Center makes unusual offer of free treatment for relapsers

Measuring treatment success rates accurately can be tough. While many organizations struggle with gathering data about their former patients, others that display success rates proudly on their websites are often criticized by those who believe there is no true way to calculate the success of individuals no longer in the treatment program.

As do most treatment executives, Joe Koelzer, founder and CEO of The Clearing (Friday Harbor, Wash.), deals with this issue on a daily basis. Since he and two others opened the organization’s doors, they have recognized that the field has a reputation for disappointing outcomes.

In order to combat the low success rates and help clients to achieve lasting recovery, The Clearing has begun to offer a “treatment guarantee.” This means that anyone who leaves treatment and begins to struggle can return to treatment at the facility at no cost.

Koelzer mentions an individual who recently was in the program who had gone through 11 different programs before coming to The Clearing. “We just don’t want to be a part of that group,” he says.

Parameters to the guarantee

Koelzer characterizes at the organization’s new announcement as a way to “stand behind what we do.” Because the guarantee was just rolled out in mid-March, no one has taken The Clearing up on this offer yet. Some professionals in the addiction treatment field have expressed concern about the parameters of the guarantee, including:

• Is there a period of time for the guarantee to be available? For example, if two years after leaving treatment someone relapses, can that person still come back for free treatment?
• Can an individual take the organization’s offer for the treatment guarantee more than once?
• How long would one be able to stay in the program for free?

Since the concept is new to The Clearing, Koelzer says many of these answers will be determined as time goes on and many of them will be based on the individual case.

The program occurs in an intimate setting with only eight beds and he explains that this turns the program into somewhat of a family. “If someone has issues moving forward and they’re a graduate of our program, they are part of our family and we’re here to help,” he explains.

He notes that the treatment center does things that are “radically different” from other organizations, and he includes the structure of the program in that as well. The 28-day program is similar to a workshop and all participants start and end on the same day. In the case of someone coming back through the program, he or she would revisit the entire 28-day program and have the opportunity to participate at a deeper level than before, according to Koelzer.

As for someone potentially taking advantage of the program’s offer and coming through for free multiple times, he says that will not occur. Currently the guarantee states that a person can come back through once for free. If someone doesn’t do well after his or her second time through The Clearing’s program, Koelzer says the team would assess the patient to determine the proper next steps.

“If he’s coming through a third time, maybe there’s something that’s not connecting and we can get him set up somewhere else,” Koelzer says. “I don’t want to be a place that says, ‘You’ve been here 12 times, awesome!’ Clearly something isn’t clicking.”

Response

The news of the guarantee has been communicated to the individuals who have gone through the program, but so far Koelzer says there hasn’t been much heard from that side of the fence.

On the flip side, addiction treatment professionals have many questions about implementing a treatment guarantee. At one Seattle counselors association meeting where 80 counselors were present, Koelzer commented on the treatment center and its guarantee. The remarks generated “an audible rumble in the room,” he noted.

He believes that most field professionals are too quick to place the blame on the treatment participant and don’t take enough of the blame themselves. Comments constantly swirl about the participant not being ready to go to treatment or not putting enough effort into the treatment work.

“We’re too quick to say in the industry that it’s the participant’s fault. We turned it around to look at ourselves,” Koelzer says.

With that, he explains that the program doesn’t accept people who are being forced by criminal justice, friends or family to come to treatment, but rather individuals who are conscious of their issues and ready to do the necessary work to make a change.

Jim Peake, who has a background in marketing and advertising and now serves as a marketing and business development consultant to addiction treatment centers, doesn’t believe in a model such as a treatment guarantee.

He mentions that he has heard this type of scenario before, such as with Narconon Fresh Start, which offers a treatment guarantee for free treatment to former clients who relapse within six months of leaving treatment.

“No one has any data, including the government, on success rates,” Peake explains. “And that’s for a number of reasons. There are so many different outside factors in this space that no one can pinpoint it and it’s different for everybody.”

He relates the issue to heart attack success rates and says that it’s practically impossible to figure out what will be the recurring rate of heart attacks. “It really depends on diet, what the guy is eating down the road, and whether or not he’s telling you the truth about what he ate. That will determine the success rate and that has nothing at all to do with how good the doctor is.”

The same holds true for addiction, Peake says.

He states that he would “hate to see the industry adopt something like this” and if an organization asked for his advice on the subject he would “blatantly say run the other direction and do not offer this guarantee.”

He adds, “Once they go out on their own, you have no control over them or their behavior. You have no control over the people that influence them. You have all these other factors that are unknown.”