Rehabs and treatment centers have long been associated with helping people who have drink problems. The name given to someone who has a drink problem is normally that of an alcoholic, but there are a number of other names floating around as well.
The most common is something like alcohol addiction, a dipsomaniac or someone who abuses alcohol. To be honest, the name is fairly irrelevant, but can be an important issue in helping the person accept and understand that they have a drink problem.
It is often recommended that someone who thinks they have a drink problem should get a formal assessment, either through a primary care giver, or someone who specialises in alcoholism/alcohol addiction.
Whilst this is generally good advice, the problem is that if someone is an alcoholic, they are likely to be in denial of it.
Admission and acceptance of a problem with alcohol normally takes quite a long time, and is normally precipitated by some disaster in the life of a problem drinker.
There is also an awful lot of medical information available as to what constitutes an alcoholic, or alcohol addiction. Again this can be valuable, but more likely for those who are trying to support or help the person with a drink problem, rather than the alcoholic themselves.
There is a saying in Alcoholics Anonymous that if drink this costing you more than money, then you have a problem.
This in many ways is often good enough to get someone to accept they may have a problem, and through seeking help are able to begin to address both the drinking, and any underlying emotional issues that may need to be dealt with.
Not everyone who comes of alcohol will need a detox, but it is probably true to say everyone coming of alcohol should really be assessed as to whether they need one or not.
This assessment can be done when someone enters a rehab, or by a primary physician beforehand.
Any alcohol rehab should have the necessary facilities to undertake a full and thorough medical assessment of whether the individual needs to be detoxed and not, and if they do, then rehab should have the facilities or access to the facilities in order to to be able do this.
Some rehabs will be able to do this on site, others may have arrangements with a local hospital or other clinical facility where it can be done.
This is especially important, as anyone who does need a detox from alcohol addiction needs to have withdrawal symptoms monitored and dealt with appropriately, which can sometimes involve medication.
Addiction treatment programs
These programs are at the heart of what happens in a rehab or treatment center.
When someone is admitted, and after an initial assessment, an individualised program needs to be put in place that covers all or some of the addiction treatment programs that the rehab facility has to offer.
These programs are primarily aimed at helping to begin the process of understanding the underlying emotional and behavioural issues that are part of someone’s alcoholism.
For someone who is an alcoholic, they normally see drinking as being the solution to their problems, not the problem itself.
This means that long-term recovery involves looking at and processing a number of emotionally turbulent issues that have normally fuelled their drinking
For many, this is a lifetime process, but begins in earnest in a rehab or treatment center.
The addiction treatment programs that a rehab offers, are a key element of this, and should be looked at carefully when deciding which to apply to for admission.
The vast majority of rehab and treatment centers utilise the experience of 12 step programs, primarily that of Alcoholics Anonymous. They will do this as part of a person’s treatment program, but also as an introduction to the main source of after-care available.
All 12-step programs have no affiliation with any rehab or treatment center, but local AA groups will normally work closely with any facility.
This can include hosting meetings at the facility itself, local AA members going into the facility to give talks, and local AA members helping to look out for people once they are released from rehab.
In addition, an alcohol rehab is likely to have its own after-care programme.
This is normally intended to bridge the gap between leaving rehab and re-entry to normal life.
Rehab is widely acknowledged as being a bit of a bubble, and this is often seen as being one of its primary benefits.
This bubble allows people to get away from their normal life, it can essentially buy them some time to begin to address the issues that they need to in relation to their drink problem.
It is also recognised that the need to re-enter life after this bubble needs to be addressed early on in treatment as well, and as such the after-care process becomes an important element early on in the treatment.
The after-care arrangements that the rehab makes itself can vary. It normally includes a regular meeting, quite often monthly, which ex-residents can attend and talk about their experiences.
These meetings can also be done online, and there’s quite often an annual social event, such as a barbecue, to which all ex-residents are normally invited.
Some rehabs will also offer to residents the opportunity to contact staff at the center once they have left, if they feel the need to talk to someone about any specific issues that may arise.
An intervention usually takes place when it is believed the situation is so serious that there is nothing else that can be done. The process is usually instigated by family or friends of the person who has an alcohol or drug problem. The nature of an intervention can vary quite a lot, but there are normally some common elements.
People who perform interventions take great pains to stress they should not be confrontational. The intent is to show the person the extent to which that addiction or alcoholism is real. This is done through family and friends sharing, writing letters, showing photographs etc. The individual concerned then understands the nature of the problem, and is willing to seek help to get better.
This type of scenario sounds very plausible, but there are some problems with it.
Anyone who is an alcoholic will have a particular mindset about their drinking.One element will be a belief system that alcohol is the only thing that is holding them together. It is likely this belief system will get deeper the worse things get, both internally and externally.
This is something that is very difficult for someone who is not an alcoholic to understand.
The complexity of active alcoholism and drug addiction means that trying to help someone can be quite difficult. It is a bit of a cliche, but still true, to say that the person needs to accept that they have a problem and that they need help. What is even more true is that that acknowledgement has to come from within them.
An alcoholic or drug addict will have a completely different view of how they need to use alcohol or drugs than someone who is not an alcoholic or an addict.
