At Sandstone Care, we back our mental health promises with real data. Our clinicians use Measurement-Based Care (MBC)—the gold standard in behavioral health—to objectively track patient progress and ensure our treatment produces results you can trust.
Download 2025 Outcomes Report
We guard the integrity of our data with the same fierce ethical responsibility we use to guard the safety of our patients.
Sandstone Care tracks patient-report symptoms and treatment engagement using four psychometrically validated scales, administered weekly or every other week. Scores are automatically charted in real time within each patient’s medical record. This allows staff to monitor progress, adjust care as needed, and review findings alongside patients to strengthen their trust and collaboration with their treatment team.
Depression and anxiety are the most common co-occurring conditions among people seeking treatment for substance use and mental health disorders. Routinely tracking these symptoms gives clinicians useful insights into treatment progress and helps guide treatment decisions.
The Patient Health Questionnaire-9 measures depressive symptom severity across five levels.
The Generalized Anxiety Disorder-7 scale measures anxiety severity across four levels.
Therapeutic alliance, or therapeutic rapport, is the relationship patients develop with their treatment team, encompassing trust, connection, and unconditional positive regard to reinforce healing and recovery. Therapeutic alliance is strongly associated with treatment engagement and success, making it a critical component in routine treatment tracking.
At all levels of care, the impact of therapeutic relationships on treatment success is crucial. That’s why patients at every level of care complete the Working Alliance Scale, Revised (WAI—SR; Munder et al., 2010) on a weekly basis to monitor the developing strength of their therapeutic relationships with the clinical psychotherapy team.
Patients feel:
Patients work towards:
Patients are clear on:
During Medical Detox and Residential Care
Detox and Residential inpatient treatment include the 24-7, hands-on, therapeutic support of nursing and behavioral health professionals (BHT) who play significant roles in our patients’ healing. Patients complete the Scale to Assess Therapeutic Relationships (STAR—P; McGuire et al., 2007) on a weekly basis so that nurses and BHTs can gauge the progress of each patients’ therapeutic alliance.
Patients feel:
Patients work towards:
Patients are clear on:
While our outcomes provided us with several meaningful insights into how effective Sandstone’s treatment programs can be for our patients, there were four key findings that stood out across our research.
Depression and anxiety were reported to significantly decrease across all age groups and levels of care.
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Across all levels of care, patients typically reported improvement after one episode of care (EOC). Those who continued their treatment journey reported even greater clinical gains.
Learn MorePatients who reported greater baseline psychiatric severity typically continued their treatment at Sandstone, reporting even greater reductions in depression and anxiety by discharge.
From the onset of care, therapeutic alliance was strongly established. When patients feel safe, validated, and supported, they are more likely to be engaged with their treatment. Those with stronger bonds also were more likely to report greater reduction in depression and anxiety.
Learn MoreIn 2025, Sandstone Care treated 3,487 patients across the United States. Half of our patients were emerging adults (between ages 18 and 30) with an average age of 25.4 years. Half identified as cisgender male, 43% as cisgender female, and 6% as nonbinary.
Across programs, the most common mental health diagnoses treated were depression and anxiety. Substance use treatment leaned heavily towards alcohol, cannabis, and at the Detox level of care, opioids.
Learn MoreOur teen findings show meaningful progress across levels of care, including significant reductions in depression and anxiety and strong connections with treatment teams. Nearly four in ten adolescents continued into a second level of care program, allowing care to evolve with their needs.
Our Teen Residential Program provides 24/7 support in a structured setting for adolescents with mental health and substance use concerns. Teens receive intensive clinical care to stabilize, build coping skills, and prepare for a safe transition home or to a lower level of care.
Teens in residential treatment reported significant reductions in depression and anxiety, moving from moderate distress at admission to mild distress at discharge. These changes met the threshold for meaningful, noticeable clinical improvement.
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Teens who began residential care with moderate-to-severe depression and anxiety showed marked symptom reductions by discharge.
Learn MoreOur Teen Partial Hospitalization Program provides high-intensity day treatment. Teens receive individual and group therapy five days a week while continuing to live at home.
Teens who completed PHP reported significant reductions in depression and anxiety, moving from moderate to mild distress. These improvements showed medium-to-large effects and met the standard for statistically meaningful, noticeable clinical change.
Learn MoreOur Teen Intensive Outpatient Program provides structured treatment four days a week while allowing teens to live at home and continue attending school. Separate mental health and dual diagnosis tracks address either primary mental health concerns or co-occurring substance use and mental health challenges.
