Job Satisfaction of Mental Health Professionals ... - SAGE Journals

International Journal of Offender Therapy and Comparative Criminology Job Satisfaction of Mental Health Professionals

Job Satisfaction of Mental Health Professionals Providing Group Therapy in State Correctional Facilities Sean W. Ferrell Robert D. Morgan Carrie L. Winterowd Abstract: The primary purpose of this research was to explore the job satisfaction levels of mental health professionals providing group therapy services in state correctional institutions. Participants (162 providers from 78 adult male state correctional facilities) completed a survey examining perceptions about a range of job responsibilities. Further analysis investigated the relationship of demographic variables, administrative support variables, and security issues to satisfaction levels. Professionals appeared especially satisfied with aspects of their jobs that involved the direct provision of psychological services (i.e., facilitating group and individual psychotherapy services, providing crisis intervention services, and conducting formal assessments). They appeared relatively less satisfied with nondirect services including administrative responsibilities, report writing, case notes, and receiving individual supervision. The findings also revealed that these professionals disagreed that they receive adequate funding from administration or that rehabilitation was an overall goal of their correctional institution. Implications of these findings and suggestions for future research are highlighted.

The ever-increasing presence of managed health care is forcing mental health professionals (e.g., counselors, psychologists, and social workers) to seek employment in established institutions where job security is more stable. The prison business is booming; therefore, more mental health professionals are needed to work in correctional environments. In fact, mental health professionals are being encouraged to seek employment in prison settings (Murray, 1998) due in part to the increased need for their skills. One impetus that has increased demand for mental health services in correctional settings is the large proportion of prisoners who have serious mental disorders (Abram, 1990; Snow & Briar, 1990; Teplin, 1990). Correctional facilities have been forced to deal with larger numbers of mentally ill inmates in part because of the decades-long move away from placing the mentally ill in psychiatric institutions. Serious mental disorders and mental illness, as operationally defined in this literature base, referred to major psychiatric diagnoses (i.e., mood, anxiety, or psychotic disorders) and generally excluded substance abuse disorders. According to recent statistics (Bureau of Justice Statistics, 1999), mentally ill patients are disproportionately common in state prisons and local jails where they account for 16% of the population. Another study, using International Journal of Offender Therapy and Comparative Criminology, 44(2), 2000  2000 Sage Publications, Inc.

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a less narrow definition of mental illness, placed the number of mentally ill inmates at approximately 70% of all inmates (Teplin, 1990). Levinson (1985) pointed out that to effectively navigate the demands required of them while working in a prison setting, psychologists need special preparation above and beyond their standard education and training. Mental health providers are called on to perform a variety of roles and functions in this demanding work environment including assessment, screening, crisis intervention, program administration, and the provision of direct services (Smith & Sabatino, 1990). One assumption of this study is that mental health workers represent a unique subspecialty with distinct job stressors and occupational variables within the correctional environment (Fry, 1990; Levinson, 1985; Smith & Sabatino, 1990). Correctional mental health workers occupy an identity somewhere between the administrative executives and correctional officers. For instance, these professionals, similar to all prison staff, must conform to the overall institutional goals of security and management of prisoners. Mental health professionals are likewise exposed on a daily basis to the violent prison culture that is typically identified as a factor that influences job satisfaction and work attitudes of all prison employees (Dignam & Fagan, 1996; Innes, 1997). However, research also indicates that correctional psychologists perceive themselves as playing a more therapeutic and helping role (Smith & Sabatino, 1990). The majority of occupational research in the correctional environment has examined correctional officers’ stress reactions (Cheek & Miller, 1982; Gross, Larson, Urban, & Zupan, 1994; Lindquist & Whitehead, 1986). Correctional executives (i.e., wardens) tend to be highly satisfied as an occupational group, with staff relations and support being the highest correlates of job satisfaction (Flanagan, Johnson, & Bennett, 1996). Research regularly suggests that correctional officers are at least moderately satisfied with their jobs (Jacobs, 1978; Lindquist & Whitehead, 1986). One recent study, however, found that correctional officers showed the lowest levels of organizational commitment and job satisfaction compared to other employees (Robinson, Porporino, & Simourd, 1996). There are few published studies that examine mental health professionals in the correctional setting (Eisenman, 1990; Fry, 1990; Levinson, 1985; Smith & Sabatino, 1990; Tewksbury, 1993), and these studies are concerned indirectly with how different parts of correctional work may influence job satisfaction. The available studies were usually qualitative in nature, and some suffered from methodological problems including restriction to one or a few prisons and a lack of random sampling (Fry, 1990). Preliminary empirical work in one prison system suggested that correctional counselors, defined as those at the bachelor or master’s level, had higher job satisfaction levels than psychologists or psychiatrists (Fry, 1990). To date, there are no published studies that have attempted to directly assess job satisfaction among correctional mental health professionals in terms of specific job duties and in relation to institutional demands. Moreover, no studies have included

