Inpatient Rehab Explained
Inpatient Drug Addiction Treatment
When most people think of rehab, they typically have in mind inpatient (or residential) drug addiction treatment, in which a client stays on-site in a dedicated facility to receive treatment. Of all the ways in which addiction is treated, inpatient treatment is probably the approach which offers the greatest chance of success in terms of permanent recovery.
Understanding Inpatient Drug Addiction Treatment
Inpatient drug addiction treatment is provided in a residential clinic where clients typically stay for between one and three months, though the duration of treatment can vary from clinic to clinic. Residential rehab are secure, peaceful, safe and substance-free environments conducive to healing. Clients can enjoy 24/7 medical support and a host of facilities designed to heal both body and mind, as well as benefiting from a peer group of fellow clients in recovery who can offer advice, support and companionship.
What happens in inpatient addiction rehab?
Every person’s experience of addiction is unique — and so too is their journey through treatment and recovery. No two clinics are the same (and treatment programmes can vary even within the same clinic), and addiction treatment by definition needs to be personalised to reflect the different experiences and circumstances that can contribute to the development of addiction. However, some commonalities may be found across treatment centres and programmes, making a rough guide possible as to what you might expect once you decide to enter treatment.
Group therapy to address chemical health
Chemical health describes an awareness of the ramifications of drug abuse and addiction on physical and mental health and the importance of living a healthy life in a society offering comparatively easy access to substances of abuse. Good chemical health education can be an extremely useful component of addiction treatment, as many clients do not fully understand the impact substance abuse can have on their health, and gaining this understanding can be a powerful deterrent to further substance abuse.
Group chemical health therapy typically brings together between three and a dozen clients in treatment into a therapy and group discussion environment. Here they can share advice and experiences and collaborate in developing ways to reinforce positive perspectives, with the aim of making it easier to lead clean lives after treatment.
Individual chemical health assessments and therapy
Chemical health education does not need to be conducted solely in group settings. One-to-one environments can also be very conducive to learning, with the therapist able to spend an entire session with one particular client targeting deficiencies and flaws in that client’s chemical health.
In addition to actual therapy sessions, chemical health assessments can be carried out on a one-to-one basis. A client’s stay in rehab will almost invariably begin with such an assessment aimed at establishing the nature and severity of the client’s addiction and the condition of their physical and mental health, including any health conditions unrelated to addiction that could complicate their treatment. This initial assessment will be used as the basis for the addiction treatment plan that will direct the client’s treatment throughout their stay in rehab.
Mental health therapy groups
At its base, addiction is a mental health disorder; it is also a significant driver and consequence of other such disorders. For example, mental health issues such as depression often lead sufferers into self-medicating and/or using substance abuse as a coping mechanism, which can result over time in the development of addiction. On the other hand, substance abuse and addiction themselves can cause various mental health disorders to arise, as a result of the neurological impact of the substance, the withdrawal from dependence or the harmful consequences of addiction.
Group therapy enables clients to discuss their own experiences of mental health issues and their relationships with addiction and to learn from those of their peers, who can often bring valuable new perspectives to bear on problems.
Individual mental health assessments and therapy
Because of the deep relationship between mental health and addiction, it is vital that doctors get as full a picture as possible of a client’s mental health when they enter the clinic. For example, dual diagnosis – a substance use disorder co-occurring with one or more mental health disorders – can make addiction treatment significantly more complicated, as both issues need to be treated simultaneously and the treatment of one can interfere with that of the other. The client’s initial health assessment will include a substantial mental health component.
One-on-one mental health therapy sessions will be provided throughout treatment in rehab in a wide range of settings and methodologies. (For more information on the therapy offered in rehab, see ‘Therapy Types in Inpatient Addiction Rehab’ below.)
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Wellness and fitness activities
The ethos of “healthy body, healthy mind” is a very prominent one in the treatment of addiction. While psychotherapy, counselling and other elements of an addiction treatment plan can address the mind, it is also vital to improve a client’s physical health and fitness. Protracted substance abuse and addiction can take a terrible toll on a person’s physical condition, both because of the direct impact of the substance abuse and because of other consequences of addiction such as poor diet and a lack of exercise.
