Workplace responses to employees experiencing performance-impairing problems have undergone remarkable changes over the past 250 years. This paper: 1) describes the evolution of such responses through five historical periods, 2) analyzes the major trends across these periods, and 3) speculates on the future directions of employee assistance (EA) as a professionalized endeavor. It is our hope that this paper will stir discussion and debate about the EA field’s evolving identity and its future as a professional specialty.