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Associations Among Job Role, Training Type, and Staff Turnover in a Large-Scale Implementation Initiative

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Abstract

Staff turnover is problematic for behavioral health agencies implementing evidence-based practices (EBPs), which are costly and time-consuming. The current study examined the association between EBP training methods and turnover and explored predictors of turnover for different types of staff. Participants (100 clinicians, 50 supervisors, 50 administrators) were randomized to one of three training conditions for an EBP. Results indicated low annual rates of turnover for clinicians, supervisors, and administrators. However, contrary to hypothesis, no statistically significant differences were found in rates of turnover across training conditions. Partially consistent with prior research, organizational climate was a significant predictor of supervisor and administrator turnover at 24 months, but was not a significant predictor of clinician turnover. Implications and future directions for research are discussed.

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References

  1. Bureau of Labor Statistics. The employment situation—December 2010. Washington, DC; 2011.

  2. Aarons GA, Sommerfeld DH, Hecht DB, et al. The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: evidence for a protective effect. Journal of Consulting and Clinical Psychology. 2009;77(2):270–280. https://doi.org/10.1037/a0013223

    Article  PubMed  PubMed Central  Google Scholar 

  3. Beidas RS, Marcus S, Wolk CB, et al. A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practices in a publicly-funded mental health system. Administration and Policy in Mental Health and Mental Health Services Research.2015. https://doi.org/10.1007/s10488-015-0673-6

  4. Bukach AM, Ejaz FK, Dawson N, et al. Turnover among community mental health workers in Ohio. Administration and Policy in Mental Health and Mental Health Services Research. 2015. https://doi.org/10.1007/s10488-015-0706-1

  5. Rollins AL, Salyers MP, Tsai J, et al. Staff turnover in statewide implementation of ACT: relationship with ACT fidelity and other team characteristics. Administration and Policy in Mental Health and Mental Health Services Research. 2010;37(5):417–426. https://doi.org/10.1007/s10488-009-0257-4

    Article  PubMed  Google Scholar 

  6. Smith B, Rutigliano T. The truth about turnover. Gallup Business Journal. 2002. http://www.gallup.com/?u?ine??journal/316/truth-a?out-turnover.a?px. Accessed 16 Jun 2017

  7. Wieder BL, Kruszynski R. The salience of staffing in IDDT implementation: one agency’s experience. American Journal of Psychiatric Rehabilitation. 2007;10(2):103–112. https://doi.org/10.1080/15487760701346016

    Article  Google Scholar 

  8. Ben-Dror R. Employee turnover in community mental health organization: a developmental stages study. Community Mental Health J. 1994;30(3):243–257.

    Article  CAS  Google Scholar 

  9. Iglehart AP. Turnover in the social services: turning over to the benefits. Social Service Review. 1990:649–657.

  10. Glisson C, James LR. The cross-level effects of culture and climate in human service teams. Journal of Organizational Behavior. 2002;23(6):767–794. https://doi.org/10.1002/job.162

    Article  Google Scholar 

  11. Mor Barak ME, Nissly JA, Levin A. Antecedents to retention and turnover among child welfare, social work, and other human service employees: what can we learn from past research? A review and meta-analysis. Social Service Review. 2001;75(4):625–661. https://doi.org/10.1086/323166

    Article  Google Scholar 

  12. Williams ACDC, Potts HWW. Group membership and staff turnover affect outcomes in group CBT for persistent pain. Pain. 2010;148(3):481–486. https://doi.org/10.1016/j.pain.2009.12.011

    Article  PubMed  Google Scholar 

  13. Griffeth RW, Hom PW, Gaertner S. A meta-analysis of antecedents and correlates of employee turnover: update, moderator tests, and research implications for the next millennium. Journal of Management. 2000;26(3):463–488. https://doi.org/10.1177/014920630002600305

    Article  Google Scholar 

  14. Maslach C, Jackson S. The measurement of experienced burnout. Journal of Occupational Behavior. 1981;2:99–113. https://doi.org/10.1002/job.4030020205

    Article  Google Scholar 

  15. Aarons GA, Sawitzky AC. Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. Administration and Policy in Mental Health and Mental Health Services Research. 2006;33(3):289–301. https://doi.org/10.1007/s10488-006-0039-1

    Article  PubMed  Google Scholar 

  16. Allen DG, Shore LM, Griffeth RW. The role of perceived organizational support and supportive human resource practices in the turnover process. Journal of Management. 2003;29(1):99–118. https://doi.org/10.1177/014920630302900107

    Article  Google Scholar 

  17. Sheidow AJ, Schoenwald SK, Wagner HR, et al. Predictors of workforce turnover in a transported treatment program. Administration and Policy in Mental Health and Mental Health Services Research. 2007;34(1):45–56. https://doi.org/10.1007/s10488-006-0061-3

