Monthly Archives: May 2014

What is a Luxury Rehab?

The idea of a luxury rehab may seem a slight contradiction in terms too many people, but is a development in the growing rehab industry that has cornered a very definite niche and can widely exploit people’s fears about what rehab is in a very lucrative and rewarding manner.

It is important to go back to a generalisation that people have in terms of what they view rehab as being. Too many people, a rehab is an institutional setting which has very strict rules and regulations about what an individual can bring into rehab, can do whilst in rehab, can wear whilst in rehab etc.

For many people the idea of a rehab presents a very controlled and tight environment in which the individual is effectively bullied by the structure into becoming and behaving in a particular way.

It is probably fair to say at this is a highly distorted view of how the majority of rehabs work and have always worked. A number of rehabs do have fairly strict guidelines and rules as per the above areas but there is a very definite philosophy behind it.

The idea is to create a structure that gives the individual a degree of discipline and safety that allows them to begin the process of exploring the alcoholism or other addictions in a safe and controlled way.

Not everyone agrees with this approach but there is at least a consistent philosophy behind it. A number of rehabs use varying levels of structure and regulation to achieve this sense of discipline and safety, and this will be reflected in the admissions policy.

Luxury Rehab

A luxury rehab unashamedly exploits this fear of rigidity and rules by offering a rehab experience that is very definitely at the top end of the luxury market for any type of institution. A luxury rehab will exist both in terms of its environment, setting, its facilities, its level of clinical staff and the freedom with which it gives the individual opportunities to participate or not in whatever activities they feel are most appropriate for them.

Having said all that, there is differing evidence as to which approach type of rehab is the most effective . This is because it is virtually impossible to quantify the effectiveness of any rehab, given the length of time that people normally stay in a rehab which is about 30 days, and that the real work a rehab does is essentially to lay the foundations for  longer term of sobriety if the individual wants it.

As such the work of a rehab is essentially very short term, and should be seen in the context of helping an individual be given the process of owning their own reality and coming to rebuild both their inner worlds and outer worlds as a long-term way of taking their life back.

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What is a Christian rehab?

People looking for a Christian rehab normally have a fairly clear idea of what they mean by this term. There are a number of rehabs that call themselves Christian based rehabs and they have a markedly different approach to the majority of other residential clinical rehabs that exist. In this context a Christian rehab will be a residential facility, normally offering help people who have addictions to drugs or alcohol or other substances.

The length of stay in a Christian we have is normally advertised as being between six and nine months with an intensive daily programme of Bible reading, shared worship, Christian counselling and personal and group prayer. In addition there is unlikely to any involvement of any 12 step process such as Alcoholics Anonymous or Narcotics Anonymous, or any type of individual or group therapy that is not rooted in biblical terms or beliefs.

How successful this approach is is debatable, but the thinking and philosophy behind it is clearly advertised for being what it is. Essentially it is a belief that a fairly fundamentalist biblical approach can cure alcoholism and drug addiction in an environment where this is the only source of healing available.

Christian Rehab

Some people are looking for this type of approach and welcome it and enter a rehab on this basis. There is a word of caution that needs to be added however. A number of Christian rehabs are closely associated with huge Evangelical churches and it will be a condition of rehab that attendance at such churches and involvement with the church process is a mandatory part of the recovery process.

This can sometimes be quite cult like in its approach, given that people who have an addiction to alcohol or drugs are in a fairly vulnerable state, and their vulnerability is essentially used to commit them to these churches on a long-term basis.

The majority of rehabs that are not Christian based and do not call themselves Christian rehabs will nevertheless be very open to an individual’s quest for God and what that means to the individual, and for the individual’s freedom to explore and question their own spirituality in the context of their recovery from alcoholism.

The principles of Alcoholics Anonymous as embodied in the 12 step program are essentially spiritual principles, often described either a spiritual or therapeutic, but essentially designed to help individual find their own inner world and their own God within . For many people this is a better approach than a so-called Christian based rehab.

