Most residential (inpatient) rehab centers are founded on the principle of full-immersion for the client. This means the client lives in the facility and is completely surrounded by recovery. Learning how to stay off drugs and alcohol is much easier when the client is removed from their home environment. Most addicts have created supportive structures for using and drinking.
In a sober environment, designed to wrap the client in a safety net away from temptation, clients can focus on recovery. The daily stresses of life can be buffered to keep the client focused on what they are doing in treatment.
Focusing on Recovery
Most addicts enjoy distraction from the harsh reality of their addiction. This is part of their denial structure. Distraction is a common tool to keep the addict’s addiction under cover. In-patient treatment will assist in keeping their eyes on their issues and the ways they got off track with drugs and alcohol.
The tools of recovery can be learned while the addict gains stability physically, mentally and emotionally from the impact of active drug and alcohol use. Apart from substance use, there are issues to be dealt with. Some are family relationships, work relationships, social issues, court and legal issues, and self-esteem or personal problems stemming from drug and alcohol dependence. Active addiction may have allowed the addict to avoid dealing with many of these. Learning to cope with them is the reason for treatment.
Inpatient settings are designed to provide the addict with gaining a strong sense of purpose and possibility. This replaces their former fears and hopelessness, often the feelings that brought them to recovery.
Today there is a dividing line for treatment programs. One is focused on 12-step recovery programs of Alcoholics Anonymous (AA), Narcotics Anonymous (NA), etc. The other is focused on Non-12-step recovery. These often refer clients to alternative programs after treatment for maintaining ongoing abstinence. One feature of treatment that remains consistent is the need for not returning to substance use. This is known as abstinence, sobriety, clean time, or recovery.
Hospital Treatment Centers
The earliest settings, prior to the advent of Alcoholics Anonymous in 1935 were hospitals for those who suffered from the horrors of addiction. Treatment has come a long way since that time. No longer are patients locked into cells as they once were.
Most hospital settings provide medical detox, along with treatment designed to guide the addict back to good physical health. The ravages of drugs and alcohol on the physical, emotional, and mental states of the addict are treated with the latest technology in medicine and mental well-being.
All hospital programs differ; some will be covered by insurance, while others are not. This depends on the severity of the addiction, the physical symptoms present in the addict, and their specific insurance coverage.
Hospital treatment programs may be an option for those who have other physical needs, as well. Determining which type of program is best can be done with the client, family members, and physician. Doctors can be knowledgeable about insurance benefits and which programs are best-suited for their patients.
Inpatient Treatment Programs
Treatment programs offering inpatient services vary widely in the program services they provide. Some will incorporate detox services to begin the process for the client. Others may refer detox clients to a different agency and then accept them for beginning the treatment process.
The length of treatment can vary for each facility. Most programs will require at least 28-30 to stabilize the client after detox. Many have custom-designed programs, structured for the needs of each client. Others offer stages of treatment that can last up to one year. While some are relatively strict in program structure, there are other variables for admission criteria. One factor of consistent concern to programs is the insurance plan of the client. Some treatment programs have contracts with insurance carriers which stipulate the number of treatment days provided to the client, the amount of co-pay and the treatment services they provide. Other programs may be self-pay only, and some have funding contracts that mandate length of treatment for clients who qualify for that funding.
Services usually include individual and group counseling. Some programs offer therapists, massage, outdoor excursions, and other mental health services, depending on the program. Meals and room and board are included, and some will have special menus, deluxe meals, private rooms, maid service, gyms or exercise facilities, laundry service and other amenities. Some programs may add services, billed separately from basic program structure, to accommodate clients.
Recovery Homes
Some facilities provide little to no medical services. There is often a physician or nurse to oversee client healthcare or in case of emergency, but do not provide medical care to clients during treatment. These facilities often cost less than treatment programs, but offer all basic services needed for treating addiction. Some operate with assistance from County, State or Federal funding sources or grants that help them serve a population who have no insurance benefits, have exhausted their benefits or choose not to use benefits for treatment.
The basic structure of the program will be the same as in treatment programs. Most of the same types of counseling services and groups will be provided by staff with credentials below those seen in treatment programs. Little or no private therapy is provided, and most of the program services are presented through people who are recovering themselves. Meals are often prepped and prepared by the clients and many tasks are done with supervision of staff; such as laundry and daily housekeeping. Rooms are usually shared with other recovery home clients and is more along the lines of dormitory style living. Each facility has different specifics for living.
Length of stay for program services is often more regulated, due to the funding agencies and their requirements. This may be 30, 60 or 90 days, depending on the program structure.
What Can I Expect in Treatment?
Group and individual sessions will include education on drug and alcohol use, the effects on the body and brain of the user, stress management techniques and identifying personal stressors, communication skills, relationship tactics, self-esteem building, and identifying triggers for relapse.
Treatment adapted to use the 12-step programs for ongoing abstinence may also include meeting attendance in the community or at the treatment facility, as well as introduction to the steps while in treatment. They may provide books, tapes, and other literature to help the client gain knowledge of their addiction and ways to recognize relapse signs. Clients will address issues that are preventing them from functioning well and adapting to life without substances.
Programs not designed for 12-steps may offer stronger focus on personal resilience. This means teaching each client to find a source of strength within to guide them in maintaining abstinence. This may involve therapy, physical fitness and nutrition, emotional balancing techniques and other forms of self-awareness.