Managing Employee Assistance Programs: A Comprehensive Guide
An employer-sponsored Employee Assistance Program (EAP) is a workplace resource designed to help employees tackle personal challenges — like marital, financial, or emotional struggles, family issues, or substance misuse — that might impact their job performance. Beyond this, EAPs often provide services like legal assistance, adoption support, elder care resources, wellness programs, and more.
EAPs typically offer employee assessments, referrals for mental health or substance use treatment, and consultation services for managers. They also train supervisors to address behavioral or performance concerns and host wellness programs on topics like stress management, healthy living, and smoking cessation.
Employers who are considering whether an EAP is right for their organizations can begin by learning the basics — what EAPs provide, how employers contract with EAPs, critical requirements any EAP should follow and avenues by which employees access EAP services.
Business Case
Employers usually pay for EAPs, and their services are often available not only to employees but also to employees' immediate family members or to anyone living in employees' homes.
Employers have a vested interest in the ability of employees to work at or close to their full potential. EAPs are valuable resources that can help employees cope with issues affecting their ability to reach that potential, including:
- Marital and family problems.
- Conflicts among co-workers and managers.
- Depression or substance misuse.
- Work-related stress.
- Legal and financial issues.
- Child and elder care needs.
These distractions may hurt productivity and drive up costs for businesses. The health care system cannot always handle these types of issues, especially those—such as needs for financial counseling or elder care help—that are not health related. EAPs are cost-effective tools to mitigate these risks. EAPs can help employers:
- Reduce absenteeism, workers' compensation claims, health care costs, accidents and grievances.
- Address safety and security issues.
- Improve employee productivity and engagement.
- Reduce costs related to employee turnover.
According to the 2024 SHRM Employee Benefits research report, 82 percent of surveyed employers offered an EAP.
SHRM Resources
Different Ways of Delivering EAPs
Employers have a number of options when establishing an EAP program, from keeping it entirely in-house to outsourcing every aspect of service. These are the most common EAP delivery models:
- Management-sponsored EAPs: These are in-house programs, and the EAP staff is directly employed by the organization. Large organizations often offer this form of EAP.
- Fixed-fee contracts: Employers contract for various services such as counseling, referrals and supervisory training with fees based on the number of employees, regardless of their actual EAP use.
- Fee-for-service contracts: Employers contract directly with the EAP provider, paying only when the service is used.
- Consortia: Small businesses join together to contract for EAP services, lowering the cost per employee.
- Member assistance programs: Provided by unions, member assistance programs (MAPs) offer services ranging from prevention and problem identification to referral and counseling activities for employees and their family members.
- Peer assistance programs: Sponsored by employers or unions, peer assistance programs (PAPs) train peers to work with troubled employees to address substance misuse and other problems within predetermined rules and limits.
- Mixed-model programs: These are used by employers and unions with multiple worksites that have different needs and resources.
Pro Tip
Communicating openly about program goals or processes reduces the risk of I&D programs being seen as unfair or biased. Perceived secrecy around the operation of a program can lead to misunderstandings regarding its functioning and objectives.
Critical Requirements for an EAP
Regardless of the vendor model, there is broad consensus around critical EAP requirements.
The Employee Assistance Professionals Association (EAPA) guidelines say EAPs must have written policies ensuring client confidentiality, an adequate number of trained employee assistance professionals, and formal procedures for following up with or monitoring people who use the EAP.
Written Policy
EAPA recommends that organizations adopt a written policy that, among other things:
- Defines the EAP's relationship to the organization.
- States the scope and limitations of services.
- Provides a clear definition of the EAP's function to make sure that all parties understand the EAP and that the EAP is used consistently throughout the organization.
Best Practices
EAPA's standards also include the following:
- An advisory process that involves representatives from all parts of the employer's organization, including leadership, line employees, key departments and unions.
- The ability to meet changing needs by adding services.
- Crisis intervention services available 24 hours a day, seven days a week.
- Procedures for determining when to provide short-term problem-resolution services within the EAP and when to refer a client to professional or community resources outside the EAP.
- Training for the employer organization's leaders, so those leaders learn to recognize issues and can intervene by referring employees to the EAP.
