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Residential Treatment: Here’s What to Expect

by Cedric Dent

May 29, 2022
A metal plate with a crooked, smaller plate screwed onto it and the word

Stages of Drug Rehab or Alcohol Rehab and Levels of Commitment to Residential Treatment

Anyone who’s gone to rehab for a drug or alcohol addiction knows there are stages to the recovery process. Working through these stages gradually shows you why treatment procedures are the way they are. They’re based on evidence in a scientific, trial-and-error industry that has been focused on troubleshooting the pitfalls of the process for years now. Residential treatment is the process that comes after medical detox in the case of high-quality treatment centers, and that’s where the rubber meets the road. Milestones toward that level of freedom closely align with certain stages into which the rehab process can be broken into segments.

When it comes to recovery phases, there’s no one-size-fits-all formula for how long people spend in each one. Understandably, some people move through the stages more quickly than others, but counselors and therapists in recovery programs apply certain ideas to help their patients through the process of recovery.

Planning & Entry

Let’s assume you make the decision to commit to the process. Many people start out in this nebulous planning stage where they’re discussing the ramifications of entering rehab with their families, their employer, the admissions department at the rehab center in question. You might not need to undergo this stage first, though, depending on what your priorities and needs actually are. Many people work all that out after the fact, because their first concern is just getting into treatment and finding the help they really need.

Keep in mind, neither of these options is really better or worse than another according to Drew Mack, executive director at Landmark Recovery of Indianapolis.

“It’s kind of an optional step,” Mack said. “There are folks who just call, get in, and then sort that stuff out later. And neither is really better or worse; either works out. This is just your first step, so a huge part of coming into treatment is creating a plan. Something that is successful, that the person is able to follow. A huge portion of treatment is also planning to leave treatment because no one stays here forever. Hopefully, they’re spending more time not in treatment than they are in treatment.”

Stage 2: Intake and Planning

Shortly after entering an addiction treatment center you’ll undergo an assessment of your physical, mental and sociological health. This is part of what determines whether or not you need to undergo detox before tackling rehab proper. It determines whether you need residential treatment, too. A treatment plan has to then be developed, but also they’ll help you develop a plan of action for financial, emotional and physical concerns.

Once you’ve been processed, the next few days are all about getting you mentally and physically stable. You’ll need to be in order to get up each morning and execute the fundamentals of functional life. These are things as basic as eating, bathing, and explaining your needs. This is more significant than it sounds because it’s important that you achieve the requisite level of socially balanced functionality. That’s how you can appropriately engage in group therapy and general treatment.

Stage 3: Developing Trust during Residential Treatment

Your life actually becomes very much about being part of a group, and developing a level of trust with those around you. Your day will be well structured so that group meetings account for about as many hours as a full-time job would. It’s all about building relationships and exploring yourself in the company of others doing the same thing. You should be looking for evidence of your own growth based on how capable you are of adapting what others have learned in their experiences to your own life. The challenge is doing so even when your experiences aren’t exactly the same.

You’ll be matched with a therapist and also paired with a roommate. Group and individual therapy will collectively account for about seven hours of your day. That’s separate from visitations or clinical sessions with nurse practitioners. Those visits start out being daily, then transition to weekly. The therapist, though, might be matched based on either availability or on the particulars of your situation.

“For example, at Indianapolis we care for a lot of veterans, and we have a couple of individual therapists who are more well versed in what it’s like to be either a veteran or a person who’s in active duty,” Mack explained.

Stage 4: Outpatient Rehab

Rehabilitation is a process Mack describes as stabilizing lots of things in a pretty short amount of time. The benefit of that for you is that it might not be as time-intrusive as you think in the grand scheme of things. On average, your peers are entering and staying for about 36 or 37 days, which is basically a little more than five weeks.

Recovery support services also abound for those who are exiting treatment, too, because the success of treatment is measured in how well you’re able to sustain your own recovery while forging a life for yourself. In the case of Landmark Recovery, these services include medication-assisted treatment, outpatient therapy, recovery coaching and self-help groups, which give you a community of support to make sure you can stay in control for the rest of your life.

