This is an email I had sent to multiple people at the ranch and have not received any response in over two weeks.

I would like to take this chance to explain the reasons why I left the Ranch on Saturday evening. Before I explain my reasoning, I would like to say that I did learn a lot from the Ranch in the groups and from the people and connections that I made. I was able to take with me a lot of information and tools. Thank you for that. But, you know as well as I do that I do deserve a certificate of completion from the Ranch for the time that I was there from the effort that I put in the entire time I was there. The Ranch is supposed to help people with mental health and addiction issues, and I feel as though you failed me when I needed the help the most, all day on Saturday until I left. I refuse to be blatantly lied to, told things to then be told something else, and to be ignored and pushed aside…especially from the people that are supposed to be helping us improve within the time we are there and not demeaned, ignored, lied to, etc. I had all intentions in staying at the Ranch, going to an IOP that the Ranch recommended and even joining the Alumni in hopes that maybe one day I could help someone. I have honestly learned a lot from the groups and was hoping to get this week since forgiveness is the topic of Week 2. But, the lack of support that I received on Saturday, when I needed it most, ruined that for me. Maybe that would have been the best time for some support since I could have possibly learned something about forgiveness and put this behind us. Communication to clients and the clients families really needs to improve. Below is most of the reasons I left, and also from my wife with the different miscommunications, lies and not being able to contact any one at the Ranch, in no particular order.

1. On Saturday, February 8th, I spoke with [my therapist] in the morning and asked that since my insurance only had me approved through the 8th, if I would be able to leave after that if they did not get any further approval that day. [Therapist] told me I was not able to leave until they heard from the insurance and there was paperwork and things to do. We were also supposed to have a meeting on Thursday, but he did not make it in due to the weather. On Friday morning he said we would meet that afternoon, but then rescheduled until Saturday. When I spoke with [Therapist] that morning, he told me that since he had not heard from the insurance company, that we had no need to meet…never asked if I had anything I needed to talk about.

2. From the first time I had met [Therapist] in an individual session with him, I had asked if my family would be able to bring my vehicle and drop off to me prior to my completion date so I did not need to inconvenience any one by making them have to take off of work or anything else. Every meeting I asked again and was told that it was no problem at all, people do it all the time and they could bring it at any time. I asked [Therapist] again on Saturday around 8am and was then told that he didn’t know if they could, what would need to be done but he would find out. At 11am I had talked to [the Director of Residential Services] and was told that they can and there were no issues with family doing that, but she had not talked to [Therapist] at all and let me use a phone to call my wife and ask her if she could bring my truck to drop off. [Therapist] never did follow up with me about that.

3. While I was on the phone with my wife, she told me that the insurance was approved. I asked her to call [Therapist] and ask him about it, and he told her he had not heard anything but “I was good” and I’d probably be able to go home early or middle of next week. But no discussion about how any extra days if the insurance did not approve more time would be paid.

4. After I had talked to my wife, I went to [Director of Residential Services] and told her that I was upset because I felt I was being led on since the insurance had been approved but no one seemed to know. She went to [Therapist] and was told that he would get with me after his afternoon groups and talk and make sure that we were all on the same page together. [Therapist] never did come to discuss anything with me, and I asked one of the BHT’s on the walk to dinner if he was still here. She went to check and [Therapist] had left for the day and [Director of Residential Services] never tried to follow up with him before he left.

5. We are supposed to have one (1) hour per week with our assigned therapist, that could be broken into two (2) half hour sessions. [Therapist] would meet with me on Tuesday afternoons, and only once did it go to a half hour which was this past week. My second session was schedule each week for Thursdays at 2pm, all of which he cancelled. I had one (1) family session and was supposed to meet with [Therapist] about 15 minutes prior that meeting to discuss anything regarding the family session. I waited for him until 5 minutes prior, and did not get to discuss anything I want to talk about. My wife, [Therapist] and I walked to the Barn, where he talked to her/us for about 15 minutes, told us we could talk for as long as we wanted and asked me to come by to talk to him after we were done and he went back to the main building. Within 45 minutes, we had a BHT come down and tell us we had to finish our meeting. I went to [Therapist]’s office afterwards and let him know there were things I needed to discuss, and was told that we will talk tomorrow (Saturday). On Saturday morning, I saw him in the main and confirmed that we were going to meet to discuss the family meeting that day, but was told he didn’t have time and we would talk on Tuesday.

