FRN Research Report June 2014: La Paloma Patient Outcomes – Sustaining Recovery at One Year

Introduction

Not all residential treatment centers offer the same quality of patient care and results. Best practice guidelines recommend integrated treatment that addresses a patient’s substance use disorder and mental health conditions (TIP 42). La Paloma Treatment Center in Memphis, Tennessee, offers an integrated treatment program that addresses co-occurring addiction and mental health issues.

Patient satisfaction and engagement in addiction treatment plays a significant role in recovery outcomes. Just as every treatment plan must be unique to fit the needs of the individual, treatment centers must be adaptable to ensure year-over-year improvements in services and care delivery. High levels of patient engagement demonstrated by positive feedback and patient satisfaction rates ensure that patients achieve greater symptom relief and higher sobriety rates.

Run by Foundations Recovery Network, La Paloma specializes in protocols that achieve patient engagement in the treatment process. Through a variety of therapeutic techniques including Motivational Interviewing, facility staff members work with patients to create greater levels of engagement in treatment and support the recovery process. The facility also offers many services, such as Cognitive Behavioral Therapy, Dialectical Behavior Therapy skills, exercise facilities, delicious and nutritious meals, daily recreational activities and meditation opportunities, which keep patients satisfied and motivated. Since the facility specializes in caring for patients with co-occurring conditions, these added services meet the greater needs of a patient population with more challenging psychiatric symptoms (Boden & Moos, 2009).

Data from 2013 shows that patients treated at La Paloma experienced reduced symptoms associated with addiction and mental health problems and used fewer substances one-year post-treatment. La Paloma’s staff commits to enhancing patient care and works diligently to address patient needs. As part of ongoing research to find the most effective treatment methods, staff members and patients participate in regular surveys to determine progress.

Research Validity

This paper discusses patient survey results and treatment outcomes based on data collected at La Paloma. The results track patient responses at intake through one-year post-treatment. In 2013, 90.7% percent of La Paloma patients consented to participate in the FRN research project. The FRN research department utilizes nationally recognized, validated instruments, and methods and results are independently verified by an Institutional Review Board made up of members that include behavioral health professionals, university professors and community representatives. The information generated from this research allows FRN to evaluate patient data, satisfaction surveys and outcome results, actively incorporating this information in the management and decision-making processes at La Paloma and other FRN facilities.

Patient Engagement and Satisfaction, Active Treatment Participation and Positive Treatment Outcomes

Residential treatment is most effective when patients complete their treatment plans. Methods that promote engagement and patient satisfaction improve the impact of treatment and, therefore, the ultimate results of treatment. A widely recognized evidence-based methodology to support greater patient engagement is Motivational Interviewing (MI). MI is a well-researched technique that gives patients the opportunity to examine their past and current choices and to determine the best course of action for the future. The technique recognizes that change comes from within the patient, and change only happens when the patient decides his or her own best course of action. This process sets the stage for the decision to change (Rollnick & Allison, 2004). MI is an integral part of the treatment process at La Paloma. All staff at La Paloma are trained in MI, and MI builds the foundation for how all communication occurs at the facility.

Treatment centers that involve patients as active participants in the development of treatment plans experience better outcomes. Getting involved at intake and staying involved in the first stages of treatment make a significant difference in post-treatment success (Simpson, Joe, & Rowan-Szal, 1997). In addition, patients who are satisfied with their treatment programs and receive an adequate number of services are more likely to complete treatment or stay in treatment longer. Longer treatment stays produce many positive lifestyle changes, such as long-term sobriety, lack of involvement in criminal activity and community involvement (Hser, Evans, Huang, & Anglin, 2004).

Every patient enters treatment with a different willingness to change. Patients who struggle with social integration problems or psychological conditions may need more early interventions to stay in treatment. Patients with depression and anxiety disorders are more likely to leave treatment early as well as those with domineering or vindictive personality traits. Treatment programs that regularly screen patients for signs of psychological or social problems can offer interventions that lead to longer stays in treatment (Doumas, Blasey, & Thacker, 2005) and, therefore, more positive long-term outcomes.

