What exactly is treatment at a drug and alcohol facility?
Substance abuse treatment can vary from different facilities, though several offer similar interventions and programs because of their proven worth.
Some treatment centers have a specific modality that is used, while others may focus on individual treatment.
Rehabs may address several addictions outside substances and treat them, such as sex addiction, gambling, or eating disorders.
Other treatment centers will offer help for a mental health component of substance abuse, often termed, a “dual diagnosis” treatment center. These facilities can benefit a person who is addicted to a substance and also displays a diagnosis of bipolar or schizoid disorders.
However, all certified treatment centers should include a licensed medical and clinical staff who run a treatment program specifically designed and well thought out to assist you in obtaining sobriety,
Medical, psychiatry, mental health therapy, group sessions, family sessions, case management, , nutrition, alternative therapies, writing, exercise, and continued care are all aspects of treatment.
Before admitting to a facility, you can ask admissions about their treatment program of what it includes and about the treatment team.
Medical treatment is imperative upon arrival for clients who need detoxification from substances. This includes an MD and a psychiatrist who work together to decide the best course of plan for you. There may also be a nurse staff on site 24/7 as well.
Depending on the addictive substance that is detoxing in your system, and after having assessed your general and specific health concerns, you may be prescribed medication from the medical doctor as well as the psychiatrist to ensure the best and safest outcome.
Th medical doctor on staff should be experienced with patients who suffer from addiction, so they can spot the often elusive signs other doctors may miss upon admission. You will see the medical doctor in the first 24 hours, unless the arrival time is on a Saturday and if the center doesn’t have an on-call physician, it ay be the following Monday. However, most rehabs have a doctor or nurse available at all times and staff are trained to take and monitor your vitals. If you have any physical issue that causes an emergency, 911 will be immediately called.
As a client it is customary to continue with once a week meetings with your psychiatrist, unless there is no need for a change in medication, though some centers may ask you as a mandatory practice. Often the psychiatrist visits are included and paid for by your insurance, but make sure upon admissions what your policy will cover. Additional medication that is prescribed may have a copay. Again, check with your policy.
You will most likely not see the MD after the initial assessment, or if something biophysical needs ongoing treatment (such as infections). The MD can be connected to from the treatment team if needed should anything arise. At Vogue Recovery Centers, there are nurses on staff 24/7 to assist with medical needs.
Mental Health Therapy
A primary therapist will be assigned to you decided upon the clinical director and the clinical staff and you will start an individua treatment plan when you arrive. The clinical staff will make decisions upon your admissions profile to who would be the best fit for your individual treatment.
A therapist may be an LMFT, LCSW, LPCC or an intern obtaining hours from a supervisor on staff, most likely the Clinical Director. Interns and staff have hundreds of hours treating clients, and most are certified drug and alcohol counselors.
The therapy team meets at least once a week to discuss the assessments and progressions/regressions of each individual client and is also responsible for writing clinical notation which is shared with the insurance company that determines the length of client stay. You may have a primary therapist, but the whole team will be interested in your well-being.
Therapists specialize in a variety of treatment modalities, the most common is Cognitive Behavioral Therapie or CBT, which has been found to be very effective for clients suffering from addiction. In addition, Dialectical Behavioral Therapy- specifically designed for personality disorders, Psychodynamic Therapy, Solution-Focused Therapy, Structural Family Therapy, Logotherapy, Feminist Therapy, Task Centered therapy, Narrative Therapy, EMDR, Seeking Safety, Neurofeedback, and Experiential Therapies are commonly used in treatment centers.
Therapists are also trained to help clients with trauma, including stages and severity of PTSD, and the effects of traumatic brain injury caused by or heightened with addictive behaviors.
Therapy will be provided for any crisis or conflicts that arise, and are on-call for emergencies.
There will be several groups that you will be attending. Group session help you establish an understanding that you are not alone in this disease. Groups can be 12 Step focused, SMART Recovery focused, Experiential Therapies, conflict resolution techniques, recovery tools, peer focused, substance abuse terms, psycho-educational and more.
Groups can last from one hour to several hours, depending on which type of modality is being used and if there is travel to an outside facility.
Groups are often the catalysts to getting a deeper idea of self through the observations and comments of others and can be the start of establishing a peer group and support for after care and new friends in sobriety. Being honest and forthcoming in group sessions may profoundly help you and others maintain sobriety and offer insight.
Case Management and Individualized care
A staff member will be provided to help you with case management. This is different from therapy. A case manager can assist you with practicalities such as: DUI classes, contacting a parole officer, getting important bills paid, or arranging for transitions, such as housing.
There might be one case manager designated for all the clients at the facility, or an existing staff member may be assigned to handle your individual needs. It is important to exercise patience when it comes to getting your needs met during your stay at rehab, since the case manager can only go as fast as the external systems allow them too. However, many case managers can navigate the systems and know how to prioritize as they important advocates for you during your stay in order to alleviate outside stressors.
