employee John Templeton? Type the correct answer in the space provided. Submit Reset Click ‘Next’ below to make a decision about whose call to return first. file:///U|/Desktop/EAPEssentials_Providers/Part1A.html#[9/29/2011 1:16:21 PM] Types of Management Referrals Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu Menu There are three types of management referrals that EAPs receive from employer organizations. Click on the name of each type of referral type to read the description. Formal Management Referral Informal Formal Mandatory If an employee shows signs of deterioration in work performance, the employer can contact Magellan’s EAP to make a Formal Management Referral. Circumstances for making a Formal Management Referral might be when an employee has emotional problems that affect work, or when the employee violates company rules, tests positive for drugs or alcohol or otherwise is suspected of having a substance abuse problem. With this type of referral, the employee’s participation in the EAP remains voluntary, although the employer will get a report from the EAP to confirm if the employee followed through with the initial appointment. Choosing not to participate fully or to follow EAP Provider recommendations does not affect the employee’s employment status. In the vignette, what type of a management referral was Jack making for his employee John Templeton? Type the correct answer in the space provided. Submit Reset Click ‘Next’ below to make a decision about whose call to return first. file:///U|/Desktop/EAPEssentials_Providers/Part1A.html#[9/29/2011 1:17:31 PM] Types of Management Referrals Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu Menu There are three types of management referrals that EAPs receive from employer organizations. Click on the name of each type of referral type to read the description. Mandatory Management Referral Informal Formal Mandatory When an employee violates the employer’s policy, which may include workplace violence or testing positive for drugs or alcohol, the employer may make the employee's participation in the EAP mandatory. With a Mandatory Referral, the employee's participation in the EAP and compliance with EAP recommendations are both required as conditions of continued employment. Magellan will send the employer ongoing follow-up reports regarding the employee's attendance and compliance with EAP recommendations. Mandatory referrals occur most commonly for employees in safety-sensitive jobs such as machine operators, truck drivers, railroad workers, and pilots. These employees are often suspended from their jobs at the time of the EAP referral. In the vignette, what type of a management referral was Jack making for his employee John Templeton? Type the correct answer in the space provided. Submit Reset Click ‘Next’ below to make a decision about whose call to return first. file:///U|/Desktop/EAPEssentials_Providers/Part1A.html#[9/29/2011 1:18:31 PM] Part 1: Handling EAP Referrals Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu John Templeton’s employer was making a formal management referral to the EAP. With this type of referral, the employer expects a rapid response. How are you supposed to deal with the three different requests that you have received for return phone calls? Whose call should you return first? Select the best choice from the list below. The Individual Client The Employer The EAP Care Manager For a more comprehensive list of requirements related to management referrals, see Magellan's EAP Handbook Supplement: Section 5: Workplace Support Services. Click ‘Next’ below to learn about management referrals to the EAP. file:///U|/Desktop/EAPEssentials/Part1B.html [11/9/2010 1:06:18 PM] Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu Menu John Templeton’s employer was making a formal management referral to the EAP. With this type of referral, the employer expects a rapid response. How are you supposed to deal with the three different requests that you have received for return phone calls? Whose call should you return first? Select the best choice from the list below. The Individual Client The Employer The EAP Care Manager Correct! In most instances, all communication related to a management referral from an employer organization will be done by Magellan's EAP Care Manager. For a more comprehensive list of requirements related to management referrals, see Magellan's EAP Handbook Supplement: Section 5: Workplace Support Services. Click ‘Next’ below to learn about management referrals to the EAP. What is a crisis? Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu Menu You decide to call Magellan’s EAP Care Manager first. When you speak with the Care Manager, she tells you that the employee is being referred to the EAP due to quickly deteriorating work performance. She asks you to see him as soon as you possibly can. How do you balance this request with your existing clientele and a busy practice? To respond appropriately to the referral, you will need to determine if the situation is routine or if it is a crisis. What is a crisis? A crisis is an emotionally stressful event or a traumatic change in a person’s life. When a crisis occurs: All covered employees and their dependents have immediate access to an EAP provider through a tollfree line staffed by Mental Health Professionals 24 hours a day, 7 days a week. A preliminary assessment is conducted by telephone and, if appropriate, the individual/family will be referred to an EAP provider for an in-person intervention. Click ‘Next’ below to learn about your responsibilities as an EAP provider. file:///U|/Desktop/EAPEssentials_Providers/Part1C.html#[9/29/2011 1:20:10 PM] Examples Essential Skills for EAP Providers Part 1: Handling EAP Referrals Menu EAP providers must be available for both crisis and routine referrals. Examples of Crisis Referrals ● ● ● Learning about the death of a close relative Being told of a spouse's affair Suicidal/homicidal gestures Examples of Routine Referrals ● ● ● Child is withdrawn in school Couple having difficulty communicating Can’t let go of a dysfunctional relationship Employers who contact Magellan’s EAP for services expect you to provide a confidential consultation for each referred employee. If what initially appears to be a routine EAP referral becomes a crisis, contact a Magellan Care Manager to obtain valuable consultation. Magellan Care Managers have considerable experience fielding crisis calls and other high risk situations. They wish to collaborate and will work with you within your schedule to address the situation. In responding to such requests, we ask that you be mindful of your EAP agreement with Magellan. You have committed your availability to respond rapidly to our members and client companies in these critically important situations. Click ‘Next’ below to continue to Part 2: Guidelines for EAP Providers. file:///U|/Desktop/EAPEssentials/Part1D.html [11/9/2010 1:06:20 PM] Part 2: The EAP Model Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu This section provides guidelines for the provision of EAP services that will assist your understanding of how EAP service delivery differs from standard outpatient mental health services. In Part 2, you will learn how to: 1. Recognize the importance of the dual client relationship when providing EAP services 2. Determine whether a client is a candidate for resolution of the presenting problem within the EAP Click ‘Next’ below to learn about the dual client relationship inherent in EAP services. file:///U|/Desktop/EAPEssentials/Part2Start.html [11/9/2010 1:06:20 PM] Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu Menu The most important aspect of an EAP that differentiates it from standard outpatient mental health services is the dual client nature of the work. EAP providers have two clients: The individual Client and The Employer Organization This dual client relationship often raises questions about communication and confidentiality. For example, in the previous vignette, you have a request for feedback from the employer, and a request from the EAP Care Manager not to call him. How do you deal with this dilemma in your role as an EAP provider? Click ‘Next’ below to find out. Guidelines for the provision of EAP services Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu EAP providers follow three guidelines for the provision of EAP services. 1. 1. Do not communicate directly with employer organizations unless the EAP Care Manager asks you to do so. 1. 2. Maintain confidentiality for both the individual client and the employer in all aspects of EAP delivery. 1. 3. Always maintain a neutral stance when dealing with a referred employee. Click ‘Next’ below to learn about these guidelines for the provision of EAP services. file:///U|/Desktop/EAPEssentials/Part2B.html [11/9/2010 1:06:21 PM] Guideline #1 Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu Menu Guideline #1 for the Provision of EAP Services Do not communicate directly with employer organizations unless the EAP Care Manager asks you to do so. In your EAP agreement with Magellan, you have committed to not having direct contact with a client’s employer (unless specifically requested by Magellan). Whenever you receive a request to communicate with a client’s employer, always notify your Magellan EAP contact for that case. Magellan's Care Managers will assist you in responding to the request you have received. Click ‘Next’ below to learn about Guideline #2 for the provision of EAP services. file:///U|/Desktop/EAPEssentials_Providers/Part2C.html[9/29/2011 1:22:21 PM] Guideline #2 Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu Guideline #2 for the Provision of EAP Services Maintain confidentiality for both the individual client and the employer in all aspects of EAP delivery. In most instances all communication to an employer organization will be done by Magellan's EAP Care Manager. ● ● If an employer contacts you directly, refer him or her to the EAP Care Manager involved with the case. Do not provide information to anyone outside of Magellan without a written Authorization to Disclose signed by the employee. Click ‘Next’ below to learn about Guideline #3 for the provision