Advancing the field of employee assistance programs research and practice: A systematic review of quantitative studies and future research agenda

Abstract

The COVID-19 pandemic has accentuated the critical role of organizational support for the workforce. An employee assistance program (EAP) represents an inclusive strategy which organizations adopt to provide supportive and empathic care to help employees overcome undesirable situations. To date, we have limited knowledge of what EAP issues have been researched from the human resource management (HRM) perspective and what theoretical underpinning these studies have used. This article systematically reviews quantitative empirical studies on EAPs. Drawing upon 115 articles from 72 journals across 40 years (1981–2020), we trace the evolutionary trend of the construct of EAP and shed light on the internal link of EAP with HRM. After summarizing research themes, methods, theories, and approaches to the evaluation of EAPs, we identify pitfalls in the current research and contribute to extending the field by proposing several research agendas for future investigation.

1. Introduction

An increasing number of organizations have started to emphasize the provision of employee assistance programs (EAPs) in the workplace, especially since the COVID-19 pandemic, which saw drastic changes to work routines. An EAP is a work-based program that encompasses a wide spectrum of helping services to address aspects of work, life, and health, and is intended to remedy existing employee difficulties as well as mitigate future adversities. Since its inception in 1917 (Kemp, 1985), EAP has evolved from compulsory units for rehabilitating problematic employees into voluntary and confidential services as part of employee fringe benefits. Evidence indicates that the provision of such programs has become essential for many organizations in developed countries, with a high coverage of more than 97% in organizations with more than 5000 employees in the USA (Employee Assistance Professionals Association [EAPA], 2016). However, major differences exist in terms of how the programs are provided and their connection with other human resource management (HRM) practices. For instance, while the majority of organizations flock into the cohort to outsource their EAPs for performance-driven services, some giants (e.g., Microsoft) manage their elaborate programs actively in concert with other forms of caring services, such as marital and parenting programs. With the increasing adoption of the programs in workplaces, research interest is growing across the disciplines of management, public health, and psychology.

Accordingly, several relevant review studies have emerged, shedding light on thematic foci, construct evaluations, and gaps in the research into EAPs (see Appendix 1 for a summary of extant review studies). Scholars pinpointed the most important knowledge gap: that EAP research has focused rather narrowly on addressing employee substance abuse issues (Joseph, Walker, & Fuller-Tyszkiewicz, 2018; McLeod, 2010), while neglecting the starting point of these programs as overall ‘personnel management programs’ (Johnson, 1985, p. 383). Despite insights from these previous reviews, most were published before 2011 and used relatively small samples, so several research gaps remain. Notwithstanding the proliferation of EAP research (over 1000 publications in the Web of Science database), only one of the six review papers (Azaroff, Champagne, Nobrega, Shetty, & Punnett, 2010) included over 100 published items in their review sample, thus limiting the opportunity for a systematic synthesis of existing knowledge. Moreover, the foci of the scholarly reviews were sketchy, mainly centering on EAP evaluation (n = 2) and EAP efficacy on a single construct (n = 2), instead of holding in-depth dialogues on the development and evolution of the construct.

Finally, although these workplace programs have long been part of HR departments' duties, EAPs were under-researched from an HRM perspective. Considering that relevant research has not kept pace with HR practices, a systematic review of extant EAP research from an HRM perspective may not only provide researchers with motivation and directions to conduct more research in this important field, but also inform HR practitioners of research findings that may help them understand more fully the intellectual explanation of the shift to a new EAP-HRM paradigm and improve the provision and effectiveness of their programs. Such an endeavor is even more critical in the context of COVID-19 and global uncertainties that have negative impacts on organizational functioning and people's lives.

As Li (2021) stated, while ‘employers and employees grappled with the aftermath of COVID-19 and its impact on the workplace’ (p. 12), the pandemic has increased employees' awareness of their mental health needs and physical wellbeing. Considering the limited research focus on the potential of EAPs to strengthen resilience at both organizational and individual levels, COVID-19 may serve as a catalyst for researchers and practitioners to rethink the role of EAPs in business strategies and review former practices.

This review is structured and guided by the following research questions: how have EAPs developed and evolved since their inception? How do EAPs function and influence workplace outcomes? How do EAPs integrate with HRM and organizational strategies? What are the research gaps in extant EAP research? And what are important topics for future research to advance theories and develop thematic orientations? To address these research questions in this review, we systematically synthesize findings and theoretical perspectives from diverse EAP studies across four decades and interpret how the literature has changed and evolved from an HRM perspective. We also critically evaluate the body of literature and identify fruitful avenues for future research. Our study contributes theoretically to the understanding of the concept by adding HRM elements to the structure of EAPs. We aim to address the limitations of previous studies and direct research foci to EAPs as an HRM-related construct. By achieving these objectives, we seek to update the image of this construct and the role they play in organizational strategy to inform practices aimed at wellbeing-oriented HRM.

2. Definition of EAPs

EAPs have a long pedigree in both academic and practitioner contexts. Although definitions of EAPs (see Table 1 for a summary) vary depending on ‘the type of programs, the nature of the services offered, the standards being applied, and the region in which the EAP operates’ (Masi, 2020, p. 16), on the whole, they take a relatively narrow and utilitarian view of these programs as a remedial tool to recover performance. Existing definitions neglect their preventative function and prioritize performance above employee wellbeing. Considering the knowledge gap, in the present study, we define EAPs as work-based wellbeing programs that encompass a wide spectrum of services addressing aspects of work, life, and health, with the dual aim of remedying existing difficulties and mitigating future adversities that employees may face.

Table 1.

Definitions of EAPs.

