The Components of the Best Residential Drug Treatment Programs

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Components of
Residential Treatment

Content Overview

What can residential drug treatments offer?

The best residential drug treatment programs offer:

  • Medical detox
  • Individual therapy
  • Medication management
  • Family or couples counseling
  • Addiction education
  • Skills-building sessions
  • Follow-up care
  • Referrals to support groups

Most experts assert that the drug rehab program type that is most likely to help individuals maintain long-term recovery is residential treatment.
In fact, a recent study from the Australian Patient Pathways National Project demonstrated that, of the various types of treatment programs, residential care was one of the most likely to result in higher rates of continued recovery from addiction.

While certain addiction cases, such as those with less severe or short-term addictions, may be sufficiently treated with outpatient treatment, severe or long-term instances of addiction most frequently necessitate residential care. However, not all residential programs are the same, and a person struggling with drug or alcohol addiction may not know what the ideal residential treatment program looks like.

According to the National Institute on Drug Abuse (NIDA), a combination of medically supported treatments and various types of therapy make up the approach most likely to result in the outcome and long-term maintenance of recovery. The components of these treatments as used in a residential setting are outlined below to help individuals who are seeking help with their addictions, or their loved ones, to find the residential treatment program most likely to support them in their journey.

The Elements of Residential Treatment

oxford_outpatientA study in the journal Addiction shows that people who receive help with recovery from addiction are more likely to stay in recovery for longer periods than those who don’t receive care. Sixty-two percent of those who had professional help in treating their addiction remained in recovery for three years after treatment, compared to only 43 percent of those who didn’t get treatment. In addition, 57 percent of those who made it three years were still free of the substance after a total of 16 years. This shows that getting professional treatment is vital to reaching the best outcome.

Residential treatment in particular is often more helpful because it requires that the person stay in treatment for the amount of time necessary to affect change.

In the NIDA article linked above, it is stated that an essential element of drug addiction treatment is staying in treatment long enough to complete the various components of the program, because this enables people to emerge with the highest level of confidence in their newly learned skills and tools for remaining in recovery. Because of this, each of the components of a high-quality treatment program works best when it is designed to help individuals get through the entire treatment process.

Residential rehab provides 24-hour care in a setting where the focus is helping individuals achieve and maintain recovery from addiction. Because of this, these programs are able to offer a breadth of services that are more likely to help clients develop capabilities and tools to stay in recovery well after leaving the program. These include:

  • Medically supported detox and withdrawal, if needed
  • Medically supported maintenance care, if needed
  • Individual therapies, such as Cognitive Behavioral Therapy
  • Family or couples counseling
  • Building skills and tools that are necessary for life post treatment
  • Follow-up care after the formalized program ends

Medically Supported Detox and Withdrawal

The physical components of treatment involve freeing the body of its dependence on the addictive substance.
When people enter drug treatment, one of the first crucial tasks is to detoxify the system and get through the often challenging, and sometimes dangerous, process of withdrawing from the addictive substances. In residential treatment, this is best performed through medically supported detox and withdrawal that can help ease the symptoms of withdrawal while keeping individuals safe.
Withdrawal usually involves at least some discomfort, which can be lessened through various medications administered by doctors and other medical professionals.

Managing withdrawal symptoms is vital to a successful residential program, as the person is more likely to remain in rehab if withdrawal symptoms are kept under control.

In the case of addiction to certain substances, such as alcohol, opiates, and benzodiazepine drugs (benzos), withdrawal can be dangerous and even life-threatening. Another study from the journal Addiction shows that even low-dose benzos, if used over a long period of time, can result in severe withdrawal symptoms that must be managed under the care of a professional who can administer medications to help prevent the worst symptoms. Individuals addicted to alcohol, opiates, and benzos should never attempt to detox cold-turkey on their own.

Medically Supported Maintenance

medical Detox NeedsFor some people, medicines are an effective way to maintain abstinence from their addiction until they can better manage the challenge of recovery on their own. For withdrawal from alcohol or opiates, for example, maintenance medications can help reduce cravings and the need for the high that the substance provides. This can give the person more time to develop tools to avoid behaviors and situations that might trigger relapse.

Because these medications can come with their own risks and are required to be administered under the care of a doctor, they are most easily managed in a residential program where medical professionals can oversee their use or discontinuation.

Other components of treatment involve psychological and social therapies that help the person being treated to understand and manage contributing factors to the addiction. This can be especially helpful for those who have a dual diagnosis, such as addiction that occurs alongside depression or anxiety. In cases of dual diagnosis, all co-occurring issues must be treated simultaneously, so it’s important to have a treatment team that understands all the factors in play.

Research from the journal Psychiatric Services has shown that something as simple as the rapport experienced between a counselor and client can contribute to a higher likelihood of continued recovery after treatment. As a result, individual therapy is essential to effective addiction treatment. While most programs incorporate some forms of group therapy, specific gains are often made in individual therapy.

Educating clients about the mental and emotional contributors to their addiction can help them recognize the triggers that might reignite the addictive cycle. It is also helpful to enable individuals to process the thought patterns that accompany cravings and the relationships that may encourage relapse, so they can develop coping mechanisms to help them work through, or avoid, certain thoughts or circumstances that might cause them to relapse. This can be accomplished through various forms of therapy.

Cognitive Behavioral Therapy (CBT) is a type of counseling that helps a person learn to recognize the specific situations that cause addictive behaviors to occur, so the person can then practice strategies to avoid those triggers and behaviors. A research review from The American Journal of Psychiatry cited a number of studies in which the effects of CBT were not only helpful while the therapy was in process, but were also effective, even sometimes growing more effective, after therapy was discontinued.

One of these studies found that adding CBT to a slow taper of benzos for people with anxiety disorders was more helpful in reducing benzo use than the slow taper alone. Three months after treatment, 77 percent of those who had received both the slow taper and the therapy remained in recovery.

Family or Couples Counseling and Education

Happy mother, father and daughter in sunsetDuring residential treatment, it’s helpful to get the individual’s family or partner involved in therapy. This can encourage family members to support the person’s new skills and behaviors after treatment is over. In order to get loved ones involved, therapy and education are needed.

As discussed in the Treatment Improvement Protocols from the Substance Abuse and Mental Health Services Administration (SAMHSA), information about the substance abuse disorder and its implications can support the recovery person’s loved ones. This information includes:

  • What the treatments are and how they work
  • What to expect after the person is released from treatment
  • How to support the results of treatment
  • Post-treatment programs and resources

It’s also important to provide counseling to the individual and loved ones together to help everyone involved learn how to build new patterns that support recovery rather than returning to old behaviors that could lead to relapse. This can help the family learn to recognize and avoid codependent or enabling behaviors, thereby building a healthier way of relating to each other in order to prevent the thoughts and situations that may lead to relapse.

Establishing Post-Residence Tools and Support Resources

A practical component of residential treatment is setting clients up for success after they leave the program. If clients are able to practice and begin using skills and resources while in treatment that will then carry through after treatment, they are more likely to be able to maintain their recovery in the months and years following rehab. These types of strategies can include follow-up interviews to check in and provide motivation for continued commitment, or encouragement to join mutual recovery groups and fellowships, such as 12-Step or alternative support programs.

Finding the Best Residential Treatment Program

Residential treatment programs that contain these elements, based on sound research, are more likely to help those struggling with addiction when treatment is customized to meet the specific individual’s physical, psychological, and practical needs during and after treatment.

Residential treatment that is personal, intense, and comprehensive provides the most hopeful path for individuals and their loved ones to attain, and thrive in, recovery.


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