Constructive confrontation was originally the central strategy in work-based programs to deal with problem drinking employees. The broadening of these programs to employee assistance programs, coupled with their rapid growth and diffusion, has been accompanied by the medicalization of employee performance problems and the professionalization of means for handling such problems. These trends, together with ideologies based in organizational management and the value orientations of American society, are barriers to supervisory use of constructive confrontation. Data from a 1981 national survey of external program consultants reveals continuing attitudinal support for constructive confrontation. Other attitudes of these consultants point however to the strong need for deliberately designed support systems for the encouragement of supervisory use of constructive confrontation.