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The impact of work stress and job satisfaction on turnover intentions: A study
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The impact of work stress and job satisfaction on turnover intentions: A study of
Australian specialist alcohol and other drug workers
Vinita Duraisingam a; Ken Pidd a; Ann M. Roche a
a
National Centre for Education and Training on Addiction, Flinders University, Bedford Park, South Australia
5042, Australia

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To cite this Article Duraisingam, Vinita, Pidd, Ken and Roche, Ann M.(2009)'The impact of work stress and job satisfaction on turnover
intentions: A study of Australian specialist alcohol and other drug workers',Drugs: education, prevention and policy,16:3,217 — 231
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 Drugs: education, prevention and policy,
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The impact of work stress and job satisfaction

on turnover intentions: A study of Australian
specialist alcohol and other drug workers
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VINITA DURAISINGAM, KEN PIDD, & ANN M. ROCHE

National Centre for Education and Training on Addiction, Flinders University,
Bedford Park, South Australia 5042, Australia

Abstract
Aims: A national study was conducted to investigate the extent and nature of job
attitudes and well-being of specialist alcohol and other drug (AOD) workers in Australia.
As part of that larger study, work stress and job satisfaction and their relationship with
turnover intentions were examined.
Method: A postal survey measuring working conditions, work stress, job satisfaction,
turnover intention and key demographics among specialist frontline workers from AOD
treatment services across Australia was undertaken. A total of 1345 responses from
workers in 369 participating AOD treatment services were obtained.
Findings: Although the majority of workers were satisfied with their jobs, one in five
workers reported above average levels of stress. One in five workers also expressed
intentions to leave the AOD field. Significant predictors of higher turnover intention were
low job satisfaction, high work stress, low workplace social support and negative attitudes
towards remuneration.
Conclusion: This study was the first attempt to collect empirical data on levels of stress
and job satisfaction among the Australian specialist AOD workforce. The findings
presented here focus on work stress and job satisfaction and their association with
turnover intention. The results indicate cause for concern and have important
implications for the development of strategies to minimize turnover and improve the
well-being of specialist AOD workers in Australia.

Correspondence: Vinita Duraisingam, National Centre for Education and Training on Addiction
(NCETA), Flinders University, Adelaide, Australia, Level 3B, Mark Oliphant Building, Laffer
Drive, Bedford Park, South Australia, 5042, Australia. Tel: þ618 8201 7565. Fax: +618 8201
7550. E-mail: vinita.duraisingam@flinders.edu.au

ISSN 0968–7637 print/ISSN 1465–3370 online ß 2009 Informa Healthcare USA, Inc.
DOI: 10.1080/09687630902876171
 218 V. Duraisingam et al.

