What to Expect During Alcohol Rehab

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Finally, your loved one has taken the huge step and agreed to check into an alcohol residential rehab. You and your family will experience apprehension, questions, and fear. But if you and your family know what to expect, the process will be much easier and less scary for you and your loved one. It is important for you to educate yourself as much as possible about what rehab will be like, the logistics, what the steps to recovery are, and what your loved one will be going through. To find out specifically what the treatment days will be like, contact your loved one’s rehab facility and ask them for details of the schedule and what happens for each activity on the schedule. We have laid out some basics of what to expect below.

Traveling to the Treatment Center

The first task to navigate is physically transporting your loved one to the alcohol rehab. If you’ve chosen the best facility with the most treatment benefits for your loved one’s needs at the price you and your insurance agree to, chances are it is not in your local area. Some travel out of you area is necessary. This is alright because so many more treatment options are available when you open your search to rehabs out of your area. Leaving the area for rehab is preferable and, in fact, recommended by professionals because of the many advantages for a more successful treatment outcome than going to rehab close to home (see more here).

Most treatment centers will help arrange travel for your loved one, but occasionally, you will need to make arrangements on your own. Determine how responsible your loved one is and their medical state first, and then make travel arrangements accordingly. The quickest trip possible avoids layovers at a bar. Attitude and behavior determine whether they need to be supervised, and if so, who is their chaperone. If booking a flight for your loved one, let the airline know they have a medical condition and you can pass through security all the way to the gate to ensure they get on their plane. Or, you could take your loved one to rehab yourself, so you can see the facility and meet the staff.

Travel to rehab is not something that insurance will usually pay for, but you can use other methods (loan, borrow from loved ones, or self pay) to cover this cost. If you work with a professional case management service, they will usually arrange for travel and they often have expertise in negotiating with the facility to roll some of the travel cost into the treatment fee to minimize your cost.

Check In

When your loved one checks into their alcohol rehab, the first thing the admissions department at a good treatment center will do is an assessment. Getting a lot of background information on the person and doing a physical exam, a mental health evaluation, and some blood work starts the treatment ball rolling. Your loved one’s medical and psychiatric stability, nutritional needs to restore their body, psychological talk therapy treatment plan, and best treatment group that fits their needs will be assigned. Learn about the different options for treatment here.

The most important initial step is determining what type of detox your loved one should be enrolled in, and how well their body will be able to handle withdrawal. Most alcoholics who are assessed will need medical detox with medical personnel 24/7, or at least supervised detox so they can be monitored closely for any dangerous withdrawal effects.

It is important during the check in process and assessment that your loved one be honest and willing to open up so nothing is missed or overlooked. This will ensure they will help get the best treatment possible and have the best chance of insurance paying for the treatment they receive.


The first treatment phase of alcohol rehab is detox. Once it has been determined what kind of detox your loved one needs, they will be taken to the detox wing, or in some cases, a hospital, to withdraw safely from alcohol. Your loved one will be provided with supportive care for their withdrawal symptoms and nutritious meals in a comfortable, monitored setting. Depending on their withdrawal severity, level of care, and medical health, they might be monitored closely by medical staff and given medications to ease withdrawal symptoms. Most patients need 4 -7 days in detox before they are ready to move on to the next phase of recovery, psychotherapy.

The first signs of alcohol withdrawal begin 4 to 12 hours after the last drink. Physical signs include shakiness, sweating, nausea, vomiting, headache, seizure, and insomnia. Psychological detox symptoms include visual, auditory, or tactile (feeling weird sensations on your body) hallucinations, anxiety, irritability, depression, anger, and social isolation.

The most severe symptoms of alcohol withdrawal occur 48 to 72 hours after the last drink. Delirium Tremens (DTs) causes disorientation, confusion, severe anxiety, intense hallucinations, dangerously high blood pressure, seizures, irregular heartbeat, low-grade fever, and severe tremors. These symptoms can be life-threatening, and need to be addressed by medical staff immediately, which is why many alcoholics are advised to go through detox in a medical setting.

Withdrawal severity peaks around 72-96 hours after the last drink, and then their medical condition improves over the next few days and the medical supervision is not needed. However, they might go into the next phase of treatment on some medications to facilitate a smooth transition off alcohol. Even though the medical danger is over, it can take 6-12 months to purge the brain from all the toxic effects alcohol has on brain cells so your loved one can truly think, feel, process, and make decisions with a fully healthy brain. So encourage them to hang in there as life will get easier and better as their brain heals.

