This dissertation is a study of the leadership development process of community mental health center (CMHC) executive directors in Ohio. CMHCs are tasked with providing services to individuals struggling with complex mental and emotional diagnoses. In Ohio these centers are nonprofit organizations that offer a multifaceted array of services paid for by a variety of third party funding sources. Many executive directors of Ohio CMHCs begin their careers as clinicians and must acquire the skills necessary to effectively lead their organization. In this study six Ohio CMHC executive directors who began their careers as clinicians were interviewed to discover the clinician-to-director developmental process. The data revealed two primary themes each with subthemes that describe the phenomenon experienced by the directors.