T HE TRUISM THAT IT IS LONELY at the top could be no more relevant than it is among executives in the nonprofit sector. Due to the idiosyncratic nature of how nonprofit executives frequently come to take on leadership roles in their organizations and the relatively limited management structures in many organizations, the position of the executive is often isolated and inadequately supported.The impetus behind the use of executive coaching strategies is rooted in the awareness that many nonprofits have undertaken limited executive transition planning, with the result that individuals who rise to the executive director (ED) position lack adequate preparation and supports for this new role. Evidence from survey research shows that the turnover among nonprofit executives will continue to be substantial, with an estimated 65 percent of current executives

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Objectives: This study examines consumer and agency level predictors of competitive employment for consumers with co-occurring disorders. Methods: The study sample included 191 consumers from mental health agencies receiving Integrated Dual Diagnosis Treatment services, including a subgroup which was referred for Supported Employment Services. Results: Logistic regression analyses show consumers with schizoaffective disorder, greater psychiatric distress, and those not referred for Supported Employment services were less likely to enter competitively employment. Lack of previous employment and consumers' perceived disability negatively affected employment through referral status. Conclusions: Implications for mental health practice, service delivery, and future research are discussed.

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