Skip to main content

Advertisement

SpringerLink
Log in

Impact of Supervisory Support on Turnover Intention: The Mediating Role of Burnout and Job Satisfaction in a Longitudinal Study

  • Original Article
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

High rates of provider turnover are problematic for our mental health system. Research indicates that supervisory support could alleviate some turnover intention by decreasing emotional exhaustion (a key component of burnout) as well as by increasing job satisfaction. However, the potential mediation mechanisms have not been rigorously tested. Longitudinal data collected from 195 direct clinical care providers at two community mental health centers identified positive effects of supervisory support on reduced turnover intention through reduced emotional exhaustion. Job satisfaction was not a significant mediator. Supervisory support may help mitigate turnover intention through work-related stress reduction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. B is used to denote unstandardized coefficients and β is used to denote standardized coefficients.

References

  • Aarons, G. A., & Sawitzky, A. C. (2006). 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, 33(3), 289–301.

    Article  PubMed  Google Scholar 

  • Aarons, G. A., Sommerfeld, D. H., Hecht, D. B., Silovsky, J. F., & Chaffin, M. J. (2009). The impact of evidence-based practice implementation and fidelity monitoring on staff turnover: Evidence for a protective effect. Journal of Consulting and Clinical Psychology, 77(2), 270.

    Article  PubMed  PubMed Central  Google Scholar 

  • Beidas, R. S., Marcus, S., Wolk, C. B., Powell, B., Aarons, G. A., Evans, A. C., … Babbar, S. (2016). 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, 43(5), 640–649.

    Article  PubMed  Google Scholar 

  • Ben-Dror, R. (1994). Employee turnover in community mental health organization: A developmental stages study. Community Mental Health Journal, 30(3), 243–257.

    Article  CAS  PubMed  Google Scholar 

  • Bond, G. R., & Drake, R. E. (2017). New directions for psychiatric rehabilitation in the USA. Epidemiology and Psychiatric Sciences, 26(3), 223–227.

    Article  CAS  PubMed  Google Scholar 

  • Brandt, W. A., Bielitz, C. J., & Georgi, A. (2016). The impact of staff turnover and staff density on treatment quality in a psychiatric clinic. Frontiers in Psychology, 7, 457.

    Article  PubMed  PubMed Central  Google Scholar 

  • Broome, K. M., Knight, D. K., Edwards, J. R., & Flynn, P. M. (2009). Leadership, burnout, and job satisfaction in outpatient drug-free treatment programs. Journal of Substance Abuse Treatment, 37(2), 160–170.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bukach, A. M., Ejaz, F. K., Dawson, N., & Gitter, R. J. (2015). Turnover among community mental health workers in Ohio. Administration and Policy in Mental Health and Mental Health Services Research. https://doi.org/10.1007/s10488-015-0706-1.

    Article  Google Scholar 

  • Carlson, L., Rapp, C., & Eichler, M. (2012). The experts rate: Supervisory behaviors that impact the implementation of evidence-based practices. Community Mental Health Journal, 48, 179–186.

    Article  PubMed  Google Scholar 

  • Cheong, J., MacKinnon, D. P., & Khoo, S.-T. (2003). Investigation of mediational processes using latent growth curve modeling. Structural Equation Modeling, 10, 238–262.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cho, Y. J., & Song, H. J. (2017). Determinants of turnover intention of social workers: Effects of emotional labor and organizational trust. Public Personnel Management, 46(1), 41–65.

    Article  Google Scholar 

  • Cohen, G., Blake, R. S., & Goodman, D. (2016). Does turnover intention matter? Evaluating the usefulness of turnover intention rate as a predictor of actual turnover rate. Review of Public Personnel Administration, 36(3), 240–263.

    Article  Google Scholar 

  • Coomber, B., & Barriball, K. L. (2007). Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: A review of the research literature. International Journal of Nursing Studies, 44(2), 297–314.

    Article  PubMed  Google Scholar 

  • Dilonardo, J. (2011). Workforce issues in integrated behavioral healthcare: A background paper. Unpublished paper, National Council for Community Behavioral Healthcare.

  • Eby, L. T., Burk, H., & Maher, C. P. (2010). How serious of a problem is staff turnover in substance abuse treatment? A longitudinal study of actual turnover. Journal of Substance Abuse Treatment, 39(3), 264–271.