Bespoke fitness and dietary plans, and access to facilities such as gyms or pools, not only benefit the client directly in terms of improving fitness and overall health but can also have significant psychological benefits in the form of the boosts to self-esteem and self-confidence that frequently stem from goal achievement and improved physical appearance.
Family programme participation
Educational and experiential workshops
Reintegrating into normal life can prove an intimidating challenge for many clients, especially those who may have neglected their education or professional experience as a result of addiction and those lacking life skills that can help make their re-entry into the outside world significantly smoother. Many rehabs offer educational and experiential workshops intended to foster and improve core life skills and to inculcate new capabilities clients can take with them when they leave the clinic.
Meanwhile, experiential therapy can also be a beneficial element of an addiction treatment plan; some clinics provide sessions featuring a variety of activities (such as climbing, sculpting, going to concerts and lectures, etc.) that enable clients to recontextualise past experiences and the ways in which they have previously approached life.
Continuing care planning
Continuing care (also known as aftercare or ongoing care) is any care provided by a clinic following addiction treatment to clients who have left the facility and embarked upon recovery. Most good rehabs offer up to a year’s free aftercare (though this can vary from one clinic to another) featuring a schedule of appointments, at the clinic, over the phone or via email, as well as various commitments such as participation in support groups or further counselling. Aftercare programmes seek to give the recovering client the strongest possible foundations for a permanent recovery by reinforcing and supporting the tools and techniques learned in rehab.
Therapy Types in Inpatient Addiction Rehab
A great range of therapy models and methodologies has been developed or refined for use in addiction treatment. Not every clinic is able to offer every therapy model, of course, and a client’s choice of facility may be determined at least in part by the methodologies on offer.
Acceptance and commitment therapy (ACT)
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy is probably the model clients are most likely to be familiar with, thanks to its frequent depiction in film and television. CBT seeks to improve overall mental health as well as tackling specific problems by identifying, investigating and seeking to remediate a client’s destructive thinking and behaviour. CBT therapists work with clients to develop more effective coping strategies and other relevant tools to counter the pressures of addiction, as well as to improve the client’s emotional regulation. They also seek to impart new skills such as information processing that will make the client’s readjustment to life outside the clinic significantly easier.
Contingency management/motivational incentives
Contingency management (CM) — also often known as motivational incentives — is a form of behavioural therapy using positive and negative reinforcement to effect behavioural change. Contingency management therapists work with clients to put in place a regimen of agreed behavioural standards and norms. These are intended to work on various levels: first, to govern the client’s actions whilst in treatment, but also to get the client accustomed to a world of checks and balances where negative behaviour has negative consequences. Complying with these standards and performing specific positive tasks (such as passing a drug test) can win the client rewards (usually privilege-based), whilst any failure to live up to the agreed commitments regarding behaviour may well result in punishment (again, usually related to privileges).
Dialectical behaviour therapy (DBT)
Dialectical behaviour therapy is an evidence-based psychotherapy methodology originally developed for use in the treatment of Borderline Personality Disorder (BPD) and since used in the treatment of numerous other disorders, including addiction. DBT is a modified approach to cognitive behavioural therapy based on biosocial conceptions of mental illness that combines standard cognitive behavioural therapy techniques with a number of concepts — such as acceptance, distress tolerance and mindfulness — derived from some eastern Buddhist meditative practices,
At the core of DBT is the work carried out between client and therapist in order to enable the client to define what they mean by “a life worth living”. The client is then encouraged to explore how they believe they might achieve such a life, bringing mindful awareness concepts to bear on the obstacles that have stood between them and that sought-after life.
Medication-assisted therapies (MAT)
Mindfulness-based cognitive therapy (MBCT)
Mindfulness is a psychological process of focussing one’s attention on living in the present moment and the experiences felt in the present. It is derived from the Buddhist principle of sati and is based on meditation techniques employed in Zen, Vipassana and Tibetan traditions. In the past few decades, mindfulness has become widely employed throughout the world, seen by many as being an important bridge between body and mind and an invaluable relaxation and coping technique.