Introduction
The provision of effective treatment and high quality alcohol and other drug
(AOD) care requires a qualified, healthy and satisfied workforce. The ability to
attract, support and retain a diverse workforce that is equipped with the requisite
knowledge, skills and abilities is a crucial element for the continuous
improvement in service quality and the capacity of services to respond to
change (Libretto, Weil, Nemes, Linder, & Johansson, 2004). There is widespread
concern both within Australia (NADA, 2003; Roche, O’Neill, & Wolinksi, 2004)
and internationally (Gallon, Gabriel, & Knudsen, 2003; Knudsen, Johnson, &
Roman, 2003; McLellan, Carise, & Kleber, 2003; Ogborne & Graves, 2005) that
the AOD field faces significant difficulties in recruiting and retaining qualified
staff in order to keep pace with the increasing demand for treatment services. Due
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to the high direct and indirect costs associated with recruiting and training new
staff, retention and turnover of existing qualified and skilled workforce are pivotal
issues to be addressed.
Evidence of high staff turnover in Australian AOD treatment agencies is largely
anecdotal. To date, there appears to be no empirical data concerning the extent or
nature of the problem within the Australian AOD workforce. In contrast,
a number of studies conducted in the USA have reported a range of turnover
estimates for their AOD workforce. In a study of AOD treatment agencies in the
USA Pacific Northwest, it was estimated that agencies, on average, experienced
a 25% turnover rate per year with voluntary resignations being the most frequent
form of turnover (Gallon et al., 2003). Similarly, data collected on treatment staff
from 34 treatment services for the purposes of developing a national addiction
treatment information system, found that an average of 50% of staff had either
left or changed positions within a year (Carise, McLellan, Gifford, & Kleber,
1999). However, there is some evidence to suggest that these
turnover figures may reflect a pattern of mobility within the field, rather than
exits from the field itself (Mulvey, Hubbard, & Hayashi, 2003). Mulvey et al.
(2003), for example, found that although USA treatment professionals moved
from agency to agency, they tended to stay in the AOD field.
The few international studies that have examined turnover within the AOD
workforce have identified a variety of potential contributory factors. For example,
Gallon et al. (2003) found rates of turnover were associated with levels of public
funding and the agency directors’ years of experience in the AOD field. Agencies
receiving less public funding and with less experienced directors were more likely
to report higher levels of turnover. Knudsen et al. (2003) found low levels of
organizational commitment, low levels of job autonomy and low salary were
associated with increased AOD workers’ turnover intentions. More recently,
Knudsen and colleagues identified that centralized decision-making processes
and levels of workplace procedural and distributive justice were also significant
predictors of turnover intentions for AOD workers employed in therapeutic
communities (Knudsen, Ducharme, & Roman, 2006). Turnover intention has
been identified as having the highest predictive power on actual turnover
 Stress, satisfaction and turnover intentions of Australian AOD workers 219

(Griffeth, Hom, & Gaertner, 2000) and is the most reliable indicator after
measuring actual turnover. Thus, it is important to understand the factors
affecting turnover intentions in order to understand actual turnover rates and
patterns (Knudsen et al., 2006).
The wider organizational research literature has found two key determinants
that have been consistently linked with turnover and turnover intentions: work
stress and job dissatisfaction (e.g. Barak, Nissly, & Levin, 2001; Cotton & Tuttle,
1986; Griffeth et al., 2000; Tett & Meyer, 1993).

Work stress
Work stress refers to psychological, physical and behavioural responses to work-
related demands over a discrete or short-term period (Dollard, Winefield, &
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Winefield, 2003). Longitudinal studies of turnover (e.g. Wright & Copranzano,

1998) have shown that emotional exhaustion, which is a primary indicator of
work stress, is a significant predictor of voluntary turnover. Health and human
service workers often experience high levels of work-related demands and are
therefore particularly at risk of stress and burnout (Dollard, Winefield, &
Winefield, 2001; Dollard et al., 2003; Dollard, Winefield, Winefield, & de Jonge,
2000). AOD workers may also be at risk of high levels of stress given the
considerable work-related challenges they face and this may contribute to their
intention to leave. Only a limited number of studies have examined the
antecedents of work stress in AOD workers. Workplace factors that have been
linked with high levels of emotional exhaustion in AOD workers include greater
levels of centralized decision making and lower levels of procedural and
distributive justice (Knudsen et al., 2006), low professional self-efficacy and
low workplace support (Shoptaw, Stein, & Rawson, 2000), excessive workloads,
staff shortages, poor physical working conditions and the demands of dealing with
difficult clients (Farmer, 1995).

Job satisfaction
Job satisfaction reflects the degree of fulfilment an individual derives from their
work (Spector, 2000). Previous studies have indicated that workers who are
satisfied are more likely to produce a higher standard of work performance
(Judge, Thoresen, Bono, & Patton, 2001) and remain with the organization (Tett
& Meyer, 1993).
Job satisfaction is a particularly salient issue for the AOD field. Research from
the USA (Evans & Hohenshil, 1997), the UK (Farmer, Clancy, Oyefeso, &
Rassool, 2002) and Canada (Ogborne & Graves, 2005) indicate that most AOD
workers report high levels of job satisfaction. The more personal and human
aspects of work such as client interactions, commitment to treatment and
personal growth, are often reported as sources of satisfaction (Gallon et al.,
2003). In contrast, factors such as excessive workload, paperwork and other
‘bureaucratic issues’ have been identified by AOD workers as sources of
dissatisfaction (Ogborne & Graves, 2005).
 220 V. Duraisingam et al.

