Social Cognitive Model: Substance Abuse in the Workplace and Employee Assistance Programs

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Social Cognitive Model Substance Abuse in the
Workplace and Employee Assistance Programs

• Trudy Millard Krause, DrPH
• Debra Reynolds

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Substance Abuse

• A maladaptive pattern of use leading to
  impairment or distress
• Failure to fulfill major role obligations
• Use in physically hazardous situations
• Substance-related legal problems
• Persistent or recurrent social or interpersonal
  problems caused or exacerbate by use

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Workplace Issues

• Employees who abuse substances do damage to their
  own and others health and well being
• Employee substance abuse may decrease
  productivity and contribute to absenteeism,
  accidents, injuries, death or violence in the
  workplace
• A workplace that tolerates or ignores employee
  substance abuse problems does not reflect the
  interests of the vast majority of employees who
  do not abuse substances or who are in recovery.

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INDIVIDUAL Emotions Health Social Motivations Fear
ENVIRONMENT Job Design, Duties Organization
Structure Job Demand Safety Social
MODERATORS AND EFFECTS
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INDIVIDUAL
ENVIRONMENT

• EFFECTS
• Safety
• Production
• Health
• Behavior

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Drug and Alcohol Use

• Use the limited, controlled consumption
• Abuse adverse toxic, physical, functional or
  psychological consequences
• Dependency reliance and expectation
• Addiction physical and psychological dependency

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What makes some travel the continuum and others
not?

• Genetic or Physical
• Behavioral
• Psychological or Emotional

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Socio Cognitive Model

• Psychosocial dynamics influence individual health
  behaviors and the methods of promoting behavioral
  changes
• Principles
• A persons behavior and cognitions affect future
  behavior.
• Human behavior is influenced by personal factors
  and environmental factors and their interaction
• The individuals ability to apply his cognitive
  skills to the evaluation of a social environment
  allows him to self determine behavior.

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Major Concepts

• Personal Factors
• Expectations
• Expectancies
• Self Efficacy
• Emotional Coping
• Behavioral Capability
• Self Control

• Environmental Factors
• Environment
• Situation
• Reinforcement
• Observational Learning

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Individual and Social Influences
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ENVIRONMENTAL FACTORS

• Workplace Culture
• Drinking/Drug Use Tolerance
• Workplace Alienation
• Autonomy
• Harassment
• Aggression
• Respect
• Job Dimensions
• Low skill discretion
• Low decision authority
• High job insecurity
• Low supervisor support
• High physical demands
• High hazardous exposure
• Low substantive complexity
• High motor skills

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ENVIRONMENTAL FACTORS

• Availability of Substances
• Lack of Supervision
• Shiftwork
• Workplace Policies
• Existence of
• Enforcement of
• Employee Awareness
• Organizational Frustration
• Job Pressure
• Responsibility
• Extrinsic Rewards

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SOCIAL FACTORS

• NORMS
• SIMILARITY
• COHESIVENESS
• ENABLING
• ACCEPTANCE
• MODELING

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Reading EXPOSURE TO COWORKER SUBSTANCE ABUSE

• Moderators a third variable that influences the
  relationship between a predictor variable and an
  outcome variable
• Finding Work group membership plays a
  significant role in moderating the effects of the
  workplace that contribute to employee substance
  abuse
• Specifically,
• Social Aspects Group Cohesiveness and Drinking
  Climate
• Occupational Aspects Risk and Mobility

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AMES-GRUBE-MOORE

• DIRECT PREDICTOR MODEL FOR DRINKING AT WORK
• -- Perceived Co-Worker Disapproval
• Perceived Co-Worker Drinking
• Best Friend At Work Drinking
• Educational Level
• Overall Drinking Outside Work
• R .34

Social Environment Social Personal Personal
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AMES-GRUBE-MOORE

• DIRECT PREDICTOR MODEL FOR SUBSTANCE AVAILABILTY
  AT WORK
• -- Likelihood of Enforcement
• --Likelihood of Discipline
• --Supervisor Referral to EAP
• --Job Design
• --Asian American
• Overall Drinking Outside Work
• R .46

