Getting to the heart of why in-home services therapists leave their job is difficult. To better understand what motivates therapists to stay or leave, we conduct exit surveys for employees who quit as well as an annual survey of current employees.

While we find that staff leave for a wide variety of reasons, themes that arise in these surveys tend to suggest that therapists would like

• higher compensation,
• more training, and
• more supervision time.

We also believe that a key factor in preventing turnover is understanding the millennial workforce. The book Keeping the Millennials gave us some good ideas of how to make us an appealing place to work for this generation. It suggests that having a “cool workplace” is important.

The millennial generation likes to

• feel connected,
• have access to technology,
• have a flexible workplace and schedule, and
• feel like they are making a contribution to the agency and community.

The book also suggests that it is important to “identify the keepers.” This means that we should identify those who we want to have stay, and be sure to let them know they are important and needed. They suggest giving these individuals special projects to allow them to feel like they are contributing or perhaps “groom them” to take over when current leaders retire.

What We Have Done

We have begun taking steps to address the factors we believe are contributing to our high rates of turnover.

• The Board of Trustees has increased the therapist salary matrix two years in a row to be more competitive with similar agencies.
• As stated above, the agency administers employee surveys annually, as well as exit surveys for employees who leave the agency, in an effort to better understand what would make us a more attractive employer.
• We recently launched a social networking site responding to employees’ desire for more opportunities to get to know each other.
• We also have strict hiring procedures to try to hire therapists that best fit the organization’s value system and mission.
• We seek and use staff input in management decisions.
• We offer supervision toward licensure to encourage therapists to stay longer.
• Our agency maintains a 5 to 1 supervisor to therapist supervision ratio to support therapists.

We have tried to implement ideas from the literature on millennials.

• When we identify staff members we believe have strong leadership potential, we send them to our supervisor training and have them fill in when the actual supervisor is on vacation or otherwise unavailable.
• We are also trying to give therapists opportunities to contribute to our agency beyond their regular responsibilities.
• We also try to celebrate employment anniversaries in a way that creates a culture of wanting to stay at the agency for a long time.

It is too soon to tell if our efforts have improved therapist turnover, but we are hopeful that as we continue to strive for a fun and fulfilling work environment, our staff members will want to stay for years to come.

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Posted by Don Fryberger
Therapist/Administrative Associate
Institute for Family Development

The National Family Preservation Network (NFPN) recently assisted with the development of the Retention and Compensation Survey and analysis of results. The following is a summary of the 27 responses that were received.

Click here to download the survey summary (PDF file, 86 KB).

In addition to the summary of responses, NFPN conducted further analysis on three issues that required comparison across responses. Here is the summary:

1. Do agencies with above average compensation have higher retention rates?
   YES. There was a significantly higher number of respondents reporting higher than average compensation who also reported retention rates of 50% or above for the past three years (13) in comparison to respondents who reported lower than average compensation but retention rates of 50% or higher (3).
   .
2. Do agencies that provide salary increases have higher retention rates?
   NO. There was little difference between respondents reporting retention rates of 50% or higher in the past 3 years along with a salary increase since 2011 (9) in comparison to respondents who reported a retention rate of 50% or higher in the past 3 years along with no salary increase since 2011 (7).
   .
3. Do agencies that pay significantly more for a Master’s degree therapist than a Bachelor’s degree therapist have higher retention rates?
   YES. All but one respondent reporting at least a $4,000 pay difference between a Master’s degree and Bachelor’s degree plus comparable experience had retention rates of 50% or higher over the past 3 years. All but two respondents reporting a $2,500 or lower pay difference between Master’s and Bachelor’s degree had retention rates of under 50% over the past 3 years.
   .

What can we learn from this survey?

