Balancing work and life on a tightrope

Work-life harmony is currently a national priority.

The Singapore Tripartite Forum deems employees able to combine work responsibilities and personal-family needs likely to be more engaged and productive at work. Businesses are being encouraged to provide for work-life balance among employees.

And the policy emphasis on work-life harmony is supported by the MoM Work-Life Grant. This grant, previously known as Work-Life Works! or WoW! (no, not World of Warcraft), supports EAP counselling and hotline services as part of Employee Support Schemes. The 2005 Work Life Harmony Report  provides findings and recommendations for employers on using work-life strategies to optimise business performance, while Tripartite Guidelines on Best Work-Life Practices lists mental wellness talks/workshops and confidential professional counselling among employee support schemes for enhancing work productivity. But what’s like on the ground?

According to a research report by Azzone and colleagues in the Journal of Workplace Behavioral Health, 90% of Fortune 500 companies implemented EAP services for their employees in 2002, while 40% of US employees in the private sector had access to EAP services in subsequent years (Merrick, Volpe-Vartanian, Horgan, & McCann, 2007; U.S. Department of Labor, 2005).

In Singapore, comprehensive EAPs are a relatively new development, even though corporate wellness programmes have been in place since the 1980s. As many as 26% of private companies in Singapore with at least 50 employees had a comprehensive workplace health promotion programme in 1998 (Chew, Cheah, & Koh, 2002). The findings published in the Singapore Medical Journal were based on a survey which had a 49.5% response rate from 4,479 companies. A 2006 National Workplace Health Promotion Survey, cited in a recent book edited by Kirsten and Karch (2012), Global Perspectives in Workplace Health Promotion, puts this number at 58.7%.

With the recent mushrooming of local EAP providers, hopefully it won’t be too long before the untangling of Employee Assistance Programmes (EAPs) and employee assistance payments can begin.

Coping with stress at the workplace

Performance pressure and work overload are theme songs sung in workplace surveys (e.g., JobCentral, Robert HalfVMWare New Way of Life), while staff turnover are evergreen issues in high stress professions like nursing (Chan & Morrison, 2008) and teaching (Fang & Wang, 2005; 2006).

Coping with workplace stress is no new stranger to nurses and teachers. In a study of 780 UK teachers, Griffith, Steptoe, and Cropley (1999) have observed that greater use of active coping, as well as greater social support such as from family and peers, is associated with less self-reported job stress. Austin, Shah, and Muncer (2005) have further demonstrated that teachers who use escape-avoidance or accepting responsibility strategies report higher levels of stress. A report on 415 secondary school teachers in Hong Kong reiterates these findings (Chan & Hui, 1995): avoidance coping relates to burnout. Teacher coping strategies clearly play a role in workplace resilience.

In a study with a local sample, Boey (1998) reports coping strategy to influence resilience in nurses experiencing high levels of stress. Nurses who reported greater use of problem orientation, ability enhancement, and change of perspective and less reliance on avoidance coping, reported greater job satisfaction than those who reported using these strategies less. Similar to the findings with teachers, active coping appears to benefit nurses compared to avoidance strategies, which can be viewed as maladaptive.

A study with a sample of 316 participants by Ko, Chan, & Lai (2007) reveals similar coping strategies among local teachers. In a book chapter in “Work Stress and Coping Among Professionals”, the authors report the most frequently used coping strategies to be active coping (scrutinizing and trying to solve the problem, analyzing the problem to prevent it from happening again, working harder to deal with the problem) and accepting responsibility (accepting and living with the problem, looking on the bright side of things). While local teachers appear unlikely to use escape-avoidance strategies (having a drink, smoking), it is noteworthy however, as discussed by the authors, that direct-action coping may not be helpful for problems outside the control of the individual. Importantly, seeking professional help is a coping strategy rarely considered by this sample.

In addition to training interventions which improve the employee’s ability to cope with routine stress, there is support for the view that professional counselling can be beneficial as well. A number of studies have shown that implementing a cognitive-behavioural intervention is better than relaxation training and no intervention control at decreasing teachers’ stress levels (Tunnecliffe, Leach, & Tunnecliffe, 1986; Cecil & Forman, 1990).

A more recent study of 124 secondary school teachers in Hong Kong has found that providing teachers with cognitive-behavioural stress management training to be more effective than a waitlist control at getting teachers to use more stress management behaviours, and therefore reducing the level of their occupational stress (Leung, Chiang, Chui, Mak, & Wong, 2011). Moreover, when faced with life difficulties such as bereavement and mental health concerns, teachers may however benefit from help provided by a professional counsellor. Psychological help such as EAP counselling services have in fact been recommended for teachers who report a high level of job stress (Yang, Ge, Hu, Chi, & Wang, 2009).

Mental wellness education and psychological support for employees in high stress environments such as teachers and nurses are instrumental in the battle against burnout and staff turnover.

What’s the return on investment for EAPs?

“The typical analysis produces an ROI of between $3 and $10 dollars in return for every $1 dollar invested in the EA program.”

That is what Attridge and colleagues have reported for the Employee Assistance Society of North America (EASNA) in a 2009 research note, first published in their “Selecting and Strengthening Employee Assistance Programs: A Purchaser’s Guide” publication.

In a study of university employees with the majority having access to face-to-face EAP counselling services, Phillips (2004) found improvements in work productivity for 59% and 62% of 704 and 1,206 cases from 2002 and 2003 respectively. The data published in Employee Assistance Quarterly revealed an ROI of 3.5:1 and 4.3:1 in 2002 and 2003 respectively (Phillips, 2005).

Another empirical study sampling employees with access to face-to-face EAP counselling services demonstrated less absenteeism and improved work productivity for 50% of 882 cases (Kirk, 2006).

In a paper presentation at the 2003 APANIOSH Work, Stress and Health Conference, Attridge (2003) reported improved an average 43% gain in work productivity for 57% of 11,909 cases from a national EAP provider supplying counselling services mostly by telephone.

A more recent presentation at the 2007 Employee Assistance Professionals Association Annual Conference, Baker (2007) documented reduced presenteeism: Based on 3,353 cases from an national EAP provider supplying telephone counselling, low-productivity days were reduced from an average of 30 days to as few as 3.4 to 8.0 days, resulting in an average gain of 58% in work productivity.

In addition to recognition that effective EAPs produce greater work productivity, better employee engagement, less absenteeism, less presenteeism, and reduced turnover, it’s gratifying to know that the return on investment for EAPs isn’t different from that reported for corporate wellness programmes: Berry, Mirabito, & Baun reported in a 2010 Harvard Business Review article that “every dollar invested in the intervention yielded US$6 in health care savings”.