Recent Submissions

  • Employee Assistance Program Counseling Improves Clinical and Work Outcomes: Longitudinal Results from CuraLinc Healthcare 2017-2022 in United States

    Attridge, Mark; Pawlowski, David; Fogarty, Sean (2022-08-06)
    This paper presents empirical findings from a multi-year applied naturalistic study that focused on changes in clinical and work outcomes after using an employee assistance program in the United States. Self-report outcomes assessed with standardized measures were collected at the start of counseling from 33,683 employees during the normal course of business at CuraLinc Healthcare during 2017 to June 2022. A total of 5,159 employees had valid Pre and 30-day Post use data on one or more of the outcomes. Tests within each outcome sample found significant improvement after counseling (most had a 5 or 6 session model). Among the 487 cases using the EAP for a depression issue, the average severity level of depression symptoms (PHQ-9) was reduced by 59%. Among the subset of these cases at-risk for clinical depression disorder (n = 292), 89% had a reliable clinical improvement in severity. Among the 440 cases using the EAP for an alcohol issue, the average severity level of alcohol misuse (AUDIT-10) was reduced by 67%. Among subset of these cases at-risk for alcohol misuse disorder (n = 288), 73% had a reliable clinical improvement in severity. Across all cases with absence data (n = 3,732), the average hours of work absence in the past month per employee (Workplace Outcome Suite) was reduced by 80%, changing from 8.9 hours at Pre to 1.8 hours at Post. At the start of counseling, 35% of these cases were classified as having an absence problem (i.e., missing more work than a typical healthy employee), but at Post only 7% had a work absence problem. Across all cases with productivity data (n = 3,845), the level of work productivity (Stanford Presenteeism Scale) improved by 35%. At the start of counseling, 34% of cases were initially classified as having a problem with work productivity (i.e., low performance and lack of focus), but at Post this rate was reduced to just 5% of cases. All primary results for each outcome were large size statistical effects. Moderator tests indicated the improvement in each outcome was generally consistent across different sub-groups of employees based on client age, sex, clinical use characteristics and other study context factors. Some moderator findings were identified for clinical issue, referral type (self or manager) and client sex having slightly different profiles on certain outcomes. Comparisons with past research, study design limitations, and best practices in conducting applied research on workplace mental health are discussed.
  • Unresolved States of Mind and Dysfunctional Caregiving Behaviors: A Systematic Review

    Pardue-Kim, Morgan (2022-07-11)
    Unresolved states of mind may inhibit the caregiving system, which may result in dysfunctional caregiving. 7 out of 10 studies have statistically significant positive associations between caregivers being classified as unresolved and engaging in dysfunctional caregiving behaviors. Effect sizes were r = .27 to .59.
  • Gender at Work: Comparing Employee Mental Health in Masculine and Feminine Workplace Cultures

    Attridge, Mark; Lashewicz, Bonnie (2021-06-09)
    Purpose of Study: Draw out interconnected aspects of individual employee experiences amidst their “social locations” in relationships and families and also the workplace practices and policies. We collected and analyzed views and experiences about work, gender and mental health from employees in one feminized workplace and one masculinized workplace. Mixed methods research study: Surveys (n=41 and n=84) and interviews (n=30) with participants from two workplaces in Calgary, Alberta, Canada. Site 1: A feminized workplace in the “disability services” sector. Provides supports for disabled children and their families, with nearly 200 employees who provide residential, vocational, educational, early intervention and therapy programs. All supervisors were women. Site 2: A masculinized workplace in the “energy” sector. Has 400+ employees. A producer of light and medium oil as a publicly-traded company. Has a bar on site that serves alcohol to employees. A mix of both women and men as supervisors. Target audience: Employers. Goal: How to understand and better resource employees concerning gender and mental health issues in the workplace. Key results: Work Culture is a key dynamic for explaining gender differences and how they influence (good and bad) employees of both sexes in the workplace. Work Culture is thus where to intervene for change – to greater effect than treating consequences of gender discrimination and stigma for mental health and addictions at the individual level.
  • Employee Assistance Programs in the United States: Market Update, Research Outcomes, & Techno Trends

    Attridge, Mark (2022-06-09)
    This presentation features research-based trends in the employee assistance program (EAP) industry in the United States. Recent data on market size, the boom in new technology-based mental health support provider companies, and research on the outcomes of EAP counseling are examined. Recommendations are given for how to better understand and evaluate the wide range of EAP and other workplace mental health support service offerings now available as employee benefits.
  • Understanding Financial Behavioral Health and Race (Racism), and their Association with Investment Risk Willingness