    Article  PubMed  PubMed Central  Google Scholar 

  • Eisenberger, R., Stinglhamber, F., Vandenberghe, C., Sucharski, I. L., & Rhoades, L. (2002). Perceived supervisor support: Contributions to perceived organizational support and employee retention. Journal of Applied Psychology, 87(3), 565.

    Article  PubMed  Google Scholar 

  • Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press.

    Google Scholar 

  • Evans, S., Huxley, P., Gately, C., Webber, M., Mears, A., Pajak, S., … Katona, C. (2006). Mental health, burnout and job satisfaction among mental health social workers in England and Wales. The British Journal of Psychiatry, 188(1), 75–80.

    Article  PubMed  Google Scholar 

  • Fritz, M. S., & MacKinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fukui, S., Rapp, C. A., Goscha, R., Marty, D., & Ezell, M. (2014). The perceptions of supervisory support scale. Administration and Policy in Mental Health and Mental Health Services Research, 41(3), 353–359.

    Article  PubMed  Google Scholar 

  • Gabel Shemueli, R., Dolan, S. L., Suárez Ceretti, A., & Nuñez del Prado, P. (2016). Burnout and engagement as mediators in the relationship between work characteristics and turnover intentions across two Ibero-American nations. Stress and Health, 32(5), 597–606.

    Article  PubMed  Google Scholar 

  • Garner, B. R., & Hunter, B. D. (2014). Predictors of staff turnover and turnover intentions within addiction treatment settings: Change over time matters. Substance Abuse: Research and Treatment. https://doi.org/10.4137/SART.S17133.

    Article  Google Scholar 

  • Glisson, C., & Durick, M. (1988). Predictors of job satisfaction and organizational commitment in human service organizations. Administrative Science Quarterly. 33, 61–81.

    Article  Google Scholar 

  • Green, A. E., Miller, E. A., & Aarons, G. A. (2013). Transformational leadership moderates the relationship between emotional exhaustion and turnover intention among community mental health providers. Community Mental Health Journal, 49(4), 373–379.

    Article  PubMed  Google Scholar 

  • Hawkins, A. J., Amato, P. R., & Kinghorn, A. (2013). Are government-supported healthy marriage initiatives affecting family demographics? A state-level analysis. Family Relations, 62(3), 501–513.

    Article  Google Scholar 

  • Hoge, M., Morris, J., Daniels, A., Stuart, G., Huey, L., & Adams, N. (2007). An action plan on behavioral health workforce development. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.

    Google Scholar 

  • Hoge, M. A., Migdole, S., Cannata, E., & Powell, D. J. (2014). Strengthening supervision in systems of care: Exemplary practices in empirically supported treatments. Clinical Social Work Journal, 42(2), 171–181.

    Article  Google Scholar 

  • Holtom, B. C., & Burch, T. C. (2016). A model of turnover-based disruption in customer services. Human Resource Management Review, 26(1), 25–36.

    Article  Google Scholar 

  • Holtom, B. C., Mitchell, T. R., Lee, T. W., & Eberly, M. B. (2008). 5 turnover and retention research: A glance at the past, a closer review of the present, and a venture into the future. Academy of Management Annals, 2(1), 231–274.

    Article  Google Scholar 

  • Holtom, B. C., Mitchell, T. R., Lee, T. W., & Inderrieden, E. J. (2005). Shocks as causes of turnover: What they are and how organizations can manage them. Human Resource Management, 44(3), 337–352.

    Article  Google Scholar 

  • Hom, P. W., Lee, T. W., Shaw, J. D., & Hausknecht, J. P. (2017). One hundred years of employee turnover theory and research. Journal of Applied Psychology, 102(3), 530.

    Article  PubMed  Google Scholar 

  • Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.

    Article  Google Scholar 

  • Hyrkäs, K., Appelqvist-Schmidlechner, K., & Haataja, R. (2006). Efficacy of clinical supervision: Influence on job satisfaction, burnout and quality of care. Journal of Advanced Nursing, 55(4), 521–535.

    Article  PubMed  Google Scholar 

  • Jayaratne, S., & Chess, W. A. (1984). Job satisfaction, burnout, and turnover: A national study. Social Work, 29(5), 448–453.

