What are the rehabilitation processes?

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The rehabilitation processes aim at helping an individual recover from the effects of an addiction as much as possible. Rehabilitation emphasises the management of a disease rather than treatment. 

The therapist acts as a facilitator in the recovery process rather than a "doer." In contrast, the patient takes an active role in achieving sobriety.  

Rehabilitation processes vary depending on the needs of the individual. It also depends on the type and severity of the addiction.

For instance, patients with co-occurring disorders may have to attend an intensive inpatient care for a long duration so that their needs can be effectively met.  

Alcohol or drug addiction treatment includes rehabilitation services such as detox, behavioural therapies, plus other forms of therapy. 

 The rehabilitation goals in drug abuse treatment include: 

  • Rectifying the drug-seeking behaviour. 
  • Instil suitable coping mechanisms. 
  • Teach essential relapse prevention skills. 

National Statistics between 2019 and 2020 from Public Health England show that the number of people seeking rehabilitation services have stabilized [1].  

Out of all the people seeking substance abuse treatment, those struggling with alcohol use are the highest (at 28%). Alcohol Change UK reports that 82% of dependent drinkers are not seeking help [2].  

Although there are a variety of reasons why people don't seek treatment, the consequence is that failure to do so leads to an unhealthy, unproductive, unfulfilling life.  

There's extensive research showing alcohol as a chronic disease that gets worse over time. The long-term effects of alcohol use include malnutrition, damage to organs (pancreas, kidneys, stomach, heart, and brain).

The disease also leads to other issues in a person's life such as job loss, relationship challenges, financial problems etc.  

The substance abuse and mental health services administration (SAMHSA) states that the recovery process should address four major dimensions [3]: 

  1. Health - Overcome or manage the disease(s) or symptoms. It also entails making healthy, informed choices that contribute to physical and emotional wellbeing. 
  2. Home - The individual should have a stable and safe place to live. 
  3. Purpose - The patient should engage in meaningful daily activities. They should also have the independence, income, and resources to participate in society. 
  4. Community - Have relationships and social networks that offer support, friendship, love, and hope. 

SAMHSA established a recovery support system that engages recovering addicts and their families.

The aim is to involve the affected parties in guiding the behavioural health system and promote individualized programs and system-level approaches that foster health and resilience.

This system identifies a proper recovery process as one that: 

  • It helps individuals with behavioural needs to be well. 
  • It helps individuals manage symptoms, achieve, and maintain abstinence. 
  • Increase housing to aid recovery. 
  • Reduce barriers to employment, education, and other life goals. 
  • Secure the necessary social supports in the patient's location. 

When it comes to substance abuse rehabilitation facilities, SAMHSA identifies a proper recovery process as one that prioritizes behavioural health.

This is essential to health, prevention works, and efficacy of treatment. Furthermore, it is integral in helping people recover from mental and substance use disorder. 

Different types of rehabilitation processes 

Different treatment centres have their unique approaches to the rehabilitation process. Some rehab facilities have five phases of rehabilitation.  

They include: 

Phase 1: Preliminary assessment 

This is the first phase of rehab admission. It involves talking to a qualified healthcare provider.

In addition to this, the care provider will review medical records, conduct a brief medical assessment, and talk to the treatment team about the ideal treatment plan for you. 

At the first meeting, the care provider will ask you about your goals and expectations. Understanding your needs helps them create an individualized treatment plan. 

At this stage, many rehab programs will speak to your insurer to determine whether your rehab insurance coverage comprehensively covers treatment.

Sometimes it can take a little more time to receive approval, and other times it may take up to a week. 

Phase 2: Admission and intake evaluation 

This phase involves your integration into the treatment process. Most facilities tend to include your family as part of the treatment team.

The first week in the facility usually entails an in-depth evaluation. This consists of a psychological and mental assessment.  

You should expect a research-based treatment and evaluation during this phase. The process is often comprehensive as the goal is to ensure that each patient's need is met throughout the treatment process. 

