Research Provides Insights on Recruitment, Retention Of Substance Use Disorder Treatment Counselors

Pennsylvania had the fifth-highest death rate from drug overdoses in the country in 2019, according to the Centers for Disease Control and Prevention. While overdose death rates declined in Pennsylvania from 2017 to 2019, preliminary data for 2020 showed an increase.

Jobs for substance use disorder, behavioral health, and mental health counselors are likely to increase 23 percent by 2026 across the U.S., according to data from the U.S. Bureau of Labor Statistics. As the opioid crisis continues to impact communities, there may be an even higher demand for substance use disorder (SUD) treatment counselors, particularly in rural areas.

However, employee turnover in the SUD treatment field is a challenging issue, as research indicates a consistently high voluntary turnover rate among counselors.

To examine recruitment and retention issues in rural SUD treatment programs in Pennsylvania, Dr. Jennifer Murphy of Penn State Berks surveyed current SUD counselors and interviewed treatment program and clinical directors to assess the characteristics of professional SUD treatment counselors in rural Pennsylvania counties and how those characteristics relate to recruitment and retention issues.

The research also assessed higher education institutions in rural counties to understand how well they prepare those entering the profession, and it analyzed the effectiveness of state-level incentives, like the student loan repayment program, to attract potential treatment counselors.

The results indicated that counselor recruitment is a major problem for SUD treatment programs in rural Pennsylvania counties. Interviews with program and clinical directors revealed their concerns about the number of qualified applicants for open positions. The three most common reasons cited for recruitment problems were: salary, the facility’s location, and applicants lacking the required training in SUD treatment.

In terms of retention, the counselor survey revealed that emotional exhaustion was the strongest predictor of intent to quit. Low job satisfaction, poor management communication, and having a high percentage of clients on medication assisted treatment were also related to intent to quit.

To increase recruitment and retention of treatment counselors, the research suggests that treatment programs should get reimbursed for services at the same rate as other mental health providers. This would allow programs to offer higher starting salaries to attract more counselors into the substance use disorder treatment field.

Another policy consideration from the research was that student loan forgiveness programs should be expanded to allow more counselors in treatment programs to qualify for the benefit. This could improve both recruitment and retention in the field.

Also, students in both undergraduate and graduate counseling programs should receive more direct education and training in addiction. Finally, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) should consider increasing the variety of its counselor trainings and including more trainings related to emotional exhaustion and trauma. DDAP also should consider consulting with programs about implementing management strategies associated with better counselor retention.

Visit the Research Reports page on the Center for Rural Pennsylvania website for a copy of the report, Recruitment and Retention Issues for Counselors in Rural Pennsylvania Substance Use Disorder Treatment Programs.