The dangers of an intervention
Whilst that are some scenarios where an intervention possibly could be justified, on the whole the process is fraught with danger. The person that the intervention is focused on is likely to feel cornered, possibly trapped and certainly under a great deal of pressure. They may give in to this pressure and agree they need help. They may go into rehab, and they may get sober.
There is an underlying issue that will be hugely important, but will possibly go unnoticed for a long period of time. That is that they did not make the decision for themselves that they had a problem and needed help. The decision was effectively made for them by other people, and they essentially went along with it.
The significance of this cannot be overstated. Any long-term recovery has to be rooted in a gut level feeling that they cannot do it any more. It is an internal dynamic that has to be genuine and authentic. Whatever horrors may be presented to them by way of evidence from family and friends, this evidence it only likely to make them feel worse.
An intervention is not a reality check. It is a process advocated by people who feel there is nothing more they can do, and something has to be done to force a situation to change. The real danger is that this presented as an opportunity for an alcoholic to get better. What it does in reality is tear down a mask that someone has put up to keep themselves safe.
It is a cardinal rule of all types of psychology, that people who use masks to defend themselves have to be able to take them down from within. Tearing them down from the outside can be cruel and callous. For an alcoholic or drug addict, it seems more complex because the mask itself is so destructive. The reality is the same however.
However tempting an intervention may seem, the solution that offers is normally an illusion. The desire for recovery has to come from within, not be forced on someone by outside pressure.
With quite literally thousands of rehabs to choose from, deciding which one to choose can be quite a daunting process.
The majority of rehabs in the US will offer quite similar addiction treatment programs, the majority of which will be rooted in the 12 Step program of Alcoholics Anonymous.
Some people will want to go into a rehab close to where they live, others will want to go to a rehab as far away as possible, either in another state or in another country completely.
Some people believe that a complete change of scenery and location can help someone in their early days of recovery, others believe they should confront their issues in a more known and local environment.
This means that the choice of rehab can literally be a worldwide one for everyone.
Very few rehabs will advertise any type of success rate, although some will talk of a percentage rate of completion. These are two very different things.
A rate of completion is simply the number of people who complete their course of treatment, which is normally 28/30 days, although in some cases this can be longer.
The reality of recovery from alcoholism and addiction is that it is a tricky road for most people, and no one really knows how many people make it in the long run.
Some rehabs will keep in touch with as many of their ‘alumni’ as possible, but very few if any will talk of a success rate. Recovery is a long-term process, often taking many years to embed in the individual.
A stay in rehab is relatively short, and is seen by most people as initially breaking the cycle of alcoholism and addiction, and laying the foundations for long-term recovery.
There are however a number of factors can that be used to determine how effective a rehab treatment center is likely to be, and all the information required should be available via the rehab’s website.
Wherever you are looking in terms of location, there are likely to be a number of legal requirements for any type of clinical facility that is offering addiction treatment programs.
It is well worth checking what these are, and making sure that the rehab adheres to them. If in doubt ask the rehab itself.
If they are at all reluctant to help, it may be an indication to move on and find somewhere else.
As already stated, for many people location is an important issue. Within the geographical area make sure that the facility itself is an attractive and comfortable place for a short-term stay.
Some rehabs will offer single accommodation, others will insist on sharing a room and facilities as part of the recovery process.
Also make sure there is plenty of outdoor space, ideally near water, as this can be very therapeutic for a number of people who need time to have a break from the intensity of the rehab itself.
All rehabs will employ a wide variety of staff, both clinical and administrative.
Clinical/ therapeutic staff can/should include a medical doctor, nurses, psychiatrists / psychologists, therapists, yoga teachers, tai chi teachers, reflexology practitioners, acupuncture practitioners, art therapy practitioners, meditation practitioners, politicians, nutritionists, social workers, transitional living workers, and priests/rabbis.
Obviously this is a wide range of differing staff, but should give a fairly good indication of the facilities that the rehab offers as well. In addition to the numbers and types of staff, it is worth checking the qualifications and experience of the most senior staff available and their experience of addiction and alcoholism.
All rehabs should have their own clinical facilities and staff that allow them to assess at the outset of treatment whether a medical detox is needed or not for any individual entering the treatment center.
If they do not have such facilities, then they should have access to a local clinical facility such as a hospital, who can make this assessment for them.
This is a crucial element of any rehab or treatment center, because of the necessity to assess the need for a detox for anyone coming off alcoholism/drug addiction.
Most rehabs do not advertise how much they charge, but it is probably fair to estimate a charge of between US$ 28,000 / $35000 for a 28 day stay in most treatment centres in the USA.
It should be noted that there are a number that describe themselves as luxury rehabs that can easily charge three or four times this amount.
Most of this cost is normally covered by insurance, but there are one or two things to be aware of.
Many insurance companies will agree to cover the cost of rehab, but will sometimes review this on a weekly basis while the individual is in treatment.
This means that they could withdraw cover at any point during the individuals stay in rehab if they deem it not necessary any longer.
Also be aware that some rehabs offer loans to help pay for the cost of their treatment, especially if the individual does not have insurance, or their insurance plan does not cover rehab treatment.
This can end up being very expensive indeed, and is an option that should probably be avoided if at all possible.
Addiction Treatment Programs
Most treatment programs should begin with an assessment of need for a medical detox as referred to above.
Most rehabs will base their addiction treatment programs around the first five steps of the Alcoholics Anonymous program.
