Inpatient vs. Outpatient
There are different levels of care when it comes to alcohol rehab. The most structured type is inpatient, or residential treatment. During inpatient rehab, you will live at the treatment facility – supervised 24/7 by qualified staff. Therapy sessions will take place throughout the day (for a minimum of 6 hours per day), and you will also take part in other recovery activities. In residential treatment your meals, activities, sleep schedule, and free time are all established for you, so that you can focus on your recovery above everything else.
Outpatient treatment is a step down from inpatient and is for individuals that are more stable in their recovery. If you are enrolled in outpatient therapy, you will live at home and go to the treatment facility for certain periods of therapy during the day: anywhere from 3 hours/day for 3 days/week (Intensive Outpatient) to 6 hours/day for 5 days/week (Partial Hospital Program). This is a less structured, but still intense, recovery program. In order to participate in outpatient alcohol rehab, you need to be responsible enough to attend all meetings and therapy sessions as directed.
In between inpatient and outpatient is a level called “Extended Care.” During this level of treatment, you live in housing provided by the treatment facility, and then are transported to the facility for treatment. Some have 24/7 staff supervision, and some have supervision only while treatment is happening, but not in housing. This type of added supervision helps aid in addiction abstinence.
Type of Detox
If you are struggling with alcohol dependence, you will need to detoxify your mind and body from alcohol before you go on to therapy and recovery. Detoxing from alcohol can be life-threatening, and you will need to be supervised when withdrawing from this substance. Detoxing from any substance is painful, uncomfortable, and very disruptive to even basic things like sleeping, eating, thinking, feeling, and decision-making. In order to ensure your safety, functioning, and comfort, you should be assessed before treatment so you can receive the level of care medically required. Some programs do not offer supervised detox, so be sure of the availability of the care you need during this phase.
There are several types of detox:
- Medical detox is performed in a hospital setting, where the patient is supervised by medical staff equipped to use medication and other medical treatment when necessary.
- Supervised detox occurs when the client is carefully monitored for any dangerous side effects of withdrawal, and staff offers supportive care throughout.
- Unsupervised detox, detoxing at home, or detoxing alone is not advised. Detox is both complicated, uncomfortable and in certain situations, dangerous, so having trained staff on hand minimizes complications and dangers.
According to SAMHSA, an estimated 43.6 million (18.1%) Americans ages 18 and up experienced some form of mental illness in 2014. During that same year, 20.2 million adults (8.4%) had a substance use disorder. Of these, 7.9 million people had both a mental disorder and substance use disorder.
Even though all addictions arise when a person is trying to self-medicate some psychological wound, 39 percent (SAMHSA) have actual full-blown psychiatric disorders causing their addiction or as a result of the addiction and the accumulated consequences. Addiction and mental health disorders commonly occur together.
Whether you think you have co-occurring substance abuse and mental health disorders or not, you should be professionally assessed before beginning treatment. If you do end up having a dual diagnosis, it is imperative that your treatment plan reflects this. Both disorders need to be treated in tandem in order for rehab to be successful. These disorders, when both present, antagonize each other, so treating one without the other leads to frustration, relapse, and worsening conditions.
In order for your alcohol rehab to be equipped to diagnose and treat dual diagnosis, it must have psychiatrists and therapists trained and licensed to treat these co-occurring mental health issues. Find out about the center’s ability to treat co-occurring disorders before committing to a program.
Intensity of Treatment
The two main reasons for going to residential rehab is 1) to get supervision because you can’t stop on your own, and 2) to get a lot of treatment in the shortest amount of time so you can heal and be successfully equipped to lead a transformed life. Just because you are living at a rehab doesn’t mean you are getting the intensive treatment you need and are paying for. So as you choose a rehab, ask to see the daily or programming schedule. Hopefully it is full, morning to night, 7 days a week with no idle time. Ask questions about what skills are being learned in the groups and activities and what is the expertise of the staff leading the different activities.
