Clinical Outcomes Methodology

This page explains how Siam Rehab collects, analyzes, and interprets outcome data from our residential addiction treatment programme and twelve-week aftercare service. It is intended for clients, families, referrers, and healthcare professionals who want to understand the evidence behind our reported clinical results.

1. Scope of the Outcomes Dataset

Our outcomes system covers all adult clients admitted to the residential programme during the reporting period (2022–2025) who completed baseline and discharge assessments using our standard battery of validated instruments. Follow-up data at 30 and 90 days after discharge are collected from clients who consent to be contacted once they return home.

The dataset includes clients with primary alcohol use disorder, other substance use disorders (for example stimulants, opioids, or prescription medications), and co-occurring mental-health conditions such as depression, anxiety, trauma-related symptoms, and burnout.

2. Assessment Points and Timing

We measure clinical change across three main time points:

• Admission (baseline) – within the first 72 hours after arrival, once the client is medically stable enough to complete questionnaires.
• Discharge (end of programme) – in the final week of the residential stay, before departure.
• Follow-up – remote assessments carried out approximately 30 days and 90 days after discharge.

During treatment we may also use brief monitoring tools as clinically appropriate, but the core outcome analyses focus on change between admission and discharge, and on maintenance of gains at 30- and 90-day follow-up.

3. Validated Instruments Used

We use a battery of validated self-report measures that are widely accepted in mental health and addiction treatment:

• PHQ-9 – Patient Health Questionnaire-9, a nine-item measure of depressive symptoms over the previous two weeks.
• GAD-7 – Generalized Anxiety Disorder-7, a seven-item measure of anxiety symptoms over the previous two weeks.
• Cravings scale (0–10) – a brief Likert-type measure of the intensity of cravings for alcohol or other drugs.
• Sleep Quality Index (0–10) – a short scale assessing sleep continuity, restfulness, and perceived quality of sleep.
• Wellbeing Index (0–10) – a brief measure of overall psychological wellbeing and quality of life.

Where possible, we rely on instruments that have been psychometrically validated in international research and, where available, in Southeast Asian or similar populations.

4. Numerical Summary of In-Programme Change

Table 01 summarises average scores at admission and discharge for key outcome measures among clients with complete data (N = 212). Symptom scales such as PHQ-9, GAD-7, and cravings move downward (lower scores are better), while positive indices such as sleep quality and wellbeing move upward (higher scores are better).

On average, depression (PHQ-9) and anxiety (GAD-7) scores decrease by around 40–50% during the residential programme, cravings scores fall by just over half, and both sleep quality and overall wellbeing show substantial improvements.

5. Subgroup Analyses by Clinical Profile

To better understand which client groups benefit most from the programme, we also examine outcomes by clinical profile, focusing on three broad subgroups:

• Clients with a primary alcohol use disorder;
• Clients with other primary substances (such as stimulants or opioids);
• Clients with a dual diagnosis picture, combining substance use and significant mental-health symptoms.

Table 02 illustrates how average PHQ-9 scores change from admission to discharge within each of these groups.

In all three subgroups we see meaningful reductions in depressive symptoms. Clients with dual diagnosis start with somewhat higher baseline levels of depression and remain more symptomatic at discharge, which is consistent with international findings in this population.

6. Follow-Up Assessments at 30 and 90 Days

Follow-up assessments are conducted remotely via phone, secure messaging, or video call, depending on client preference and contact availability. We aim to contact all clients who completed the programme, but not everyone can be reached or chooses to respond. For this reason, we report both response rates and outcomes among respondents.

Table 03 shows overall response rates and the proportion of respondents who report sustained improvement at 30 and 90 days after discharge.

These figures suggest that the majority of clients who respond at follow-up feel that their mental health, substance use, and daily functioning remain clearly improved relative to their pre-admission status, even when occasional brief lapses occur.

7. Symptom Scores Over Time

To illustrate how symptom levels change over time, Table 04 presents average PHQ-9 and GAD-7 scores at four key points: admission, discharge, 30-day follow-up, and 90-day follow-up.

Most of the improvement occurs during the residential stay, with average scores remaining broadly stable at 30 and 90 days. This pattern is consistent with a “step change” during intensive treatment, followed by consolidation and gradual adjustment during early recovery.

