Therapist Turnover and New Program Sustainability in Mental Health Clinics as a Function of Organizational Culture, Climate, and Service Structure

  • Charles Glisson
  • Sonja K. Schoenwald
  • Kelly Kelleher
  • John Landsverk
  • Kimberly Eaton Hoagwood
  • Stephen Mayberg
  • Philip Green
  • The Research Network on Youth Mental Health
Original Paper


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.


Organizational culture Organizational climate Organizational social context OSC Therapist turnover Sustainability 


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Charles Glisson
    • 1
  • Sonja K. Schoenwald
    • 2
  • Kelly Kelleher
    • 3
  • John Landsverk
    • 4
  • Kimberly Eaton Hoagwood
    • 5
  • Stephen Mayberg
    • 6
  • Philip Green
    • 1
  • The Research Network on Youth Mental Health
    • 7
  1. 1.Children’s Mental Health Services Research CenterUniversity of TennesseeKnoxvilleUSA
  2. 2.Family Services Research CenterMedical University of South CarolinaCharlestonUSA
  3. 3.Children’s Research InstituteOhio State UniversityColumbusUSA
  4. 4.Child and Adolescent Services Research CenterUniversity of CaliforniaSan DiegoUSA
  5. 5.New York State Psychiatric InstituteColumbia UniversityNew YorkUSA
  6. 6.Calilfornia Department of Mental HealthSacramentoUSA
  7. 7.ChicagoUSA

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