The World of EAP

Survey Explores Global EAP Delivery

By John Maynard, PhD, CEAP

Do you ever wonder how many external EA firms are active in today’s global market? 
Accurate answers are elusive for a number of reasons, among them the ongoing churn of acquisitions, start-ups, and closings; as well as the reality that many firms are not engaged with EAPA or other professional associations who might have an interest in tracking industry data. 

Chestnut Global Partners (CGP) recently surveyed its EAP partners around the world to examine the number of external EAP firms and the perceived needs of the field that must be addressed to sustain the growth of EAP services in the future (Hagen et al., 2016). Matt Mollenhauer, CGP Managing Director, wrote about the survey findings in the CGP 2017 Trends Report (Mollenhauer, 2017). The following information is adapted with permission from his article and the survey results.

Global, Regional, and Local/National EAP Firms
According to the CGP survey, there are more than 839 external EAP firms in the world. These firms can be categorized into three groups based on the geographical scope of their services. Global EAP providers deliver services throughout the majority of countries in the world. Regional EAP providers offer services in multiple countries within a particular geographic region or a specific continent. Local/national EAP providers focus their efforts primarily within a single country.  

Six EAP firms were identified by CGP as global service providers. Global providers typically build local relationships that allow services to be delivered in each country served. They are broadening their capability to deliver services remotely via technology. Using a global EAP firm can be an attractive option for many organizations, as it allows employers to work with a single vendor to provide EAP services for all its employees, regardless of where they are located. Often, however, several global providers subcontract with the same local/national EAP provider to deliver services within a particular country. As a result, the global firms may face challenges in differentiating their unique value in that market. 

The survey identified 56 regional EAP firms serving multiple countries. Regional firms face many of the same challenges as their global counterparts, although they may have the advantage of recruiting and managing somewhat smaller and less diverse provider networks. Many purchasers may prefer working with one or more regional EAPs, feeling that a regional firm can provide more culturally sensitive services to employees while still being large enough to offer multiple service delivery platforms.

Local/national EAP firms are differentiated by their emphasis on delivering services within all or part of a single country. According to CGP’s survey, there are currently about 777 local/national EAP firms in the world, nearly 75% of which are located in the United States. Local/national EAP firms can grow independently or as subcontractors to regional and/or global EAP firms. They vary widely in terms of clinical capability, service delivery infrastructure, and knowledge about EAP best practices or workplace cultures. Local/national EAP firms offer perhaps the greatest opportunities for growth in the worldwide EAP market, especially in developing countries.

Top Issues for Preserving EAP Market Vitality
CGP’s survey participants were also asked to identify what they saw as the most important needs that the field must address to sustain and grow the EAP market worldwide. The top four needs identified were: 

Increase utilization rates. Consistent research findings over time and across cultures reveal that up to one-third of the working population every year experiences mental health concerns. (Steel et al., 2014). However, a recent survey suggests that only 4-5% of employees typically access available EAP services each year (Attridge et al., 2013). Addressing this long-term concern may require changes in pricing strategies and finding new ways to increase awareness and trust of EA services within working populations.

Improve collaboration and coordination of care. Successfully connecting clients with appropriate treatment or other resources is a core component of EA services. In many countries, the scarcity of qualified treatment resources makes appropriate referral and follow-up difficult. This sometimes forces the EAP to operate as a de facto treatment program. The growing use of mobile and wireless technology platforms may help overcome some of the current geographical constraints or other barriers and make evidence-based treatment and follow-up services more readily available to clients.

Increase purchasers’ perceived value of EAP by measuring valid outcomes. Despite more than 500 applied research papers that conclude that workplace behavioral health intervention is generally effective, most of these remain unpublished, proprietary, or simply not shared with the purchasing organization (Attridge, 2013; Taranowski & Mahieu, 2013). As the use of valid tools like CGP’s Workplace Outcome Suite becomes more widespread, and carefully constructed outcome research like the EARF-funded “Impact of EA Services on Workplace Outcomes” study (Richmond & Wood, 2015) becomes more widely published, EAPs need to assure that the information gets to current and prospective purchasers.

Improve adherence to standards of quality. EAPA has published EA program standards and professional guidelines since 1981. Other associations and organizations have published their own standards, usually drawn from EAPA’s standards. However, most customer organizations and even many long-time EA practitioners are unaware of what the standards are or where to find them. Without agreed-upon quality standards, the EAP field will never achieve the perceived value and professional acceptance to which it aspires.

Let’s Continue the Discussion
My thanks to Chestnut Global Partners for allowing use of their survey information and to Matt Mollenhauer for taking the time to review and discuss the survey with me as I was preparing this column.  Let’s continue the discussion of needs and trends in the global EAP market! You’re welcome to contact me directly anytime or to post your feedback, questions, or suggestions on EAPA’s LinkedIn group.  

Dr. John Maynard served as CEO of EAPA from 2004 through 2015. Prior to that, he was President of SPIRE Health Consultants, Inc., a global consulting firm specializing in EA strategic planning, program design, and quality improvement. In both roles, he had the opportunity to observe, meet, and exchange ideas with EA professionals in countries around the world. He currently accepts speaking and consulting projects where he can make a positive difference. He can be reached at 


Attridge, M. (2013). The business value of employee assistance: A review of the art and science of ROI. EAPA’s 2013 World EAP Conference, Phoenix, Arizona.

Attridge, M., Cahill, T., Granberry, S., & Herlihy, P. (2013). The NBC industry profile of external EAP vendors. Journal of Workplace Behavioral Health, 28(4).

Hagen, R., Sharar, D., & Mollenhauer, M. (2016). State of global EAP and top needs in the industry. Employee Assistance European Forum, Bucharest, Romania.

Mollenhauer, M. (2017). EAP survey reveals market segments and top industry needs. 2017 Trends Report. Chestnut Global Partners.

Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J., Patel, V. & Silove, D. (2014). The global prevalence of common mental disorders: A systematic review and meta-analysis 1980-2013. International Journal of Epidemiology, 43(2), 476-493.

Richmond, M. & Wood, R. (2015). Impact of EA Services on Workplace Outcomes. EAPA’s 2015 World EAP Conference, San Diego, California.

Taranowski, C. & Mahieu, K. (2013). Trends in EAP implementation, structure, and utilization, 2009-2010. Journal of Workplace Behavioral, 28(3).