According to the Counsellor’s Guide to Working with EAP, by 2013, almost 50% of the UK workforce was supported by an Employee Assistance Programme (EAP), representing 13.79 million people. The EAP industry began in the UK during the mid-1980s and has since become firmly established, with a rapid expansion in schemes following the recommendations made by Carol Black and David Frost in their report on sickness absence (Black & Frost, 2011). A high percentage of the larger public and private sector organisations and an increasing number of small to medium sized enterprises provide their employees with access to some form of short-term EAP service.  

The EAP association say, in their 2013 Market Watch report: “The difficult economic climate of the past five years may also be a driver, as employers look to support staff with non-work related issues to prevent these from intruding on the workplace.”

The Conservative’s austerity programme in the UK has presented the wellbeing industry with many lucrative business opportunities, and there are many profits being made on the growing poverty, inequality, social injustices and inevitable subsequent psychological distress of the population.

The relentless political drive towards the privatisation of government functions has turned traditional public services, social security and other safety net provision into profit-making enterprises as well. 

A major cause of economic inequality within market economies such as the UK is the determination of wages by the market. The systematic (and partisan) undermining of trade unions over recent years via Conservative legislation has seen the collapse of collectivism as the main way of regulating employment, and a substantial loss of space for bargaining for working rights, conditions and pay. The substantial cuts to social security support over the past few years have also served to drive wages down further. 

Neoliberalism, which was adopted as an overarching socioeconomic policy during the Thatcher and Reagan era onward, is premised on an idea that tight monetary control will contain inflation, and that labour market deregulation combined with regressive tax and benefit reform will somehow secure full employment. The expectation is that the more unequal redistribution of income and the freeing up of markets will dramatically improve competitive economic performance, and that the benefits of this higher rate of growth will trickle down the income distribution, benefiting everyone. Of course, that hasn’t happened.

The CBT technocratic sticking plaster

EAPs commonly use Cognitive Behavioural Therapy – usually in digital form – online or by phone – and it’s a “workplace-focused programme” to assist in the identifying and resolving of employee concerns, which affect, or may affect, performance. Such employee concerns typically include, but are not limited to:

Personal matters – health, relationship, family, financial, emotional, legal, anxiety, alcohol, drugs and other related issues.

Work matters – work demands, fairness at work, working relationships, harassment and bullying, personal and interpersonal skills and work/life balance.

According to NHS Choices, Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.

CBT is a talking therapy that can help you manage YOUR problems by changing the way YOU think and behave. It doesn’t address your circumstances as such, nor does it address the socioeconomic and political context that imposes constraints and increasingly untenable living conditions on people.

In fact, the briefing document for counsellors working with EAP says:

“When working with an EAP referral it is important to remember that the organisation is your client as well as the individual concerned, therefore there will be two people who will be ‘in the room’ with you. It is, after all, the employer that is indirectly funding the sessions. Developing your understanding of the organisation will help you work with both ‘clients’ since an insight into the type of business and the pressures of this work can help you build up a rapport with the client.

[…] The employer is often keen to know whether the support offered by the EAP is having a business benefit. This will be part of the implicit or explicit requirements of the employer and they may need to have evidence of any return on investment. For instance, is there evidence that the employee/client has returned to work more quickly as a result of the counselling? Has the counselling prevented the client from taking time off work for sickness?”

This presents a constraining framework of conflicted interests for counsellors with favourable “outcomes” invariably weighted towards employers and not employees. How, for example, does a counsellor support someone in a decision to leave their job and find another with better conditions, more security and pay? In this context, the mass provision of CBT may be regarded as a technocratic “fix” for poor employment and social conditions, and is rather more about policing critical thinking and dissenting behaviours in the workplace than providing support for employees. Treating each individual as if the problems lie “within” their thoughts and behaviours also serves to discourage collective bargaining to improve workplace (and social) conditions.  

Although the briefing paper doesn’t tell us if 50% of the UK workforce have actually accessed the EAP services, the perceived need for this service provision and the growth of the industry tells us a lot about employment and social conditions in the UK.

And what does the mass provision of CBT tell us about how this is being addressed?

CBT has become a means of re-socialising those who have become casualities of neoliberalism to accept and internalise the normative “logic” of neoliberalism. It’s a repressive state “therapy” for micromanaging dissent and critical thinking. It inhibits progressive social change, by locating all of our socioeconomic and political problems within the thoughts and behaviours of individuals.

Meanwhile private providers are making lots of profit on something that can never work in the long term. By coercing individuals to accept the terrible burdens and ravages of neoliberalism, the state and co-opted agencies are propping up a socioeconomic system that is collapsing, and in the process, it is profoundly harming people.