Adapting EAP to
Support Expatriate
Populations.
Global Business News Conference
Monica Ratcliff, LCSW PHR
Chicago IL, USA
EAP Program Director, Caterpillar Inc.
June 13, 2014
Todd Donalson, MA LCPC
Director of Training & Consultation, Chestnut Global Partners
Agenda
1.
The personal impact of global mobility
2.
Expat mental health research
(CGP & Caterpillar collaboration)
3.
Caterpillar’s IAP program
2
What “Risk” Are We Managing?
A failed expat assignment may be defined as:
. . . early repatriation of the employee and/or family
. . . a lack of optimal job performance
. . . family or employee “burnout”
. . . negative interactions between cultures
. . . family or employee stress / illness
. . . turn-over, even after repatriation
3
Expatriate success.
Does the assignment
maximize the benefits to all
three?
1. General Adjustmentgeneral living, lifestyle
and family
2. Work Adjustment- job
tasks in a foreign
workplace, performance
measures
3. Interactional
Adjustment- interactions
with host country
nationals
4
Risks / Benefits
of an expatriate
assignment.
Factors Responsible For Assignment Failure (excluding attrition)
GMAC 2006 Global Relocation Trends Survey Report.
Spouse/Partner dissatisfaction
57%
Inability to adapt
47%
Other family concerns
39%
Poor candidate selection
39%
Job doesn't meet expectations
34%
Poor job performance
34%
Poor mgt of assignee
23%
Quality of life
15%
Dissatisfcation with C+B
Safety and security
0%
5
9%
5%
10%
20%
30%
40%
50%
60%
Reason For Early Return
Brookfield 2012 Global Relocation Trends Survey Report
Family concerns
33%
Early completion of the assignment
19%
Tranfer to a new position
17%
Career concerns
5%
Secruity concerns
3%
Cultural adjustment challenges
3%
0%
6
10%
20%
30%
40%
Are Companies Doing Enough To Address
Relocation Stress Experienced By The Family
 Family suitability was a competency assessed in the selection process
of only 29% of candidates Brookfield 2012 Global Relocation Trends Survey Report
 One half of all expats report their company does not do enough to
support their personal needs
National Foreign Trade Council, Cigna, Worldatwork. 2002.
 Less than 20% of companies provide any assistance for the personal
needs of the spouse and family
SHRM/Willimatte university study, “Emerging Trends in Global Mobility: An Assignees Perspective. 2004)
7
Circumstances That Impact Expatriate Health & Productivity









Increased workload
Isolation, loneliness, lack of social support, language barriers
Cross-cultural adjustment and culture shock
Unreliable means of communication/transportation
Difficult living conditions/harsh environments/pollution
Reduced access to medical and professional services
Exposure to suffering, violence, insecurity, poverty
Risk of infectious disease
High expectation of self-sufficiency
All of these increase stress and the risk of emotional and
social problems (work and home)
8
What Do We Know About Expat Mental Health?
 Expats are commonly assumed to be more resilient
because they are often high performing employees.
 Mental health professionals, however, have suggested
that the stress of cultural adjustment places expats at
higher risk.
 There are few empirical studies of mental health risk in
expats. Most are anecdotal reports or case studies.
9
Historical study
U.S. nationals vs. expatriates
50%
50.8%
40%
30%
20%
10%
12.7%
17.5%
7.7%
3.7% 3.4%
3.2%
0%
Alcohol use
disorders
Depression
Adjustment
disorders
Anxiety
U.S. nationals National Comorbidity Study, 2006
Expats, Valk, 2002
10
Research Study:
Truman, Sharar & Pompe (2012)
 Cross sectional comparison of 2 large multinational
employers headquartered in the US.
 Expatriate Group (n=455) living overseas > 6 months.
 US Based Group (n=1460)
 Each group comprised of production and management
employees
The Mental Health Status of Expatriate Versus U.S. Domestic Workers. A comparative Study. Truman, Sharar
and Pompe. International Journal of Mental Health. Vol. 40. No. 4. Winter 2011-12. pp 3-18.
11
Increased Risks For Expatriates
The Mental Health Status of Expatriate Versus U.S. Domestic Workers. A comparative Study. Truman,
Sharar and Pompe. International Journal of Mental Health. Vol. 40. No. 4. Winter 2011-12. pp 3-18.
12
Principles of Adapting Traditional Mental Health
and Support Programs For Expats
 Expats don't typically use traditional passive EAP support
programs. They suffer silently due to distrust.
 Ongoing communication and awareness is critical.
 Healthcare coverage alone isn’t enough. Finding providers,
particularly those sensitive to expat and workplace issues, is
complex.
 Confidentiality and easy access are more important.
 Services must accommodate the “life cycle” of an expat
assignment, including after the assignment.
13
Caterpillar’s International
Assistance Program (IAP)
IAP
14
Caterpillar’s International Assistance Program (IAP)
15

Early 2000s, Caterpillar had over 1000 expats

Virtually no EAP outside North America

Expats appeared dissatisfied

Generous relocation
policy but minimal
personal (EAP-type)
support provided
International Assistance Program (IAP)
16

