Impact of turnover on organizational climate of substance abuse treatment clinics

1
Impact of turnover on organizational climate of
substance abuse treatment clinics

• E. Agius, C.L. Arfken, M.W. Dickson, J.
  Mitchelson, H.L. Anderson
• Wayne State University
• Funded by NIH Grant DA-14483

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Background

• Turnover in substance abuse treatment clinics is
  high.
• High staff turnover in substance abuse treatment
  programs has the potential to create many
  problems, including continuity of care, resource
  allocation and organizational climate

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Organizational Climate

• Organizational climate refers to the policies,
  practices and procedures that are rewarded,
  supported and expected in specific areas such as
  treatment (Schneider).
• We will explore the impact of turnover on
  treatment beliefs, one aspect of organizational
  climate

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Attraction-Selection-Attrition Model (Schneider
87)

• People are attracted to organizations that share
  beliefs similar to their own.
• Organizations are more likely to select (hire)
  people they perceive to share their values and
  beliefs.
• People exit organizations that do not share their
  beliefs.

5
Research Questions

• Do newly hired clinicians have similar beliefs
  about treatment compared to other staff?
• Do clinicians who leave a facility have
  dissimilar beliefs about treatment compared to
  other staff?

6
Methods

• Longitudinal study of research-affiliated and
  non-research-affiliated substance abuse treatment
  clinics
• Annual self-administered surveys of clinical
  staff in 2002, 2003.
• Year 1 151 clinical staff from 14 clinics
• Year 2 118 clinical staff from 14 clinics

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Do Clinics Have Turnover?
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Characteristics of Stay, Leave, New
p.009
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Treatment BeliefsForman et al. 2001

• Confrontation should be used in addiction
  treatment
• Methadone maintenance should be used with heroin
  addicts
• Spirituality should be emphasized in addiction
  treatment
• Research findings should be used in addiction
  treatment
• Psychiatric medication should be used in
  addiction treatment
• New approaches should be used in addiction
  treatment
• Working in the addiction treatment field has been
  a rewarding experience
• People who are unsuccessful in treatment just
  dont want it bad enough
• Addiction really is a disease
• Recovering counselors make the best therapists
• Noncompliant clients should be discharged

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Clinician-level Stability of Beliefs Year 1 to
Year 2
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Clinic-level Stability of BeliefsYear 1 to Year
2
12
Stay vs. New
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Leave vs. Stay
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Limitations

• The use of single items to measure beliefs.
• The small sample size limits the sensitivity of
  the analysis.

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Conclusions

• Most beliefs are stable at the clinic level and
  not unduly impacted by turnover.
• New staff are dissimilar on demographic
  characteristics but hold similar beliefs to those
  who stay.
• In accordance with Schneiders model, staff
  exiting organizations held more dissimilar
  beliefs than those people entering the
  organizations.