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Rehab (Residential Rehabilitation)
What Is rehab?
Rehab is short for Residential Rehabilitation. Typically, Rehabs are usually privately run and owned clinics. They may also call themselves 'Treatment Centres' or 'Recovery Clinics'. There is a dizzying array of approaches used by different rehabs around the country. Some stick closely to the 12 step model that AA is based on; others will have an approach based on cognitive therapy. Some are based on the Christian faith; others have formulated their own philosophies.
All will have some sort of programme for you to follow, based on private sessions with a counsellor or therapist, and on group sessions with other residents. Some rehabs also have a lot of therapeutic activities - gardening, art, canoeing and abseiling for example. Some even run farms. The length and content of each rehab's programme will vary.
The staff working in rehabs will vary enormously too. Some may have a professional background (like nurses or social workers), some may have done some counselling training, and some may be ex-clients.
Many rehabs have their own detoxification units, with their own medical and/or nursing staff. Those without detox facilities will have medical services from a local GP surgery.
Some rehabs treat just drinkers, whilst some will treat drinkers and drug users together. Others may also treat compulsive gamblers, and people with eating disorders or other mental health problems. Some will only have clients who are paying for themselves, others will also have people whose treatment is being paid for from the public purse.
Most rehabs provide some sort of aftercare, for when you leave. Sometimes this is a separate unit where the interventions are less intensive, and you live more independently, or they may be 'dry houses' which are local to the unit. Sometimes follow-up is provided as daycare at the clinic or in a separate day unit.
When to use a rehab
Residential treatment may be a good idea if: You've tried everything else and you're still drinking. Life at home is becoming impossible & unmanageable for either you, or your partner & family.
How rehab works
The way rehab works is largely dependent on their treatment philosophy. However, any rehab offers a place where you can concentrate full time on the solutions to your problems, without any distractions, and in the company of people who are in the same boat.
What's good about rehab
Well run rehabs will give you the chance to closely look at how you can think and live differently. There will be a range of different experienced staff, with different personalities and styles, and you can meet an astonishing array of fellow clients, and learn a lot together. This kind of group experience, away from home, can be dramatic and life changing.
What's not so good about rehab
Any stay at rehab is only as good as the people you're in there with. If your fellow clients are disruptive, difficult and sneaking drink and drugs in, you'll struggle to do well if the staff aren't skilled enough to stamp this out.
Rehab is expensive. Typically you can pay anything from £800 to £4000 per week. This is money well spent at a good rehab. Even at some of the very expensive ones, though, you can be paying for a prestigious consultant who you might see only a couple of times, and for gorgeous landscaped gardens and lovely bath towels. But the day to day treatment is sometimes provided by less skilled and experienced workers, or even by agency staff.
Thirdly, whatever changes you make in rehab, don't forget you have to go home eventually. It can be a slightly artificial fairy-dairy land that can lull you into a false sense of security.
How to choose & use a rehab
Since the quality of rehabs is extremely variable, you need to choose one very carefully. The best way, if you can, is to get a personal recommendation. As a minimum, they should be registered with the Care Quality Commission. The clinical staff should either be from a relevant profession (doctor, nurse, social worker, occupational therapist for example) or be registered with the Federation of Drug & Alcohol Professionals (www.fdap.org.uk). If you're looking at websites, or ringing around, make sure that you get a clear idea of:
- The treatment philosophy (eg 12 step, cognitive-behavioural, Christian)
- The content of the treatment programme
- The length of the programme
- Aftercare & cost
- Whether detox is included
- The range of clients who'll be in treatment with you
- How many restrictions they have on visits, use of phones & computers etc
- The range of skills & experience of their staff
- The quality of the accommodation, if that's important to you
Don't forget that many of these clinics may be desperate for income, and you may find them trying to bounce you into signing up. Don't act on impulse - think carefully about what'll be right for you. The more you feel pressured into paying for treatment, the more alarm bells should go off in your head. Don't be afraid to haggle over price. You may well be able to knock hundreds of pounds off the weekly cost.
There are a number of 'intermediary companies', 'rehab brokers' or 'referral agents' who can sell you rehab placements. They either bulk buy places at discount, and then sell them on to you, or they take a commission from the rehab you're admitted to. Whilst these can be great deals, have your wits about you and make sure that you stay in charge of choosing the right place for you. A good referral agent will get to know you thoroughly, and will help you to find the right place for you. They should also tell you what business arrangements they have with rehabs, and how much commission they take. You should make sure that you're not being denied the choice of rehabs that aren't offering the broker commission.
Note that many results on Google, particularly the paid ones, will be agents and brokers, and many won't be upfront about this role. The less scrupulous ones may pressure you into accepting their choice of placement, and may play on your worst fears to do so.