What Is Inpatient Alcohol Addiction Treatment?
Although there are many different approaches to the treatment of alcoholism, for those suffering from acute alcohol use disorders, inpatient alcohol addiction treatment may be the most appropriate option. This type of treatment provides 24-hour support from a medically trained staff, as well as the services of an in-house psychiatrist. Unfortunately, most of these services are no longer available on the NHS and are only available as a privately-sponsored addiction detox and rehab.
Inpatient alcohol addiction treatment is the treatment of alcohol addiction in a residential situation. Residential rehabilitation (rehab) facilities offer inpatient treatment programmes, which each have their specific advantages and disadvantages to individual clients. Inpatient treatment involves a stay of typically 30 to 90 days in a secure, pleasant and confidential facility in which people suffering from an addiction can receive treatment while focusing wholly on their recovery.
Inpatient treatment typically consists of a holistic treatment plan, including detoxification (detox) and therapy phases, along with various other elements, such as bespoke fitness and diet plans. An alcohol user receiving inpatient treatment will have the benefit of medical support 24/7, along with any medications deemed necessary for a successful detox. They will be able to receive support from and share advice and experiences with others who are also going through addiction treatment to understand the pressures and challenges resulting from addiction.
Alcohol addiction treatment is not a permanent cure for alcoholism. Although treatment can lead to abstinence, recovery is a lifelong process. However, alcohol addiction treatment, including inpatient programmes, can create the foundations for recovery and equip clients with the tools and techniques they need to re-enter and re-engage with life in recovery.
Types of Inpatient Alcohol Rehab Programmes
All inpatient alcohol rehab programmes are not the same. Elements of treatment programmes can vary from one facility or organisation to another, with some facilities adopting particular or niche treatment philosophies and others potentially targeting certain demographics. However, inpatient alcohol rehab programmes can typically be divided into two main types.
Inpatient residential rehab
This type of alcohol addiction treatment require clients to remain on-site day and night, residing in accommodations in the facility and receiving treatment, including therapy during the day. Inpatient rehab removes those suffering from an addiction from their abusive environment where alcohol abuse originated and enables complete focus upon treatment and recovery without the distractions of the outside world.
In some cases, full-time residential treatment may not be deemed necessary. Partial hospitalisation may be considered a kind of halfway approach between full-time inpatient treatment and outpatient options. Clients in this type of programme visit the facility for significant periods five to seven days a week, receiving treatment in an alcohol-free environment, but return home or to other accommodations overnight. Typically, signs of constant improvement and other conditions must be observed for the client to continue receiving treatment on a partial hospitalisation basis. However, the constant commuting between the safe place and the stressful everyday environment, may cause even more discomfort.
What Happens During Inpatient Addiction Rehab?
There is no universal roadmap through inpatient rehab; every client’s treatment experience is different, and one facility may differ significantly from another. However, some key elements of treatment may be common across most facilities and treatment programmes.
Detox is a vital early component of alcohol addiction treatment. No treatment programme can be considered effective if the client continues to struggle with alcohol abuse. Detox is the stage during which the system is cleared of any substances of abuse. It needs to take place before anyone who is abusing a substance can engage fully with therapy and other elements of the treatment plan. However, alcohol withdrawal has its risks, and for the safety of the client, alcohol detox needs to be managed and assisted by medical professionals who can prescribe medications to help with withdrawal if needed. Home detox used to be a widely discussed topic, but nowadays hardly anyone would actively support a detox away from medical supervision and access to easy emergency help.
One of the less commonly touted benefits of residential rehab is the ability to interact with and learn from other people struggling with alcoholism. Group therapy typically brings together three to 12 clients who can share experiences and advice and bring different perspectives to challenging memories and opinions, helping each other to reshape their outlook and remediate behaviours and thinking that have led to addiction. Private rehab facilities also have leisure rooms, gyms, pools where the inpatients can have fun and spend time together, outside of therapy environment.
Individual assessments and therapy
Much of the therapy provided in rehab is conducted on a one-to-one basis, with the therapist working alongside the client over a series of appointments. Various therapy methodologies may be provided in any given facility, and an individual client may need to try several therapeutic approaches before settling on one that is most appropriate or beneficial to them.
