The addiction treatment profession is a relatively new profession. We are still creating ourselves.
As I’ve studied this issue, it’s my opinion that there are two crises that face us in this field. The first is that our leadership is aging out at a rapid rate, and we have not created mentorship programs or long-range succession plans within our organizations that have actively brought people through the ranks who can effectively take over these positions.
The second crisis is the fact that we have a huge number of untreated addicts, and as the public becomes better educated and more people attempt to access care, and more are able to access care as a result of the Affordable Care Act, we don’t have enough clinical workers entering the workforce to care for the ever-increasing needs of the population. As a result, we experience these gaps at multiple levels of treatment services and within our organizations.
Most people enter the profession at a certain level and tend to remain there. Addiction treatment is not generally a field where there has been extraordinary upward movement for employees. There are very few leaders in the addiction profession that have worked in a variety of positions and levels over many years. As a result, it can be difficult for leadership to understand everything that goes into a day of treatment, and it can be difficult for people who work in clinical areas to understand administrative needs.
Beyond this disconnect, there is also the gap between males and females in the workforce. I became most profoundly moved to begin exploring the history of female leadership both within the 12 Step movement and in the addiction profession as I began to realize the number of women that made up the addiction treatment field. Clinical workers tend to be female. Upwards of 70% of the workforce in the addiction field is made up of women, yet the leadership is still predominantly male.
Many people who take on administrative roles in treatment centers started out in high levels of behavioral health management and hospital type settings, which are heavily male dominated. I don’t bring these gender disparities up to condemn or point the finger, but merely to note their existence and examine the ways in which we can begin to bridge the gaps in our field.
Addiction treatment is not a field that has an identified school or preferred institute of higher learning where we can officially tackle this issue in the classroom setting. Most young people do not set out to become addiction counselors or treatment center administrators—they often join the field as a secondary career move or after having been exposed to addiction on a personal level. We must begin at home then, in our own organizations, to train the next generation of leadership in addiction treatment. There are certain organizations that have already created internal training programs that allow for more upward mobility amongst employees, such as La Hacienda, Hazelden, and Valley Hope Association. The National Association of Addiction Treatment Providers (NAATP) has also begun to consider reinstituting its American College of Addiction Treatment Administrators (ACATA) credentialing program, which focuses specifically on learning the ins and outs of administrative work in this field. Hopefully these programs can be examined and used as models for other groups.