Some will be slightly more specialised, and based around certain steps such as step one, or steps three and 11.
There is also likely to be a significant amount of personal therapy/counselling done, either on a one-to-one basis or in group. Some rehabs also offer specialised therapy such as CBT/EMDRA
Most treatment centers will also encourage, sometimes insist, that individuals attend meetings of Alcoholics Anonymous or Narcotics Anonymous whilst in treatment.
These may sometimes be held on site, by local groups or in the locality where the treatment center is based.
A number of rehabs will also offer so-called alternative therapies, which are recognised by the therapists listed above.
They may also include things such as adventure programs which can be things such as white water rafting, hill or rock climbing or equine therapy.
A rehab’s approach to what happens when someone leaves rehab is almost as important as what happens to them when they are in treatment.
It is generally recognised that a rehab is something of a bubble, almost intentionally, that takes the individual out of their normal environment to provide a safe place allowing them to lay the foundations for their recovery.
Like all bubbles, a return to normality has to be thought through and carefully planned.
Thus a rehab should from day one lay the foundations for being able to integrate what happens in rehab back into the individuals normal life once they have returned to their home and family.
Most rehabs will encourage continued attendance at meetings of Alcoholics Anonymous, and in addition could have their own regular meetings, normally monthly, that are open to any residents or former residents to attend if they so wish.
Former residents are normally referred to as alumni and are encouraged to return to the treatment center, both for their own good and as examples to current residents.
Sober Living / Transitional Living
Some rehabs will have links to what are referred to as sober living or transitional living houses.
These are normally long-term shared houses, normally under some type of supervision, where people in early recovery can live together, and stabilise their own lives once sober.
This is an option foro some people who need an additional degree of stability around where to live and what do for work once they have finished treatment.
Many people have heard the phrase ” going into rehab” or simply the phrase ‘rehab’ itself, but are unclear about what it means or what is really involved with it.
A rehab is essentially a clinical institution, in the same way that a hospital is a clinical institution, but one that deals purely with different types of addiction.
There are other significant differences between hospitals and rehabs which are explained further on.
Traditionally, a rehab would deal with people who were alcoholics, or who had a serious drink problem, even if they were unaware of what alcoholism was or whether or not they were alcoholics.
As time went on, rehabs realised that they could treat people who had other addictions as well, namely addictions relation to drug abuse, gambling, food, sex etc.
Rehabs and treatment centers realised that their approach to recovery meant they focused mainly on the individual and their internal triggers, and as such could apply the process to anyone who had any type of addiction at all.
With this overall approach to addiction, some people and some rehabs felt their message was a bit blurred, and started describing themselves as alcohol rehabs or drug rehabs or alcohol and drug rehabs.
Other treatment centers found this approach unnecessary, but it has meant that sometimes there has to be a distinction as to what an alcohol and drug rehab is.
The reality is that the majority of rehabs will focus on alcohol and drug addiction, and the majority of people entering a rehab will be doing so for the same reasons.
There is one proviso relating to rehabs offer treatment programs for drug addiction specifically. They will often enlist the specific types of drug addiction they have expertise in, and this may be of some value to people.
Not necessarily in terms of the addiction treatment programs that they offer, but much more in that knowledge of and treatment facilities they have for any detox or withdrawal program that may be necessary at the start of their recovery.
Rehabs and Hospitals
Describing a rehab as a clinical environment is an important element of its institutional nature, but it is also important to clarify what that means.
It simply means that the rehab will have clinical staff as part of its overall recovery team.
They will have specific clinical functions within the team. It normally applies to doctors, nurses, psychologists, therapists etc.
These clinical staff will have very specific roles in a professional capacity, relating either to any detox program in place at the beginning of the treatment program, or a role in the addiction treatment program itself.
In most other respects, a rehab is very unlike a hospital. Most rehabs are more like country clubs, and make a serious effort to provide a gentle and soothing environment within which an individual can begin the process of recovery.
Depending upon the rehab, the country club type approach will vary considerably in terms of its rules and regulations.
Some rehabs make a big point of incredibly rigid regulations about every aspect of the individual’s life whilst there, largely as a way of providing structure, which they believe helps aid recovery.
Other rehabs take a very different approach, believing that giving an individual freedom to be themselves as part of their recovery process is an integral part of them being able to find recovery in the first place.
Very few treatment centers will actually declare themselves as non-12-step based, but many will offer alternative programs that are designed to help people deal with alcoholism and addiction, but which use no part of a 12 step program in their recovery.
Sometimes this is because these rehabs believe the 12 step model is in some way flawed, and other times because they know there is a market for people who are apprehensive about what is perceived as a religious/spiritual approach to recovery.
The majority of treatment centers and rehabs base their addiction treatment programs around some elements of the AA 12 step model of recovery.
Historically, what most of them have done is to take the principles of the first five steps, and modify or change them to their own requirements, yet still present them as being part of the AA recovery approach.
This approach does inevitably lead to some confusion, especially for the individuals undergoing treatment, who believe they have gone through the AA approach to recovery, when in fact they have gone through a different version of it.
Traditional 12 Step Rehabs
A number of people believe that the real value of most treatment centers and rehabs is twofold.
Firstly they provide a physically safe environment for people to begin to deal with their alcoholism and addiction, that is out of their normal life, and as such away from pressures that they associate with their drinking.
