Originating in the U.S. 70 years ago as industrial alcoholism programs, and promoted for decades by R. Brinkley "Brink" Smithers, these programs finally gained popularity during the 1970s and 1980s, when they were renamed "employee assistance programs" and given a broader mission than identifying alcoholics. Attempting to change their image as instruments of coercion, EAPs added a variety of social work functions to their portfolios but, now primarily operating as external contractors, have seen cash flows fall dramatically in the face of intense competition from similar services. EAP practitioners have called for restoring the approach promoted by academics supported by Smithers, who aggressively maintain that eliminating behavioral health problems is the responsibility of employees rather than employers. This article compares the evidence addressing the efficacy of that approach with that of alternatives, being developed outside of the U.S., that expand employee rights.