The demands of AOD-related work that contribute to stress are also

likely to result in low job satisfaction. Research indicates that the relation-
ship between work stress and job satisfaction are interconnected (Cordes
& Dougherty, 1993; Lee & Ashforth, 1996; Schaufeli & Enzmann, 1998)
and identifies that many of the same work characteristics influence both
outcomes.
In summary, while there is some limited international research that has
examined work stress, job satisfaction and turnover within the AOD workforce,
there is no empirical data on these issues for the Australian AOD workforce.
In order to address this paucity of research, a national study was conducted by the
National Centre for Education and Training on Addiction (NCETA) to
determine the extent and nature of Australian specialist AOD workers’ well-
being and job attitudes. This article focuses on one particular aspect of the study,
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i.e. an examination of work stress and job satisfaction and their relationship with
turnover intention. It is anticipated that findings from this study could inform
strategies to facilitate retention, minimize turnover and improve the well-being of
AOD specialist frontline workers.

Method
Sampling frame
The Clients Of Treatment Service Agencies (COTSA) database (Shand &
Mattick, 2001) was utilized to source specialist AOD treatment agencies for the
study. The COTSA database contains details of government, non-government
and private specialist AOD treatment services from all states and territories within
Australia (Shand & Mattick, 2001).
The COTSA database defined a drug and alcohol treatment service as an
agency that provides one or more face-to-face specialist treatment services to
people with alcohol and/or drug problems (Torres, Mattick, Chen, & Baillie,
1995). It includes a variety of outpatient treatment services, inpatient rehabilita-
tion programs, detoxification, therapeutic communities, methadone maintenance
plus an additional treatment service and smoking cessation programs. Excluded
were self-help groups, sobering-up centres and services that only provide
information, education, accommodation, brief counselling or crisis interventions
(Shand & Mattick, 2001).

Participants
Survey participants were all frontline workers employed in specialist drug and
alcohol treatment services or agencies contained in the COTSA database.
Frontline workers included general AOD workers, nurses, psychologists, social
workers, counsellors and other workers who have direct professional experience
with clients with AOD-related concerns.
 Stress, satisfaction and turnover intentions of Australian AOD workers 221

Measures
A specifically designed questionnaire was utilized to measure workplace factors
and worker well-being. Measures were obtained from well-established and
validated scales that have been widely used in previous research. Responses for
items on each scale ranged from 1 (strongly disagree) to 5 (strongly agree), unless
otherwise stated. Scores for each item were summed to give a total score for each
measure.

Demographics
Measures of participants’ background demographics included age, gender,
occupation, academic qualifications, location of employment (metropolitan/
rural/regional), organizational sector (private/government/non-government) and
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lengths of service in current organization and in the AOD field.

Workload. Three items from the Role Overload subscale of the Michigan
Organizational Assessment Questionnaire (Cammann, Fichman, Jenkins, &
Klesh, 1983) were used to measure perceptions of workload.

Client-related pressure. Nine items were used to measure the degree of pressure
workers felt when dealing different types of clients. Five items were developed by
the researchers (clients with co-morbidity issues, poly-drug clients, clients with
primarily alcohol-related problems, young clients and uncooperative clients) and
four items were based on the Client Demand subscale of Farmer et al.’s (2002)
Addiction Employee’s Stress Scale (i.e. manipulative clients, violent clients,
demanding clients and aggressive clients).

Job autonomy. Three items were selected from the Job Control subscale from
Karasek’s (1985) Job Content Questionnaire to measure the extent to which
workers are encouraged to make their own decisions about their work.

Workplace support. The eight-item Workplace Social Support subscale from

Karasek’s (1985) Job Content Questionnaire was used to measure the degree of
perceived support from supervisors and co-workers.

