Addiction A-Z

Residential treatment

Residential treatment, also called residential rehabilitation or inpatient rehab, describes either a mental health facility or a drug and/or alcohol or process addiction treatment program that is provided to patients in a residential setting. Some residential treatment centers specialize in only one illness, such as eating disorders or substance abuse. Others treat people with a variety of diagnoses or dual diagnosis of substance abuse and a psychiatric diagnosis.

The term does not usually refer to treatments in hospitals or centers specializing in physical or occupational therapy, but rather to centers for long-term treatment for substance abuse disorders and other mental problems in which patients live in facilities together with other patients and therapists, receiving therapy and medication on a 24-hour basis. The term also refers to therapeutic boarding schools or wilderness programs for young people.

Most residential treatment is voluntary. Only rarely is a person forced into residential treatment, although it may occur as the result of a court order. Residential treatment is expensive, and some people have to go through it more than once before they finally achieve their goals. Nevertheless, it is considered the best treatment for behaviorally based disorders such as drug addiction, alcoholism and obesity and many mental disorders, especially those that are treatment-resistant, life-threatening or involve suicidal ideation or severe acting out.

Residential treatment can be short-term (30 days or less) and long-term (more than 30 days) and depends on the type of addiction, duration and frequency of use, any co-occurring addictions or mental health disorders and other factors. Some residential treatment is time-limited due to the patient’s insurance coverage. In such cases, either the patient or his or her family has to pay out of pocket or transition to outpatient treatment or other form of support, including 12-step self-help groups (Alcoholics Anonymous and Narcotics Anonymous, for example) or other community-based support.

When a patient enters a residential treatment center they will first undergo physical and mental tests to determine their diagnoses and treatment protocols. If the problem is substance abuse, the initial phase of treatment is usually detoxification, in which patients clear their bodies of all traces of the chemicals they have been abusing. Physicians monitor their withdrawal processes and help ease physical symptoms with medications. Following detox, patients usually receive different forms of treatment, depending on their specific needs, including one-on-one counseling, group therapy, other forms of therapy (such as cognitive behavioral therapy or CBT), lectures and discussions, participation in a 12-step program and relapse prevention training.

Days at a center are highly structured and the second stage of residential treatment is more focused on the development of life skills, reintegration through education, training, employment-focused needs and learning the skills required to maintain a drug-free lifestyle. Before the person returns home, the patient’s case manager will arrange for after-care treatment within the their local community. This might include support such as 12-step meetings or individual and family therapy.

Therapeutic boarding schools for teens have similarly structured days, except residents will attend classes and have study sessions along with their therapies. Young people, usually in a group of seven or less, explore nature with professional therapists and adults experienced in outdoor survival. Wilderness programs usually last three months.

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