Show Notes

Welcome back to the Designer Practice Podcast, and I’m your host, Kayla Das.

It’s not uncommon for therapists to accept EAP, or Employee Assistant Program, contracts as an independent contractor in private practice. In fact, for many private practitioners, this is the first stepping stone into private practice that doesn’t feel so scary.

In today’s episode, I’ll be discussing the advantages, disadvantages, and some considerations to think about before accepting an EAP contract within your private practice.

As you might already know, I am pro doing whatever aligns with your values and your vision. I don’t believe that there’s one right or wrong way to run a business. The only way is your way.

Defining Your Values and Vision

So, when it comes to accepting EAP work, I believe the first place to start is by asking yourself, what are my private practice values and vision? And once you have clarity on what your values and vision are, you can then ask yourself, will accepting an EAP contract, or any other contract for that matter, support you in following through with those values and vision?

Now when it comes to our values and vision, the most common thing that I hear from therapists is that their value is flexibility and freedom and their vision is to have a full caseload of full paying clients. And to some accepting a contract that doesn’t give full- pay may seem counterproductive to the goal, but that’s not entirely true.

When we think of our values and vision, it’s also important to consider the stepping stones that can help you get to the main goal. Because one of the biggest things that prevent therapists and coaches from ever opening their private practice to begin with is fear. Whether it’s fear of not getting enough clients, not making enough money, failing, and so on. But when we have stepping stones that narrow these gaps, it can feel less scary, and it moves us towards the bigger vision, to one day have that full caseload of full paying clients.

Sometimes we imagine ourselves having to jump into water without a life jacket. But for many therapists starting out, that’s rarely the case. When I started out, I did choose to accept an independent contract as I grew my practice with full pay clients. And because I started with the contract, within about two and a half months, I had enough clients that I felt ready to quit my day job and move into private practice full time. Of course, at this time, I did not have a full caseload of full paying clients. But I did have enough clients to support the financial goals I had at the time. I don’t know if I would have felt confident enough to jump into the water if I didn’t have a contract job as my life jacket.

What the life jacket represents for you may be very different from me, or from your colleagues in the field. For some, it may be having a nest-egg of cash to support the transition, so that if it takes a little longer to fill your caseload of full paying clients, you don’t feel under pressure. For others, it may be hiring a marketing team from the start to get ongoing clients coming in quickly. Or, like me, it may be accepting a contract to support the flow of clients, even temporarily, so that you can start your private practice with a little less fear. But let’s be honest, the fear won’t totally be absent regardless of your life jacket because you are still jumping into a big ocean. Whatever a lifejacket means to you, just remember that no one expects you to jump in without it, unless you’re prepared to swim and if this is you, all the power to you.

Advantages and Disadvantages of Accepting an EAP Contract

So, with all of that being said, let’s dive into the advantages and disadvantages of accepting an EAP contract.

Now I want to provide a disclaimer before we start though, that you’ll notice that I’ll say the words “some EAPs”, a lot. And that’s because all EAPs, or even group practices for that matter, have their own standards, policies, and expectations. So, it doesn’t mean that all of these advantages or disadvantages that I outline occurs for any particular or all companies or EAP programs, because they all run independently from each other.

But the intention behind listing the advantages and disadvantages is so that you can think about what aligns or doesn’t align with your values and vision and help you prepare for questions for the interviews and/or contract negotiations if you decide to apply or accept an EAP contract.

Advantages

So, any who, let’s start with the advantages.

So, because EAPs tend to have a lot of employers on their roster, they tend to have a lot of available clients to work with, so you usually don’t have to worry about searching for clients or getting clients.

Also, because it’s an EAP program, clients are not usually paying for their services out of pocket, and they tend to come in with very different expectations, specifically regarding the speed of progress or recovery, than paying clients. One of the biggest differences that I’ve noticed is that clients who have sessions covered through their employee assistance programs tend to worry less about the financial cost, because of course they’re not paying, and don’t necessarily expect quick results with counselling as those who are paying out of pocket.

Also, depending on your niche, you might see more specific types of client issues than others. Let me give you an example, if you work with people who experience workplace issues, there’s a good chance that their employer has an EAP program that they can access. As a result, their EAP program would likely be the first place that they’ll seek help over out-of-pocket options. And this is because it’s accessible and free of cost.

In addition, EAPs tend to do all of the billing for you and you get paid on a specific schedule for the sessions that you’ve complete. This can decrease your administration time so that you can work with more clients and not have to worry too much about when or how you get paid.

Some EAPs offer access to a charting or booking system that you can get access for free when working with their clients so you don’t necessarily have to go out and buy a monthly subscription to a practice management system, unless you work with clients outside of that EAP.

And the final advantage, at least since the pandemic, many EAPs have telehealth and/or virtual therapy options for clients so that they can reach their therapists, so you can work with clients from the comfort of your own home or in your own office space.

Disadvantages

Now let’s go into some of the disadvantages.

