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What actually is Rehab?

By Graeme Alford, Founder, 21Renew


In todays world the term rehab usually refers to a residential treatment facility for people who have substance abuse, drug addiction and alcoholism issues.


I despise the term for several reasons and in particular the following;


First, “Rehab” comes with a great deal of stigma in society. It falls into the same category as terms like “Junkie” and “alcoholic” and conjures up images of people overdosing, sleeping on the streets and drinking on park benches out of brown paper bags.


People often fear rehab, just because of what the word has instilled in their perception of what it means... "it's the end of the road"... "life is over". Yet ask anyone who has attended a rehab and they will likely tell you... "it was the best decision" they ever made and "life really began" once they sought professional help.


My second concern is “Rehab” is short for rehabilitation, and people seeking help for their substance abuse issues don’t need to be rehabilitated, they need to receive treatment. When you receive professional care for diabetes, depression, cancer and other illnesses or diseases you are not rehabilitated, you are treated. So why should people with substance abuse issues be classified as needing to be rehabilitated?


Essentially a rehab is a facility with two main purposes. Firstly, to physically remove a person from the substances they are having issues with and allow a controlled withdrawal period. Withdrawals, plus easy access to substances is usually why a person continues to use and drink again and again despite having the resolve and intention to control or stop. Secondly, they are there to treat the mental complexities of substance abuse. To help the individual understand why they continue to rely on substances, and to realign their way of thinking to break the pattern. The work with professionals who understand is designed to not just get them out of the ongoing trap, but to learn how to live a healthy life without resorting to substances.


90% of “Rehabs” in Australia, South East Asia and the USA adopt the Therapeutic Community (TC) model, combined with a form of 12 Step program (Alcoholics Anonymous and Narcotics Anonymous). These facilities offer a one size fits all approach and despite what they advertise they do not offer individualised treatment plans, as people flow in and out of their system.


People seeking treatment for substance abuse come from all walks of life. They have different backgrounds, are at varying stages of their life, with diverse education and employment history. On top of this, their substance issues will be unique, in terms of types of substances, length of usage, depth of problem and motivation to use. Living conditions, family life and support structures around them will vary immensely.


With such a diverse range of age, education, employment, living conditions and support how can any one treatment facility properly deliver a customised program for each client?


They can’t.


It’s not rocket science to realise that what a 23 year old ice addict on bail for drug related charges needs by way of treatment, is totally different to what a 45 year old professional person who is still functioning day to day requires.


Selecting the appropriate treatment option is always difficult. Most of the treatment facilities have glossy websites promoting their program and the vast majority of the public have little or no understanding of what treatment is required for themselves or a loved one.


Over the past 20 years I have assessed hundreds of clients and spoken with their partners and families. Their beliefs of what good treatment looks like is often way off the mark.


Most treatment facilities offer 30, 60 and 90 day packages and this is something I have never understood. What is magical about 30, 60 or 90 days. Why isn’t it 23, 49 and 71 days? Some clients might need more, some may need less. Every client progresses at a different rate and a good treatment facility understands this, monitors their progress and adapts accordingly.


The level of experience of the clinical team is critical to a successful outcome, as is having all the counsellors and medical support team united and on the same page. I have heard countless stories of people who entered a residential treatment program and they really liked one particular counsellor and did not get on with another. This can lead to a fracturing of the client engagement in the program and seriously reduce their likelihood of completing the program.


At 21Renew we regard the post residential component of our program equally as important as the client’s residential stay. We provide each client with a coach who works with the client for a minimum of 2 months after they complete their residential stay and this includes working with their families to resolve any issues that may occur.


The bottom line is when it comes to substance abuse and addiction there is no one size fits all “Rehab”. Do your research, ask the important questions, and find a rapport with the people you speak to on the phone. They are the ones you are trusting with your life.

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