In this environment, it is believed that it is easier for people to begin to comprehend the enormity of what they are dealing with, and lay the foundations for their recovery.
The second value that people associate with treatment centers is that most of them will introduce people to the actual reality of Alcoholics Anonymous, both in terms of the treatment centers approach to 12 step recovery, and an introduction to actual meetings of AA, either on site or in the local community.
It is believed that if individuals in recovery are exposed to AA early on, then it is more likely they will make AA a part of their recovery process, both whilst in treatment and once they have left.
The above is a slightly simplistic approach to the effect that rehabs and treatment centers can have on people, but is probably a fairly good basic guide to the 12 step model that is often used in this type of recovery.
12 Step Programs
12 step programs inevitably apply to the principles used in Alcoholics Anonymous, and a wide range of other fellowships/organisations that have borrowed this approach, and applied it to their own recovery needs around different addictions.
Whilst there is a significant amount of experience, both current and historical, that this 12 step approach can be hugely beneficial for a lot of people, there are also a significant number of critics of this approach, for different reasons.
Without going into the debate itself, it is fair to say that a number of people on both sides tend to get quite fundamentalist about it, and inevitably distort many of the actual issues themselves.
When someone is looking for help to deal with an alcohol or drug problem, it is probably not that helpful to get involved in this debate itself.
There are however a significant number of people who have already decided that they don’t want anything to do with a 12 step program, and such seek some type of recovery that does not include it.
Non 12 Step Recovery
Any type of recovery that begins with the premise that it is not something else is perhaps slightly suspect, but is perfectly valid in the sense of trying to help people who are heading in a particular direction.
There are a number of treatment centers whose programs tend to be focused around a more holistic approach, the word holistic implying a rounded approach to recovery.
This approach will often include a number of different areas of help, including diet, yoga, meditation, therapy, exercise etc.
All these areas of recovery can be extremely helpful, if practiced professionally and correctly, and which in theory can benefit anyone, whether they are in recovery or not.
Whilst this type of recovery can be beneficial to anyone, it is more debatable whether it can genuinely help shift the nature of someone’s alcoholism and addiction.
Often in all types of medicine and approaches to illness and recovery, the phrase clinical evidence or evidence-based research is used to verify a particular type of treatment or not.
The intent is to make sure that any treatment for any illness is based on actual evidence and proof that the treatment works, and that such proof can be validated in clinical terms.
With regard to alcoholism and addiction this is very difficult, if not impossible to do.
AA itself keeps no records of membership, or any type of records about so-called success rate in terms of sobriety.
As such we can simply do not know how effective it is, in terms of short-term and long-term success rates
The same applies to virtually all treatment centres and non-step approaches to recovery.
Some rehabs will talk about a success rate in terms of percentages, but they are normally meaning how many people have actually physically stayed and completed their recovery program.
As such, assessing the most suitable approach to treatment can be quite a difficult thing.
Many people will simply go with the accepted wisdom of our age that Alcoholics Anonymous, and rehabs and treatment centers based program around it, offer the best hope of recovery.
There are others who are for whatever reason are ideologically opposed to the whole idea of 12-step recovery, and will look for any type of alternative recovery available.
Spirit of Recovery
The spirit of the early members of AA was very open in that they believed they did not have a monopoly on recovery, and genuinly encouraged people to try alternatives if they were not able to adhere to the principles of the AA program itself for any reason.
This was an authentic approach to recovery. These people knew that they had something that worked, but were also humble enough to know that there may well be other ways for people to heal their alcoholism and addiction as well.
The spirit of openness and looking for help whenever it may be has probably become much more marginalised in the recovery world today, where the different approaches to recovery have become more driven by ideology, rather than simply being driven by need.
Buddhism and the Smart Recovery Program are two good examples of this.
A rehab or treatment center should employ a wide range of different health care professionals, who have extensive clinical experience in dealing with alcoholism and addiction.
If the rehab is basing some of its therapeutic treatments on the twelve step progarm of Alcoholics Anonymous, then it is usually helpful if some of the staff are in recovery themselves, often having been in rehab themselves at some point.
This assessment of clinical staffing levels should relate to number of staff, different disciplines, qualifications and experience.
This information should be available on the rehab’s website, along with inforemation about availability of medical staff (should be 24/7) and regularity of therapy / conselling sessions etc.
Below is a list of the main types of clinical and therapeutic staff normally employed in a rehab. In addition a rehab should employ a number of well trained admin staff who can help the client through the often complicated admissions and insurance verification process.
Therapists / Counsellors
Chi Kung / Tai Chi Teachers
Art Therapy Practitioners
Meditation / Mindfulness Practitioners
Transitional Living Worker
Traditionally, a rehab program or treatment center would help treat people through two specific routes.The first would be a medical detox if needed, followed by a fairly intensive therapeutic process based around the first five steps of the twelve step program of Alcoholics Anonymous.
This would mainly be done in a mix of group discussion, group therapy and personal one to one therapy, with some life skills work done as well, under the supervision of qualified clinical staff.This has evolved into an environment where rehabs can offer a bewildering display of what they refer to as rehab programs.A selection of these programs is listed below !
