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失率高于其他任何行业。特别是，最近一项关于药物滥用治疗中心的全国性研究报告称，药物滥用咨询师的年流失率为18.5%(Roman，Blum，&Johnson，2002)。人员更替造成药物滥用治疗中心的直接成本(例如，工作人员替换成本)和间接成本(例如，较低质量的病人护理、丧失机构知识)，是该领域公认的问题。拟议的项目全面审查药物滥用咨询师和临床督导员之间的离职情况，重点是临床督导关系对双方离职的影响。本文从辅导员和临床主管的角度考察了积极的(即好处)和消极的(即成本)监管经验，这是基于越来越多的人认识到临床监管关系可以为双方带来好处和成本。这项研究的具体目的是：(1)检验药物滥用咨询师和临床督导员中离职的预测因素；(2)探索工作态度(例如，工作倦怠、工作满意度、承诺)在临床督导和离职之间的中介作用；(3)跟踪咨询师和临床督导员关系随时间发展和/或恶化的变化，展示关系的变化如何预测职业和工作态度以及离职；以及(4)考察咨询师和临床督导员的角色与离职和其他研究变量的关系。咨询师-临床主管二人组将在一项关于离职的纵向研究中随着时间的推移而进行研究。本项目是对PA-03-011《国家药物滥用网络服务研究》项目公告的响应。附属于临床线索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.