Mental health therapy groups
Therapy in rehab does not necessarily address only addiction. Some individuals in rehab for alcohol addiction also suffer from co-occurring mental health issues; group therapy sessions may be set up to address those issues specifically. As with group therapy, members can give each other advice and support and learn from each other, in particular, addressing how their mental health issues drive addiction and how best they may be countered.
Medication assisted detoxification
Wellness and fitness activities
Many treatment facilities operate on the basis of “healthy body, healthy mind”. Many users experience significant physical deterioration whilst they are engaged in alcohol abuse, but inpatient rehabs can provide structured fitness programmes including regular exercising. This can improve both physical fitness and health and self-esteem as clients achieve set fitness goals and see a positive change in health and appearance.
Family programme participation
Families can play a crucial role in recovery from addiction and also benefit from therapy and other treatment addressing damage done by a loved one’s addiction. Some facilities provide family therapy and other programmes family members can get involved in if they choose. These programmes are aimed at healing some of the wounds caused by addiction and enabling family members to play a meaningful part in the treatment and recovery of their loved one.
Just as physical fitness can be neglected during addiction, so can nutrition. Many rehabs offer bespoke dietary plans aimed at improving the general health of the client and familiarising (or re-familiarising) them with proper food, emphasising healthy ingredients and a balanced diet.
While for some clients spiritual matters may be of no concern, for others they may be incredibly important. Attending to a client’s spiritual well-being is an important part of many approaches to alcohol addiction treatment, and on-site spiritual care for clients undergoing inpatient alcohol addiction treatment is provided by many treatment facilities.
Educational and experiential workshops
Private facilities run educational workshops aimed at providing clients with new and useful skills and abilities they can use in the outside world, both for recreation and gainful employment. The learning process can itself be a positive force for healing, enhancing self-esteem and creating a sense of purpose. Experiential workshops may also be provided, either as part of formal therapy or simply as an adjunct to treatment.
Continuing care planning
Continuing care, often known as aftercare, is provided during the period of recovery following the end of a formalised addiction treatment programme. Good treatment facilities may provide up to a year’s free aftercare, comprising a structured programme of activities, appointments and commitments (possibly including attending self-help/support group meetings and ongoing counselling) to optimise the client’s chances of a successful recovery.
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Therapy Types in Inpatient Addiction Rehab
Therapy lies at the heart of addiction treatment, and many therapeutic models and approaches have been applied. Since each facility offers specific methodologies, you should consider the therapy models offered when choosing a facility.
Acceptance and commitment therapy (ACT)
Acceptance and commitment therapy is a type of counselling and clinical behaviour analysis that uses various acceptance and mindfulness strategies, alongside commitment and behavioural change techniques, to promote and increase psychological flexibility. ACT does not aim to get rid of problematic feelings and thoughts; instead, it encourages clients to be receptive to unpleasant feelings and learn how to manage them rather than avoiding situations in which they may arise.
Cognitive behavioural therapy (CBT)
CBT is probably the best known of the therapy methodologies commonly provided in rehab. It aims to improve mental health by challenging and changing negative thoughts and behaviours and enabling clients to improve emotional regulation and develop coping strategies to address specific problems. The therapist works with the client to find effective mechanisms for dealing with addiction and triggers and teaches new information-processing skills that can help equip the client for life after treatment.
Contingency management/motivational incentives
Contingency management (CM), sometimes called motivational incentives, is an approach to behavioural therapy found in operant conditioning (also called instrumental conditioning) in which specific behaviours are conditioned by the use of either positive reinforcement or punishment. In the case of addiction treatment, adherence to specific required behaviours (such as passing sobriety tests or attending therapy sessions) can produce awards (which can be financial but are more typically privilege-based), while failure to adhere to those requirements can result in punishment.
Interpersonal psychotherapy (IPT) is an attachment-focused therapy methodology based on resolving interpersonal challenges and the principle that mood can be affected by relationships and life events, and vice versa. IPT seeks to help clients improve interpersonal skills and communication within relationships and build social support networks that can assist them with challenges that may arise during recovery.
Dialectical behaviour therapy (DBT)
Dialectical behaviour therapy is a modified form of CBT that combines standard techniques used in that therapy with concepts such as mindfulness, acceptance and distress tolerance derived from certain Buddhist practices. DBT seeks to enable the client to define, and subsequently achieve, a “life worth living”.