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Does a Rehab make you go to Alcoholics Anonymous ?

It is probably fair to say that the majority of rehabs that are residential base their approach to their addiction treatment programs with a view that they are better supported by the individual attending meetings of Alcoholics Anonymous and Narcotics Anonymous and other 12 step organisations .

Indeed the majority of rehabs base their addiction treatment programs and their therapeutic treatment methods on the 12th model of Alcoholics Anonymous which they adapt to their own purposes.

A rehab that follows this viewpoint is likely to make it a condition of the residency that the individual attends a certain number of meetings of Alcoholics Anonymous or other 12 step organisations during their stay at rehab.

This is a condition of treatment that should be made clear at the outset and at admission, and if the individual has a real problem with it then it is something that needs to be factored into the decision-making process as to which rehab should be considered or not.

Some rehabs are stricter than others about applying this condition of residency. Some rehabs take a view that it is down to the individual to decide whether or not they want to attend meetings of Alcoholics Anonymous whilst in rehab.

On this basis a number of clients in rehab will be attending meetings while a significant number will not be. This can often lead to conflicts within the rehab which add to a general pressure on the individuals concerned and can sometimes generate real problems.

Rehabs and Alcoholics Anonymous

Other rehabs will take a view that is in effect stricter and will make it a condition of entry and residency that people need to attend a minimum number of meetings of Alcoholics Anonymous whilst in rehab.

Whilst this avoids some of the problems mentioned above, it does mean that the individual does not come to the view that they need to attend AA meetings based on their own individual experience, rather they are forced into it by the rehab.

This can have complications further on, where the individual feels that there principles of choice about their recovery and rebuilding their lives has been taken away from, first by being forced into rehab against their will effectively, and secondly by being forced to attend meetings of Alcoholics Anonymous.

The counter argument to this normally runs that although the principle of choice may have been compromised, the reality of being forced into a rehab or of being forced to attend meetings of Alcoholics Anonymous at some level breaks down the denial of the alcoholic and give them the opportunity to experience a real freedom and truth that they would otherwise not have.

It is important to add that there are rehabs that do not push meetings of Alcoholics Anonymous or other 12 step organisations and operate more on what is known as a life skills basis.

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Does a Rehab do detox?

Anyone entering a rehab who has had a problem with alcohol and/or drugs is at risk from withdrawal symptoms that could be extremely serious medically, potentially life-threatening. For this reason it is absolutely crucial that a rehab has qualified medical staff who are able to assess and monitor the withdrawal symptoms of the individual concerned and assess whether a medical detox is needed or not.

The majority of rehabs will have their own clinically qualified medical staff who are able to assess and perform and oversee any medical detox that may be needed. If a rehab is not qualified in this way, then it should have access to a local clinical facility who can either assess or perform a detox on behalf of the rehab.

The ability to assess whether an individual needs a detox that is medically supervised or not is actually crucial to the future well-being of the individual concerned. Many individuals do not need a supervised detox, but some do and it is crucial that the rehab is able to assess this adequately.

Some rehabs offer what they term an holistic detox, which is likely to be a significantly different process to a supervised medical detox that should be undertaken on admission to the rehab. The term holistic detox can mean different things and should be taken with a degree of caution. It sounds very appealing as a concept, and some rehabs exploit this sense of purification as a means of attracting people into the rehab in the first place.

 

Detox and Rehab

The majority of rehabs take an approach that an individual is essentially an addictive personality, whatever that means, and that they effectively can choose what drug they become addicted to. This is a controversial approach and not all people agree with it, but it does suit the majority of rehabs as it allows them much wider access to a potential client base that they can draw on.

What it also means is that some rehabs take this to an extreme where they say that any type of stimulant be it caffeine or nicotine or anything else is dangerous, and that the individual should refrain from all types of stimulant whilst in rehab.

