Residential or Non Residential Rehab?

Which of these alternative Addiction Rehab options gives the best outcome?  Residential or non-residential? This is one of the things that many people with addiction, and their families, want to know. There are some fundamental principles which apply to good addiction treatment, irrespective of what type of Rehab is chosen.

What does the latest research tell us?

These days, addiction is seen as a multi-factorial problem, which involves every aspect of a person’s life.  This is true for all addictions whether it happens to be to drugs, alcohol, gambling, sex addiction, or any other addiction.

Addiction has it’s own natural history. It begins gradually, but progresses to a stage where a person’s whole way of functioning becomes impaired. This results in the gradual loss of control over their behavior, and their ability to deny the compelling cravings, and drivers of addiction.  The result is that every aspect of their life is harmed.  It adversely affects their work, their finances, their social life, their mental health, their physical health, and their family.

There are several basic principles that are widely agreed upon in the treatment of any addiction.

  • The earlier the treatment, the easier it will be, and the greater the likelihood of successful recovery. Never the less, it’s always ‘better late, than never’.
  • Early treatment can prevent damage to the addicted person’s health and life, by achieving abstinence and  Recovery before the worst of the damage has been done
  • A good rehab program must take into consideration, every aspect of the person’s life.  This includes their general health, mental health, home life, accommodation, employment, social supports, and their spirituality – whatever that might be, for any one individual person.
  • This is what is meant when a Rehab program describes itself as being Holistic – it means that every aspect of the whole person is treated, not just the addiction in isolation.  Trying to treat addiction in isolation from all the other factors in an addict’s life, is unlikely to be successful in the long term.
  • Whenever possible, promoting an understanding of Addiction in the family, friends, and employers of addicts, will increase a person’s chance of successful long term recovery.
  • Some studies have shown that an abstinence reward system using cash incentives can improve success rates. Arch Gen Psychiatry. 2005 Oct;62(10):1148-56.
  • Many studies have shown that addictions should be treated the same as any other chronic illness, which means that treatment and support has to be on-going for years, to maintain recovery, and prevent relapses.
  • The conditions that gave rise to an addiction are mufti-factorial, and occurred over the long term, therefore the treatment to overcome and change those conditions must also be mufti-factorial, and long term. Successful rehab requires more than the initial removal of drugs from the body that occurs in Detox.

Residential or Non Residential Rehab – which is best?

This depends partly on the particular addiction involved, and to some extent, the preference of the individual.  Several studies have shown that for alcohol addiction, treatment from home can be equally effective, as long as there is frequent professional counseling, community support, and a stable home environment.

Smoking addiction is usually treated outside a rehab facility, and does not usually require a residential program.

Successful recovery nearly always requires extended Rehab after the initial Detox. A good rehab program will emphasize this when describing their rehab program to potential clients. This is not because they will receive more money for a longer rehab process, but because it’s true: Recovery nearly always requires Rehab after Detox to be successful, long term.

Most rehab facilities which charge fees, charge for the whole, complete, training program, not just by the week. This encourages their customers to complete their rehab, and therefore increase their chance of successful outcomes. This fee structure means that extending the program for monetary gain, will not occur. Most facilities that charge fees, have an optional pay by installments, structure.

And of course, there are many perfectly good rehab facilities that are free, and don’t charge fees at all.

In the real world, the choice between Residential and Non Residential rehab, will be affected by what is available in the area, and the cost that might be involved. Being treated and counseled for addiction while still living in the community has some advantages, but also some disadvantages.

Non Residential Rehab

Advantages

If someone has a good stable job, and a supportive family, and does not have friends who also have a currently active addiction, they might benefit from being treated with a non-residential rehab program.  This can be provided by some Rehab Facilities that also have an non-residential option, or by a local Rehab professional.  Doing this, will mean less disruption to a person’s established way of life, and that might be an advantage in the long term.

Disadvantages

Undergoing Rehab while still in the community can mean that a person remains exposed to the same situations and environment, they were exposed to during the period when they were developing their addiction. The friends from work might still want them to go for a drink after work, or their ‘addict acquaintances’ will still be there encouraging them to join them, in whatever addiction they used to share. All the same old stresses and tensions, will all still be there – and all the high risk situations, and all the same temptations.

Residential Rehab

Advantages

Taking someone out of their old environment can help to change how they think, feel, and behave.  This is because they are removed from the old outside influences, and are exposed to new, therapeutic ones instead.

Residential rehab removes residents from contact with outside addict friends and suppliers, and also the temptation of easy access to the means of their addiction.

Personal relationships which might distract, or aggravate, and increase the temptation to relapse back into addiction will also be temporarily absent.

Residential rehab provides a more focused and intense treatment – every day there will be activities to help an addict to want to reach recovery, and to believe that they are able to achieve that recovery.  Some of these activities will be in groups, and most Residential facilities have personalized one-on-one treatment as well.

