How Do I Make Sense of Claims of Success?
At Foundations Recovery Network, we believe that defining success is a very personal process. This is part of our commitment to provide individualized treatment. Counselors at our facilities will work with patients to determine exactly what “success” means in each individual case.
Many programs in the addiction treatment industry generate their “success” rates based on “successful completion of (their) programs.” This is not a fair reflection of the goal of treatment and is completely self-serving in its definitions of success.
Foundations Recovery Network reports on how our patients are doing after they receive treatment at one of our centers. These are not individual case studies, like you might see with most other treatment websites, but actually the result of years of data collection both at treatment intake and again at one month, six months and 12 months after treatment. We refer to these as outcomes.
We report a variety of outcomes, including:
- Abstinence rates – The percentage of patients who are not using at specific time points after treatment.
- Changes in use rates – The overall averages of substance use at intake and again at specific time points after treatment.
- Improvement in mental health symptoms – The changes in days of symptoms and in the severity of symptoms between intake and several time points after treatment.
- Improvement in key areas of life functioning – The changes in medical issues, relationship, employment and other life areas measured before and at several time points after treatment.
How Can I Trust Numbers and Rates Reported?
Unfortunately, there are a lot of claims of success in the addiction treatment industry that do not stand up to scientific scrutiny.
So how are true results determined?
- Validity and Reliability of Outcome Statistics
Reliability determines how consistent outcomes are, factoring out as many variables as possible.Validity determines the accuracy of the outcomes you are measuring actually do so.For the addiction treatment industry, the Substance Abuse Mental Health Services Administration (SAMHSA) has set some baseline standards for measuring the reliability and validity of treatment outcomes that the vast majority of treatment providers espousing “outcomes” simply do not use.
- How many of your patients agree to participate in research (enrollment) is the first critical benchmark. Legitimate research attempts to enroll 100% of patients in research. In order for research to be considered valid, a sufficient number of patients must be included in the original sample or group of participants so that the researchers can eliminate the possibility of any kind of selection bias. In light of this, 80% is considered an acceptable percent (because many people do not want to participate, so 100% enrollment is virtually impossible). In order to reach this baseline, tremendous effort must be made, and any type of “filtering” (pre-selecting more favorable patients) simply cannot be done.
- The second SAMHSA baseline involves the percentage of patients’ enrolled (base 80%) that you are actually able to reach post discharge for follow-up and phone calls and outcomes. When SAMHSA awards funding to an organization, the organization must reach a minimum of 60% of patients for follow-up after treatment in order to maintain their funding. Further recommendations include reaching patients at multiple time points , for example, 30 days, 6 months and one-year after treatment. Again, this large a number of patient participation generally eliminates any potential filtering of favorable or unfavorable participants.
- Here’s how FRN’s enrollment and follow-up results look:
Follow up rates for 2015 at one year time point was 73%.
Many programs in the addiction treatment industry generate their “success” rates based on “successful completion of (their) programs,” then “compliance with follow-up recommendations.” These are not valid or reliable methods for measuring outcomes and are completely self-serving definitions of success.
FRN exceeds SAMHSA standards for enrollment and follow-up and meets validity and reliability standards measured by independent third parties.
- Third Party Validation
Real results must be open for scrutiny by completely independent groups, such as academics, other researchers, even consumers and advocates. All true research undergoes a review process. This process requires that the research is first determined appropriate and safe by an Institutional Review Board (IRB). The IRB is also given periodic updates as to the progress and any problems that might have occurred as a direct result of the research study. Finally, research is reported and validated by a third party. This third party should be independent and unaffected by the results of the research. The IRB is one source of such review. The review required to publish in scientific journals is another example of review that confirms the results as reliable and valid.Extremely few private addiction treatment providers are willing to be this transparent with their results. FRN has an almost 20 year history of gathering valid, reliable research outcomes, and we present our results to an IRB composed of university professors, independent researchers, mental health and addiction professionals, consumers and advocates.Once outcomes are gathered and validated and conclusions are drawn, a credible provider should be willing to share results (good and bad) with the world (transparency). In order to be considered credible, these results must be accepted by what are called “peer-reviewed” journals and public forums (scientific conferences). FRN is pleased to be published in peer-reviewed journals and been accepted for presentations both in the US and internationally.