No.	Source	Definition	Main foci
1.	The Society for Human Resource Management (2020)	An EAP is a work-based intervention program designed to assist employees in resolving personal problems that may be adversely affecting the employee's performance.	EAPs as part of benefits system. EAPs are anchored in job performance.
2.	Employee Assistance Professionals Association (2020)	An EAP is a work-based intervention program designed to enhance the emotional, mental, and general psychological wellbeing of all employees, and includes services for immediate family members.	Incorporating employees' family members into EAPs. Focusing on remedial intervention while ignoring preventative functions.
3.	The Employee Assistance Society of North America (2017)	An EAP is an employer-sponsored service designed for personal or family problems, including mental health, substance abuse, various addictions, marital problems, parenting problems, emotional problems, or financial or legal concerns.	Encompassing a variety of new emerging employee concerns into EAPs. Remedial intervention oriented.
4.	Roman & Trice (1976)	EAPs are formal intervention systems with two primary functions: consulting with supervisors of employees whose job performance has suffered because of personal problems, and offering assistance on a self-referral basis to employees with self-defined problems.	The important role of supervisors in implementing EAPs. EAPs for both self-referral and referred employee.
5.	Kirk and Brown (2003)	EAPs are employer-funded activities that provide professional assessment, referral, and short-term counseling directed at personal, family, and work-related problems that might interfere with worker performance or health.	EAPs are anchored in job performance. EAPs as a short-term intervention.
6.	Spell and Blum (2005)	EAPs are formal programs that assist employees with personal problems that may be affecting their work-related behaviors.	EAPs are anchored in job performance

2.1. Distinctions between EAPs and other related concepts

The relationships between the concept of EAPs and employee benefits, workplace counseling, substance abuse programs, employee health/wellness programs, and work-life programs are intricately correlated. EAPs are part of employee benefits schemes and can be subcategorized under health benefits, or more precisely, wellbeing benefits (McFarland, Lierman, Penner, McCamant, & Zani, 2003). They were seen as equivalent to substance abuse programs in the early studies considering the origin of this concept (Reynolds & Lehman, 2003). However, contemporary programs cover many aspects of assistance beyond addictive rehabilitation (Joseph et al., 2018). We regard workplace counseling as part of EAPs, as the service scope falls into the remit of core tasks of EAPs (Kirk & Brown, 2003). Sometimes, the terms EAPs and employee health/wellness programs are used interchangeably. Regarding EAPs versus work-life programs, we hold the view that EAPs are more comprehensive workplace programs than work-life balance initiatives and that assistance in striking work-life balance is an important domain of EAPs.

3. Method

This paper intends to ‘develop evidence-informed management knowledge’ through ‘accessing the relevant intellectual territory’ (Tranfield, Denyer, & Smart, 2003, p. 207). Specifically, we followed Onwuegbuzie and Frels's (2016) approach to systematically examine EAP-relevant quantitative research from its emergence, and then trace the evolutionary trend across four decades by highlighting the concepts, theories, and phenomena emerging in the literature. Additionally, in line with the research aim, we teased out the developmental trend of EAPs from an HRM perspective by incorporating multidisciplinary literature (broad management, psychology, and public & occupational health literature) into our systematic review, to ‘consider cross-disciplinary perspectives and alternative ways in which a research topic has previously been tackled’ (Tranfield et al., 2003, p. 214). Short (2009) points out that conceptual reviews that bridge disciplinary backgrounds have the strongest potential for contribution. Hence, we did not set disciplinary or subject criteria to filter insights from the broader literature. We did not adopt a quantitative meta-analysis because extant quantitative studies encompass a wide variety of antecedents and outcome variables rather than concentrating on certain frequently used indicators.

3.1. Literature search, selection, and coding

Following Denyer and Tranfield's recommendation to conduct a systematic review that best matches ‘the nature and characteristics of the field of study’ (Denyer & Tranfield, 2009, p. 673), we take a similar approach to that of Mäkikangas, Kinnunen, Feldt, and Schaufeli (2016) and Oreg, Vakola, and Armenakis (2011), i.e., focusing only on the EAP-relevant quantitative studies and excluding the qualitative ones, because of the high percentage of case studies that broadly introduce specific experiences of EAPs. Many of these studies do not engage with theories. The present review regards EAP as a practice-oriented and evidence-based management construct; as such, we consider the quantitative studies and investigate the intellectual gaps. Our aim is to advance EAP research so that it better matches with and informs management practices.

The data collected for this review paper consisted of 115 peer-reviewed journal articles to the end of December 2020. The process of data collection follows the guidelines for writing review papers in management disciplines (Short, 2009; Tranfield et al., 2003). Web of Science, EBSCO, Google Scholar, Wiley, SAGE, Emerald, Springer, Taylor and Francis, and other mainstream databases were trawled for peer-reviewed English articles. Keywords used for the search included: employee assistance programs, employee assistance, assistance employee, and EAP in their titles, abstracts, or keywords. We did not set an initial time span to identify the maximum number of relevant articles. Over 500 articles were identified and downloaded after the initial screening.

To ensure appropriate input quality, further screening of the articles was carried out according to the following criteria. For an article to be included in our review, first, the journals where EAP related articles were published had to be positioned on either the Social Science Citation Index or Science Citation Index journal lists, because we aimed to focus on high-quality articles based on robust methodology and with a sound theoretical basis. Second, only peer-reviewed journal articles in English were incorporated. Third, we included in-press articles possessing substantive contents (over three pages), given that many studies we found had only one or two pages (e.g., Carchietta, 2015; Fink, Smith, Singh, Ihrke, & Cisler, 2016). Most of these short-length studies briefly introduced an EAP or left a short commentary, giving insufficient information for further in-depth analysis. Fourth, the articles needed to focus on EAP as a key construct, rather than discussing EAPs in passing as part of a general discussion. Fifth, the articles should include at least one quantitative study centered on EAP. That is, the research could either be purely quantitative or a mixed-method one. In addition, given our research focus on EAPs as an HRM-related construct, we manually searched the homepages of major HRM journals (i.e., Human Resource Management, Human Resource Management Journal, The International Journal of Human Resource Management, Asia Pacific Journal of Human resources, and Journal of Manpower) and supplemented another five relevant papers. We employed the citation pearl-growing technique (Ramer, 2005) by going through the reference lists of the pool of articles to check and identify any missing literature. Finally, two authors screened through the articles and agreed on the final sample.

We followed Short's (2009) and Tranfield et al.'s (2003) approach of inductive categorization to unfold the emergent thematic foci and theoretic advancements in the literature; this approach reveals the evolutionary trend of EAP research and the extant research gaps. The tables and figures were generated from the coded data in an excel file. The first author did the initial coding based on a template agreed with by the authors. The second author then checked the coding. Different opinions were discussed and agreed upon by the authors. In the next section, in line with the research questions, we analyze the main findings and present the development and evolution of EAP research across four decades. Following Tranfield et al.'s (2003) method of organizing the research findings of a systematic review in management, we report descriptive analysis and content findings of extant research sequentially to address the research questions before presenting our original conceptual contributions in the context of past studies.

4. Characteristics of existing quantitative research on EAPs

Our review spans 40 years (1981–2020). As can be seen from Fig. 1 , which depicts the articles published by year, the last two decades saw more than twice as many articles as the first half of the period.