The two main reasons for going to residential rehab is 1) to get supervision because you can’t stop on your own, and 2) to get a lot of treatment in the shortest amount of time so you can heal and be successfully equipped to lead a transformed life.
Dr. Andrea Chamberlain
What will my Treatment Plan Look Like?
You are your own unique person, created specially by God. When it comes to alcohol rehab, your individual needs and goals need to be considered before a treatment plan can be established. Most treatment plans follow these steps: detox, inpatient rehab, outpatient therapy, and after care, or Transformational Care. The length of time you spend in each of these stages of recovery will be determined by you, your progress, your life situations, and your treatment team.
What Types of Staff and Credentials are there?
The staff is what really makes a rehab program function. The therapists and staff should be compassionate and caring, dedicated to helping clients achieve true transformation. A friendly smile or a kind word can go a long way toward making you feel comfortable in your new surroundings. Likewise, a positive attitude from staff members will motivate and encourage you in your recovery. Great and successful staff will both live and role model the very skills they will be teaching you for successfully handling life, stress, adversity, and temptation.
The staff also needs to be experienced and licensed. Treatment providers, including psychiatrists, addiction specialists, doctors, therapists, counselors, and registered nurses, all work together to help clients, and each discipline of caregiver has its own certification process. An addictions counselor is the least trained, with no graduate degree, so make sure your therapy groups and individual sessions are with a masters-level therapist or higher. Ask about the credentials of the treatment staff before enrolling in rehab. Every state has its own licensing requirements as well, but you can check with your state to be sure a treatment center is accredited. You can also check if the facility is a member of the Joint Commission or Commission on Accreditation of Rehabilitation Facilities that regularly review and certify health care organizations.
How is the Facility Set Up?
Because the facility is often what catches a person’s eye before anything else about a rehab, treatment centers will spend large amounts of money on their facility. New and modern, vacation-like settings are popular for recovery, but it is much more important to find out what the different amenities and components of a facility have to do with your actual recovery. If you want to find the most effective program, investigate levels of care, licensing, and staff before you focus on the facility itself.
When in residential treatment, you will usually share a room with another client. You will eat meals in a dining room, designed specially for your body and brain’s recovery and healing. Structured treatment will occur in larger group rooms and smaller offices for individual sessions. Different amenities are often available and useful during rehab, such as an exercise room or gym, outdoor recreation area, commons area, and laundry facility. You should find out all your treatment center has to offer and take advantage of the added perks that will most help in your recovery.
How Much Does it Cost?
Finally, cost will play into your decision as to what rehab to enroll in. Cost can vary dramatically when it comes to alcohol rehab. Some programs are free, such as community-run or government subsidized programs. Mid-range rehabs charge around $2,000 – $25,000 per month, and if you want a spa-like alcohol rehab, you can expect to pay $50,000 – 80,000 per month. Medicaid and Medicare can pay for rehab at certain centers if you qualify, and if you have private medical insurance it will most likely cover at least part of treatment. Be sure to ask the facility about discounts based on income level and payment plans if you need to self-pay. Find out how to pay for alcohol rehab.
In the case of alcohol rehab, experts advise that you don’t always get what you pay for. Spa-like treatment centers often charge you for added perks that have nothing to do with recovery. On the other hand, many other programs are cost effective because they are owned and operated by people who have your recovery in mind. These qualified facilities treat addiction in the most efficient, cost-effective manner. You don’t need a facility with all the bells and whistles in order to recover. You just need the expertise of qualified, caring staff members who are able to help you take control of your life again.
Finding the right alcohol rehab is complex and challenging, and your insurance company is focused on the cheapest, but not necessarily the best, option for you. By considering the points above, you can narrow your search down relatively quickly, based on what you want and need. The key point is that you find a treatment program you feel comfortable with which will meet your unique clinical needs while also fitting your insurance and budget.