This can be extremely confusing to people researching a rehab, both in terms of what the program is, and how effective it is.Part of the way through this is to have a general undertsnading of how rehabs work, visit the website of any rehab that interests you and see what programs they offer by way of treatment.These programs are sometimes referred to as therapeutic modalities.
If it is not clear what a particular program means, ring or email them and ask them. Also ask them whether the program is evidenced based, in terms of its effectiveness. This really means, is it based on current or ongoing clinical research.
Bear in mind also that the rehab industry is highly competitive and very lucrative, and some rehabs will offer exotic sounding therapies in order to attract business, ie you!Whilst these therapies might be fun, it is often questionable how effective they are in helping deal with alcoholism and drug addiction.
After Care Programs
Behaviour Modification Therapy
Body Image Therapy
Cognitive Behavioral Therapy
Creative Art Therapies
DBT – The Stages of Change
Dialectical Behavioral Therapy
Drug Primary Treatment
Educational & Experiential Group
Emotional Freedom Technique
Equine Assisted Therapy
Group & Individual Therapy
Herbal / Homeopathic / Naturopathic medicine
Hyperbaric Oxygen Therapy
Individual Consultations with Registered Dietitian
Intensive Continuing Care Planning
Life & Career Skills Planning
Meal Planning & Preparation
Mindsight and Interpersonal Neurobiology
Neuro Feedback (Bio Feedback)
Physical Fitness Therapy
Relapse Prevention Therapy
Relationship Building Activities
Somatic Experiencing (Trauma)
Spirituality & Yoga Therapy
Systemic or Strategic Addiction Family Therapy
Therapeutic Restaurant Outings
Thought Field Therapy
Vivitrol Treatment for Opiate Addiction
Wilderness survival programs
12 Step Groups
Long Stay Programs
Early Recovery Skills
Relapse Prevention Skills
Social Support in Recovery
Most rehabs will offer to treat addiction to alcohol and a wide range of drugs, as well as possibly other addictions. The website of the rehab should list the names of the drugs that it offers treatment for the addiction to.
It is likely that the recovery process in the rehab will focus on the individual themselves and their underlying emotional drives, rather than on a specific addiction to a specific drug.
What is really important in this context is the detox process. Anyone entering a rehab who has has been or is addicted to any type of drug, prescribed or not, needs to be assessed by a clinical team to see if a medical detox is needed or not.
For this reason it is important to know if the rehab offers a program for recovery from the specific drug or drugs that the individual is or has been addicted to. This information should be available on the rehabs website. If not , it should be established during the admissions enquiry.
Below is a list of the most common types of drugs that a rehab will offer help with.
Spice / K2
Rehabs are probably best know for dealing with two types of addiction, people who are addicted to alcohol, alcoholics, and people who are addicted to drugs, either prescribed or not. People who are addicted to both alcohol and drugs are commonly referred to as dual addicted.
Some rehabs have broadened their scope of what they say addiction means, and offer treatment for a wide variety of addictions, some of which are listed below.
The rehab will take an approach that the individual is what they call an addictive personality, and use the particular addiction as a trigger.
This approach has allowed some rehabs to broaden their scope of who they treat enormously, which has many implications from a business point of view, and has rasied many ethical questions about what addiction really is and what it means, and whether or not some rehabs exploit that.
Alcohol Addiction / Abuse
Bath Salts Abuse
Most rehabs recommend, and most people follow, that anyone entering rehab goes to one that is a significant distance away from where they live, either in another state or in another country.
The logic behind this is that rehab is something of a bubble for a period of time, and it is better for the client / patient to be in this bubble away from their normal environment, home, family, work etc.
As a rehab is a clinical facility, and should oversee any medical detox and therapeutic work that needs doing, it is crucially important that you check the local accreditation and licensing requirements for where the rehab is located, and make sure the rehab fully complies.
This is a state by state list in the US where these requirements can be checked
People who ask or talk about rehab facilities often do so with a understandable but misguided idea that rehab is are a mix between an upmarket hotel and a country club, a sort of retreat with varying degrees of comfort or opportunities.
The reality is that rehabs differ widely in terms of the facilities that they offer to people, and that approach as to how the environment and addiction treatment programs should be offered to any individual who enters an inpatient rehab.
Traditionally, a rehab would treat someone who was an alcoholic or had a problem with alcohol, and their time spent in a rehab would consist of a medical detox if needed, followed by a period of different types of therapeutic treatment, often a mix of 12-step program ideas and meetings of Alcoholics Anonymous.
There would be a need some type of clinical facility, along with a modicum of comfort and very basic facilities.
The rise of treatment centers and rehabs has meant the growth of this industry, and a white approach that can differ considerably.
The initiators of the treatment center industry tried to strike a balance between providing an environment where the alcoholic could feel safe and secure, along with facilities treated them as someone who was trying to get well, rather than as a bad person.
At the same time, there was a belief that treatment centers and rehabs needed to be a fairly structured environment, and should be designed to focus the individual fully on their recovery process.
Rehabs and treatment centers take a number of different approaches. Some believe that a rehab should be a fairly spartan place, with very basic facilities and an entirely structured timetable from morning till night.
Some rehabs believe in an incredibly tight grip on what the individual can bring into rehab, and what they can and cannot do whilst there.
This can seem incredibly regulated some people, inevitably attracting some and alienating others.
