ABOUT THE RANCH
The Ranch sits on 2,000 acres of rolling hills in rural Nunnelly, Tenn., 45 miles west of Nashville. Also a working horse ranch, the facility treats men and women struggling with behavioral and mental health concerns, including substance use disorder, process addictions, mental illness, and co-occurring disorders. The facility provides medical detox, residential treatment, and outpatient care. The length of stay is dependent upon each client’s needs.
The Ranch also operates a facility in Pennsylvania, and both facilities are owned by Promises Behavioral Health, which also operates facilities in Texas, Arizona, and Florida.
TREATMENT & ASSESSMENT
Upon intake, all clients undergo a thorough assessment, the findings of which help inform their personalized treatment plan. Individuals who require medical attention for withdrawal symptoms begin their treatment at Piney Lodge, The Ranch’s detoxification and stabilization unit. While undergoing detox, clients receive counseling, 24-hour supervision, and nursing support. The length of detox depends on the client's needs, but typically, an individual can expect to be in the program for between two and seven days.
Once stabilized, clients may move on to the facility’s residential program. The Ranch takes a holistic approach to addiction and mental health treatment, combining clinical therapies such as eye movement desensitization and reprocessing (EMDR), cognitive behavioral therapy (CBT), and dialectical behavior therapy (DBT), which is use at 55.8 percent of Tennessee-based facilities, with less traditional modalities, such as equine therapy, adventure therapy, and Native American healing traditions.
Counseling is conducted in both group and one-on-one settings, and addiction and mental health education are core components of treatment. Residents are introduced to both 12-step and alternative recovery models, and medication management is provided on an as-needed basis.
Families may intend a two-day family workshop or an intensive four-day family program, both designed to help families establish healthy communication and prepare for long-term recovery and sobriety.
The Ranch also offers treatment for gambling disorder and Internet use disorder, which there's treatment at 9.7 percent and 10.1 percent of Tennessee-based facilities, respectively, as well as addictions to shopping, video games, and sex, love, and pornography. All process addictions are addressed only when they arise with a primary substance use disorder or mental health disorder.
Outpatient care consists of a partial hospitalization program (PHP), offered at 18.4 percent of Tennessee-based facilities, which offers much the same treatment as the residential program, plus an added focus on life skills such as budget management.
Aftercare offerings include the option to schedule further sessions with the Ranch's counseling staff, plus referrals to further treatment and self-help resources in the community, as appropriate. Program graduates also have access to the Ranch’s extensive alumni network.
The clinical and medical teams include a board-certified psychiatrist, nurses, psychiatric nurse practitioners, licensed clinical social workers, licensed marriage and family therapists, and certified alcohol and drug counselors, as well as holistic wellness practitioners and sex therapists. The seven individuals polled by Rehabs.com to date on the center's staff were mostly impressed.
Staff Experience and Training: 4.3/5
ACCOMMODATIONS & AMENITIES
The Ranch has a number of home-like, gender-specific residential facilities, many of which border the Piney River. Facilities range from cottages and contemporary log homes to Cape Cod-style houses with pitched roofs and dormer windows. Each residence offers comfortably furnished communal areas, and some also have front porches. Clients sleep in twin beds and share rooms with up to two other residents. The facility is equipped with horse stables, and there is a small on-site fitness center. The seven individuals polled by Rehabs.com to date on the center's accommodations and amenities gave positive feedback.
Exercise and Leisure: 4.3/5
WHAT ALUMNI SAY
Alumni reviews were mixed; however the few dozen individuals polled by Rehabs.com submitted more positive reviews than negative ones. Multiple alumni praised the staff, whom they described as “friendly and conscientious,” “exceptional,” and “committed.” Alum Kate wrote: “Everyone that works there cares about the clients and treat you like a real person — not just an addict. All the staff are top notch and know what they are doing."
Among those who were satisfied with their experiences, there was a general consensus that The Ranch’s programming was challenging but ultimately effective. “The Ranch programming works, but you have to work it. And you have to want to get well,” B.A. wrote in a representative review. Multiple alumni also felt that the center’s trauma programming was particularly strong. “Working through trauma and digging deep to find the reasons i was using drugs to cope was difficult but it was the most incredible thing i have ever done for myself,” alum Anna wrote.
Despite mostly positive reviews, a number of former clients found The Ranch’s treatment services to be overpriced and ultimately ineffective. Alum Tyler described his stay as “the worst experience” he’d ever had, noting that many of the center’s advertised amenities cost extra. “Most of the activities you have to pay more than the cost of enrollment. You only get 4 credits with your package, and those run out the first week,” he wrote.
On secondary sites, the Ranch has mixed feedback at the time of this writing, with average ratings of 3.2 out of five stars based on 93 reviews on Google, 3.5 out of five stars based on 27 reviews on Yelp, and 4.1 out of five stars based on 71 opinions on Facebook (where the facility may manage its own page).  
Some reviewers reported that the center's knowledgeable and dedicated staff and rigorous program had helped them on the way to lasting sobriety. However, there are also several complaints that echo alumni polled by Rehabs.com, noting that services promised on the center's website were not offered. "This place is a joke. Don’t use the website as a tool to make your decision because half of the stuff you read, they don’t even do there anymore," A.S. wrote in a typical comment.
WHAT FRIENDS & FAMILY SAY
Loved ones polled by Rehabs.com have given mixed reviews of the Ranch. The four individuals polled by Rehabs.com on the facility's performance in a variety of areas appreciated the center's family programming and counseling options, and several noted that they would recommend the facility.
Family Participation: 4/5
Counseling Options: 4/5
Would Recommend: 3.8/5
However, in their comments, several reviewers complained that the center was not able to provide treatment as promised, particularly for individuals struggling with eating disorders. "Our daughter was there for 9 weeks for her ED and we were lied to every step of the way. We were told they were experienced with ED and they are not," J.B. wrote in one such comment.
Meanwhile, others praised the center's staff and physical comfort. “It is clean, comfortable, and effective, allowing the patient and family to get down to business,” an anonymous reviewer wrote. And Linda added: “This facility--its wonderful staff, its treatment program, and the community they build among the residents--gave my daughter her life back."
WHAT STAFF SAY
Each of the three former staff members polled by Rehabs.com at the time of this writing noted that they would recommend the facility to friends and family members seeking treatment. They praised the staff, characterizing their peers as devoted, “amazing,” and “open minded.” However, they felt that The Ranch’s employees were underpaid and overworked, resulting in staff burnout.
According to the facility’s website, The Ranch accepts most major PPO insurance plans, including those from Aetna, Humana, and Magellan. Estimates for treatment costs are provided following a confidential phone consultation. The eight individuals polled by Rehabs.com to date on the center's affordability gave lukewarm feedback.
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