This approach can verge on the extreme and be seen as a sort of purification process, and in this context is sometimes referred to as an holistic detox. The danger with this approach is that it misses out on focusing on one or two major problems such as alcoholism and drug addiction, and puts the individual in an extreme black-and-white situation. For many people this is simply too extreme and the process can fall down.

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What is alcoholism?

People have had a problem with alcohol pretty much since time began, and this has commonly been referred to by many different terms over the centuries. Even in today’s world someone who has a problem with drink is either referred to as alcoholic or in other seemingly less threatening terms. These can include alcohol addiction, general addiction, alcohol dependence, problem drinking and many others.

The general acceptance of alcoholism as being the defining term for people who are seriously addicted to alcohol and cannot stop came with the advent of the organisation of Alcoholics Anonymous some 60 or 70 years ago. The growth of this organisation went hand-in-hand with a more general acceptance of alcoholism as being an illness, rather than being a moral weakness which in many ways has always been seen as before.

The medical profession and the approach of the majority of rehabs sees alcoholism as an illness, and treats addiction more generally as an illness as well. Whilst it is almost impossible to define alcoholism, the general approach of Alcoholics Anonymous is to see alcoholism is a threefold illness, mental physical and spiritual.

This is not a theoretical approach or a theory borne out of medical research. This is a lived experience approach, based on the recovery of many millions of people from alcoholism through the 12 step program of Alcoholics Anonymous.

It is probably fair to say that if someone really wants to understand the nature of alcoholism as an illness, the best way is properly to attend open meetings of Alcoholics Anonymous and listen to people talk about their experience of active alcoholism and active recovery.

Alcoholism and Rehab

For a number of people this is not possible, and perhaps the most important thing to grasp is the understanding that alcoholism is an illness. It may not be possible to define what that illness is, but it does become more evident if one looks out on those or understands an individual who is suffering from it.

It is probably worth saying also that there is a distinction between an alcoholic and a heavy drinker, a distinction made in the book Alcoholics Anonymous. The general sense is that a heavy drinker whilst encountering many of the same problems that an alcoholic might have on the lives will be able to stop on their own willpower, albeit with a significant amount of difficulty.

The alcoholic, on the other hand. will at some point be completely unable to stop even if they need to or want to. Indeed the mindsets of most alcoholics is that alcohol is the only thing that is really holding them together, and the worse their life gets both internally and externally the more they turn to alcohol at one thing they can depend on in a life of seeming internal chaos.

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What happens in a Rehab?

Anyone approaching the idea of going into a rehab for a residential stay is likely to be fairly apprehensive about what is involved and what the outcome is likely to be. Many people have an idea that the regime in a rehab is fairly strict, and that people often talk about a rehab feeling quite like a prison in some ways, albeit a very luxurious and open prison.

This is a somewhat simplistic generalisation and tends not to be true of the majority of residential rehabs. This generalisation comes from a sense that most rehabs do have fairly strict guidelines across a whole range of areas that affect the individual whilst they are in rehab.

The approach of the majority of rehabs that a client enters on a residential basis will normally be for about a period of 30 days. During this time they are living in somewhat of a bubble, which can both be a safe and a threatening experience.

The intent of a rehab is to help individuals begin the process of accepting that they have a problem with alcohol or drugs or both, and to begin the process of recovery.

To this end a rehab will take a view on what is needed to help the individual in this process, and this is where the litany of dos and don’ts tends to come in. The approach taken by a rehab varies widely as to how structured the environment needs to be, and this should be a major consideration when deciding which rehab should be approached with a view to entry.

Some rehabs will take a view that the individual needs to be challenged in many ways in order to accept the fact that they are an alcoholic. This starts with a fairly strict regime of what they are allowed to bring into the rehab by way of cellphones, laptops, iPads etc.

It is likely that this approach will mean the individual shares a room with another individual during their stay, as a matter of principle, to help break down the center of isolation that they may feel. In addition a rehab that adopts this type of approach is likely to have a fairly strict regime about what the individual can wear and what they cannot wear during their stay in rehab.