Environment Environment Social Environment Persona
l Personal
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CONCEPTUAL MODEL
INDIVIDUAL SOCIAL COGNITION
ENVIRONMENT OPPORTUNITY CONSTRAINT
SOCIAL NORMS OBSERVATIONAL LEARNING
RECIPROCAL DETERMINISM CONSEQUENCES
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RECIPROCAL DETERMINISMCONSEQUENCES

• INDIVIDUAL
• Health
• Emotions, Morale, Job Satisfaction
• Social Relationships, Family, CoWorkers,
  Supervisors
• Performance, Recall, Tasks,

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RECIPROCAL DETERMINISMCONSEQUENCES

• ENVIRONMENT
• Work Avoidance
• Safety Risks
• Productivity Decline
• Security Risks
• Deviancy Potential
• Costs

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WORKPLACE CONSEQUENCES DOL

• Cost 185 Billion
• Lost productivity - 81 Billion
• Theft 15 Billion
• Accident - 37 Billion Premature Death
• Additional Health Care Costs - 44 Billion
• 2/3 Related to Alcohol Costs
• 1/3 Related to Drug
• 50 Drug Crime

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WORKPLACE CONSEQUENCES DEA

• State of Wisconsin estimates that expenses and
  losses related to abuse average 25 of the salary
  for each worker affected
• Drug using employees use 133 more sick leave and
  more unexcused absences
• One auto mfg reports that drug-using employees
  averaged 40 sick days/yr compared with 4.5 for
  non users

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WORKPLACE CONSEQUENCES DOL

• 40 of industrial fatalities linked to alcohol
• 47 of industrial injuries linked to alcohol
• 500 million lost workdays annually due to
  alcoholism
• Alcohol abuse accounts for 86 of total costs
  (172 Billion)

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NATURE AND EXTENT OF WORKPLACE SUBSTANCE ABUSE DOL

• Of the current illicit drug users age 18-49, 77
  are employed full time 7 of FT workers.
• Of the current heavy alcohol users, 77 are
  employed full time 7 of FT workers.
• 30 of heavy drinkers are also illicit drug
  users.

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Small Business Vulnerable DOL

• FT Employed Drug Users
• 44 in Small Business (1-24 emp)
• 43 in Med (25-499)
• 13 in Large (500)

• FT Employed Heavy Drinkers
• 36 in Small Business (1-24 emp)
• 47 in Med (25-499)
• 17 in Large (500)

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NATURE AND EXTENT OF WORKPLACE SUBSTANCE ABUSE

• Full time substance-abusing workers age 18-49.
• 32 vs 18 worked for 3 employers in past year
• 12 vs 6 took an unexcused absence from work in
  past month
• 26 vs 14 voluntarily left employer in past year
• 5 vs 1 were fired by an employer in past year

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NATURE AND EXTENT OF WORKPLACE SUBSTANCE ABUSE

• Full time substance-abusing workers age 18-49.
• 2.2 times more likely to request time off
• 2.5 times more likely to be absent 8 days
• 3 times more likely to be late to work
• 3.6 times more likely to be involved in a
  workplace accident
• 5 times more likely to file a workers
• compensation claim

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NATURE AND EXTENT OF WORKPLACE SUBSTANCE ABUSE

• A survey of drug users revealed
• 75 reported using drugs on the job
• 64 admitted that drugs adversely affected job
  performance
• 44 sold drugs to other employees
• 18 had stolen from coworkers
• to support their use

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Rates of Substance Abuse DOL
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Rates of Substance Abuse DOL
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Rates of Substance Abuse DOL
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Rates of Substance Abuse DOL
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Rates of Substance Abuse DOL
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Rates of Substance Abuse DOL
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Rates of Substance Abuse DOL
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BREAK

• When we return..
• Discussion on EAP
• Discussion on Drug Screening Programs
• Group Activity

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DRUG FREE WORKPLACE

• The Drug Free Workplace Act passed in 1988
  prohibits the manufacture, distribution,
  possession, and use of controlled substances in
  the workplace. (excludes Alcohol)
• The Act affects companies that receive any
  federal grants of contracts in excess of 25,000
  and government employees.