of EAP services. file:///U|/Desktop/EAPEssentials/Part2D.html [11/9/2010 1:06:22 PM] Guideline #3 Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu Guideline #3 for the Provision of EAP Services Always maintain a neutral stance when dealing with a referred employee. When an employee’s job is at risk he/she may be anxious at the prospect of demotion or job loss and may strive to seek refuge in the EAP. Your goal is not to “save” or “defend” the employee from the employer, but rather to preserve the employee's ability to work or return to work. This can be done through precise assessment and supportive confrontation when indicated. It is not helpful to collude with an employee’s denial of his/her chemical abuse or other problems that could ultimately prove destructive to current employment and future health. By remaining neutral and objective, the EAP provider will be in a better position to meet the needs of the workplace as well as the needs of the referred employee. Click ‘Next’ below to learn about your responsibilities as an EAP provider. file:///U|/Desktop/EAPEssentials/Part2E.html [11/9/2010 1:06:22 PM] Assessment Issues Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu EAP providers are expected to perform a comprehensive assessment for all referrals, which may include individuals, couples, and/or family members. You must be a generalist with the ability to assess any and all areas a client may present, including workplace issues, chemical dependency, and issues related to both children and older adults. EAP providers must be able to determine whether or not the client is a candidate for resolution of the presenting problem within the EAP. Keep in mind that the number of allowed EAP sessions with a client is limited, as specified in the contract with the associated employer. ● ● For some issues, EAP providers offer short-term counseling to maximize a client’s strengths and coping skills to help resolve personal issues and improve performance in the workplace. For other issues, EAP providers play a vital role in facilitating a referral to a more appropriate resource or to a higher level of care. Which of the following presenting problems is not generally appropriate for resolution within the EAP? Select all that apply. Parent child problems Submit Work stress Reset Click ‘Next’ below for more on the EAP model. file:///U|/Desktop/EAPEssentials/Part2F.html [11/9/2010 1:06:23 PM] Bi-polar disorder Bereavement DUI evaluation Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu Menu EAP providers are expected to perform a comprehensive assessment for all referrals, which may include individuals, couples, and/or family members. You must be a generalist with the ability to assess any and all areas a client may present, including workplace issues, chemical dependency, and issues related to both children and older adults. EAP providers must be able to determine whether or not the client is a candidate for resolution of the presenting problem within the EAP. Keep in mind that the number of allowed EAP sessions with a client is limited, as specified in the contract with the associated employer. For some issues, EAP providers offer short-term counseling to maximize a client’s strengths and coping skills to help resolve personal issues and improve performance in the workplace. For other issues, EAP providers play a vital role in facilitating a referral to a more appropriate resource or to a higher level of care. Which of the following presenting problems is not generally appropriate for resolution within the EAP? Select all that apply. Parent child problems Submit Work stress ✔ Bi-polar disorder Reset Click ‘Next’ below for more on the EAP model. Bereavement ✔ DUI evaluation Examples Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu The key to being an effective EAP provider is your awareness of the nature of the EAP model before beginning work with a client. The combination of the session model, diagnosis, and severity of symptoms will be an indicator of whether or not resolution might take place within the EAP. Examples of EAP appropriate services might be: ● ● ● ● ● Parenting issues Marital discord Job stress Simple bereavement Health concerns Examples of assessed problems generally not appropriate for resolution within EAP are: ● ● ● Substance abuse Multiple problem areas Chronic psychiatric issues Magellan EAP providers have access to all forms necessary for providing EAP services. Visit MagellanProvider.com for a complete list of EAP clinical forms. Click ‘Next’ below for information on determining a client's needs. file:///U|/Desktop/EAPEssentials/Part2G.html [11/9/2010 1:06:24 PM] Essential Skills for EAP Providers Part 2: Guidelines for EAP Providers Menu Menu An effective EAP provider is able to determine various needs of a client related to a wide variety of clinical and life issues. Determining the needs of an EAP client can be similar to the role of a triage nurse in a hospital. Many times this involves making a referral to external services. Examples of these situations might occur if, for example, the assessed