Integration Insights

EAP Integration with Worksite Wellness Programs

By Mark Attridge, PhD

This column addresses the integration of EAPs with other workplace services. This particular issue describes trends in workplace wellness services and how EAPs can address the growing interest in adding behavioral health approaches to prevention.  

Trends in Workplace Wellness & Prevention 
The core practices of wellness programs typically include: (1) strategic planning to prevent disease, decrease health risks, and contain rising health care costs; (2) conducting health screenings of individuals and risk stratification of the entire employee population; (3) providing risk-related health management interventions (exercise, behavior change programs, health coaching, educational materials, nurse advice lines, and referral to disease management specialty programs); and (4) ongoing evaluation and metrics.

A 2015 benchmarking study by World at Work revealed that 74% of employers planned to increase their spending on employee well-being programs and that the “primary champion” of such programs is shifting from human resources to an organization’s CEO or other non-HR senior management. This data indicates that employers are expanding their support – financially and strategically – for employee wellness programs. Another study by Humana of 225 U.S.-based companies with wellness programs showed that 70% considered such programs to be cost-effective. However many of the same companies struggled with how to successfully drive participation and produce positive outcomes. 

Comparing EAP and Wellness
Given these trends, it makes sense for EAPs to try to better align themselves with wellness and offer ways to make wellness more effective. Many EAPs are already in the business of wellness. A National Behavioral Consortium Survey of 82 vendors of EAP services found that in 2011, about half (49%) of these EAP vendors also offered wellness as an additional primary service. But there are many variations of what constitutes a preventive health and wellness program. In a 2014 presentation at the National Wellness Conference, Dr. Joel Bennett and I compared and contrasted the roles and skills involved with EAP and wellness programs. 

There is a difference in time frame, as most EAP cases are for acute issues and take only a few sessions to successfully resolve or refer to more intensive treatment, whereas most wellness cases last for 3 to 6 months and focus on gradually making lifestyle changes. Both programs share an interest in individual assessments and technological tools for client education and self-change.     

Opportunities for EAP to Make Wellness More Effective
Where EAP can help wellness is in avoiding dropout from these programs through enhanced risk screening and co-management and also with the referral of new cases. EAP can advise on how to conduct more comprehensive risk assessments that screen for anxiety, depression and addictions (i.e., SBIRT model). EAP can then co-manage those employees who screen positive for mental health or addiction risks while they are in the wellness program.

Generally speaking, EAP counselors can support participants in wellness programs with other issues involving family, financial, and work stressors that can derail wellness activities. An ongoing cross-referral of relevant cases between wellness programs and the EAP is also an easy way to bolster the ROI for both programs through more effective case-finding tactics. Participating in a better diet and getting more exercise can also make EAP cases more likely to experience clinical improvement.  

Examples of EAP and Wellness
Some EAPs have a long history of collaborating with wellness. Since the late 1990s, Optum has provided a combined EAP, work-life, and 24/7 nurse advice program that uses telephonic point of entry and a shared database for case management. In a 2005 book on the integration of EAP, work-life and wellness, Michael Mulvihill profiled the cross-referral practices at Pfizer in which the EAP counselors referred their cases with tobacco cessation, weight loss, and stress management issues to the wellness program. Wellness coaches, in turn, referred anxiety and depression cases to the EAP. 

Additionally a 2012 ComPsych report showed that wellness coaches are trained to assess program participants for possible emotional or behavioral issues that may complicate the adoption of healthier habits. They referred between 7% and 10% of their cases to the EAP or work-life programs. These are but some of the examples in how EAPs are adapting to make wellness programs more successful and employees healthier and more productive at work.  

NOTE: In future articles, I would like to profile EAP programs or vendors that partner with client organizations and other programs in innovative ways. Contact me with your suggestions for a case study.  

Dr. Mark Attridge is an independent research scholar as President of Attridge Consulting, Inc., based in Minneapolis. He has created over 200 papers and conference presentations on various topics in workplace mental health, EAP, psychology, and communication. He delivered a keynote presentation on ROI and the business value of EAP at EAPA’s 2013 World EAP Conference and is past Chair of the EAPA Research Committee. He can be reached at