Remuneration. Three items from the Pay Attitude subscale of the Michigan
Organizational Assessment Questionnaire (Cammann et al., 1983) were utilized
to measure the degree of satisfaction with pay in terms of amount and equity in
relation to what others were paid.

Work stress. Work stress was measured using the eight-item Emotional
Exhaustion subscale of the Maslach Burnout Inventory (Maslach & Jackson,
1986).
 222 V. Duraisingam et al.

Job satisfaction. Price and Mueller’s (1986) three-item Job Satisfaction Scale was
used to measure workers’ satisfaction with their jobs.

Turnover intention. Three items measuring intentions to leave the organization

and/or the field were adapted from O’Driscoll and Beehr’s (1994) Turnover
Intention measure. Two items measured participants’ intention to leave their
current job and one item measured their intention to leave the AOD field.

Procedure
Agency managers were contacted via telephone and E-mail and informed of the
study and its relevance. Attempts were made to contact all listed services. The
managers’ assistance was sought in distributing the questionnaires to all frontline
workers in their agency. Managers were assured of survey respondents’
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confidentiality and anonymity. Once managers agreed to assist, they were asked
to confirm their name, contact details and the number of frontline workers they
managed so that an appropriate number of questionnaires could be mailed to
them. If managers declined to participate, they were asked to provide a reason for
declining and basic agency demographics (i.e. location, sector and number of
frontline workers) were recorded.
Two waves of data collection were conducted. The first wave of surveys was
sent out to agency managers with a cover letter reiterating the importance and
details of the study, along with a note of appreciation for their assistance in
distributing the questionnaires. A reply-paid, self-addressed envelope was
attached to each questionnaire. In the second data collection wave, reminder
letters and additional copies of the survey were sent out to managers of
participating agencies 2 weeks after the initial wave.

Data analysis
All data were analysed using SPSS V12.0 software. Cronbach’s  coefficients
were used to assess the reliability of measures. Descriptive statistics (e.g. means
and standard deviations) were performed to describe the overall data. Bivariate
correlations were performed as a preliminary examination of the associations
between variables. A hierarchical regression was conducted to examine the
association of work stress, job satisfaction and workplace factors, with turnover
intention.

Results
The means, standard deviations, reliability estimates and intercorrelations of
variables are shown in Table I.

Response rate
Of the 532 agencies listed on the COTSA database, 46 agencies had either closed
down, were listed twice, no longer provided AOD treatment services, or did not
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Table I. Descriptive statistics, reliability estimates and intercorrelations of variables.

Intercorrelation

No. of
Variable items M SD  A LOS CP W JA WS R JS S TI

Age (A) – 42.9 10.23 – –

Length of service (LOS) – 4.9 5.07 – 0.369** –
Client-related pressure (CP) 9 24.3 7.11 0.87 0.000 0.009 –
Workload (W) 3 8.7 2.61 0.83 0.072** 0.092** 0.140** –
Job autonomy (JA) 3 11.1 2.26 0.74 0.031 0.070* 0.094** 0.129** –
Workplace support (WS) 8 31.3 5.41 0.86 0.094** 0.072** 0.029 0.250** 0.400** –
Remuneration (R) 3 8.5 2.82 0.82 0.012 0.024 0.078** 0.137** 0.153** 0.125** –
Job satisfaction (JS) 3 11.8 2.26 0.90 0.079** 0.023 0.164* 0.137** 0.366** 0.362** 0.122** –
Stress (S) 8 20.0 5.82 0.89 0.035 0.026 0.280** 0.459** 0.306** 0.346** 0.157** 0.514** –
Turnover intention (TI) 3 8.7 3.03 0.81 0.189** 0.077** 0.072** 0.219** 0.243** 0.334** 0.170** 0.519** 0.446** –

Notes: N ranged from 1266 to 1328.