Involving the family is an important part of the treatment process. There is a saying often heard “this is a family disease” because often the members of the family play a part (sometimes unconscious) or are directly affected by the client’s actions around addiction. Family sessions differ at each treatment center and can offer face-to- face sessions and tele sessions if the family cannot travel.
Family sessions are important at the later stages of the treatment program and can offer healing to all involved. Family sessions are conducted by the primary therapist and may include additional staff members.
To keep in note- what you say in individual and group sessions is confidential, and none of what you share with your therapist can be discussed with your family without your approval, by law.
Your therapist will be able to guide you through the family process, and most likely will give the family and education on the “why’s” of substance abuse behavior, making it easier to understand how to support you through the process.
Good nutrition and a balanced diet is important for over all health, Each treatment facility will have different policies on nutrition: some have 5 star chefs, others will focus on health food, and most will have restrictions such as no energy drinks, sodas or sweets with high fructose corn syrup. Sugar and chemicals are frowned upon when detoxification occurs. However, there are always exceptions and most, if not all centers take your individua needs into consideration. For instance, if you a vegan or have food allergies, please inform the center before or at admissions.
Like nutrition, exercise will be included in your treatment plan for optimal health and to inspire you on the road to recovery. Exercise creates endorphins which directly help with depression, anxiety, and other stressors. It helps clients “feel good” even if they don’t think that they can. It will most probably be a consistent part of your treatment to be involved in some exercise program.
Many recovery centers utilize yoga, gym workouts, and specialized activities depending on the locale of the facility.
The staff at the treatment center will review your assessment and you will have to have a clearance by the doctor prior to doing any physical excursion or groups where it may put added stress on your body. If you have a ongoing medical condition, light exercise may be the option. Most treatment centers take into consideration throughout your stay what may potentially be difficult due to physical limitations, but they will suggest some form of exercise knowing the benefits it has for people getting and staying sober.
Exercise is a great way and one of the strongest tools to maintain sobriety, however, there are a select few who transfer drug addiction to exercise addiction.
Some people find that when they get a few weeks off of substances, they feel so good and want to make up for time lost, or can work out their problems. While exercise is very beneficial for overall wellness, make sure it does not become a new obsession or addiction. Treatment center staff will help you find a balance with this.
During treatment, a basic tool in recovery is journaling your experiences. There may not be much in the way of watching a favorite program, and journaling can help alleviate feelings, and also keep a record of your successes. You will most probably be asked by your therapist or staff members to do some “homework” that includes writing on specific experiences. Making lists will also be helpful for transitioning to other levels and after care needs.
Alternative therapies are integrated into a treatment plan, and can widely vary at each addiction treatment center. Alternative treatments include but are not limited to: EMDR, Neurofeedback, art therapies and adventure or outdoor excursions. Alternative therapies are OFTEN influential in creating self-efficacy, learning new skills, kinesthetic learning, supporting traditional therapy, and neuro functioning.
Alternative therapies are often termed “experiential” and can include a wide variety of experiences. Many centers will have mindfulness groups, focusing on meditation or destressing techniques. There are treatment centers where music and art are a large component of the facilities approach.
Beach walks and groups, rope courses, equine and animals fall under the alternative.
Drama therapy, where applied theater techniques help you in everyday life have proved popular.
Hypnotherapy can be a beneficial alternative treatment when getting sober, and some centers may offer this intervention.
Spiritual focus groups will depend on each facility. If a certain spiritual or religious affiliation is important to you, this is something to discuss up front. Treatment centers will incorporate your beliefs into your treatment plan, which is part of individualized care.
Your departure plan is being designed as soon as you admit to treatment- it is a necessary part of your treatment plan. The staff will take into consideration all options when you transition from one level to the next, and can prepare you for different choices regarding your after-care of residential treatment. If you stay after residential treatment, and are in a partial hospitalization program (PHP) or outpatient program, it is likely that you can keep the same therapist and case manager.
To be enrolled in a program of continued care, whether at the same treatment facility or if you return home, is imperative for sobriety.
Continued care will address short and long -term goal planning and most often “systems” mapping- where your job, home, family, friends and interests can all be designed on paper to help manage going back into your life after your treatment is concluded.
The largest percentage of people who return to using is during transition stages. A plan for success with sobriety should be worked on prior to transitioning in order to reduce the possibility of relapse.
After leaving the treatment center, your therapist and staff members can be a lifeline to you during your transition. It is also helpful to keep in touch with the people who went through treatment with you. Some centers will make it mandatory that by the time you leave you have at least three phone numbers of people who you can call in case of need. To find out more about these specific treatments, please read the programs that Vogue Recovery Centers in Las Vegas and Phoenix have to offer.