    Article  PubMed  Google Scholar 

  18. Morse G, Salyers MP, Rollins AL, et al. Burnout in mental health services: a review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research. 2012;39(5):341–352. https://doi.org/10.1007/s10488-011-0352-1

    Article  PubMed  Google Scholar 

  19. Bonham CA, Sommerfeld D, Willging C, et al. Organizational factors influencing implementation of evidence-based practices for integrated treatment in behavioral health agencies. Psychiatry Journal. 2014:1–9. https://doi.org/10.1155/2014/802983

  20. Pritchard RD, Karasick BW. The effects of organizational climate on managerial job performance and job satisfaction. Organizational Behavior and Human Performance. 1973;9:126–146. https://doi.org/10.1016/0030-5073(73)90042-1

    Article  Google Scholar 

  21. APA Task Force on Evidence-Based Practice for Children and Adolescents. Disseminating evidence-based practice for children & adolescents: a systems approach to enhancing care. Washington, DC; 2008.

  22. US Department of Health and Human Services. President’s New Freedom Commission on Mental Health. Achieving the promise: transform mental health care in America: executive summary. 2003.

    Google Scholar 

  23. Lang JM, Connell CM. Measuring costs to community-based agencies for implementation of an evidence-based practice. The Journal of Behavioral Health Services and Research. 2017;44(1):122–134. https://doi.org/10.1007/s11414-016-9541-8

    Article  PubMed  Google Scholar 

  24. Droege SB, Hoobler JM. Employee turnover and tacit knowledge diffusion: a network perspective. Journal of Managerial Issues. 2003;15(1):50–64.

    Google Scholar 

  25. Proctor EK, Landsverk J, Aarons G, et al. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research. 2009;36(1):24–34. https://doi.org/10.1007/s10488-008-0197-4

    Article  PubMed  Google Scholar 

  26. Stirman SW, Kimberly J, Cook N, et al. The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research. Implementation Science. 2012;7(1):17. https://doi.org/10.1186/1748-5908-7-17

    Article  Google Scholar 

  27. Herschell AD, Kolko DJ, Baumann BL, et al. The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations. Clinical Psychology Review. 2010;30(4):448–466. https://doi.org/10.1016/j.cpr.2010.02.005

  28. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annual Review of Psychology. 2001;52:397–422. https://doi.org/10.1146/annurev.psych.52.1.397

    Article  CAS  PubMed  Google Scholar 

  29. Aarons GA, Fettes DL, Flores LE, et al. Evidence-based practice implementation and staff emotional exhaustion in children’s services. Behaviour Research and Therapy. 2009;47(11):954–960. https://doi.org/10.1016/j.brat.2009.07.006

    Article  PubMed  PubMed Central  Google Scholar 

  30. Herschell AD, Kolko DJ, Scudder AT, et al. Protocol for a statewide randomized controlled trial to compare three training models for implementing an evidence-based treatment. Implementation Science. 2015;10(1):133. https://doi.org/10.1186/s13012-015-0324-z

  31. McNeil CB, Hembree-Kigin TL. Parent-child interaction therapy. 2nd ed. New York, NY: Springer Science & Business Media; 2010.

    Book  Google Scholar 

  32. Lieneman CC, Brabson LA, Highlander A, et al. Parent-Child Interaction Therapy: Current perspectives. Psychology Research and Behavior Management. 2017;10:239–256. https://doi.org/10.2147/PRBM.S91200

  33. PCIT International Inc., Get certified by PCIT International. http://www.pcit.org/pcit-certification.html. Accessed December 5, 2016.

  34. Scudder AT, Herschell AD. Building an evidence-base for the training of evidence-based treatments in community settings: Use of an expert-informed approach. Child and Youth Services Review. 2015;55:84–92. https://doi.org/10.1016/j.childyouth.2015.05.003

  35. Markiewicz J, Ebert L, Ling D, et al. Learning Collaborative Toolkit: raising the standard of care for traumatized children and their families. 2006.

    Google Scholar 

  36. Kolko DJ, Baumann BL, Herschell AD, et al. Implementation of AF-CBT by community practitioners serving child welfare and mental health: A randomized trial. Child Maltreatment. 2012;17(1):32–46. https://doi.org/10.1177/1077559511427346

  37. Lehman WEK, Greener JM, Simpson DD. Assessing organizational readiness for change. Journal of Substance Abuse Treatment. 2002;22(4):197–209. https://doi.org/10.1016/S0740-5472(02)00233-7

    Article  PubMed  Google Scholar 

  38. IBM Corp. IBP SPSS statistics for Windows, version 24.0. 2016.

  39. Raudenbush SW, Bryk AS, Congdon RT. HLM 7.00 for Windows. 2011.

    Google Scholar 

  40. Bjorklund RW, Monroe-DeVita M, Reed D, et al. Washington State’s initiative to disseminate and implement high-fidelity ACT teams. Psychiatric Services. 2009;60(1):24–27. https://doi.org/10.1176/appi.ps.60.1.24

    Article  PubMed  Google Scholar 

  41. Garner BR, Hunter BD, Modisette KC, et al. Treatment staff turnover in organizations implementing evidence-based practices: turnover rates and their association with client outcomes. Journal of Substance Abuse Treatment. 2012;42(2):134–142. https://doi.org/10.1016/j.jsat.2011.10.015.

