Date of Conferral

10-14-2026

Date of Award

October 2026

Degree

Doctor of Psychology (Psy.D.)

School

Psychology

Advisor

Dr Kimberly McCann

Abstract

Behavioral health organizations face challenges related to client turnover, inconsistent service engagement, workforce instability, and operational inefficiencies that can disrupt continuity of care and organizational performance. Guided by the Baldrige Performance Excellence Framework, the purpose of this qualitative case study was to explore organizational and leadership factors contributing to client turnover and inconsistent service engagement within a nonprofit outpatient behavioral health organization. Data were collected through semistructured interviews with organizational leaders and review of organizational documents, attendance reports, retention-related data, and operational records. Thematic coding and triangulation identified eight themes: leadership communication and responsiveness, workforce strain and burnout, inconsistent engagement strategies, service delivery gaps, operational inefficiencies, workforce support and supervision, organizational culture and morale, and data-informed decision-making challenges. Findings indicated that inconsistent communication, staffing instability, fragmented engagement practices, and operational barriers contributed to reduced continuity of care and client disengagement. Recommendations include standardized engagement and follow-up protocols, stronger leadership communication, workforce wellness and supervision supports, and data-informed quality improvement practices. The study contributes to behavioral health leadership practice and social change by identifying strategies that may strengthen workforce sustainability, improve client participation and continuity of care, and support more responsive and equitable behavioral health services.

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