While EAP’s may provide additional services, there is a “core technology” that includes basic services viewed as essential in
the EA field. These seven core technologies are as follows19:

1. Consultation to managers, outreach to employees
2. Assessment of employee’s personal problems
3. Intervention with employee about performance issues
4. Referral of employee, case-monitoring, follow-up
5. Encourage effective relations with providers
6. Consultation to employer about health benefits
7. Program evaluation as to program effectiveness

Although formal employee assistance programs have arguably only been in existence since the mid 1970’s when James Wrich published The Employee Assistance Program (1974), marking the first usage of this term to describe workplace programs, the component parts of this broader service have undergone development for well over a century.1 As a result of alcohol’s presence in the early American workplace, occupational concerns arose early regarding alcohol-impaired employees.  Between 1790 and 1830, per capita consumption rose dramatically, exacerbating the existing employee problem.2 As a result of the concomitant factors of the temperance movement and a growing awareness of the risk posed by alcohol-impaired employees working in an increasingly industrialized workforce, open use of alcohol in the workforce was suppressed.

In response to these problems arising in the newly industrialized workforce, many employers assumed a paternalistic role in assisting their employees.  Among the first steps taken by leading industrialists was the provision of social welfare services, including the introduction of the occupational social worker. While such “rescue work” was a fairly common theme during the temperance movement2, these early efforts were described as “unorganized, with neither established leadership nor recognized membership, and little guidance or control1.”  Compounding the difficulties faced by early occupational social work programs was the fact that workers began to view the occupational social worker as a management tool to avoid unionization.  As a result of this loss of trust, the position lost its presence and relevance for several decades3. 

Around the middle of the 20th century, industrial alcoholism programs replaced informal, paternalistic interventions. As American businesses became larger and more depersonalized, humane treatment of alcoholism in the workforce decreased as those driven by efficiency replaced paternalistic employers. In place of attempting to treat alcoholic workers, employers responded to alcoholism either by firing or retiring on the job.2 It was within this punitive environment that the 1940’s saw the development of informal assistance programs in which employees who had sobered themselves up counseled other employees trying to do the same for themselves. 

Galvanized by this trend towards treating workplace alcoholism, the Yale Plan was devised by Ralph Henderson and Selden Bacon.  Fundamental to this plan was the emphasis on establishing an employee alcoholism program as a formal part of an existing administrative unit.  In addition, this plan “stressed the key role of the first-line supervisor in identifying clients and referring them to the program, where they in turn would be sent to counseling1.”  Moving away from supervisors attempting to identify symptoms of and diagnose alcohol problems, Wrich (1974) trained employers to focus exclusively on job performance and deterioration prior to confronting an employee.  Serving as a central developmental component, these occupational alcoholism programs (OAP’s) were the predecessors of employee assistance programs (EAP’s).3

During the 1950’s, companies such as Consolidated Edison, Standard Oil of New Jersey, and American Cyanamid expanded the scope of traditional OAP’s to cover the mental health problems of their employees.  As a result, OAP’s had evolved into the “broadbrush” EAP’s characteristic in today’s market.2 On December 31, 1970, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act was signed into law.  This law included the provision that mandated the development of programs to offer assistance to problem-drinking employees of federal agencies.1 In turn, an Occupational Programs Branch was established within the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in the early 1970’s.  Predictive of the future trends in OAP’s, Will Foster and Donald Godwin contended that when dealing with workplace interventions, the NIAAA should not be focused on alcoholism but on the broader spectrum of behavioral health concerns of employees.2

As these early “broadbrush” EAP’s began to become established in the American workforce, a trend occurred in which these programs were relocated outside of the company by contracting with local or national behavioral health organizations.2 Due to this expansion in contracted services, behavioral health care agencies delivering EAP services proliferated, leading to intense market competition.  One key contribution of these external vendors has been their support of a drug-free workplace.  Widespread drug testing leading to mandatory EAP referrals has served as a means to identify substance abusing employees as well as delivering services targeting recovery for the employee.

While many countries were enhancing the quality of their mental health programs, the Cultural Revolution (1967-1976) in China nearly discontinued all professional training in mental health and psychological counseling.12 With the Open-Door policy in the early 1980’s, however, training programs were reinstated, leaving the quality of China’s mental healthcare system in disarray.  

Compared with the United States, which established its National Mental Health Program in 1946, China’s plan is still in its infancy, as it was not formulated until 1992. Over the course of the past 15 years, the World Health Organization (WHO) has worked closely with China to reorganize their mental health services.  Currently there are five WHO collaborating centers in China dealing with neuropsychiatric and behavioral disorders, allowing for further collaboration and training.13

In spite of the recent collaboration with the WHO, China’s mental health services remain deficient due to several factors.  First, many Chinese citizens cannot afford mental health services.  While Americans primarily finance their mental healthcare through private insurance companies and tax-based funding, Chinese citizens primary source of financing mental health services comes from out of pocket spending. Because only 20-25% of China’s population has health insurance (mostly residing on China’s more urban east coast), roughly 800 million citizens remain uninsured, most of which must bear the full burden of paying for mental health services.15 

For those citizens who can afford mental health services, a second deficiency in China’s system of mental health arises: an inadequate supply of mental health professionals for the demand placed upon them by 1.3 billion citizens.  Whereas the United States provides 10.5 psychiatrists per 100,000 citizens, China offers 0.9 psychiatrists per 100,000 citizens.18 While the demand placed upon American psychiatrists often requires appointments to be scheduled several weeks in advance, the corresponding demand placed upon their Chinese counterparts seriously limits access.  In addition to this lack of highly trained psychiatrists, psychologists in China are categorized as skilled workers, along with barbers and masseuses.14 As a result, the training they receive is often inadequate for the positions that they hold.

One final factor that appears to be detrimental towards many Chinese citizens obtaining adequate mental health services is the concomitant familial nature of Chinese society and the stigma associated with seeking mental health services.  Unlike much of western society, which prides itself on individualism, many eastern cultures rely on close family relationships. Recent research has demonstrated many Chinese citizens reluctance to seek formal mental health services, preferring instead the informal network of parents and friends.12 Perhaps in an attempt to remedy many Chinese citizen’s reluctance to seek formal mental health services, roughly 4,000 hotlines and websites providing psychological counseling have been created in China.16 While these services provide an outlet other than the family, their professional credibility has yet to be established.12 

In spite of these apparent deficiencies in China’s mental health services, there has been rapid progress in the past two decades. With the help of the WHO and increasing levels of mainstream acceptance of psychological care, it appears that China may be on the right track to installing an effective system of delivery of mental health services.

As you can assume, EAP appears to be a brand new concept to Chinese people. However, through the recent 20 year’s development of mental health in China and progress made in the mental health system, companies in China begin to become aware of the need of their employees, which cast light to bring in EAP services to build a new health system for Chinese organizations. The key issue is how to develop and adapt EAP to meet Chinese unique culture to provide better service to Chinese organizations.

Therefore, it is important to relocate the emphasis of EAP service in China. Compared with western societies, where EAP providers stress on how to solve individual’s problem and balance work-family life, EAP in China should attend to needs of groups and organizations, as well as individuals.

To develop EAP in China, we still need to keep the essence and core technology of EAP, which aims at solve these personal problems which would harm work performance. Also, we need to develop the part which is missing or not taking great proportion in EAP services of western countries, such as organizational culture building, group building, and to enlarge the proportion of education and training in EAP programs. Only by taking care of both organizational and individual needs can EAP make a success in China.