Is collaborative addiction care effective?

Unfortunately, Practical Recovery does not yet have any long-term follow-up data on our clients. The task of designing the data collection is daunting. No two clients do the same treatment! However, we are in the process of designing a basic data collection system. We expect it to reveal that our clients do about as well as clients in well-run studies.

Our lack of data should not be surprising. We are a for-profit facility in a highly competitive market. We are also blazing a trail that few others seem to be following on (so far). Blazing this trail has kept us fully occupied. Raising fees to cover the cost of extensive research (because it would require additional staff) would make our approach even more expensive.  We are hopeful that as “collaborative addiction care” becomes more recognized our clients and our processes we will be studied by independent and independently funded scientists.

A large amount of the addiction treatment research in the US is funded by the federal government. It would ideal if the federal government funded study of the collaborative care approach to treatment that Practical Recovery uses. Given the addiction research priorities that the federal government has, we may need to wait awhile. In the meantime our services are available to discerning clients.

Because the core of our addiction interventions is evidence-based addiction treatment (few addiction treatment facilities can accurately state this), there is perhaps a less pressing need for us to have outcome data. When your psychologist provides cognitive therapy for depression, or your physician prescribes a proven medication for high blood pressure, do you ask about their personal outcome statistics? We might ask our surgeon, however, because in surgery there are often immediate life and death risks.

Revealingly, our clients typically do not ask about outcome data. Why should they? They fully understand that change is all about what they are going to do, not primarily about we are going to do. At our facilities they are free to leave at any time (even our alcohol and drug rehab), and free to adjust their treatment as they see fit. Under these conditions we can do little harm. Even if our outcomes are not necessarily better than those of another facility, the self-designed nature of our approach is more interesting to most, and prompts more rapid entry into treatment. Many of our clients state that they simply would not attend a facility that did not offer the choices we offer.

To the few potential clients who insist on knowing about outcome data, we respond that we can include in their treatment the main elements of the evidence-based approaches, to the extent the client wants to include them. We add that for a client who is well motivated to change, a wide range of facilities might be helpful, but that if they are not well motivated, no facility is likely to help. We ask them to consider whether our collaborative approach seems like a good fit for helping them make the changes they want to make.

Revealingly, once clients are in treatment with us questions about outcome data stop being asked. The question then is not whether something works for others, but “is it working for me?” Fortunately, in our approach, you can focus on what is working for you, and leave the rest behind.