Improving the Recruitment and Retention of Counselors in Rural Substance Use Disorder Treatment Programs

Abstract

While access to drug treatment has increased in recent years, there is still a shortage of substance use disorder (SUD) treatment counselors in the United States, especially in rural areas. This study examined recruitment and retention issues for counselors in rural substance use disorder treatment programs. Qualitative interviews were conducted with 26 program, clinical, and/or human resource directors of SUD treatment programs. Almost all interviewees had problems recruiting high-quality counselors although only a small number saw retention as a significant issue. Improving educational opportunities and training related to addictions counseling could result in more people entering the SUD treatment field. Strategies for improving retention of counselors include more supportive and inclusive management practices. The stigma of SUD also contributed to recruitment and retention problems.

Substance use among rural adolescents with incarcerated parents: Evidence from a state‐wide sample

“…43,44 With respect to care management, some substance use behaviors can be addressed in the primary care setting through counseling or medication-assisted treatment; however, there are severe shortages in providers in rural areas. [44][45][46][47] Adolescents who present high-risk substance use behaviors may require more intensive care, raising additional concern over what access to services may look like within rural communities. 21,44,48 These numerous barriers underscore the need for increased investment in rural pediatric professionals in primary care and behavioral and mental health.…”

“…Primary care practitioners play a key role in prevention, screening, and management of substance use disorders in adolescents, yet time constraints and inadequate resources introduce considerable barriers for screening in rural communities 43,44 . With respect to care management, some substance use behaviors can be addressed in the primary care setting through counseling or medication‐assisted treatment; however, there are severe shortages in providers in rural areas 44–47 . Adolescents who present high‐risk substance use behaviors may require more intensive care, raising additional concern over what access to services may look like within rural communities 21,44,48 .…”

Emotional Exhaustion and Turnover Intentions among Counselors in Rural Substance Use Disorder Treatment Programs

“…Trauma-informed clinical supervision could help counselors process the secondary trauma they experience (Jones & Branco, 2020). Counselors also want more paid time off which can help them reduce their emotional exhaustion (Beitel et al, 2018;Murphy, 2022). Further, programs should monitor job satisfaction and perceptions of workplace environment to identify negative changes in these areas that could lead to turnover (Garner & Hunter, 2014).…”

“…To aid in recruitment and retention of counselors in rural areas, states also need to expand incentives to attract people to work in rural areas. Student loan repayment programs, educational pipelines, and more clinical internships in rural programs could improve recruitment and address the shortage of rural counselors (Baum & King, 2020;Covino, 2019;Murphy, 2022). While several states have implemented these strategies, their impact is largely unknown.…”

“…Rural SUD treatment workers in Kentucky were more likely to work in facilities that lacked space and were in worse physical condition than their urban counterparts, which they said hindered the quality of treatment they could provide (Pullen & Oser, 2014). Rural locations might also not produce the "pipeline" of prospective counselors into the profession, leading to recruitment and retention issues (Murphy, 2022). Given the increasing demand for SUD treatment in rural areas, more research is needed to better understand the experiences of rural SUD treatment workers and the causes of turnover (Baum & King, 2020).…”