Residential treatment (RTC) is a 24-hour intensive level of care for individuals who are in need of substance abuse or mental health treatment. Clients who enter inpatient treatment typically struggle with cravings and need around-the-clock support to prevent relapse. Most clients who enter residential rehab cannot go more than a couple days without using alcohol or drugs.
A detoxification program is required before entering residential treatment. The detox program is usually the initial stage of residential treatment.
Residential treatment is provided at state-licensed alcohol and drug rehabilitation treatment centers with licensed healthcare professionals. Residences are community-based settings such as campus-based wilderness lodges, residential neighborhood homes, and boarding schools.
RTC is considered a high level of care: a step down from inpatient hospitalization, however more intense and disciplined than partial hospitalization or outpatient care. Individuals are not allowed to leave the center without permission, and they must also take random drug and alcohol tests to ensure sobriety.
Who can enter residential treatment?
Clients who have successfully completed drug or alcohol detox but still require around-the-clock support for their substance abuse should undergo residential treatment. Individuals who are struggling with minor medical complications associated with their withdrawal or addiction may undergo residential treatment. However, if the medical complications are severe or life-threatening, the client should be placed in a hospitalized setting until medically stable.
How is residential treatment different from outpatient treatment?
Inpatient and outpatient treatment programs often include many of the same therapies, but outpatient clients reside at home, whereas residential clients live on-campus for the entirety of the program, including overnight. The benefits of inpatient treatment include:
- Lack of opportunities to relapse
- An immersive treatment experience
- Fewer distractions
- Continual support
How is residential treatment different from inpatient rehabilitation?
Inpatient rehab, also known as inpatient hospitalization or inpatient treatment, is different from residential treatment in that it takes place in a hospital setting for individuals who are undergoing severe medical complications associated with their alcohol and/or drug addiction. Withdrawal symptoms from alcohol and certain drugs can be life-threatening and may require hospitalization in order for the individual to become medically stable. Additionally, inpatient hospitalization is required for individuals who have recently overdosed on drugs or alcohol and require specialized medical supervision. Individuals who are actively suicidal or homicidal should also be placed in an inpatient hospital setting until they are stable.
What type of therapy is offered at residential treatment?
Each client will be assigned a treatment team consisting of a therapist, a physician, a dietitian, a nurse, and ancillary staff who will provide medication, psychotherapy, lead group discussions, and ensure each client is learning how to adopt positive coping skills and conflict resolution skills. On average, an individual will participate in five to six hours of therapy each day. The following are specific treatments that are offered at residential rehab:
- Medically-assisted detoxification
- Individual therapy including cognitive behavioral (CBT) and dialectal behavioral therapy (DBT)
- Family therapy
- Nutritional counseling
- 24-hour nursing supervision
- Recreational therapy such as yoga and meditation
- Daily group therapy, including specialty groups and peer groups
- Aftercare and discharge planning
Group therapy topics may include the following:
- Substance abuse
- Introduction to the 12-step program
- Grief and loss
- Trauma survival
- Family patterns
- Interpersonal relationships
What is the average length of stay for residential treatment?
Residential treatment programs typically last 30–90 days, depending on each client’s needs. In some instances, clients will take part in a shorter inpatient treatment program, such as 28-30 days, and then transition into an outpatient care program that lasts much longer. Although some inpatient programs only last 28 days, the most effective inpatient programs last 90 days or longer, per the National Institute on Drug Abuse.
How effective is residential treatment?
Although there is no single treatment that’s right for everyone, residential rehab is one of the most effective forms of care for drug and alcohol addiction. According to statistics, 51% of individuals who enter residential treatment will complete residential treatment and 21% remain sober after five years. The success rate of drug treatment programs does not depend on achieving complete sobriety, but rather on improving the individual’s quality of life as a whole. According to the Office of National Drug Control Policy, there are many factors that determine success in substance abuse recovery:
- Reduced drug and alcohol use
- Improvements in employment
- Improvements in education
- Relationship improvements
- Improved overall health
- Better legal status: shown by fewer arrests and convictions, and fewer crimes committed.
- Better mental health
- Improved public safety: including drug-related fires, car accidents, and trauma to yourself or others.
Is detoxification offered in residential treatment?
When individuals enter a residential treatment facility, one of the first crucial tasks is to detoxify the body and get through the challenging, and sometimes dangerous, process of withdrawal from drugs and alcohol. Because it is often accompanied by uncomfortable and potentially fatal side effects, detoxification is often managed with medications administered by a physician in a controlled setting. Therefore, it is also referred to as “medically managed withdrawal” or “medical detoxification.” Medications are available to assist in the withdrawal from opioids, benzodiazepines, cocaine, alcohol, nicotine, barbiturates, and other sedatives. Detoxification usually takes 3-5 days, depending on the substance. In residential treatment, medical detoxification can ease the symptoms of withdrawal while keeping the client safe.
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Are co-occurring disorders treated in residential treatment?
Co-occurring disorders are substance abuse disorders that occur in the presence of mental health disorders. Studies show that one in five Americans is diagnosed with a mental health disorder, and within this group, approximately 9 million Americans are also suffering from a substance abuse disorder. An individual can be struggling with alcohol addiction but may be diagnosed with anxiety or depression at the time of residential treatment admission. Many substance abuse disorders can trigger the mental health disorder, or vice versa. It is important to treat the substance abuse disorder simultaneously in order for the individual to fully recover. Residential treatment at Akua Mind & Body has a specialized treatment track for individuals who have a substance abuse disorder co-occurring with a mental health disorder.
Major depressive disorder (MDD) affects more than 15 million adults in the United States and presents with feelings of sadness, sleep disturbance, loss of interest in activities, feelings of guilt, loss of energy, difficulty concentrating, changes in appetite, psychomotor agitation, sadness, and even suicidal ideation. Individuals are encouraged to enter residential treatment for depression when the symptoms are interfering with all aspects of their life. If an individual is unable to work, is constantly struggling with their relationships, and is failing to complete daily tasks at home because their depression is taking over, residential treatment offers a healthy road to recovery.
Alcohol treatment includes both a pharmacological approach and a psychotherapy approach. Medications are used to prevent cravings associated with alcohol, to lessen or prevent withdrawal effects, and to induce unpleasant side effects when alcohol is consumed. Behavioral therapy, family-based approaches, and recovery support systems such as Assertive Continuing Care, Mutual Help Groups, and Peer Recovery Support Services are the mainstay of psychotherapy approaches used for alcohol treatment and any co-occurring disorders.
Behavioral therapy focuses on identifying the negative feelings, thoughts, and emotions driving the individual to use alcohol, and uses positive behavior approaches, coping skills, and problem-solving techniques to resolve these negative thought and behavior patterns.
Cognitive behavioral therapy (CBT), interpersonal therapy, and dialectal behavioral therapy (DBT) are three types of behavioral therapy that can be used to help treat individuals with alcohol use disorder. Family therapy provides education to the family as a unit, to focus on family stressors and negative behaviors that may be persistent triggers for the client’s behavior.