It is also possible that the rehab will take what they termed a holistic view of addiction, meaning that things like smoking and drinking coffee are banned during the individuals stay there.

If all this sounds a bit grim, you’re not alone. Many rehabs have realised that this type of approach puts so many people off that it’s bad for business. To that extent you’re likely to find differing levels of regimen amongst different rehabs concerning these areas and boundaries.

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What does Rehab cost?

Anyone browsing the websites of virtually any rehab will be struck by one particular fact, that virtually none of them give any indication of how much they cost.

The one notable exception is the corporate website of Hazelden, who are one of the major treatment providers. They give a very general indication that a 30 day stay in one of their rehabs is likely to cost somewhere in the region of US dollars 25,000 – US dollars 30,000.

This is probably a very conservative estimate, and the cost of any rehab for a 30 day period is likely to be significantly more.

There are some rehabs, which call themselves Christian rehabs, who offer what seems to be a much cheaper alternative. The cost is often minimal and there is the promise of a long-term route to recovery, mainly in the region of 6 to 9 months.

These rehabs are normally very closely associated with some extremely large churches, and whilst some may have good motives, there is normally a sense that the rehab is used as a recruiting ground for people who are vulnerable into the wider domain of the church itself.

Whilst these churches may not literally be cults, that is likely to be a cult-ish element to some of the approachs that some of these churches offer and as such should be treated with caution.

At the other extreme, are what are known as luxury rehabs. There is a belief that they are all located in Malibu, but they are to be found dotted throughout the United States and other countries. A luxury rehab can cost anything up to US dollars 125,000 – 150,000 for a 30 day stay.

Cost of Rehab

As with a normal rehab, if there is such a thing, the cost can escalate with additional expenses for items or services that are not considered part of the standard package.

The majority of rehabs cost their services against provisions that are available under an individual’s insurance plan. The rehab should have an efficient admissions unit who are well versed with how insurance companies approach an individual or their family going to rehab and provisions that do and do not apply under the insurance plan.

If an individual is looking around for a rehab, it is a good idea to talk to the admissions unit first as they can advise whether or not an individual’s insurance plan is appropriate for their rehab or not.

If an individual does not have health insurance, then it is highly recommended that they seek other alternatives first, the most obvious is going directly to meetings of Alcoholics Anonymous or Narcotics Anonymous.

Many millions of people literally have done this and have got sober and clean without the need for going into rehab, and this option should be seriously considered.

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Does Rehab Work?

Anyone looking for help either for themselves or someone else who has a problem with drink or drugs is likely to consider the possibility of going into rehab.

There are other options, such as going directly to meetings of Alcoholics Anonymous or Narcotics Anonymous or some other type of day treatment, depending upon the availability and where you live.

Many people consider going into a rehab as their primary choice, in part because it has become accepted as a standard route for dealing with the problem of drug and alcohol addiction.

The nature of rehab can vary quite considerably depending upon where the rehab is located, and the type of approach the rehab adopts in terms of its addiction treatment programs. The majority of inpatient clinical rehabs adopt a model of addiction treatment that is based on the 12-step approach of Alcoholics Anonymous.

These rehabs will often offer what they refer to as the first five steps of Alcoholics Anonymous, although in practice the therapeutic approach adopted is different to that used in the actual 12 step program of Alcoholics Anonymous.

Whether or not a rehab uses the model based on Alcoholics Anonymous or some other type of therapeutic and clinical approach, it is important to realise that a rehab has a limited time span is available in which to facilitate major changes.

Does Rehab Work ?

The majority of rehabs will offer a 30 day treatment program, which has probably two main elements to it. Firstly is to try and help the alcoholic begin the process of accepting the fact that they have an illness, called alcoholism, and that because they suffer from this illness they are, de facto, an alcoholic.

The individual acceptance of this premise may vary widely, and may take a significant time after they have left rehab to really accept the reality of what this means.

