Preventing Workplace Substance Abuse: Beyond Drug Testing to Wellness

278 Pages·2003·16 MB·English

by  Joel B. Bennett

P r e v e n t h a W o r k d a c e
Substance" A b u s i
Beyond Drug Testing
to Wellness
Joel B. Bennett and Wayne E. K, lehman, Editors
American Psychological Association
Washington, DC
CONTENTS
Contributors .................................................. ix
Preface .................................... : .................. xi
Introduction .................................................. 3
Joel B. Bennett
Chapter 1. Understanding Employee Alcohol and Other
Drug Use: Toward a Multilevel Approach ........ 29
Joel B. Bennett, G. Shawn Reynolds, and
Wayne E. K. Lehman
Chapter 2. A Workplace Coping-Skills Intervention to
Prevent Alcohol Abuse ........................ 57
David L. Snow, Suzanne C. Swan, and Leo Wilton
Chapter 3. Integrating Substance Abuse Prevention Into
Health Promotion Programs in the Workplace:
A Social Cognitive Intervention Targeting the
Mainstream User .............................. 97
Royer F. Cook, Anita S. Back, James Trudeau, and
Tracy McPherson
Chapter Helping At-Risk Drinkers Reduce Their Drinking:
4.
Cardiovascular Wellness Outreach at Work ...... 135
Max Heirich and Cynthia J. Sieck
Chapter 5. Team and Informational Trainings for Workplace
Substance Abuse Prevention .................... 165
Wayne E. K. Lehman, G. Shawn Reynolds, and
Joel B. Bennett
vii
Chapter 6. Lay and Scientific Perspectives on Harm
Prevention: Enabling Theory and Program
Innovation .................................... 203
Martin Shin and Helen Suuroali
Chapter 7. Symbolic Crusades and Organizational Adoption
of Substance Abuse Prevention Programs ........ 227
William J . Sonnenst uhl
Chapter 8. Cautious Optimism and Recommendations: A Call
for More Research From Applied Psychology ..... 239
Joel B. Bennett, G. Shawn Reynolds, and
Wayne E. K. Lehman
Index ........................................................ 259
About the Editors ............................................. 271
...
Vlll CONTENTS
CONTRIBUTORS
Anita S. Back, MS, The ISA Group, Alexandria, VA
Joel B. Bennett, PhD, Institute of Behavioral Research, Organizational
Wellness and Learning Systems, Fort Worth, TX
Royer F. Cook, PhD, President, The ISA Group, Alexandria, VA
Max Heirich, PhD, Worker Health Program, Institute of Labor and
Industrial Relations, University of Michigan, Ann Arbor
Wayne E. K. Lehman, PhD, Institute of Behavioral Research, Texas
Christian University, Fort Worth
Tracy McPherson, MS, The ISA Group, Alexandria, VA
G. Shawn Reynolds, MS, Institute of Behavioral Research, Texas
Christian University, Fort Worth
Martin Shain, SJD, Centre for Addiction and Mental Health, Toronto,
Ontario, Canada
Cynthia J. Sieck, PhD, Worker Health Program, Institute of Labor and
Industrial Relations, University of Michigan, Ann Arbor
David L. Snow, PhD, School of Medicine, Department of Psychiatry,
The Consultation Center and Division of Prevention and
Community Research, Yale University, New Haven, CT
William J. Sonnenstuhl, PhD, School of Industrial and Labor Relations,
Cornell University, Ithaca, NY
Helen Suurvali, BA, Centre for Addiction and Mental Health, Toronto,
Ontario, Canada
Suzanne C. Swan, PhD, School of Medicine, Department of Psychiatry,
The Consultation Center and Division of Prevention and
Community Research, Yale University, New Haven, CT
James Trudeau, PhD, The ISA Group, Alexandria, VA
Leo Wilton, PhD, Department of Counseling and Clinical Psychology,
Teachers College, Columbia University, New York
ix
PREFACE
As trainers in adult substance abuse prevention, we have had the
opportunity to talk directly with employees about their views of policy and
substance abuse. Often, employees describe circumstances in which sub-
stance abuse policy and rudimentary training programs were not effective.
We have heard stories of accidents, physical harm, exposure to toxic sub-
stances, and damaged equipment that were linked to one or more employ-
ees who did not monitor or control their drug or alcohol use. The incidents
occurred in workplaces that had good policies in place, including drug
testing and easily accessed employee assistance counselors. In our research,
many employees tell us that they support drug testing, but they also convey
a need for additional programs that somehow show a deeper appreciation
of human potential. Two stories (modified to protect anonymity) illustrate
the need for this new type of prevention program.