Depending on your niche, you might actually see less of a specific type of issue. This might depend on the client’s ability to access the Employee Assistance Program, or just the type of services that an EAP covers as part of their plan. Typically, family members who are covered under the employee’s health plan can be covered under the EAP as well, so a spouse or child can still access the program, even if they’re not employed. But again, depending on your private practice niche, you may see a little less of a particular issue. Again, whether it’s because people can’t access the EAP program or the EAP program only covers certain types of issues.

When it comes to working for EAP programs, the pay per session on average tends to be much lower than other type of contracts, such as accepting a contract in a group practice. It’s not uncommon for EAPs to have an almost employee-like pay structure versus a typical pay-split that most other therapy contracts provide. I’ve heard of EAPs paying anywhere from $30 a session to $80 a session. Of course, there are EAPs out there that pay more, but it’s important to best understand your current financial and caseload capacity to determine if you did accept an EAP contract at a lower rate, will it still align with your values and vision, whether short-term or long-term?

Because clients tend to not pay for their sessions under the EAP program, some clients may be less committed to sessions and you may notice more no shows or late cancellations than paying clients. And that’s because they are not paying out of pocket. So, they are not paying for any late cancellation or no-show fees. Now, a side note though is some EAPs may pay you even if a late cancellation or no show occurs. So, if this is the case, you may not be at a financial loss for the session. So, it’s important to really know is this something that the EAP does intend to provide you if someone is a no show.

Depending on the client versus therapist ratio of the EAP, therapists may be strongly encouraged or even pressured to accept more and more clients to fit the client demand. This in turn can prevent you from building your own practice. gaining the flexibility and freedom that you’ve been looking for and ultimately, lead to burnout or compassion fatigue.

EAPs tend to have stricter policies and procedures that therapists must adhere to. I’ll discuss this a little more in the consideration section of this episode.

And to add to the stricter policies and procedures, some EAPs may have strict case note documentation deadlines where you may be expected to have your case notes written within, say, a 24 hour or 48-hour timeline to be paid. Although, we all know it’s good practice to get these pesky case notes completed as soon as possible, we also know that sometimes it is unrealistic or impossible to complete this within a 24 hour to 48-hour time period, especially if you’re working with six to seven clients per day or a personal or professional emergency happens.

Considerations

Now I’m going to discuss some considerations to think about before accepting an EAP contract.

First of all, ensure that if you’re accepting a contract, that you’re being hired as an independent contractor and not as an employee. Some EAPs only hire therapists as employees, and if you accept an employee relationship over an independent contractor relationship, it could impact financial and job function flexibility.

If you’re thinking to yourself, “How do I determine if I’m being hired as an employee or an independent contractor?” And you’re a little uncertain about what the difference between both are, you can check out Episode 38, Employee vs. Independent Contractor: Which is best for you and your practice, by heading to kayladas.com/episode38, after you finish this episode, where I give you a breakdown between the two.

As I mentioned in the disadvantages section, EAPs tend to have stricter policies and procedures that therapists must adhere to. These policies may include a specific timeline for case note documentation to be completed. There might be a specific booking procedure or schedule where you have limited ability in choosing the types of clients you receive or control over your own schedule. Even if you have the control to choose your schedule, you may be bound to that schedule. And let me give you an example, if they ask you to provide notice 30 days in advance of what your schedule might be, you might say Mondays and Tuesdays, and even if you don’t get clients during that time from the EAP, you might find it difficult or even impossible to fill the gaps that it leaves. When it comes to contracts, I personally prefer when I have the ability to schedule clients within my existing schedule as I see fit and not necessarily have to provide advance notice of my availability. But again, this really depends on what works for you and what works for your practice.

And for me, this consideration was a deal breaker when I first started my private practice. The non-competition clause. Even though non-competition clauses are controversial in hiring contracts, they are often still used in therapy contracts today. So, it’s important to understand what the EAP is asking of you in your contract and are they requiring you to sign a non-competition clause in order to work with them? And if they do what do they consider competition? Are they preventing you from working with another EAP? Or does it prevent you from accepting any other contract, say with a group practice? Or are they even restricting your ability to work in and grow your own private practice? These are important considerations when we go back to your values and vision. When I started out, I knew that my number one priority was to grow my business. So any contract that asked me to sign a non-competition clause, I immediately turned down.

If you want to learn a little more about non-competition clauses, I actually have an episode that goes into detail about the differences between non-competition and non-solicitation clauses. It’s Episode 28: Non-Competition versus Non-Solicitation Clauses: Are they legally enforceable in contracts? And you can check it out by going to kayladas.com/episode28. In this episode, Corinne Boudreau, a Nova Scotia lawyer breaks down when these contracts are and are not enforceable by law. So, I hope you find it helpful if you decide to accept any contract EAP or otherwise.

Conclusion

So that’s it! The advantages, disadvantages, and some considerations to think about when deciding if becoming an independent contractor for an employee assistance program is right for you in your practice.

Thank you for tuning in to today’s episode, and if you like this episode or the Designer Practice Podcast as a whole, I would really, really appreciate if you would share this podcast with a colleague or someone in your own community, so that other therapists can tune into the podcast as well.

Until next time, bye for now!

Credits & Disclaimers

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