The second aim of the majority of rehabs therapeutic addiction treatment programs will be to help the alcoholic not only understand that they have an illness, but to begin to understand the basic tools available, therapeutically and spiritually speaking, that can help them get sober and stay sober.

A part of this approach is likely to be an introduction to meetings of Alcoholics Anonymous, which may be held either on the site of the rehab itself or in the local vicinity. A great deal of importance is likely to be stressed to the individual on the need to regularly attend meetings of Alcoholics Anonymous once the individual has left rehab.

This is likely to help lay the foundations for a much better likelihood of the individual getting sober and staying sober over a significant period of time.

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Rehab Programs

A rehab has traditionally focused on recovery from alcoholism/alcohol abuse and drug abuse. Although alcoholism/alcohol abuse has been around for a long time in human history, it is only fairly recently, in the 1930s, that there has begun to be an acceptance of alcoholism/alcohol abuse as an illness.

When rehabs began to treat people for the illness of alcoholism/alcohol abuse it became obvious that many people were in effect dual addicted. This in effect means that not only were people suffering from alcoholism/alcohol abuse but they were also using prohibited or illegal drugs as well.

It thus became a feature of rehabs that they would treat people who were suffering from either or both of these conditions. In rehab terms, this became known as a dual diagnosis. In many respects this remains the main focus of programs that rehabs offer.

The type of program will be a mix of various therapeutic techniques, quite probably including an adaptation of various 12 step programs, individual or group therapy, various life skills and other approaches to getting and staying sober.

Rehabs have evolved this approach over time and from the idea of treating people who have a dual diagnosis, a whole range of programs are available for different approaches to people who are affected by either of these conditions.

Rehab Addiction Treatment Programs

This means that a rehab/treatment center is quite likely to advertise its programs as been focused to certain different groups of people. These are likely to include an approach to young adults, and at the other end of the spectrum people who would be classified as executives in business or commerce.

A rehab/treatment center may sell itself as being a luxury rehab, often meaning that it doesn’t impose the restrictions on people in terms of a structure that many rehabs do.

Many rehabs now offer programs aimed at people with eating disorders, people who are addicted to prescription drugs, as well as rehabs that are specifically either for men or for women only.

A rehab/treatment center may quite often be focused on people in various professions or trades, such as the military or the clergy.

Part of the attraction of this type of program is the added anonymity that it gives to people in those professions who may have a problem with alcohol and/or drugs and need a space away from their colleagues in order to get sober.

A rehab/treatment center, whilst mainly focused on people who need to get sober or clean, will often also offer a program to people who have been in recovery for a while.

This is aimed at people who have been sober for a period of time but feel they need an intensive period of work in the environment of a rehab/treatment center to focus on issues that for whatever reason they have not yet dealt with.

A rehab/treatment center may also focus on a number of emotional/mental health issues that they feel they can help with, such as helping people deal with depression, anxiety management, anger management or codependency issues.

In addition to the professions already mentioned, a rehab will also offer a safe environment for people in professions who need to be trusted and where the admission of a problem with alcohol or drugs would effectively end their career.

This applies primarily to people such as healthcare professionals, public safety officers, aviation professionals, law enforcement officers as well as any government or local area politicians or well known public figures.

A rehab/treatment center will offer a program of recovery that is essentially based on the spiritual approach to recovery found in programs such as Alcoholics Anonymous/Narcotics Anonymous.

Many rehabs will talk about term spirituality in different words and may approach it in different ways.

Some will use the word quite guardedly so as not to alienate people who are atheists or agnostics or simply have a problem with the word God. Other rehabs/treatment centers will be much more specific that this is their approach.

Some rehabs will specifically focus on what they perceive as a Christian or other type of religious model, and effectively advertise themselves as a Christian alcohol and drug rehab or a Jewish alcohol and drug rehab or treatment center.

In all these cases, a rehab/treatment center should say that they will offer each individual a personally prescribed program plan based on their specific circumstances.

