For most people, their notion of “rehab” comes from television and films. The reality is far less sensational yet far more structured. While each facility has its quirks of operation, there are many overlaps among various residential programs.
So, what really happens over the course of a few weeks or month away from home?
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Those First Few Days Are Awkward
Walking into a residential treatment facility is uncomfortable for most. From intake forms to physical examination inquiries to simple anxiety of what’s about to happen, the first couple of days serve primarily to get someone stabilized and assessed.
Staff conduct an immediate intake assessment. Vital signs are taken, extensive inquiries about what someone has been using and how long they’ve been doing so are asked, and any medications previously taken are noted. This isn’t excessive small talk. Depending on what drugs were used, detox can get dangerous, and accurate information is needed.
Some enter after detoxing already. Some enter needing to detox as part of their stay. Regardless, there’s a lot of adjusting going on – the new facility, new people, and new schedule – and a lot of physical discomfort or psychological angst.
The Daily Schedule Is Pretty Rigid
Once acclimated to the new space and general expectations, it doesn’t take long for a formal routine to kick in. And make no mistake, there’s a routine. Many residential facilities maintain a heavily structured day for patients from morning through night.
Most likely, someone’s awake early because breakfast happens at a set time before group therapy, individual counseling, or educational meetings. The middle of the day exists as the morning does with additional scheduled activities, perhaps some recreational time, time for journaling or self-reflection.
Afternoons and evenings continue with various programming – some additional group sessions or classes or evidence-based approaches like dialectical behavior therapy and cognitive behavioral therapy. Maybe yoga or mindfulness or art therapy is integrated before evening support group meetings, downtime after dinner, and lights out.
It’s not because this structure needs people to be busy. Instead, the structure replaces the chaos that typically envelops an active addiction. When someone knows each hour of the day, there’s limited opportunity for anxiety to manifest.
Therapy Takes Different Forms
Therapeutic modalities don’t just include one-on-one counseling in an office, although that certainly happens. Instead, therapy incorporates several facets.
Group therapy takes up a good portion of the day. These sessions unite various individuals experiencing like-minded circumstances. Everyone connects through shared experiences, learns from one another, gains insight that they’re not alone in this struggle. A skilled facilitator knows how to maneuver through tough conversations without allowing them to derail completely.
Individual therapy provides the ability to work through personal histories, traumas, family issues, co-existing mental health conditions in a private setting. These sessions may occur once or twice weekly depending upon facility needs. This opportunity allows full honesty without concern about what might sound good to a room full of peers.
Many residential treatment centers also engage in family therapy or family education opportunities. Addiction doesn’t only impact the person using; it severely alters the entire family dynamic. Repairing the relationships and instilling appropriate boundaries and understanding of what recovery looks like is key for all parties involved.
In addition to such therapeutic engagements are educational groups that cover the science behind addiction, relapse prevention skills, coping mechanisms, and basic life skills that may have fallen by the wayside. It’s akin to sitting in a classroom; however, this acquired knowledge is truly necessary for those looking to rebuild their lives.
Medical Staff Is On Site
What most people fail to realize is that there are medical professionals present at residential treatment facilities. And this means more than one would think. Withdrawal symptoms may catch people off guard days into treatment; mental health conditions like depression and anxiety require medication reassessments; physical health needs that went ignored during active use must now be treated with the attention they deserve.
Psychiatrists or psychiatric nurse practitioners evaluate those in residence and manage their medications. Some patients come in on prescriptions that aren’t working appropriately; others require new medications for underlying concerns that drove their usage in the first place.
In-house medical help promotes safety; if anything, physical or psychologically feels off at any point, someone immediately qualified without waiting for an external appointment can assist.
Living With Others Creates Unique Dynamics
Residential treatment means living with others enacting recovery strategies alongside you 24/7. Roommates are assigned, dining hours are shared; group activities promote camaraderie. But you don’t get to pick who you live with – and this fosters positives and negatives alike.
Many find peer support unexpected in a positive way – hearing someone else articulate exactly how they feel helps dispel any notions that they’re all alone in this process. Late-night chats with a roommate who understands your struggle; motivation before a tough therapy session; applauding one another’s unique goals – those connections matter.
At the same time, personality clashes emerge; it’s not always sunshine and rainbows when people live together. But this is also normal staff-assisted mediation where these issues play out – and they become part of the therapeutic learning process therein as well. Learning how to resolve conflicts without drug use or avoidance instead of healthy discussions is an invaluable tool.
Planning for What’s Next
As a patient nears discharge, discharge planning becomes essential. This is critical because exiting a highly structured environment back into one’s daily routine often facilitates the worst relapses.
Good discharge planning integrates outpatient therapy opportunities, local support group meetings, maybe sober living accommodations, integration with community resources. Some facilities even assist in finding work or getting back into school. The goal is to ensure someone doesn’t leave with no plan; that’s not safe for anyone.
Residents who are getting ready to leave practice skills they will need at home – how to manage cravings when they hit; what to do when stress mounts; who to call when it feels like everything’s falling apart. They role play situational difficulties and learn how to create detailed relapse prevention plans. They identify triggers and practice strategies for each condition.
Some programs offer alumni services or continuing care – a phone call check-in here or there every month or alumni gatherings for those who’ve graduated but want connection down the road for refresher courses if necessary.
It’s Just the Beginning
30/60/90-day treatment doesn’t fix everything – addiction is multifaceted, and recovery takes longer than just residential treatment. But what this endeavor does do it provide intensive help when one needs to step away completely from their normal everyday life compartmentalization to focus entirely on getting better.
With structured endeavors arranged by professionals focused on medical safety and the blended confidence building through medical staff accounting for acquired knowledge and support fostering peer safety, a new space emerges where real change can occur.
What happens inside varies by facility based on needs; however, the overwhelming plot points ring true across the board – a safe space for individuals to finally address their addiction with professional help without all of life’s distractions or triggers going against them outside their walls. It’s not a cure – but it’s often exactly what one needs to get started in a better direction.