Addiction is a complex disease that can be effectively addressed with a specialized addiction treatment program that can be either residential, where the person remains on site for the duration of care, or outpatient, where the person returns home each night.
With outpatient rehab, there are generally two main types: general outpatient and intensive outpatient rehab. General outpatient programs allow individuals the flexibility to schedule meetings and sessions around their existing schedules while intensive outpatient programs are often very similar to inpatient, or residential, rehab programs.
Since addiction is such an individual disease that does not affect everyone in exactly the same way, each person’s needs are different. The National Institute on Drug Abuse (NIDA) publishes that there are around 14,500 different specialized drug treatment facilities in the United States that can provide a wide range of services to fit any particular circumstance. Rehab is tailored to the individual with their specific needs in mind. Substance abuse, medical, and mental health professionals work together to design a rehab program that will be the most compatible and optimal for recovery.
Rehab programs may include:
- Pharmacological tools: Medications are often a vital part of addiction treatment as they help to manage cravings, withdrawal symptoms, and potential co-occurring disorders that may be present.
- Therapy and counseling sessions: Individual and group therapy and counseling sessions are essential in helping people to work through potential triggers to self-destructive thoughts and behaviors, leading up to and including alcohol and/or drug abuse. These sessions work on improving self-esteem and building self-reliance. They also focus on communication, coping, and anger management skills.
- Educational programs: The more a person can learn about the disease of addiction and what to expect during recovery, the better. Educational programs often cover a wide variety of topics pertaining to relevant information during rehab.
- Life skills training sessions: During these sessions, people learn viable skills for moving forward in recovery after leaving rehab. These may include parenting classes, trade skills training, and more.
- Nutrition planning: Physical health is important during rehab and ongoing recovery, and structured meal times and a balanced diet are often part of an overall treatment program. Proper nutrition and hydration can help to relieve stress and stabilize emotions as well as help the body (and brain) to heal, encourage a healthy lifestyle, and reduce cravings, the journal Today’s Dietician Caffeine is typically avoided. Foods rich in vitamins and minerals, and low in refined sugars and saturated fats, are ideal during recovery.
- Fitness regimes: Rehab programs often provide structured exercise programs or opportunities for individuals to work out and improve physical fitness. Exercise is a healthy way to curb cravings and improve moods, thus helping the brain to stabilize and heal.
- Complementary therapies and holistic techniques: Rehab programs often include amenities, such as spa treatments, massage therapy, art therapy, chiropractic care, acupuncture, yoga, mindfulness meditation, and more. These adjunct therapies and techniques can help to balance the mind and body, and aid recovery.
- Support group meetings: These groups are made up of peers and often follow a 12-Step model. Meetings are designed to provide a safe and anonymous environment where individuals struggling with addiction can lean on other people who understand and are currently in recovery. These groups can offer ongoing and long-term support and encouragement, and a healthy social network of people all working to maintain sobriety together. Meetings often continue throughout recovery and after rehab has been completed.
- Family programs: There are many different ways for families to get involved in recovery with their loved one. Some programs provide intensive and short-term workshops, while others may offer weekly counseling and educational programs both with and without the individual in recovery present. Family support is integral to a sustained recovery.
In general, a rehab program is structured so a client will know what to expect and to use their time working on healing and moving forward in recovery. A typical day in rehab can vary from program to program, depending on the specifics of each person’s needs. A general format is highlighted below.
During rehab, much of the day is highly structured and this includes a set waking time. Nurses will often come around to rooms and check to ensure that everyone is up, hand out any necessary medications, and do a quick morning progress check. Chores may be divvied up and need to be completed. Individuals will get dressed and ready for the day, and head to breakfast.
After eating and cleaning up, a person will attend their morning sessions. Usually the morning sessions will be in a small group format led by a therapist or counselor. Topics related to addiction and recovery are covered, and individuals check in with each other and the group leader. Then, there will be a break for lunch.
Following a balanced and healthy lunch, there will typically be a series of intensive sessions. Therapists will use both individual and group therapy sessions to explore negative thought patterns and work to improve upon them. Cognitive Behavioral Therapy, or CBT, is a standard type of therapy used in rehab that has been shown to positively change some of the circuitry in the brain and dysfunctions of the central nervous system impacted by substance abuse and addiction, the Journal of Neuropsychiatry and Clinical Neurosciences publishes. CBT can be used during both group and individual therapy sessions.
A person may go into an individual session directly following lunch. Individual therapy sessions are often followed with some quiet reflection time during which journaling is encouraged. Another group session may come next, during which individuals can practice newly learned techniques with others. Specialized and alternative therapy sessions, skills training, relapse prevention, and educational programs are often hosted during the afternoons in rehab as well. These programs may not be held every day, but perhaps a few times a week as needed. Homework may be assigned after a group or skills training session for individuals to complete before returning to the next session.
There may also be structured exercise and other fitness opportunities for individuals during the middle of the day in rehab. Many rehab facilities have several amenities that residents can take advantage of during a scheduled break in the afternoon. Saunas, pools, fitness trails, ping pong tables, and more may be open for use during this time. A healthy lifestyle is encouraged during rehab to help the body and brain to heal physically. The journal Frontiers in Psychology publishes studies showing that people who regularly engage in aerobic exercise are less likely to abuse drugs. A healthy dose of exercise can stimulate the reward center in the brain, help to manage cravings, and help to rebuild the reward processing center in the brain that has been damaged by drug and/or alcohol abuse. Rehab facilities often provide numerous outlets for individuals to attend to their physical, as well as mental, health during recovery.
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Dinner is served usually at the same time each evening. After dinner, there may be another short group session for individuals to discuss their day and assess progress. Support group meetings are also often held in the evenings, and these groups may meet on or off site, depending on the group and a person’s status in a rehab program. Twelve-Step programs, like Alcoholics Anonymous (AA), have been shown to help prevent relapse and encourage long-term sobriety for those who regularly attend and participate actively in meetings, the Journal of Addictive Disorders reports. These support groups can offer encouragement and support from a person’s peer group, helping to improve long-term abstinence rates.
The structured part of a typical day in inpatient rehab generally starts at 7-8 a.m. and lasts until 8-9 p.m. Families may be included in therapy and group sessions, and there may be structured visiting time in the evenings or on weekends. After group sessions and support group meetings are completed for the day, there may be a movie or other fellowship time before bed.
Another important aspect in recovery is getting enough sleep. Lights-out times are highly structured during rehab to ensure a person’s brain has plenty of time to heal with a healthy dose of sleep each night. Sleep disturbances are common side effects of addiction that are managed during rehab. When a person is rested, they are more emotionally stable and better equipped to handle cravings and other issues that may arise. Nurses will often check in with individuals before bed and give any necessary medications as well.