Re-examining the addiction counseling workforce: Training, treatment approaches, and turnover

The characteristics and competencies of the addiction treatment workforce are directly related to the quality of care available to persons needing help with alcohol and other drug problems. In 2005, questionnaire data were collected from a nationally-representative sample of N=1140 addiction counselors employed in specialty treatment settings throughout the US. While instability in the workforce is often cited, counselors reported relatively low scores on measures of burnout and turnover intention, and organizational commitment scores were high. However, age, recovery status, and work hours were associated with burnout; tenure, salary, and satisfaction with program management were associated with intent to quit. Dissonance between counselor receptivity to innovative practices and use of such practices in the treatment program was a strong predictor of intent to quit and low organizational commitment. Counselors reported on exposure to numerous evidence based practices. Counselors were more familiar with and supportive of using psychosocial counseling techniques. Counselors were less familiar with, and less accepting of pharmacotherapies, although these perceptions varied with the number of years elapsed since a medication's FDA approval. More detailed analyses identified significant associations between counselor characteristics and attitudes toward evidence-based practices. Recovering counselors and those endorsing a 12-step approach were less supportive of pharmacotherapies. Those with master's degrees, shorter tenure, and less endorsement of 12-step philosophies were more open to more recently-introduced treatment techniques. The treatment workforce varies in its composition, its exposure to evidence-based practices, and its stability. Implications for the quality of care available to clients will be highlighted.