As an industry insider, I could shorten this article to one sentence: Don’t believe anything you see and hear about a rehab’s success rate, statistics, or testimonials. But, there is so much more to be said on how the consumer can use success rate information to make a better choice.
Success rates in rehab advertising are surprisingly complicated constructs, especially for the following reasons:
-Many alcohol and drug residential rehabs don’t even try to measure how well their guests do after completing their program. If they don’t care enough to know how well they are accomplishing their mission, should this be a red flag for you?
-Some addiction programs call retention rates “success rates” where the “retention rate” refers to the percentage of guests who complete the residential part of the program. Retention rate, as a separate measure, is important information in itself: if the rehab has trouble keeping their guests for the duration of attendance, that is certainly a sign of a problem. However, how well one does after rehab is the question here, regardless of their attendance during the program.
-(and most importantly...) Success rate research has no agreed upon standards, so every program has a different methodology; and usually one that presents the rehab in the most positive light (imagine that). This creates the problem of “comparing apples to oranges.” One program might measure relapse rates, another might ask if a person has been sober in the last week, month, or year; still another might call any reduction (including harm reduction) in drinking or drugging a success.
How would you measure ‘success?’ Perhaps in one of the following ways…
-Whether or not the person leads a relapse-free completely clean and sober life. Or…
-Whether the person has relapsed multiple times but has not gone back to her old pattern of drinking or drugging. Or…
-Finally, what if the person has gone back to his old pattern of drinking or drugging, for months or years, but as long as he hasn’t done so recently, say, in the last thirty days or so, –would you even consider this a ‘success?’
…Rehabs will proudly display their success rate percentage without ever mentioning how they define success – a definition that could be quite different from yours.
Many rehabs that keep success statistics do so by surveying a sample of their program completers (from recent graduates to others who have completed their program years ago). The survey question is of the variety, “Are you currently drinking or using drugs?” If the person answers “no” than the rehab will include it in their success rate. However, is that person’s ‘current’ sobriety a direct result of the rehab’s program? What if the person completed their program, returned to their previous pattern of drinking and drugging, went to another program, and then stopped because of this second program – should the previous rehab get credit for this? No, but according to their methodology they will. What if the person relapsed back to his old ways after leaving the program but eventually (months or years later) stopped on his own –should the rehab take credit for that? Again no, but yet again, they will.
Gathering data can be tricky too: what if the participant can’t be reached, or he refuses to participate in the survey? Would this indicate a higher likelihood of drinking or using? Would the participant claim she is clean, sober, and relapse-free in order to please the surveyor; or answer inaccurately out of a sense of shame? Would the participant be compelled to claim sobriety out of fear that the survey may not be 100% confidential?
An extremely small number of rehabs that claim a high success rate actually explain their research methodology. Most would correctly fear that it would simply not stand up to any measure of scrutiny. Upon careful review, one can usually see flaws in data gathering, analysis, conclusions, and, most importantly, how the rehab represents “success” to their potential customers on their website and over the phone. Rehabs will try to get as much advertising and sales mileage as possible out of success rates, even if the truth can only be stretched a few inches.
One trend that has been spotted is the use of third-party research or survey companies that are paid to independently verify accuracy and (most importantly to the rehab’s advertising efforts...) add perceived legitimacy to the rehab’s claimed success rate. Here are the problems with this approach: (1) flaws in the rehab’s data collection can be just as easily duplicated by the research company (see above paragraph beginning with “Gathering data…”); (2) no research company can absolutely claim that the rehab gave them a fair (or truly representational) sampling of their program completers; for instance, a client database can be easily queried to provide a biased retrieval sample to the research company (unbeknownst to them); and (3) just as with the rehab’s own claims of success, an outside research company’s analysis and conclusions are rarely derived from a sound scientific method (objectivity, full disclosure, and reproducibility) yielding results that are just as suspect.
The success rate should be important, both to the rehab and its potential customers. A rehab should care about its ability to provide a valuable service to its clientele, and therefore constantly monitor outcomes. In fact, a consumer is advised to re-think any rehab that cannot provide a substantive answer to the question of that rehab’s success rate.
In a rehab’s zeal to claim a high success rate, one wonders if their “research” is manipulated beyond any measure of truth-in-advertising. Even those rehabs that try their best to accurately represent their success rate could be using research methodology that wouldn’t hold up to even the most elementary scrutiny.
So what is the consumer to do? First, don’t believe anything regarding a rehab’s success rate claims. By starting with this attitude, you won’t be setting yourself up for disappointment upon failed expectations.
Second, if a rehab’s research methodology is described in clear detail on their Web site, or other sales material, then review it carefully using the information you learned in this article. When you find flaws, or if you have questions, contact the rehab to get the clarification you need.
Third, if the rehab claims a certain success rate, but does not describe their research methodology in clear detail, ask them to describe it to you over the phone (if they can’t otherwise send you a description in writing). This sounds like a poor alternative, because it is. It should make you wonder why the rehab would state a success rate yet not provide information on their Web site as to how they arrived at such a number.
Fourth, if you don’t feel comfortable with a rehab’s stated success rate, and such information is important to you, just keep persevering until you find one that can give you the necessary degree of comfort you need to make that important admission decision.
A short note on testimonials…
About the nicest thing one can say about testimonials, especially as used in the rehab industry, is that they are a marketing gimmick. Testimonials at best provide only anecdotal evidence of a program’s success. Also, who is to say that the testimonial, if even authentic, is still valid; did the person who wrote it since relapse or go back to his old habits (a retraction of a testimonial would probably be rare even in such a case)?
I appreciate your feedback, especially by email!
My email: betteraddcare@yahoo.com
Related: Residential alcohol treatment center, drug rehab, addiction rehabilitation, substance abuse, alcoholism, twelve step, alternative to 12 step, recovery program, prescription drugs, before rehab, best rehabs
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