No counselor left behind : addressing counselor workforce attrition during implementation of integrated treatment and evidence-based practices for co-occurring disorders in substance abuse treatment programs

The recent push for integrated systems of care for "individuals with co-occurring mental health and substance abuse disorders has led to the need for behavioral healthcare systems to transform their service delivery. The purpose of this study was to identify those factors which facilitate substance abuse counselors' ability to adopt the principles of integrated treatment, adapt to the change and remain in their position. The researcher used a qualitative design with a sample of nine substance abuse counselors employed by a behavioral healthcare system that recently implemented an integrated system of treatment for co-occurring mental health and substance abuse disorders into its substance abuse treatment program. Data collection consisted of face-to-face interviews with each participant and indirect observations. Data analysis followed a known and accepted constructivistic phenomenological design.

The data revealed that while substance abuse counselors are adapting to organizational change they undergo a parallel process similar to that of their clients in recovery. During this process several internal factors such as temperament, personal beliefs, and experience help the counselors adapt and remain in their position, while external factors such as clinical supervision, extensive trainings, and supportive teamwork helped guide them towards change.