Fig. 1.

Number of EAP publications included in this review by year.

4.1. Publication outlets and countries researched

The 115 articles included in this review were across 72 journals and no single journal included more than ten articles. Despite the close connection of EAPs with HRM, less than 15% of the sample articles were published in management journals (see Table 2 for a summary). In addition, the appearance of EAP studies in top-tier journals remains relatively rare. Nearly 80% of the studies were based on either US or Canadian contexts. Compared with developed economies, developing countries have rarely featured in publications in English, which suggests a knowledge gap across the world.

Table 2.

Types of journals publishing EAP research included in this review (N = 115).

Journal Types	No. of Articles (1981–2000)	No. of Articles (2001−2020)	% of N
Public and Occupational Health Journals	18	40
Subtotal	58		50.4%
Psychology Journals	9	14
Subtotal	23		22.0%
Management Journals	5	12
General management	1	2
Human resource management	/	4
Other management specialties	/	2
Public management	4	4
Subtotal	17		14.8%
Other	9	8	8
Subtotal	17		14.8%
Total	115		/

4.2. Dimensions of EAPs

We noted the main contents of EAPs over the review period (see Table 3 ). Although diverse at first glance, many of the existing studies focused on substance abuse issues, which accounted for 34.8% of the included research. Several researchers in the field (e.g., DeGroot & Kiker, 2003; Joseph et al., 2018) thus call for broadening the focus of EAP research to reflect the diverse and fast-changing work environments in contemporary societies. (See Table 4.)

Table 3.

Sub-dimensions of EAPs in the current research (1981–2020) (N = 115).

EAP themes	Sub-category	Key features/foci	No.	Example of Studies
General EAPsa	/	Having both remedial and preventive functions. Employee wellbeing is concerned.	48	Hsu et al. (2020)
Subtotal			48
Substance abuse intervention	/	Considering substance abuse as a treatable medical condition that can be prevented and intervened in. Offering assistance, normally through medical treatment, to help employees get rid of addiction.	40	Street et al. (2018)
Subtotal			40
Employee health program	Physical wellness program	Physical health promotion/intervention-oriented. Closely related to medical insurance schemes.	9	Street and Thomas (2017)
	Mental health program	Mental health promotion/intervention-oriented, normally by professional and outpatient assistance	1	Dimoff and Kelloway (2019)
Subtotal			10
Work-life program	General family support program	Offering assistance on family concerns.	4	Caillier (2017)
	Work-life balance program	Maintaining or striving to strike a balance between employees' work and life.	4	Masi and Jacobson (2003)
	Child-care assistance program	Organizational care on employees' child-care duties. Normally in a form of a financial subsidy.	3	Morrissey et al. (2009)
	Intimate Partner Violence counseling	Normally through confidential and one-to-one counseling. Female employees more likely to use this service.	2	Pollack, Austin, & Grisso, 2010, Pollack et al. (2010); Walters et al. (2012)
	Spouse adjustment program	Close links with expatriate and cross-cultural management.	1	Cole (2011)
Subtotal			14
Group-specific assistance program	EAPs on disabled employees	Offering tailored helping services to a specific group of employees	1	Kiernan and McGaughey (1992)
	EAPs on HIV/AIDS employees		1	Ramsingh and van Aardt (2006)
	EAPs on sportspeople		1	McDuff, Morse, and White (2005)
Subtotal			3
Total			115

^a‘General EAPs refers to studies that do not mention specific employee assistance contents for further categorization or studies that clearly mention EAP as an encompassing of a repertoire of services.

Table 4.

Research methods employed in the EAP studies included in this review (N = 115).

	Research Methods	Sub-category	No. of Articles	% of N
1	Survey	/	47
	Subtotal	47		41%
2	Statistical analysis	Secondary data	28
		Primary data	1
	Subtotal	29		25%
3	Quasi-experiment	Quasi-experiment (control group test)	12
		Quasi-experiment (pre/post-test)	11
	Subtotal	23		20%
4	Mixed-method design	Survey and Interview	7
		Survey and secondary data	3
		Survey and control group test	2
		Interview and pre/post-test	1
		Interview and secondary data analysis	1
		Secondary data analysis and survey and focus group	1
		Survey and ethnographic research	1
	Subtotal	16		14%
Total		115

4.3. Research methods used

Nearly half of the studies included in this review relied on a survey method, followed by those using statistical analysis and quasi-experiment. Understandably, surveys are broadly employed because of the convenience of this approach. In addition, we detected the emerging use of the quasi-experimental method, consistent with the broad interest in EAPs in occupational health disciplines. The relevant research generally conducted control-group tests to compare the different outcomes for the EAP recipients and non-EAP recipients after assessing the relative comparability. Considering the absence of experimental methods grounded in management research, EAPs provide an opportunity to facilitate the adoption of a wider range of research methods from other disciplines.

In the following section, we take a retrospective view of the evolution of relevant research since its inception, focusing mainly on the conceptual and thematic development of existing research.

5. The evolution of EAP research and recent developments

While workplace employee outreach assistance dates from the turn of the 20th century, it was not until the early 1980s that the first empirical research on EAPs appeared (Foote & Erfurt, 1981). Despite advances in conceptualization and thematization, we believe the evolutionary process of EAP research falls behind the practical development, given that the ‘political, economic and social pressures on the world of work’ have changed the practical connotations of EAPs (Masi, 2020, p. 74). In this section, we intend to address this gap by mapping the evolutionary process and highlighting the state-of-the-art development of relevant research. Following the research questions that drive this review, we adopt an integrative framework to systematically analyze the conceptual and thematic concerns, and how these programs have been integrated with HRM from an evolutionary perspective. We accentuate the latest development of EAPs to guide HRM practices in contemporary workplaces.

