Evidence-Based Outcomes
Ethos Summer 2023 Evaluation Report
ETHOS SOBER LIVING RESIDENCE
Ethos structured sober living is an all-male recovery community in West Los Angeles. Long-term sobriety is fostered by peer encouragement and expectations of accountability, camaraderie, and character development. House members eat and live as a family and meet regularly to support each other in their new ways of living. This cohesive unity helps men work together through the challenges of sobriety.
EVALUATION
In keeping with their accountability standards, Ethos is dedicated to understanding and sharing the impact of their work. Ethos evaluates changes on their house members’ substance use, as well as relationship, mental, and social health. This report summarizes this evaluation for members who attended Ethos between 2016 and 2023.
MEMBER CHARACTERISTICS & TREATMENT PROGRESS
Ethos is a program for males only, who are, on average, 26 years old when they come to the program. By spring 2023, 165 members had come to the house, ten of whom were in program at that time. Not all house members stay engaged with Ethos for the recommended duration. Indeed, two thirds (66%) depart after having completed one-quarter, or less, of the program. These members stayed an average of 43 days. Seven percent stay about half the recommended time, with an average stay of 161 days. Nine percent stay about three quarters of the program, staying an average 270 days, and 18% fully complete the program, staying an average 449 days.
HEALTH OUTCOMES
Outcomes are the mental, relationships, and behavioral changes members experienced, associated with their engagement with the program. Ethos adopts a widely used, validated, reliable instrument to assess the mental, behavioral, and social health of their clients, the Outcome Questionnaire 45.2. This is a 45-question instrument that measures mental health symptoms, relationships, and social behavior. The OQ45.2 is administered every 30 days at Ethos during and after treatment. Members also complete a Patient Health Questionnaire called the PHQ-9, which assesses symptoms of depression.
DEPRESSION SYMPTOMS
One of the outcomes measured at Ethos is depression symptoms, assessed with a tool called the PHQ-9 (Personal Health Questionnaire – 9 Item Survey). Scores of 10 – 14 indicate moderate depressive symptoms; 5-9 mild, and less than 4, minimal. The figure below shows PHQ-9 scores from when members started at Ethos, during the program, and after discharge. The blue represents members who fully completed the Ethos program. The orange line represents those who departed before completion. Members at Ethos enter the program in the high end of the mild, or the low end of the moderate range of symptoms. Symptoms improve over time and are sustained after departure, particularly for those who complete the program.
MENTAL HEALTH SYMPTOMS
The Symptom Distress Scale of the OQ45.2 measures depression and anxiety. Scores of 36 or higher indicates clinically problematic symptoms. House members at Ethos admit to treatment with scores in the clinically problematic range. As time from admission increases, mental health symptoms are healthier. This is particularly the case for those who complete the program. Sustained gains are clearly more well maintained among those who complete the program than those who do not.
INTERPERSONAL RELATIONSHIPS
Scores on the Interpersonal Relations scale of the OQ45.2 of 15 or higher indicate clinically problematic symptoms. House members at Ethos, on average, admit to treatment with scores in the clinically problematic range. For those who complete the program, Relationship health is healthier as they progress through the program and these gains are sustained after departure. For those who do not complete the program, Relationship scores see little change during the program, and fluctuate between healthy and unhealthy after they depart.
SOCIAL BEHAVIOR
The Social Role Scale of the OQ45.2 measures social functioning such as respect for the law and ability to meet responsibilities. Any score of 12 or higher indicates clinically problematic symptoms. Generally, those who complete Ethos present with healthy social functioning and sustain that health during and after the program. Those who do not complete start with slightly unhealthy scores and fluctuate between healthy and unhealthy after they leave Ethos.
OTHER HEALTH INDICATORS
Three, six, and twelve months after departure, Ethos members are asked to report on their health, behavior, and relationships. Thirty-three former members completed a survey at 3-months postprogram, 26 at 6-months, and 15 at one year. A summary from those who responded is below. It must be noted that this sub-sample of members might be biased toward those who are inclined to keep in touch with the program and its staff and members.
Substance Use. After departure, members are asked whether they are abstinent from drugs and alcohol. Most reported abstinence, early after the program and through the first year. Most reported being abstinent whether they completed the program or not.
Family Functioning. After departure, members are asked whether they have experienced improvements in important family relationships. Most members reported ‘improved a little bit’ or ‘improved greatly’, which are shown as ‘Improved’ in the figure here from early after departure from the program through the first year.
Employment. Members are asked to rate whether their employment status has improved, declined, ore stayed the same. Most, particularly those who complete the program, report improved employment status throughout the year after the program. The figure here suggests that sustained employment improvements are more well maintained by completers than those who do not complete the program.
Educational Goals. Members are asked to rate whether their education goals have improved, declined, ore stayed the same. The figure shows the proportion of respondents who indicated they improved a little or greatly over the first year after Ethos.
Satisfaction with Life. Members are asked to rate whether their satisfaction with life has improved, declined, or stayed the same. Shown here are the proportion of respondents who reported improved or greatly improved life satisfaction.
OTHER HEALTH INDICATORS
Three, six, and twelve months after departure, Ethos members are asked to report on their health, behavior, and relationships. Thirty-three former members completed a survey at 3-months postprogram, 26 at 6-months, and 15 at one year. A summary from those who responded is below. It must be noted that this sub-sample of members might be biased toward those who are inclined to keep in touch with the program and its staff and members.
Substance Use. After departure, members are asked whether they are abstinent from drugs and alcohol. Most reported abstinence, early after the program and through the first year. Most reported being abstinent whether they completed the program or not.
Family Functioning. After departure, members are asked whether they have experienced improvements in important family relationships. Most members reported ‘improved a little bit’ or ‘improved greatly’, which are shown as ‘Improved’ in the figure here from early after departure from the program through the first year.
Employment. Members are asked to rate whether their employment status has improved, declined, ore stayed the same. Most, particularly those who complete the program, report improved employment status throughout the year after the program. The figure here suggests that sustained employment improvements are more well maintained by completers than those who do not complete the program.
Educational Goals. Members are asked to rate whether their education goals have improved, declined, ore stayed the same. The figure shows the proportion of respondents who indicated they improved a little or greatly over the first year after Ethos.
Satisfaction with Life. Members are asked to rate whether their satisfaction with life has improved, declined, or stayed the same. Shown here are the proportion of respondents who reported improved or greatly improved life satisfaction.
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