    Anvari-Clark, Jeffrey; Frey, Jodi J; 0000-0003-3234-8549 (2022)
    The conception of financial behavioral health (FBH) is new and lacks a common definition. This dissertation frames FBH as being comprised of financial precarity, financial self-efficacy (FSE), and financial well-being, and has the potential to influence multiple other behavioral health domains. The literature review shows how each component of FBH relates to other domains of behavioral health, including mental health, physical health, coping health, and social health. Stress and life course theory and insights on scarcity from the behavioral sciences are used to understand how FBH impacts the human condition, which, in a negative context, can manifest as money disorders. To explore FBH empirically, data from the 2018 National Financial Capability Study (N = 27,091; FINRA Investor Education Foundation, 2018) was used. First, a measure of financial precarity was constructed with both objective and subjective components, using exploratory and confirmatory factor analyses, and achieved adequate fit. Next, the relationship between FBH and its component parts was assessed, again with adequate fit. The study attempted to determine how a subset of Black and White survey respondents experienced FBH differently, according to collectivist or individualist financial values orientations. However, it was found through measurement invariance testing that although the FBH model had an excellent fit for White respondent data, it poorly fit the data from Black respondents. Due to the model variance, determining further impact of racial group affiliation on the outcome could not be conducted. The study concluded with a structural equation modeling analysis and determined that, controlling for key demographic variables, FBH accounted for 37% of the variance in investment risk willingness (R2 = .368; β = 0.256, p < .001). The project contributes a new measure of financial precarity and a basis for FBH. The variance between the sub-groups may indicate that the survey questions are inadequately capturing the collectivist experience by which many people treat their finances. The project shows how finances can have a psycho-behavioral impact on well-being and decisions, the influence FBH has on investment risk willingness, and suggests that low FBH may perpetuate wealth gaps.
  • Resilience Strategies for Law Enforcement Families

    International Association of Chiefs of Police (IACP), 2022
    This series of resources is designed to support agencies and departments to address officer mental health and wellness concerns through unique and practical resilience strategies, customized to roles within the field of public safety.
  • International Employee Assistance Digital Archive - Poster

    Herlihy, Patricia A.; Frey, Jodi J (2022-06)
    This is a Poster designed for the Work Family Research Network Conference in NYC in mid June 2022. The poster is a brief display of five current pieces in the International Employee Assistance Digital Archive exhibiting collaboration with Boston College Center on Work and Family, Ohio State, MeQuilibrium, and then a set of slides from a Virtual EAPA Presentation on Law Enforcement and a tip sheet on talking to children about the war in Ukraine. The intent of this poster is to introduce the Work Family Research community to this FREE resource.
  • Police stressors and health: a state-of-the-art review

    Violanti, John M.; Charles, Luenda E.; McCanlies, Erin; Hartley, Tara A.; Baughman, Penelope; Andrew, Michael E.; Fekedulegn, Desta; Ma, Claudia C.; Mnatsakanova, Anna; Burchfiel, Cecil M. (Oxford Academic, 2017-11)
    Purpose –—The purpose of this paper is to provide a state-of-the-art review on the topic of police stressors and associated health outcomes. Recent empirical research is reviewed in the areas of workplace stress, shift work, traumatic stress, and health. The authors provide a comprehensive table outlining occupational exposures and related health effects in police officers. Design/methodology/approach –—A review of recent empirical research on police stress and untoward psychological and physiological health outcomes in police officers. Findings –—The results offer a conceptual idea of the empirical associations between stressful workplace exposures and their impact on the mental and physical well-being of officers. Research limitations/implications –—A key limitation observed in prior research is the cross-sectional study design; however, this serves as a motivator for researchers to explore these associations utilizing a longitudinal study design that will help determine causality. Originality/value –—This review provides empirical evidence of both mental and physical outcomes associated with police stress and the processes involved in both. Research findings presented in this paper are based on sound psychological and medical evidence among police officers.
  • Time-Use and Well-Being in Family and Other Unpaid Caregivers of Older Adults

