Toward a resilient opioid treatment workforce: Clinical supervision, training, and trauma-related functioning in a multistate study.

Staff in opioid treatment programs (OTPs) face elevated risk of secondary traumatic stress, yet the availability and effectiveness of training and clinical supervision to address this risk remain unclear. This study characterized current OTP training and supervision practices and examined their associations with staff vicarious trauma (VT) and burn-out. In a cross-sectional survey of OTPs, administrators (N = 44, 21 U.S. states) reported on staff training. Staff (N = 83) completed validated measures of VT and burnout. Counselors (n = 30) reported on clinical supervision. Training in VT and burnout was widely available, and most administrators (83.3%) and staff (89.6%) expressed interest in reflective supervision tailored to OTPs. In regression models, clinical supervision was associated with lower VT and burnout, whereas training availability was associated with higher VT and burnout. Findings suggest existing training models may be insufficient to address OTP staff stress. Expanding relationally-focused supervision may buffer the emotional toll of substance use treatment work.