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International Journal of Offender Therapy and Comparative Criminology

a comprehensive inquiry into prisons randomly sampled from different regions of the country. The purpose of this study was to investigate the job satisfaction of mental health professionals who provided group therapy services in state correctional institutions. Specifically, the study was concerned with how satisfied mental health professionals from around the United States were with different aspects of their jobs. The current research, for example, examined how satisfied professionals were with duties including (a) individual therapy, (b) group therapy, (c) formal assessments, (d) crisis intervention, (e) case management/rounds, (f) report writing/case notes, (g) administrative responsibilities, (h) receiving individual supervision, (i) supervising other professional staff, and (j) providing consultation services to professionals outside prison. This study also closely examined the relationship of administrative support, security, and demographic variables as they relate to satisfaction with group therapy as a job duty. Gender and ethnicity were examined because of the homogeneity of the male inmate population and the fact that prisons are commonly associated with racial tensions (Haney & Zimbardo, 1998). Previous research (Fry, 1990) also indicated that there may be differences between the job satisfaction levels of mental health providers at differing educational levels. Hence, the researchers felt it prudent to include these demographic variables given their potential influence on professional identity and the incipient stage of this research. The overall goal of this research is to add to the body of knowledge of mental health professionals as workers in the correctional settings by exploring their attitudes and perceptions about key issues related to their occupational satisfaction.

METHOD PARTICIPANTS Participants for this study consisted of 162 mental health professionals providing group therapy services from 79 randomly selected state penitentiaries and correctional facilities for male inmates in the United States. Of the 50 states, 48 are represented by at least one participating correctional facility. The participants included 100 men and 60 women with a mean age of 44.8 years (SD = 10.14). They were predominantly Caucasian (n = 139); however, other ethnic groups were represented in this sample including African American (n = 11), biracial (n = 3), Hispanic/Latino(a) (n = 1), Native American (n = 2), Asian American (n = 1), and other (n = 1). Of the 162 participants, 22 had obtained a doctoral degree, 99 obtained a master’s degree, and 38 participants obtained a bachelor’s or other degree. The majority of these professionals were from the specialty areas of clinical psychology (n = 48), counseling psychology (n = 31), social work (n = 31), or