6. Routine is preached to us throughout the curriculum and in groups. On Thursday, February 6th, a cabin with four (4) people who had been together in that cabin for multiple weeks, was told without any warning that they had to pack their things and move into the cabin I have been in with five (5) people, four (4) of us had been there together for multiple weeks. The routines of nine (9) people had been ruined because now all of us had to rearrange different things and also learn to live with four (4) new people in our home. New clients moving to a cabin is one thing but uprooting an entire cabin after multiple weeks and moving them into another, due to short staffing, is totally different.

7. **TW: SUD/police** I sat in a group on Monday, February 3, where one of the younger clients opened up about some of his addiction problems and even admitted to having sold some as well. One of the group members was coming back from a meeting and knocked on the door, to which the therapist make the comment, “the police are here to get drug dealer *******”. That comment triggered him, he left the group that day and it sent him on a multiple day downward spiral, which I know myself (since we had become close friends) and BHTs had all tried to help him through it. **end TW**

8. On Tuesday, February 4, I had a meeting with [the Psychiatrist] to discuss my medications and how things were doing. My blood pressure had been elevated since I had been at the Ranch, which I asked her if any of my medications I take could be the cause or if it was still because I have been recovering from a concussion and have not been drinking the amount of water I usually do. I was told “Well, snorting [drug] up your nose will make your blood pressure high”. That is extremely unprofessional and should not be said in a recovery center by a psychiatrist. Especially, since I had been there for almost three (3) weeks and had not touched any kind of substance in months.

9. No one ever offered to sit down and talk with me on Saturday to find out if there was anything they could do to try to change my mind or ease my concern. I was left to use the coping skills I learned there to myself. No one tried to call my wife. The only time my wife heard from anyone at the ranch is after multiple phone calls that day with no answer, my wife had called six (6) times to get support and no one had answered the phone, she was finally able to get in touch with [Director of Residential Services], which was around 7:30 pm, after I was able to call her at 7:15pm (1 hour and 15 minutes after I had first asked to call her). [Director of Residential Services] told her that I would be considered AMA if I left but she can’t do anything to keep me here, but she was going to try to call [Therapist], to which my wife asked, “[Therapist], the therapist that was supposed to talk to him but left?”. [Director of Residential Services] told her she would let me call her back, then pulled me out of reflections and said, “So I guess you want to use the phone?”, took me down stairs, handed me the cordless phone and walked away, and said nothing else to me or came to me at all the rest of the evening. No one told me that I would be considered to be AMA until they were getting my luggage out of cabin 4, the now empty cabin except for the BHTs, when *** (BHT) sat down with me for a couple minutes to talk at 7:45pm. I was told that I’d be AMA because I was acting on emotion. There had been eight (8) hours that had passed from my initial conversation with [Director of Residential Services] that something could have been done to rectify the situation and nothing was. Also, when [Director of Residential Services] had finally given me the phone at 7:15, she said she had to call a supervisor. She is the Director of Residential Services, as such, should not have to call a supervisor regarding a resident’s concerns. I had practiced my skills, but no one helped. When my wife arrived at the Ranch, she called three (3) more times with no answer until finally one of the nurses answered and told where to go when she comes past the gate.

10. BHTs are supposed to be in our cabins at all times. But, because of the short staffing, if we needed a BHT to open a closet to get our toiletries or get detergent to wash our clothes and open the closet with the wash machine, even to use a lighter to smoke, we usually have to go out of our cabins to find one. **TW: SI, mention of su*c*de** The day that I arrived, due to lack of staffing, another client was left unsupervised and [attempted su*c*de] and was found [in a very upsetting manner]. **END TW**

11. From the day that I arrived at the Ranch, I never missed any group, class or anything except for the two (2) afternoon groups on Wednesday, February 5. I only decided to sit in the main because I needed a break and wanted to write down things that were on my mind to get them out. The therapist leading the first one hour group, left his group to come question me why I wasn’t there, and told me to “don’t make a habit of it”. ***** (BHT) had checked on me to make sure I was ok, and understood that I needed a break and that I had not missed anything prior.

