Overview

The demand for in-person mental health care is at its highest point since the beginning of the pandemic – and the impact this treatment modality has on anxiety, depression, substance use and productivity is undeniable.

The International Journal of Scientific and Research Publications just published a peer-reviewed study based on health and productivity outcomes from over 35,000 CuraLinc EAP cases that were delivered face-to-face – the largest study of its kind – and the results were outstanding.

Workforce mental health and employee assistance programs (EAPs) that can’t offer fast access to high-quality in-person care are missing opportunities to build better therapeutic alliance by supporting employees who prefer face-to-face counseling and coaching.

For the full report, visit the International Journal of Scientific and Research Publications. For a summary, continue reading or fill out the form below.

 

In-person EAP Counseling: Profile of 35,228 Cases and Tests of Depression, Anxiety, Alcohol and Work Outcomes at CuraLinc Healthcare 2017-2023

Source: International Journal of Scientific and Research Publications, Volume 13, Issue 12, December 2023

This applied study examined client characteristics and outcome data for users of brief counseling treatment delivered by licensed counselors in person at clinic office settings. A sample of 33,228 clients was obtained from archival records of the normal course of business at CuraLinc Healthcare, which is a national employee assistance program (EAP) service provider in the United States.

Based on a seven-year naturalistic study design, we profiled who the users are, how and why the counseling was used and what impact it had on their health and work. Almost all of the clients were employees (98%; 2% family) and voluntarily used the EAP (97% self-referrals; 3% formal management referrals from work). There was a wide range between users for age (range 16-86 years; average 40) and gender (females 61%, males 39%). Many different industries were also represented (10+ types). The reasons why the EAP was used had substantial variation across mental health (63%), personal stress (20%), relationships and family life (20%), work (7%) and substance use (2%) issues. The duration of the counseling treatment per case spanned from 1 week to over 10 months, but most clients found relief after about two months of time engaging in talk therapy with their EAP counselor. Self-report outcomes were assessed with standardized measures. Prevalence rates for clinical status when starting counseling were: 39% at risk for anxiety; 29% at risk for depression; 14% at risk for alcohol misuse; 39% at risk for a work presenteeism problem; and 22% at risk for a work absenteeism problem. 

At 30 days after completing counseling, improvements in the severity of symptoms and clinical recovery (i.e., changing from at-risk/unhealthy to no-risk/healthy) were documented for each outcome. Longitudinal tests conducted within each clinically at-risk subsample of clients found significant improvement after counseling with large-size statistical effects: 

  • Anxiety severity was reduced by 65% for the average at-risk case and 80% of the 124 at-risk cases recovered

  • Depression severity was reduced by 50% and 78% of the 281 at-risk cases recovered

  • Alcohol misuse was reduced by 53% and 76% of the 307 at-risk cases recovered

  • Work absenteeism per past 30 days was reduced by 88% from 25 hours at Pre to 4 hours at Post and 88% of the 1,101 at-risk cases recovered

  • Work presenteeism (i.e., lack of focus and performance while working) was reduced by 47% for the average case and 88% of the 1,217 at-risk cases recovered

Overall, the broad appeal and high level of effectiveness of in-person delivered counseling for health and work outcome areas confirms this kind of delivery context is an important option for EAPs and other workplace mental health support services. Comparisons with past research, study limitations, and implications are also discussed.

Depression

Tool used: Patient Health Questionnaire (PHQ-2)

  • 22.9% of EAP users met the criteria for clinical depression before starting treatment; after completing in-person counseling, this dropped to only 5.8% of users

  • 78% of people who started in-person counseling at risk for depression recovered to no longer be at risk after completing treatment

  • The level of symptom severity for the average user with clinical depression at the start of counseling was 60% lower at the follow-up

Anxiety

Tool used: Generalized Anxiety Disorder (GAD-2)

  • 32.6% of EAP users met the criteria for clinical anxiety before starting treatment; after completing in-person counseling, this dropped to only 7.6% of users

  • 80% of people who started in-person counseling at risk for anxiety recovered to no longer be at risk after completing treatment

  • The level of symptom severity for the average user with clinical anxiety at the start of counseling was 65% lower at the follow-up

Alcohol use

Tool used: Alcohol Use Disorders Identification Test (AUDIT-3)

  • 20.2% of EAP users met the criteria for hazardous alcohol use before starting treatment; after completing in-person counseling, this dropped to only 4.6% of users

  • 68% of people who started in-person counseling at risk for alcohol misuse recovered to no longer be at risk after completing treatment

  • The level of symptom severity for the average user at risk for alcohol misuse at the start of counseling was 63% lower at the follow-up

Presenteeism

Tool used: Stanford Presenteeism Scale (SPS-6)

  • 36% of EAP users had a presenteeism problem before starting treatment; after completing in-person counseling, this dropped to only 5.7% of users

  • 88% of people who started in-person counseling with a presenteeism problem recovered to no longer be at risk and had a level of performance in the range of a typical employee after completing treatment

  • The average level of presenteeism while working decreased by 47% during the previous 30 days for the average user with a presenteeism problem

Absenteeism

Tool used: Workplace Outcomes Survey (WOS)

  • 30.7% of EAP users had an absenteeism problem before starting treatment; after completing in-person counseling, this dropped to only 5.6% of users

  • 88% of people who started in-person counseling at risk for absenteeism recovered to no longer be at risk and had a level of performance in the range of a typical employee after completing treatment

  • The average number of hours missed during the previous 30 days dropped 85%, resulting in 20.94 fewer hours lost for the average user with an absenteeism problem