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DRUG FREE WORKPLACE

• Requirements of the Act
• Policy Statement Prohibiting Drugs
• Drug Awareness Program
• Enforcement
• Employee must report to the employer any
  conviction on a drug related charge within 5 days

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DRUG FREE WORKPLACE

• Drug Awareness Program
• Education on Drug Abuse
• Awareness of Policy
• Employees give notice that they understand
• Good Faith effort of employer to be drug free
• Personnel with conviction are required to be
  enrolled in an EAP or rehab program

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DOT Regulations

• Cover natural gas and pipeline workers, motor
  carrier workers, aviation and railroad workers
• Required to drug test job applicants
• Required to drug test during routine physicals,
  random basis, reasonable cause, and after
  accidents

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WORKPLACE INTERVENTION

• 1. EMPLOYEE ASSISTANCE
• PROGRAMS Referral
• 2. DRUG SCREENING PROGRAMS Biochemical Testing

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EMPLOYEE ASSISTANCE PROGRAMS

• Assist in identifying and aiding employees who
  need assistance because of behavioral, health and
  job performance problems attributable to alcohol
  and drug abuse as well as health, emotional,
  marital, financial, etc.

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EMPLOYEE ASSISTANCE PROGRAMS

• Training of Supervisors and others for
  identification and intervention
• Confidential and timely problem assessment
  services
• Referrals for appropriate diagnosis and treatment
• Establish links to community resources
• Education and prevention activities in the
  workplace

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EMPLOYEE ASSISTANCE PROGRAMS

• IDENTIFICATION AND REFERRAL
• Self Referral 40
• Supervisor Referral unsatisfactory work
  performance 45
• Incident Referral result of safety issue, drug
  testing, conviction
• Peer/Co Worker Referral 15

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EMPLOYEE ASSISTANCE PROGRAMS

• UTILIZATION
• 8 of Employees Use EAP Annually
• 30 of EAP Cases Related to Employee Substance
  Abuse,
• 28 Marital Problems,
• 24 Psychological or Emotional,
• 18 Other Family Problems
• 37 Of Supervisors Have Referred an Employee to
  the EAP

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EMPLOYEE ASSISTANCE PROGRAMS

• COST EFFECTIVENESS
• Return of 5-16 for every 1 spent on EAP
• Average annual cost 20-25 per employee
• GM saves 37 million per year
• UA estimates 16.95 return
• Oldsmobile decline in lost man hours 49,
  decline in health care costs 29, decline in
  leaves 56, decline in grievances 78, decline in
  disciplinary problems 63, decline in accidents
  82

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EMPLOYEE ASSISTANCE PROGRAMS

• DISCUSSION
• The results of a national survey revealed..
• 69 of workers surveyed said they know co workers
  who have gone to work under the influence of
  drugs or alcohol
• 60 believe that use during the workday somewhat
  or greatly impairs an employees ability to do his
  or her job
• 18 have approached a co-worker to discuss his or
  her substance abuse

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DRUG SCREENING PROGRAMS

• DSPs are Objective Measurements
• that Use Evidence as Basis for
• Employer Action.
• Applicant Testing
• Random
• Reasonable Suspicion
• Accident or Unsafe Activity
• Follow Up
• 81 of Businesses Conduct Some Form of Applicant
  or Employee Drug Testing

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DRUG SCREENING PROGRAMS

• Rate of Positive Drug Screens for Job Applicants
  is 12
• Rate of Positive Drug Screens for Current
  Employees is 9
• DSP seen as a Method to Enforce Drug Free
  Workplace and as a Deterrent

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FISHBONE ACTIVITY

• Used to Identify Cause and Effect
• Used to Illustrate Decisional Balance
• Socio Cognitive Concept
• Reciprocal Determinism
• Major Influences/Causes on Left
• Outcomes/Effect on Right
• Negative Influences Above
• Positive Influences/Moderators Below

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FISHBONE ACTIVITY
--
SUBSTANCE ABUSE

INDIVIDUAL ENVIRONMENT SOCIAL