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

Abstract

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 7-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 (all p < .001) with large size statistical effects: Anxiety severity (GAD-2) was reduced by 65% for the average at-risk case (d = 1.71) and 80% of the 124 at-risk cases recovered; Depression severity (PHQ-2) was reduced by 50% (d = 1.91) and 78% of the 281 at-risk cases recovered; Alcohol misuse (AUDIT-3) was reduced by 53% (d = 1.48) and 76% of the 307 at-risk cases recovered; Work absenteeism per past 30 days (Workplace Outcome Suite) was reduced by 88% from 25 hours at Pre to 4 hours at Post (d = 1.63) and 88% of the 1,101 at-risk cases recovered; and severity of work presenteeism (i.e., lack of focus and performance while working; WOS or Stanford Presenteeism Scale) was reduced by 47% for the average case (d = 1.71) 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.