Implementing long-term EAP follow-up with clients and family members to help prevent relapse-With implications for primary prevention.

This paper reports on a study in progress which involves (a) regular post-treatment contact by employee assistance program (EAP) staff with employees who seek help through the EAP, and (b) contact with a family member or other support person designated by the employee. The contacts are designed to provide support for maintenance of therapeutic gains, assistance in adjusting to current life situations, and early identification and prevention of relapse. The study will evaluate the process of initiating these contacts and will examine their effectiveness at reducing relapse. Factors associated with implementing these services in an EAP context are discussed.

The role of work for wives of alcoholics.

The family has increasingly been recognized as an important component in the development, maintenance, and treatment of alcoholism. Few empirical studies, however, have examined alcoholism within a family context. Questionnaire and interview data were collected from women whose husbands received inpatient treatment for alcoholism. Since wives now typically work outside the home, this article focuses on the 60 employed wives. Employment was examined as a source of stress as well as social support. The majority of working wives reported minimal negative impact of their husbands' drinking on all areas of their work functioning, with a small subset indicating impairment attributable to the drinking. These wives were very satisfied with their current positions and described work as a positive experience. However, unobtrusive measures that alcoholism in a family member intrudes into the workplace were apparent, including changing jobs, absenteeism, and discussing husbands' drinking at work. Further, these women scored closer to a sample of depressed women than a community sample on measures of physical and mental health, depressed mood, and smoking symptoms. Possible reasons for the discrepancy between subjective reports and objective indicators are discussed.

The employee as client: perceptions of a work-based alcohol treatment program.

The clients' reports provide invaluable insights into the EAP in which they participated. Overall, they reaffirmed the viability of occupational alcoholism programs as an effective intervention in problem drinking. They did raise serious questions about the fit between the theoretical expectations of EAPs and actual practice. They felt work performance problems were poorly documented and therefore were not used in the confrontation-referral process. As a consequence, early problem identification, seen as one of the major advantages of occupational intervention, does not seem to take place. Most of the clients felt they were referred only after long periods of problem drinking. While the reports of the clients represent an insider's view of the EAP, an obvious question that arises is how valid are their reports? Precisely because they are the targets of the EAP activity and because their problem drinking is generally seen as deviant behavior, their reports may be clouded by fear, rationalization, attempts to please others in the work organization and endless other personal concerns. The validity of self-reports are always difficult to assess. The usual precautions were taken in collecting the data, including assurance of confidentiality, voluntary participation in the study, assurance that the research team was independent of any work-related interest group and the use of neutral grounds for data collection. While all of these add some measure of confidence to the reports, they do not constitute guarantees of validity. Another source of evidence for validity is corroborating evidence.(ABSTRACT TRUNCATED AT 250 WORDS)

Measuring the success of occupational alcoholism programs.

The research on the success of occupational alcoholism programs (OAPs) was reviewed. One measure of the success of OAPs has been a change in drinking behavior. This may seem like the most relevant measure but there are questions about its reliability because researchers usually depend on subjects' self-reports and do not define their criteria for successful outcome well. In addition, attempts by employers to dictate the drinking habits of their employees may be difficult to justify. Varying rates of success on this measure have been reported. Subjects have generally been able to control drinking in the long term, but it is suggested that their control erodes over time. A second measure of the success of OAPs has been work performance, as revealed by absenteeism, disciplinary actions, accidents, sick and injured days taken, turnover rate and job efficiency. Studies of this measure have been hindered by employers' poor record keeping and by the difficulty of developing standard measures of outcome success. In general, studies with weaker research designs have shown more improvement on this measure. A third measure has been the cost efficiency of OAPs, as revealed by direct savings for employers resulting from OAPs such as decreases in absenteeism and indirect savings such as increased accuracy of work. This measure seems to be the one most relevant to employers' profit motives. Studies of cost efficiency have had ambiguous findings. A fourth measure has been the penetration rate--the extent to which an OAP reaches its target population. This measure has never been studied successfully. A problem with all the studies reviewed has been their poor design (a lack of control groups, follow-up periods that were too brief and problems with selection of subjects), which raises serious questions about their validity. The obstacles to measuring outcome success were also discussed--poor documentation by employers, lack of access to subjects and reluctance on the part of employers and treatment staff to allow studies.