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Types of employee assistance programmes (EAPs)

Spot the difference between external, internal, and embedded EAPs, as well as modern EAP alternatives.

In this article
Pros and cons of external EAPsPros and cons of internal EAPsPros and cons of embedded EAPsModern EAPs and EAP alternatives

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  • There are four types of employee assistance programmes: external, internal, and embedded EAPs, and then modern EAP alternatives.
  • External EAPs are a popular choice due to their low cost, confidentiality, and range of support.
  • Internal EAPs are managed in-house, either by the company’s own HR team or by another designated EAP team. 
  • Embedded EAPs come as part of a larger package, such as company-wide health insurance.
  • Modern EAP alternatives (like Spill!) offer dedicated mental health support for companies while tackling the downsides of traditional EAP providers.

Employee assistance programmes (EAPs) are a popular choice for companies wanting to support their teams through personal and professional challenges that can affect their performance at work. Around one in six people experience mental health problems in the workplace but 87% of employees feel uncomfortable discussing their mental health at work. 

For an EAP to successfully support your team, it has to be the right fit for their challenges and goals. Researching an EAP can be a bit of a muddle (as we’ve found out ourselves) so let’s start with basics and look at the difference between the types of EAPs available.

The four types of EAP programmes

Typically, there are three types of traditional EAPs but modern EAP alternatives are making a good name for themselves, too. Here’s a rundown of the four types of EAP programmes.

External EAPs (the one you pay for as a specific service)

Of the 88% of UK employers that use an EAP, it’s likely that the majority of them use an external EAP: after all, around the world, there are more than 839 external EAP providers. These providers are contracted by a company to provide EAP services to their employees: they’re an independent organisation and work with multiple companies at any one time. This separation can imply more privacy and confidentiality, particularly from the user’s perspective. External EAPs offer a number of services including counselling, financial advice, legal support, manager training… the list goes on. Access to external EAPs tends to be via phone, or an online chat or form. Individuals calling the EAP number may need to quote their company name so that they’re given access to the specific services their company can use.

Logos of five external EAP providers: Telus Health, Health Assured, Wellbeing Solutions, Vita Health Group, and PAM Assist
Logos of examples of external EAP providers

Internal EAPs (the do-it-yourself option)

Managed and provided by a company’s HR team (or another designated internal team, like a culture or wellbeing committee), internal EAPs offer similar services to an external provider but everything is organised and handled by internal staff. It’s much harder for us to regale tales of internal EAPs due to their, ahem, internal nature. But we do know of one such example and that’s the drinks company innocent. Known for its proactive approach to mental health, innocent worked with an external consultant to develop its own internal support. From upskilling managers and team members in mental health awareness, to coaching sessions for stress management, innocent has now brought mental health care into the folds of the company.

Embedded EAPs (the get-it-free-with-something-else-you-buy package)

Much like it sounds, embedded EAPs are provided as part of a larger health and wellbeing package, like company health insurance. These types of EAPs tend to be an additional service provided by health plans to add value to their services, or benefits and rewards platforms that offer EAP services alongside other perks such as discounts.

Logos of three embedded EAP providers: AXA Health, Perkbox, and Bupa
Logos of examples of embedded EAP providers

Modern EAP alternatives (the new kid on the block)

Offering similar services to the more traditional EAP, modern EAP alternatives are tackling the downsides of other types of EAPs. For example, online booking makes it easier to access support (removing the need to call a hotline) and they’re a great option for companies with less than 50 employees, which most external EAPs won’t cover.

The logos of six examples of modern EAP alternatives: Spill, Unmind, Modern Health, Plumm, Ginger, and Oliva
Logos of examples of modern EAP alternatives

Pros and cons of external EAPs

What better way to understand the ins and outs of external EAPs than an overview of their pros and cons…

Pros of external EAPs

✅ Employees will (usually) get support from qualified professionals

The areas covered by EAPs all need professional guidance: workplace mental health challenges, like stress and burnout, addiction, family difficulties, financial problems..they all need to be handled by qualified professionals who know what they’re doing. Most external EAPs have qualification requirements for their staff members: counsellors for example, tend to have been qualified for a minimum of years and have a set amount of clinical experience. However, with some EAPs, the people answering the phones will be ‘advisors’ rather than qualified counsellors. If you’re in the market for an EAP, it’s worth checking whether this is the case.

✅ You can offer mental health support at a very low cost to the company

External EAPs offer blanket mental health cover for everyone in the company at a very low cost: the price is typically between 40p and £1.25 per employee, per month, depending on the size of your business.

✅ Employees will have a safe, confidential place to talk

As a general rule, EAPs provide a confidential service: the specific details of an EAP counselling session will never be relayed back to anyone at your company. This reassurance can help your team feel safe to speak openly with a trained professional without fear of ‘being found out’ or negative consequences and stigma at work. With this peace of mind, people can (in theory, at least) feel able to seek support earlier, which prevents their problems from becoming more severe.

