Does workforce matter? Examining the relationship between workforce characteristics and client treatment outcomes in the alcohol and other drug (AOD) field

Posted to ENEWS for Katinka van de Ven, Alison Ritter and Ann Roche from UNSW

While there is a long-standing and commonly held belief that the characteristics of the alcohol and other drug (AOD) workforce can impact client treatment outcomes, the available literature to date has not been systematically reviewed. The demand for evidence of ‘what works’ in relation to AOD staffing and treatment optimisation is growing, and it is therefore critical to synthesize relevant research in this field.

We undertook a systematic review of peer-reviewed research articles that examined the relationship between workforce characteristics and client treatment outcomes. Papers were included if they measured one or more of five workforce characteristics: 1) years of clinical experience; 2) level of education/qualifications; 3) staff turnover; 4) staff-to-client ratio; and/or 5) professional development (incl. clinical supervision and training). And the papers needed to also include treatment outcomes – defined as changes in alcohol or other drug use, improvements in psychological or social functioning, and/or retention in treatment.

What did we find?

  • There is a lack of empirical evidence: Out of more than 1,300 papers, we only found 12 studies that directly examined the relationship between workforce and treatment outcome.
  • The methodological quality was very average: Most studies were of low (42%) or moderate (25%) quality, with only 33% being of high quality.
  • The outcomes were mixed: Workforce characteristics influence treatment outcome in multiple directions (positive, negative or no effect on client outcomes), making it difficult to make any firm statements about the relationships between workforce and treatment outcomes
  • There were no Australian studies.

While the systematic review did not give us any definitive answers, it did show that more research on this topic is desperately needed. We presented these findings at the International Society for the Study of Drug Policy (ISSDP) Conference in May this year and have now submitted the work for publication in a journal.

This work is part of a larger project, named “Horizons”, which examines how funding approaches, purchasing mechanisms, and workforce characteristics of Australian AOD treatment impacts on client treatment outcomes. This project is aimed at improving the ways in which AOD treatment in Australia is funded and purchased as well as better knowledge about the importance of workforce characteristics. We are currently recruiting in Victoria for this project. More information can be found here:


If you are interested in participating in Horizons, have questions or want more information, please contact Dr Katinka van de Ven via email ( or phone (02) 9385 6407. Recruitment in Victoria closes at the end of September.