Clinical Supervision and Turnover in Substance Abuse Tx

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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.