Residential Treatment

Known also as residential rehab, residential treatment describes a substance addiction program that involves a patient being treated in a residential environment. In a residential setting, patients will feel more like a resident than a client, and addiction therapy is more laid back. The length of residential treatment can vary, ranging anywhere between 30 days or less (short-term) up to 90+ days (long-term) depending on the severity of the addiction.

The term “residential treatment” is commonly used to refer to the long periods that residents live together with other patients and therapists. What separates residential treatment from other inpatient treatment programs is that residential treatment explores the psychological reasons behind a patient’s dependence and addiction. Residential is commonly confused with other treatments that generally take place in rehab centers and hospitals, which specialize more in treating physical dependence.

Why Residential Treatment?

A commonly debated topic in society today is whether medical supervision is necessary to treat substance dependence and addiction. While it is typically thought that detox counts as addiction treatment, it is not enough to fully treat addiction. Although detox is effective in cleaning all substance and substance residue from the body, it does nothing with treating the psychological aspect of long-term addiction. Medical detoxification does not count as recovery, and relapse and abuse are common in patients that do not continue with treatment after detox. 

Medical detox is arguably one of the most difficult and intensive steps in the path to recovery, and rightfully so. The success of the addiction treatment programs is undoubtedly highly dependent on the success of detox alone. With this in mind, it is always important to remember that completing medical detoxification without following up with further treatment is like cutting a weed and then ignoring it; unless you pull up the roots, it will keep coming back. 

After Detox

The first step in almost all addiction treatment programs is medical detox, but what exactly is detox, and what does it do? Detox is defined as the cessation of a substance to cleanse the body of any substance residue or toxins. The reason that detox can be so difficult for many people is that someone engaging in medical detox will endure a significant number of uncomfortable and severe withdrawal symptoms. Anxiety, depression, nausea, agitation, and insomnia are the most common withdrawal symptoms. 

The point in medically-supervised detox is to ensure that all withdrawal symptoms are in check and the patient is as comfortable and stress-free as possible. When neglected, the withdrawal symptoms associated with substance addiction detox can lead to relapse and sometimes even prove fatal. The completion of medical detoxification alone, while a huge step in the treatment of someone’s addiction, is not enough to ensure that someone stays sober, and lack of after-detox treatment greatly increases the risk of relapse and the development of addiction again. 

Residential Treatment and Avoiding Relapse

Although it should be avoided at all costs, relapse is sometimes inevitable and is much more common than you think. While many people would view relapse as a failure, we at Maryland House Detox view relapse as an opportunity to learn. When someone relapses, doctors can identify the reason behind the relapse and learn more about the cause of previous addiction.

To aid those that are at risk of relapse, we suggest the following tips that can greatly reduce the chance of relapsing while in recovery:

• Make friends with people that have been successful during recovery. More than likely, they will have useful advice that you could use; if they do not, simply being around someone who’s successful in staying sober can easily influence you to do the same.
• Though it may seem strange, it is important to ensure that you do not over-distract yourself while suffering from withdrawals. Many people will overwork themselves to take their mind off of their withdrawal symptoms, but those that do it too much are susceptible to workaholism. Always be on the lookout for strange behaviors related to workaholism that may affect you or someone you know. 
• Though it is treatable and sometimes can help in the treatment process as a whole, relapse should never be counted as “acceptable.” Viewing relapse as a minor inconvenience rather than what it actually is, a huge roadblock in the path to sobriety, can cause a user to not care as much about treatment.
• It is always important to remember that recovery is something to appreciate and enjoy. If the residential treatment you are taking part in feels like it is forcing you to do things you are not comfortable with, you may want to consider finding a new center. Your comfort and happiness should always be the number one priority as patient comfort directly correlates to higher success rates.

What to Expect from Residential Treatment Programs

In general, a residential treatment program will use clinically-proven methods and modalities to help treat addiction. Through the use of Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Motivational Interviewing, a patient will find themselves learning about the psychological reasons behind their addiction. With this knowledge, drug addiction recovery is generally much easier for someone struggling with addiction.

Cognitive Behavioral Therapy

As a well-tested, successful method, Cognitive Behavioral Therapy (CBT) has been one of the most effective therapies in treating psychiatric illnesses and disorders. As the most widely used evidence-based method for treating mental health conditions, CBT is the psychosocial treatment of choice.

While its intended use was to treat depression, there have been multiple studies that show CBT to be effective in treating less severe mental health disorders, such as anxiety, PTSD, substance abuse and addiction, and personality disorders. When used together with professionally-administered medications, CBT can also treat obsessive-compulsive disorder, severe depression, opioid addiction, bipolarity, and other psychotic disorders.

