When it comes to drug and alcohol rehab, there are a number of different terms that can be confusing. For example, what is residential addiction treatment? How does it differ from outpatient treatment? What is intensive outpatient treatment?
It's enough to make those who need help for a drinking or drug problem paralyzed by indecision, but it doesn’t have to be. It’s all part of an interconnected process that will help you identify your problem, specify the help you need and make the right treatment decision that will give you the best chance at long-term sobriety.
So if you’re wondering, “What is residential addiction treatment?,” don’t stress. We’ll break all those terms down.
First Things First: Screening and Assessment
Before anything else takes place, those who have an opportunity to provide you with care for a drug or drinking problem need to know what they’re dealing with. An initial phone call to a drug and alcohol treatment center, for example, will likely serve as a screening. A more thorough assessment will take place upon admission. But wait, you may be wondering: What’s the difference?
According to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), “Screening involves asking questions carefully designed to determine whether a more thorough evaluation for a particular problem or disorder is warranted. Many screening instruments require little or no special training to administer. Screening differs from assessment in the following ways:
- “Screening is a process for evaluating the possible presence of a particular problem. The outcome is normally a simple yes or no.
- “Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis.”
In other words, once you call a treatment facility, trained and compassionate admissions counselors will conduct a screening over the phone. This isn’t to put you on the spot or to catch you off guard — you may be calling simply to ask “what is residential addiction treatment?,” but before that’s decided upon as an option for your particular problem, the scope of your problem needs to be determined. Admissions counselors will take the answers to your screening questions, gather the information needed to consult with your insurance company and then return with a recommendation for a level of care.
That recommendation will depend on a number of factors: What your insurance plan will cover, for one; how much and how often you’re using or drinking (it’s important to answer those questions as honestly and thoroughly as possible, so that you’re not short-changed when it comes to the care you need to remain comfortable and healthy!); and the different types of substances that are contributing to your problems.
It'll be up to you to accept the recommendation, but if you do, then those counselors will work out a day and time for you come to treatment and go through a formal admissions process — which includes an assessment of your specific treatment needs. According to SAMHSA, “A basic assessment covers the key information required for treatment matching and treatment planning. Specifically, the basic assessment offers a structure with which to obtain
- “Basic demographic and historical information, and identification of established or probable diagnoses and associated impairments;
- “General strengths and problem areas;
- “Stage of change or stage of treatment for both substance abuse and mental health problems; (and)
- “Preliminary determination of the severity of the (problem) as a guide to final level of care determination.”
What is Residential Addiction Treatment? It Starts With Detox
If you’re wanting to know what is residential addiction treatment, know this: Medical detox is the first step of the treatment process. It can take place after you’ve been assessed, or in the case of severe withdrawal, it may be initiated before or during the assessment phase. What is it? According to the National Institute on Drug Abuse (NIDA), no matter what type of treatment that’s recommended for your particular drug or alcohol problem, “most … start with detoxification and medically managed withdrawal, often considered the first stage of treatment. Detoxification, the process by which the body clears itself of drugs, is designed to manage the acute and potentially dangerous physiological effects of stopping drug use.”
In other words, it’s a way of slowly and safely purging your body of the toxins caused by the constant use of drugs and alcohol. Why is it necessary? Harvard Health Publishing puts it this way: “Addiction is a physical dependence on a chemical substance. The dependence leads to unpleasant symptoms, called withdrawal, when a person stops using the substance. People often begin using an addicting substance because it initially gives them pleasure. By the time addiction has developed, the pleasure is often gone. The driving force behind continued use is a need to avoid the unpleasant symptoms of withdrawal.”
If you’ve ever experienced withdrawal from alcohol or drugs, you know that it’s debilitating, uncomfortable, miserable and any other adjective you can think of to describe a horrendous experience. Doing it on your own — “cold turkey,” as they call it — can be done, but going through a medical detox program, where your withdrawal symptoms are managed through medication and medical staff members can keep an eye on you for any adverse reactions is always a better course of action.
However, know this: While a great many individuals equate stopping the use of drugs and alcohol with sobriety, there’s a lot more to it, as the NIDA points out: “detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery. Detoxification should thus be followed by a formal assessment and referral to drug addiction treatment.”
And that leads us to your original question: What is residential addiction treatment? The process through which your problems, both those directly related to your drug and alcohol use and those that exist around it, can be addressed.
So … what is residential addiction treatment?