issue is chemical dependency or domestic violence. In these situations, it is especially helpful if the EAP provider has the ability to educate and motivate the client to seek appropriate treatment when necessary. Some EAP providers struggle with the notion of assessment and referral without being able to engage the client in a therapeutic relationship. Keep in mind that providing information and education about an illness is a legitimate way to respond and intervene. Information like this can be a tremendous relief to a client who may have misconceptions about mental health issues either through ignorance or misunderstanding. Recognizing that they are not alone in dealing with their problem(s) can be a great motivator for the person to seek care. Click ‘Next’ below to continue to Part 3: EAP Service Delivery. Part 3: EAP Service Delivery Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Within the EAP, one of the roles of an EAP provider is to provide a variety of services to help with maintaining or restoring a client’s workplace performance. These services include assessment of treatment needs, with either solution-focused brief counseling or referral to external resources. In Part 3, you will learn how to: 1. Include substance abuse screening and assessment as an essential element of a comprehensive assessment 2. Recognize when and how to make a referral if a client needs services beyond the scope of the EAP Click ‘Next’ below for information about EAP assessments. file:///U|/Desktop/EAPEssentials/Part3Start.html [11/9/2010 1:06:25 PM] EAP Assessments Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu In order to identify a wide variety of clinical and life issues, EAP providers are responsible for conducting a comprehensive assessment for all referred employees. The EAP provider must perform a complete bio-psychosocial assessment of the client’s concerns, including the impact of the client’s issues in the workplace. This is especially significant given the dual client relationship inherent in EAP work. EAP customers who contract with Magellan's EAP have the expectation that the EAP will provide a thorough assessment that includes, but is not limited to: ● ● ● ● ● ● Personal stressors Family concerns Physical illnesses/ medical treatment Threat of violence concerns/ risk assessment Depression screening Substance abuse, chemical dependency, and other addictions Click ‘Next’ below for information about screening for substance use. file:///U|/Desktop/EAPEssentials/Part3A.html [11/9/2010 1:06:25 PM] Screening for Substance Use Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Screening and assessment of substance abuse is one of the most basic and critical components of EAP work. If the presenting problem involves substance abuse, or if the screening identifies a substance use issue, a more comprehensive assessment is needed. Early identification of substance abuse, addiction, or dependence is critical. Roll your cursor over each term below for a definition. Abuse Addiction Dependence Employers are well aware of the impact of substance use problems on the workplace, such as decreased performance and productivity due to accidents, absences, interpersonal problems, and theft. They realize that an incomplete assessment or a delay in facilitating a client’s movement to an appropriate resource or referral may result in a client experiencing unnecessary distress. To see a list of EAP assessment requirements, visit the COA (Council on Accreditation) web site. Click ‘Next’ below for more on substance abuse assessments. file:///U|/Desktop/EAPEssentials/Part3B.html [11/9/2010 1:06:27 PM] Screening/Assessment Resources Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Screening and the assessment of substance use is a core component of the overall EAP assessment. Remember John Templeton from the Big Box Company scenario? As an EAP provider, how would you assess his drinking? Click to learn about various tools that could be used to screen for and assess an EAP client's drinking behavior. Every client or dependent 12 years of age or older who comes to the EAP for services is to be screened for substance abuse. Resources for Magellan EAP providers: ● View or print a copy of Magellan's Substance Abuse/Chemical Dependency Assessment tool. ● For a selection of Magellan EAP forms that you can use as needed, visit MagellanProvider.com and scroll down to the list of Auxiliary forms. ● Learn about EAP Core Technology on the Employee Assistance Professionals Association web site. Click ‘Next’ below for an example vignette. file:///U|/Desktop/EAPEssentials/Part3C.html [11/9/2010 1:06:28 PM] Screening/Assessment Tools Screening/Assessment Tools for the EAP Provider There are many screening/assessment instruments available to assess for Chemical Dependency and Substance Abuse, including self-report and interview style questionnaires. MAST - Michigan Alcoholism Screening Test This tool is a 25-item questionnaire designed to provide rapid and effective screening for lifetime alcoholrelated problems and alcoholism. MAST can be used in either paper/pencil