    Article  CAS  PubMed  Google Scholar 

  • Kadushin, A., & Harkness, D. (2014). Supervision in social work. New York: Columbia University Press.

    Book  Google Scholar 

  • Kilminster, S. M., & Jolly, B. C. (2000). Effective supervision in clinical practice settings: A literature review. Medical Education, 34(10), 827–840.

    Article  CAS  PubMed  Google Scholar 

  • Kim, H., & Lee, S. Y. (2009). Supervisory communication, burnout, and turnover intention among social workers in health care settings. Social Work in Health Care, 48(4), 364–385.

    Article  PubMed  Google Scholar 

  • Knight, D. K., Becan, J. E., & Flynn, P. M. (2012). Organizational consequences of staff turnover in outpatient substance abuse treatment programs. Journal of Substance Abuse Treatment, 42(2), 143–150.

    Article  PubMed  Google Scholar 

  • Knight, D. K., Becan, J. E., & Flynn, P. M. (2013). The impact of staff turnover on workplace demands and coworker relationships. Counselor (Deerfield Beach, Fla.), 14(3), 20.

    Google Scholar 

  • Knudsen, H. K., Ducharme, L. J., & Roman, P. M. (2008). Clinical supervision, emotional exhaustion, and turnover intention: A study of substance abuse treatment counselors in the Clinical Trials Network of the National Institute on Drug Abuse. Journal of Substance Abuse Treatment, 35(4), 387–395.

    Article  PubMed  PubMed Central  Google Scholar 

  • Landsman, M. J. (2001). Commitment in public child welfare. Social Service Review, 75(3), 386–419.

    Article  Google Scholar 

  • Leiter, M. P., & Maslach, C. (2009). Nurse turnover: The mediating role of burnout. Journal of Nursing Management, 17(3), 331–339.

    Article  PubMed  Google Scholar 

  • Little, R. J. A. (2009). Selection and pattern-mixture models. In G. Fitzmaurice, M. Davidian, G. Verbeke & G. Monlenberghs (Eds.), Longitudinal data analysis (pp. 409–431). Boca Raton: Chapman & Hall/CRC.

    Google Scholar 

  • Locke, E. A. (1969). What is job satisfaction? Organizational Behavior and Human Performance, 4(4), 309–336.

    Article  Google Scholar 

  • Luther, L., Gearhart, T., Fukui, S., Morse, G., Rollins, A. L., & Salyers, M. P. (2017). Working overtime in community mental health: Associations with clinician burnout and perceived quality of care. Psychiatric Rehabilitation Journal, 40(2), 252–259.

    Article  PubMed  Google Scholar 

  • MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. New York: Lawrence Erlbaum.

    Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39(1), 99–128.

    Article  PubMed  PubMed Central  Google Scholar 

  • Martin, U., & Schinke, S. P. (1998). Organizational and individual factors influencing job satisfaction and burnout of mental health workers. Social Work in Health Care, 28(2), 51–62.

    Article  CAS  PubMed  Google Scholar 

  • Maslach, C., & Jackson, S. E. (1984). Burnout in organizational settings. In S. Oskamp (Ed.), Applied social psychology annual: Applications in organizational settings (Vol. 5, pp. 133–153). Beverly Hills: Sage.

    Google Scholar 

  • Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach burnout inventory manual (3rd ed.). Palo Alto: Consulting Psychologists Press.

    Google Scholar 

  • Maxwell, S. E., & Cole, D. A. (2007). Bias in cross-sectional analyses of longitudinal mediation. Psychological Methods, 12(1), 23.

    Article  PubMed  Google Scholar 

  • McEvoy, G. M., & Cascio, W. F. (1987). Do good or poor performers leave? A meta-analysis of the relationship between performance and turnover. Academy of Management Journal, 30(4), 744–762.

    Google Scholar 

  • Miller, W. R., & Rollnick, S. (2002). Preparing people for change. Motivational interviewing (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Moeller, J., Ivcevic, Z., White, A. E., Menges, J. I., & Brackett, M. A. (2018). Highly engaged but burned out: Intra-individual profiles in the US workforce. Career Development International, 23(1), 86–105.

