The Ranch Philosophy
Surrounded by the scenic beauty of farms and ranches in the rolling hills of Nunnelly, TN – just outside of Nashville – The Ranch provides a full spectrum of addiction and mental health treatment services. The program offers treatment for trauma, depression, eating disorders, substance abuse, sex and intimacy disorders, and other mental health disorders. The Ranch’s experientially based program is designed to meet the needs of each individual and help them address thoughts, feelings and behaviors that keep them stuck in destructive patterns. Through a trauma-focused treatment approach, clients address underlying issues and learn to embrace their authentic selves while gaining a sense of belonging and connection.
Areas of Specialization
Trauma often underlies addictions, eating disorders, intimacy disorders and other mental health issues. The Ranch is known for its comprehensive, trauma-focused approach to treatment. A wide selection of trauma therapies helps clients address these underlying issues while building resiliency.
Clinicians at The Ranch draw on an unparalleled selection of traditional, alternative and experiential approaches to help clients heal in many different ways. By addressing the physical, mental and spiritual deficits that destructive behaviors leave in their lives, clients are able to recover fully and adopt a healthy, positive lifestyle.
Meet the Staff
Paul Wilhelm Ragan, MD
With over three decades of experience in mental health and addiction treatment, Dr. Ragan is a sought-after expert in the field. He regularly appears in the media as a consultant on behavioral health topics and is the recipient of several prestigious awards. Past roles include director of mental health for the Direct Support Command, Fleet Marine Force, in Saudi Arabia/Kuwait during Operation Desert Shield/Desert Storm, clinical investigator for the National Institute on Alcohol Abuse & Alcoholism, and associate clinical professor of psychiatry at Vanderbilt, among others. Dr. Ragan earned a medical degree from the University of Arizona, College of Medicine and completed an internship and residency in psychiatry at the National Naval Medical Center. He is certified in general adult psychiatry, addiction psychiatry and psychosomatic medicine.
Gina Marchando, DMFT, LMFT, CHt, CIt
A licensed marriage and family therapist, board certified hypnotherapist, certified incorporation therapist, and traumatologist, Dr. Marchando brings a wealth of experience to The Ranch. She earned master’s and doctoral degrees from Nova Southeastern University and has a post-graduate certificate in family systems healthcare. Dr. Marchando has worked in inpatient and outpatient psychiatric care and private practice, and also has taught at both the master’s and doctorate levels. She specializes in dissociative disorders and treating survivors of trauma and abuse.
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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.
Published on August 2019
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