5.1. Conceptual development of EAP

A continuing issue in the overall conceptual development of EAPs was that a plethora of research still regarded EAPs as substance abuse interventions and inevitably labeled them with ‘the stigma that may be associated with an alcoholism program’ (Foote & Erfurt, 1981, p. 216; Waehrer, Miller, Hendrie, & Galvin, 2016). To remove the label of substance abuse intervention from these programs, scholars have sought to enrich conceptual explanations of the concept of EAP in line with practical developments (Aseltine, Demarco, Wallenstein, & Jacobs, 2009; Bennett, Blum, & Roman, 1994; Zinkiewicz, Davey, Obst, & Sheehan, 2000). Over four decades, the concept has gradually evolved into a multi-level and multi-faceted construct, incorporating a wide range of supportive resources beyond substance abuse rehabilitation into the services. Multiple stakeholders, including, but not limited to, employees, supervisors, labor unions, legislative bodies, and organizations were incorporated into the existing research (Lightner & McConatha, 1995; Milne, Blum, & Roman, 1994; Shaffer, Vander Bilt, & Hall, 1999; Spell & Blum, 2005). With the expanded service scopes, a new perspective emerged, viewing EAPs as organizational provisions of a bundle of resources for employees (Aseltine et al., 2009; Knudsen, Roman, & Johnson, 2004). This perspective promoted both the thematic and theoretical development of EAPs because they were endowed with more strategic roles (Zinkiewicz et al., 2000). In addition, a resource orientation of EAPs fostered the understanding of the complexity of the construct, since they can be perceived as distinct resources by different groups of stakeholders, thus accelerating the fusion of EAP with organizational behavior (OB) and HRM research. It is noteworthy that EAPs came to be seen as not limited to one-way organizational assistance to problematic employees; they are considered to be associated more with organizational strategy, leader-member exchange, and HRM (Knudsen, Roman, & Johnson, 2003; Spell & Blum, 2005). In general, the evolution of the EAP concept has reinforced the humane nature of organizational assistance and reduced the stigma associated with the plethora of foci on addictive rehabilitation.

EAPs look very different today than they did in the early decades. While the previous three decades saw the development of the EAP concept toward HR tools, the changes over the past decade are unprecedented, with a rapid rise in outsourced programs in most workplaces (Masi, 2020). On the one hand, a surge in outsourced programs offered more opportunities to access helping resources. On the other hand, they became less tailored to specific employee needs (Richmond, Pampel, Wood, & Nunes, 2016). For instance, while outsourced EAPs have an advantage in general psychological counseling, they are inadequate to deal with work-related or profession-related requests, which are quoted as one of the main reasons for visiting them (Hu et al., 2012; Peek-Asa, Casteel, Rugala, Romano, & Ramirez, 2013). In addition, the business competitions between third-party vendors make EAPs more similar and standard than diverse, such that they seem to become standardized HR configurations offering similar services (Hsu, Wang, & Lan, 2020). It is noteworthy that a handful of current research holds that ‘while EAPs have evolved over the years to include services for work-life concerns, addressing alcohol and substance abuse problems in the workforce remains a core priority’ (Waehrer et al., 2016, p. 53). These diverging conceptual ideas reveal the near absence of multidisciplinary dialogues in current EAP research and the rich opportunities for integrating different research streams.

5.2. Research themes

In terms of the thematic foci of EAP research, we see a continuing shift in attention from macro-level discussions regarding organization-level decisions on EAPs to more detailed micro-level investigations on individual perceptions or experiences of these programs. A large quantity of research sought empirical evidence of EAP efficacy on various outcome variables. In addition, we see a cluster of research investigating how to evaluate EAPs more scientifically, focusing on manifold indicators beyond pecuniary tradeoffs.

First, a series of early studies (most before 2000) focused on the macro-level antecedents of organizational responses to this new supportive approach. Specifically, two questions drove this cluster of research: under what circumstances should organizations adopt EAPs? What kind of organizations could benefit more from adopting EAPs? Prior research suggested that both organizational size and industry influenced organizations' first step toward instituting the programs (Blum, Roman, & Patrick, 1990; French, Zarkin, Bray, & Hartwell, 1999). In addition, the existence of labor unions, the unemployment rate of enterprise locations, and federal funding were found to influence the final decision to institute EAPs (Bennett et al., 1994; Blum et al., 1990; Delaney, Grube, & Ames, 1998; Nathan, Terry, & Paul, 1994). Following institutional theory, several factors (e.g., labor policy, and legislative mandates) were found to impact the organizational adoption of EAPs (Bennett et al., 1994; Zarkin & Garfinkel, 1994). Other factors (e.g., the enterprise's economic situation) reflected organizational evaluations of both internal and external environments before initiating EAPs (Beck, Lenhardt, Schmitt, & Sommer, 2015). It was noteworthy that few studies discussed these macro-level antecedents of EAPs despite the wide proliferation of such programs in workplaces since the late 1990s.

Second, attention has shifted to empirical investigations of micro-level individual antecedents and outcomes of EAPs after 2000, constituting the mainstream of research until now. Compared with discussions on the individual-level antecedents of EAPs, a greater body of research has empirically investigated their outcomes. A good variety of performance-related, attitudinal, and behavioral outcomes variables were researched. In general, early studies (mostly before 2000) focused more on certain outcome variables that could demonstrate EAP efficacy (e.g., absenteeism and performance), in response to the employers' doubts about this new approach (Macdonald, Lothian, & Wells, 1997; Ramanathan, 1992). With the enhanced coverage of the programs after 2000, more multi-faceted and multi-level outcomes enriched the empirical evidence on EAP efficacy. However, performance has remained the most researched outcome variable during this period (e.g., Hinze & Gambatese, 2003; Masi & Jacobson, 2003). Since the 2010s, performance-related outcomes have been less researched, reflecting a more employee-centered lens in contemporary research. Within the body of contemporary research on EAP efficacy, the positive results on multi-level outcomes (e.g., attitudinal, emotional, and behavioral) provided confirmatory evidence that EAPs generate satisfactory outcomes for workplaces. We summarize the nomological network of EAP-related research in Fig. 2 .

Fig. 2.

The nomological network of EAP-related research.

When management practices revealed emerging problems of low use rate after 2000, another dilemma emerged: how could organizations improve employee participation in these programs? The first step in this shift was to develop an understanding of the motivations and obstacles to employee utilization of EAPs. We consider that this cluster of studies drove the sustainable development of managerial practices, as it considered the individual differences facing EAPs and assisted in tackling the obstacles to employee engagement in them. Work inability (e.g., Peek-Asa et al., 2013), work-family conflict (e.g., Wang & Verma, 2012), personal wellbeing concerns (e.g., Dimoff & Kelloway, 2019), career management (e.g., Wang, Lin, & Sha, 2014), psychological problems (e.g., Street, Lacey, & Somoray, 2018), were identified as the main reasons for accessing the programs. Regarding the influencing factors on employee propensity to seek EAPs, in addition to superficial excuses of lack of knowledge (Aseltine et al., 2009; Morrissey, Warner, & Buehler, 2009) or doubt about confidentiality (Hu et al., 2012), more complex and in-depth influencing factors were found to underly employee reluctance to use the programs. For instance, Reynolds and Lehman (2003, p. 238) observed that employees chose not to seek the programs because of low trust in the management and the fear that the stigma of engaging in such programs would have negative effects on their image in organizations. Similarly, Hu et al. (2012) indicated that stigma and perceived negative impacts of EAPs on careers prevented some employees from utilizing them. This shows that EAP efficacy depends not only on external environmental factors but also on the soft environment and employees' internal psychological states.