- Trained professionals who maintain and upgrade their skills.
Communication
HR generally develops EAP program guidelines and trains employees and managers to ensure that everyone understands the organization's EAP services and how to access them. Consequently, is also generally HR that develops internal documents to communicate policy requirements, changes and clarifications.
Employees will not turn to EAPs unless they understand what the programs really offer, so employers need to promote the offerings frequently. A quarter of employees (26%) say they do not know whether their employer offers mental health benefits — such as an EAP, flexible work arrangement, or paid time off for mental health — and only a little over half (53%) know how to access their mental health care benefits, according to a 2025 poll of more than 2,000 U.S. adults conducted by the National Alliance on Mental Illness in cooperation with Ipsos.
Different Types of EAP Referrals
Once an EAP is in place, employees can begin using EAP services in a variety of ways:
- Self-referral: Employees or family members contact the EAP directly.
- Informal: A friend or colleague (who may or may not have used an EAP) suggests the EAP to the employee and recommends its use.
- Formal: Based on observation, a supervisor, manager or HR professional recommends the EAP to an employee. Such a referral may be mandatory due to poor performance or disciplinary actions. However, a formal referral based on discipline or performance creates specific legal considerations for the employer.
Pro Tip
In addition to providing information about the EAP's services during employee orientation and the open benefits enrollment period, employers frequently offer lunch seminars and information sessions about the EAP and how to use it.
Choosing a Vendor
When selecting an EAP service provider, an employer needs to consider the following factors:
- Years of service, references and current clients: Do other employers with similar workforces recommend the vendor?
- Service location: Will the EAP services be available in-person (onsite, offsite or both) and/or remotely via phone or videoconference?
- Ability to provide services to employees in different locations: Can the provider handle clients who are not all in the same geographic area?
- Hours of service: Are services available to employees who work night shifts or unusual hours?
- Scope of services: Does the vendor offer a full range of services, such as stress management, elder care help, substance misuse programs, wellness programs and financial counseling?
- Referrals: Is the vendor able to refer employees to outside resources when the employees need more or different help than the EAP alone provides?
- Follow-up services: Is there a process for tracking clients' progress and ensuring they continue to get the help they need?
- Credentials and training: Can the EAP provider show that its professional employees are trained and that they hold appropriate and updated credentials?
SHRM Resources
Pro Tip
Different generations in a workforce may prefer different methods of communicating with an EAP counselor or receiving services. Consider workers of all ages when weighing an EAP provider.
Legal and Compliance Considerations
Because EAPs often deal with issues involving mental health, employee discipline and confidentiality, employers that provide EAP services must be aware of legal concerns surrounding those services.
Mandatory Referrals
Mandatory EAP referrals, unlike voluntary ones, should generally occur with the employee's consent. Employers must ensure the employee has documented performance issues alongside signs of depression, suicidal tendencies, or hostility before making such referrals.
In supervisory referrals, employers often discuss performance concerns with the EAP counselor beforehand (not necessarily with the employee present). With the employee's signed consent, the EAP can later share limited feedback on attendance, compliance, and prognosis. For workplace violence concerns, employers may require a "fitness for duty" certification before allowing the employee to return.
Employers should avoid using termination threats to enforce counseling, as this could lead to claims of disability discrimination, invasion of privacy, or misuse of confidential medical information.
Confidentiality
A critical component of an EAP program is confidentiality. EAPs may not release any information without signed consent, regardless of the nature of the problem. Information is usually only available to the employer if the employee provides written permission. This general rule has two exceptions:
The employer may receive a general report from the EAP with totals of services provided and types of problems addressed.
When counseling is mandatory due to disciplinary problems, the EAP may inform the employer about whether the employee is attending required sessions. The employer may also inquire about the employee's progress.
Laws that Apply
Mental Health Parity and Addiction Equity Act of 2008: This law mandates that an EAP cannot be used as a gatekeeper — in which members are required to use the EAP before accessing mental health or substance use addiction benefits — unless a similar program is required for medical and surgical benefits. The parity requirements apply to U.S. employers with 50 or more workers whose group health plans offer mental health or substance use disorder benefits.