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counseling (n = 27). Cognitive-behavioral (n = 51; 31.5%) and eclecticism (n = 50; 30.9%) were identified as the most common counseling theoretical orientations. Finally, the respondents were employed in state correctional facilities ranging in inmate population of 46 to 20,0001 with a median of 1,162.5 and a mode of 900 inmates. SURVEY A survey was developed to assess a wide range of areas related to job satisfaction in myriad duties performed by mental health professionals within the correctional system including: (a) individual psychotherapy, (b) group psychotherapy, (c) formal assessments, (d) crisis intervention, (e) receiving individual supervision, (f) supervising other professional staff, (g) administrative responsibilities, (h) case management/rounds, (i) report writing/case notes, and (j) providing consultation services to professionals outside the prison. In addition, the survey included information about the demographics of the group facilitators, level of administrative support, and security issues. Participants were asked to rate their level of job satisfaction using a 7-point Likert scale (1 = very dissatisfied, 7 = very satisfied). Participants rated their level of agreement in terms of administrative support and security issues using a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree). A cover letter explaining the purpose of this study and a selfaddressed stamped return envelope were provided with each survey. PROCEDURE For this study, 113 state penitentiaries (correctional facilities) were randomly selected from the 1994 American Correctional Association’s directory that includes a listing of current institutions (American Correctional Association, 1994). The director of the psychology department or its equivalent at each site was called by one of the researchers to explain the nature and purpose of the study and to assess their interest and willingness to participate in the study. If the director verbally committed to participate in this study, copies of the cover letter and survey were mailed to the department. Of the 113 facilities randomly selected, 79 state correctional facilities participated in this study. Three hundred and eighty-six surveys were sent to these 79 facilities. One hundred and sixty-two surveys were completed and returned for a return rate of 41.97%. Thirty-four state correctional facilities did not participate in this study for a variety of reasons: 25 facilities did not offer group psychotherapy services, 6 facilities were unable to be reached by phone (and thus surveys were not mailed), 1 facility was in the process of closing, 1 facility required a lengthy proposal review process and therefore the researchers of this study did not pursue data collection with this site, and only 1 facility declined to participate in this study.

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TABLE 1 MEAN, MODE, AND STANDARD DEVIATION SCORES OF OVERALL SATISFACTION RATINGS OF VARIOUS JOB RESPONSIBILITIES Overall Satisfaction Type of Job Responsibility Group therapy (N = 148) Individual therapy (N = 147) Crisis intervention (N = 148) Supervising other professional staff (N = 81) Formal assessments (N = 145) Providing consultation services to professionals outside the prison (N = 77) Case management/rounds (N = 128) Report writing/case notes (N = 151) Receiving individual supervision (N = 124) Administrative responsibilities (N = 112)

Mean

Mode

Standard Deviation

5.58 5.30 5.28 5.08 5.01

6.00 6.00 6.00 6.00 6.00

1.40 1.54 1.42 1.66 1.44

4.77 4.67 4.51 4.48 4.41

6.00 5.00 5.00 5.00 4.00

1.95 1.54 1.50 1.72 1.61

RESULTS The purpose of this study was to investigate how satisfied mental health professionals providing group therapy services were with different aspects of their jobs in state correctional institutions and to examine the relationship of demographic variables, administrative support variables, and security variables with participants’ satisfaction with group therapy as a job duty. Table 1 presents the descriptive statistics for the participants’ratings of satisfaction for the 10 job responsibilities (e.g., group therapy, individual therapy, and administrative responsibilities). As can be seen in Table 1, participants indicated a general satisfaction with the various aspects of their job responsibilities. The participants reported they are satisfied with a variety of job responsibilities including the facilitation of group and individual psychotherapy services, providing crisis intervention services, supervising other professional staff, and conducting formal assessments. Participants are less satisfied with administrative responsibilities, the individual supervision they receive, and writing reports and case notes (i.e., progress notes). Therefore, in relative terms, the participants in this study do not appear dissatisfied with any particular job responsibility within the prison setting; rather, they appear more satisfied with certain aspects of their jobs. As this is an exploratory study with group psychotherapy providers, further analyses were conducted to assess the impact of therapists’characteristics and job factors on mental health professionals’ satisfaction with their group psychotherapy responsibilities. To evaluate if differences in gender, level of professional training, and ethnicity led to differences in participants’ satisfaction with group