Is There Any Truth to Claims of “Cures” and “Guarantees”?
There remains a tremendous stigma associated with being labeled an “addict” or “mentally ill.” Unfortunately, there are some treatment providers who prey on people’s fears related to these labels.
Whether or not you label yourself an addict or as mentally ill, most people who contact us are struggling with cravings or compulsions to use; disruptions in their work, school or family lives; problems with judgment or risky behaviors, mood problems or even legal problems. We won’t label you; we want to help you achieve your individual goals.
However, if your level of drug or alcohol use has become so severe that you meet the diagnosable level of drug or alcohol addiction and/or mental illness, then there is a neurological basis (brain disorder) for what is happening to you, not necessarily a character flaw. In this situation, you may have a chronic medical condition. Like any chronic medical condition (cancer, diabetes, heart disease) you can absolutely reach a level of remission with your disease and live a healthy, productive, happy and content life if your disease is managed well for the rest of your life. But there is no “cure” for the chronic disease of addiction and mental illness, and anyone who claims to offer such an empty promise should be viewed with suspicion.
If you are offered a “guarantee,” please read the fine print! Similar to the discussion about enrollment and follow-up, some providers in the addiction treatment industry may have very self-serving language that adds significant qualifiers to their guarantees. A guarantee by itself is not necessarily bad or wrong, but most guarantees out there now require that you 1.) complete their program successfully (as defined by them), and 2.) that you comply with all their aftercare recommendations (as defined by them). These guarantees include significant, and often difficult to achieve “If, then” qualifiers. “If you (blank), then we will (blank).” Again, please view these with extreme suspicion and scrutiny.
What we can tell you is that good treatment can help you achieve what you desire. This statement is backed up by valid, reliable research. There is no false cure or empty guarantee, but there is real help and hope available for you.
How Much Does Treatment Cost?
Cost depends on what you want, need and, honestly, have the resources to pay for. There are high cost treatment services, low cost treatment services and local, state and federally-funded treatment services available. Most of our callers start by telling us what they want. Then together we talk about what they may need. “Need” is an important factor when considering paying for treatment utilizing private insurance.
Private insurance companies will only pay for what they consider “medically necessary.” If you have a pain in your knee, your insurance will not leap to paying for surgery. What is medically necessary is a doctor’s visit first, then depending on the physician’s assessment of your knee, he may recommend acetaminophen or ibuprofen. If that doesn’t work, you may have an X-ray and physical therapy. If these don’t work, you may get an MRI; depending on these results, you may qualify for “medically necessary” surgery covered by your insurance policy.
Addiction and mental health treatment is exactly the same. You may or may not “need” treatment in a 24-hour setting for an extended period of time. Determinations of “need” and the amounts of coverage (payment) provided by an insurance company varies.
To determine what you need and what your insurance carrier will pay for, you can call us or call your insurance company. Your insurance company will likely direct you to one of their providers for an assessment. For more information about insurance, visit our Insurance FAQ page.
The primary drivers of cost are 1.) levels of staff on-site and their level of competence (clinical credentials), 2.) content and components of their program, and 3.) the type of experience offered (food, beds, cleanliness, environment/setting and other provided services).
FRN accepts most private insurance plans (85% of our patients utilize private insurance). Deductibles, co-pays and costs for any non-covered services (such as sober housing following or in addition to treatment) vary widely based on wants, needs and coverage.
FRN also offers a range of treatment options and experiences, so what you want and need may also be unique. To really determine your unique wants, needs and ultimately costs, we must do so in conversation with you. If you use private insurance, we will work with them and you: We will advocate for you to them based on what both we and you believe you need, but ultimately they will determine what they will or won’t pay. We will keep you closely informed every step of the way. We have experience with thousands of patients and different payers, so we’re very experienced in determining what you can expect.
FRN does not currently work with any local, state or federal government payers. No matter who your payer is or what your unique needs involve, if you call us, we are committed to helping you find help.