ERISA, ACA and COBRA: EAPs that offer medical benefits such as direct counseling and treatment, rather than just referrals for counseling and treatment, are regulated under the Employee Retirement Income Security Act (ERISA) and are subject to COBRA regulations. If the EAP does not provide services directly but only helps employees obtain those services, it is not considered a group health plan and is not subject to COBRA regulations.
The Patient Protection and Affordable Care Act (PPACA, or ACA): The ACA also addresses the issue of whether an EAP is a group health plan or is an "excepted benefit" in that it does not provide significant medical care and is therefore exempt from most of the ACA rules.
HIPAA: The Health Insurance Portability and Accountability Act (HIPAA) privacy rule establishes national standards to protect an individual's medical records and other personal health information. Whether an EAP is subject to HIPAA comes down to whether the EAP is considered a group health plan (see above). Whether the employer is responsible for HIPAA compliance comes down to whether or not the plan is embedded in another policy the employer provides that is already ensuring HIPAA compliance. If not, employers are responsible for ensuring confidentiality on any personal health information that is shared related to the EAP.
Americans with Disability Act (ADA): Mandatory EAP referrals can pose legal risks under the ADA. Case law shows that such referrals may imply the employer perceives the employee as having a disability, which is protected under the ADA and some state laws. This perception could lead to legal issues if the employer later takes adverse action against the employee.
Pro Tip
Employees are likelier to use EAP services if employees know their use of the EAP will be confidential. Conversely, if employees believe that use of these services will have a negative impact on their careers, they will avoid using the EAP if possible.
Metrics and Reporting
Measuring EAP performance can be challenging, but it’s crucial to determine its value.
Use rate reporting: The most common metric is the use rate, which tracks employee utilization of EAP services. However, inconsistent definitions and limited research make it difficult to link use rates to business goals. Employers should also assess factors like the number of cases opened for employees and dependents, follow-up services, employee education, management training, and non-case services such as workgroup consultations or stress debriefings.
Customizable reports: Many employers find standard EAP reports inadequate, as they often provide only basic operational metrics with little insight into program value or outcomes. To address this, HR should request customized reports that measure variables that matter to the employer, such as clinical outcomes, productivity impact, and effects on disability and health care costs. EAP providers should validate their program’s effectiveness using both quantitative tools, like outcome-based surveys, and qualitative data, such as case studies.
Global HR Considerations
Employers with workers in locations outside the United States will find that offering an international EAP can help support employees and maintain productivity. If employers lose expatriate or local workers due to stresses or burnout, the employer's investment in those employees is lost. An international EAP makes business sense because it protects that investment.
Identifying Clients and Their Needs
Clients for an international EAP can include:
- Expatriates on short- or long-term assignments and their family members.
- International permanent hires.
- Business travelers temporarily in a host country.
- Local employees.
- Virtual managers on global teams
The issues facing these employees can be different from those facing domestic employees, and the EAP must be capable of providing services to help employees handle culture shock, isolation, stress from an international move, separation from family members, concerns about elderly parents living in the employee's country of origin, and the stresses of daily life in another country.
Choosing an International EAP
When choosing a global EAP provider, employers must decide between a single global vendor or a decentralized network of regional providers. A single vendor offers broad coverage, centralized management, and standardized reporting but may struggle with local legal, cultural, and mental health nuances. In contrast, decentralized models leverage local expertise but can be complex to manage, with multiple contracts and potential coordination issues.
The choice depends on resources. Employers with the time, budget, and expertise to build a global network may benefit from a decentralized approach, while those with limited resources may prefer a single vendor. Additionally, cultural acceptance of EAP services and leadership’s support for domestic EAPs are critical factors in making a global EAP successful.
Pro Tip: If the employer has the time, budget, knowledge and volume of employees to essentially construct its own global network, the decentralized model has benefits. For employers with more constraints on their resources, relying on a single, central vendor is probably the better path.
SHRM Resource
Pro Tip
Qualified international EAP professionals must understand the dynamics of culture shock and should be familiar with the challenges of living abroad. Moreover, ff a cultural stigma regarding mental health treatment exists in a certain location, employees may be reluctant to approach the EAP.