There has been a growth in recent years of what can be termed luxury rehabs, which take almost an extreme opposite view. They believe that a rehab should essentially be the most serious and pleasant environment that someone can spend their time in, and that this is conducive to aiding in their recovery.
Both these approaches are somewhat of the extreme, and inevitably there are a wide number of different approaches in between.
There is no right and wrong approach to recovery, and every individual should approach a rehab based on what they feel is most appropriate to them.
The rehab facilities that are available should be outlined on the rehabs website, and rehab should be open to discussing what these facilities are, and how they help a client in their 12 step recovery.
The nature of alcoholic treatment can be detailed in certain ways, but should always be fully understood that there are a number of variables that determine whether any form of addiction treatment programs will actually work or not.
Probably the most proven method of treatment for an alcoholic is effected through the organisation Alcoholics Anonymous, and its 12-step program of recovery.
There has also grown a huge industry of treatment centres and rehabs which offer a wide range of varying treatment programs for an alcoholic, normally residential, and normally for a period of around 28/30 days.
One of the main issues concerning any type of treatment for an alcoholic relates to what is commonly referred to as the self delusion of the alcoholic themselves.
This normally refers to the nature of an alcoholic themselves, in terms of emotional and mental character, and the nature of how they relate to alcohol itself.
There are a number of different interpretations of what being an alcoholic means, and how alcoholism itself manifests within different people.
They are also a number of common features of alcoholism and alcoholics, which allow people to relate to each other at a particular level, and can help in terms of enabling people who are alcoholics to get a measure of stability and stay sober.
An alcoholic treatment program, whether it be in a rehab or treatment center, will need to address a number of highly sensitive areas, one of which will be the relationship between the alcoholic and alcohol itself.
It is probably fair to say, that at some point in their drinking, an alcoholic will come to see alcohol as being the solution to their problems, rather than the problem itself. This may happen at the beginning of their drinking, or maybe an element of the progressive nature of their drinking, Becoming the only type of reality they are able to understand towards the end.
This sense that alcohol becomes the only thing that is holding them together is perhaps unique to alcoholics, and is one of the hardest things for anyone outside of that circle to either understand or be able to deal with.
What is important, is that there is a safe environment created that allows an alcoholic to begin the process of feeling safe enough to dismantle the various emotional coping mechanisms that they have erected in order to keep themselves safe. This can include a variety of emotional survival skills as well as the main coping mechanism, alcohol itself.
Recovery from alcoholism can in some ways be as difficult to understand at the nature of alcoholism itself when someone is drinking as a full-blown alcoholic.
This in part is because recovery from alcoholism for most people is not simply about stopping drinking.
Stopping drinking is an essential and crucial part of the process, but for many people who intend to stay sober long-term, there is a real need to address and deal with a variety of underlying emotional and mental drives that have fuelled by drinking in the first place.
Many people will often talk about the issue of willpower in connection to either their drinking, that ability to stop drinking, and their ability to get sober or stay sober, or as a reference to an individual’s self will and the ability to seemingly force their life to happen.
Much of this can really refer to a distorted understanding of willpower, self well and alcoholism itself.
For anyone who is an active alcoholic, the issue of willpower often does not simply arise.
The reason for this, is that there are many alcoholics who simply do not wish to stop drinking, and never do or never try to.
This is not because they are oblivious to the reality of what their drinking is doing to them, but because the nature of that alcoholism in someway turns them in would, and makes them believe that however bad the lifers either internally or externally, alcohol becomes the only thing that matters, and the only thing that is actually holding them together.
In those cases, will power does not refer to an individual’s desire to stop drinking.Willpower is more likely to be seen in how an alcoholic will try their life board in order to allow them to keep drinking, and somehow seemingly hold themselves or their lives together, however precariously.
This sense of trying to force life to happen, regardless of the reality of how that life presents itself, is often a key characteristic of alcoholism. It is often referred to as self will, which is one expression of this type of enormous energy that somehow can manifest itself in a drive to create and living what in today’s jargon is referred to as a virtual reality.
Alcohol abuse is a term that is often used amongst many others, such as alcohol dependency, when people are in some senses either trying to avoid using the word alcoholism, or when people are quite significantly opposed to the idea of alcoholism being a progressive illness.
In some ways, the terminology itself does not really matter.
People debate the nature of alcoholism, whether or not it is an illness, and whether or not a rehab or treatment center is the best option, whether people should or should not use Alcoholics Anonymous etc.
Whilst all of these are valid questions and debates in their own right, the reality is that someone has a drink problem it should be owned as such, either by the individual themselves if they are able, or by family members, or by an employer or friends.
If the fact that the person has a drink problem can be owned, that Lisa is a process set in motion whereby the nature of the problem is identified, whatever the terminology.
Once a problem has been to some extent owned, then at least a search some type of solution will move forward.
If the debate stays around terminology, be it alcoholism, alcohol abuse, binge drinking, Alcoholics Anonymous, then quite literally the person may never get the proper help and treatment that they need.
There is a much greater sense that if people are open to the reality of their lives, then they can see over time clearly the nature of the problem and of the solution.
Alcohol abuse may relate to either active alcoholism, heavy drinking at a sustained level, periods of binge drinking or simply a long-term decline in an individual’s sense of motivation and purpose about the life.
Getting an individual to relate to the fact and understand the fact that they have a problem with alcohol is obviously the most difficult and pressing challenge.
