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How Better Interviews Lead to Longer Lasting Hires in Behavioral Health

Considering the amount of turnover in behavioral and community healthcare, retaining quality staff is a struggle—especially if much of your time is spent on recruiting and interviewing candidates rather than focusing on engaging and developing your current staff. Yet, the interviews you conduct can make the biggest difference to the hiring process in behavioral and community healthcare; and, thus, the quality of staff you hire.

Conducting a strong interview is a critical first step in building a culture of long-term staff retention. If you have ever been on the receiving end of a weak interview, you may understand why. You walk away from the interview feeling like you nailed it and made a best friend at the same time. “Wow, it was so easy! They didn’t ask me any difficult questions!”

After you’re hired and some time goes by, you begin to think, “Hmm…this isn’t what I expected,” and you start putting feelers out for other positions because you become increasingly frustrated. When you leave, your department suffers, but so does the organization’s overall performance due to the constant churn of staff and subsequent training costs.

During a presentation on the topic of What Great Managers Do Differently, Relias CEO Jim Triandiflou asks the audience, “What is the most important thing a manager does?” It is a multiple-choice question to which most people answer incorrectly. What was the correct answer? Hiring. And if you drill it down further… it is the interview process itself, and the questions asked, that determines the success of a hire.

Understand the elements of a weak interview

First, let’s identify what a weak interview is, because you may be thinking, “Wait a minute. I don’t act like the candidate’s best friend during an interview,” or “Of course I know I have to ask questions.”

I’ve listed a few examples below. If you answer yes to any of the following statements, there is a good chance that your interviewing technique needs some adjusting.

  • I have hired candidates too quickly without thoroughly interviewing them only to turn around and rehire someone new due to poor job fit.
  • I have turned the other cheek on some obvious red flags knowing I would regret it later, but I just really needed the role filled.
  • I have “taken it easy” on candidates that I notice are obviously nervous.
  • I spend most of the interview discussing the organization culture, benefits and job expectations.
  • I go with my gut. I have a very good sense of who people are and can determine whether they’ll be a good fit while I’m speaking with them.
  • I have relied on someone else’s interview feedback to make my decision since I was too busy at the time.

How did you do? While some of these examples are understandable, when you look back on the social workers, peer support counselors, case workers, physicians, nurses or other practitioners who have left your organization—whether voluntarily or involuntarily—see if you can trace the reasons for their departure back to any of these statements.

Track for quality, not just efficiency when hiring in behavioral healthcare

According to an article in HR Magazine, human resource metrics used to be efficiency-focused and based on measuring cost-per-hire and time-to-fill data. After realizing that efficiency is only part of the equation for selecting the right candidates, it is now understood that quality must be the other part.

The article goes on to state that, while top executives agree that hiring the best people is important, the priority of tracking the outcomes of hires is low, essentially giving the impression that managers are getting a “free pass” on talent selection.

As workforce growth slows down and competition for talent speeds up, the need to identify—and build training programs around—managers who can bring a high level of quality in selecting candidates will be increasingly important.

“Managers’ hiring choices should be subject to the same level of scrutiny as their performance in generating revenue or managing money.”
—Pete Ramstad, Personnel Decisions International

Spend your time wisely

If you truly want to be able to focus your time on the work that drives the mission of your behavioral or community healthcare organization instead of focusing the majority of your time on a never-ending cycle of staffing, you need to improve your hiring process at its most critical stage—the interview.

Think of it this way: The way you choose to spend that block of time—conducting a single interview—will impact the success of your department and the future of your entire organization. So, learn to spend that time wisely so you can save time later.

Now that you understand the elements of a weak interview and how critical it is to improve on your interviewing technique, let’s talk about a best practice technique that, if done correctly, provides excellent results.

Commit to behavioral interviewing

Behavioral interviewing is a technique that was developed by industrial psychologists in the 1970s based on the premise that “the most accurate predictor of future performance is past performance in a similar situation.”

Traditional interviews incorporate questions that are opinion-based. For example, the questions “What attracted you to this position” and “What is your greatest weakness” both allow a candidate to provide an opinion as a response.

On the other hand, behavioral-based interviews use questions that compel a candidate to respond with stories about how they handled challenges that directly relate to the skills required for the position.

For example, if a position requires excellent decision making skills, or the ability to think quickly, you might say, “Give an example of a time in which you had to be relatively quick in coming to a decision,” or “How quickly do you make decisions? Give an example.”

Behavioral interviewing helps you gain the confidence—drawing from anecdotal validation of skills—to hire the right candidate for your department and organization.

For a treasure trove of behavioral interview questions organized by skillset, check out the following links.

Crafting role-specific questions is also important, since you would seek different competencies in, say, a substance use counselor versus a primary care clinic nurse, as shown below. Please note that the following examples are not all-inclusive.

Questions to ask in the hiring process of behavioral healthcare professionals



Tell me a time when you:

Substance Use Counselor Clinical aptitude for assessments Assessed and treated a client with co-occurring disorders and what techniques you used
Social worker Intervention planning Used the transtheoretical stages of change model to identify a person’s current stage to match treatment efforts accordingly
Case Manager Monitoring Conducted a safety check during a home visit and what steps you took to monitor the environment for danger
Peer Support Specialist Ethics, boundaries and self-care Recognized burnout or compassion fatigue and how you addressed it

Questions to ask in the hiring process of community healthcare professionals



Tell me a time when you:

Ambulatory LPN Infection control Treated a patient with an infection, what type of infection it was and what steps you took to control or prevent it
Primary Care Clinic RN Pharmacology and immunization Encountered an error in a medication you administered to a patient, what the error was and how you reconciled it
CNA General knowledge of disabilities Treated a patient with a disability who presented challenging behaviors and what methods you used to respond to it and prevent it
Pediatric Pharmacologist Medication administration Administered an intradermal, subcutaneous or intramuscular injection and what procedure you used
Psychiatric Behavioral Health Medication identification and recognition Treated someone who wasn’t ready to become completely abstinent from a substance use disorder and what harm reduction treatment you provided
Medical Assistant Patient education Communicated a self-care technique or action plan to a patient in which there was a communication barrier
Dental Assistant Medical emergencies management Encountered a medical emergency in the dental office and what you did to manage it


For more tips on how to improve the way you hire and retain highly skilled behavioral and community healthcare staff, download the free guide, How to Become an Employer of Choice When You’re Short on Staff and High on Turnover. Inside, you’ll find an in-depth walkthrough on hiring, interviewing and onboarding, along with helpful templates and worksheets.


Free Guide: How to Become an Employer of Choice When You’re Short on Staff and High on Turnover

The staff shortage crisis and soaring turnover rates in the healthcare industry is creating a demand for employers to re-examine the way they attract, hire, onboard and develop staff. This guide—complete with worksheets and practical tools—includes four actionable steps behavioral and community health centers can take to improve current strategies and become an employer of choice.

Download the guide →

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