Clinical Supervision and Turnover in Substance Abuse Tx

描述（由申请人提供）： 医疗保健行业的员工流动率高于其他任何行业。特别是，最近的一项关于药物滥用治疗中心的全国性研究报告说，药物滥用咨询师的年更替率为18.5%（Roman，Blum，&约翰逊，2002）。营业额使直接（例如，工作人员更替费用）和间接费用（例如，较低质量的病人护理、机构知识的损失）给药物滥用治疗中心带来成本，并且是该领域公认的问题。拟议的项目提供了一个全面的检查营业额之间的物质滥用辅导员和临床主管，重点是临床监督关系对双方的营业额的影响。两者都是积极的（即，益处）和负面（即，成本）的监督经验进行审查，从顾问和临床主管的角度来看，基于越来越多的认识，临床监督的关系，可以产生利益，以及双方的成本。本研究的具体目的是：（1）探讨药物滥用咨询师和临床主管离职的预测因素，（2）探讨工作态度（如，职业倦怠，工作满意度，承诺）在临床监督和营业额之间的关系，（3）跟踪的变化，随着时间的推移，它的发展和/或恶化的咨询师-临床主管关系，演示如何在关系的变化预测职业和工作态度，以及营业额，和（4）检查的作用，咨询师和临床主管的经验，因为它涉及到营业额和其他研究变量。随着时间的推移，辅导员临床主管二人组将在纵向研究营业额。本项目响应PA-03-011“国家药物滥用CTN服务研究”计划公告。隶属于临床跟踪网络的药物滥用治疗中心将为该项目提供数据。

DESCRIPTION (provided by applicant): The healthcare industry has staff turnover rates that are higher than any other industry. In particular, a recent national study of substance abuse treatment centers reports that the annual turnover rate among substance abuse counselors of 18.5% (Roman, Blum, & Johnson, 2002). Turnover renders direct (e.g., staff replacement costs) and indirect (e.g., lower quality patient care, loss of institutional knowledge) costs to substance abuse treatment centers and is a recognized problem in the field. The proposed project provides a comprehensive examination of turnover among substance abuse counselors and clinical supervisors, focusing on the effect that the clinical supervisory relationship has on the turnover of both parties. Both positive (i.e., benefits) and negative (i.e., costs) supervisory experiences are examined, from the perspective of both counselor and clinical supervisor, based on the growing recognition that clinical supervisory relationships can yield benefits as well as costs for both parties. Specific aims of the research are to: (1) examine the predictors of turnover among substance abuse counselors and clinical supervisors, (2) explore the mediating role of work attitudes (e.g., burnout, job satisfaction, commitment) in the relationship between clinical supervision and turnover, (3) track changes in the counselor-clinical supervisor relationship over time it develops and/or deteriorates, demonstrating how changes in the relationship predict career and work attitudes, as well as turnover, and (4) examine the role of counselor and clinical supervisor experience as it relates to turnover and other study variables. Counselor-clinical supervisor dyads will be studied over time in a longitudinal study of turnover. This project responds to program announcement PA-03-011 "Services Research in the National Drug Abuse CTN". Substance abuse treatment centers that are affiliated with the Clinical Trails Network will provide data for the project.