Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure

Charles Glisson, Sonja K. Schoenwald, Kelly Kelleher, John Landsverk, Kimberly Eaton Hoagwood, Stephen Mayberg, Philip Green, John Weisz, Bruce Chorpita, Robert Gibbons, Evelyn Polk Green, Kimberly Hoagwood, Peter S. Jensen, Jeanne Miranda, Lawrence Palinkas, Sonja Schoenwald

Research output: Contribution to journalArticlepeer-review

163 Scopus citations


The present study incorporates organizational theory and organizational characteristics in examining issues related to the successful implementation of mental health services. Following the theoretical foundations of socio-technical and cultural models of organizational effectiveness, organizational climate, culture, legal and service structures, and workforce characteristics are examined as correlates of therapist turnover and new program sustainability in a nationwide sample of mental health clinics. Results of General Linear Modeling (GLM) with the organization as the unit of analysis revealed that organizations with the best climates as measured by the Organizational Social Context (OSC) profiling system, had annual turnover rates (10%) that were less than half the rates found in organizations with the worst climates (22%). In addition, organizations with the best culture profiles sustained new treatment or service programs over twice as long (50 vs. 24 months) as organizations with the worst cultures. Finally, clinics with separate children's services units had higher turnover rates than clinics that served adults and children within the same unit. The findings suggest that strategies to support the implementation of new mental health treatments and services should attend to organizational culture and climate, and to the compatibility of organizational service structures with the demand characteristics of treatments.

Original languageEnglish (US)
Pages (from-to)124-133
Number of pages10
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Issue number1-2
StatePublished - Mar 2008


  • OSC
  • Organizational climate
  • Organizational culture
  • Organizational social context
  • Sustainability
  • Therapist turnover

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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