The atmosphere of a Residential facility is totally focused towards providing information, and support, and to encourage a real personal commitment to abstinence.

One of the big advantages of a Residential rehab program is that you get an opportunity to spend time on your own – time to stop and think about how your life has turned out so far, and how it might turn out in the future if you don’t make some radical changes.  Having the time and opportunity to reflect on your life and your future is important for anyone, but for someone with an addiction, you have more things to think about than most people.

You will be encouraged to do this by the staff in a good rehab.  You will also hear the life stories of other addicts – all their catalogs of failed dreams and wasted opportunities.  That’s enough to make anyone stop and examine their own life and future. And that’s what you need to do if you want to beat your addiction – stop and think, and decide that you want a different future to the one you that seems to be your destiny if you cannot make a committed personal decision to change.

If a resident has other mental illness, such as anxiety, or depression, or schizophrenia, or Bipolar disorder, medical staff are always on hand to treat and monitor their progress.

Disadvantages

  • Cost can be a major factor
  • There may be no local Residential facilities, and the person has to move far away from family and friends during the Rehab period.
  • If someone has to take time off from a job, they may lose their job
  • If someone has a job, they may need the income from that job to pay the rent and bills.
  • If there are children at home and there’s no one else to care for them, that is a problem
  • If they lose their job, or can’t pay the bills, they might lose their home

Summary

Whether the addiction is treated in the community, or in a residential facility, successful recovery almost always requires more than just a short term Detox.  It requires months (usually) of rehabilitation, followed by years of actively working at maintaining Recovery, so that relapses are avoided, or at least, recur less often.

For Rehab to be successful, genuine changes have to occur an addict’s attitude to themselves and others, in decision-making, impulse control, self-esteem, and self-confidence. To achieve and maintain Recovery, there has to be a belief in a future, and a belief that it’s possible to achieve that future.

None of these things can be achieved overnight. None of these things are easy to do – but they are achievable. No situation is ever hopeless. Whether you choose Residential or Non Residential Rehab, undergoing any type of rehab that provides the necessary treatment, is the most important thing you can do.

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Comments

Residential or Non Residential Rehab? — 4 Comments

  1. Hello
    I stubble upon your link on Mayo clinic site
    So the question being ask residential or not…good question.
    I did a therapy back in 1997 as a residential patient and it wasnt some 28 days type of deal either and it as the best investment in my life, I was a user for over twenty years alcohol, cocaïne, haschich & benzodiazepine were my preffered substances.
    I had become a wreck so I needed the medical attention provided at this clinic, I was in for one heck of a withdrawl I never would of made it as a non residential patient.
    I can only share my own personnal experiences…there were many, I found out that no matter the vehicule that one chooses to numb or escape our turmoil it counts for about 15% of the problem, getting clean & sober under the watch of a medical team and in a setting were you have no access to the substance is I wont say easy that would be a lie but by doing so your giving yourself all the chances to succeed but still life on the outside awaits you so one as to cease the moment or else its money wasted.
    I say this because to often a person will go in under the pressure of the familly or because a employer willl draw a line before thanking them for there services, the key is one own willingness to change and thats were the work begins and the lessons to be learn.
    I did one therapy that lasted 2 years counting the folow up at the end I would see my therapist once a month before detaching myself.
    I havent use since then the days od addiction are far behind me…LESS I FORGET.

    -Momentum-

    • What a great comment, Momentum, and thanks for sharing your story with others. And congratulations! You are a fantastic example of how residential rehab, plus ongoing support in the community can result in long term recovery.

      Also, thank you for giving a message of Hope to anyone reading this – it’s never easy, but it really is possible – once you have some hope that a better future is possible, and a goal worth fighting for.

      Many people who enter Rehab, even those who enter unwillingly, can find that with the support of staff and fellow inmates :), hope can be restored, and the journey to Recovery can start.

      Well done, momentum – stay strong!

      Carol

  2. Hi guys. Always interesting to read peoples opinions on this topic. I have a blog which summarizes why private residential treatment is better. The short answer is essentially that people from residential treatment are less likely to relapse.

    • I agree Owen, if you only consider, what is the best way to achieve Recovery. But sometimes the availability, cost and social/personal outcomes of being taken out of the community are disadvantage of Residential Rehab.

      Of course, it’s always great if you can achieve Recovery. But if you were previously in a well paid job, with a mortgage and a family to support, and you lose your job, and house, as a result of going into extended Residential Rehab, these are big risk factors for falling back into addiction as soon as you try to re-establish your place in society.

      IF you can find, and afford, Residential Rehab, and your ‘outside life’ doesn’t disintegrate as a result of job losses etc, then Residential Rehab would be better.

      Sometimes, life is more complicated than that.

      It’s always important to remember that we are dealing with real people, with real lives, not just statistical outcomes.

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