Therapist Turnover and New Program Sustainability in Mental Health Clinics as a Function of Organizational Culture, Climate, and Service Structure
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The present study incorporates organizational theory and organizational characteristics in examining issues related to the successful implementation of mental health services. Following the theoretical foundations of socio-technical and cultural models of organizational effectiveness, organizational climate, culture, legal and service structures, and workforce characteristics are examined as correlates of therapist turnover and new program sustainability in a nationwide sample of mental health clinics. Results of General Linear Modeling (GLM) with the organization as the unit of analysis revealed that organizations with the best climates as measured by the Organizational Social Context (OSC) profiling system, had annual turnover rates (10%) that were less than half the rates found in organizations with the worst climates (22%). In addition, organizations with the best culture profiles sustained new treatment or service programs over twice as long (50 vs. 24 months) as organizations with the worst cultures. Finally, clinics with separate children’s services units had higher turnover rates than clinics that served adults and children within the same unit. The findings suggest that strategies to support the implementation of new mental health treatments and services should attend to organizational culture and climate, and to the compatibility of organizational service structures with the demand characteristics of treatments.
- Argyris, C. (1958). Some problems in conceptualizing organizational climate: A case study of a bank. Administrative Science Quarterly, 2, 501–520. CrossRef
- Ashkanasy, N. M., Wilderom C. P. M., Peterson M. F. (Eds.). (2000). Handbook of organizational culture and climate. Thousand Oaks: Sage Publications, Inc.
- Blau, P. M. (1960). Structural effects. American Sociological Review, 25, 178–193. CrossRef
- Blau, P. M., & Scott, W. R. (1962). Formal organizations: A comparative approach. San Francisco: Jossey-Bass.
- Burns, T., & Stalker, G. M. (1961). The management of innovation. Oxford: Oxford University Press.
- Denison, D. R. (1996). What is the difference between organizational culture and organizational climate? A native’s point of view on a decade of paradigm wars. Academy of Management Review, 21(3), 619–654. CrossRef
- Dowd, K., Kinsey, S., Wheeless, S., Thissen, R. Richardson, J., Suresh, R., et al. (2004). National Survey of Child and Adolescent Well-Being (NSCAW), Combined Waves 1–4, Data File User’s Manual, Restricted Release Version. Research Triangle Institute, University of North Carolina at Chapel Hill, and Caliber Associates, University of California at Berkeley.
- Fleishman, E. A. (1953). Leadership climate, human relations training, and supervisory behavior. Personnel Psychology, 6, 205–222. CrossRef
- Glisson, C. (2007). Organizational climate and service outcomes in child welfare systems. Manuscript submitted for publication.
- Glisson, C., Dukes, D., & Green, P. (2006). The effects of the ARC organizational intervention on caseworker turnover, climate, and culture in children’s service systems. Child Abuse and Neglect, 30, 855–880. CrossRef
- Glisson, C., & Green, P. (2006). The effects of organizational culture and climate on the access to mental health care in child welfare and juvenile justice systems. Administration and Policy in Mental Health and Mental Health Services Research, 33(4), 433–448. CrossRef
- Glisson, C., & Hemmelgarn, A. L. (1998). The effects of organizational climate and interorganizational coordination on the quality and outcomes of children’s service systems. Child Abuse & Neglect, 22, 401–421. CrossRef
- Glisson, C., & James, L. R. (2002). The cross-level effects of culture and climate in human service teams. Journal of Organizational Behavior, 23, 767–794. CrossRef
- Glisson, C., Landsverk, J., Schoenwald, S. K., Kelleher, K., Hoagwood, K. E., Mayberg, S., & Green, P. (2008). Assessing the Organizational Social Context (OSC) of mental health services: Implications for implementation research and practice. Administration and Policy in Mental Health and Mental Health Services Research, 35(1).
- Glisson, C., & Schoenwald, S. K. (2005). The ARC organizational and community intervention strategy for implementing evidence-based children’s mental health treatments. Mental Health Services Research, 7(4), 243–259. CrossRef
- Hage, J., & Aiken, M. (1969). Routine technology, social structure, and organization goals. Administrative Science Quarterly, 14, 366–375. CrossRef
- Handy, C. G. (1976). Understanding organizations. New York: Penguin.
- Kahn, R. L., & Boulding, E. (1964). Power and conflict in organizations. New York: Free Press.
- Katz, D. K., & Kahn, R. L. (1966). The social psychology of organizations. New York: Wiley.
- Litwak, E., & Hylton, L. F. (1962). Interorganizational analysis: A hypothesis on co-ordinating agencies. Administrative Science Quarterly, 6, 395–420. CrossRef
- McGregor, D. M. (1957). The human side of enterprise. Management Review, 46, 22–28, 88–92.