According to SAMSHA, “Residential treatment for substance abuse comes in a variety of forms, including long-term (12 months or more) residential treatment facilities, criminal justice-based programs, halfway houses, and short-term residential programs.” It’s typically the next step after a medical detox program, which typically lasts 3 to 5 days (but can last longer, depending on the severity of the addiction).
Once detox is complete, patients transition into a community of peers in various stages of the recovery process. The idea that there is strength in numbers isn’t just anecdotal; there’s actual science behind the idea that a community of individuals in recovery can help and encourage one another. A 2008 study published in the journal Occupational Therapy International, for example, concluded that “Evidence suggests that a peer-supported community programme focused on self-determination can have a significant positive impact on recovery from substance addictions.”
How does it work? The nonprofit organization Herren Project puts it this way: “Often times, when faced with a difficult life event, many people will find solace in connecting with those who have been through a similar situation. If you have ever found yourself seeking out advice from a specific person or group due to their understanding of what you are going through, you’ll recognize the power that lies within peer support.”
However, in asking “what is residential addiction treatment?,” it’s important to understand that it’s so much more than just a collective of individuals — it’s the various therapies, counseling and educational processes they experience together that brings change on an individual level. And it works: According to SAMSHA, “Evidence from a number of large-scale, longitudinal, national, multisite treatment studies has established the effectiveness of residential substance abuse treatment. In general, these studies have shown that residential substance abuse treatment results in significant improvement in drug use, crime, and employment.”
While residential addiction treatment programs vary according to the facilities that administer them, the most effective rely on a combination of traditional rehab protocol — what’s known as the “Minnesota model,” based on the facilitation of the 12 Steps of Alcoholics Anonymous — and evidence-based therapies that are rooted in psychology, like Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Cognitive Processing Therapy and more.
Combined with a number of other therapeutic protocols like family therapy, activity therapy, fitness therapy, one-on-one counseling, psychiatric care for co-occurring mental health issues and a regular assessment by on-staff medical personnel, these facilities use what’s known as a “whole person” approach to treatment. From classes and group lectures to processing groups and individual assignments, treatment in a residential setting looks very similar to a college experience — albeit with clinical supervision and guidance to focus on the reason an individual has sought help.
What is residential addiction treatment? It’s so much more than just quitting. It’s about a lifestyle change, one designed to help an individual’s sobriety last beyond a stay in rehab.
So what happens next?
As the NIDA points out, there are different types of residential addiction treatment, the most common being the 30-day model, or short-term, treatment — followed by a commitment for additional care: “Following stays in residential treatment programs, it is important for individuals to remain engaged in outpatient treatment programs and/or aftercare programs. These programs help to reduce the risk of relapse once a patient leaves the residential setting.”
Usually, this involves transitioning into a sober living facility, either one associated with the treatment center itself or a stand-alone residence that provides a similar level of care. There is empirical data to suggest that they’re effective: Researchers in a 2011 study published in the Journal of Psychoactive Drugs concluded that “our study found positive longitudinal outcomes for 300 individuals living in two different types of SLHs (sober living houses), which suggests they might be an effective option for those in need of alcohol- and drug-free housing. Improvements were noted in alcohol and drug use, arrests, psychiatric symptoms and employment.”
In many cases, transition to sober living is also accompanied by enrollment in an intensive outpatient program, or IOP. A 2014 paper in the journal Psychiatric Services noted that “IOPs have emerged as a critical facet of 21st century addiction treatment for people who need a more intensive level of service than usual outpatient treatment, and they allow participants to avoid or step down successfully from inpatient services.” Furthermore, researchers added, “There is a high level of evidence … that IOPs are equally effective when compared with inpatient and residential treatments.”
In other words, follow-up treatment, also known as aftercare, provides a metaphorical “parachute” that softens an addict’s or alcoholic’s “landing” back into the real world after residential treatment. When substances have been used for so long that they’ve provided a crude but effective barrier at living a sober life, the reintegration process into society without those substances can be a difficult one. Aftercare can play a critical role in easing that transition, and is thus considered a vital part of the treatment process.
So what is residential addiction treatment? Simply put: So much more than just 30 days at a rehab. From the initial phone call you make to the day you transition fully back into your sober life, it’s a journey designed to help you address a problem, change your coping mechanisms, face the hurdles that keep you returning to alcohol and drugs and build new life skills that don’t just help you recover — they help you grow into the person you’ve always wanted to be.