Phase 3: Treatment facility orientation 

Once the comprehensive intake process is complete, one of the staff in the treatment facility will help you get oriented to the centre. You will be shown where you'll reside in the facility and given a tour of the establishment. 

At this phase, most rehab facilities will have a custom-suited treatment plan based on the knowledge and understanding of your addiction.

This treatment plan is based on your strengths, weaknesses, interests, and personality. 

The treatment plans are coordinated with a team of experts that include psychologists and neuropsychologists. 

You will be given an outline of the treatment plan so that you'll know what to expect during your length of stay. 

Additionally, you'll be acquainted with the rules, and the disciplinary actions in place should the rules be broken. 

Your belongings will be searched to ensure that you have no harmful items in your possession. 

Lastly, the facility will inform you on how you'll communicate with your family. 

Phase 4: Rehabilitation and continuing improvement 

The next phase involves how long the rehabilitation will last. This will be determined by the medical status of the individual patient.

As the individual continues with ongoing treatment, the professionals at the treatment facility will be able to decide the patient's expected outcome. 

Addiction treatment involves the use of a variety of therapies. They include CBT (cognitive behavioural therapy), group therapy, family therapy, 12-step facilitation.

Other rehab options will include art and music therapy, yoga, and meditation. The therapy comes after detox.  

Continuing improvement of the individual will be assessed by a rehab team.  

Phase 5: Discharge planning 

Discharge planning takes place towards the end of the rehabilitation process. At this stage, the goal of treatment is to help the patient transition smoothly into their daily life. 

Rehab facilities usually have a team of professionals to help their patients with their career, school, or volunteer goals. A therapist may help with workplace placement to help the individual return to work.

They may also visit the patient's home to ensure that it's conducive and promotes the individual's wellbeing. 

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Addiction recovery rehabilitation process 

People struggling with alcohol or drug abuse have a different approach to the rehabilitation process. The phases involved in the treatment are: 

1. Assessment - You will first go through an assessment to help the treatment staff create an individualized plan for you. 

2. Detoxification - Individuals involved in alcohol or drug use must first go through detoxification. This process helps the body get rid of the harmful toxins in the body due to substance use. 

3. Rehabilitation - Rehabilitation comes after detox. This process is the beginning of the healing process. The goal of rehabilitation is to help the patient get to the core issues that fuel the addiction. 

4. Aftercare - Aftercare aims to help the individual achieve long-term health and recovery. This process ensures that the skills learned during rehabilitation become part of your daily life. 

Below is an explanation of each phase listed above. 

Assessment and admission 

As pointed out earlier, this phase involves meeting with the patient to discuss their treatment options. Next, the patient works with a team of professionals to create a customized plan that works for them. 

The assessment phase is extensive. It may include medical examination, psychological and psychosocial assessment.

You will also be required to provide your personal drug use history, family history of addiction, and even your payment option for treatment. 

The assessment phase is the ideal time for your medical practitioner to conduct a dual diagnosis. This type of diagnosis applies to individuals who have a mental illness in addition to the substance use disorder.

Over the years, there has been a strong build-up of research literature demonstrating a strong association between mental illness and substance use [4]. 

If you have a co-occurring disorder or dual diagnosis, you will have to discuss with your treatment provider about the best recovery programme for you. 

Detox 

Alcohol or drug use is associated with withdrawal symptoms. These symptoms can vary from mild to severe depending on the severity and duration of use.

People at risk of developing severe withdrawal symptoms benefit from medical supervision. 

In many instances, the detox entails the use of medication. The medication aims to ease the withdrawal symptoms. 

Before the detox, professional medical personnel will assess you to determine the withdrawal symptoms you're likely to experience.

The assessment will help them determine the type of intervention needed to mitigate these risks during detox. 

The type of pharmacotherapeutic regimen needed varies depending on the type of substance dependence. 

Rehab 

After detox, the patient goes through rehab. The rehab process can take place either in an inpatient or outpatient setting. 

Inpatient treatment programmes help the person struggling with the healing process by removing them from their ordinary environment.

Instead, it places them in a safe environment where they can receive 24/7 care from staff personnel. 