✅ Employees can access support that’s right for your company

With so many services on offer and different ways to get in touch, many external EAPs can be tailored to your company’s specific needs. For example, perhaps you have a lot of younger staff or staff on lower salaries: in that case, your team might benefit from access to financial advisors. And, if you have a large company, you can feel reassured that you’re offering a wide range of services to meet the needs of the individual problems your team might be experiencing. 

Cons of external EAPs

❌ Employees won’t get support from someone who knows the ins and outs of the company

Many of the challenges your team face at work are specific to your company’s culture: how conflicts arise, the hours and pace of work, work-life boundaries…there are plenty of nuances within each company that have positive and negative impacts on how someone is feeling. While talking to a professional outside of the company can feel easier, they won’t have a deep understanding of your company’s policies, culture, or procedures. This lack of connection can make it difficult for external EAPs to fully understand the context of your employee’s issues.

❌ Employees can only get support for a limited amount of time

External EAPs offer short-term support for current problems. The counselling offered through EAPs tends to be solution-focused, making it ideal for someone wanting to find an immediate resolution to a problem they are currently facing. External providers tend to offer around six counselling sessions per person and it’s not a guarantee that everyone who wants counselling will get it. This style of counselling, while effective for certain challenges, can be limiting for anyone wanting support with complex or long-term issues, and can leave people feeling frustrated or unsupported.

❌ Employees might have to wait a while for a response

When one of your team contacts the EAP, they’ll likely be expecting support straight away. But, with many external EAPs, this isn’t the case. During the initial call, the EAP will take some details to find out more information about what’s going on, in order to direct your team member to the right form of help. Then, your employee will have to wait for a callback. Often, this can take a good few days, which can leave people feeling unsupported and vulnerable at a time when they really need someone to talk to.

❌ You might see low engagement with the EAP

Despite the reassurances that conversations with an external EAP remain private, some people may still feel nervous about using the service due to its confidentiality. And if they can’t find the contact details for the EAP, they’ll have to ask for them, which takes away their anonymous use of the programme. This can limit how well the EAP is used within your team and even prevent some people from accessing the support they need.

❌ Your company might be too small 

Some of the larger external EAP providers only offer support to larger companies. This tends to be a company of 50 employees or more, so if you’re a smaller team you might have to rule out an external EAP altogether.

💡Spill’s take on external EAPs

Obviously, Spill is also an external organisation helping companies support their team’s mental health, so we’ll be as objective as possible here. Of the three types of EAP programmes, an external EAP ticks the most boxes for us — but it still doesn’t quite meet the mark we’d expect from a service aiming to improve employee mental health. From our research, it's hard to avoid an external EAP and we wonder whether that’s why they’re used by so many companies: they’re the main search result when you start looking into different EAPs. Modern EAPs, which are starting to become more commonplace, are doing a great job of tackling the cons of external EAPs and we’d recommend expanding your research to look into some of these alternatives. But, we’ll get to that later in this article as well, so sit tight!

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Pros and cons of internal EAPs

And now onto the internal EAPs! The decision to go down this route largely depends on your company's resources, goals, and the needs of your team.

Pros of internal EAPs

✅ You don’t have to pay an external EAP provider

Bringing everything in-house will save you some pennies and take you away from an annual contract, the payment plan offered by many external providers. 

✅ Employees can get help that is specific to the company

The ability to customise an internal EAP is far greater than an external provider. Depending on the needs of your team, you can cherry pick the services they’ll benefit from the most. Perhaps one employee needs 20 counselling sessions: unlike with an external EAP, your internal EAP team could make this happen. Perhaps the customer ops department would really benefit from a session on how to handle the stress caused by angry complaint calls: your internal EAP team could organise this. Plus, an internal team knows your company culture: workplace problems will have context and understanding, helping the support feel more tailored and actionable.

✅ Employees might prefer talking to a friendly face

Providing internal support may make your team feel more comfortable in terms of confidentiality: there’s no ‘risk’ that your employees’ concerns will be relayed from an external provider back to your company because it’s already in-house and you’ll have your own privacy policy in place. Plus, your team might feel happier seeking help from someone they already know and trust.

✅ Employees can easily access support

To contact an external EAP, your team will have to call them up or contact them via an online contact form or message and then, they wait. An internal EAP, however, is on site, meaning your team can either physically go and see someone to benefit from in-person support, or otherwise access remote support within existing company structures. In both cases, this can help your employee feel like their case is being handled appropriately.