If someone is an alcoholic or has a serious alcohol addiction and / or alcohol abuse there is a fair chance that at some point they have moved that locus of control from within themselves to alcohol.
At this point they are likely to see alcohol as being the solution to their problems, rather than the problem itself.
It is this viewpoint that is the most damaging to both themselves and their own lives, and is without doubt the most difficult barrier to get the the person to lower and seek help.
An alcohol rehab, which can also be referred to as a treatment center, is possibly thought of as a more traditional type of rehab, as when rehabs and treatment centers began to emerge as a way of treating alcoholics, they tended to deal with alcohol only, and as such are often referred to as alcohol rehabs.
Nowadays, anyone seeking help for a problem with alcoholism or alcohol dependency is likely to look at several routes, the most common ones being either going straight to meetings of Alcoholics Anonymous, or entering a residential treatment center rehab for a period of time, normally about 28 days, where the recovery process will involve a wide range of addiction treatment programs.
Anyone entering a rehab or treatment center is likely to soon be enveloped in the world of 12 Recovery, and specifically in the principles and meetings of Alcoholics Anonymous.
It is important to be really clear that the organisation Alcoholics Anonymous itself has no connection whatever with any rehab treatment center anywhere.
There are however a wide number of informal connections can often overlap, that can sometimes seem bordering on a degree of enmeshment.
ALCOHOL REHAB ALCOHOLICS ANONYMOUS
This degree of cooperation between the majority of treatment centres and Alcoholics Anonymous can be broken down into a couple of areas.
The majority of rehabs and treatment centres that offer addiction treatment programs based these programs on some of the principles of the 12 step program of Alcoholics Anonymous.
In reality these addiction treatment programs normally quite different in content to the specific cost program of Alcoholics Anonymous, but are often presented as being the same thing.
They are in fact normally quite different, but again do overlap in terms of referring to specific steps, even if the work involved in a specific step is quite different.
The other way treatment centres and alcohol rehabs overlap with alcoholics anonymous is at a number of treatment centers will physically host AA meetings at their venue, and residents in the alcohol rehab will be expected to attend these meetings.
Where this happens it is normally made fairly clear that the a meeting is completely independent of the rehab, and is simply hiring venue in the same way that it hides venues such as church halls. AA
Anyone entering a rehab or a treatment center is likely to come across the term dual diagnosis, as well as a lot of other jargon or terms that are fairly unique or specific to the whole world of 12-step recovery.
Perhaps the term jargon is a bit unfair, but there are certainly a wide range of terms that have some meaning, but can also be used to making them sound more important or more severe as they are.
The term dual diagnosis is normally used to refer to someone who is both an alcoholic, or who has a problem with alcohol, and also has a problem with drugs, narcotics or prescription drugs.
This broadening of the definition of an addict, from alcohol to include drugs, has come about through the growth of treatment centres, and the addiction treatment programs that they offer as a way of helping residents.
A rehab will tend to look at the issue of addiction in a slightly different way than perhaps people who do not work in the field will do, and there are pluses and minuses in this approach.
REHAB DUAL DIAGNOSIS
The majority of rehabs and treatment centers initially dealt with people who had a problem with alcohol, and could safely be described as alcoholics or alcohol dependent.
As the industry grew, it became clear that people who were entering a rehab because of an alcohol problem also had other problems such as drugs, gambling etc.
Rehabs and treatment centres started to invert this process, whereby they began to see the problem as the individual, and the addiction as a symptom of their problem.
This in many ways allowed a rehab in much broader range of client base, but also slightly distorted the real nature of an individual’s alcoholism and other types of addiction.
The value of the term dual diagnosis is often hard to verify, except say that it can flag up an individual has a problem with the hottest drugs or prescription drugs as well as alcohol.
There is a practical issue to this which is hugely important, which is knowing I have individual has a dual diagnosis can seriously affect the assessment, or the need for a medical detox, and that should be carefully monitored and accurately assess both prior to admission and during a treatment undertaken that after.
There tends to be a belief that anyone who needs a type of treatment for alcoholism or any other type of addiction needs to enter a residential rehab in order to get better and get the help they need to either stop drinking or using the substance that is causing them so much grief.
It is certainly true, that a rehab is quite often seen as the first port of call for anyone who has a problem with alcohol or drugs and needs help or treatment.
However there are many other sources of help available, either through voluntary 12-step organisations such as Alcoholics Anonymous and Narcotics Anonymous, or through a variety of daycare and even care type treatment programs that are non-residential.
It is important to recognise that a stay in a residential rehab can have some advantages for people, but there are also disadvantages.
The main advantage and disadvantage actually tends to be the same thing, the fact that a residential rehab is in effect a bubble that can take people out of their normal life for a period of time, normally a month or so, whilst their treatment programs begins and moves forward.
Rehab and Treatment
The advantage of a rehab being a bit of a bubble is that it can isolate the individual from the pressures that are external that are part of the life, and give them a space that should be safe, that should allow them and opportunity to begin to process the underlying emotional drives that will have fuelled their drinking and their addiction.
There is no doubt that for many people the idea of a residential rehab can seem an attractive option, although the reality camp I’d often be a different experience in terms of a sense of rigidity and tight time and people management.
The significant disadvantage of a rehab is also the fact that it is a bit of a bubble, potentially.