Sandy was a valued employee who had worked for the same company
for more than 20 years. She pulled a trainer aside in the training room one
day to tell him she would never had survived in her job if the current (and
stricter) policy had been around even 10 years ago. “I would have been
out of here if it weren’t for people-the managers-who understand.” She
went on to describe her own recovery from alcoholism with the help of
Alcoholics Anonymous (AA). She had been given, over a 10-year period,
three separate chances to come back to work after struggling with recovery
and relapse. The message Sandy wished to convey was that other employees
could overcome addiction-if they had the right understanding and man-
agerial support. She was concerned about a group of young employees who
reminded her of her younger days. Sandy believed that with new, stricter
policies, those “good people” would likely get fired. She believed that AA
could help, but she did not know how to approach the situation.
Another time we listened as a group of senior supervisors were talking
xi
with a new supervisor, Fred, about a problem employee, Tom. Many of the
supervisors had had previous dealings with Tom, who had a history of
absences and safety concerns that they attributed to drug problems. They
agreed that Tom had learned to beat the system and that it was too much
trouble to do all the paperwork involved to implement drug testing for
cause or reasonable suspicion. This discussion prompted another supervisor
to describe a situation in which such testing of another employee had
produced a positive test. The employee had executed his right to have a
second (split) sample tested which, for unknown reasons, the testing lab
had lost. This mishap resulted in no remedial action to this employee, and
several supervisors agreed that they had lost faith in drug testing. Even
though all the supervisors had been trained in employee assistance program
(EAP) services and in informal referral skills, they did not see the EAP as
helpful because of confidentiality concerns. As a result of this discussion,
Fred grew anxious about doing anything to deal with Tom. Fred was caught
between his desires to really help this troubled worker, to follow policy
(i.e., to stay accountable), and to conform to the norms of passivity and
tolerance that the older supervisors had learned and behaviorally modeled.
We believe that the above scenarios represent common situations in
the workplace today. The situations involve substance abuse, but they also
reflect or are symptomatic of general failures in organizational health and,
in Fred’s case, accountability. Workplace policies that deal with any sort
of behavioral issue (e.g., substance abuse, sexual harassment, discrimina-
tion, or violence) often focus on compliance, legal liability, and safety
issues and neglect the importance of fostering personal accountability and
social interest. Such policies are necessary, but they require a healthy work-
place to be effective. Various writers echo this call for a “healthy work-
place” when writing about social health, a sense of shared responsibility, a
vision of the common good, and a supportive organizational culture.
After hearing these and other stories, we explored the empirical and
academic literature to see what kinds of research on workplace prevention
existed. We discovered that most studies on employee substance abuse had
focused on the problem rather than the solution. We reasoned that social
scientists could play an important role by building on the research to de-
velop and evaluate prevention programs. At the same time, we discovered
a small group of studies on workplace educational programs that showed
positive effects on employees, and we learned that other researchers- the
authors of chapters in this volume-had or were conducting new studies.
It became increasingly clear that some venue was needed to showcase
workplace programs and examine if, when, and how they work. This book
was assembled because it is time to refocus our efforts-using scientific
procedure and reason-on how the workplace can help employees. The
ideas and findings in this volume represent a major, although early, step in
this direction. We also believe that the best approaches to preventing em-
xii PREFACE
ployee substance abuse may eventually come from the research and ideas
presented in this volume. Indeed, early evidence suggests that employers
who enrich their policies with prevention programs will reap benefits far
beyond what current approaches, including drug testing, can accomplish.
The term beyond in the title of this book has various meanings. It
refers first to the need to enhance prevention as a necessary and critical
complement to testing. The studies presented in this volume show that
preventative interventions are key for addressing employee substance abuse.
We are not suggesting that prevention programs replace testing. Rather,
given the evidence in this book, employers should seriously consider adding
or enhancing psychoeducational, training, or other prevention-oriented
programs-regardless of what they might do with their testing programs.
In fact, rarely does a workplace program use only one component. In
passing legislation to deal with the problem of employee substance abuse,
the U.S. government requires that many workplaces have a multicompo-
nent strategy that includes a written policy, employee education and train-
ing, drug testing, and access to counseling (in the form of EAPs). This
critical point is overlooked in-and contributes to-much of the contro-
versy about drug testing.
Few topics generate as much debate and controversy as workplace drug
testing. Opinions range from complete support to absolute rejection.
Arguments concerning the safety of employees, the public and the
environment are pitted against the perceived need to protect employee
privacy. These strong opinions, however, may have been formed be-
cause drug testing is considered as a stand-alone programme, as opposed
to one possible component of a comprehensive drug and alcohol
policy.'