or interview format. SASSI - Substance Abuse Subtle Screening Inventory This tool has three scales specifically designed to increase accuracy in the face of denial and defensiveness. One scale distinguishes substance abusers from non-abusers even when substance abusers are trying to conceal an addiction problem. Two other scales identify defensive clients and determine if their defensiveness is indicative of an underlying substance abuse disorder. DAST - Drug Abuse Screening Test This tool helps assess the severity of a client’s problems with drugs other than alcohol. The brief questionnaire takes five minutes to administer and can be used in either self-report or interview format. CAGE FOR YOUTH and ADOLSCENTS This tool consists of four yes or no questions and two questions about frequency and multi-substance abuse. UNCOPE This tool consists of six questions regarding the impact of substance use. When two or more questions are answered yes, this indicates abuse or dependence. EAP providers may also use some of the many other available instruments to screen for depression, anxiety, etc. Close Window file:///U|/Desktop/EAPEssentials_Providers/Tools.html[9/29/2011 3:01:33 PM] Vignette Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Menu The following vignette illustrates how a complete assessment by the EAP provider helps to clarify some of the underlying issues behind the client’s presenting problem. Mary Smith presents to the EAP with depression related to continued marital problems. She admitted being not as focused at work, but tardiness was not a problem. She is finding it difficult to enjoy and participate in her normal social activities. She has not seen her PCP. When asked to identify her marital concerns, Mrs. Smith became quiet and appeared to withdraw. When she finally spoke, she admitted that her husband drinks alcohol most days, but does not miss work. They are stretched financially as a result of a DUI he received last year. She denied any use of alcohol or drugs on her part. After careful probing, Mrs. Smith gave a detailed report of her husband’s drinking, including amount, frequency and consequences. She compared him to her father who was a functioning alcoholic. She is contemplating a divorce because she wants relief from the worry and from covering for her husband. Click ‘Next’ below for information on EAP interventions. file:///U|/Desktop/EAPEssentials_Providers/Part3D.html[9/29/2011 1:31:30 PM] Models of Intervention Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu There are two models of intervention available in the EAP service delivery model. (For some accounts, only the Assess and Refer option is available.) 1. The Assess and Refer Model is for assessment and referral purposes only. 2. The Brief Counseling Model is to identify and address goals that can be achieved within the EAP sessions available, typically within one to five months. EAP clients are required to read and sign a Statement of Understanding that explains these EAP services. View or print a copy of Magellan's Statement of Understanding. If Brief Counseling is an available option for the particular client, then the EAP provider will need to carefully document the results of the bio-psychosocial assessment. Documentation for both the initial and any subsequent sessions must support the identified issues and rationale for the counseling sessions. Click ‘Next’ below to check your understanding of EAP interventions. file:///U|/Desktop/EAPEssentials/Part3E.html [11/9/2010 1:06:32 PM] STATEMENT OF UNDERSTANDING You have chosen to receive employee assistance program (“EAP”) services which are provided through a Magellan Behavioral Health* company (“Magellan”). EAP services may include assessment and referral or brief counseling. The EAP counselor will work with you to clarify the problem, identify choices, and develop an action plan. Magellan customer service associates and EAP consultants are available to respond to your call 24 hours a day, 365 days a year. FEES These services are provided at no direct cost to employees and family members. The employee's company pays for the services. However, if you need longer-term counseling or a specialized service, Magellan will assist in locating a resource or service in the community. It is your responsibility to pay for services provided by any resources outside the EAP. (Your benefit plan may cover some of the cost. Check with your benefits representative before services are provided by outside resources.) CONFIDENTIALITY The EAP will maintain confidential records of your contact with the EAP and the services provided to you in order to provide continuity and coordination of your care. No one will reveal information concerning your use of the EAP to anyone outside the program except as follows: (1) you consent in writing; (2) life or safety is seriously threatened; (3) disclosure is required by law; or (4) your counselor refers you to benefits-covered treatment and the claims payor requires information. In addition, your counselor will disclose information and records to Magellan as needed for