Inpatient care delivers you from the risk factors that you face in your usual environment. This gives you the chance to focus on improving your health condition. 

Outpatient treatment is a good option for those struggling with mild or short-lived addictions. T

his option allows you to visit a treatment facility for a few hours a day. After the sessions, you get to go back home and resume your daily routine. 

Patients seeking rehab also have the option of a partial hospitalization program (PHP). This is a hospital-based form of outpatient drug rehabilitation.

A PHP can occur in the same setting as inpatient treatment, but the levels of care are different. This treatment option is ideal for patients that are likely to experience mild to moderate withdrawal symptoms. 

Once detox is complete, patients undergo extensive rehab therapy. This phase is integral for successful long-term recovery.

The therapy provides an opportunity for the individual to address the underlying issues behind their addiction. 

Patients undergoing rehab therapy are likely to go through: 

  • Group therapy. Group therapy is the mainstay of many rehab programmes. Extensive research shows that this therapy is helpful as it allows individuals going through the recovery process to interact. This sense of community support plays a significant role in the recovery process. 

  • Individual therapy. This therapy offers an opportunity for the individual to focus on themselves. One of the things that patients learn during this therapy is to identify triggers. They also learn how to manage their time plus coping skills that will help them avoid relapse. 

  • Family therapy. Many rehab facilities offer family therapy as part of their programme. This therapy allows family members to participate in the sessions. The therapy is beneficial for the individual and their family members as it helps them resolve issues that may have resulted from the addiction. 

Recovery and aftercare 

Recovery from addiction is a lifelong process. Even after a person's rehabilitation programme ends, they must meet with other treatment providers to discuss their aftercare plan. 

Rehab centres have different approaches to aftercare. Some may offer their patients additional counselling, alumni programmes, or meetings.

Alternatively, the patient may live in a sober living facility for a while before resuming their daily activities. 

Many patients continue with regular therapy sessions post-rehab. They can join support groups such as Alcoholics Anonymous (AA) or Smart recovery to help them remain on the path to sobriety.

Other patients submit to a scheduled drug testing to keep them accountable for their sobriety. 

4 stages of alcohol rehabilitation  

Stage 1: Treatment initiation  

Treatment initiation begins when you reach out to the rehab facility. Some people begin treatment by consulting their GP.

The GP conducts a medical assessment and helps the individual identify the best treatment approach for them depending on their needs.  

At this stage, most people have doubts whether they are making the right decision. You or your loved one may be anxious about their ability to give up the drug or alcohol permanently.

You may also think that your addiction is not as bad as others. It's important to be aware of this feeling of ambivalence or denial as it may impede your progress during the initial phase of treatment. 

At this stage, the patient works with the substance abuse counsellor to: 

  • Identify the damaging effects of the addiction.  
  • Explore the feelings of denial with regards to the addiction.  
  • Help the person become motivated to recover  

The addiction counsellor will document the patient's history with addiction. Next, they will introduce the programme and work with the individual to come up with an individualized treatment plan.

Stage 2: Achieving early abstinence  

This stage is for patients who agree to continue with treatment. Early abstinence is the hardest stage as it involves dealing with withdrawal symptoms.

These symptoms range from mild to severe depending on the duration and severity of the alcohol use.  

Aside from the withdrawal symptoms, the patient has to overcome: 

  • The social pressure to drink  
  • Psychological dependence  
  • Physical cravings  
  • Triggers that tempt them to relapse  
  • High risk situations that can lead to alcohol use.  

The addiction counsellor works with a patient at this stage to help them develop the coping skills that they need to live a sober life. The counsellor works with the individual to help with: 

  • Finding alternative behaviours to engage in other than alcohol use.  
  • Participating in self-help groups that offer information and support.  
  • Identifying triggers in their environment that could lead to alcohol.  

The addiction counsellor also encourages the individual to participate in healthy activities.  

Stage 4: Advanced recovery  

Advanced recovery happens after five years of abstinence. At this stage, you will take the skills and knowledge you've learned during your rehab counselling and use them to build a satisfying, fulfilling life.  

