Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Johnson-Kwochka A, Wu W, Luther L, Fischer MW, Salyers MP, Rollins AL. The Relationship Between Clinician Turnover and Client Outcomes in Community Behavioral Health Settings. Psychiatric services (Washington, D.C.). 2020 Jan 1; 71(1):28-34.
PubMed logo Search for Abstract from PubMed
(This link leaves the website of VA HSR&D.)


Abstract: OBJECTIVE: High clinician turnover in community behavioral health settings can lead to increased costs and can have a negative impact on care quality. Few studies have examined the implications of clinician turnover for client outcomes. This study investigated changes in client outcomes associated with clinician turnover. METHODS: The study used prospective observational data collected as part of a larger randomized controlled trial. Clients (N = 328) from two community behavioral health centers identified the clinician (N = 121) whom they saw most often. Clients completed measures of depression, anxiety, mental and physical health functioning, and patient activation at baseline, 6 months, and 12 months. Clinician turnover during the 12-month study was obtained from agency records. Latent growth curve modeling was used to analyze the data. RESULTS: Of the 328 clients, 24% experienced clinician turnover. For all outcomes except depression, the association with turnover was moderated by baseline status on the outcome measure. Turnover tended to be associated with clinical decline for clients who at baseline had low to moderate anxiety, high patient activation, or high physical health functioning. Surprisingly, turnover was associated with increased mental health functioning for clients who at baseline had very low mental health functioning. For physical health functioning, the association with turnover was also moderated by age. Turnover was associated with a sharper decline in functioning for older clients. CONCLUSIONS: Results suggest that clinician turnover was associated most strongly with decline for higher functioning or older clients, but it was not uniformly associated with worsening clinical outcomes.

Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.