You want to help your clients stop abusing substances. You want to help them function healthily in their lives, families, and communities. So, how can you assure your clients, family members, and insurers that your program will lead to a successful recovery? Simply put, by effectively measuring outcomes in substance abuse treatment.
Like other healthcare fields, addiction treatment demands accountability. By measuring outcomes and success rates, you can inform potential clients and the public about your substance abuse treatment program’s performance. But measuring accurate treatment outcomes also informs progress in the field and for your program–leading to greater quality of life for recovering people, more satisfaction from your clients, and an increase in business.
But how do you measure success? And how do you construct quality outcome studies? Beyond advertising and promoting your program’s services, there are ethical implications behind the success rates that you publicize. Your program (and every treatment program) needs a system to measure treatment outcomes. Here’s a look at why, how to do it, and how it will add value to your program.
Why You Should Measure Treatment Outcomes
The primary purpose of treatment outcomes is to provide objective data about which methods work best for which groups of people. As more of this knowledge is gathered, treatment programs can establish evidence-based practices. Programs can implement those practices and better help their clients achieve sustained recovery, which means:
- Fewer instances of relapse, which reduces costs on hospitalizations, car crashes, and incarcerations.
- Insurers can know which treatment methods and programs will improve their members’ health and reduce future healthcare costs.
- Treatment will start to meet client and family expectations by actually providing services that set clients on a path of long-term recovery.
Substance Use Disorders (SUDs) are chronic conditions. Therefore, treatment needs to prepare people for life-long recovery. Treatment outcomes should help payers, patients, and families to find programs. They should show how they can have the best chances for long-term recovery. And not just an immediate reduction in substance use. Yet, unlike other healthcare fields, substance abuse treatment lacks a life-long model of treatment. Not to mention the standards for measuring long-term outcomes.
Problems With Treatment Success Rates
Sure, high success rates are way more marketable. You’ll attract more clients and increase your revenue, right? But handling success rates solely as a marketing tool poses serious ethical problems for your program.
In scientific, peer-reviewed journals, average rates of sustained recovery and continued abstinence after treatment are reported between 20% to 30%. Yet, many treatment programs are advertising 70 to 100% success rates on their websites! Inaccurate success rates like these oversimplify treatment, leading people to believe that a stay in treatment is almost a “cure.”
Programs want to assure clients and families that “treatment works,”. However, success rates today can be deceiving–and sometimes they’re flat-out fake. Yes, scientific research shows that long-term recovery is definitely possible. In a survey of adults in the general U.S. population, among those who had once met the criteria for SUDs in the past, about 50% no longer meet SUD criteria and have gone into “remission.”
But, this also means that relapse is possible. Relapse does not mean that treatment is a failure. As with other chronic conditions, symptom recurrence is likely in addiction. Treatment is the beginning of a process–not a quick fix. Clients need to be aware that Substance Use Disorder (SUD) problems may persist after treatment. This is so they can be better prepared to handle them.
How Does Your Program Measure Success?
Many studies of treatment outcomes base their rates of “success” on how many clients report reductions in their substance abuse immediately after treatment. But, with three, six, or even twelve months of abstinence, can “success” in addiction treatment be measured in such relatively short intervals? Successful recovery is much more than abstinence or reducing substance abuse.
Do you ask about your clients’ health and mental well-being, their coping skills, or their overall quality of life? Your follow-up protocol is an essential piece of the process. Do you contact all clients who have been through your program or only some of your clients? Following up with only ‘graduates’ isn’t representative of the general population and can overly-inflate success rates. Do you factor in clients who don’t respond to follow-up surveys? Often, clients who don’t respond may not be as successful in their recovery.
Ultimately, is the long-term success of your clients important to you? If so, it’s time to demonstrate that in how you measure treatment outcomes. How long do you continue to follow up? If you stop after just 6 months or even a year, your rates of “success” aren’t actually representative of long-term recovery.
Creating a System to Measure Outcomes
There are many ways to collect data and measure treatment outcomes. You want to set up a structure that will last over time, and won’t be too much of a burden on your program staff.
- At intake, collect contact information for patients and their family members so you can follow up about their treatment experience and recovery process. Be sure to get the client’s consent and let them know from the start that you plan to follow up with them. It’s best to collect data from your clients directly, but in some cases, you may need to contact family members.
- After discharge, follow up with your clients and their families–those who complete your program and those who leave early or against medical advice.
- It’s important to follow up more than once, so set up routine follow-ups (about every three months) when you contact every client.
- You also need to check in over an extended period of time. Continue to follow up at a year, 3 years, and even 5 years after discharge, to gauge the long-term success of your program.
- You can structure your follow-ups as phone calls, or consider incorporating them into your alumni program.
- Another option is to use a program like Survey Monkey to send out your surveys. Electronic assessments are ideal because they are consistent, easier to maintain, and are private for your clients. Privacy allows your clients to be more honest in their reporting, so your success rates will be less biased.
Concretely define what you’ll evaluate as measures of success in recovery, so your staff can be well-trained and aware of what to observe. As you’re designing your follow-up studies, consult the CONSORT (CONsolidated Standards of Reporting Trials) guidelines and checklist to ensure you’re following best practices.
To best avoid bias, it helps to recruit and consult with local behavioral scientists, such as your local universities. When all is said and done, be sure to make your outcome studies available to the public and open for professional review. Ethically, the public deserves to know what data is informing the success rates that you publicize.
Add Value to Your Treatment Center
As it stands, only a select few treatment programs are actually measuring treatment outcomes and providing real-time data on the success of their facility. Honestly and accurately measuring your treatment outcomes could be a groundbreaking model for your program. As the demand for accountability in the field increases, this effort on your part may earn greater recognition for your program.
Most importantly, the research that you gather will help your program to improve. Your treatment success rates likely won’t be 100%, and this is expected. But, rather than distorting this data, use this knowledge to shape changes in your clinical practice.
As you correlate shorter stays in treatment with lower success rates, you can confidently encourage clients to stay longer based on your data. If treatment dropout presents a problem for your program and your success rates, focus on improving motivational techniques to keep clients engaged. If you measure long-term outcomes and see clients are prone to relapse, you can reshape your program to include continuing care services.
Your Ethical Responsibility
Research studies show that addiction treatment absolutely can improve the lives of a significant portion of people who experience severe SUDs. But, exaggerating the potential power of addiction treatment can produce serious harm. Your clients feel the pressure of unrealistic expectations. Those expectations cause strains in families when treatment doesn’t seem to “work” as they were led to believe. This emphasizes the importance of measuring outcomes in substance abuse treatment.
Stays in addiction treatment are typically brief, but recovery needs to continue long beyond that stay. Ultimately, long-term sobriety requires long-term engagement with your clients. Committing to measure treatment outcomes (beyond 6 or 12 months) is one step in that direction.
If the goal of treatment truly is to help clients maintain long-term recovery and improve their quality of life, your program also needs to measure long-term outcomes. Use that data to critically evaluate your clinical practice, so you can actually help clients achieve that goal.
Success rates are so much more than numbers to advertise–they are the key to making treatment more effective. Treatment can save lives. Make your program an example worth following–always growing, always willing to improve, and always with the best interests of your clients in mind.
