Workforce development in the US: a third approach
| Date | 01 May 2006 |
| Published date | 01 May 2006 |
| DOI | https://doi.org/10.1108/17556228200600007 |
| Pages | 42-44 |
| Author | Charles Rapp |
| Subject Matter | Health & social care |
42
Workforce development in the US:
athird approach
Abstract
The author identifies the two key issues in mental
health workforce development in the United States
at the moment as recovery and evidence-based
practice, viewed in the context of a workforce with
ahigh quotient of unqualified personnel. Two
common responses to this problem, training and
the hiring of more experienced staff are assessed as
either ineffective (the former) or not realistic (the
latter). The author recommends and produces
supportive evidence for the benefits of a more
extensive use of workplace mentoring and group
supervision approaches.
Key words
recovery; evidence-based practice; supervision;
field mentoring
The two dominant movements in mental health in the
United States are recovery and evidence-based practice.
Both movements demand new policies, perspectives and
skill sets within our mental health service delivery
agencies. The challenge is made more formidable by the
fact that the great majority of services are delivered by
people who are not fully credentialed professionals. Rather,
they tend to have a bachelor’sdegree, with no professional
training, and very little human service experience. The jobs
themselves are demanding and complex. Occupational
stress, burnout and job dissatisfaction are high (Kirk,
Koesky & Koeske, 1993; Finch & Krantz, 1991; Gellis, Kim
&Hwang, 2004). Turnover in these positions is frequent.
Acommon workforce development strategy solution is
some combination of attracting more seasoned and
credentialed staff and an increase in training. The first
recommendation is unrealistic. Salaries would have to be
increased by 30–50% in order to hire fully credentialed staff.
Given that mental health budgets are likely to be relatively
stable in the coming years, this would mean a reduction of
personnel of about a third to a half with a comparable
increase in caseload size. Yet caseload size is related to
effectiveness in many services (Rapp & Goscha, 2004).
Increasing the training of staff using traditional
approaches has also been found wanting. Traditional
approaches include workshops, didactic presentations,
dissemination of practice guidelines, etc. The evidence is
that these approaches do not produce changes in practice
(Bero et al,1998; Grimshaw et al,2001). The research on
change in health care consistently shows that educational
efforts alone do not strongly influence health care
provider’spractice behaviours (Davis et al,1992; Oxman,
Thomson & Davis, 1995). Curry, Caplan and Knuppel
(1994) estimate that only 10–13% of skills taught are
transferred to the working environment.
The supervision imperative
Another approach to improving the quality of services
would focus on the nature and methods of people
supervising frontline staff. In the United States, this role is
usually performed by professionals with full credentials
and with some years of experience but no training or
preparation for the particular role as supervisor. There is
also evidence that the quality of care received by clients
can be influenced mightily by the quality of supervision
that frontline workers receive (Corrigan et al,2000;
Ahearn, 1999; Harkness, 1997; Harkness & Hensley, 1991;
Harkness, 1995). Gowdy and Rapp (1989) found that the
major factor common to the most effective programmes
was the programme leader not the size of the budget,
location (urban, rural) or years in operation. In this
human resources context described above, there are
several innovations that hold considerable promise for
developing the mental health workforce.
Group supervision
As Ryan and Morgan (2004) describe, ‘group supervision is
basically a peer-based sharing process, intended to provide
mutual reinforcement and development of day to day practice’
(p118). Group supervision is a structured event focused
on specific cases and following a prescribed set of
protocols (Rapp & Goscha, 2006). The advantages of
group supervision include generating creative ideas for
difficult client situations, support and affirmation from
Charles A Rapp
Professor, School of Social Welfare, University of Kansas
The Journal of Mental Health Workforce Development Volume 1 Issue 1 May 2006 © Pavilion
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