    Article  PubMed  Google Scholar 

  42. Selden DR. The effects of staff turnover on psychiatric rehabilitation programs. Psychiatric Rehabilitation Journal. 2010;34(1):71–73. https://doi.org/10.2975/34.1.2010.71.73

    Article  PubMed  Google Scholar 

  43. Aarons GA, Sommerfeld DH, Willging CE. The soft underbelly of system change: the role of leadership in organization climate in turnover during statewide behavioral health reform. Psychological Services. 2011;8(4):269–281. https://doi.org/10.1037/a002619.The

    Article  PubMed  PubMed Central  Google Scholar 

  44. Glisson C, Schoenwald SK, Kelleher K, et al. 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. 2008;35(1–2):124–133. https://doi.org/10.1007/s10488-007-0152-9

    Article  PubMed  Google Scholar 

  45. Lavigne J V, Binns HJ, Arend R, et al. Psychopathology and health care use among preschool children: a retrospective analysis. Journal of the American Academy of Child & Adolescent Psychiatry. 1998;37(3):262–270. https://doi.org/10.1097/00004583-199803000-00010

    Article  CAS  Google Scholar 

  46. Herschell AD, Kogan JN, Celedonia KL, et al. Understanding community mental health administrators’ perspectives on Dialectical Behavior Therapy implementation. Psychiatric Services. 2009;60(7):989–992. https://doi.org/10.1176/appi.ps.60.7.989

  47. Kim H, Lee SY. Supervisory communication, burnout, and turnover intention among social workers in health care settings. Social Work in Health Care. 2009;48(4):364–385. https://doi.org/10.1080/00981380802598499

    Article  PubMed  Google Scholar 

  48. McGowan B, Auerbach C, Strolin-Goltzman J. Turnover in the child welfare workforce: a different perspective. Journal of Social Services Research. 2009;35(3):228–235. https://doi.org/10.1080/01488370902900782

    Article  Google Scholar 

  49. Palinkas LA, Horwitz SM, Chamberlain P, et al. Mixed-methods designs in mental health services research: a review. Psychiatric Services. 2011;62(3):255–263. https://doi.org/10.1176/appi.ps.62.3.255

    Article  PubMed  Google Scholar 

  50. American Psychological Association. Demographics of the U.S. psychology workforce: findings from the 2007–2016 American Community Survey. Washington, D.C.; 2018.

  51. National Research Council and Institute of Medicine. Preventing mental, emotional, and behavioral disorders among young people: progress and possibilities. (O’Connell ME, Boat T, Warner KE, eds.). Washington, DC: National Academies Press; 2009.

    Google Scholar 

  52. Glisson C, Williams NJ, Hemmelgarn A, et al. Increasing clinicians’ EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC. Behaviour Research and Therapy. 2016;76:40–46. https://doi.org/10.1016/j.brat.2015.11.008

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, West Virginia University, 1124 Life Sciences Building, P.O. Box 6040, Morgantown, WV, 26506-6040, USA

    Laurel A. Brabson MS & Amy D. Herschell PhD

  2. Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, USA

    Amy D. Herschell PhD & David J. Kolko PhD

Authors
  1. Laurel A. Brabson MS
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  2. Amy D. Herschell PhD
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  3. David J. Kolko PhD
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  4. Stanley J. Mrozowski PhD
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Correspondence to Laurel A. Brabson MS.

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Conflict of Interest

 Amy Herschell has received funding through grants from the National Institute of Heath (2U54GM104942-02), and Mental Health (R01 MH095750; R34 MH11059), a cooperative agreement with the Association of University Centers on Disabilities (AUCD)/Center for Disease Control (5NU38OT000140-05-00), and contracts with the Community Behavioral Health and Community Care Behavioral Health. David Kolko has received funding through grants from the National Institute of Mental Health (R01 MH095750-01), Substance Abuse andMental Health Services Administration (U79 SM080056-01; U79 SM080000-01), National Institute on Drug Abuse (U01 DA040213-02), and National Institute of Neurological Disorders and Stroke (P/I #XDK0216EPI). Laurel Brabson and Stanley Mrozowski have no conflicts of interest to report.

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Brabson, L.A., Herschell, A.D., Kolko, D.J. et al. Associations Among Job Role, Training Type, and Staff Turnover in a Large-Scale Implementation Initiative. J Behav Health Serv Res 46, 399–414 (2019). https://doi.org/10.1007/s11414-018-09645-1

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