In December of 2011, Warren Helfrich, a program evaluation consultant in private practice, was contracted to complete an evaluation of the services offered by Choose Again at their Healing Centre in Costa Rica (El Cielo). The primary purpose of the evaluation was to measure the impact (outcomes) of Choose Again’s services in the lives of the individuals they have served and to provide useful information for improving the quality and effectiveness of their services.
The evaluation had two phases; a cross sectional survey of a sample of individuals that had attended the Centre prior to the February 2012 and time series (pre/post/follow‐up) evaluation of individuals attending after that point in time. A total of 60 respondents ended up participating in the pre‐post evaluation on‐site in Costa Rica between February 2012 and November 2013. Follow‐up surveys began in May of 2012 and continued until May 2014. A total of 36 individuals (60% of the total sample) ended up participating in the follow‐up surveys.
The following were the main findings from this phase of the program evaluation:
95% of those attending the Centre reported having ‘very good’ quality of life at the time of exit, an 89% improvement over the pre‐test result.
For the three most commonly identified issues of those attending the Centre – anxiety/worry concerns, communication issues, and depression/severe sadness – the decreases in the proportion of individuals rating them as serious, extreme or life threatening were 79%, 78% and 76% respectively.
The changes individuals experienced were highly durable in most instances. The severity ratings they assigned to issues and concerns from the time they exited to the time of followup stayed the same or decreased in 9 of 16 areas. In areas where there was some increase in the proportion of individuals rating the issue as serious, extreme or life threatening, it was general small and averaged less than 5%.
77% of individuals exiting the Centre indicated that they had a strong sense of the purpose and value of healthy relationships, an increase of 148% over pre‐test results.
The total number of individuals indicating that they had a very positive relationship with their spouse/partner more than doubled from pre‐test ratings to follow‐up (a 132% increase).
At the time of exit, fully 89% of individuals felt that they ‘somewhat’ or ‘definitely’ had a sense of their passion in life (an increase of 98%) and 85% had a sense of their purpose as an individual (an 89% increase).
32% more individuals (from 60% to 92%) indicated that they were able to ‘somewhat’ or ‘definitely’ incorporate their passion or purpose into their personal lives (a 53% increase).
Engagement in spiritual practices at follow‐up was above the levels identified at entry in all categories. Regular contemplation and reflection were practiced even more frequently at follow‐up.
Individuals were much more likely to indicate that they were ‘always’ happy in terms of their relationship with themselves from pre to post‐test, going from 6% at pre‐test to 53% at posttest (a several hundred percent increase). Most (37%) had been able to maintain that gain at the time of follow‐up.
Two thirds of individuals were able to maintain active use of all of the steps for resolving interpersonal conflict taught at the Centre at the time of follow‐up.
All but one (59 of 60) of the individuals that attended the Centre agreed or strongly agreed that the services offered to them met their needs. Similarly, all but two (58 of 60) agreed that the facility and accommodations met their needs.
All individuals that exited the Centre during the study period indicated that they would recommend Choose Again to someone close to them, while all but two individuals indicated they would recommend it at follow‐up.
The results of this evaluation provide additional evidence for the effectiveness of the services offered by Choose Again at its Centre at El Cielo, both confirming and extending the results of the crosssectional survey conducted for the first evaluation. Individuals attending the Centre experienced positive benefits in terms of their relationships with significant others in their lives, their sense of passion and purpose in their life, their integration of spiritual practices, their overall quality of life, and freedom from self‐destructive behaviors, including addictions. Although the magnitude of the changes varied from outcome to outcome, it appears that the overwhelming majority of those attending the program experience some positive benefits. One of the key findings from this phase of the evaluation is in regards to the durability of the gains made by individuals during their stay at El Cielo. In general, individuals were able to maintain or improve upon those gains from the time of exit to follow‐up.
The full evaluation is available to download here: