August 17, 2017

How to Find the ‘Right’ Rehab

As someone who works with addicts and their families, I get asked with some regularity for help finding a treatment center.  So I thought I would put together a list of questions to ask in the process so that you can find the right treatment facility for yourself or your loved one.
First, I think it's important to note that there are no perfect treatment centers just like there are no perfect people.  However, I think you can find something that is a 'more right' or better fit than another treatment facility.

Are you (or they) ready?

Have you come to a realization that you cannot live this way anymore?  By the way, the evidence does not support that treatment outcome is dependent on a person hitting rock bottom.  Outcome is far more impacted by willingness to admit that you do not have the answers and your life cannot continue as you are currently living.  If you or your loved one isn't ready/able to say that life cannot go on as is then now may not be the right time for treatment.

What level of care do they need?

Detox

A medical detox is necessary in many (not all) cases with alcohol and heroine because withdrawl from both can cause seizures, vomiting, fever, tremors, etc.  In addiction, there are always withdrawals when you are going cold turkey (even from sugar and caffeine) but not all addicts are in need of a medical detox for safety but trying to detox from heroine and/or alcohol on your own can be dangerous.

Inpatient treatment

Inpatient is pretty self explanatory but there are different lengths of stay ranging from one week to six months.  Most insurance companies will reimburse for about 30 days of impatient treatment (depending on your policy) but you or your loved one may need to be in treatment longer.  Most facilities can offer you a payment plan so that you can get the treatment needed.  It is pretty standard to have at least one psychiatric evaluation during a 30 day treatment stay and to have several hours of group and individual treatment daily.  There is typically a family component to treatment as well.

PHP

Partial hospitalization program (PHP) is typically Monday through Friday from about 8am to 5pm.  In those programs, it is common to see a psychiatrist a couple of times per week and to spend much of the day in groups and regular check ins individually with a treatment provider.  This level of care is probably most common for minors  and most PHP programs allow for students to do at least a little school each day.

IOP

Intensive outpatient programs (IOP) are a really popular option for adults as well as minors.  It allows you to continue to go to school or work but feels most of your free time with focused group treatment.  I often think this can be a good first half step when someone doesn't have a total buy in with treatment but agrees there is a problem.

Sober living

Sober living is a great option for anyone who is trying to learn new habits but is probably most common as a step down from inpatient.  There are typically a lot of rules, house meetings and there can even be drug/alcohol testing done in order stay there.  It can be a really good way to learn how to deal with the world/life while coming home to a place with were drugs and alcohol are not tolerated or allowed so there is an element of safety and accountabilty.

Have they been in treatment before?

For a lot of people, treatment is necessary a few times before they are in remission.  It may be helpful to search out different treatment styles or modalities if they are already tried treatment.

Does the facility cater to age?

There are families that cater to creatives, young people, the GLBTQIA community, veterans, dual diagnoses, etc.  For some people, it can be easier to embrace sobriety if they feel as though they can related to the treatment providers and the people in treatment with them.

Do they need a facility that can handle dual diagnoses?

For many people who struggle with chemical dependence there is a mental health disorder that contributes to or complicates to use.  If he person in need of treatment has been diagnosed with a mental health disorder it is important to ensure that the treatment program is equipped to treat both their disorder as well as their addiction.  They are a package deal and should be treated as such.

How are you paying for it?

If you are relying on your insurance, it is important to call both the treatment family and your insurance company to know what if any additional costs you could encur.

What about aftercare?

Keep in mind that addiction and unhealthy lifestyles rarely form in 30-90 days and to get sober and stay sober will take longer than that too.  Aftercare is critical in order to set yourself up for success.  Aftercare can look like a lot of different things including but not limited to sober living, AA/NA/CA meetings, individual therapy, group therapy, support groups, church groups, etc.  Think of it like being in remission from cancer.  Your doctor will likely recommend some lifestyle changes and you will have to get follow up tests/scans in order to ensure that the cancer doesn't come back.
This is not a complete list but this is a good place to start.  As much as possible, it is good to customize the treatment to your needs.  The more it speaks to where you or your loved one is, the more likely the necessary shifts will come.
Good luck in your search!  I would love to hear from you.  If you feel like I missed a question, please let me know.  If you would like some local suggests I will do my best to help you.
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