At this stage, you develop long-term goals that will aid you in achieving lifelong sobriety. 

Some of the strategies you can implement include: 

  • Forming social relationships with other sober minded individuals.  
  • Coming up with a consistent, daily schedule.  
  • Participating in alcohol-free recreational activities.

Learning to implement these strategies will help you achieve a happier, healthier life.  

Finding a proper treatment plan 

The first step to finding a proper treatment plan involves working with your GP. The professional will provide a proper diagnosis which is instrumental for an effective treatment plan. 

A practical treatment plan factors your lifestyle, habits, and any other factor that may increase your chances of relapse. It is not advisable to seek self-rehabilitate if you struggle with moderate to severe addiction. 

You can use online platforms such as the NIAA alcohol treatment navigator to find the right treatment programme near you [6].

The UK Rehab and UK Addiction treatment centres also provide you with information about the treatment options available for you depending on your needs.  

When should rehabilitation start?

In addiction treatment, rehabilitation starts when you decide to enter a professional drug or alcohol rehab programme. Recovery from addiction requires willpower, effort, and sacrifice from your end (e.g., you need to sacrifice your time).

A loved one cannot decide for an addict when they should start rehabilitation. Rather, it is up to the affected individual to realize that they have a problem and need help. 

Many rehab facilities offer a free call back option. When you go to their sites, you'll see a form where you can leave your contacts so that a professional can call you back.

Rehab centres also offer an interventionist if you are seeking rehab for a loved one. Still, it is important to understand that you cannot force a person to accept treatment. He or she must be willing to go for rehab. 

What is basic rehabilitation? 

Basic rehabilitation entails various stages depending on one's dependency on alcohol. The rehabilitation process can be long-term( about 90 days up to a year) or short-term (about 28 to 30 days).  

The principles of basic rehabilitation are: 

  • Begin the rehabilitation process as early as possible to improve the outcome. 
  • Uncover the underlying cause of the addiction.  
  • Build upon the patient's ability to avoid relapse.  
  • Treat the whole individual. 

Rehabilitation is care that helps you resume your ordinary, healthy life by equipping you with the abilities that you need for a healthy, sober life.  

Basic rehabilitation consists of two main processes: detox and rehabilitation. The detox process may be medically assisted or non-medically assisted.

Most facilities administer addiction medication so that the patient can safely manage the withdrawal symptoms. A person can undertake detox from home if they have mild cases of alcoholism.

If you consume more than 20 units per day, or previously experienced withdrawal symptoms, you should be able to detox from home using medication.  

However, if you suffer from severe dependence, it is recommended that you go for detox in an inpatient setting.  

Basic rehabilitation can take place in an inpatient and outpatient setting. In inpatient, the individual gets to live in a rehabilitation centre where they will work with a team of professionals to facilitate treatment.

Extensive research associate’s inpatient rehabilitation with higher chances of achieving long term sobriety.  

Outpatient care allows the individual to engage in treatment for a few hours each week in a treatment centre. After that, the patient goes back home.  

A multidisciplinary team handles basic rehabilitation. This team includes nurses, fitness trainers, nutritional staff, dieticians, psychiatrist, addiction recovery mentors, counsellors, occupational therapists, dieticians, medical doctors and so on. 

The team liaise with the patient and their family members to come up with a customized treatment plan that's suitable for the individual.  

Conclusion 

Different rehab facilities have different approaches to the rehabilitation process. Regardless of the approach, rehabilitation aims to restore the health and wellbeing of the patient.

Rehabilitation aims to aid the patient in resuming their daily routine. This aim is achieved by taking the patient through medically assisted detox and therapy. 

Through the basic process of detox and rehabilitation, the programmes aid the patient in getting rid of the body's toxins from substance use.

Next, the programme helps the patient uncover the underlying cause of the addiction and develop coping skills that will help him avoid the triggers. 

If you or your loved one are seeking rehabilitation, you can benefit from NHS of private programmes. You can reach out to your local authority or work with a care practitioner to identify the best rehab facility for you. 

Abbeycare Pricing Bot

Last Updated: October 27, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.