coordination of EAP services, quality assurance, or payment. Professional auditors (not employed by the employee's company) may also examine your file to evaluate the services. Depending on the privacy policy of the employer, the employer’s privacy official might have access to information in connection with the employer’s obligations in the Privacy Rule under HIPAA (the Health Insurance Portability and Accountability Act). Check the employer’s privacy policy to see if the privacy official or anyone else will have access to information. IF YOU HAVE BEEN REFERRED TO THE PROGRAM DUE TO A WORK PERFORMANCE PROBLEM: Under your employer’s policy, 1) Magellan is expected to confidentially advise the referral source whether you are participating in the EAP and cooperating with the EAP plan. To permit Magellan to do so, you will need to sign an authorization permitting disclosure of that information. However, you may use EAP services even if you do not sign an authorization. Your personal problems will not be discussed with the referral source, unless you request, in writing, that this be done. 2) Participation is voluntary--whether or not you decide to use the EAP services, your decision will not affect your employment security or advancement opportunities. I, (print name) , understand this form, including the confidentiality of the EAP and the limitations to confidentiality, and accept it as the terms of my participation in the program. As an EAP consumer, I also understand that I may request written information describing Magellan's confidentiality policy and/or the EAP counselor’s confidentiality policy. Signature Witness Parent, guardian, or legal representative (when required) Date Counselor Signature: _________ Initial if a copy was given to client. *Services in California are delivered by Human Affairs International of California or Magellan Health Services of California—Employer Services. ©Magellan Health Services, Inc. 2005 SOU/Generic Standard SOU-Magellan/206 Scenario 1 Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Menu Check your understanding of the two different intervention models. Click on the name of the client to hear his voice and read a transcript of his words. Then answer the question below by indicating whether the assessment supports the Brief Counseling Model or the Assess and Refer Model. Joseph 16 year old male “I don’t really care that school kicked me out for punching that kid. I’d do it again if I had to. So what if my grades are down – no one cares. My parents certainly don’t. They’re too busy fighting over custody and who gets the house. Never mind. It doesn’t really matter. Besides, hanging out with my friends is way better than school anyway. We party all the time these days.” Which method of intervention is most appropriate for Joseph? Assess and Refer Brief Counseling Click ‘Next’ below for another scenario. file:///U|/Desktop/EAPEssentials_Providers/Part3F.html#[9/29/2011 1:34:12 PM] Scenario 2 Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Menu Check your understanding of the two different intervention models. Click on the name of the client to hear her voice and read a transcript of her words. Then answer the question below by indicating whether the assessment supports the Brief Counseling Model or the Assess and Refer Model. Rosette 42 year old female “Don’t get me wrong, I like my new position at work. I just didn’t think there would be so many deadlines, and the boss seems so inflexible. This is the first time I’ve ever been to counseling. You must have clients with more important problems. I debated whether I should come or not, since my husband and girlfriends are very understanding. But I’ve got to find a better way to handle this stress. I really want to make this job work out.” Which method of intervention is most appropriate for Rosette? Assess and Refer Brief Counseling Click ‘Next’ below for more about EAP interventions. file:///U|/Desktop/EAPEssentials_Providers/Part3G.html#[9/29/2011 1:35:58 PM] Models of Intervention Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu What about your client John Templeton from the Big Box Company? If your assessment (including an alcohol screen) revealed that John had a significant alcohol problem, would you refer him out for services? Click on each choice below to consider factors that might influence your decision. Assess and Refer Brief Counseling Click ‘Next’ below for information about making referrals for ongoing care. file:///U|/Desktop/EAPEssentials/Part3H.html [11/9/2010 1:06:37 PM] Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Menu Generally, you should be able to determine within the first few sessions whether or not the EAP is the appropriate level of care. While most clients who access the EAP will be able to resolve their problems within the EAP, there are times when a referral for ongoing care is needed. The most frequent reasons for referral are: The client needs specialized care, such as psychiatric or substance abuse treatment. Resolution of the presenting issue(s) requires more sessions than allotted within the particular