The third area of thematic foci is relevant to management practices; employers request more scientific and detailed evaluations of EAPs. We categorize the existing EAP evaluation approaches into economic, process, and outcome evaluations. Overall, there is a gradual shift of EAP evaluation from pecuniary tradeoffs (e.g., return on investment) to effectiveness assessment (e.g., workplace outcomes evaluation) although cost-benefits and cost-effectiveness have remained two main evaluation approaches. The first perspective is in line with the tradition of calculating the cost-effectiveness of instituting the programs, mainly focusing on the costs incurred by self-referrals and treatment (Cowell, Bray, & Hinde, 2012), while the latter highlights the enhanced employee-level outcomes before and after EAPs (Hsu et al., 2020; Merrick et al., 2011; Peek-Asa et al., 2013). A new evaluation approach emerged during this period, focusing on evaluating the whole process of EAPs from the outset. For instance, Hsu et al. (2020) developed an evaluation approach following the input-process-output-outcome order, thus evaluating the process of EAPs within five dimensions (management support, plan making, resource allocation, program introduction, and service provision). In short, the evaluation has taken a more actionable and scientific direction. We summarize the existing EAP evaluation approaches in Fig. 3 .

Fig. 3.

A summary of EAP evaluation approaches.

5.3. EAPs and HRM

Considering the practical orientation of EAP as a management construct (Johnson, 1985), it is important to investigate the connection between EAP and HRM to accentuate the significance of more research from an HRM perspective. In the early stages of evolution, we found the link between EAPs and responsible HRM in that ‘a cornerstone of EAP philosophy is the idea that the program improves an employee's prospects for long-term survival in the organization’ (Macdonald, Albert, Maynard, & French, 1989, p. 115). Considering the early programs were oriented toward substance abuse interventions, it could be understood that organizational provision of these programs to problematic employees offered an alternative to the normal course of discipline (layoff). As such, EAPs were seen as manifestations of ethical and responsible HRM and employees benefited from the opportunity to recover from their troubles and conserve their job and career (Roman & Blum, 1988).

In the second stage (around 2000–2010), accompanied by rising coverage of EAPs and increasing business competition, they were performed more closely with strategic and performance-driven HRM. Relatedly, an increasing number of studies (e.g., Spell & Blum, 2005) over this period argued that EAPs could work as effective HRM approaches to solving productivity issues. Based on the performance-driven HRM perspective, Masi and Jacobson (2003) designed a suite of employee-OB and HRM outcome variables, including leader-member relationship and employee performance, to better understand EAP efficacy. This perspective has had long-lasting influences on the understanding of the relationship between EAP and HRM (Kirk & Brown, 2003). In addition, the link between EAP and organizational strategy emerged when scholars emphasized the role of EAPs ‘as strategies for assisting employees’ (Zinkiewicz et al., 2000, p. 63) while reducing ‘uncertainty for management’ (Knudsen et al., 2003, p. 622).

Recently, it has been widely acknowledged that an EAP ‘plays an important role in human resource management’ (Hsu et al., 2020, p. 935). EAPs are increasingly acknowledged as ‘HRM practices implemented to improve outcomes, such as reducing turnover, absenteeism, and improving performance’ (Gullekson, Griffeth, Vancouver, Kovner, & Cohen, 2014, p. 994). The growth of workplace assistance has also facilitated the integration of a more diverse workforce, advancing the link between EAPs and inclusion and diversity management (Anema & Siigar, 2010). Notwithstanding the mainstream performance-driven research, we see a small shift toward wellbeing-oriented HRM. For instance, Hsu et al. (2020, p. 935) pointed out that EAPs could ‘facilitate employee wellbeing’ by delivering managerial support, and organizations can benefit from EAPs' cost-effectiveness in the long run. There is a cluster of empirical research investigating the relationship between EAPs and employee wellbeing (e.g., Donnelly, Valentine, & Oehme, 2015; Rivera, Ford, Hartzell, & Hoover, 2018). The integration of EAPs and wellbeing-oriented HRM has challenged the performance-driven perspective and provided more opportunities for the sustainable development of EAP research and practice. It also represents a significant theoretical shift from viewing EAPs as a management tool to seeing them as part of management strategies.

5.4. Summary and inconsistent research findings

The above analysis addresses both the knowledge bases and boundaries of what we know about the body of EAP research and highlights the need to extend the scope of relevant research and build closer ties with HRM and other theoretical perspectives, drawing on the knowledge base and insights of cognate fields. After a four-decade journey, the concept of EAP has been enriched by gradually incorporating more work- and non-work components, while aligning more closely with HRM and organizational strategy. Most importantly, EAP has been recognized as a means to bridge ‘the gap between employer and employee — to the benefit of both’ (Masi, 2020, p. 3), thus fostering a win-win employment relationship. To better grasp the evolutionary process of the concept, research themes, and the relationship of EAP with HRM, we summarize the main aspects of development in Table 5 .

Table 5.

A summary of the evolution of EAP quantitative research since 1980.