8. Patterns of Substance Use After Discharge

Abstinence is an important goal for many clients, but outcome reporting must also reflect the reality that recovery is often non-linear. To capture this nuance, we categorise self-reported patterns of use at follow-up into four broad groups:

• No use since discharge – complete abstinence from the primary substance(s);
• Single lapse – one or two isolated episodes of use, followed by a return to recovery routines;
• Short relapse – a brief period (for example less than one week) of resumed use before regaining stability;
• Return to pre-treatment pattern – a sustained return to the frequency or intensity of use reported at admission.

Table 05 shows the distribution of these patterns at 30 and 90 days among clients who completed follow-up assessments.

Among respondents, a substantial proportion report no use or only a brief lapse. A smaller group experience short relapses or a more sustained return to pre-treatment patterns. These results align with international data from comparable residential programmes and highlight both the benefits and the challenges of early recovery.

9. Programme Completion and Early Discharge

Completion rates are another important component of outcomes. Table 06 summarises how many clients completed the full residential programme and how many left early, either by personal choice or on clinical grounds.

High completion rates support the interpretation that observed improvements reflect the impact of the structured programme rather than short stays or unplanned discharges. At the same time, we recognise that some clients may need alternative pathways, including hospital care, outpatient treatment, or a later return to residential rehab.

10. Satisfaction, Likelihood to Recommend, and Therapeutic Alliance

In addition to symptom and substance-use measures, we routinely track client experience. At discharge, clients are invited to rate their overall satisfaction with the programme, their likelihood of recommending Siam Rehab to others in need, and the quality of their working relationship (therapeutic alliance) with the clinical team.

Table 07 presents average scores on these measures among clients who completed the programme and the discharge questionnaire.

High average ratings for satisfaction, likelihood to recommend, and therapeutic alliance are consistent with internal qualitative feedback and help contextualise the quantitative clinical outcomes described above.

11. Inclusion Criteria, Missing Data, and Potential Bias

To ensure that our outcomes analyses are meaningful and comparable over time, we apply simple inclusion criteria:

• Adults (18+ years) admitted to the residential programme;
• Baseline assessment completed within 72 hours of admission;
• Discharge assessment completed within seven days before leaving the programme;
• Consent given for anonymised use of data for quality improvement and reporting.

Clients who do not meet these criteria may still be included in descriptive admission-only profiles but are excluded from analyses of change scores. Missing data are an inherent challenge in real-world clinical services. When clients leave early, decline to complete questionnaires, or cannot be reached after discharge, their data are incomplete. To reduce bias, we:

• Report the number of clients included in each analysis;
• Present response rates for 30- and 90-day follow-ups alongside outcome figures;
• Avoid assuming that non-responders have the same outcomes as responders;
• Provide narrative context about common reasons for missing data.

Our results should therefore be interpreted as conservative, real-world estimates of programme impact, rather than as a controlled clinical trial.

12. How Outcomes Data Inform Quality Improvement

Outcomes data are reviewed regularly in our clinical governance meetings. We use these findings to:

• Identify which client groups benefit most from the current programme structure;
• Detect areas where clients improve less than expected (for example, sleep or anxiety);
• Refine group content, individual therapy focus, and aftercare planning;
• Monitor the impact of programme changes over time.

This continuous quality-improvement loop is an essential component of our broader clinical governance framework and supports transparent, data-informed decision-making.

13. How Clients and Families Should Interpret These Results

Our outcomes data can help clients and families understand typical patterns of change during and after treatment at Siam Rehab. However:

• Results are reported for groups, not for individual clients;
• Outcomes vary based on substance, duration of use, co-occurring mental-health conditions, social support, and many other factors;
• No treatment centre can guarantee abstinence or a specific numerical improvement for any particular person.

We encourage families and referrers to consider outcomes data alongside licensing, staffing, safety protocols, and overall fit with the client’s needs when deciding about treatment in Thailand.

14. Questions About Our Methodology

If you are a referrer, researcher, or family member who wishes to discuss our methodology in more detail, please contact our clinical team. Subject to privacy and data-protection requirements, we may be able to provide more detailed aggregated reports or collaborate on quality-improvement projects.