counselor

licensed vocational nurse

dietitian

therapist

program coordinator

Alsana

Alsana is a program that I feel truthfully has so much potential to do what it claims. However, due to an incredibly incompetent and selfish administration and staff, Alsana fails to pass as even a decent recovery residential center. 

They see clients as numbers, ironically enough. All admin cares about is having "successful" discharges- AKA letting a client go before they leave against medical/clinical advice. This was such a big deal. that the company even made it a competition amongst treatment centers to see which center could have the most amount of discharges before Christmas- most discharges won. No care for the actual long-term succession rate of clients.

The treatment of staff was deplorable. Now having worked in an actual, sophisticated company, I am appalled that I dealt with Alsana's employee management for the time that I did. Time and time again, direct care is thrown under the bus despite working the hardest regarding client care and getting those "desirable" numbers that admin so desperately wants to see. Admin spoke down to me and my coworkers as if we were children, even laughing and saying "Why don't you just quit?" to my coworkers numerous times when someone questioned how things were being managed. 

I pride myself in putting my all into my work and nothing less, but Alsana did not deserve my all. I was more than done with Alsana and had been given a new job opportunity but decided, knowing that it would be a hassle to hire and train a replacement, to give leadership a notice far longer than 2 weeks. In my offboarding period, I wanted to leave but was told that "from a business needs perspective" and the lack of staff it would not be able to lessen my load. MORE THAN ONCE after being told this, I was left on my own due to others calling out. I was forced to succumb to the disadvantages that I was threatened would happen if I left, the irony was great.

The PD is in way over her head. She is extremely busy and doesn't know how to practice time management, and doesn't seem to have an empathetic bone in her body. I have truthfully never encountered a more egotistical person. it did not even occur to her that she had told me that me leaving early would possibly leave one person on shift by their lonesome, only for it to happen to me on shift soon after. She is terrible at communicating and time and time again has to be asked for clarification points by staff in order to understand what she means. She will leave out extremely important details in new protocols, trainings, procedures, etc. but never speak them into existence until someone asks. She dropped the ball numerous times with client care and staff workload whenever taking vacations of being out of the office. Would forget to tell a staff member key information and then be unreachable when needed. It is clear she prioritizes her outside commitments far more than her job, as she was once in charge of introducing a client who had just admitted close to her time to go, 5PM, and it was found out she chose to forget over half of the essential admission proccesses and conversations so that she could leave, not realizing that the direct care staff would have to aimlessly fit together the missing pieces she left as we had a client who did not understand anything when beginning treatment.

The food waste situation was further unsettling. Being a place that prides itself as a "healthy eating community" they sure did teach clients how to throw away food. Food that was never close to expiring, and sometimes even untouched entirely, would get thrown out out of pure convenience. 

The lack of cultural competency in such a space was horrid to witness. Any time a non-white client admitted it was so obvious how much more comfortable they felt around me and the very few other POC staff. I had multiple non-white clients confide in me regarding the lack of understanding the clinical staff had on their background, always giving off white-savior complexes. Staff was equally very odd towards me due to my own non-white / my religious practices and beliefs. Even the clients were more tolerable and understanding of diversity than the staff.

In all, avoid. Regardless of whether you're a clinician or straight out of undergrad. This place simply serves as a stepping stone to something better. 

Constantly understaffed despite ratio. You will be going above and beyond with daily tasks without a raise in sight, then asked to train new employees who are making more than you. 

Leadership will gaslight you into thinking you aren’t doing your job, which is insulting and unprofessional.  During the big layoff, there was absolutely no communication between leadership and direct care (last chain of command), unless you were the one being laid off. The situation was handled very poorly and unprofessionally. 

Leadership will see clients who are struggling in the moment, instead of helping deescalate in the moment, they will seek out direct care staff to take over, despite being busy with other tasks, giving off the sense that leadership is far too superior to do a job described for direct care. I have witnessed far too many times where a client has asked a member of the leadership team for the bathroom support then be directed toward direct care because “that’s a question for direct care”.  

There is no direct supervision over the Direct Care position. When we have problems, they go directly to leadership, who then tells us to deal with the issue on our own or lie to their employees as “it’s being handled behind the scenes”. 

Tone-deaf leadership; there are many instances where diet culture was unintentionally promoted in the workplace. Drinking diet sodas, bringing in low calorie lunches and hiring interns/clinicians with active eating disorders. 

There is an obvious lack of diversity within the Birmingham location. There have been clients of color who have mentioned that they were not comfortable with the lack of employees of color. 

