This was the question that first introduced me to the BRC Family of Programs and Marsha Stone. If I remember correctly, I was eating a “sampling” of desserts at The Oceanaire at the Galleria in Dallas, Texas. I admit, the question was inconveniently timed as I was somewhere between a bite of key lime pie and the flourless chocolate torte. My mind felt a little sluggish from all the food, and I didn’t want to talk with my mouth full. Plus, I had just met Marsha at this dinner and now she was asking hard questions. So, I punted and said the usual, “Here’s my card, give me a call if you want to discuss. I think I can help you figure it out!” To my surprise she did, and we started working on this project about five years ago.
Marsha explained that when she took reigns of BRC, she found a legal pad in the desk of Mark Houston. On it was a list of names, and the columns beside those names had check marks showing whether or not the alumni was sober. While this was not empirical, it was something and made it possible for Mark and his team to know loosely how the treatment they were providing was working for alumni. This was the starting point of outcomes collection at BRC, and while it does not meet criteria for empirical rigor, I personally do not think we should ever criticize any effort at tracking the success of our clients post-treatment. Instead, we should take this platform and continue building from it. This is exactly what Marsha did and what I have done since joining the effort (after I finished the key lime pie).
Marsha knew that she wanted to add resources to the outcomes effort and went to one of the few publically available resources measuring treatment success, the website of SAMHSA. There she found a recommended and empirically normed measure, which she began implementing. When I met her, she had five-years of data that the BRC team had collected at varying times during treatment, but no idea what to do with it. (Hence, the interruption of my dessert consumption.) Since that time we have added many additional measures and strategies for tracking our outcomes. We have automated it all using the Trac9 platform and have just about convinced all of our staff how their extra effort makes a huge difference to the treatment industry overall.
If you want to know the answer to the title question, my best bit of advice is to ask for help. The general curriculum of most programs that train counselors and staff for this field are limited in offerings for research design and data analysis. That doesn’t mean that the treatment industry is dumb, doesn’t care about outcomes, or doesn’t understand their importance. It simply means that we often divert our attention away from things that aren’t emergent in the course of our daily work. It takes a champion to get an outcomes program going at your facility, and it takes someone with a passion for data to work through the analysis process (yes, these rare individuals exist!). Find your champion and if there isn’t one in your organization…OUTSOURCE.
There are many resources that will help you clean and analyze your data, and many of them are free or low-cost. If you have financial resources, there are companies that will work with you on design, collection, and analysis. If you have limited resources, call the university in your town. There are graduate students and faculty who have an interest in this field and who need data for dissertations and publications. Or, ask around and find a consultant (which is how I came to work at BRC). There is value in using an outside entity or professional for data analysis. It allows a third party to review your data and provide analysis which meets scientific rigor. If you want or need recommendations, please email me directly. I am happy to point you in the right direction. Last, as I mentioned in my last post, consider technology!
I know this blog doesn’t tell you how to analyze the data. That subject has consumed countless textbooks over long periods of time and it too broad to cover here. Rather, tell this story because there are many points where the outcomes data can hit obstacles which may seem insurmountable. DON’T GIVE UP!! It doesn’t take a genius to collect, analyze, and make use of outcomes, it just takes a bit of tenacity. Stay tuned and next month, I will show you some fruits of our tenacity!!