Sustaining outcomes research in residential treatment: A 15-year study of the Gould Farm program

We present findings from a study of outcomes of residential treatment for people who have mental illness, primarily schizophrenia-spectrum and bipolar disorders. The study assesses a range of individual variables before and after participation in the program, to examine clinical and personal recovery and facilitate program improvement. To our knowledge, it is the longest ongoing outcomes study (15+ years) of its kind. The program, Gould Farm, provides recovery-focused, milieu treatment on a 700-acre working farm. It integrates counseling and medication with a work program that provides opportunities for the development of daily living, social, and work skills as well as mental and physical health. Clients were interviewed in person at intake and at discharge. Also, since study year 10 when the follow-up arm began, former clients were interviewed at 6, 18, and 36 months postdischarge via phone. Interview protocols included standard measures of psychiatric symptoms and functioning, substance use, quality of life, and treatment satisfaction. Follow-up interview protocols also assessed individuals' living, working, family, and social situations as well as their satisfaction in these areas of recovery. Statistically significant improvements on all measures were found at discharge, and were not moderated by key demographic or clinical factors. Preliminary follow-up data showed maintenance of treatment gains, and high treatment satisfaction. We discuss clinical implications of the findings as well as limitations, directions for future research, and recommendations for sustaining outcomes research in organized care settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).