How Do I Make a Referral?
A Tool For Managers


Handling situations in which employees are not performing up to expectations is hard work, takes time, and may be awkward or uncomfortable. It is natural to hope the issue will resolve itself, but the earlier a concern is addressed, the greater chance one has of keeping it from becoming unresolvable. Duke EAP is a tool available to help managers deal with employee situations.

Duke EAP provides the following services to assist managers:
  1. Telephone or 1:1 coaching for managers about specific problems with employees (could include co-coaching with a company Human Resources Consultant).
  2. Personal coaching for managers who want private coaching sessions to help them improve their managerial effectiveness.
  3. Assessment and counseling or referral for employees to help resolve workplace issues, domestic problems, or personal concerns that may be affecting the employee's performance at work.
The first step in handling an issue with an employee is to give the employee effective feedback about his/her performance. Effective feedback is clear and describes specific behaviors that need to be changed. It is important to deliver the feedback in a manner that will lessen defensive reactions in the employee.

It is not uncommon for an employee to feel very stressed when receiving feedback about unacceptable performance or behaviors, and this stress may affect the employee's ability to hear what is being said. It is essential for you, as a manager, to take steps to ensure that the employee has really heard what you are saying. Writing down your concerns for the employee to read after meeting with you is an important step in this process.

It is normal for a manager to feel somewhat anxious about discussing concerns directly with an employee. You are also unlikely to have numerous opportunities to perfect the skills needed in these situations. Many managers find it useful to have assistance in deciding how to work their feedback most effectively, and how to deliver the feedback in a manner likely to be heard by the employee. Taking the time to get expert assistance at these times can help keep situations from deteriorating.

Confronting an employee can be just as stressful for you, as a manager, as it can be for your employee, and you deserve all the support you can get. Counselors are available at Duke EAP to help coach you through this process. The earlier you call with your concerns about the employee, the more likely it is that you will be able to prevent the problem from escalating. Calling Duke for consultation is not limited to employees that may need an EAP referral. You can call for coaching for any difficult situation with an employee. Also, calling EAP for coaching should not be viewed as a replacement for, but rather an adjunct to, calling your Human Resources Consultant (HRC) for coaching and assistance. EAP counselors always suggest that you consult your HRC and will refer you back to your HRC as indicated (for example, for any situation related to company policy and in instances where work restrictions or job accommodations are concerned).

Your Duke EAP coach will also discuss ways of making an
informal suggested referral to Duke EAP. At times, an employee's deteriorating performance is caused by issues that can be resolved through counseling. These issues may include conflicts with certain workers, family problems, emotional concerns, or substance abuse. As a manager, your job is to focus on and document deficiencies and improvements in your employee's performance and to identify any areas where the work setting may be contributing to the situation (see job deficiency checklist). Duke EAP can help identify any other areas that may be affecting the employee's performance. It is a good idea to suggest Duke EAP to your employee as soon as you see that performance is being affected. When you broach the idea of using Duke EAP positively and effectively, many employees will seek the help they need to resolve their issues. Your Duke EAP coach can also give you suggestions on how to make an informal referral in a manner that will increase the probability of the employee following through.

If, after giving your employee feedback and informally suggesting Duke EAP, the performance issues persist, you may want to consider making a formal supervisory referral to Duke EAP. In a formal supervisory referral, the manager tells the employee their performance is unacceptable, and what they need to do to correct it. The manager then instructs the employee to contact a specific EAP case manager. The manager tells the employee that utilizing the EAP is not mandatory, but that failure to do so may be interpreted as not making the concerted effort to resolve performance issue(s). This discussion with the employee should clarify what will be the consequences if their performance does not improve (i.e., grade reduction, verbal warning, written warning, final warning and separation). The manager tells the employee that appropriate performance information will be communicated to EAP. With adequate consents, EAP will share compliance information with you, the manager, or a designated company representative.

Although a supervisory referral is intended to assist the employee in getting outside help in assessing and addressing issues that may be affecting their performance, there are no guarantees that the employee's performance will improve. After making the supervisory referral, it is the manager's responsibility to give ongoing feedback to the employee on his/her performance and to follow through on any disciplinary actions if the performance does not improve.

It should be noted that adequate performance consists of more than just getting one's job done. An employee who completes all his work in a timely fashion may still be considered to have a performance problem if he alienates many of his co-workers in the process. Another employee may do a great job when she is at work, but have an excessive number of absences. You may be worried about your employee because, even though he is getting his work done, in the last three months, he has changed from being an outgoing, fun-loving individual, to someone who is very withdrawn. A call to Duke EAP can help you determine the appropriate steps to take to get help for your employee in any of these situations.

For information on:

Duke Occupational Mental Health Programs
Duke Employee Assistance Program, a component of Duke OMHP
Division of Occupational and Environmental Medicine
Department of Community and Family Medicine