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Nov 10, 2023

From Recruitment to Retention: Best Practices for Strengthening the Mental Health Workforce

Today, it's more important than ever to recruit and retain therapists. What are some effective strategies?

Carla Smith, Ph.D, LCSW, LMFT

Chief Clinical Officer

Thousands of treatment centers, clinics, community centers, and organizations are competing for the same workers. Mental health workers are jumping around between jobs—50% of all employed therapists leave their positions within two years.

How do you recruit and retain the best therapists for your organization in today’s environment? 

And how do you make sure your therapists are the 50% that want to stay with you instead of moving on?

The Recruitment/Retention Process

  1. Make sure you define your problem and goals
  2. Attract candidates
  3. Hire the best candidates
  4. Retain quality staff
  5. Iterate/Evaluate the process

The mental health worker shortage is a long term situation

We’ve been saying "crisis" for a long time now. A crisis points to a climax or critical point… A culmination.

What we have is a situation. It’s been a long time coming, and it’s going to be here for a while. 

We need to move out of crisis mode and create long-term strategies. Even though the demand for care far outstrips our workforce, we need to pace ourselves. 

  1. You need new, creative approaches to treating enough clients with the staff you can draw to your organization (It’s almost impossible to be creative in crisis mode).
  2. Your organization needs to retain your clinicians because the vicious cycle of recruitment and training means less time treating and improving.

A constant cycle of new workers has become the status quo for organizations “in crisis,” but it’s not sustainable or affordable. 

  • Advertising
  • Interviewing
  • Checking references
  • Onboarding
  • Preliminary training
  • Exit interviews

These are all tasks that keep funding and energy in HR instead of in actual patient care.

How do you approach recruitment differently?

Stage 1: Assess your mental health worker situation

Ask the hard questions, and not just while you’re talking to yourself. Ask your workers in whatever way you think you will get honest answers. 

  1. Anonymous surveys
  2. Third-party interviewing
  3. Make periodic reviews go both ways
  4. Get feedback from directors
  5. Ask those who are leaving during the exit interview (though many won’t give you the honest answer, take seriously the ones who do).

The answers you need to recruit and retain effectively: 

Why did your clinicians choose to work with you? 

Why do they choose to leave?

Why do they choose to stay? How long have they stayed?

What is the one thing that almost stood in the way of their accepting your offer?

What would draw them away? Can you offer that?

Why most clinicians leave:

  • Poor compensation (salary and benefits)
  • Stress/burnout
  • Little or no advancement potential
  • Better opportunities in an entirely different field
  • They attain a higher degree
  • Lack of administration support

How can you address these issues in your organization before you resume hiring?

2. Know who you want to attract 

“Dress for the job you want.”

Companies need to dress for the employees they want to attract. But first, know what kind of candidate you want. 

  • Do you want associates who are going to move on in a year or ones who will stay once they are familiar with your organization and its purpose?
  • Are you looking for therapists with basic clinical skills or do you want those who are already working independently?
  • Do you need particular specialties to serve your population?  
  • Are you willing to make room for growth and opportunities for advancement and specialization? 

Define what skills and characteristics you need from your applicants. Include negotiable and non-negotiable. Then evaluate those expectations: 

  • Are they realistic and open to growth? 
  • Do you require certain licenses or certificates or are you willing to help them get there?
  • What hours or days must they work? Remote? In-office? Hybrid?
  • What does the applicant want and how do your goals align? Ask.

What are your competitors offering their prospects? How do you compare? You’re wooing the same workers. How do you make sure you’re the prime choice?

Sometimes the difference is in 1 or 2 more personal days, educational benefits, or offering clinical supervision. 

Take the Proactive Approach with Your Recruitment

Many practices and private treatment programs historically avoid recruiting new graduates because they don’t want to train or provide clinical supervision. Recruit where your ideal workers are:

Universities and graduate programs: 

With a dwindling workforce and the ability to outsource clinical supervision, organizations like yours are finding associate therapists are an asset.

  • Associate therapists bring energy and excitement to your therapy team.
  • New clinicians know they need to learn and are eager to do so.
  • Give them purpose within your organization. When they feel like they are valuable, growing, and making a difference, the time and investment in their training pay off in dividends. 

LinkedIn and other social media:

When people look for professional jobs, they go to LinkedIn. List there, and advertise. Other social media outlets are creative options for targeting your ideal audience. 

Be interesting, even fun if that fits your work style. Find a fresh approach in your job descriptions.  Use fresh images and job descriptions with personality. Describe “a day in the life.”

Your current employees:

Let your current therapy and admin teams know you’re recruiting.

Offer a referral bonus that pays not only if the candidate is hired but if they stay for six months. 

A unique approach: sell the lifestyle

When you post positions, sell the life outside the office. You don’t have to be someplace glamorous to make that work. Plenty of people are looking for affordability, a remote or hybrid position, or a community with great restaurants and outdoor activities. 

Retention: Encourage Your Therapists to Stay

The main reason therapists (or any workers) stay in a job is that they feel appreciated and respected. 

A good start is to look at what makes them leave and solve that.


Is the pay fair and are they able to conduct their work and meet their needs without worrying about paying the rent and power bill? Are they able to do more than just get by?

Therapists often carry student loan debt. If your organization qualifies for any student loan forgiveness programs, complete whatever steps you need to so they can qualify. Make sure your HR department is ready to help them with applications.

Caseload and Organizational Attitude Toward Work: 

It’s ridiculous to think that people who work with those who are in pain aren’t touched by that pain. A balanced workload, vacation time, and personal time to meet their own needs are important. 

  • Encourage breaks between therapy sessions for mental and physical refreshment. 
  • When assigning clients, balance challenging cases with less challenging cases to avoid exhaustion. 
  • Offer generous paid time off and vacation time so they can maintain their energy levels over the long term and meet their own needs for health and personal care.

Associate therapists struggle to meet their licensure requirements, especially finding clinical supervision. Companies that provide internal or outsource external clinical supervision have an advantage over companies that leave the burden on the new clinician to find a clinical supervisor, pay for them, or travel to them on their days off. 

When your organization has a healthy attitude toward work/life balance, you relieve a huge burden from your therapists who naturally feel the pressure to help people.

Advancement Opportunities:

Do therapists have the opportunity to advance to higher roles in your organization? Is the pathway clear and communicated? Are you open to providing training and educational opportunities for certifications and even advanced degrees?

Do you support your therapists?

Lack of administrative support is one of the big reasons why people leave. Employees who feel like staff well-being takes a secondary role to admin policies or focus on bringing in money don’t feel appreciated.

Recruitment and Retention: Wash, Rinse, and Repeat

At the beginning of this article, I suggested looking inward at your organization to see what you could improve to attract and keep your therapists.

Just because they signed the paperwork, don’t stop. 

Work with your clinical supervisors and directors to keep communication open with each other and your team. Empower each other to follow healthy leadership practices. 

Watch your new hire and retention metrics for improvement. Keep adjusting and testing.

Motivo would love to help you with recruitment and retention. We offer vetted, affordable, virtual clinical supervision, continuing education courses, and supportive communities. Connect with us to find out how.

Carla Smith, Ph.D, LCSW, LMFT

Chief Clinical Officer

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