Employee counseling approaches are affected by a common set of issues, including effectiveness and ethics. While a considerable amount of the evidence to support these interventions is based on anecdotes, the trend is toward more rigorous studies. Several factors make it difficult for rigorous research to be conducted on these topics. The personal nature of many problems addressed by counseling, such as substance abuse and mental illness, may make organizations reluctant to allow researchers access to the data needed.

Federal and state legislation and regulations have had a significant impact on employee counseling programs, especially in the area of alcohol and drug abuse. In the case of substance abuse, reasonable accommodation is interpreted to mean the employee must be permitted the time necessary for the treatment to take effect before firing for poor performance is justified. Employees, the organization, supervisors, HRD professionals, and unions all have roles to play in employee well-being. Organizations stand to gain significant benefits from efforts to improve employee mental and physical health.

Confidentiality is a key concern in all types of employee counseling interventions. It is possible that participating in a counseling or fitness program can have unintended negative consequences. Employees participating in fitness programs could experience scheduling problems, increased fatigue, and/or lower performance. There is little research on this topic to guide organizations in making decisions, though anecdotal evidence suggests that a comprehensive wellness program can, in fact, decrease workers’ compensation costs.