    Baik, Sol; Lehning, Amanda J.; 0000-0002-5081-4956 (2022)
    Due to the intensive time commitment for caregiving, caregivers report limited freedom to engage with others, participate in physical activities, pursue leisure activities, and have adequate time for sleep. Few studies have focused on caregivers’ time-use across different activities, particularly how different patterns of time-use are associated with well-being. This study aimed to: (1) identify time-use profiles of family caregivers of older adults, (2) examine associations between identified time-use profiles and caregiver well-being, and (3) assess whether the effects of gender and race on caregiver well-being vary by the identified time-use profiles. I analyzed 1,640 family caregivers of community-dwelling older adults by combining secondary data from Round 7 (2017) of the National Study of Caregiving and the National Health and Aging Trends Study. I conducted latent profile analysis to estimate time-use profiles including covariates and outcomes. Three classes of caregivers emerged based on time-use patterns. The High Committed class (20%) spent the longest time in non-eldercare related committed activities, such as household activities and paid work. The High Discretionary class (49%) spent the highest amount of discretionary time, including social activities, physical activities, and other free-time activities. They also spent the least amount of non-eldercare committed time compared to the other two caregiver types. Lastly, the Balanced class (31%) allocated time relatively evenly in all activities. When comparing well-being outcomes between time-use profiles, caregivers in the High Discretionary class had worse self-rated health but lower levels of anxiety than the Balanced class. This study also found significant gender differences in depression, which varied by time-use profiles. Research on time-use and caregiver well-being may help identify at-risk caregiver groups based on lifestyle profiles and develop targeted policies to promote better caregiver well-being.
  • Mental Health Mondays: Perspectives, Ltd

    Frey, Jodi J; Dyme, Bernard S.; Schenkelberg, Doug; Beyer, Cal (Perspectives, Ltd, 2022-05)
    During Mental Health Awareness Month in May of 2022, Perspectives Ltd launched a Mental Health Mondays video series. Four guest experts provided actionable advice and strategies for leaders prioritizing their employee's and community's mental health. The four videos are available here.
  • The San Francisco Story: All It Just Takes is Two People Talking - Creating a Vision for the Workplace

    San Francisco Chapter of EAPA; Webb, Mike (San Francisco EAPA Chapter, 1998-01-01)
    This video was completed in 1998 by the San Francisco EAPA Chapter with the plan to interview the initial managers of several Employee Assistance Programs (EAPs) with the then-current managers of the same programs when possible. Interviews were conducted with managers from the following EAPs: Chevron, PG&E, and Wells Fargo. The initial manager of the Bank of America EAP and the then head of the Levi Strauss program were also interviewed. George Cobbs, CEAP was interviewed. Cobbs was the President of EAPA, Inc. from 1994-1996 and was the head of the Member Assistance Program for the International Longshoreman Warehouse Union / Pacific Maritime Association in San Francisco. These Union programs were and continue to be an important resource for helping employees.
  • Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020

    Czeisler, Mark É.; Lane, Rashon I.; Petrosky, Emiko; Wiley, Joshua F.; Christensen, Aleta; Njai, Rashid; Weaver, Matthew D.; Robbins, Rebecca Ph.D.; Facer-Childs, Elise R.; Barger, Laura K.; et al. (Centers for Disease Control and Prevention, 2020-08-14)
    The coronavirus disease 2019 (COVID-19) pandemic has been associated with mental health challenges related to the morbidity and mortality caused by the disease and to mitigation activities, including the impact of physical distancing and stay-at-home orders. Symptoms of anxiety disorder and depressive disorder increased considerably in the United States during April–June of 2020, compared with the same period in 2019 . To assess mental health, substance use, and suicidal ideation during the pandemic, representative panel surveys were conducted among adults aged ≥18 years across the United States during June 24–30, 2020. Overall, 40.9% of respondents reported at least one adverse mental or behavioral health con- dition, including symptoms of anxiety disorder or depressive disorder (30.9%), symptoms of a trauma- and stressor-related disorder (TSRD) related to the pandemic† (26.3%), and having started or increased substance use to cope with stress or emotions related to COVID-19 (13.3%). The percentage of respondents who reported having seriously considered suicide in the 30 days before completing the survey (10.7%) was significantly higher among respondents aged 18–24 years (25.5%), minority racial/ ethnic groups (Hispanic respondents [18.6%], non-Hispanic black [black] respondents [15.1%]), self-reported unpaid care- givers for adults§ (30.7%), and essential workers (21.7%). Community-level intervention and prevention efforts, including health communication strategies, designed to reach these groups could help address various mental health conditions associated with the COVID-19 pandemic.
  • The critical pediatric behavioral health care your employees need: Employee wellbeing and focus starts at home