At intake, teens reported depression and anxiety below the moderate range, which may reflect underreporting of distress. Even with these low starting scores, both symptoms decreased significantly to the none-to-minimal range by discharge.
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As with Dual Diagnosis IOP teens, Mental Health IOP teens may have underreported some distress at intake, with symptoms near the moderate range. By the end of treatment, depression and anxiety decreased significantly into the mild range, reflecting noticeable improvement.
Learn MoreOur young adult findings show statistically significant and clinically meaningful reductions in depression and anxiety across levels of care, alongside strong connections with treatment teams. Over half continued into another program, allowing care to evolve as their needs changed.
Our Young Adult Medical Detox Program provides 24/7 medical support through withdrawal, along with daily therapy and clinical groups. Detox helps young adults stabilize safely before beginning the next phase of treatment.
Young adults who continued from detox into residential care entered with greater distress and achieved significant, clinically reliable reductions in both depression and anxiety by discharge.
Learn MoreOur Young Adult Residential Programs provide 24/7 support for mental health, substance use, and co-occurring concerns. Young adults receive intensive care in a structured setting where they can stabilize, build lasting coping skills, and prepare for greater independence.
Young adults who entered residential care with moderate-to-severe symptoms showed clear reductions in depression and anxiety by discharge.
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Young adults in residential treatment reported significant reductions in depression and anxiety, moving from moderate to mild distress. These improvements had large statistical effects and met the standard for reliable, clinically meaningful change.
Learn MoreOur Young Adult Partial Hospitalization Program provides high-intensity day treatment five days a week for mental health, substance use, and co-occurring concerns. Young adults receive individual and group therapy while continuing to live at home and practice new skills in daily life.
Young adults who completed PHP reported significant reductions in depression and anxiety, moving from moderate to mild distress. These improvements met the threshold for reliable, clinically-meaningful change.
Learn MoreOur Young Adult Intensive Outpatient Program provides structured treatment four days a week while allowing young adults to live at home and maintain school or work responsibilities. Separate mental health and dual diagnosis tracks address either primary mental health concerns or co-occurring substance use and mental health challenges.
Young adults in Dual Diagnosis IOP may have underreported depression and anxiety at intake, with scores near clinical cutoffs. Even with these lower starting scores, both symptoms decreased significantly, with clinically-meaningful improvements by the end of treatment.
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Young adults in Mental Health IOP reported significant reductions in depression and anxiety, moving from moderate to mild distress. These improvements had large statistical effects and met the threshold for reliable, clinically-meaningful change.
Learn MoreAdult findings highlight clinically-meaningful reductions in depression and anxiety across detox and residential care, with stronger gains for patients who continued treatment.
Our Adult Medical Detox Program provides 24/7 medical support to help patients move safely through withdrawal. Patients also meet with a therapist daily, and once medically stable, participate in clinical groups to prepare for the next phase of treatment.
Adults who continued from detox into residential treatment reported significantly lower depression and anxiety by discharge than those who completed detox alone. Their improvements met the standard for reliable, clinically-meaningful change.
Learn MoreOur Adult Residential Program provides 24/7 clinical care in a structured setting removed from daily stressors and triggers. Adults receive support to stabilize, break away from long-standing patterns, and build skills for returning to their work, relationships, and responsibilities.
Adults who completed residential treatment reported significant reductions in depression and anxiety, moving from moderate to mild distress. These improvements showed large effects and met the strict standards for reliable, clinically-meaningful change.
Learn MoreTherapeutic alliance describes the trust, safety, and shared sense of purpose patients develop with their treatment teams. Across Sandstone Care, patients with strong therapeutic relationships achieved clinically meaningful improvement at a rate of 56%, compared with 38% among patients reporting weaker relationships. For every six patients who developed a strong alliance, one additional patient achieved meaningful improvement.
Adolescents developed strong therapeutic relationships across levels of care, as seen here in the findings for PHP and the clinical team. Overall, 91% reported strong rapport with their clinical team. This connection started out strong and continued throughout care.
Young adults developed strong therapeutic relationships across levels of care, as seen here in the findings for residential treatment and the nursing team. Overall, 93% reported strong rapport with their clinical team and 94% reported strong bonds with nursing and behavioral health staff. This connection began early and continued throughout care.
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Adults formed strong connections with their treatment teams in both detox and residential care. As seen here in the detox example, 95% reported strong bonds with nursing and behavioral health staff. Our findings also showed that 95% of clients reported strong rapport with their clinical team, even within this shorter, intensive level of care.
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