If this letter did nothing to help me, hopefully I am able to help the clients there and any new clients from a situation like this happening to them.

**admin note: names have been redacted per site policy

Ok full disclosure I was at the Ranch about a year ago and I’ve heard they changed ownership since I left and a lot of things are different but I’ll still talk about my experience.
When were you there: January 2018- March 2018

How many patients on average?
This is kind of a complicated question…everything they treat has a different house- each disorder is treated in their own separate house where the clients (thats what we are called at the Ranch) are housed. So there were 5 women’s houses for different things- the ED house was medium sized and we had anywhere from 5-13 clients in the house while I was there. The entire women’s program probably had between 50-60 patients at a time but there is also a lot of staff and you get to know people from every house really well as you do groups together so it never felt that big.

Does it treat both males and females? If so, is treatment separate or combined.
Yes, the Ranch treats both males and females (there is no ED treatment for men) but they are on completely separate campuses. You are really not allowed to interact with the men and get punished if you do. The only time you see the men is once a week for the all-campus meeting and sometimes in passing from different appointments.

How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc?
This was probably the most frustrating part of the Ranch for me. You see your therapist for individual sessions only once a week- but their offices are in the houses so if you have an issue you can generally get a few minutes with them. You see the dietitian once a week but she only works with the ED clients and hangs out in the house most of the time (other clients in other houses that need a dietitian have someone else) so it’s easy to see her if you need extra support too. The worst part was the psychiatry support- theres something called “med group” once a week and basically the psychiatrist checks in with you for about 5 minutes. And it’s impossible to see her outside of this group. She was pretty much incompetent and I left the ranch on a lot of meds that I really didn’t need. If you need a medical doctor they have nurse practitioners on site as need be, but if you need a specialist they can arrange appointments for you off-campus.

What is the staff ratio to patients?
In my opinion, the staff to patient ratio was excellent. There is 1 dedicated ED dietitian, 2 primary therapists for the ED house. And there were always about 2-4 resident assistants on staff at all times.

What sort of therapies are used? (DBT, CBT, EMDR) etc?
The Ranch has SO many therapies that they offer and it’s amazing. CBT, DBT, EMDR are all easily available (there is DBT group once a week but you can see a separate DBT therapist if your primary thinks you need it), they have multiple trauma therapists that administer EMDR. My favorite thing about the Ranch was the equine therapy. Equine therapy changed my entire life and was where I had the most breakthroughs. The equine therapist at the Ranch is one of the most amazing humans I have ever met- she cares so deeply about the clients and is so gentle and reassuring. There is group equine once per week, but you can have individual equine once a week as well (I did this and would highly recommend it). Also the adventure therapy is amazing- there are high and low ropes courses. I was really not into adventure therapy at first but the therapist is phenomenal as well. He is in addiction recovery and is proud to share is experiences and insights.

Describe the average day:
I was there almost a year ago so I kind of forget. If you have any specific questions you can contact me!! Lots of people wake up early (around 5:30) to shower, make their bed, smoke etc. but no one cares what time you get up as long as you’re in the kitchen on time. Basically you have to be in the kitchen by 6:15 I think and you eat at 6:45 . At 7:15 you process and at 7:45 you do chores. I’m pretty sure there’s basically free time after chores are done until primary group. Primary group is with your house and your two therapists. It’s two hours and you can talk about whatever- sometimes we did structured activities, sometimes people would just talk about random stuff. After primary there is lunch. After lunch everyone had individual groups or appointments scheduled until dinner. After dinner there was a 12 step meeting and at 9 we had night snack if you needed it. Then you could get your meds and go to bed- lights out was 10:30 but as long as you were quiet and in your room it was ok. Also one day a week was adventure day where you don’t have primary and spend all day in adventure therapy with about 2-3 other houses. You bring a packed lunch and also meet with the psychiatrist during lunch time.

What were meals like?
Each client cooks every meal for themselves. Basically you have about 30 minutes in the kitchen to prepare your meal and you could have whatever you wanted as long as it met your meal plan. Everyone’s meal plan is super different. But everyone sits at the same table with the RAs in the same room but not at the same table. You get 30 minutes for meals and 15 minutes for snacks. After meals everyone sits in the living room and processes the meal. this is also safety time where you have to be in the living room. There is community meal a few times a week where a couple people will cook for the whole house (you never need to participate in the community meal if you don’t want to but it is encouraged). On Fridays there is dessert after lunch which is also always optional but really encouraged. If you never eat dessert your therapist and dietician will probably start encouraging you to try it. there are table rules that are common sense (no food/body talk, no talk about behaviors, exercise, calories, etc- just common sense stuff really).

What sorts of food were available or served?
Basically they can get you anything that you would find at a supermarket. We had something called grocery group once a week where everyone ordered all of the food items they wanted for the next week. Also you could have one frozen meal per week.

Did they supplement? How did that system work?
Yes- if you finished more than 50% of your exchanges but not 100% you had to have 1 ensure. If you finished less than 50% you were given two ensures.

What is the policy of not complying with meals?
Most people supplement multiple times during their stay. The resident assistants are so wonderful and very supportive. There is no real punishment for not complying but if you are really struggling a lot and not making progress or using behaviors they may transfer you to another facility (this happened to one girl during my entire stay and she was transferred to ERC I believe). All of the staff really want you to succeed so the dietician will work with you to adjust your meal plan if you are having trouble with the quantity of exchanges (such as decreasing exchanges at meals and give you more snacks).

Are you able to be a vegetarian?
Yes! There was even a vegan client when I was there. Since you prepare all of your own food, you can really do whatever you want. This is great sometimes but can also be really difficult. Because you really have to want to challenge yourself, no one will make you eat anything you don’t want to.

What privileges are allowed?
It depends on what phase you’re on.

Does it work on a level system?
Yes- they are called phases. When you come in you are on safety and at Phase 1 is the most strict- you basically can’t do anything except sit around and breathe. Safety means that you can’t shower at night, your bathroom is locked, you are under bathroom supervision, and you can’t do any physical activity. In Phase 1 you can’t use the phone or anything. Phase 2 you get to use the phone for 20 minutes twice a week and can go off campus. Phase 3 didn’t need to have their plates checked before meals (but still needed to have their plate checked at the end) and could use the phone for 20 minutes 3 times per week. I think you could have gum on phase 3 but I really don’t remember. The best part of phase 3 was being able to go to the dollar general on the weekends. Phase 4 is the best (most people don’t get to phase 4 because it takes a long time). But you didn’t need to have your plate checked at all during meals. Plus you could use your own cell phone or laptop (while supervised) for 20 minutes 3 times per week. You also got to plan an outing with your therapist.

How do you earn privileges?
there is a list of tasks you need to complete for each phase. Additionally, you need to write a letter to your housemates which you read during the house meeting and then everyone votes if you should phase up or not.

What sort of groups do they have?
Basically every group you could imagine. DBT, body image, substance related groups, trauma groups, equine group, adventure group, the ED house had a special music group when I was there where basically everyone submitted a song during the week and then we would listen to them all.

What was your favorite group?
Definitely equine or music group.

What did you like the most?
All of the staff really want the best for their clients and will go above and beyond to support their recovery process. A lot of the staff have personal experience with ED, self-harm, trauma, and addiction. there is always someone there to talk to and they are happy to do so. there have been times in the middle of the night when I was really struggling and one of the nurses would talk to me until I felt better (even if it was like 2 or 3 in the morning). Also the equine therapy is so amazing. I can’t talk highly enough about the equine program. Also if you like horses you can request rides and barn time. Barn time just means you go to the barn and groom the horses or clean stalls or pretty much whatever you want to do. if you ask for barn time, you pretty much always get it, but rides are in more demand (I had two during my entire 2 months).

