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Adm Policy Ment Health. 2019 Nov;46(6):713-723. doi: 10.1007/s10488-019-00949-8.

Therapist Financial Strain and Turnover: Interactions with System-Level Implementation of Evidence-Based Practices.

Author information

1
School of Social Service Administration, University of Chicago, Chicago, IL, USA.
2
Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA.
3
School of Social Work, Boise State University, Boise, ID, USA.
4
Hall-Mercer Community Mental Health Center, Philadelphia, PA, USA.
5
Evidence-Based Practitioners of New Jersey, Summit, NJ, USA.
6
University of Texas, Southwestern, TX, Dallas, USA.
7
Qualtrics, Provo, UT, USA.
8
Community Behavioral Health, Philadelphia, PA, USA.
9
Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA. rbeidas@upenn.edu.
10
Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. rbeidas@upenn.edu.
11
Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA. rbeidas@upenn.edu.

Abstract

Therapist turnover is a major problem in community mental health. Financial strain, which is composed of cognitive, emotional, and behavioral responses to the experience of economic hardship, is an understudied antecedent of therapist turnover given the tumultuous financial environment in community mental health. We prospectively examined the relationship between therapist financial strain and turnover in 247 therapists in 28 community mental health agencies. We expected greater therapist financial strain to predict higher turnover and participation in a system-funded evidence-based practice (EBP) training initiative to alleviate this effect. Controlling for covariates, financial strain predicted therapist turnover (OR 1.12, pā€‰=ā€‰.045), but not for therapists who participated in an EBP training initiative. Reducing financial strain and/or promoting EBP implementation may be levers to reduce turnover.

KEYWORDS:

Behavioral health services; Evidence-based practice; Financial strain; Implementation; System transformation; Turnover

PMID:
31203492
DOI:
10.1007/s10488-019-00949-8

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