Remuda Ranch Eating Disorder Treatment Outcomes
Frequently Asked Questions
- How many patients responded to your questions about their recovery?
- What about the patients who did not respond to your survey—how are they doing?
- Since you do your outcome research in-house, isn’t it biased in Remuda’s favor?
- What does “good recovery” mean?
- Aren’t your excellent outcomes just a result of your long length of stay?
- Since you rely on self-reports from your former patients, what if they are telling you that they’re doing better than they really are?
- What about relapses and readmissions to inpatient treatment or hospitals? How is your success rate 95%, but your readmission rate is 11% within the first year--the percentages don’t seem to add up.
- Why should we place such importance on scientifically-valid outcome studies in choosing a program for our loved one?
How many patients responded to your questions about their recovery?
Questionnaire methodology indicates that you need to reach at least 75% of a group of people for their answers to accurately represent the whole group. At Remuda, we work hard to reach that important 75% mark required for validity. We use good science to randomly select former patients to contact, so that our sample is unbiased and large enough to draw firm conclusions about our program. To date, we have received responses from more than 75% of the patients in our samples, totaling 3,225 former patients. These numbers make our outcome studies scientifically-valid and reliable measures of our patients’ experiences with recovery.
What about the patients who did not respond to your survey—how are they doing?
The science of questionnaire methodology indicates that you need to reach at least 75% of a group of people for their answers to accurately represent the whole group. As such, since 75% of our former patients have responded to our surveys, it is likely that the information they provided reflects the experiences of all Remuda patients. From this, we conclude that patients who did not respond are doing just as well as those who did. In addition, we have compared the 75% of patients who responded to the 25% who did not respond using a large amount of information found in our medical records: patient diagnoses, demographics, social characteristics, severity-of-illness, and psychological testing data. We have found no differences between those who responded and those who did not respond to our surveys, further suggesting that those who chose not to respond are in good recovery like the majority of those who did respond.
Since you do your outcome research in-house, isn’t it biased in Remuda’s favor?
Remuda’s outcome studies are conducted by a licensed psychologist who is bound by the ethical codes of the American Psychological Association to conduct research that is scientifically-valid and transparent. The entire outcomes research program—questionnaires used, validity of data entry and analyses—has been reviewed by an independent auditing firm that specializes in research audits. This firm, EMT Associates of Folsom, California, concluded its audit with these words:
“EMT Associates has conducted a comprehensive and detailed audit of the Remuda Ranch performance monitoring system and treatment outcome study reports. The audit included review, assessment and empirical verification of instrumentation and measures; sampling and retention; data collection and management; data integrity; and statistical analysis and reporting methods employed in the treatment outcome studies. EMT verifies that the performance monitoring system is comprehensive and accurate, and that the treatment outcome studies are accurate, objective, unbiased, and methodologically sound.”
Finally, Remuda’s outcomes have been published in a peer-reviewed scientific journal, Eating Disorders: The Journal of Treatment and Prevention (Vol. 15, pp. 111-124). The peer-review process rigorously examines research to establish its scientific accuracy and validity and only permits publication of research that meets strict standards. Remuda’s outcome studies have passed this test.
What does “good recovery” mean?
Good recovery has been defined in many ways across published eating disorder outcome studies. In Remuda’s outcome studies, good recovery means that the individual no longer has a diagnosable eating disorder. Since people with anorexia often move into bulimia, and vice versa, it is important to be sure that Remuda’s former patients have neither of these disorders. We do just that. Good recovery does not necessarily mean that every single patient is completely symptom-free. Some are symptom-free. Some have one or two symptoms, but not enough to have an eating disorder any longer. Simply put, good recovery means that a person who once had an eating disorder that was dominating their life has had their life restored: they can work, go to school, date, raise their kids, have fun, and so on, without the eating disorder interfering like it once did. They may not be totally symptom-free, but the symptoms are no longer the center of their life.
Aren’t your excellent outcomes just a result of your long length of stay?
Other eating disorder treatment centers with equally long, and longer, lengths of stay have published outcomes considerably lower than Remuda’s. So, our length of stay is not the only factor in our excellent outcomes. Our outcomes are excellent because our treatment program is state-of-the-art: if there is scientific evidence that a treatment technique works with eating disorders, we typically include it in our comprehensive program. In addition, we assist our patients to heal in all domains of personhood—body, self, others, and spirit—using a complete bio-psycho-social-spiritual model of treatment addressed by healthcare specialists in each area. It takes 45-60 days to deliver the full range of treatment that each person deserves, so our lengths of stay are important. But it’s what we do with the time that matters, not the time itself.
Since you rely on self-reports from your former patients, what if they are telling you that they’re doing better than they really are?
Research with eating disorder patients indicates that they rarely offer inaccurate information on questionnaires and surveys. In addition, our patients’ parents also complete questionnaires about their daughters’ symptoms, and the parents are saying the same excellent things about their daughters’ recovery. This cross-validates our outcomes and indicates that they can be taken with confidence. Ultimately, self-reports and parental reports are the primary ways that all outcome studies obtain their data; Remuda’s studies therefore use the same methods to gather information that are used throughout the industry.
What about relapses and readmissions to inpatient treatment or hospitals? How is your success rate 95%, but your readmission rate is 11% within the first year--the percentages don’t seem to add up.
Remuda’s one-year post-discharge success rate is 95%. During that one-year time frame, some patients deal with relapses and symptoms, usually within the first few months following treatment. This is a normal part of the recovery process from eating disorders. 11% of Remuda’s patients require a second dose of inpatient treatment to fully reach recovery. By one-year, these anticipated bumps in the road have stabilized and 95% of our patients have achieved a sustainable level of good recovery for years to come.
Why should we place such importance on scientifically-valid outcome studies in choosing a program for our loved one?
Because eating disorders are serious, complicated, life-threatening illnesses, it is essential to choose treatment that has the best chance of offering recovery to those we love. Treatment programs demonstrate their commitment to using the most effective treatment methods known today when their treatment providers are licensed in their respective professions, the treatment center is accredited by the Joint Commission on the Accreditation of Healthcare Organizations or a similar quality-assurance accrediting body, and when outcome studies factually prove the success of the treatments provided. Remuda does all three. Would someone with a life-threatening illness rely on a medicine that hasn’t been proven to work, if a proven medicine exists? Of course not. Scientifically-valid outcome studies are the way that modern healthcare options are tried, tested, and proven. With outcome studies, we know that we are relying on facts rather than just opinions or unsubstantiated assertions.
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