Medication-assisted therapy (MAT) is the use of therapy in conjunction with certain medications used in the treatment of addiction. In the case of alcohol addiction specifically, some medications are only considered effective when provided along with therapy.
Mindfulness-based cognitive therapy
Mindfulness-based cognitive therapy (MBCT) uses standard CBT methods alongside mindfulness and other meditative practices. Originally designed as a relapse-prevention methodology, MBCT is considered particularly effective in reducing cravings.
Motivational enhancement therapy (MET)
Motivational enhancement therapy uses motivational interviewing to analyse the content of client sessions, with the aim of giving clients as much information as possible in order to allow them to achieve set goals and develop a healthier focus for their lives. MET does not aim to guide clients through recovery but to create inner change from which recovery can be more positively entered into.
Motivational interviewing (MI)
Motivational interviewing is a client-centred counselling approach aimed at creating behavioural change through the exploration and resolution of ambivalence. MI is non-judgmental and non-adversarial, with therapists taking a more directive role than in many other traditional therapeutic models.
Psychoeducational group therapy is based on CBT principles and aims to educate clients about their alcohol use disorders and coping strategies. Topics include realistic thinking, skills training, exposure to triggers and relapse prevention.
Solution-focused brief therapy/solution-focused therapy
Solution-focused brief therapy (SFBT) is a goal-directed therapeutic approach focusing on solutions rather than problems. Clients are encouraged to question previous solutions they may have applied to life challenges and to investigate why they have not been successful before developing new solutions more appropriate to their situations and characters.
Twelve-step facilitation therapy aims to increase the chance that people struggling with alcohol addiction will become actively involved with 12-step organisations such as Alcoholics Anonymous (AA). Twelve-step facilitation familiarises clients with AA’s 12-step methodology and begins to shape their outlook and behaviours in order to align them with 12-step principles prior to joining a group such as AA.
Factors That Play a Role in Treatment during Inpatient Rehab Programmes
Various factors can affect how treatment is provided in rehab and which rehab facilities might be more appropriate for particular individuals.
The age of an client can determine many elements of treatment, including the kind of medication provided, the environment in which treatment should be provided and the age of fellow treatment clients. Some age-specific treatment facilities, including facilities dedicated to the treatment of young alcohol users, now operate across the UK.
Cases of dual diagnosis — when a mental health issue occurs alongside a substance use disorder — are common. Dual diagnosis can significantly complicate treatment as each condition can interfere with the treatment of the other, and specialist care is typically required. The right inpatient rehab team will help identify the disorder, if it hasn’t been already done, and find the correct treatment for both the addiction and the mental condition.
An individual’s medical history has a significant bearing on any treatment they may receive for alcohol addiction; for example, they may have conditions that make some medication dangerous that might otherwise be used in their treatment.
Relationship with alcohol
The longer someone has been abusing alcohol and the higher the quantities they consume, the more problematic their condition is likely to be, including posing a significantly higher risk of very dangerous withdrawal symptoms.
A user’s belief system may have a significant influence on how they view certain approaches to treatment and may even determine the treatment facility in which they enrol. For example, an atheist may struggle with 12-step programmes in which a commitment to a higher power is a crucial step.
Substance abuse and multiple addictions
Polydrug use can make alcohol addiction treatment much more complex, as not only do multiple addictions need to be treated simultaneously but the medication that might normally be used in the treatment of one addiction may interact dangerously with another substance of abuse. Moreover, withdrawal from more than one substance simultaneously is significantly more dangerous and challenging than withdrawal from one substance at a time.
Advantages of Inpatient over Outpatient Programmes
While outpatient addiction treatment might be considered appropriate in some cases, inpatient treatment does have certain advantages. Inpatient alcoholism treatment keeps the person suffering from an addiction disorder within a secure environment free of substances of abuse so that no temptation will be encountered. Outpatient treatment does not provide an escape from daily environment in which substance abuse and addiction have proved so challenging, thus making relapse much more likely.
Inpatient treatment allows clients to focus solely on recovery in a calm and peaceful environment, while outpatient clients must deal with issues and situations that can distract them from treatment.
Importantly, inpatient treatment provides the security of having experienced medical professionals on-site 24/7; in case of emergency, patients can be attended to in a matter of minutes at most. Those receiving outpatient treatment may be far from medical help if anything goes wrong. Inpatient treatment programmes also provide other elements on-site, while outpatient treatment requires clients to engage independently with many elements of a treatment programme.
