Substance Abuse Treatment Staff Educational Level and Perceptions of Organizational Readiness for Change

Background/Purpose: Several studies have found that substance abuse treatment (SAT) staff with higher levels of education have more positive attitudes about evidence-based addiction treatment practices, science-based staff training, and the usefulness of evidence-based practices (EBPs). This study examined the association between clinical staff's level of education and treatment experience and perception of organizational capacity utilizing the Texas Christian University Organizational Readiness for Change (TCU-ORC) measure as the dependent variable.

Methods: Analysis included 588 clinical staff from community-based SAT organizations who received funding from the Substance Abuse Mental Health Services Administration between 2003 and 2008 to implement EBPs. Two separate sets of analyses were conducted. Bivariate analysis (one-way ANOVA and correlation analysis) examined the statistical relationship between all independent variables (age, gender, level of education, years of experience in drug abuse counseling, organizational affiliation with a research institution, type of treatment unit, primary service area, program duration, type of EBP implemented, and the 18 TCU-ORC subscales). Multivariate linear regression models were developed using all variables significant at the bivariate level (p < 0.05)  and testing each TCU-ORC scale as dependent variables.

Results: Controlling for a range of staff and organizational characteristics, multivariable models identified clinical staff with lower levels of education (no high school diploma, a high school diploma/some college education) had significantly more positive attitudes about their treatment unit's organizational readiness for change when compared to college graduate staff. Further, findings from separate regression models testing the association between education and each of the TCU-ORC sub-scales further support its negative relationship. These results contradict findings that addiction treatment staff with higher levels of education work in units with greater levels of organizational readiness for change (i.e., greater level of organizational capacity to implement new EBPs).

Conclusions/Implications: Researchers using TCU-ORC scores should not assume a positive relationship between higher levels of education among organizational staff (i.e., the organization they work in have more resources to hire more highly educated staff) and positive ratings of organizational readiness for change. It may well be that more highly educated staff members have greater expectations of the treatment units they work in and consequently rate their units lower. Hence, staff levels of education and organizational readiness for change are not necessarily synonymous.