EAP’s session model. The client could benefit from community resources like: A 12-Step program Financial counseling A support group A Community Mental Health Center Click ‘Next’ below to learn about referral options. Referral options Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu When the problem cannot be resolved within the scope of the EAP, you will need to make recommendations and discuss referral options with the client. Some employers have Dependent Care and Work Life Services to help clients connect with resources to assist in dealing with challenges related to a full continuum of life stages, from newborn to teen and adult to senior. These resources may include: ● ● ● ● ● ● ● ● ● Referrals for family and child care Before and after school care Day care centers Adoption assistance Senior living arrangements Retirement homes Skilled nursing or Hospice care Special needs care for newborns or developmentally challenged adults Legal and financial services Click ‘Next’ below to check your knowledge of referral options. file:///U|/Desktop/EAPEssentials/Part3J.html [11/9/2010 1:06:39 PM] Knowledge Check Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu Check your knowledge of referral options by answering the question below. If your client’s employer does not have dependent care or Work Life services, which of the following resources might you consider using to locate the necessary supports for your client? Select the best answer from the list below. Contact your local police or fire department Reach out to community centers and churches Use the community pages of your local telephone book Search the internet or the local newspaper All of the above Click ‘Next’ below to learn more about ‘Assess and Refer’ interventions. file:///U|/Desktop/EAPEssentials/Part3K.html [11/9/2010 1:06:40 PM] Assess and Refer Interventions Essential Skills for EAP Providers Part 3: EAP Service Delivery Menu When ongoing or specialized care is clinically indicated, EAP providers are expected to facilitate a referral into the client’s mental health benefit plan. You should be aware that some Employee Assistance Programs contractually prohibit EAP providers from referring clients to themselves for services beyond EAP. Read the scenario below to check your knowledge about Assess and Refer EAP interventions. After a comprehensive assessment, you determine that your client needs ongoing therapy with a substance abuse specialist. You happen to be a substance abuse specialist and you are also a provider under the client’s medical plan. However, the client’s EAP paperwork indicates that the employer does not allow you to continue seeing the client beyond the EAP sessions. What should you do? Select the best choice from the options below. Refer the member to yourself for continuity because the client wants to continue in treatment with you. Refer the client to another substance abuse provider in their health plan network. Ask the member to call the EAP and request to continue in treatment with you under their medical plan. Click ‘Next’ below to finish the course. file:///U|/Desktop/EAPEssentials/Part3L.html [11/9/2010 1:06:40 PM] Conclusion Essential Skills for EAP Providers Menu Menu Congratulations! Now that you have completed Essential Skills for EAP Providers, you should be able to: Respond appropriately to management referrals Determine whether a client is a candidate for EAP services Intervene effectively within the EAP service delivery model We appreciate the time you have taken to enhance your understanding of your role as an EAP provider within Magellan Health Services Employee Assistance Programs. The authors of this training welcome your feedback, questions, and comments regarding any aspect of this training or providing EAP services at Magellan. For more information, please contact us at EAPfeedback@MagellanHealth.com We look forward to hearing from you and hope that this is only the beginning of a stronger partnership between you, our EAP providers who take care of our members in the field, and all of Magellan Health Services Employee Assistance Programs. Note: Magellan Health Services did not receive any commercial support for this continuing education program. Resources used in preparing this course on Essential Skills for EAP Providers can be found in the Bibliography. Click ‘Next’ below for CE credit information and exit instructions. file:///U|/Desktop/EAPEssentials_Providers/End1.html[9/29/2011 1:39:29 PM] End Essential Skills for EAP Providers This is the conclusion of this online course. Please contact EAPFeedback@MagellanHealth.com if you have questions, feedback and / or comments. If you wish to request 2.0 continuing education (CE) credits and / or Professional Development Hours (PDH), click here. You must achieve a passing score upon completion of the course post-test and complete the CE survey to receive a CE and /or PDH certificate. Contact EAPFeedback@MagellanHealth.com if you have questions about continuing education or professional development hours. END file:///U|/Desktop/EAPEssentials_Providers/End2.html[9/29/2011 3:05:09 PM]