Mindfulness-based cognitive therapy (MBCT) uses traditional cognitive behavioural techniques in conjunction with mindfulness and similar meditative and psychological practices. MBCT was originally designed as a relapse-prevention tool for clients suffering from depression, but it is increasingly provided during the treatment of addiction. It is considered especially effective in reducing the frequency and severity of the cravings recovering clients can continue to experience after they leave treatment.
Motivational enhancement therapy (MET)
Motivational interviewing (MI)
Motivational interviewing is an approach to counselling that seeks to instigate and develop behavioural change through the client’s investigation and resolution of ambivalence. MI is client-centred, non-judgmental and non-adversarial, with its core concepts deriving from its founders’ experience with treating alcoholics. It departs from traditional client-centred therapy in that MI therapists are much more assertive in directing the client, actively attempting to influence them to consider making substantial changes to their thoughts and behaviour, rather than engaging in primarily non-directive therapeutic exploration as in many other therapy methodologies often found in addiction treatment. MI is centrally defined by its philosophy rather than its technique, and MI therapists can vary significantly in terms of style and operating practice.
Psychoeducational group therapy
Psychoeducational group therapy applies traditional cognitive behavioural therapy (CBT) principles to group discussions. Groups of three to 15 clients come together to share ideas and collectively interpret experiences in order to learn and understand more about addiction and its impact, as well as the various coping strategies they can employ. Therapists lead group members through topics as varied as relapse prevention, skills training and trigger recognition and avoidance.
Solution-focused brief therapy/solution-focused therapy
Solution-focused brief therapy (SFBT), as the name suggests, looks at solutions to problems rather than focussing upon the problems themselves. It is a goal-directed collaborative approach to psychotherapeutic change, founded upon social constructionist thinking and carried out by observng how clients respond to a series of precisely constructed questions. Whereas clients in some types of therapy are asked to examine solutions to life challenges they may have applied unsuccessfully and investigate why, with the aim of developing new and improved solutions, SFBT sessions focus primarily on the present and future, with the past only used to give the therapist a better understanding of the client’s concerns and increase empathy between client and therapist.
Many clinics now offer 12-step facilitation therapy, designed to increase the likelihood that clients will engage with the 12-step model originally developed by the founders of Alcoholics Anonymous (AA). The 12-step model is employed by a broad range of support group organisations, including Narcotics Anonymous (NA), and is increasingly commonplace within rehabs themselves as a core aspect of addiction treatment plans. Twelve-step facilitation educates clients about the methodology and aims to help clients reshape their thinking and behaviours to bring them into alignment with the 12-step principles to make it easier for clients to engage with 12-step treatment and support groups.
Factors that Play a Role in Treatment Recommendations
Various factors can have an impact on a user’s eventual choice of rehab and treatment programme.
The age of a client can affect their choice of treatment in numerous ways. For example, it may not be deemed appropriate for an especially young client to receive treatment in a clinic where adults with substance use disorders are also being treated. Much older clients are more likely to suffer from age-related conditions that can complicate treatment. Numerous age-specific facilities now operate across the UK.
An individual’s medical history can often have profound implications for their treatment. One thing to bear in mind is the potential health impact of any medication provided as part of addiction treatment. Some health conditions can be dangerously affected by particular medicines, so a person suffering from such condition would be unable to benefit from that medication, potentially making treatment more challenging. A person in poor health may also be required to go through treatment more gradually — especially detox, which might have to take place over a much longer period to minimise any potential shock to the person’s system.
The specific substance a person abuses can also have affect where they go for treatment. Some specialised clinics treat only clients with specific substance use disorders. Even within clinics, treatment organisers may seek to keep certain types of clients together to make their peer group more relevant. Of course, the substance consumed will also have a big impact upon the type of medication and medication-assisted therapy provided. An opioid addict, for example, may prefer to attend a clinic that operates a methadone substitution programme before residential treatment.