    Article  Google Scholar 

  • Morazes, J. L., Benton, A. D., Clark, S. J., & Jacquet, S. E. (2010). Views of specially-trained child welfare social workers: A qualitative study of their motivations, perceptions, and retention. Qualitative Social Work, 9(2), 227–247.

    Article  Google Scholar 

  • Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 341–352.

    Article  PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user’s guide (8th ed.). Los Angeles: Muthén & Muthén.

  • Nagy, M. S. (2002). Using a single-item approach to measure facet job satisfaction. Journal of Occupational and Organizational Psychology, 75, 77–86.

    Article  Google Scholar 

  • O’Donoghue, K., & Tsui, M. S. (2013). Social work supervision research (1970–2010): The way we were and the way ahead. The British Journal of Social Work, 45(2), 616–633.

    Article  Google Scholar 

  • Ogresta, J., Rusac, S., & Zorec, L. (2008). Relation between burnout syndrome and job satisfaction among mental health workers. Croatian Medical Journal, 49(3), 364–374.

    Article  PubMed  PubMed Central  Google Scholar 

  • Paris, M., & Hoge, M. A. (2010). Burnout in the mental health workforce: A review. The Journal of Behavioral Health Services & Research, 37(4), 519–528.

    Article  Google Scholar 

  • Poghosyan, L., Clarke, S. P., Finlayson, M., & Aiken, L. H. (2010). Nurse burnout and quality of care: Cross-national investigation in six countries. Research in Nursing & Health, 33(4), 288–298.

    Article  Google Scholar 

  • Pritschet, L., Powell, D., & Horne, Z. (2016). Marginally significant effects as evidence for hypotheses: Changing attitudes over four decades. Psychological Science, 27(7), 1036–1042.

    Article  PubMed  Google Scholar 

  • Rollins, A. L., Kukla, M., Morse, G., Davis, L., Leiter, M., Monroe-DeVita, M., … Collins, L. (2016). Comparative effectiveness of a burnout reduction intervention for behavioral health providers. Psychiatric Services, 67(8), 920–923.

    Article  PubMed  Google Scholar 

  • Rollins, A. L., Salyers, M. P., Tsai, J., & Lydick, J. M. (2010). 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, 37(5), 417–426.

    Article  PubMed  Google Scholar 

  • Salyers, M. P., Bonfils, K. A., Luther, L., Firmin, R. L., White, D. A., Adams, E. L., & Rollins, A. L. (2016). The relationship between professional burnout and quality and safety in healthcare: A meta-analysis. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-016-3886-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salyers, M. P., Fukui, S., Rollins, A. L., Firmin, R., Gearhart, T., Noll, J. P., … Davis, C. J. (2015). Burnout and self-reported quality of care in community mental health. Administration and Policy in Mental Health and Mental Health Services Research, 42, 61–69.

    Article  PubMed  Google Scholar 

  • Salyers, M. P., Garabrant, J., Luther, L., Henry, N., Fukui, S., Shimp, D., … Rollins, A. (2019). A comparative effectiveness trial to reduce burnout and improve quality of care. Administration and Policy in Mental Health Services Research, 46(2), 238–254.

    Article  Google Scholar 

  • Salyers, M. P., Hudson, C., Morse, G., Rollins, A. L., Monroe-DeVita, M., Wilson, C., & Freeland, L. (2011). BREATHE: A pilot study of a one-day retreat to reduce burnout among mental health professionals. Psychiatric Services, 62, 214–217.

    Article  PubMed  Google Scholar 

  • Scanlan, J. N., & Still, M. (2013). Job satisfaction, burnout and turnover intention in occupational therapists working in mental health. Australian Occupational Therapy Journal, 60(5), 310–318.

    PubMed  Google Scholar 

  • Schumm, W. R., Pratt, K. K., Hartenstein, J. L., Jenkins, B. A., & Johnson, G. A. (2013). Determining statistical significance (alpha) and reporting statistical trends: Controversies, issues, and facts. Comprehensive Psychology. https://doi.org/10.2466/03.CP.2.10.

    Article  Google Scholar 

  • Selig, J. P., & Preacher, K. J. (2009). Mediation models for longitudinal data in developmental research. Research in Human Development, 6(2–3), 144–164.