The IAP model was created jointly by Caterpillar and
Chestnut Global Partners

Piloted in 2003-2004. Implemented October 2004

Goals

Provide confidential, global and culturally relevant personal
support for ISEs and families at no charge

Minimize risks of family adjustment and personal problems

Enhance the ISE experience for the family and those in the
company supporting ISEs
IAP
Emotional lifecycle of an expatriate assignment
H
I
G
H
HOME
COUNTRY
HOST
COUNTRY
HOME
COUNTRY
Emotion
& Energy
Level
L
O
W
Excitement/
anxiety
17
Honeymoon
Burnout
Adjustment/
settling in
Stages repeat
Key elements of expat support
Pre-acceptance
consultation:
.
H
I
G
H
HOME COUNTRY
HOME COUNTRY
.
.
Emotion
& Energy
Level
L
O
W
Pre-departure
outreach and
counseling
HOST COUNTRY
Repatriation
outreach and
support:
Destination
outreach:
.
On going outreach
and clinical services
(counseling and
referrals):
Adjustment Stages Over time
18
.
.
Ongoing outreach
and support post
repatriation
IAP Services
 Pre-departure meeting with family
 Proactive Outreach (phone & email) to employee and
spouse during assignment for support
 Referral to “in country” EAP for counseling as needed
 High touch case management
 Educational Support – Webinars by expats,
Web products, newsletters
 Educational booklets tailored to children
 Virtual spousal support group
 Repatriation support
19
International Assistance Program (IAP)
“I am grateful for having this “safe haven” to reflect, have healthy discussion, and
receive a little help from someone who is qualified when I have wandered a bit off
my path. The IAP has contributed very positively to my satisfaction with this
assignment, my respect and loyalty toward my employer, and my overall mental
well-being. I would not recommend an international assignment to another without
such a program being available.”
- An ISE located in Europe
"When our family moved from Europe to the Midwest, the 3 first months were
chaos. There were so many things to do, to discover, and so little time to breathe.
Then after 6 months, one morning, at 4 am on the day we were supposed to
celebrate our daughter's birthday, a terrible "homesick feeling" hit me really hard. I
called the 24/7 phone number of EAP and I’m really glad I did. The person I spoke
with helped me get through the rest of the day, thanks to her listening skills and her
professionalism. I knew I was in good hands. I started counseling a few days later
and that help was precious through the most difficult moments.”
IAP
-ISE spouse in the U.S.
20
Clinical EAP Utilization
25%
21%
18.0%
20%
13%
15%
10%
14%
8.4%
100
cases
13.0%
222
209
5%
15%
250
11.0% 12.0%
160
129
164
123
120
0%
2005
2006
N = 1188 N = 1264
21
2007
N = 1495
2008
2009
2010
2011
N = 1668
N = 1047 N = 906
N =978
2012
2013
N = 1085 N = 1010
Caterpillar Expat Survey Data
Percent reporting dissatisfaction with . . .
Emotional state
Social
relationships
Marital
relationships
Pre IAP
22
Family
relationships
Job
After first year of IAP
Kids'
educational
experience
Caterpillar Expat Survey Data
Percent reporting dissatisfaction with . . .
29%
decrease
27%
decrease
36% decrease
Prior to IAP
After first year of IAP
59%
decrease
Support with
policy
23
Overall HR
support
Support finding
healthcare
Level of personal
support
Caterpillar Expat Survey Data
Percent who have considered early repatriation
49% decrease
Pre IAP
1-year
follow up
57% decrease
Considered early repat
due to personal problem
24
49% decrease
Considered early repat
due to work problem
Family considered early
repatriation
“How has your personal life been affected while living
abroad?” Percent reporting a “negative” impact.
49%
39%decrease
decrease
Pre IAP
25
1 year follow up
Percentage of expats reporting more than 4 days absent
“due to a personal or emotional problem.”
39% decrease
26
Monica Ratcliff
EAP Program Director, Caterpillar Inc.
Ratcliff_Monica@CAT.com
Todd Donalson, MA LCPC
Director of Training & Consultation
Chestnut Global Partners
tdonalson@chestnut.org
Key citations and references
28
•
Claus, Lungu & Bhattacharjee (2011). The Effects of Individual, Organizational
and Societal Variables on the Job Performance of Expatriate Managers.
International Journal of Management Vol. 28 No. 1 Part 2 Mar 2011 249
•
Brookfield Global Relocation Trends Survey. 2012.
•
GMAC Global Relocation Survey (yearly).
•
Cole, (2011). Managing global talent: solving the spousal adjustment problem.
The International Journal of Human Resource Management. Vol. 22, No. 7, April
2011, 1504–1530
•
Truman, Sharar & Pompe. The Mental Health Status of Expatriate Versus U.S.
Domestic Workers A Comparative Study. International Journal of Mental Health,
vol. 40, no. 4, Winter 2011–12, pp. 3–18.
•
Valk, (2003) Sending employees and families overseas: Mental health in the
workplace abroad. In J. Kahn & A. Langlieb (Eds.), Mental health and
productivity in the workplace (pp. 155–168). San Francisco: Jossey-Bass.
•
A.P. Copeland, S.K. Norell / International Journal of Intercultural Relations 26
(2002) 255–272 261