Effectiveness of Interventions to Improve Resiliency & Burnout in Behavioral Health Residential Staff

The goal of this clinical trial is to compare Integrated Resiliency Training and Task Sharing (IRTTS) to Workplace Improvement Learning Collaborative (WILC) in group homes for adults with serious mental illness and/or intellectual and developmental disabilities. The main questions it aims to answer are:

* Is IRTTS superior to WILC in improving residential care worker (RCW) resiliency; stress management and burnout; depression and anxiety; and positive health behaviors?
* Is IRTTS superior to WILC in improving RCW turnover/retention; RCW sick days/absenteeism; and group home safety and resident incidents?
* What are the barriers, facilitators, and resources required to successfully implement IRTTS and WILC?

Participants may engage in training sessions, collaborate with residents and other RCWs in their group homes, attend meetings with RCWs from other group homes, complete surveys, participate in focus groups, and/or give qualitative interviews.

Researchers will compare IRTTS to WILC to see which intervention should be implemented to achieve the greatest improvement in RCW resiliency and greatest reduction in burnout and turnover in group homes for adults with serious mental illness and/or developmental and intellectual disabilities.

This study involves group homes for adults (age 18+) with serious mental illness (DSM-V Diagnosis of Axis-I Mental Illness with persistent functional impairment) and group homes for adults with developmental and intellectual disabilities operated by public-sector community-based human service organizations. Approximately n=180 group homes operated by two human services organizations in Massachusetts (Vinfen and Bay Cove Human Services) with approximately 900 residential care workers (RCWs) will be included in this study.

To test whether site-level Integrated Resiliency Training and Task Sharing (IRTTS) is superior to an organization-level Workplace Improvement Learning Collaborative (WILC) in improving RCW-level and group-home-level outcomes, researchers will conduct a cluster randomized trial randomizing n=180 congregate care homes to either IRTTS (n=90 homes) or WILC (n=90 homes) in three 18-month phases over the study period (60 homes enrolled per phase). Note: the unit of randomization is group home, not individual RCW. Cluster randomization is adopted as the interventions are system-level interventions delivered to groups of individuals in each home. As IRTTS consists of training RCWs in group-based resiliency, researchers will provide training to approximately 5 RCWs in each group home and evaluate outcomes for 90 group homes and approximately 450 RCWs assigned to IRTTS (30 IRTTS group homes and 150 IRTTS RCWs in each of three phases of the implementation). WILC consists of a learning collaborative approach involving group home leaders. For the n=90 WILC group homes, researchers will involve n=90 group home leaders and will evaluate the impact on group home-level outcomes for the n=90 group homes on approximately 450 RCWs assigned to WILC (30 WILC group homes and 150 WILC RCWs in each of the three phases of implementation). The project will take place over four years.

Eligibility Criteria:
Inclusion Criteria:

* Permanent-salary staff working in participating group homes

Exclusion Criteria:

* Temp staff and per diem workers
* Staff working in group homes not included in this study