They will use the circumstances of the person, be they their religious affiliation or their profession or their gender as a lead in, if you like a selling point for their treatment center.

That may to some extent put people off, but bear in mind that a rehab/treatment center is essentially a business and they are attracting customers.

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Rehab Facilities

Many people view a rehab/treatment center as somewhat of a glorified hotel or five-star resort. This is in part because a rehab/treatment center will most likely be situated in beautiful surroundings, quite often in Florida, with extensive grounds and impressive buildings.

A rehab is first and foremost a business, and at some level needs to have pleasant and functional surroundings. A rehab/treatment center should also have a huge range of facilities, both in terms of different levels of staffing but also in terms of different therapies and activities that are available to people.

It is important to qualify that by saying that a rehab will have a number of very strict rules about people’s admission and behaviour whilst in the rehab.

These can sometimes seem quite oppressive and are designed to create an environment where people’s sole focus is their alcoholism/drug addiction and what they can do to recover from it.

A rehab/treatment center will have or should have a significant number of fully qualified staff. This should include medically trained staff such as doctors, psychiatrists, nurses, councillors, nutritionists, possibly a chiropractor or physiotherapist.

In addition a rehab/treatment center is likely to offer a number of different types of therapies such as yoga/art therapy/mindfulness techniques/Chi Kung etc. The rehab should ensure that the people offering these therapies are fully qualified and have adequate insurance if they are not employed directly by the rehab itself.

Accommodation is likely to be in dual rooms. Most rehabs like people to share a room, although some will offer single rooms as well.

A rehab/treatment center will offer a number of specific programs aimed at the recovery process for people with alcoholism/drug addiction. These programs will include a very detailed timetable, on a daily basis, designed to keep the person both occupied and aware of their illness and treatment.

There’s likely to be a large input of group therapy, either literally as group therapy or simply as group talk.

In addition a rehab/treatment center is most likely to be very proactive in encouraging membership and attendance at 12 step meetings, such as AA/NA/GA/OA etc.

A rehab/treatment center has no formal link whatever with any of these fellowships, but will quite often make use of their literature, and will quite often make it a condition of being in rehab that people attend a certain number of these meetings every week.

AA meetings may be in the local area, or they may even be held on site as well.
There are some rehabs/treatment centers that are not keen on the 12 step model and focus on other aspects of recovery instead.

These are normally referred to as life skills, and may include things such as CBT and other types of problem/solution-based orientation therapy. The website of any treatment center or rehab should make it clear which of these approaches it favours.

It is fair to say that the vast majority of rehabs are pro fellowships such as AA and encourage active membership both during and after time in rehab.

Is a Rehab Expensive?

In short yes, very.

Most rehabs are geared towards being paid by people’s health insurance, rather than private pay and can be comparable in cost to hospital admissions.

A rehab/treatment center is primarily a business, and that should always be remembered in dealing with them, something that is easy to forget because of the therapeutic nature of the work that goes on there. A rehab/treatment center will expect you to stay for a fixed number of weeks, possibly months.

The length of your stay will be decided at the time of admission, and you will be expected to fulfil that. If you choose to leave early, the rehab will probably still book you or your insurance company for the full length of your stay. The cost of your stay in a rehab/treatment center will be made up of different components.

This can include a residential charge, a detox charge, charges for various therapeutic activities etc etc. When applying for admission to a rehab/treatment center check that you are covered by your own insurance or that of your partner if appropriate.

Make sure your insurance company talks to the rehab and that all charges the rehab is likely to levy upon you are covered by your insurance company. If you are expected to co-pay part of it, make sure that is specified and the amount agreed upon.

If you do not have medical insurance, or for any other reason not covered by a type of insurance it is still worth contacting the rehab directly prior to admission. They will have a negotiable scale of charges and may be able to agree a cost with you that is satisfactory.

In addition they might be able to offer some type of financial help by way of referral to a non-profit.

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