Emotional Exhaustion and Turnover Intentions among Counselors in Rural Substance Use Disorder Treatment Programs

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Counselor turnover is a serious problem for substance use disorder (SUD) treatment programs, especially in rural areas. This study examined the relationship between workload, workplace environment, and emotional exhaustion on turnover intentions among SUD treatment counselors in rural Pennsylvania. An online, anonymous survey was administered to rural SUD treatment counselors in Pennsylvania between October and December 2020. Completed surveys from 206 counselors were used for analysis. Variables included multi-dimensional measures of emotional exhaustion, intention to quit, workload, and workplace environment. Results showed age, perceptions of distributive justice, and management communication to be inversely related to emotional exhaustion and intention to quit. A subsequent analysis showed that the direct effects of these variables on intention to quit were reduced with the inclusion of emotional exhaustion in modeling, suggesting a potential mediation effect. Findings indicated that higher levels of emotional exhaustion were directly related to a greater intention to quit. A statistically significant indirect relationship was also found for distributive justice on intention to quit through emotional exhaustion, indicating a significant mediating effect. While counseling is a stressful occupation with high potential for burnout, these results show that organizations can adopt practices that help lower emotional exhaustion and turnover intentions for their counselors which could improve retention in the SUD treatment field. This is especially important for rural areas, where there is a high demand for SUD services and not enough treatment workers to meet that demand.

Original languageEnglish (US)
Pages (from-to)180-187
Number of pages8
JournalSubstance Use and Misuse
Issue number2
StatePublished - 2023

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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