Types of Inpatient Drug Rehab Programmes
Treatment programmes can differ significantly from one clinic to the next, in terms of the length of treatment, types of therapy provided and other factors.
Inpatient residential rehab
Inpatient residential treatment sees clients staying on-site for treatment in a secure, confidential and substance-free environment. All treatment is provided in the clinic, and clients also benefit from 24/7 medical access and the presence of a ready-made and supportive peer group of fellow clients in recovery. Inpatient treatment takes clients away from their daily environments in which substance abuse and addiction have developed, ensuring they can focus completely on healing and recovery.
In cases where 24/7 treatment is not required, some clinics may offer partial hospitalisation. A kind of bridge between inpatient and outpatient treatment programmes, partial hospitalisation sees clients attending the facility for treatment during most of the day, typically for five to seven days a week, but returning home or to other accommodation overnight. Usually, clients in partial hospitalisation are required to show constant improvement and agree to and follow certain rules; if they are unable to abide by these rules, they may need to return to the clinic on an inpatient basis for further treatment.
How Long Does Inpatient Drug Rehab Take?
While a typical inpatient programme lasts between 30 and 90 days, how long a client will need to remain in treatment will be affected by several factors, including the nature, severity and duration of their addiction; the type of treatment they are provided with; and any specialist care (for example, for dual diagnosis) they may require. Moreover, a client may enter treatment with a particular duration of treatment in mind but need to adjust their expectations because of how they respond to treatment or the emergence during treatment of any unexpected circumstances.
Advantages of an Inpatient Program
Inpatient treatment provides a client with a confidential, substance-free and friendly environment removed from the temptations of the outside world where they can concentrate on healing and recovery and receive every component of treatment. Residential rehabs offer 24/7 medical support, and clients can enjoy the company and support of their peers in treatment.
How Much Does Inpatient Addiction Treatment Cost?
The costs of inpatient addiction treatment can vary significantly from one clinic to another, and even between different programmes within the same clinic. Factors such as the type of clinic, the standard of care, the length of a client’s stay and any specialist care provided can impact upon final pricing. Very roughly, treatment costs range from between £4,000 and £15,000 per month; to get more information on pricing, speak with an addiction specialist.
How to Choose a Drug Inpatient Rehab
Which rehab you choose to attend will depend on a great many factors. If you are unfamiliar with the UK’s addiction treatment landscape, you may not be aware of what these factors might be when you begin your research into treatment options. You should always begin by contacting an addiction specialist familiar with addiction treatment in Britain who can lead you through the decisions you will need to make and help ensure you find the clinic that will give you the best chance of recovery.
The Role of Counselling in Inpatient Drug Addiction Treatment and Rehab
Counselling is key to beating addiction, both during treatment and throughout recovery. Building a trusted relationship with your counsellor will make it easier to discuss difficult thoughts and emotions that may obstruct other areas of your treatment. Having an independent, non-judgmental and supportive person to talk to about upsetting issues can prove invaluable at any stage of the recovery journey and help you see things more clearly so you can make the changes necessary to build a life without substance abuse.
Inpatient Drug Addiction Treatment and Rehab Success Rate
Getting an accurate picture of how effective rehab is in the treatment of drug addiction can be difficult, partly because many people who complete rehab do not keep in touch with their clinics to report their success. However, a UK government study in 2012 showed that the best-performing private addiction treatment clinics could show success rates of between 60% and 80% in terms of clients who were abstinent five years later.
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Get Help Today
If you are suffering from a drug addiction, you are taking huge risks with your physical and mental health, potentially causing you permanent harm. Your addiction could destroy everything you hold dear in your life. However, you can overcome your condition with professional help. Battling addiction is no easy process, but there are treatment facilities across the country waiting to give you the help you want and need.
Call your GP and/or an addiction specialist today to discuss your situation and find out about the treatment options available to you. Don’t wait until it’s too late: Make that call today, and take the first step on the path back to happiness and a successful life.
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