Higher scores reflect higher levels of the variable.
LOS ¼ length of service in current organization.
*p < 0.05, **p < 0.01.
Stress, satisfaction and turnover intentions of Australian AOD workers
223
 224 V. Duraisingam et al.
Table II. Hierarchical regression analyses of job satisfaction, stress and
workplace factors on turnover intention.

Step Predictors  R2
R2

1. Age 0.162***
Organisational tenure 0.026
0.034 0.036***
2. Job satisfaction 0.351***
Work stress 0.183***
Client-related pressure 0.040
Workplace support 0.164***
Workload 0.050
Job autonomy 0.034
Remuneration 0.073**
0.361 0.330***
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Notes: ***p < 0.001, **p < 0.01.

N ¼ 1166.

fit the definition of a specialist AOD treatment service. These agencies were
excluded from the sample. Thus, the total number of eligible agencies was 486.
Of these, 117 agencies did not return calls or respond to notifications, needed
further approval or ethics clearance or declined to participate. This resulted in
369 agencies whose managers agreed to distribute questionnaires to their
workers. Questionnaires were sent to 3524 specialist frontline workers employed
at these participating agencies and 1412 questionnaires were completed and
returned (a response rate of 40%). Sixty-four returned surveys were invalid,
resulting in a final total of 1345 participants (38% response rate).

Respondents
The majority of respondents (66%) were female. Respondents’ ages ranged from
20 to 73 years with 48% aged 45 and over (M ¼ 42.9 years, SD ¼ 10.23). Fifty
percent were employed in the public sector and 42% in non-government
agencies, while 8% were employed in private agencies. Most of the respondents
(62%) were based in urban areas, with 18% in rural and 17% in regional areas.
The majority of respondents (89%) possessed some form of tertiary
qualifications and 71% were employed as either general AOD workers
(n ¼ 517) or nurses (n ¼ 419). Most general AOD workers (e.g. welfare workers,
support workers and youth workers) did not have a specific professional
qualification. The remaining 29% comprised psychologists (10%), social workers
(8%), counsellors (5%), doctors (3%) and other occupations (3%). Mean length
of service in the current organization was 4.9 years (SD ¼ 5.07) and mean length
of employment in the AOD field was 7.1 years (SD ¼ 6.45).

Work stress
Respondents’ emotional exhaustion scores ranged from 8 to 40
(M ¼ 20.0, SD ¼ 5.82). While the majority of respondents reported relatively
low scores, a substantial proportion (approximately 19%) reported emotional
 Stress, satisfaction and turnover intentions of Australian AOD workers 225
100
Work stress
90 Job satisfaction
80 78%

70
Percentage
60 58%

50
40
30
23% 19%
20 15%
10 7%

0
Low Medium High
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Levels

Figure 1. Proportion of workers by levels of work stress and job satisfaction.

exhaustion scores indicative of high stress levels (Figure 1). There were no
significant demographic differences identified for AOD workers with high stress
scores.

Job satisfaction
Respondents’ job satisfaction scores ranged from 3 to 15 (M ¼ 11.8, SD ¼ 2.26).
The majority of respondents (78%) were satisfied with their jobs (Figure 1). Job
satisfaction was positively associated with age (r ¼ 0.08, p < 0.01), with older
workers reporting higher job satisfaction. Significant differences were observed
across organization type. Non-government workers (M ¼ 12.1, SD ¼ 2.14)
reported significantly higher levels of job satisfaction compared to government
workers (M ¼ 11.5, SD ¼ 2.31, p < 0.001). Around a quarter of respondents with
high levels of work stress also had low levels of job satisfaction.

Turnover intention
Turnover intention scores ranged from 3 to 15 (M ¼ 8.7, SD ¼ 3.03). Over half of
the participants (54%) had thought about leaving their job in the past 12 months
and 31% intended to look for a new job in the next 12 months. Almost one in five
(19%) intended to search for a job outside the AOD field. Turnover intention was
negatively associated with age (r ¼ 0.19, p < 0.01) and length of service in
current organization (r ¼ 0.08, p < 0.01). Younger workers and those with fewer
years of employment in their current agency were more likely to have greater
intentions to leave.

