Finding an Effective Rehabilitation Program

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What would be an effective treatment program for me?

Addictions are deeply personal, as are the treatment programs that are considered effective. A program that works for one person might not be ideal for someone else. Drug treatment options include:

  • Inpatient care
  • Outpatient care
  • Residential treatment
  • Therapeutic communities
  • Medical detox
  • Partial hospitalization
  • 12-Step involvement

Drug and alcohol addiction is a pervasive disorder that affects every area of the individual’s life and has a negative impact on that person’s functioning.
According to the National Institute on Drug Abuse (NIDA), this disorder leads to intense cravings for the addictive substance, and these cravings are so strong that they are often experienced as being uncontrollable.

Seeking and consuming the addictive substance becomes a compulsion when addiction is experienced. Addiction affects the brain, including areas responsible for motivation, learning, and impulse control. Thankfully, various types of rehabilitation programs are available to aid in the recovery process to individuals struggling with addiction can go on to lead healthy, balanced lives.

The Substance Abuse and Mental Health Services Association (SAMHSA) reports that in 2014, 22.5 million people in the US needed treatment for a drug or alcohol use problem. Only 2.6 million people received treatment at a facility specializing in addiction rehabilitation, and 4.1 million people received any treatment at all.

It’s important that those in need are able to find an effective rehabilitation program that can guide them on the path to long-term recovery. While there is a plethora of treatment facilities in the US, it’s important to find a program that specializes in addiction treatment and one that can offer tailored service.

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Components of Effective Programs

Because of the pervasive nature of addiction, NIDA recommends that a treatment program include several components that address all areas of life. An effective rehabilitation program will focus not only on the individual’s drug use, but also on employment training, interpersonal relationships, and other important areas of functioning.

NIDA reports that over 14,500 specialized drug treatment facilities currently provide rehabilitation services in the United States. Drug abuse and addiction are also treated by medical doctors and mental health providers outside of specialized facilities, including counselors, physicians, nurses, and social workers.
Programs may deliver treatment in outpatient, inpatient, or residential settings, and include a variety of different interventions. The appropriateness and effectiveness of each setting and treatment approach is dependent on individuals and their unique situations; there is no one “right” way to receive treatment.

A study published by the Taylor and Francis Group found that treatment programs assisted by medication, inpatient therapeutic communities, and outpatient drug-free programs were very effective in treating addiction. Overall, addiction treatment was shown to be promising in its effectiveness and showed much higher rates of success than detoxification alone. The journal Addiction reports that even brief treatment approaches to alcohol dependence recovery show positive outcomes.

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Types of Rehabilitation Programs

sunrise_talking_outsideMost rehabilitation programs begin with detoxification. NIDA defines this as the process by which the body rids itself of drugs, and it is often accompanied by uncomfortable withdrawal symptoms, both physical and psychological. Rehabilitation programs are designed to manage these side effects via medical detox and support the affected individual through the transition. Many programs utilize medications to assist in the detoxification process; however, their use should be determined on a case-by-case basis.

Further treatment is always necessary after the detoxification process in order to bring about lasting change and prevent relapse. Therapeutic intervention and ongoing case management are common factors in successful rehabilitation programs.

SAMHSA lists the main types of treatment programs as the following:

Residential Treatment

Pain IssuesResidential treatment is available as both a long-term and short-term treatment modality. Residential facilities provide 24-hour care in an inpatient setting. The most common model for this type of program is the “therapeutic community,” according to NIDA. This treatment model focuses on social relationships and connections to aid in recovery.

Addiction and recovery are considered in relationship to their environment. Social and psychological deficits are identified and repaired, and personal accountability is emphasized. These highly structured programs encourage direct confrontation of problems, including negative self-beliefs, self-concepts, and patterns of behavior that have perpetuated the addiction. These damaging patterns are replaced with constructive behaviors that encourage health and wellbeing. Employment training and various other services may be offered on site as well.

Long-term programs generally last 6-12 months, while short-term programs provide more intensive treatment for a shorter period of time. Because of the shortened time spent in the residential setting, it is important that the individual remain in outpatient treatment after leaving the facility. NIDA reports that outpatient therapy and self-help groups help to reduce the risk of relapse following completion of a short-term residential program. The Journal of the American Medical Association (JAMA) published a study reporting that while both long-term and short-term rehabilitation programs showed success in establishing and maintaining recovery from addiction, long-term programs were somewhat more successful in certain areas of recovery.
Many rehabilitation programs use medication in addition to other modes of treatment to assist in the recovery process, particularly during detoxification. SAMHSA reports that the medications used for this purpose work in a variety of ways. Some medications reduce cravings by mimicking the effects of the addictive substance; some block the positive sensations associated with the substance; and some produce negative feelings when the substance is taken. This form of treatment has historically been used primarily for opioid addiction recovery; however, some medications have also been used to assist in recovery from alcohol and other substance addictions.

Outpatient Treatment

The types of outpatient treatment available vary greatly and include programs that range from low-intensity drug education programs to intensive day treatment, which is comparable to the services offered by residential programs. A person’s level of functioning and social support factor greatly into what level of treatment is appropriate for that individual. NIDA reports that outpatient programs may involve individual counseling, group counseling, and treatment of other disorders or health problems.

Partial hospitalization, or intensive outpatient treatment, involves intensive and frequent treatment sessions multiple times a week, generally with fewer session as treatment progresses. According to SAMHSA, people often move into regular outpatient treatment, involving fewer hours per week, after completing partial hospitalization.

This assists the individual in maintaining sobriety; because addiction is chronic, most treatments must be long-term in order to prevent a relapse.

The intensity of the treatment may wane over time, as the individual gains a greater foundation in recovery. For example, a person might start with inpatient treatment and then move on to daily outpatient therapy. Over time, the person may scale back to weekly outpatient therapy and then to monthly sessions.

Individual counseling can greatly assist in rehabilitation by not only addressing the addiction, but also addressing any other areas of life where the individual may be struggling, such as relationships, employment, or illegal activity. This type of counseling can help to develop coping strategies that assist in abstinence and coordinate care with group therapy and medical practitioners. SAMHSA lists Cognitive Behavioral Therapy, Contingency Management, and Motivational Enhancement Therapy as common and effective approaches to individual therapy for addiction.

Group counseling is widely used in addiction rehabilitation, often in conjunction with a 12-Step program. According to NIDA, group therapy leads to positive outcomes when offered in combination with individual counseling. The Taylor and Francis Group reports that when attended at least weekly, participation in a 12-Step program significantly increases the chances of maintaining sobriety. Participation in these programs following more intense treatment, such as inpatient care, was shown to be an effective mode of abstinence maintenance.

Rehabilitation programs that offer comprehensive care can be found all over the US. In addition to the elements explored above, an effective rehabilitation program should tailor treatment to each individual. This means that each person’s treatment plan will vary, depending on the person’s background, personal circumstances, and progress in recovery.

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