The clinical/nursing staff is amazing, they go above and beyond their job description and will take the time out of their busy schedule to check in on direct care and offer to help. They are very consistent and communicative. They are very appreciated amongst the direct care staff as well as the clients. 

As for the rest of the direct care staff, they are amazing as well. Very personable and lovely people to work with. They are very hardworking and thorough, physically, mentally, and emotionally. They honestly keep the company afloat, despite being treated as expendable. 

I would say that it's important not to judge a book by it's cover when considering Alsana! The grounds and facilities are absolutely BEAUTIFUL at all locations, however, there is a lot to be desired at the facilities in the St. Louis area. 

Leadership is very inexperienced. Due to high turnorver and dificulty with finding qualified applicants in the surrounding area, there have been quite a few internal transitions that are not effective. Newly licensed individuals can/have become part of leadership or promoted within leadership without leadership experience! Those with lesser experience do not feel confident in receiving feedback from those who, frankly. barely know what they are doing themselves. There is a push toward only one or two modalities of treatment (IFS and attachment theory), with little insight or training to other effective modalities. There is also very little understanding of the impact of comorbid or co-occuring diagnosis on eating disorders, thereby lessining the effectiveness of the treatment provided. 

There seems to be an unspoken energy around client treatment: some get preferential treatment, while others get pushed out the back door (the same could be said for staff). The census levels are too high, meaning that the staff are pretty overworked, with little reward. The organization as a whole rewards and promotes "overworking", and gives little credence to the nuances associated with treatment in regards to time management and individual requirements for client treatment. Many clients and staff members do not feel supported by leadership, as many complaints and concerns go unresolved.  

Overall, the organization as it regards to St. Louis has an identity crisis: it wants to hold on to some of the vestiges of it's Castlewood era, yet represent something more inclusive and holistic. Problem with this is that the organization has failed to show either a solid understanding of holistic healing principles, or the values of old that should be held on to. There is also an energy that says the bottom line is more important than clientemployee care. 

I would not recommend working for this company. In my experience, there was little to no work-life balance, and employee well-being was not prioritized. While the company offers a signing bonus, employees should carefully review the repayment requirements, as they may be required to repay the bonus if they resign or are terminated.

The work environment was highly stressful, with unclear expectations, inconsistent procedures, and a lack of stable leadership. The position of Director of Clinical Services appeared to have significant turnover, resulting in a lack of continuity and direction. Staff turnover was also exceptionally high, with new employees frequently hired and then leaving within a matter of months.

Employees were often asked for feedback regarding their needs and support, but meaningful changes or accommodations rarely followed. There was a disconnect between what was communicated and what was actually provided to staff. This created an environment where employees felt unsupported despite repeatedly expressing concerns.

As an associate therapist, I found that the workload and expectations often exceeded what was reasonable or sustainable. Rather than fostering professional growth, the culture frequently left employees feeling overextended and undervalued. Setting healthy professional boundaries could be met with resistance, making it difficult to maintain personal well-being while meeting job demands.

For clinicians early in their careers, particularly associates working toward licensure, this type of environment reflects many of the workplace challenges and exploitation concerns often discussed in graduate training programs. Prospective employees should carefully evaluate whether the organization’s culture, leadership structure, and expectations align with their professional goals and personal well-being.

The Good: Great Culture (for the most part) compassion for the well-being of clients, if you are a graduated new therapist --- you will learn a lot.

The Bad:  Transitioning "new" company so it is unorganized, especially management/leadership.  Never a concise answer and very little support from no matter what position you are in.  Overworked.  Always comes down to the money/budget and extreme lack of follow up.  If you like structure, this is not your place.  Training is via zoom and rarely in person, mainly due to COVID-19 and that is with the training you do receive.  Expect to learn as you go or fend for yourself in finding out answers.

DO WORK HERE if you can bypass unorganized leadership/management, want to make a difference in the lives of clients and can get by with little teamwork.

DON'T WORK HERE if you value teamwork, organization and are looking for support from top down and within your team.

Again, this is a newer company that is still evolving and growing with many things to learn.  Really think about your values and goals within a position before accepting one here. Lots of growth is to be had especially from leadership and some leaders needing to really learn how to lead v. manage or even manage.  Really sad, as I intended to be an employee longer but due to not being heard and improper follow up form colleagues and leaders --- left me to leave.  Again, know your values.


I was brought on as a part-time/PRN employee for Alsana. What ended up happening, however, was that I worked 40 hours some weeks, and then 8-24 the following so that I would not be eligible to receive benefits or full-time pay. Or there would be weeks that I would work 7-8 days in a row, but still was not considered a full-time employee. 