Similarly, a patient’s willingness to recommend a facility to others indicates confidence in the treatment program and a strong belief in its worth to others. Patients who recommend La Paloma to others are willing to put their reputations at risk with friends and family. A person who recommends a treatment facility to others is making a stronger statement than a person who says he or she is satisfied with a facility’s service (Reichheld, 2003). Approximately 85% of patients “agree” or “strongly agree” that they would recommend La Paloma to others.

La Paloma Patient Outcomes

Ultimately, however, treatment is about outcomes. In health care, the bottom line is always, “Did the patient get better?” La Paloma tracks patient outcomes for a full year after treatment. All patients who enter treatment at La Paloma have the opportunity to participate in FRN’s ongoing research study. Participants must sign Institutional Review Board approved consent prior to participation, and the follow-up study includes interviews at intake and again at 30 days, six months and one-year post-discharge. Data is collected using validated instruments, including the Addiction Severity Index and Treatment Service Review. Over 65% of La Paloma patients responded to follow-up surveys. Responses from the research instruments are designed to assess several aspects of a patient’s mental and physical functioning.

La Paloma’s patients continue to see positive outcomes at one-year post-treatment. Patients have fewer mental health symptoms and report fewer days of alcohol and drug use. At intake, 44% of patients reported experiencing psychological or emotional problems within the 30 days prior to intake, and 18% reported symptoms within the 30 days prior to the one-year post-discharge interview. Patients reported experiencing an average of 20.84 days of symptoms in the 30 days prior to intake and an average of 8.6 days in the 30 days prior to the one-year post-discharge interview—almost two weeks of fewer symptoms per month. This translates to significant improvements in well-being and social functioning for patients who have attended La Paloma.

After one year, the overall use of illegal drugs dropped by 53%. Of the 44% of patients reporting multiple substance use at intake, only 10% reported multiple substance use at one year. The percentage of patients reporting any drug or alcohol use also fell significantly at one year compared to intake (see the chart below). Approximately 82% of patients reported drinking only three times or fewer during the 30 days prior to the one year interview. Significant improvements were observed for all measures associated with substance use.

Conclusion

Patients who are engaged and motivated at the very beginning of substance use treatment stay in treatment longer and see better outcomes. Involved patients who are satisfied with their treatment and services learn more skills and absorb more techniques for staying positive and committed to sobriety. Furthermore, high recommendation rates indicate patients are pleased with their treatment and encouraged by the entire process.

La Paloma’s excellent satisfaction rates and recommendation scores indicate a vibrant program with the ability to meet patient needs on many levels. The facility offers a variety of services in a positive, loving atmosphere that gives patients the tools they need to be successful at one-year post-treatment and beyond. Recovery outcomes, including mental health symptom improvement and reduction in substance use, all show significant and lasting improvements.

Foundations Recovery Network is committed to research that improves treatment for all addicted individuals. If you would like to speak with an admissions coordinator today or if you would like to learn more about our research methods and programs, please call us directly at 615-490-9376.

References

Boden, M. T., & Moos, R. (2009). Dually diagnosed patients’ responses to substance use disorder treatment. Journal of Substance Abuse Treatment. 37 (4), 335-345.

Doumas, D. M., Blasey, C. M., & Thacker, C. L. (2005). Attrition from alcohol and drug outpatient treatment. Alcoholism Treatment Quarterly, 23 (4), 55-67.

Hser, Y.-I., Evans, E., Huang, D., & Anglin, D. M. (2004). Relationship between drug treatment services, retention and outcomes. Psychiatric Services, 55 (7), 767-774.

Reichheld, F. F. (2003). The one number you need to grow. Harvard Business Review, 1-11.

Rollnick, S., & Allison, J. (2004). Motivational interviewing. In N. Heather, & T. Stockwell (Eds.), The Essential Handbook of Treatment and Prevention of Alcohol Problems (pp. 105-115). Chichester, West Sussex, England: John Wiley & Sons Ltd.

Simpson, D. D., Joe, G. W., & Rowan-Szal, G. A. (1997). Drug abuse treatment retention and process effects on follow-up outcomes. Drug and Alcohol Dependence, 47 (3), 227-235.