    Brightline, 2022
    This infographic addresses the issues of pediatric behavioral health needs and outlines ways Brightline can provide personalized support to kids, teens, and caregivers.
  • An Evaluation of the Effectiveness of Extended-Release Naltrexone

    Hochheimer, Martin; Sacco, Paul; Unick, George Jay; 0000-0001-6644-4841 (2022)
    Medications for the treatment of opioid use disorder (MOUDs) are considered the gold standard form of treatment for this condition. There are two forms of MOUD treatment, agonist, and antagonist. Agonist treatment has the medical system provide people with opioid use disorder methadone or buprenorphine which are long lasting opioids that do not produce a euphoric reaction with the goal of alleviating cravings and mitigating illicit use of opioids. Conversely, antagonist treatment blocks opioid absorption in the brain. Extended-release naltrexone (XR-NTX) is the most common antagonist treatment it is administered as a once-monthly injection. During the month after injection, patients who use opioids will not experience their effect and by negating the reward of opioid use the treatment discourages continued use. This study evaluated the effectiveness of buprenorphine and XR-NTX treatment on three characteristics: treatment retention, risk of opioid related acute care incidents, and changes in healthcare costs during treatment. Data from the Truven Health MarketScan® databases which records the date, type of interaction, and cost of every interaction that a person insured privately with one of over 250 insurance providers has with the healthcare system was used to identify a sample of approximately 30,000 people who were treated with buprenorphine or and 617 who were treated with XR-NTX for opioid use disorder. Treatment episodes were constructed based on filled prescription information and a frailty model survival analysis was fit both to a matched sample and the whole sample to length of treatment for each medication. The risk of acute care incidents was evaluated using a generalized estimating equation, and healthcare costs were evaluated using fixed-effects regression models. The study found that there are no significant differences in treatment retention between the MOUDS. Treatment with either medication was associated with an approximately 10% reduction, per day in treatment, of the odds of experiencing an acute care incident during one month. Healthcare costs increased while people were in treatment, with either MOUD, between approximately 0.85% and 1.5% for both opioid related and non-opioid related services.
  • Expanded Paid Parental Leave: Measuring the Impact of Leave on Work & Family

    Harrington, Brad; Lawler McHugh, Tina; Fraone, Jennifer Sabatini (Boston College Center for Work & Family, 2019)
    This report compares the leave experiences and attitudes of over 1,200 new mothers and fathers, who were eligible for at least 6 weeks of gender-neutral, paid parental leave. It assesses employees' use of leave and explores how taking leave impacts caregiving, career progression, and the ability to combine work and family successfully.
  • Centering Black Lives: Exploring Oral Histories of Legacy African American Women in the Black Belt to Heal the Wounds of Racialization as Justice

    Sermon, Michelle Crowder; Negi, Nalini; 0000-0002-8542-1941 (2022)
    Narratives of unresolved racialized injury among Legacy African American(s) (LAA) women in the rural US south, or the Black Belt, offer meaning to observed disparities and healing to the contemporary and future lives of LAA in Black Belt communities. This dissertation study considered LAA women’s layered exposures to racialized adverse live experiences (ALE)/traumas with historical, cultural, intergenerational, race-based, and complex traumas, and the impact of this multidimensional trauma perspective, on wellness outcomes for rural African Americans. Adverse mental and physical health conditions among LAA are critically disproportionate in this population yet current research and treatment protocols to address these disparities are based in a Eurocentric worldview. For example, race is often examined in research as a demographic category without fully conceptualizing the impact of racialization. By applying the Black Lives Matter Healing Justice framework, this study centers the Black experience and aims to elucidates the relationship between racialization and ALE/trauma through the voices and lived experiences of LAA women in the Black Belt, captured in archived oral histories. Employing thematic, critical constructivist, and historical discourse analysis, this study also sought to reveal the language of racialized trauma, expressed in the archived oral/life histories of LAA women sharing their ALE of Jim Crow segregation and racial integration in the Black Belt. Findings suggest that Race-Place-Space collectively served as the foundation of the gendered and racialized experiences of this population. Relying on my personal reflective experiences as a LAA Black Belt woman and an assembled research advisory panel (RAP) as well as theory and extant literature, I discuss the meaning of Race-Place-Space, racialized trauma, and healing justice. Contributions and implications to social work practice and research are presented along with suggestions for future directions in research and practice centering the Black perspective.
  • Steps to Take When an Employee Reports Sexual Harassment