Then it became more and more noticeable that the company did not care for its employees or patients. Patients would berate us with no support or training from higher ups, patients would come in with serious trauma or mental health issues and we would receive no training in how to support them, we would be left alone with 6-10 patients over the weekends or holidays with usually only a nurse to assist, higher ups would not respond to phone calls or for requests for help, we were asked to not take sick days unless if we had someone available to cover for us, we were given little to no training in the beginning due to it being short staffed, we were not given PTO unless we were full-time, burn out was a real thing that was not acknowledged or aided in. 

The company's message states that "They put their clients in the center of their universe," but this ended up feeling sincerely untrue. Instead it seemed that the company truly only cared about was bringing in more money through very sick and vulnerable people.

Working with clients with eating disorders has been rewarding. I truly get to impact lives and make a difference. This is also a challenging population to work with. My supervisor is not very supportive and does not fully understand the demands of the job. Therapists are asked to see 800% more clients than the lead therapist who only carries a case load of 1 client, while therapists have to see 9 clients often with high acuity. The Lead therapist runs limited groups; 2-3 while therapists are assigned to run 9-10 groups and cover groups for other staff that’s on PTO for no extra pay. Paperwork is a lot. Support is usually verbal but no action is taken to change the issues to continues to cause very high turnover, the highest I have ever seen in my career. Changes are often with little to no warning and you get zero say in decisions and schedules that negatively impacts your life.  They don’t pay a 15% differential for weekends and late nights as most organizations do and this is one of the reasons past staff left. There is little room for growth but training is good. Time off is limited and accumulates very slow. It’s challenging to use PTO because therapists are asked to get their own coverage when that’s really the job of the supervisor. Sick time is very limited and difficult to use too. They need to address the PTO, salary and allow therapists to have a voice that’s actually heard. 

I worked at Alsana for only a month for a number of various reasons. First, they gave all evening shift only on the weekends even though I had open availability. They leave Direct Care staff alone on the weekends even though they know it's the most chaotic and hectic days of the week. They worked me over 50+ in my second week and left me to burn out completely. Not only do they not care about their employees but their clients as well. These clients have serious medical needs such as serious food allergies, long disassociation, heart conditions, asthma attacks, severe panic attacks and do not give ANY training on how to handle these situations leaving the client's lives in our hands. Often times I wouldn't be able to finish my documentation and had to stay back 1-2 hours and finish notes on clients. The pay is extremely low for what we do for the company and for how they treat employees. This company has VERY HIGH retention rates which is already the first warning sign. And lastly, clients would report high urges on self-harm and suicide and the company didn't mandate us reporting it. 

The goal of the company is supposedly to help clients recover from their eating disorders but the way they actually fund the eating portion of their recovery is pathetic. When I worked there, our residential facility had 14 clients at most (and we were almost always full) which we would have to prepare individualized meal plans for each client as well as for the support staff 2/3 meals a day plus make sure they had snacks sorted out. In addition we also had an outpatient facility to make food for only 2-3 times a week due to the availability of us as the kitchen team. Said kitchen team only being myself, working part time 3.5 days a week, and my head chef, working 5 days a week with OT almost every day. Whenever we asked for more support for the kitchen we were always told it wasn't in the budget or that they'd "look into it". Despite countless pleas that the way the kitchen lacked support didn't allow us to give our clients the care they deserved, we were left to fend for ourselves basically. That's when I quit, because between the emotional energy needed to work in this field and the lack of support from upper management (especially at the rate I was offered), I just couldn't handle the stress of it all.

What is the best part of working at the company?
The best about working at Alsana during my time serving there where the Direct Care. Many went above and beyond to serve the clients.  

What is the most stressful part about working at the company?
The most stressful part of working at Alsana in the Birmingham location was clinical staff and the culture. 

I believe that the clinical staff operated under a lot of poor judgement when it came to decision making. There were a lot inconsistencies which created a lot of confusion and even affected client care. There are wonderful therapists and dietitians that work at the Alsana BHAM location, but overall the clinical staff has poor leadership due to Clinical Director. 

I believe that there was a curated culture that that was not relatable to certain clients and staff. Having served as a former clinical staff, I’ve had many complaints from a lot of African American clients and staff that they did not feel seen nor heard because of the lack of cultural competence.

Top Job Titles	Average Salary
Counselor 6 salaries reported	$22.50 per hour
Licensed vocational nurse 4 salaries reported	$37.00 per hour
Dietitian 4 salaries reported	$89,750 per year
Therapist 2 salaries reported	$70,000 per year
Program coordinator 1 salary reported	$70,000 per year

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