Cons of internal EAPs

❌ You might have to slim down the services you can offer

The services provided by an internal EAP depend on the capabilities of your in-house team and the amount of money you’re willing to spend on bespoke external help. As a result, you may find you’ll have to offer a limited number of services compared to the variety an external EAP can offer.

❌ There may be a conflict of interest

Having an internal EAP brings that team into the business fold, and that could lead to a conflict of interest: their goal changes to serve the company’s interests, rather than to focus on the interests of individual employees. 

❌ You might not be able to offer highly trained professionals

It’s all very well upskilling existing team members or bringing new people in, but this might fall short from the expertise and experience available with an external EAP provider. Some of the issues your team might need help with could require extensive knowledge and training beyond that offered by a short course like Mental Health First Aid, which teaches people to start conversations around mental health at work and signpost people towards support, but doesn’t equip them to provide actual counselling.

❌ You might see lower uptake

A direct counter to feeling more secure in terms of confidentiality, there’s a chance your team might feel hesitant to use an internal EAP because it's within the company. Concerns about stigma, fear or retaliation, or the impact on performance reviews in response to their issues, especially if they’re work-related, could leave people feeling reluctant to reach out for help.

💡Spill’s take on internal EAPs

We can see the merits of an internal EAP: we like that it could be a way to upskill existing team members, and it certainly normalises the conversation around mental health. However, there are two sticking points for us, and the first is the quality of support. You can look after your team’s mental health without offering counselling: think, informal check-ins, coffee chats, and peer support groups. But if you do want to offer counselling, the counsellors should be highly trained and have plenty of experience. Second, is the potential conflict of interest and confidentiality concerns. We’re all for talking internally about mental health but when someone is having a really tough time, they need to feel safe and able to talk freely.

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Pros and cons of embedded EAPs

Finally, embedded EAPs: the providers that ‘bundle’ mental health support in with general employee health insurance (for example). Embedded EAP providers often promise the same benefits and outcomes as a traditional EAP but at a reduced cost.

Pros of embedded EAPs

✅ You can offer employee support without having to pay someone else

Embedded EAPs that come as part of an existing package are often touted as ‘free’, or at least much cheaper than using another external provider.

✅ You can support your team without any extra work

Let’s face it, embedded EAPs are a convenient choice. Buying a full health service that covers physical injury or illness as well as mental health support saves you time: no need to research another provider and there will be far less paperwork.

Cons of embedded EAPs

❌ You might get stung by hidden costs

If it's billed as ‘free’, then it's usually too good to be true. The cost of an embedded EAP is often built into the cost of your premium, so you’ll still be paying for it. Embedded EAPs are usually sold at or below cost to attract attention to a higher margin product (i.e. the insurance).

❌ You’ll have fewer services

Generally, embedded EAPs offer a limited range of services. Bupa’s EAP for example excludes crisis intervention, substance abuse support, and manager training from its services, and makes no mention of offering your business with support or anonymous data to help you manage the EAP. If your employees require specialist help, they’ll need to go elsewhere at their own expense.

❌ They’re not the main product

Bupa and AXA Health make their money via health insurance: that’s their product. Their EAP services on the other hand are an afterthought; the company wasn’t built to primarily provide an EAP. As a result, embedded EAPs don’t always have the same standards or rigour when it comes to hiring and training counsellors, compared to an external EAP, and might have lower service standards than external EAPs. Taking Bupa and AXA Health as examples again: on their website, there’s no ready information about the qualifications and accreditations their counsellors must have. Health Assured on the other hand has a long, visible list of the requirements their counsellors must have to work for them.

❌ You’ll have to promote it on your own

In most cases, embedded EAPs don’t come with promotional support. While this can drive down costs, it can also translate into low usage rates and more work for you, as you’ll be responsible for driving engagement. 

💡Spill’s take on embedded EAPs

At Spill, we focus on offering high quality therapy to anyone that needs it, and to us, embedded EAPs just don’t cut it. Your team’s mental health deserves great care, and with proper support you’ll see the positive effects not just in each individual team member, but as a company, too. We hold really high standards for our therapists and we’d expect the same from any other company offering mental health support. Look out for providers that recruit counsellors with a minimum number of years since qualifying, a certain number of clinical/private hours, and who are registered with counselling bodies like the British Association of Counsellors and Psychotherapists (BACP) or the National Counselling Society (NCS). We also provide supervision and safeguarding support for all our counsellors, as well as extra training and upskilling on topics relevant to employees, like neurodiversity at work.

