The past five years have provided a number of opportunities for change in the EAP field: the events of 9/11, extreme natural disasters, biologic attacks, and the looming threat of a global avian flu pandemic. The convergence of these events along with increased awareness of their impact on organizations and human capital have provided a great opportunity for EAP and workplace behavioral health experts to be in leadership positions around risk and response.
One such expert is Robert Ursano, MD, the director of the Center for the Study of Traumatic Stress and professor and chairman of the Department of Psychiatry at the Uniformed Services University of the Health Sciences. Speaking at a conference of government, research, and private-sector leaders on crisis response, he stated, “Only by sustaining the social and emotional health of employees can organizations and the nation sustain continual operational effectiveness in light of today's new threat environment.”
Historically, EAPs' role has been to respond only “on request” or postevent with psychological debriefings designed to alleviate individual symptoms in response to a traumatic experience. For many organizations, however, EAPs’ postevent response is no longer enough. EAPs’ skills as behavioral experts can be reclaimed as a key consultative value to organizations.
The traditional behavioral health and EAP therapeutic approach of leading with a clinical first model does not serve organizational crisis management or response very well. This became evident following last year's devastating hurricanes, when traditional resources and responses were overwhelmed or nonexistent and continue to be in short supply. Many EAPs found themselves operating in a new environment, providing aid and comfort directly related to necessities of daily living, assisting overwhelmed HR managers in locating evacuated employees and separated family members, and supporting community responses through religious organizations. These tasks were critical to creating organizational continuity of operations.
In a recent conversation with EAP counselors working for Gulf Coast governmental agencies, one counselor pointed out that although the daily living struggle a year later is difficult, the worst thing EAPs can do is to pathologize the situation based on expectations of normal living. For Gulf Coast residents, “normal” has become different from what other Americans consider normal.
Experts on Human Behavior
In current risk-management process thinking, the term “convergence” to manage risk describes bringing together internal and external experts who have key contributions to the success of influencing and protecting employee behavior before, during, and after a crisis. This convergence of experts often includes organization and/or community leaders in medicine, security, safety, human resources, employee assistance, and operations. Each plays a key role in behavior management, preparing the workplace for operational risk management and employees’ families for crisis behavior.
Many risk-management experts speak of the three Rs of continuity:
redundancy, in which “people knowledge” is spread and shared across a working population;
reliability, in which people have the knowledge and ability to back up or take over for the equipment that does most of the work; and
resiliency, in which the human factor has the learned flexibility to function under new or difficult conditions.
Together with other organizational professionals, EAPs can play an active role in improving the three Rs and planning to ensure they function well after crises. In fact, in some larger organizations EAPs actively are joining the risk-management process. Many of the larger behavioral health/EAP provider organizations, however, have yet to be able to successfully provide this level of value because of their operational and structural distance from the organizations they serve.
Behavioral health experts' new role is to link both individual and organizational preparedness with psychological and social well-being. To be successful in the linkage, behavioral health professionals and EAPs need to become active participants in the convergence conversation. Behavioral health and EAP experts can help to create critical organizational thinking around crisis preparedness and planning that puts the plans and thinking into everyday situational behaviors.
When organizations create plans, they often rely on people doing things according to the written plan and don't account for the fact that people react differently during crises. In addition, many external EAPs operate under a set plan that is expected to be applied repeatedly for all events without a clear understanding of organizational differences. Therefore, the goal of being a part of the convergence team is to incorporate a level of flexibility and relationship building within the organization that can respond to a variety of events in light of the variability of human behavior. For EAPs and behavioral health experts, not knowing or seeking to actively participate in the development of their client organizations’ disaster planning is like intentionally climbing a ladder to nowhere when it comes time to deliver support.
Psychological First Aid
After 9/11, controversy surrounded the validity of applying the traditional clinical debriefing model to the masses. Individuals' needs following the December 2004 Asian tsunami and last year's hurricanes demonstrated the inappropriate use of clinical debriefing.