Thus, moving beyond drug testing also means moving beyond con-
troversies about drug testing, conducting research on all aspects of policy,
and determining and focusing on what works. In that sense, we believe
that this book can have more practical or utilitarian value than continued
debate about testing technologies. To be clear, none of the studies reviewed
in subsequent chapters (nor any study of which we are aware) evaluate the
relative effectiveness of different policy components. Our point is that
whenever possible, multicomponent policies should become empirically
driven and practical in focus.
Moving beyond drug testing also means that policies should take a
holistic or humanistic view of the various risks for employee substance
abuse. They should move beyond the view that problems only need to be
authoritatively controlled. Instead, employers should proactively address
factors that might lead to or aggravate the tendency to abuse alcohol or
'Campbell, D. I. (2001). The proactive employee: Managing workplace initiative. Academy of
Management Executive, 14(3),5 2-66.
PREFACE xiii
drugs. In the scenarios described above, both Sandy and Fred, like most of
their colleagues, actually supported drug testing. They also had received
basic training and were aware of policy and their EAP. Apparently, that
information was not enough for them. They were faced with circumstances
requiring not only information but direct interpersonal, social, or cultural
solutions. In short, they needed innovative programs similar to those pre-
sented in chapters 2 through 6. Of course, not all the solutions provided
by researchers are likely to meet the needs of every organization. The areas
covered herein, however-work-life balance, health, stress, teamwork,
and employee involvement-show that substance abuse can be reduced by
addressing the whole human being and the various contexts in which em-
ployees live and work. Moreover, those areas are of increasing interest to
human resources personnel as well as to managers and policymakers.
This book is written for employers and their advisors who can shape
policies and workplace training programs to support, help, and encourage
employees who are at risk for or face problems related to substance abuse.
The above two scenarios show employee concern about the effectiveness
of current policies. Sandy, a recovering alcoholic, hoped that policies could
be more lenient. Fred, a new supervisor, wanted to respond better to a
troubled employee. Although the two scenarios reveal concerns, they also
point to solutions. In both instances, the individual employee expressed a
desire to do something to correct the situation. Sandy, partly because she
herself was treated with respect as someone who could recover from alco-
holism, wanted to help other employees in a similar way. Fred wanted to
be responsible and “do the right thing” despite the fact that his colleagues
had become cynical. Both Sandy and Fred had “higher level” motivations
to do something for the common good. They were looking for both a
method and a supportive environment for dealing with the problem. The
methods described in this book help tap those motives of self -imp rovement
’
and responsibility. Such methods should be useful in the changing work-
place. Indeed, growing evidence indicates that employees are becoming
proactive in handling problems and that programs encouraging worker in-
itiative can be extremely helpful to managers.*
This book is also written for counselors and researchers in prevention,
health promotion, and the various social sciences, including psychology.
Each discipline can play a much more significant role than it currently
does in addressing substance abuse within-and through- the employee
population. The cross-disciplinary approach shown in the primary chapters
speaks to the many opportunities and avenues for addressing problems.
Researchers draw on a wide-ranging set of methodologies-from meta-
analysis and multivariate statistics to narrative and discourse analysis. The
’Jardine-Tweedie,L ., & Wright, P. C. (1988). Workplace drug testing: Avoiding the testing
addiction. Journal of Managerial Psychobgy, 13, 534-543.
Xiv PREFACE
field of workplace substance abuse prevention is quite young, and we hope
that the breadth represented will help spark the interest of practitioners
from many backgrounds. We hope that the findings in this book will pro-
vide a foundation for researchers to explore new questions and lead to
increasingly effective interventions. Finally, we hope that this book can be
a resource for workplace trainers, counselors, and other practitioners in the
helping professions. Readers who find something useful are encouraged to
contact any of the authors for assistance in accessing and implementing
the programs described herein.
This book was a 3-year collaboration during which the researchers
and scholars interacted with the editors and with each other to help shape
the volume.
Such collaboration was fostered through the support of the National
Institute on Drug Abuse, which sponsored a forum at which several of us
first met each other (Drugs and the Workplace: Planning the Research
Agenda, May 1999, Bethesda, MD). Both the American Psychological As-
sociation and the National Institute of Occupational Health and Safety
provided a venue for our collaborative efforts at the Third International
Conference on Work, Stress, and Health (March 1999, Baltimore, MD).
We also have benefited from the forum provided by the Center for Sub-
stance Abuse Prevention’s Workplace Managed Care project on substance
abuse (visit http://wmcare.samhsa.gov).
Finally, we extend our deepest appreciation to Linda Houser-Ferdi-
nand for her patience, help, and clerical support through the many stages
required to complete this book.
PREFACE xv