Dialectical Behavior Therapy

Another method that is commonly used to help people who have personality disorders is Dialectical Behavior Therapy (DBT). Not only is it effective in treating personality disorders, but it has been tested and found to be effective in treating negative patterns of behavior, including but not limited to self-harm, suicidal thoughts, substance abuse, and many other disorders that may affect mood. 

As a modified branch of Cognitive Behavioral Therapy, DBT shares many of the same methods and qualities. Both CBT and DBT are referred to as types of “talk therapy,” and while CBT delves deep into the understanding and interaction of a patient’s emotions, DBT follows a much looser structure and is more centered on the social and emotional aspects of addiction. 

Motivational Interviewing

Motivational Interviewing ventures off the path of traditional models and has a very specific use. The idea of Motivational Interviewing (MI) asserts that through specific tone of voice and speaking style, a therapist can influence a client to make behavioral changes and resolve ambivalence (commonly known as “mixed feelings”). 

In the case of addiction treatment, MI is used to help resolve mixed feelings toward whether drug abuse’s cons outweigh the pros.

Motivational Interviewing was first referenced in an article by clinical psychologist William R. Miller, Ph.D., in Behavioral Psychotherapy titled “Motivational Interviewing with Problem Drinkers.” Throughout the article, Miller describes the traditional idea at the time (1983) as “The traditional model of motivation in problem drinkers attributes almost all motivational properties to the personality of the individual.” 

Is Residential Treatment Effective?

Treatment is often the best way to overcome a substance use disorder and achieve freedom from active addiction. Residential treatment is ideal for people who aren’t able to safely live on their own without relapsing or experiencing medical complications. 

However, addiction is a chronic disease, and relapse is a serious threat for everyone in recovery. According to the National Institute on Drug Abuse (NIDA), addiction can lead to relapse at rates that are similar to other chronic diseases like hypertension and asthma. 

Studies show that addiction relapse rates are at about 40 to 60 percent, while hypertension and asthma have rates at 50 to 70 percent. 

Relapse is a normal part of recovery for many people, but it’s not inevitable. Addiction treatment options like residential treatment are designed to help you avoid relapse while you’re in treatment and in the future. While treatment doesn’t guarantee that you will never relapse, it’s centered around giving you the best shot at maintaining your sobriety in the long-term. 

According to NIDA, people who get the treatment they need and stay in it for the proper amount of time, have shown to decrease criminal activity, stop using drugs, improve their social relationships, maintain jobs, and improve psychological functions. 

How to Choose the Right Residential Treatment

With the overdose and addiction epidemic causing people all over the United States to seek addiction treatment, there are a wide variety of addiction treatment options available. However, not every treatment option will be ideal for your specific needs. 

Choosing the right addiction treatment can make a huge difference in achieving long-lasting freedom from active addiction. Not all treatment centers offer care that will be ideal for you, and not all levels of care will be able to meet your needs. 
When you are looking for residential treatment, or any other level of addiction treatment, it’s important to consider some essential factors. NIDA has identified a few principles of effective treatment that should be present in an effective addiction treatment program.

While you’re considering a rehab facility, you may want to ask questions about some of these factors. Some of the most important principles NIDA has outlined includes:

• Addiction is a complex but treatable disease. It’s important for an addiction treatment program to recognize that addiction is a disease, but that it’s one that can be effectively treated.
• There is no one-size-fits-all treatment plan. Everyone is different, and they respond to treatment differently. Treatment plans should be adaptable and tailored to your specific needs. Fitting a person to a cookie-cutter treatment plan is less likely to be effective.
• Treatment should address multiple needs. Treatment should address more than just a substance use problem. Addiction is often accompanied by other biological, psychological, and social problems that can feed into a substance use disorder. To effectively address addiction, these underlying issues should also be addressed.
• Treatment plans should be continually reassessed. As you progress through your treatment program, your plan should be reassessed at least once a week to make sure it’s still effective for your needs.

Sources

American Psychiatric Association. (2017, January). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

Miller, W. R. (1983). Motivational Interviewing with Problem Drinkers | Behavioural and Cognitive Psychotherapy. Retrieved from https://www.vad.be/assets/1961

National Institute on Drug Abuse. (2018, July). Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

National Institute on Drug Abuse. (2018, January). Principles of Effective Treatment. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

National Institute on Drug Abuse. (2018, January). How effective is drug addiction treatment? Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment