From January 2002 NASW NEWS
Copyright ©2002, National Association of Social Workers, Inc.

EAPs Offer Multitude of Internet Services

The Council on Accreditation for Children and Family Services and the Employee Assistance Society of North America, with support from the Substance Abuse and Mental Health Services Administration, have developed accreditation standards for EAPs, including standards for delivery of Internet and telephone services.

The standards for telephone and online services include:

• The kinds of client populations to be reached.
• Informing clients of optimal circumstances.
• Using hard-wired, nonportable telephones.
• Having a counselor available in the clients' geographic area when online services are not available.
• Problems not to treat by telephone or online, like emergencies.
• Provision for the prevention of faulty transmissions.
• How to verify identity of clients and providers.

EAPs offer a multitude of services on the Web, said Masi. They include:

• Educational services about many influences on human behavior, including mental health, substance abuse, work stress, finances, geriatric care and many others.
• Chat rooms with counselors on many topics.
• Telephone availability of counselors, although services are not regularly scheduled, and EAPs don't call it counseling.
• Self-assessment tools for problems like depression, anxiety, stress and substance abuse.

Online services from and through the workplace are crucial because so many people, especially women, spend much of their time at work and otherwise would have little time to seek out a counselor, said Masi. Managed behavioral health organizations are very strict about what services they will provide, often denying those that aren't diagnosable in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. EAPs, on the other hand, offer a much broader range of services on parent-child, marital, addictions, financial, legal and many other issues. They become a workplace, in-house family service agency.

Masi is concerned that some want to limit Internet and telephone services. "Why not let the clients choose what kind of services they want?" Masi said. "We are supposed to meet the clients where the clients are. I think we have to work with clients where it helps, not just be negative."

Social work needs to begin to train people for online and telephone counseling, she said.

The issue of malpractice insurance clouds the picture for online and telephone services, said Masi. "Lawyers say there is no case history on this — whether the counselor needs to be licensed where the counselor is or where the client is," she said. "It will be several years before people have to worry." The malpractice insurance provider through NASW's Insurance Trust hasn't ruled against it, she said.

NASW's liability insurance carrier, American Professional Agency, says it is not necessary to purchase another policy for Internet or telephone/telecrommunication practice. However, the company cautions that great care should be taken to prevent a breach of privacy and confidentiality. And, the company says, "due to the changing atmosphere and unprecedented legislation regarding the Internet, it is imperative that you keep abreast of current events concerning your methods of practice." Also, says Insurance Trust Director Loretta Robinson, the insurance carrier will cover Internet practice only if the insured practitioner is in compliance with state law.

Medicine has the same questions of licensing, yet telemedicine has been going on for years, said Masi. Attorneys and other professions also have the same licensing issues.

"Traditional social workers are much more conservative and jumpy," said Masi. "EAPs have been on the cutting edge of services."

A survey in 1999 by the Employee Assistance Professionals Association showed that about 46 percent of its 6,000-plus members were social workers, making them by far the largest professional group employed in EAPs, said a spokesperson for the association.

A survey for Ceridian, an EAP company, by the University of Maryland School of Social Work in 2000 showed that 25 percent of respondents used self-assessment programs on the company's Web site for problems like anxiety and depression. Over 85 percent accessed the Web site from work. Nearly 93 percent reported that they found the site helpful or extremely helpful and said they would use it again.

Of respondents who used the Web site because they had issues too embarrassing to share face to face, 29 percent were Hispanic, 18 percent were African American, and 16 percent were Asian, compared to only 8 percent Caucasian.

Information, helpful hints and resources for further assistance on many problems are offered by big EAPs on the Internet. The following are offered by one EAP, which is far from a comprehensive list, said Masi: abusive relationships, agoraphobia, anger, anxiety, assertiveness, coping with change, depression, diet and nutrition, eating disorders, post-traumatic stress disorder, premenstrual syndrome, procrastination, relationships, relaxation, sexual dysfunction, sleep problems, smoking cessation, stress management, substance abuse, suicide prevention, time management, and "what is therapy?"

Related information from NASW: "Online Therapy and the Clinical Social Worker" practice update, July 2000, www.socialworkers.org/practice/update/online.htm

Back to NASW NEWS Contents