1. We know from the previous post that high turnover is costly and the earlier the therapist leaves, the more cost the agency incurs. Could the field of IFPS develop a screening tool that would help to identify applicants who are more likely to stay for a longer period of time?
   .
2. Higher pay appears to be linked with higher retention while, at least in this survey, salary increases are not linked with higher retention. Perhaps IFPS therapists don’t factor in salary increases because they only occur annually, if at all? Agencies definitely do need to consider overall compensation if they want to retain therapists.
   .
3. Therapists place value on earning a Master’s degree and expect greater compensation in return. IFPS agencies need to look at the difference in pay between Master’s level and Bachelor’s level therapists and make sure that obtaining a Master’s degree is incentivized and rewarded.
   .
4. In understanding why they stay, agencies need to know that therapists value flexibility above all else. So agencies need to emphasize flexibility when hiring, ask therapists what flexibility needs they have, and fulfill them!
   .
5. Understandably, therapists leave IFPS agencies for higher pay but a very close second is “professional growth opportunity.” If IFPS agencies could meet this need, more therapists would stay.
   .

Sharing Ideas, Information, and Resources

1. What tools and resources is your agency using to recruit and retain IFPS therapists?
   .
2. If compensation is determined mainly by the funding provided through a contract, could IFPS therapists have input on how that pool of funds is allocated?
   .
3. Do any agencies use loan forgiveness programs to aid an IFPS therapist in obtaining a Master’s degree and to retain that therapist as an employee?
   .
4. Among the reasons why IFPS therapists stay at agencies are flexibility and a supportive work environment. How are flexibility and a supportive work environment defined by your agency?
   .

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Posted by Priscilla Martens
Executive Director
National Family Preservation Network

At our agency, we believe that therapist turnover has both financial and intangible costs.

To understand better how therapist turnover affects us, our management team recently requested an in depth analysis of therapist turnover.

The Direct Cost of IFPS Therapist Turnover

We measured the direct costs of turnover using costs of termination, ad placement, interviewing, training, salary, lost revenue, etc.  The cost to replace one IFPS therapist, including costs to the agency and lost revenue, is approximately $43,000.  In 2011, 8 IFPS therapists left our agency. This means that in 2011 alone, turnover among these therapists cost us approximately $344,000.

Beyond the Dollars: Intangible Costs of IFPS Therapist Turnover

Although intangible costs cannot be measured in dollars, we believe that they are important to take into account.

• When an experienced therapist leaves and is replaced by someone who has not had experience delivering IFPS, the quality of services offered to families may be impacted.
• High turnover in a team of therapists may also make it difficult to develop binding relationships and may have negative impacts to employee morale or lead to a culture of leaving in an agency.

IFPS Therapist Retention

We were recently asked what percentage of our IFPS therapists from 3 years ago were still employed here. We were disappointed to find that only about 30% of the 31 therapists from April 2010 are still with us today.

On a positive note, our IFPS therapists do tend to stay longer than therapists in our other programs.  When we looked at all therapists hired between 2002 and 2008 who have since quit, IFPS therapists stayed an average of 28 months while other therapists only stayed an average of 16 months.  This supports current research that suggests that there is less turnover in evidence based practices (Aarons, Sommerfeld, Hecht, Silovsky, and Chaffin, 2009).    Unfortunately, evidence based practices also have substantially higher training costs than other programs.

Agency-wide Therapist Turnover

In light of the identified costs of therapist turnover, we have put together some information about the specific turnover rates across all programs at our agency. The following table and pie chart show therapists hired between 2002 and 2008.  The six month period category describes the amount of time a therapist stayed before leaving or if they are still currently employed with us.  Fifteen percent of our therapists stayed less than six months, 48% left before 18 months, while 25.1% are still currently employed by our agency.

Table 1: Therapists Hired from 2002 through 2008

Now what?

We know that turnover among front line workers is costly. We have identified how many people leave, how long they usually stay before leaving, and how much it costs when they leave. Now the question is: how do we keep the good therapists longer?

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Posted by Don Fryberger
Therapist/Administrative Associate
Institute for Family Development