Duration	1980–1999	2000–2009	2010–2020
Key conceptual foci	Mainly focused on substance abuse intervention, with an increasing number of components added to EAPs	Broad-rush rehabilitation programs, with more work-related and non-work-related services included	Daily work performance-oriented programs, with aroused attention on employee wellbeing
Key research area	North America (USA & Canada)	North America, UK	North America, Australia
Key data collection tool	Organizational record	Survey	Quasi-experiment
Key research themes	Antecedents of organizational adoption of EAPs	EAP efficacy on certain outcome variables (e.g., absenteeism, performance)	Influencing factors on employee propensity to seek EAPs; EAP efficacy on manifold outcomes
Key evaluation foci	Cost-effectiveness and cost-benefit analysis	Outcome evaluation	Process evaluation
Key measurement scale & contents	Nadolski and Sandonato's (1987) EAP evaluation scale on five main aspects: lost time, health insurance claims, discipline, accidents, work productivity	Yu et al.'s (2009) 15-item EAP perception scale on employee perception of job-related activities (EAP1) and life- and health-related activities (EAP2)	Hsu et al.'s (2020) 27-item EAP performance evaluation scale on five main aspects: management support, plan making, resource allocation, program introduction, service provision
Key theories	Institutional theory	Social cognitive theory	Social exchange theory
Understanding of EAPs with HRM	EAPs are part of responsible HRM that rehabilitate problematic employees and offer an alternative to the normal course of discipline (layoff).	EAPs belong to strategic and performance-driven HR practices to reduce harm and uncertainty of performance.	EAPs are day-to-day workplace HR practices addressing employee wellbeing and productivity issues.
Key EAP research from an HRM perspective	Bennett et al. (1994); Johnson (1985)	Spell and Blum (2005); Yu et al. (2009)	Gullekson et al. (2014); Hsu et al. (2020)

However, there were some inconclusive research findings. For instance, in contrast to the mainstream research viewing EAPs as a stress-alleviating antecedent, Richmond, Pampel, Wood, and Nunes (2017) reported no reduction in individual stress after employee utilization of the programs. Similarly, EAPs were found to improve employee productivity without reducing stress (Ramanathan, 1992). Regarding other inconsistencies, in Furukawa, Horikoshi, Kawakami, et al. (2012) study, no difference in presenteeism was found after EAPs were adopted. Also, Osilla et al. (2010) observed no group difference in absenteeism, contrasting parallel groups with and without EAP interventions. Interestingly, Caillier (2017) found increased turnover intentions after certain types of EAP interventions. These non-significant results indicate that the functional mechanisms of EAPs warrant further examination.

6. Theoretical advancement

We identified a handful of theories adopted in the reviewed articles (see Fig. 4 ). The theories originate from various disciplines with different foci, such as roles of individuals (e.g., social exchange theory), institutions (e.g., institutional theory), and interpersonal relationships (e.g., social relationship theory, leadership theory). The variety of theoretical origins highlights the complexity of the process of EAP implementation, where institutional, environmental, and personal factors intersect. It also underlines the fragmentation in theoretical foundations. Overall, there is insufficient theoretical engagement in the body of EAP research.

Fig. 4.

The theoretical paradigm of current EAP research.

From the institutional perspective, a ‘top-down’ approach has been employed to investigate the institutional impacts on organizational decisions about EAPs (e.g., Knudsen et al., 2004; Shumway, Kimball, Korinek, & Arredondo, 2007; Zarkin & Garfinkel, 1994). For instance, two early studies sought institutional explanations for why EAPs were adopted and prevailed in certain organizations (Blum et al., 1990; Blum & Roman, 1988). Similarly, it has been argued that EAPs could be effective organizational vehicles to address three types of institutional pressures—coercive, mimetic, and normative (Spell & Blum, 2005). Punctuated equilibrium theory was utilized to foster an understanding of institutional impacts. For example, Spell and Blum's (2005) study shows that although the decision to implement EAPs was internally derived, it was to a large extent driven by radical and significant environmental changes or crises. Overall, institutional theories provide useful explanations for the growth and proliferation of EAPs.

Social cognitive perspectives were mobilized to understand the impacts of organizational adoption of EAPs on individual employees' cognition. Employee perception of EAPs was believed to relate to the social climate, perceived encouragement, and trust in management (Masi & Jacobson, 2003; Reynolds & Lehman, 2003; Yu, Lin, & Hsu, 2009). Based on signaling theory (Spence, 1973), Bainbridge and Townsend (2020) argue that EAPs can be seen as manifestations of responsible and supportive HRM. When organizations (the sender of signals) offer such programs to assist with a wide variety of issues, employees (the receiver) may react positively to their organization after receiving and interpreting the organizational signals of goodwill. Another relevant theoretical perspective, confirmation theory, looked into how organizational communication styles impact EAP implementation. This approach suggests that organizations may benefit from delivering a combination of accepting and challenging messages to employees during the process of EAPs. Specifically, accepting messages are expressions of positivity and warmth, while challenging messages may be when another employee pushes the troubled person to accomplish the changes. A representative study by Dailey et al. (2018) found that EAPs that involve the support of significant others seemed to achieve more progress. In general, these two theoretical perspectives highlight the significant role of social cognition in the process of instituting EAPs and advance the understanding of their importance.

Several studies draw on social exchange theory to explain how EAPs facilitate positive outcomes or reduce harm through the process of social exchange and reciprocity (Avgoustaki & Bessa, 2019; ⁎Caillier, 2016, ⁎Caillier, 2017; Gullekson et al., 2014). Specifically, the provision of EAPs demonstrates the goodwill of organizations expressed through caring measures. Reciprocally, employees may feel obligated to repay the organization for providing helping resources to them. Although there has been a steady increase in applying social exchange theory to EAP research, we suggest that the existing research model may not be sufficient to address the complex functioning of EAPs. To be specific, employers' offering of such programs may be adequate to address employees' adversities, but, due to cognitive bias, may not directly galvanize employee reciprocity toward organizations.

Consistent with the thematic shift, several research strands mobilized social relationship perspectives and leadership theories to offer theoretical explanations for perceived individual differences in EAPs. As Reynolds and Lehman (2003, p. 239) stated, ‘employees notably face a variety of barriers when considering seeking help.’ It is argued that a series of variables relevant to social relationships, such as relationships with leaders, supervisors, and colleagues, exerted significant impacts on employee propensity to engage in EAPs (Delaney et al., 1998; Reynolds & Lehman, 2003). For example, from the leadership-driven perspective, Wang and Verma (2012) shed light on the important role of product leadership in business strategies to promote organizational responses to employees' needs for help.

Finally, emerging research has taken a resource-based approach, albeit immature, for theoretical underpinnings. In this perspective, EAPs are proposed as ‘a resource for employees to use at their own initiative for problems they received’ (Cohen & Schwartz, 2002, p. 1222). Although these workplace resources are remedial and performance-oriented (Walters et al., 2012), they have the hallmarks of flexibility and accessibility, which are regarded as effective approaches to solving both organizational and individual problems (Walters et al., 2012; Wang & Verma, 2012). Despite the progress in this strand of research, few studies use the job demands–resources (JD–R) perspective, in which organizations may benefit from supplementing both work and individual resources, manifesting in the form of work outcomes (e.g., performance), and individual capacity (e.g., resilience).

