What a standard EAP covers, and where it stops

The category is more standardised than the marketing suggests. Almost every UK EAP is some combination of these.

• A 24/7, 365-day telephone line, answered by a counsellor or an adviser, for in-the-moment support.
• A clinical assessment that decides whether someone is referred on to structured counselling.
• A fixed number of counselling sessions if they are referred. Typically six or eight, usually per issue per year.
• An app or portal with self-help material, mood tracking and sometimes live chat.
• Information lines for legal, financial, debt and consumer questions, which are often used more than the counselling is.
• Manager support and critical incident response as an add-on or a higher tier.
• Aggregate reporting to the employer on usage.

We sell something else, so take this as a statement against interest: there are things an EAP does that we do not, and a buyer who has not thought about them will make a bad decision.

• It answers at three in the morning. An appointment-based therapy service does not. If somebody in your organisation is in distress at an hour when nothing else is open, a staffed line is worth a great deal, and nobody should give that up lightly.
• It covers problems that are not clinical. A large share of EAP contact is about debt, housing, a legal question, a bereavement. Routing those to a therapist would be both expensive and wrong.
• The cost is predictable. A per-employee licence is one budget line that does not move with usage. For a large workforce and a finance team that hates variance, that is a genuine feature and not just a vendor convenience.
• It is one thing to communicate. One number, one app, one benefit to explain at induction.

If those are the problems you are solving, an EAP is the right purchase and you should buy one. The rest of this page is about the part that is often assumed to be covered and often is not.

The session count is not a secret. Several UK providers publish it plainly, which is to their credit and makes it a fact about the category rather than an accusation about anyone.

Set that against the outcome research. A systematic review of twenty-six studies of therapy delivered in real services put optimal doses between 4 and 26 sessions, varying by person, problem and setting. The classic dose-effect study found roughly half of patients measurably improved by session eight and roughly three quarters by session twenty-six.

So six is not a scandal. Six is inside the evidence range, at the lower end, and for a great many people it will be enough. The structural problem is different: the number is fixed before anyone knows who is asking. The person whose difficulty needs eighteen sessions and the person whose difficulty needs three both get six. One finishes early. The other stops in the middle, at the point they had built enough trust to start doing the work.

Our own view on how much to fund, with the sources laid out and the contested parts flagged, is on how many therapy sessions actually help.

In most EAPs the pathway is assessment then allocation: someone is triaged, then matched to an available counsellor from a network. It is efficient, and it is how you staff a service that has to answer every call.

It also means the single largest predictor of whether therapy works is left to chance. The therapeutic relationship is not a soft extra on top of the technique; it is one of the most consistent findings in the outcome literature. A person who does not click with the counsellor they were given usually does not complain. They attend twice, decide therapy is not for them, and quietly stop, having used two of their six sessions to find that out.

You will be shown utilisation rates and return-on-investment multiples. Treat both with the scepticism you would apply to any vendor-supplied figure, including ours.

A spread from roughly 3% to over 12%, much of it attributed to the same trade body, is not a number you can plan with. It is a reason to ask what is being counted: a phone call to an information line and a completed course of therapy are both "utilisation", and they are not remotely the same purchase.

This is why we publish no comparison table of our own. We cannot independently source market-wide figures, and a table built on numbers we could not stand behind would be worth less than nothing on a page whose entire argument is that you should ask providers for their sources.

• Large workforce, unpredictable needs, wants 24/7 cover: an EAP. This is what the product is for.
• A specific group who have been through a specific thing: a bounded programme, not a benefit. See incident and change support.
• A small team where a per-head licence buys coverage nobody uses: pay for sessions delivered. See how employer-funded therapy works.
• Your customers rather than your staff: neither. An EAP is an employee benefit and cannot be pointed at the public. See crisis response.
• You already have an EAP and people are running out of sessions: keep it and put funded therapy behind it, rather than upgrading an entire workforce to a higher tier to serve the few who will use it.

• Which register is each practitioner on, and can we have numbers to verify?
• Is there a difference between the organisation being accredited and the person in the room being registered?
• What happens to someone who needs more sessions than the allocation?
• Does the person choose their therapist, or get assigned one?
• What exactly will our organisation receive about who used it?
• Who, other than the therapist, can hear or access a session?
• Where does the source for that utilisation or ROI figure come from?

The first two are the ones most likely to separate providers, and they are set out in full on our clinical governance page. The full buyer's checklist, written to be used against us as well as anyone else, is in how to choose a therapy provider for your organisation.