    EAPA South Africa (EAPA South Africa, 2019-09-13)
    This article presents statistics on sexual harassment in the workplace in South Africa and outlines the following topics surrounding employee reports of sexual harassment: Know the process; Avoid not taking reports seriously; Investigation and disciplinary action; and Resolution through informal or formal procedures.
  • Examining depression and social and emotional development outcomes in parents and children in migrant and seasonal farmworker families

    Siegel, Jennifer L.; Negi, Nalini; 0000-0002-1825-9518 (2022)
    Migrant and seasonal farmworkers (MSFWs) provide essential food production services in the U.S. yet often experience discrimination, stress related to migration and work, and financial insecurity. Such ecological risk factors unique to agricultural work and being an immigrant of color have previously been shown to heighten MSFW risk for depression. A glaring gap in the literature is that just over half of MSFWs are parents accompanied by their families, and half have children 5-years or younger. This study, guided by the Modified Integrative Model of Child Development for Latinx families, is one of the first to investigate the mental health and social and emotional development outcomes of MSFW families. Specifically, binary logistic regression was conducted using data from the 2017-18 Migrant Seasonal Head Start (MSHS) Study, to examine the relationship between discrimination, work experiences, and cultural resources with the depressive symptomology of caregiving MSFWs. Further, the association of these factors with child social and emotional development outcomes was investigated. MSFWs were mostly women (89%), married or cohabitating with a partner (79%), born outside the U.S. (83%) and mostly from Mexico (80%). All children were 36 months through 5-years of age, just over half were girls (51%), the majority born in the U.S. (93%) and had been enrolled in MSHS for an average of 1.5 years. Results indicated that MSFW caregivers with higher levels of MSFW stress, higher levels of acculturation, and who were separated/divorced had higher levels of depressive symptomology. Children with caregivers with higher levels of depressive symptomology had greater odds of scoring in the range of concern/clinical concern for cognitive social problems. Further, children whose caregivers reported greater importance of religion were less likely to score in the range of concern/clinical concern for emotional behavioral regulation problems. Contrary to this study’s hypothesis, parent depression did not mediate the relationship between contextual factors and child social and emotional development outcomes. Findings are highly significant as they advance understanding of a critically under-studied group and have implications for intervention strategies uniquely suited for this family population. Future research that explores MSFWs’ resiliency along with their structural vulnerability is recommended.
  • The Interplay of Home Visitors’ Personal and Professional Identities in Effectively Screening and Supporting Women around Sensitive Topics

    Burruss-Cousins, Karen M.; DeForge, Bruce R.; 0000-0003-3665-1211 (2022)
    Home visiting programs provide information, support, resources, and tools that empower new parents to promote positive maternal and child health outcomes. During home visits, there is a unique opportunity to screen for intimate partner violence (IPV), reproductive coercion, and unintended pregnancy with women in unguarded settings (i.e., the women’s homes) while providing ongoing services via a therapeutic relationship. Using individual interviews and a deliberative discussion focus group, the current study examined the research question, to what degree do home visiting staff members’ personal and professional identities impact their ability to effectively screen and support pregnant women and new mothers around the topics of unintended pregnancy and intimate partner violence including reproductive coercion? Interviews and a deliberative discussion focus group were conducted virtually with staff members from Healthy Families America (HFA) programs in Maryland. Six major themes emerged from the interviews and focus group: personal versus professional experience, therapeutic alliance building, keeping families engaged, use of supervision, addressing intimate partner violence/reproductive coercion in families, and home visiting in the time of a health pandemic. Participants shared how their personal and professional identities helped shape their perceptions of their roles within the home visiting field including the terms, its meaning, and the expectations of that role. The findings suggest that home visitors need additional training around reproductive health since they routinely interact with pregnant women and new mothers who are at-risk for poor pregnancy-related health outcomes that may be due to the lack of control or intention related to reproduction. Participants expressed general knowledge, comfort, safety plan creation, and resource linking around the issue of IPV. Participants had received extensive training on administering the Relationship Assessment Tool (RAT), which is the IPV screener for HFA. However, relatively few program recipients endorsed that their HFA program recipients are experiencing IPV using the RAT. Therefore, HFA staff would benefit from advanced level training utilizing more clinical skills around the topic of IPV including advanced screening skills.
  • Medications for Opioid Overdose, Withdrawal, & Addiction

    National Institute on Drug Abuse (NIDA), 2022-01-14
    The National Institute on Drug Abuse supports research to develop new medicines and delivery systems to treat opioid use disorder and other substance use disorders as well as other complications of substance use (Including withdrawal and overdose), to help people choose treatments that are right for them.

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