This means that when the recovery period in a rehab or treatment center has finished, then the individual asked to return to a normal life, and integrate the experience that they have had in a rehab or treatment center back into their normal life.
This can obviously be a challenge, although in reality using meetings and the organisations of Alcoholics Anonymous and Narcotics Anonymous can effectively bridge that gap back into so-called normal life.
Anyone who enters a rehab is unlikely to very quickly become familiar with the term 12-step work, and the idea of concept of a 12 step program as practice and experienced by members of Alcoholics Anonymous and other tall step organisations.
The phrase 12 step work has a slightly different meaning in organisations such as Alcoholics Anonymous.
In that context it tends to refer to people who reach out and are available to help people who are new to the organisation, and who have asked for help in either attending meetings or talking to someone about the fact that they think they may have a drink problem and need some help with it.
In a rehab, the phrase 12 step work is more likely to refer to one or more of the therapeutic programs or addiction treatment programs that a rehab is likely to offer as part of its treatment methodology in relation to alcoholism and addiction.
In addition, the majority of rehabs tend to either endorse and embrace organisations such as Alcoholics Anonymous and Narcotics Anonymous, and actively promote the concept of a 12 step recovery program both inside and outside of the rehab.
A rehab is likely to have a number of different types of therapeutic help available, and it may have some type of self styled 12-step program as well.
REHAB and 12 STEP WORK
This may simply be a focus on step one of a program, the admission of being powerless over alcohol or some other substance.
Alternatively the rehab may have a deeper road into the recovery process, and spend more time on other parts of the 12-step program such as an understanding of a spiritual path, the nature and practice of doing an inventory on oneself, and generally becoming more willing to open up and share with other people is going on in the individual’s life.
It is worth making the point that the majority of rehabs offer any type of 12-step program all work as part of their ailing addiction recovery programs will be using an interpretation of the 12 step program of Alcoholics Anonymous that is different to the actual 12-step program of AA itself.
This is an important distinction, but one that many people understandably find it bit confusing.
The significance is simply that upon leaving rehab, the majority of rehabs will advise people to attend meetings of Alcoholics Anonymous, where they can gain a fuller understanding and actual appreciation of what AA’s program of recovery action involves.
Alcohol treatment will be a process designed for anyone who recognises or comes to recognise that they have a problem with alcohol, and are often referred to as alcoholics or people who have alcohol addiction problems.
The nature of alcoholism and alcohol addiction can sometimes be endlessly debated, but in reality the basis for acknowledging there is a problem and what treatment options may be available should be based on the experience and behaviour of the individual, not any academic interpretation of what alcoholism or alcohol addiction may be.
The notion of alcoholism as an illness, now widely accepted in medical circles, was born out of the experience of many doctors and early members of Alcoholics Anonymous, who recognised the abnormal craving and compulsion of people drinking, drinking which was essentially out of their mental control.
In the big book of Alcoholics Anonymous, the point is made that alcohol will have a different effect on someone who is an alcoholic, to someone who is not an alcoholic.
The comparison to an individual having an allergy is used, a comparison that some people find helpful and others find slightly confusing.
The important thing to realise is that at some level and for some reason an alcoholic drink differently to someone who is not an alcoholic, even a heavy drinker who may externally show some of the same characteristics and behaviour is that of an alcoholic.
Alcohol can be a part of many people’s lives, and may even be a problem in some people’s lives at certain points of their life.
Trying to define an alcoholic, or someone who has an alcohol addiction can be a very difficult and time-consuming process.
There are many people especially in the youth who might exhibit problems associated with alcohol, but who will in effect grow out of them.
There are other people of exactly the same age who may drink the same and exhibit similar behaviours and experiences who are in reality alcoholics but have not yet come to realise it.
Alcohol treatment can come in many forms, ranging from residential rehab addiction programs, through to 12 step programs such as Alcoholics Anonymous, through to medical detox, through to an individual simply abstaining.
It is sometimes surprising to people that the word alcohol only appears once in the 12 step program of Alcoholics Anonymous, given that this program is regarded as the main recovery tool in the field of alcoholism and addiction work.
It is something of a paradox, that it is a realisation of powerlessness and alcohol triggers a willingness to move in a different direction internally, and create a world that is based on a reality of real-life, rather than a fantasy world that an active alcoholic can live and feel safe in.
Any reading of the 12 step program of Alcoholics Anonymous will give people an understanding of the process, even if the enormity of what it means in reality can only really be understood by someone having an experience of the order that working through the 12 steps tends to produce.
An admission of being powerless over alcohol should not be taken as an admission that is not true.
The wording of step one in the 12 step program is designed to be read as a statement of experience, not as a belief system or as a guide, or as advice to other people as to what they should or should not do.
The early members of Alcoholics Anonymous were very clear that they felt they had a solution that works for them, and they were very happy to share that solution we are the people who felt that they had a similar problem.
The early members of AA also very clear that they would not force and did not want to force this solution on anyone either did not want it, or who felt they could solve their alcohol problem in their own way, or who could drink, even quite heavily, and yet somehow manage it themselves or keep it under control themselves.
It is probably inevitable that people have lost sight of this principle that th this 12-step program is a statement of experience, and should be regarded as a source of freedom, rather than a source of either trapping people or forcing people into believing things that are not true.