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As the opioid crisis continues to devastate families across the United States, Boston College researcher聽Erika Sabbath聽and her colleagues are working to improve the wellbeing and retention of workers at residential addiction treatment facilities.
High turnover rates at these facilities are expected to contribute to a national provider shortfall of 47 percent by 2036, according to Sabbath, exacerbating the opioid crisis through long wait times for treatment and reduced continuity of care.
鈥淥nce people get into treatment, they need to successfully complete treatment, and a bottleneck to successful completion is continuity within the addiction treatment workforce,鈥� said Sabbath, an associate professor at the 51成人动漫 School of Social Work who studies workplace stress. 鈥淭he goal of our project is to improve worker retention within residential addiction treatment centers by improving working conditions within these facilities.鈥�
Her work is backed by a six-year, $6 million grant from the , a congressionally funded effort to accelerate scientific solutions to the nation鈥檚 opioid crisis.
The project, titled the Residential Staff Health and Advancement Program for Excellence in Care, or Reshape, is divided into two phases, with funding distributed in stages. The first two-year phase will pilot and refine an intervention at three residential facilities in Massachusetts, while the second four-year phase will expand the program to between 30 and 40 facilities across the state if the researchers meet a series of benchmarks.
Workers in addiction treatment face a variety of stressors, according to Sabbath, including vicarious trauma, problems coordinating care, and limited opportunities for career advancement.
At each facility participating in the pilot, a committee of workers from across roles and levels will identify the most pressing workplace challenges and develop strategies to address them.
鈥淩ather than telling facilities what the problems are, we will work with a committee of workers to identify the stressors that are most salient within each facility,鈥� said Sabbath, whose collaborators include Susan Peters, a senior research scientist at the Harvard T.H. Chan School of Public Health, and Elisabeth Stelson, an assistant professor at the Washington University in St. Louis Bursky School of Public Health. 鈥淭he people who know the work best are the ones who do it every day.鈥�
Erika Sabbath.
The researchers have partnered with the Massachusetts Department of Public Health鈥檚 Bureau of Substance Addiction Services, which licenses and oversees substance use treatment facilities across the state. Jennifer Parks, the bureau鈥檚 assistant director for provider support, is working with the group to ensure that Reshape is developed in partnership with the state鈥檚 addiction treatment system. The intervention itself, however, will be tailored to the needs of each participating facility.
The committees will receive support from Reshape coaches, who will help workers assess conditions at their facilities, select problems to address, and identify evidence-based strategies that fit their needs. If workers are unable to take breaks, for example, a committee might examine whether staffing shortages or scheduling practices are contributing to the problem and develop a solution based on the underlying cause.
鈥淥ur coaches will be really involved at first and then gradually step back to help people feel like they can do this themselves,鈥� said Sabbath.
The researchers will collect data before, during, and after each facility receives the intervention so that they can evaluate the extent to which the program improves working conditions, worker wellbeing, turnover, and client outcomes. If the data show that the intervention helps retain workers, it could be expanded to other types of addiction treatment in the Commonwealth and beyond.
The project is personal for Sabbath. Her sister, Lauren Sabbath-Clayton, MSW鈥�15, is in recovery and has worked in addiction care for more than a decade.
In 2019, Sabbath-Clayton told Sabbath that her work was taking a physical and mental toll, pointing to burnout and compassion fatigue among addiction treatment professionals as major barriers to overcoming the opioid epidemic.
Sabbath realized that her own research on workplace stress put her in a position to help. 鈥淚 feel compelled to help make things better for this workforce because the work they provide is saving families, and it is bringing families back their loved one who has been in the throes of addiction,鈥� she said.