On the whole, despite insufficient theoretical engagement across existing EAP research, we observe emerging integrations of relevant research with theoretical perspectives in the OB-HRM field, through which the complexity of the process of EAP efficacy could be better understood.

7. Agenda for future research

7.1. Theories for future EAP research

In this section, we list a few theoretical perspectives that may contribute to the theoretical advancement of EAP research, with examples of research questions (see Table 6 ).

Table 6.

Examples of theoretical directions for future EAP research agenda.

Theories or theoretical perspectives	Theoretical connections with EAPs	Example(s) of research question(s) for future research
Conservation of resources theory	EAPs can be viewed as a supplement to job resources and personal psychological resources, which may lead an employee to invest greater resources into their career.	How can organizations benefit from EAPs to obtain positive outcomes through supplementing the psychological resources of employees? What are the dual impacts of EAPs on job demands and resources to facilitate positive outcomes?
Role stress theory	EAPs may promote positive outcomes as a result of the remission of role conflicts, such as work-family conflicts.	How do EAPs work for relieving the role stress of employees? What type(s) of role stress has/have been relieved after obtaining help from EAPs? What is the role of the relief of role stress between EAPs and work outcomes?
Wellbeing-oriented HRM perspective	EAPs can be seen as part of wellbeing-oriented and human-centered HRM practices	How can the implementation of EAPs connect with organizational strategic HRM? What may be the workplace outcomes of enhanced employee wellbeing through implementing EAPs? Why will organizations benefit from projecting wellbeing-oriented practices (e.g., EAPs)?
International HRM and cross-cultural perspectives	Multinationals' localization strategies of EAPs; EAPs on expatriate and cross-cultural management	How do organizations adjust or adopt EAPs to cater to organizational localization strategies? How do organizations implement EAPs to manage expatriates effectively with care? How can international businesses enact EAPs that can deliver care to employees from multicultural backgrounds?
Gender perspectives	Gender may impact employee propensity to EAPs Organizations may tailor specific services for certain genders	Will gender influence employees' propensity to use EAPs? What kinds of EAPs are preferred and utilized by employees of a certain gender? What is the role of masculinity on the individual propensity to EAPs for an employee whose identified gender is male?

7.1.1. Conservation of resources (COR) theory

The COR theory developed by Hobfoll (1989, p. 513) contends that ‘people strive to retain, protect, and build resources and that what is threatening them is the potential or actual loss of these valued resources.’ EAPs can be regarded as a supplement to job resources and personal psychological resources, enabling employees to invest greater resources into their careers, and in turn influence workplace outcomes. Although there is fragmented research employing COR to support arguments in EAP research (Nunes, Richmond, Pampel, & Wood, 2017; Wang & Verma, 2012), future research may revisit the indirect mechanisms through which EAPs may contribute to positive outcomes. In addition, based upon the JD–R model, we encourage researchers to examine EAPs' dual impacts on relieving employee stress and enhancing overall wellbeing, namely, the reduction of job demands and reinforcement of personal resources.

7.1.2. Role stress theory

According to Peterson et al. (1995), role stress is one of the components of job stress and consists of three sub-dimensions; namely, role ambiguity, role overload, and role conflict. The former two dimensions help us understand the risks that unclear and overloaded roles may have for employees, while the focus on role conflict may provide a new, intuitive perspective to explore the mechanism through which EAPs may work to facilitate positive individual and organizational outcomes through the remission of role conflicts, such as work-family conflicts. Therefore, we encourage researchers to establish mediation models to examine the possible bridging function of role stress in linking EAPs and positive workplace outcomes based on this theoretical perspective.

7.1.3. Wellbeing-oriented HRM (WBHRM) perspective

As Guest (2017, p. 22) contends, ‘what is […] needed is a different approach to HRM that is more likely to enhance employee well-being but which may also offer an alternative route to high performance.’ Based on the WBHRM model, organizations are likely to benefit from enhanced performance when employees' well-being is strengthened. Although existing EAPs are deemed more performance-driven than employee wellbeing-oriented, scant research has looked at them as part of the WBHRM practices. We encourage more empirical research employing this theoretical lens to test EAPs' effect on performance outcomes through enhanced employee well-being.

7.1.4. Gender perspectives

Gender differences in attitudes toward EAPs, accessibility to the programs, types of services visited, and the effects of EAPs on gender-related troubles should be given more attention. Given that a large percentage of program users are female (Zeytinoglu, Cooke, & Mann, 2010) and that male employees may be reluctant to attend such programs because of a culture of masculinity (Chan, Neighbors, & Marlatt, 2004), gender issues related to EAPs warrant more in-depth empirical examination to inform organizational practices.

7.2. Opportunities for thematic advancement

7.2.1. Organizational options for the source of EAP provision

A dilemma around EAPs is the in-house provision or outsourcing of them. Why and when do organizations outsource the provision of EAPs? Extant research has mainly addressed this question from a cost-benefit perspective (Cowell et al., 2012; Gullekson et al., 2014; Hipp, Morrissey, & Warner, 2017). However, there are issues other than pecuniary concerns around the delivery of programs to employees. Scholars have highlighted the side effects of outsourcing EAPs to an external party, for instance, the dilution of internal HR participation (Masi, 2020). We call for more empirical investigations on this significant HRM issue, including comparisons of pre/post-outsourced EAPs and their outcomes.

7.2.2. Side effects of EAPs on workplace outcomes

There is limited research on the possible side effects of imposing compulsory EAPs (e.g., for substance abuse intervention) on employee performance or workplace outcomes (Macdonald et al., 1997). In other words, the negative effects of EAPs on individuals and organizations have yet to be better understood. Current research overlooks the side effects for employees who may experience low-quality helping measures, since a large number of outsourced ‘broad-brush’ programs may not be tailored to employees' individual needs. In practice, EAPs may promote laziness and lower organizational performance in cases when employees take unfair advantage of the provision. For instance, employees may ask for more paid leave for the sake of attending treatments. Such behavior may cause harm to or resentment from peers, especially if they have to pick up the workload left by these individuals. As employees' issues and the effects of EAPs may be diverse, more tailored studies will be helpful to shed light on what may be the most effective employee assistance practices for all concerned and under what contexts and boundary conditions.