Detox (detoxification) helps your loved one cleanse their body of the drugs and alcohol they have been using, but it will do little to keep them sober for any length of time. For that, they need skills to process life and make better decisions. Dr. Andrea Chamberlain


Detox (detoxification) helps your loved one cleanse their body of the drugs and alcohol they have been using, but it will do little to keep them sober for any length of time. For that, they need skills to process life and make better decisions. Psychotherapy facilitates real change, as the person comes to understand who they are, their addiction, what caused it, what allowed it to continue, and how to change their thoughts and attitudes to allow for long-term sobriety. There are many different types of psychotherapy – some are effective and some are a bunch of fluff. Below are some therapies that are proven to produce real life results.

Behavioral Therapy (or Behavior Modification). This is the most common form of talk therapy in rehabs. It is the simplest but the least effective. The focus is modifying a person’s behaviors to treat their alcoholism. An example would be: change your behavior of driving a certain route home so you don’t drive by the bar you are tempted to go into for happy hour. Modifying behaviors is important, but if you don’t work on the deeper issue, you will just find a new bar on your new route. Behavior therapy is easy to teach so facilities with minimally qualified counselors, like someone with a certificate in addictions counseling, will have this as the main form of therapy, and it leads to quick relapse.

Cognitive Behavioral Therapy (CBT). This deeper therapy is the foundation for most lasting success and is a method for dealing with the faulty thought patterns which lead to dysfunctional behaviors. Addiction is a person’s unhealthy coping system for their inner struggles, whether real or perceived. If the addict is given the training and tools to change their negative thought (cognition) patterns, they can learn to deal with stress and conflict in a healthy way that doesn’t involve drug or alcohol behaviors. Masters level or licensed therapists are more often trained in this therapy so you want to make sure of the therapists’ credentials and style.

Trauma Therapy. Alcoholism and drug addiction commonly have their beginnings in traumatic experiences, or are somehow fueled by various traumatic events. During trauma therapy, the patient learns how to uncover, re-process in a more accurate way, and deal with unresolved trauma in a therapeutic setting; in essence bringing healing into those dark past wounds. This therapy recognizes the individual in recovery as resilient and as possessing the ability to continue on and take control of their life despite challenges. Trauma therapy can be messy and should only be done by a licensed Masters level or above therapist with experience and expertise. If not, the damage could be worse than the original traumas.

Dialectical Behavioral Therapy (DBT). An offshoot of CBT, DBT is a cognitive behavioral treatment that teaches being in the moment, managing stress, dealing effectively with others, and regulating emotions. Individuals learn basic skills to identify and cognitively process their emotions so emotions won’t overwhelm or frighten the individual. Emotions are important to enjoying life and making decisions, but many don’t know how to handle their uncomfortable feelings so they use alcohol to numb, escape, or self-medicate these feelings. DBT slows our mind down so we can manage emotions and incorporate them into a healthy decision making system for lasting success. DBT is intricate and should only be done by a licensed Masters level or above therapist with experience and expertise.

Christian Therapy. A true Christian therapy program will help individuals transform their lives through a closer relationship with God, accessing His divine power. But faith-based therapy is not just for the religious – it has beneficial qualities for everyone. Building powerfully on CBT, in order to retrain and correct your thinking, a patient must determine what values, morals, and set of absolutes they will adopt and base their thinking on. Through Bible study, prayer, reflection on God’s will, and learning His life-management instructions, individuals renew their thinking based on our Creator’s guidelines, and then experience peace in God’s forgiveness of their past wrongs, love in their Savior Jesus Christ, and new life in the Holy Spirit. As you can imagine, without Christian therapy’s attributes, CBT, DBT, and trauma therapy are limited, but with Christian therapy, those other therapies are deeper and more powerful and research shows, more successful for lasting recovery and transformation.

Social/Educational. Another model for addiction treatment is the social and educational model. Under this type of therapy, addiction is seen in the context of upbringing and social influences. During social/educational based therapy, the addict re-learns how to interact with others in a positive way, stressing socialization and communication. This therapy also focuses on educating the person in recovery, helping them learn and practice life skills along with making positive choices.

Discharge or Post-Treatment Plan for Relapse Prevention

Most facilities call this After Care, but it can also be called the Transformation Plan because no therapy is effective if it only applies to the here and now. In order for your loved one to stay sober after rehab, they must continue to grow, mature, or transform by applying what they learned in therapy to their life. The best way to prevent relapse is to establish a practical post-treatment plan they understand and can implement. With ongoing transformation, addiction temptation continues to melt because they are excited about where they are going and don’t want to go backwards. Your loved one should make a post-treatment plan with their therapists while still in rehab. Then, when they return home, you can help them stick to that plan and provide encouragement in their sobriety and exciting transformation.

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