- NSCAW Research Group (2002). Methodological lessons from the National Survey of Child and Adolescent Well-Being: The first three years of the USA’s first national probability study of children and families investigated for abuse and neglect. Children and Youth Services Review, 24, 513–541. CrossRef
- Pettigrew, A. (1979). On studying organizational cultures. Administrative Science Quarterly, 24, 570–581. CrossRef
- Pfeffer, J. (1981). Power in organizations. Boston: Pitman.
- Rentsch, J. R. (1990). Climate and culture: An evolution of constructs. In B. Schneider (Eds.), Organizational climate and culture (pp. 5–39). San Francisco: Jossey-Bass.
- Roethlisberger, F. J., & Dickson, W. J. (1939). Management and the worker. Cambridge: Harvard University Press.
- Rousseau, D. M. (1977). Technological differences in job characteristics, employee satisfaction, and motivation: A synthesis of job design research and sociotechnical systems theory. Organizational Behavior and Human Performance, 19, 18–42. CrossRef
- Schein, E. H. (2000). Sense and nonsense about culture and climate. In N. M. Ashkanasy, C. P. M. Wilderom, & M. F. Peterson (Eds.), Handbook of organizational culture & climate (pp. xxiii–xxx). Thousand Oaks: Sage Publications.
- Schneider, B. (1990). Organizational climate and culture. San Francisco: Jossey-Bass.
- Schneider, B. (2000). The psychological life of organizations. In N. M. Ashkanasy, C. P. M. Wilderom, & M. F. Peterson (Eds.), Handbook of organizational culture & climate (pp. xvii–xxi). Thousand Oaks: Sage Publications.
- Schoenwald, S. K., Chapman, J. E., Kelleher, K., Hoagwood, K. E., Landsverk, J., Stevens, J., Glisson, C., & Rolls-Reutz, J. (2008). A survey of the infrastructure for children’s mental health services: Implications for the implementation of empirically supported treatments (EBTs). Administration and Policy in Mental Health and Mental Health Services Research, 35(1).
- Schorr, L. B. (1997). Common purpose. New York: Doubleday.
- Scott, W. B., & Mitchell, T. R. (1967). Organization theory: A structural and behavioral analysis. Homewood: Richard D. Irwin, Inc.
- Selznick, P. (1949a). Leadership in administration: A sociological interpretation. New York: Harper & Row.
- Selznick, P. (1949b). TVA and the grass roots. Los Angeles: University of California Press.
- Simon, H. A. (1946). The proverbs of administration. Public Administration Review, 6, 53–67. CrossRef
- Taylor, F. W. (1911). The principles of scientific management. New York: Harper Brothers.
- Thompson, J. D. (1967). Organizations in action. New York: McGraw-Hill.
- Trist, E. L., Higgin, G. W., Murray, H., & Pollock, A. B. (1963). Organization choice: Capabilities of groups at the coal face under changing technologies; the loss re-discovery and transformation of a work tradition. London: Tavistock.
- Vintner, R.D. (1963). Analysis of treatment organizations. Social Work, 8, 3–15.
- Weber, M. (1922). Bureaucracy. In H. H. Gerth, & C. W. Mills (Eds.), From Max Weber: Essays in sociology (pp. 196–244). New York: Oxford University Press.
- Wieland, G. F., & Ullrich, R. A. (1976). Organizations – Behavior, design and change. Homewood: Irwin.
- Woodward, J. (1958). Management and technology. London: HMSO.
- Woodward, J. (1965). Industrial organization. London: Oxford University Press.
- Yafa, S. (2004). Big cotton: How a humble fiber created fortunes, wrecked civilizations, and put America on the map. New York: Viking Books.
- Therapist Turnover and New Program Sustainability in Mental Health Clinics as a Function of Organizational Culture, Climate, and Service Structure
Administration and Policy in Mental Health and Mental Health Services Research
Volume 35, Issue 1-2 , pp 124-133
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Organizational culture
- Organizational climate
- Organizational social context
- Therapist turnover
- Author Affiliations
- 1. Children’s Mental Health Services Research Center, University of Tennessee, 128 Henson Hall, Knoxville, TN, 37996-3332, USA
- 2. Family Services Research Center, Medical University of South Carolina, Charleston, USA
- 3. Children’s Research Institute, Ohio State University, Columbus, USA
- 4. Child and Adolescent Services Research Center, University of California, San Diego, USA
- 5. New York State Psychiatric Institute, Columbia University, New York, USA
- 6. Calilfornia Department of Mental Health, Sacramento, USA