How Long Does Inpatient Alcohol Rehab Take?
How Much Does Inpatient Addiction Treatment Cost?
The cost of inpatient addiction can vary significantly from one facility to the next, depending on factors including the type of treatment provided, the nature of facility in question, any medications prescribed and the optional extras a client may request. Roughly speaking, costs can range from between £4,000 and £15,000 per month; for more precise costs, you can directly contact a facility that interests you or speak with an addiction specialist who can give you a better idea of costs in your area.
Inpatient Alcohol Addiction Treatment and Rehab Success Rates
It can be very difficult to determine the success rates for alcohol addiction treatment of any kind, partly because many clients who complete treatment do not update treatment facilities with their progress. However, what is clear is that success rates vary significantly from one facility to another.
A survey carried out by the NHS’ National Treatment Agency for Substance Misuse in 2012 showed that the best private treatment clinics in the UK were achieving success rates of between 60% and 80% in clients remaining abstinent five years after treatment. At the other end of the spectrum, the worst-performing facilities were only achieving success rates of under 20%.
If you are considering entering inpatient alcohol addiction treatment, ask for evidence of success from any facility you may be thinking of enrolling in and speak with an addiction specialist about which facilities show the greatest long-term success rates.
Questions to Ask Inpatient Alcohol Rehab Treatment Centres
If you are thinking of checking into an inpatient treatment programme, it is important to do research prior to committing to any one facility. Some of the questions you should ask the staff at any facility you may be considering include:
Is the programme licensed and accredited? What evidence can staff show that the facility is fully professionally licensed and approved?
How long is the programme? Are there different lengths of a programme on offer, and which might be most appropriate for your specific situation?
Can you change programmes halfway through treatment if it is felt that you are advancing more quickly or slowly than the programme allow for?
Does the programme offer specific types of therapy? What opportunities do you have to try out different therapy models if you do not feel you are getting sufficient benefits from the therapy with which you are provided initially?
What are the programme’s success rates one year, five years and 10 years after treatment? What evidence of this success can the facility provide?
Can you see testimonials from clients who have gone through the programme? Will your treatment specialist help transition you into ongoing maintenance programmes after completing rehab? What maintenance programmes are available?
What are the success rates of those programmes, and can you see evidence of that success?
Does the facility accept insurance or offer other options for financial assistance? What are the payment terms?
Is credit available in cases where insurance will not cover treatment?
Will you be able to contact loved ones during your stay (phone call, email, social media)?
If visits are allowed, what is the frequency and duration of visitation, and what is the environment in which it takes place? Can loved ones participate in therapy?
What types of medical specialists are on site? Do they provide 24-hour care? Can you see proof of their qualifications?
What experience they have of treating situations like yours? In case of emergency, how are your security and safety guaranteed? What is the facility’s relationship with local hospitals?
Inpatient Alcohol Addiction Treatment & Health Insurance
Alcohol addiction treatment can come at significant cost, but many patients are able to cover this cost through private health insurance. However, not all health insurance covers all forms of alcohol addiction treatment, and inpatient treatment can be especially problematic due to its comparatively high cost. If you are unsure whether your health insurance covers inpatient alcohol addiction treatment, check your policy thoroughly and call your provider to confirm exactly what is and what is not covered to be sure they will pay all necessary costs covered by the policy in accordance with a particular timeline.
If you wish to find out more about what health insurance typically covers and which insurers offer the best policies for private alcohol addiction treatment, contact an addiction specialist.
Inpatient Alcohol Treatment and Rehab Facts and Statistics
- In 2017/8, 75,787 people in the UK were receiving treatment for alcohol addiction alone, while an estimated 589,101 alcohol-dependent adults were in need of specialist treatment, according to a National Drug Treatment Monitoring System (NDTMS) report.
- In 2016, Alcoholics Anonymous (AA) had over 2.1 million members around the world.
- The World Health Organisation (WHO) estimates that over 200 million people suffer from alcoholism worldwide — over 4% of the population aged 15 and over.
- Approximately 3.3 million deaths per year (just under 6% of all deaths) are thought to be due to alcohol, according to WHO.
- As long ago as 2003, the Cabinet office estimated the total cost of alcohol abuse to the UK taxpayer to be between £18 and £20 billion annually.
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