Issue: EAP-provided telephone counseling is controversial but becoming more common. Still, quality varies among vendors.
Benefit: Teletherapy cuts costs because it's less expensive than face-to-face counseling.
Action: Screen potential teletherapy providers carefully using the following six questions.
More employers are turning to EAPs that offer therapy from counselors in call centers. Why? Teletherapy cuts EAP costs by up to 30 percent, is effective for many nonserious behavioral problems, has higher employee usage rates and delivers help faster.
Criticisms: Face-to-face counseling is more effective. Teletherapists misdiagnose problems more often. There are no standards for delivering services, licensing and training.
"If your work force isn't highly skilled, has a high turnover rate and you want to offer something on a limited budget, it may be the best answer for you," says Kenneth Collins, a California-based behavioral health care consultant with 25 years of EAP experience.
To choose a good teletherapy vendor, ask the following questions:
1. What guidelines do you use to decide which callers receive teletherapy and which receive face-to-face counseling? "There should be an articulate answer. Most phone counselors use some type of mental, not written, checklist," says John Maynard, chief of the Employee Assistance Professionals Association.
2. What percentage receive telephone assistance versus face-to-face counseling? Utilization reporting can be misleading because it isn't standardized.
"Reports that HR people get from vendors often don't distinguish between the types of counseling. Some Fortune 100 companies have 80 percent of their counseling done by phone and don't have a clue," says David Sharar, managing director of the EAP division of Chestnut Health Systems, an Illinois-based behavioral health provider.
3. What percentage of calls fall under various categories of problems, such as marriage counseling, work/life balance and personal/family issues? You want a provider that handles a variety of common problems, except those such as serious mental illnesses and addictions. Those require face-to-face counseling.
4. How long has your EAP handled teletherapy? "EAPs that have just added phone counseling may not be the best because it's new to them," says Maynard.
5. What's the average length of counseling sessions? Look for a service that doesn't limit calls to 10 or 15 minutes, but is flexible enough about session lengths to address problems.
6. How do you measure the effectiveness of telephone counseling, and what is the success rate? Many EAPs ask counselors a list of questions after each session to determine how effective it was. Ask EAPs what questions they ask.
Final tips: Inquire about licensing, education and training. Try to tour the center that handles the calls. Don't allow teletherapy to substitute for mental health care that medical benefit plans should offer.
"The danger of fully integrating EAP and behavioral health is that the teletherapy can be misused," says Maynard.
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