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therapy service provision, t tests were performed. Due to multiple comparisons, the Bonferroni correction was used to adjust the alpha level to .016, and pooled variance estimates were incorporated to account for unequal groups. There was not a significant difference between males (M = 5.48, SD = 1.49) and females (M = 5.75, SD = 1.24), t(145) = – 1.12, p = .265, on levels of satisfaction. Doctoral level professionals (i.e., Ph.D., M.D., and Ed.D.) had similar levels (M = 5.67, SD = 1.32) of satisfaction to master’s- and bachelor-level providers (M = 5.57, SD = 1.42), t(146) = .28, p = .782. Finally, Caucasians (M = 5.49, SD = 1.46) were not significantly different from other ethnic groups (M = 6.33, SD = .72), t(140) = –2.21, p = .029, on group psychotherapy satisfaction ratings when the Bonferroni adjustment was implemented; however, there did appear to be a trend that ethnic minority therapists were more satisfied with their group psychotherapy job responsibilities than Caucasian therapists. Thus, gender and education do not contribute to differing levels of satisfaction with the provision of group psychotherapy services, but the trend suggests that non-Caucasian groups may be more satisfied with this aspect of their job. Further correlational analyses were conducted to specifically examine group therapists’ ratings of satisfaction with their group psychotherapy job responsibilities. These satisfaction ratings were correlated with security issues, administrative support, and years of experience conducting group psychotherapy in correctional settings (see Table 2 for a list of the means, standard deviations, and correlations for these variables). Participants rated their level of agreement with issues related to administrative support for group programming and research as well as security issues when facilitating psychotherapy groups with inmates. On average, the participants who provided group psychotherapy services to male inmates in correctional settings felt fairly secure about security issues related to facilitating group psychotherapy (e.g., feeling safe and security personnel nearby). They perceived having responsibility and flexibility with regard to their group programs but indicated a relative level of disagreement with the level of funding they received to help implement groups. As can be seen in Table 2, several of the items assessing administrative support were significantly related to satisfaction with group psychotherapy responsibilities were statistically significant at the p < .05 level, and one security issue (i.e., therapist safety when facilitating groups) was significantly correlated with level of satisfaction at the p < .01 level. Table 2 shows that group therapists’ satisfaction with group psychotherapy work was significantly correlated with (a) having responsibility for developing group programs, (b) having flexibility with regard to new or innovative group therapies, (c) consulting with other departments, (d) receiving adequate support from prison administration, (e) perceiving rehabilitation as an institutional goal, and (f) feeling safe when facilitating groups. Therapists’ perceptions of administrative support and their feelings of safety when providing their group psychotherapy services are significantly correlated with their group psychotherapy satisfaction ratings.

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TABLE 2 SUMMARY OF MEANS AND STANDARD DEVIATIONS OF ADMINISTRATIVE SUPPORT, SECURITY ISSUES, YEARS OF EXPERIENCE IN A CORRECTIONAL SETTING, AND CORRELATION WITH PARTICIPANTS’ SATISFACTION RATING WITH PROVIDING GROUP THERAPY

Variable Years of experience with group therapy in the correctional setting Institutional variables Responsibility for developing groups Flexibility with regard to new and innovative groups Adequate funding for group programming Consultation with other departments Adequate support from prison administration Rehabilitation as an overall institution goal Security issue variables Feeling safe when facilitating groups Security personnel in nonintrusive areas during group facilitation

M

SD

Satisfaction With Group Therapy Duties-Correlations

6.54

6.05

.14

5.90

1.65

.21*

5.47 3.45 4.04

1.76 1.87 2.06

.19* .11 .20*

4.19

1.89

.19*

3.64

1.87

.18*

5.73

1.48

.32**

5.03

2.07

.08

*p < .05. **p < .01.

DISCUSSION The results of this study indicate that prison mental health employees are generally satisfied with the various aspects of their jobs in correctional settings. They appear especially satisfied with aspects of their jobs that involve the provision of psychological services (i.e., facilitating group and individual psychotherapy services, providing crisis intervention services, and conducting formal assessments). They appear relatively less satisfied with nondirect services including administrative responsibilities and report writing and case notes. This finding makes intuitive sense as one would expect service providers to be more satisfied with aspects of their jobs that include the provision of services to clientele. The results were consistent with those of Smith and Sabatino (1990) who found that correctional psychologists wanted to spend less time in diagnostics and program administration and more time in counseling and psychotherapy. The current investigation indicated that the ethnic composition of group leaders does not parallel the prison population at large. Statistics estimate that although African American men represent approximately 6% of the general U.S. population, they constitute 48% of inmates confined in state correctional facilities


