Date of Conferral

2-18-2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Matt Frederiksen-England

Abstract

Many outpatient substance use treatment centers struggle with retention and recruitment of counseling staff. Without sufficient staff, substance use outpatient treatment centers are unable to provide services to patients who need such support, and patients often seek care in places like the emergency department, which creates problems for the healthcare system, such as overcrowding. The purpose of this research was to identify strategies to increase retention and improve recruiting effectiveness for counseling staff at outpatient substance use treatment centers. The conceptual framework of plan, recruit, retain underpinned this integrative review. The review question centered on the best strategies to reduce counseling staff turnover and increase counseling staff retention in outpatient substance use treatment centers. Using the Johns Hopkins evidence-based appraisal tool, sources were narrowed to 20 that fit for content and quality. Thematic analysis revealed four themes and 11 subthemes, with the four themes being build a culture of retention, promote provider resilience, develop recruitment strategies, and engage in strategic planning for targeted recruitment. Subthemes focused on wages, educational opportunities, and team cohesion. Final recommendations include proactive workforce planning, leadership development that prioritizes staff retention and provider resilience, modernized recruitment strategies to reflect the evolving expectations of behavioral health professionals, and improvements to compensation and benefit structures. By improving access to substance use treatment services, healthcare leaders may be able to foster positive social change for some of the community’s most vulnerable individuals.

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