Hierarchical regression
A hierarchical regression was conducted to examine the effects of work stress, job
satisfaction and workplace factors on turnover intention (Table II). Age and
 226 V. Duraisingam et al.

length of service in current organization were entered in the first step to control
for these variables. Work stress, job satisfaction and all workplace factors were
entered in the second step. Job satisfaction, work stress, workplace support and
remuneration were significant predictors of turnover intention. Thirty-three
percent of the total variance in turnover intention scores was explained by job
satisfaction, work stress and workplace factors.

Discussion
The NCETA undertook Australia’s first national survey to examine workforce
development issues of work stress and job satisfaction among specialist AOD
workers. This article examined the relationship of work stress and job satisfaction
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with turnover intention. Other aspects of the full study are reported elsewhere
(Duraisingam, Pidd, Roche, & O’Connor, 2006). To date, there appears to be no
other study that has addressed this issue in the context of the Australian AOD
workforce. Generally, most AOD workers were found to have high levels of job
satisfaction and low levels of stress. Nonetheless, approximately one in three
workers intended to leave their work organization within the next year, while
nearly one in five intended to leave the AOD field. Intention to leave was
significantly associated with a shorter length of time in the current workplace and
nearly half (43%) the workers had been in their present organization for 2 years or
less. In addition, more than half of those surveyed had worked in the field for
5 years or less. Overall, the results indicate cause for concern regarding retention
within the AOD workforce in Australia.
The most significant predictors of turnover intention were low levels of job
satisfaction, high levels of work stress, low levels of workplace support and
negative perceptions about remuneration. Interventions aimed at these factors
need to be developed and implemented if the issue of turnover is to be effectively
addressed.
The strongest predictor of turnover intention in the study was low levels of
job satisfaction. This is in line with previous research that has found low job
satisfaction to be a consistent antecedent of turnover and turnover intent (e.g.
Griffeth et al., 2000). Nevertheless, more than three quarters of the Australian
AOD workforce surveyed reported high levels of job satisfaction. These results
are consistent with international research on AOD workers in Canada (Ogborne
& Graves, 2005) and the USA (Evans & Hohenshil, 1997). While most workers
reported high job satisfaction in the present study, nearly half were dissatisfied
with their level of remuneration. It may be that workers in Australia are similar
to their overseas counterparts in that they derive satisfaction from the
interpersonal factors of AOD work such as a desire to help others and self-
growth (Gallon et al., 2003). Echoing results from previous studies (e.g. De
Lange, Taris, Kompier, Houtman, & Bongers, 2003), the present study found
significant associations between job satisfaction, work stress, job autonomy and
workplace support. The low levels of stress and high levels of job autonomy and
 Stress, satisfaction and turnover intentions of Australian AOD workers 227