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(Haney & Zimbardo, 1998). Overall, there were many more White individuals providing group psychotherapy services in state correctional facilities. In spite of this discrepancy, there was a statistical trend possibly suggesting that minority participants were more satisfied with their group therapy work than White participants. Although this issue warrants further investigation, the active recruitment of minorities for these positions should be considered. The finding that mental health professionals emerged as less satisfied with the individual supervision they receive when compared to some of the other job responsibilities is a concern. This may be the result of a lack of opportunities for supervision activities in the prison setting considering some 20% of group therapists do not receive supervision regarding their group psychotherapy services (Morgan, Winterowd, & Ferrell, 1999). However, this finding could also be an indication of the quality of supervision or the fact that mental health professionals in correctional settings do not like to be supervised. Nevertheless, this finding is disconcerting considering that the stress of working in a correctional environment will task even the most experienced clinician (Brodsky, 1982; Inwald, 1982). Eisenman (1990) reported that immediate supervision was one of the major problems he encountered in his 2 years as a prison psychologist. This personal account included an example of when a supervisor demanded unethical behavior from his or her supervisee by asking them to alter a test report (Eisenman, 1990). Furthermore, he believed this problem would likely characterize most prisons (Eisenman, 1990). Perhaps the supervisory role as it occurs in a prison milieu is more adversarial than supportive. The practice of supervision of mental health workers in the correctional setting is worthy of more investigation, especially given the exceptional demands imposed on professionals operating in these environments. Whereas the results of this study provide preliminary evidence of mental health professionals’ job satisfaction in correctional settings, some limitations of this study should be noted. First, this survey was developed to assess group therapy services, and the participants consisted of group therapy providers and department directors (i.e., psychology and mental health). Therefore, the sample may not be representative of correctional mental health providers in general. Secondly, this study does not address the particular aspects of the job responsibility or duty the mental health professionals were or were not satisfied with. For example, although the participants tend to be relatively less satisfied with the individual supervision they receive, the authors do not know, as indicated previously, what they are dissatisfied with. Therefore, the authors do not know whether more supervision is desired, if the quality of supervision needs improvement, or if the participants do not like to receive individual supervision. Future studies need to address this limitation before modifications can be applied to those job responsibilities found to be less satisfying. In conclusion, as expected, administrative support variables seemed to play a key role in mediating job satisfaction. Mental health professionals generally did not agree that they received adequate funding for group programming efforts. They slightly disagreed that rehabilitation efforts were an important overall goal

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of their institution. Furthermore, their job satisfaction levels were significantly associated with adequate support from prison administration. These findings reflect the prevailing zeitgeist in prison policy: Rehabilitative activities are generally not considered a major component of prison life (Haney & Zimbardo, 1998). On the contrary, in reality, prisons can be psychologically damaging to staff and prisoners (especially those with concomitant mental illness); although supported by research (Lovell & Jemelka, 1998; Zimbardo, Haney, Banks, & Jaffe, 1974), this does not seem to be reflected in commensurate funding for rehabilitation programming and services. In spite of the findings regarding administrative support, the current findings showed that mental health professionals remain largely satisfied with positions and job duties in correctional settings.

NOTE 1. The authors believe that the respondents reporting an inmate population of 20,000 worked in a prison complex that included several separate correctional institutions.

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Sean W. Ferrell, Ph.D. Postdoctoral Psychology Fellow University of Oklahoma Health Sciences Center Department of Psychiatry and Behavioral Sciences PO Box 26901, G. Rainey Williams Pavilion, 3rd Floor Oklahoma City, Oklahoma, 73190 USA Robert D. Morgan, Ph.D. Forensic Psychology Fellow Department of Psychiatry University of Missouri–Kansas City, School of Medicine Kansas City, Missouri USA Carrie L. Winterowd, Ph.D. Associate Professor, Counseling Psychology School of Applied Health and Educational Psychology Oklahoma State University 434 Willard Hall Stillwater, Oklahoma, 74078 USA