Title: The Influence of Leadership Style on Staff Attributes in Substance Use Treatment Settings

Background and Purpose: Leadership is one of the key organizational factors in implementation science, yet few studies address its role in translating effective substance use interventions to practice. In particular, while leadership has been shown to affect organization readiness for change, the specific ways that implementation leadership styles impact staff attributes, an element of organizational readiness, is not well known. This quantitative study examined the influence of implementation leadership style on staff attributes relating to organizational readiness for change in substance use treatment settings.

Method: Clinical staff and program directors (N = 416) from substance use treatment programs completed an online survey measuring organizational readiness to change (ORC) and implementation leadership (ILS) as part of a larger study exploring barriers to implementation. The Texas Christian University ORC is a measure of organizational readiness to change comprised of 18 subscales, including staff attributes of staff efficacy, adaptability, growth, and influence. The ILS is comprised of four subscales representing knowledgeable, supportive, perseverant, and proactive leadership styles. Multiple regression was used to examine whether leadership style predicted each of the ORC staff attributes, controlling for profession and educational degree of survey participants.

Results: Multiple regression analyses suggest that knowledgeable leadership and supportive leadership are significantly associated with higher levels of staff efficacy (F(10, 397) = 22.06, < .001), whereas supportive leadership and perseverant leadership were significantly correlated with staff growth (F(10, 397) = 28.75, p < .001). Additionally, proactive and supportive leadership were significantly associated with staff influence (F(10, 397) = 20.5, p < .001). Knowledgeable leadership was the only leadership style significantly associated with staff adaptability (F(10, 397) = 13.58, p < .001).

Conclusions and Implications: Differential leadership styles may play an important role in shaping staff attributes related to implementation readiness in substance use treatment programs and organizations. Supportive and knowledgeable leadership appear to influence multiple staff attributes, while perseverant and proactive leadership seem more restricted in their effects, impacting a single staff attribute each. While proactive leadership may play a role in enhancing staff influence among their peers, knowledgeable leadership may lead to staff feeling more capable or effective in what they do and willingness to try new ideas. Lastly, supportive leadership may play an important role in enhancing a variety of staff attributes in relation to organizational readiness to change. Further examination of staff attributes as mediators of perceived implementation barriers may lead to targeted techniques addressing diversification of leadership styles or increasing specific staff attributes within a substance use treatment organization.