All About Addiction

Helping addicts get their lives back

Is Leaving Residential Treatment the Most Effective Part?

Residential treatment for substance use has been suffering with low success rates. We've been blaming the clients, but what if the treatment itself is more jail than therapy? Depression and failure could be the outcome. Read More

In Patient only a small part

I have always felt that residential treatment in isolation is, in many cases, an absolute waste of time, and can, in fact, be iatrogenic. Addiction is often a result of wider systemic issues, and so to remove the patient from the system will obviously result in behavioural changes, but to simply return them without appropriate coping mechanisms is largely pointless.

Rather residential treatment should form part of a larger case management process. Individuals should be prepared prior to entering, and should be discharged into the continued care of an out-patient program or on going therapy. Personally I feel that it is only a minority of patients that require residential treatment, and it should be one of the final resorts, rather than a knee-jerk initial reaction.

Leaving rehab can also have its' own negative effects. Many people with addiction issues are resolving complex relational issues through their drug use and in initial recovery transfer their primary attachments to the therapist or therapeutic team - the rehab community becomes a family substitute. If this happens, leaving this new "family" is possibly a precipitating factor for relapse, and as such requires some form of therapeutic intervention that goes beyond the residential treatment setting.

Although I am not a fan of life-long 12 step meetings and even more averse to 12-step facilitation based residential programs, the continued involvement in these meetings post-rehab does help resolve the initial relational void that many patients feel.

Thanks for the input

Shaun, I am always happy to have constructive input and I agree - residential treatment CAN be useful if it is part of a larger treatment plan, although it could also still be traumatic and upsetting and not in the way "therapeutic-communities" want to pretend that it is.
Thanks again for reading!
Dr. J

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Adi Jaffe, Ph.D., is the executive director of Alternatives Behavioral Health and a lecturer at UCLA and California State University Long Beach.

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