7.2.3. EAPs under COVID-19

As few, if any, employers and employees have been spared from the disruptions of the ongoing COVID-19 pandemic, it is timely to call for more research into the fit between EAPs and global crises such as pandemics, as well as prospective research on how EAPs need to be adapted to the ‘new normal’ post-COVID environment.

First, we call for empirical investigations into the preventative function of EAPs, as COVID-19 makes it clear that, for both organizations and individuals, daily preparedness for disruptive events, namely resiliency, is particularly important. We identify the preventative functions of EAPs as a significant research gap. We argue that delivering organizational care not only assists employees and their families to rehabilitate, but also conserves energy so that employees can bounce back with recovered productivity. The supplementary resources offered by EAPs may extend personal resilience at work, and organizations will undoubtedly benefit from the programs when drastic workplace changes are needed. We recommend more investigations into the accelerating use of artificial intelligence (AI) and remote services in delivering EAPs under COVID-19. We see several interesting but controversial EAPs that are managed largely by AI at a small cost. However, whether these programs are as effective and intelligent as the traditional ones deserves empirical investigations. The efficacy of remote delivery of assisting services also warrants empirical examination.

7.3. Opportunities for empirical advancement

7.3.1. Improving EAP measurement

Consistent with Joseph et al. (2018), we argue that current evaluation approaches may not unfold the intrinsic value of EAPs. Regarding the measurement scale, most researchers processed EAP as a dichotomous (yes/no) variable (e.g., Bainbridge & Townsend, 2020; Henning-Smith & Lahr, 2019), which may not capture the intrinsic and complex contents of EAP as a comprehensive workplace construct. Fortunately, there is a growing body of contemporary research responding to this concern. For instance, Hsu et al. (2020) developed a 27-item scale to evaluate EAP performance by five dimensions validated through both qualitative and quantitative data. However, this scale is yet to be validated outside Taiwan. We advocate more research to check its reliability and see whether some of the measurement items can be simplified.

7.3.2. Improving research design

Our review shows the prevalence of quasi-experimental methods for EAP research, which reveals the potential for incorporating more experimental research into management disciplines. However, selection bias may exist in the group division, considering the limited samples. A potential solution for reducing these concerns may be the adoption of mixed-method research. By applying multiple regression methods to the experimental data, the results of research into EAP performance may be more reliable. In addition, we call for more future research addressing the possible cognitive bias in the data collection period, given that the majority of current studies used self-report as research data (Joseph et al., 2018).

Furthermore, we call for bringing more mediators, moderators, and outcomes into EAP research to enrich the research models. In terms of outcome variables, resilience is overlooked, considering its important role in the turbulent business environment. Concerning mediators, more strategic HRM-related variables, such as high-involvement work systems and high-performance work systems may be employed to fuse the link between EAPs and HR strategies. In addition, our review reveals the neglect of the roles that organizational and cultural contexts play as moderators. For instance, organizational change is a reasonable context variable to influence both employees' utilization of EAPs and the outcome variables. Cultural impacts are also overlooked, considering the contrast of power distances in Western and Eastern societies. Additionally, more employee wellbeing-oriented HRM variables are yet to be tested as mediators to consolidate the functional mechanisms of EAPs on workplace outcomes, such as employment security and job quality.

8. Conclusions

This review paper synthesizes existing literature on the under-researched HRM construct of EAPs, with a retrospective analysis of the evolution of the EAP concept in the literature, theoretical and thematic advancements, and links between EAPs and HRM. Through a systematic review of the quantitative research on EAPs in the last four decades, we contribute to the extant literature in three ways. First, we challenge the assumption of prior research, which regards EAP as a utilitarian construct targeting productivity improvement. We put forward our definition of the multi-faceted concept by stressing both remedial and preventative functions of EAPs, with a stronger emphasis on employee wellbeing as a core concern. Second, we broaden the understanding of EAPs as a clinical intervention or counseling service by highlighting their strategic roles as part of HRM. Finally, we identify the meta-trend of the evolution of EAPs by stepping back and delineating how the literature has evolved in three time periods. As Milne et al. (1994, p. 124) stated, ‘rigorous research on EAPs […] has not kept pace with their rapid proliferation across organizations.’ In closing, we highlight opportunities for theoretical, thematic, and methodological advancements. We hope this review serves as a starting point to advance the understanding of EAPs from an HRM perspective, and call for more rigorous academic research contributing to this important field.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of Competing Interest

The authors have no competing interests to declare.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Appendix A. A summary of extant EAP review studies (N = 6)

No.	Author (s)	Published⁎ Journal	Time span	Review base	Review focus	Review insights	Review limitations
1	DeGroot and Kiker (2003)	HRM	1950s to 2003	22 published journal articles, books, and unpublished research	Effectiveness of employee health management programs (EHP) on employee job performance	A systematic meta-analysis on the effects of EHPs on employee job performance	Narrowly focusing on EHPs with insufficient data for analysis; regarding EAPs as part of EHPs.
2	Csiernik (2005)	EAQ	1990s to 2005	39 published studies	EAP evaluation	A comprehensive review of EAP evaluation approaches in North America	Incorporating North American research only
3	McLeod (2010)	CPR	1980–2005	N/A	Effectiveness of workplace counseling	An in-depth analysis of the positive impacts of workplace counseling on workplace outcomes; insights on the possible deteriorating effects of workplace counseling	Limited sample for analysis; regarding EAPs as part of workplace counseling.
4	Azaroff et al. (2010)	JWBH	1982–2008	103 peer-reviewed articles	EAPs' impacts on workplace stress	A clear division of the impact of different EAP services on diverse sources of stress at both organizational and individual levels	Focusing only on EAP efficacy on stress
5	Csiernik (2011)	JWBH	2000–2009	42 publications	EAP evaluation	A clear summary of EAP evaluation approaches	Solely focusing on EAP evaluation; only incorporating North American research.
6	Joseph et al. (2018)	EJWOP	2005–2016	17 peer-reviewed journal articles and Doctoral Dissertations	EAPs on various employee and organizational outcomes	Presenteeism and absenteeism as appropriate outcome variables to evaluate EAP efficacy	Limited studies included for in-depth analyses; lack of categorization of EAPs

^⁎HRM = Human Resource Management, EAQ = Employee Assistance Quarterly, CPR = Counseling and Psychotherapy Research, JWBH = Journal of Workplace Behavioral Health, EJWOP = European Journal of Work & Organizational Psychology.