What did you like the least?
the admit process sucks. Basically when you get there you have to go to a place called Piney. It’s a mixed gender building that is kind of like a hospital. If you go to the ranch try to get there as early as possible- if they process you quickly enough you might not have to spend the night in piney. If you do, it really isn’t bad it’s just frustrating because you don’t get any therapy while you’re in there. While you’re in Piney they do labs, physical exams, drug screens, etc. Most people only spend a night or 2 unless you’re detoxing. people who were coming off of drugs or alcohol could stay for up to 5 days. they also decide on you’re house placement while you’re there (there are two substance abuse houses, a sex and love addiction house, the ED house, and the trauma/mental health house). there are pretty much no groups and it’s a nightmare for ED patients- the bathrooms are always unlocked and there is no staff in the dining room so it’s up to you about how much and what you eat). also the psychiatrist was literally incompetent and I left the ranch on so many meds that were more harmful than hurtful.

Would you recommend this program?
yes and no. I do have to say that if you go to the Ranch you have to really want recovery. This place is great for those with co-occuring disorders (especially with trauma) but those with severe eating disorders didn’t seem to get much better. If eating disorders are your main diagnosis and it is really problematic- I’d recommend finding a different facility.

What level of activity or exercise was allowed?
It really depends on your physical health. You aren’t really allowed to do anything when you first get there but most people are doing physical activity by the end. You can take a walk for 30 minutes a day and there is gym time twice a week for an hour I think (I really don’t remember). But there are different levels of gym allowance and it’s kind of complicated. the one thing that sucked a lot was that even if you weren’t cleared for gym you still had to go and just sit there while other people worked out.

What did people do on weekends?
There were still groups on weekends but they were really slow and pretty boring. There were no therapists on campus during the weekends so all the groups were led by the resident assistants. A lot of the resident assistants are also counselors so the groups are good. Sometimes we got to go to an outside AA meeting which was always a highlight. Also you are only allowed to watch movies on the weekends so we spent a lot of time just hanging out watching movies. On Sunday a lot of people go to church (I am not christian but loved going to church!!).

Do you get to know your weight?
No- weights are done blind on Monday, Wednesday, and Friday right before lunch. Your therapist may tell you if you are in your weight range or how your weight is compared to when you admitted if they feel like it is beneficial to your recovery but they will never give you a number.

How fast is the weight gain process?
I’m not sure as I didn’t need to gain weight.

What was the average length of stay?
There was no average length really. Some women stayed only 3 weeks while some stayed 3-4 months (it really depends on how long you need to stay and how much your insurance will cover). I was there for 2 months and at the time of my discharge only one client had been there longer than me. Most people were at the Ranch for 4-5 weeks.

What was the average age range?
I was 18 when I was at the Ranch and most people were older than me. They only treat clients over 18. There were clients as young as 18 and as old as 65 when I was there. I would say the average age was 22-35 but as one of the youngest clients I never felt out of place.

How do visits/phone calls work?
There are no visitors allowed at the ranch. The only way people can visit is if you are having family therapy (most people didn’t but a few did) or if you do the family program. DO NOT DO THE FAMILY PROGRAM!!! It actually did more harm than good for me and my family. The person in charge of the family program is horrible and had no idea how to deal with eating disorder patients. Your ability to use the phone depends on your phase. Basically if you have the privilege you can use the phone whenever there is free time.

Are you able to go out on passes?
Yes and no. Those on phase 2 and above could go to church on Sunday and go to an outside AA meeting (we hardly ever went to the AA meeting but it was amazing!). Those on phase 3 and above also got to go to the dollar general on the weekend. If you had family therapy or were in the family program, you were able to go on a pass with your family afterwards. Clients on phase 4 got to plan an outing with their therapist and could do pretty much whatever they wanted (when I was a phase 4 my therapist and I went to lunch, did shopping, and then visited the animal shelter).

What kind of aftercare do they provide? Do they help you set up an OP treatment team?
They really suggest you go to sober living place after treatment but this wasn’t an option for me. So my therapist and I made all the appointments I needed at home together in the week leading up to my discharge. She even looked into meetings for me in my area. There is something called an aftercare plan that you put together with your therapist.

Are there any resources for people who come from out of state/country?
Most people are from out of the state and a couple were from out of country. There weren’t any particular resources that I can think of but they are definitely used to it.

Other?
You really have to be your own advocate at the Ranch- if you want or need something, don’t be afraid to ask/demand it. Also the ED house is way stricter than the others so a lot of people had issues with that but it’s totally understandable.

Any recent reviews of The Ranch?