This is where all the tools you’ve gained help you achieve legitimate self-control in life, which is the main thing you need in order to have the life you prefer for yourself, though substance use disorder makes this difficult to see. Seeing through that fog is the variable that can potentially set everything in motion if you’re able to first solve for that. Whether or not people take the first step obviously makes all the difference. Just like the external phases covered above, there are internal stages you’ll undergo, too.

Precontemplation Stage
Those going through the first internal stage and questioning whether they need help or even have a substance abuse disorder. At this stage, you’re unlikely to even be reading this because you’re probably still defensive when it comes to the subject of addiction. People around you, however, would likely say that you keep making justification for your actions. You’re struggling with addiction without fully appreciating the scope of its impact on your life.

Contemplation Stage
The second stage is characterized by a state of readiness. It comes at the point when you make the decision to change something, but most likely, you’re not yet acting on the decision. This is, in fact, when you might find yourself online reading content about rehab, like this article, just to see if it’s something you can do or would be willing to try. You’re contemplating the idea of recovery. To be frank, though, taking action is not what immediately follows in a lot of cases because a lot of people actually stall in this stage.

You’re more reasonable in conversations about addiction, though, if you’re contemplating whether or not to take action and how. Making a change is hard, but what’s most significant about this stage is the fact that you probably don’t need convincing that a change needs to come. That’s what should give you hope that you’re mentally headed in the right direction, but you can’t afford to rest on your laurels. Taking action and getting into a treatment center is what brings all that potential to fruition.

Preparation Stage
The Preparation Stage comes when you develop a sense of urgency about the problem, which is what will ultimately push you to the Action Stage. At this point, friends and family might observe you starting to engage in healthier activities and perhaps even attempting to kick your own habit unassisted. You might join a gym, go to church or initiate other activities considered to be healthy changes. You may, indeed, kick your habit for a couple days, but statistically you’re likely to backslide into the Contemplation Stage.

Action Stage
This is where one makes significant life changes based on their understanding of the problem. It usually distinguishes itself from the productive part of the Preparation Stage by the level of commitment to that change. They may exhibit prolonged abstinence and actually seek professional help, and they’re likely to be more transparent about their struggle. Self-care becomes a priority to the individual at this stage.

Maintenance Stage
In this fifth stage, one struggles with addiction yet demonstrates the requisite determination to avoid relapse potential with consistency. The lifestyle and self-care changes of the Action Stage remain intact. The urge to relapse theoretically assuages in this stage because of the prolonged abstinence in the Action Stage. The transtheoretical model characterizes this as being a stage that could last anywhere from six months to five years.

Treatment Modifications
There are a myriad of factors related to customizing treatment plans for a specific patient’s substances of choice. For example, opioid addiction and cocaine recovery treatment must adjust as patients’ health improves, shifting therapeutic approaches. These changes at a suboxone clinic, like Landmark Recovery, are required since therapies that work well at the start of treatment may become less effective or even hazardous down the road.

Patients who are recovering from marijuana addiction via medical detox have different needs from those in recovery from alcoholism or opioid addiction. Furthermore, meeting those needs in no way provides any guarantee against relapse, which modern addictionologists advocate be considered part of the recovery process, too. Addiction and substance abuse constitute not only a neurological complex but also chronic condition; therefore, it’s unreasonable to expect success without relapse. All of which impacts how these stages work.

Institutional and payment constraints are a frequent bulwark against progress, however. Those with substance abuse disorder remain vulnerable and dependent, and they need help maintaining behavioral adjustments during the middle stages described below. For many people, the later stages are reached with the help of therapy, which equips them with psychological tools to cope with and avoid “triggers,” experiences that lead a person toward relapse.

The Transtheoretical Model for Stages of Rehab
Originally developed in 1983, the transtheoretical approach to changing behavior was intended as a means to help people quit smoking. By 1992, it broadened in its utility to be clinically applied to various behaviors related to addiction. J.O. Prochaska, C.C. DiClemente and J.C. Norcross observed trends in how people’s behavior shifted as they studied several treatment strategies for mental health and substance use conditions.

If you’re considering rehab for a substance abuse issue, just know that it’s easy to start but complicated to do right. This is a process that’s going to have lots of moving parts, including the people you’ll inevitably have to depend on. Everything needs to work in sync to give you adequate support. That’s why it’s important to choose a treatment provider with proven experience and a high success rate. What’s going to ultimately determine whether you make a successful recovery is if you have the proper motivation to see it through.

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