External EAPs Internal EAPs Embedded EAPs
The number of services available
Offers a wide range of services Probably offers a reduced number of services depending on how the company sets it up Typically offers fewer services
The quality of counselling Counsellors usually meet a minimum set of requirements Depends on how the company sets it up and their knowledge of counselling standards Typically has lower standards for hiring and training counsellors
The number of counselling sessions an employee can have A limited number, usually six Depends on how the company sets it up A limited number, usually six
The confidentiality of use All counselling remains confidential, but the admin may know who is using the service All counselling remains confidential, but the admin may know who is using the service All counselling remains confidential, but the admin may know who is using the service
The speed of counselling support Counselling is not available immediately: it can take a few days (or more!) to get a callback Depends on how the company sets up counselling services Counselling is not available immediately: it can take a few days (or more!) to get a callback

Modern EAPs and EAP alternatives

In addition to the three traditional types of EAPs, there’s an increasing number of alternatives offering support for teams and individuals. This goes back to the importance of understanding what it is your team really needs: a traditional EAP is no longer the only option, so take a moment to explore other options and then ask your team what it is they think they’d actually use.

Digital mental health solutions

As healthcare continues to get a digital revamp, mental health support is doing rather well in the digital world. From apps and wearables to online communities, you could very easily mix and match the support you offer. Just be mindful of what it is you want to achieve — and beware that some of the more novel offerings in this category are aimed at consumers rather than businesses. 

🧘 Mindfulness and meditation apps

Accessible to everyone and easy to use, mindfulness and meditation apps are a great company perk and when used, can make a tangible difference: research shows that a consistent meditation practice reprograms neural pathways in the brain and improves our ability to regulate emotions. Calm and Headspace both offer packages for businesses but keep in mind that meditation alone will not be the right support for someone who is really struggling.

⌚ Wellness wearables

By wearables we mean technology that’s designed to be worn: think fitness trackers, smart watches, even rings. In addition to the more well-known brands (think Apple, Garmin, and FitBit), a number of other companies such as TouchPoint (a stress buster), Muse (a real-time meditation coach), and Oura Ring (a health tracker) all offer wearables that are billed to help you improve your physical and mental wellbeing. While some are only available on an individual basis, others, like Oura Ring, offer packages for businesses (and even schools in the case of Muse) to kit their employees out. It's a pretty new prospect and while it's an exciting way to bridge the gap between physical and mental health, issues around confidentiality and privacy can be a concern.

✏️ Coaching and training

Let’s start with mental health training, like Mental Health First Aid. Offering training courses to help managers spot the signs of poor mental health in others, this can be a great way to change your company’s attitude towards mental health. However, an independent report by the Health and Safety Executive ruled that while such training raises employees’ awareness of mental challenges, it doesn’t improve the wider management of mental health at work.

Coaching, on the other hand, is a great way to help employees overcome work-related problems. For example, if you have a team of young struggling managers, investing in coaching that teaches them how to develop into their role would be a good use of time and money. Purely focusing on work-related issues, however, doesn’t address any underlying mental health challenges going on, making coaching and training courses a good benefit to offer alongside other support.

Modern EAPs

At last, we get to modern EAPs! Offering the same services as traditional EAPs, these modern alternatives are doing a great job of supporting the way people actually work and communicate today (i.e. online). 

Spill, Modern Health, Ginger, Unmind, Oliva, and Plumm are all examples of modern EAP alternatives that pledge to support your team's mental health and wellbeing. That sounds pretty similar to traditional EAPs but the difference is that each of these companies makes it easier to access support. 

Take Spill for example.

In addition to offering 1:1 corporate therapy sessions with qualified counsellors at an affordable monthly cost, Spill also:

  • Gives support to anyone that needs it
  • Proactively reaches out to employees that look like they need support
  • Offers next-day therapy sessions
  • Allows you to cancel in 30 days

Traditional EAPs Modern EAP alternatives Spill
How easy is it to make first contact?
Employees need to call a telephone hotline number of submit an online form Employees can use online booking systems Employees can quickly access Spill from their company's Slack or MS Teams
How quick is it to get support? Unless signposted to self-help resources, employees can expect to wait a few days for further support Employees can typically get support faster than traditional EAPs Employees can book appointments with qualified therapists within 24 hours of first contact
Can you see how it's being used? Not as standard, but sometimes upon request Shares anonymous usage data Shares anonymous usage data, feedback, and changes in low mood and anxiety scores
How easy is it to support diverse teams? Check with the provider for details on counselling specialisms and services in different languages Offer better support coverage for different languages and timezones Employees can access a team of therapists offering 80+ specialisms and therapy in 15 languages

Researching an EAP takes time

Choosing the right service for your team is an important decision and it can take time to find the right solution. We’re really passionate about giving employees access to mental health support that benefits them, which is why we’ve built up a collection of articles all about researching, choosing, pitching, and promoting an EAP for your company:

Good luck! Your team will thank you for it 💙

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Spill is typically used by 50% of employees in a year. That means up to 10 times as many people get support vs. an EAP.

See how Spill stacks up against EAPs