support reported by most workers may have also influenced their levels of job
satisfaction.
Approximately one in five workers reported high levels of stress. The results
also indicated that work stress is significantly associated with turnover intention
i.e. workers who reported high levels of work stress also reported high levels of
turnover intention. This is consistent with previous research findings (e.g. Barak
et al., 2001; Griffeth et al., 2000; Layne, Hohenshil, & Singh, 2004). These
results are of concern for both worker well-being and staff retention. As found in
previous studies, work stress not only aggravates physical and psychological
health but also impacts upon worker attitudes and performance (e.g. Dollard
et al., 2000; Wright & Copranzano, 1998). As such, interventions are required to
manage the stress levels of workers by minimizing work demands such as
workload and/or increasing resources to help them cope with the stressors of their
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jobs. These measures may decrease the risk of them leaving their jobs voluntarily
as a result of being stressed or burnt out.
Another significant predictor of turnover intention in this study was low levels
of workplace support. These results are consistent with previous studies that
have found an inverse relationship between workplace support and turnover
intention (e.g. Copranzano, Howes, Grandey, & Toth, 1997) indicating that
support from co-workers and supervisors could have beneficial effects on the
well-being and attitudes of workers. Additionally, results of the present study
indicated that workplace support was significantly correlated with job
satisfaction and work stress. That is, workers who reported low levels of
workplace support also reported low levels of job satisfaction and high levels of
work stress. The importance of positive social relationships at work cannot be
overstated. Simple, cost-effective measures such as encouraging supportive
relationships at all levels can produce important improvements to the work
environment.
Finally, the current study also found negative perceptions about remuneration
was another significant predictor of AOD workers’ turnover intentions. That is,
workers who perceived higher levels of dissatisfaction and unfairness with pay also
reported greater turnover intentions. It is suggested that satisfaction with pay has
its basis in equity theory which compares the ratio of outcomes to inputs (Adams,
1965). If the ratio is equal, then feelings of satisfaction and equity would result.
This relationship between pay satisfaction and turnover intention has also been
evidenced in other studies (e.g. Lum, Kervin, Clark, Reid, & Sirola, 1998). The
implication here is that it is important to recognize the skills and contributions of
AOD workers via appropriate reward mechanisms.
The present findings are subject to some qualifications. First, the study
measured turnover intention rather than actual turnover rates. The degree to
which turnover intentions actually result in a worker leaving could not be
examined in the current cross-sectional study. Longitudinal studies are required
to clarify the relationship between turnover intentions and actual turnover.
However, other studies have shown that self-reported intentions to leave are
 228 V. Duraisingam et al.

reliable and strong predictors of actual turnover (e.g. Tekleab, Takeuchi, &
Taylor, 2005; Tett & Meyer, 1993; Van Dick et al., 2004).
Second, the survey response rate, while adequate, was relatively low. Only 40%
of workers returned the survey, thus the results may not be representative of the
AOD workforce. Moreover, the only available database of agencies used for the
study did not provide an exhaustive list of AOD treatment services in the country
despite efforts to update agency information during initial call-up sessions. This
further limits the generalizability of the findings. The rapid changes (i.e.
organizational, structural and political) in and the extensiveness of the AOD
field adds to the difficulty of establishing a complete list of services and workers
for benchmarking and monitoring purposes.
The most common reason cited by managers for not participating in the
study was that workers were ‘too busy’. Thus, those with heavier workloads
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and/or higher work stress levels may have not been included. In addition, as
AOD workers could not be contacted directly due to the lack of a workforce
database, managers were requested to distribute the questionnaires to their staff.
This may have introduced the possibility of managers not circulating the
questionnaires to all staff or influencing the way workers responded to the
questionnaire.

Conclusions
The results presented here provide the first comprehensive national data on the
working conditions, well-being and attitudes of Australian AOD workers.
The results are consistent with the findings of previous international research
on AOD workers and other worker populations. AOD frontline workers who are
dissatisfied with their jobs and/or stressed are more likely to quit their jobs.
Turnover is a costly and serious issue, particularly for the AOD field, as it can
affect the quality of care and treatment of clients. High turnover rates may add
to the workload of remaining workers thereby increasing their levels of stress and
decreasing morale (Barak et al., 2001). This in turn, may further dissuade
workers from remaining in or entering the field (Guerts, Schaufeli, & De Jonge,
1998).
The present findings can inform the types of interventions required to address
the problem of turnover in the field. Strategies that aim to reduce levels of
turnover and increase retention levels may do well to focus on enhancing job
satisfaction, minimizing work stress, enhancing workplace support systems and
ensuring fair and adequate levels of remuneration and other forms of reward
and recognition. Particular attention should also be given to younger workers,
and those new to the AOD field as the study found these workers were less
satisfied with their jobs and more likely to have intentions to leave. Finally, this
study also provides a useful starting point to further examine broader workforce
development issues of recruitment and retention of the AOD workforce in
Australia.
 Stress, satisfaction and turnover intentions of Australian AOD workers 229

Acknowledgements
This project was funded by the Alcohol Education and Rehabilitation (AER)
Foundation Limited.
Declaration of interest: The authors report no conflicts of interest. The authors
alone are responsible for the content and writing of the article.

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