    Article  Google Scholar 

  • Smith, B. D. (2005). Job retention in child welfare: Effects of perceived organizational support, supervisor support, and intrinsic job value. Children and Youth Services Review, 27(2), 153–169.

    Article  Google Scholar 

  • Tett, R. P., & Meyer, J. P. (1993). Job satisfaction, organizational commitment, turnover intention, and turnover: Path analyses based on meta-analytic findings. Personnel Psychology, 46(2), 259–293.

    Article  Google Scholar 

  • Tziner, A., Rabenu, E., Radomski, R., & Belkin, A. (2015). Work stress and turnover intentions among hospital physicians: The mediating role of burnout and work satisfaction. Revista de Psicología del Trabajo y de las Organizaciones, 31(3), 207–213.

    Article  Google Scholar 

  • Verhaeghe, M., & Bracke, P. (2012). Associative stigma among mental health professionals: Implications for professional and service user well-being. Journal of Health and Social Behavior, 53(1), 17–32.

    Article  PubMed  Google Scholar 

  • Wanous, J. P., Reichers, A. E., & Hudy, M. J. (1997). Overall job satisfaction: How good are single-item measures? Journal of Applied Psychology, 82, 247–252.

    Article  CAS  PubMed  Google Scholar 

  • Wright, T. A., & Bonett, D. G. (1992). The effect of turnover on work satisfaction and mental health: Support for a situational perspective. Journal of Organizational Behavior, 13(6), 603–615.

    Article  Google Scholar 

  • Wright, T. A., & Cropanzano, R. (1998). Emotional exhaustion as a predictor of job performance and voluntary turnover. Journal of Applied Psychology, 83(3), 486.

    Article  CAS  PubMed  Google Scholar 

  • Wu, W., & Jia, F. (2013). A new procedure to test mediation with missing data through nonparametric bootstrapping and multiple imputation. Multivariate Behavioral Research, 48(5), 663–691.

    Article  PubMed  Google Scholar 

  • Wu, W., Selig, J. N., & Little, T. D. (2013). Longitudinal data analysis. In T. D. Little (Ed.), Handbook of quantitative methods. Oxford: Oxford University Press.

    Google Scholar 

  • Yanchus, N. J., Periard, D., Moore, S. C., Carle, A. C., & Osatuke, K. (2015). Predictors of job satisfaction and turnover intention in VHA mental health employees: A comparison between psychiatrists, psychologists, social workers, and mental health nurses. Human Service Organizations: Management, Leadership & Governance, 39(3), 219–244.

    Google Scholar 

  • Yanchus, N. J., Periard, D., & Osatuke, K. (2017). Further examination of predictors of turnover intention among mental health professionals. Journal of Psychiatric and Mental Health Nursing, 24(1), 41–56.

    Article  CAS  PubMed  Google Scholar 

  • Yanos, P. T., Vayshenker, B., DeLuca, J. S., & O’Connor, L. K. (2017). Development and validation of a scale assessing mental health clinicians’ experiences of associative stigma. Psychiatric Services, 68(10), 1053–1060.

    Article  PubMed  Google Scholar 

  • Zhang, Y., & Feng, X. (2011). The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: A cross-sectional study. BMC Health Services Research, 11(1), 235.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The study was supported by Patient-Centered Outcomes Research Institute (Grant No. IH-1304-6597).

Author information

Authors and Affiliations

  1. Indiana University School of Social Work, 902 West New York Street, Indianapolis, IN, 46202-5156, USA

    Sadaaki Fukui

  2. Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD120c, Indianapolis, IN, 46202-3217, USA

    Wei Wu

  3. Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD124, Indianapolis, IN, 46202-3217, USA

    Michelle P. Salyers

Authors
  1. Sadaaki Fukui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wei Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michelle P. Salyers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sadaaki Fukui.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Disclaimer

The content is solely the responsibility of the authors and does not represent the official views of PCORI.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fukui, S., Wu, W. & Salyers, M.P. Impact of Supervisory Support on Turnover Intention: The Mediating Role of Burnout and Job Satisfaction in a Longitudinal Study. Adm Policy Ment Health 46, 488–497 (2019). https://doi.org/10.1007/s10488-019-00927-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-019-00927-0

Keywords

Search

Navigation