After Rehab - Transitioning Back to Work

Employee Information Servicesance abuse continues to be a major health issue with no signs of abating, employers must address the question of allowing employees to access treatment for alcohol and other drugs of abuse. Many companies are recognizing that sending employees to rehabilitation for substance abuse is cost effective, and are including provisions for treatment in their policies. The costs of replacing and re-training an employee, especially one who has been with the organization for a significant period of time, are greater than the cost of treatment.

If a company has decided to allow employees to seek treatment, either after coming forward voluntarily and admitting to a problem or after testing positive on a drug and/or alcohol test per the company drug testing program, the story doesn't end when the primary portion of treatment is over. There are many important transition issues that "pop up" as the employee returns to work.

Confidentiality
Confidentiality is probably the employee's biggest concern. Since many people are embarrassed about their substance abuse, they often attempt to hide the extent of their dependence even from their families. It is often even more humiliating for recovering individuals to have co-workers and subordinates learn of their condition. The worst case scenario is when co-workers find out about the employee's rehabilitation because of a lack of confidentiality on the part of management.

Therefore, managers and supervisors have a responsibility to their employees to maintain strict confidentiality. It is highly advisable to keep a separate file for confidential documents related to the treatment. It is also wise to limit the number of management members with knowledge of the treatment to a "need-to-know" basis.

Sometimes co-workers will ask direct questions of management about an employee's whereabouts if he or she is absent while in treatment. Managers are encouraged to handle the questions with respect for the employee's privacy, and to let the co-worker know that management is not at liberty to discuss the matter. There are also legal ramifications to divulging confidential information to co-workers.

One area where respect for confidentiality and discretion are extremely important is follow-up testing. If your company policy requires follow up testing after rehabilitation, the manner in which you notify your employees can become extremely important. There is a big difference for a manager to discreetly call an employee into his/her office to send him or her in for a test at the beginning or end of a shift. The absence is less noticeable than the manager walking into the employee's work area and stating for all to hear, "Hey, Fred - go for your drug test!"

Relapse
The first year of recovery from chemical dependence, whether from alcohol or other drugs, is the hardest. Relapse will most likely to occur in the first year. Treatment centers usually offer aftercare or continuing care services to lessen the likelihood of relapse. Companies that make aftercare attendance mandatory usually find the relapse rate drops dramatically.

Review your policy with your recovering employee carefully. If your policy has a strict limit on the number of times an employee may test positive and be referred to treatment, or simply the number of times an employee will be allowed to enter treatment, then it's critical the employee understand the limits of the policy. Let the employee know that while the company supports his or her recovery, the drug and alcohol policy will be enforced in the same manner as for any other employee. Do not make exceptions or excuses for employees just because they have been in rehab.

Keep the Door Open
While it's not advisable to play "counselor" with your employees, it is helpful to keep an open door policy and encourage employees to talk about the transition back to work and the subsequent adjustments. Some of these adjustments may include changes in social patterns that are difficult for the employee. If he or she was accustomed to "happy hour" after work, or engaging in social activities such as sports events where alcohol was a part of the camaraderie, the employee may feel isolated.

One important area for your company to explore is the underlying message being sent to employees about alcohol and other substance abuse. If co-worker drinking is encouraged, this makes the challenge of sobriety more difficult for abstinent employees. Search avenues to foster non-drinking events. Posting information prominently about the company employee assistance program and educational materials about alcohol and other drugs of abuse create an atmosphere of company caring and responsibility.

The Challenge of Compliance
One of the greatest challenges in coping with a recovering employee is monitoring compliance with treatment. Many employees continue to work while in treatment. This is commonplace and often advisable from a therapeutic perspective. However, managers may wish to have the employee sign a "rehabilitation agreement" at the onset of treatment to stipulate terms of compliance.

Non-compliance indicators include poor attendance, testing positive on treatment center drug or alcohol tests after the detoxification period, refusal to follow treatment plan goals such as attendance at outside support group meetings or generally disruptive behavior. If management can establish a method of being informed by the treatment provider about non-compliance, then the employee can be warned. Warning letters are preferable, with dates and times of non-compliance and deadlines for compliance. Remember - you will need to have the employee sign a consent form in order for treatment counselors/staff to alert you to non-compliance. Due to confidentiality, it is best to inquire about attendance and general compliance - do not ask to be informed of the treatment sessions.

Check with your Employee Assistance service or third party drug testing administrator to find out if they offer compliance monitoring services. The nominal cost for these services is well worth it. It takes management out of the line of fire and places trained professionals in the monitoring position.

Informed Caring
If you are a manager, supervisor, HR representative or play some other key role with a recovering employee, make it your business to educate yourself about substance abuse. Know the signs of relapse and keep the lines of communication open. Impart a message of informed caring, but make it known that job performance standards will not be weakened because someone is in rehab. You will find that consistency in the following critical areas will improve the success rate for your recovering employee:

• respect for confidentiality,
  
• understanding relapse and the need for continuing care,
  
• an "open door" attitude
  
• an emphasis on compliance

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