Residential treatment, also called residential rehabilitation or inpatient rehab, describes either a mental health facility or a drug and/or alcohol or process addiction treatment program that is provided to patients in a residential setting. The patients receive treatment at the residential treatment facility and they reside there for the duration of their treatment program.
People live in facilities together with other patients and therapists in order to receive therapy and medication on a 24-hour basis. The term does not usually refer to treatments in hospitals or centers specializing in physical or occupational therapy, but rather to centers for long-term treatment for substance abuse disorders and other mental problems, or to therapeutic boarding schools or wilderness programs for young people.
Some residential treatment centers specialize in only one illness, such as eating disorders or substance abuse. Others treat people with a variety of diagnoses or dual diagnosis of substance abuse and a psychiatric diagnosis.
Residential treatment is expensive, and some people have to go through it more than once before they finally achieve their goals. Nevertheless, it is considered the best, state-of-the-art treatment for behaviorally-based disorders such as drug addiction, alcoholism, and obesity, and many mental disorders, especially those which are treatment-resistant, life-threatening, or involve suicidal ideation or severe acting out.
Length of Time for Residential Treatment
There is short-term (30 days or less) and long-term (more than 30 days) residential treatment. The length of time for a patient in residential treatment depends on the type of addiction, duration and frequency of use, any co-occurring addictions or mental health disorders, and other factors.
Some residential treatment is time-limited due to the patient’s insurance coverage. Or, the individual may have exhausted his or her coverage for substance abuse treatment but still requires treatment. In such cases, either the patient or his or her family has to pay out of pocket or transition to outpatient treatment or other form of support, including 12-step self-help groups (Alcoholics Anonymous and Narcotics Anonymous, to name two) or other community-based support.
What Happens During Residential Treatment
In most cases, detoxification is required before any formal program of treatment can begin. Detoxification is the clearing out of all the harmful toxins from addictive substances such as alcohol or drugs (or both) from the body.
Following detox, patients in residential treatment usually receive different forms of treatment, depending on their specific needs. Such treatment may include one-on-one counseling, group therapy, other forms of therapy (such as cognitive behavioral therapy or CBT), educational lectures and discussions, participation in a 12-step program, and relapse prevention training.
It may be best to think of residential treatment as occurring in stages, although the stages often overlap. The first stage is intensive therapeutic intervention and the immediate responses to living drug- and alcohol-free (or free of process addictions such as gambling addiction, work addiction, compulsive sex, overeating, and the like).
The second stage of residential treatment is more focused on the development of life skills, reintegration through education, training, or employment-focused needs, and learning the skills required to maintain a drug-free lifestyle while still participating in and receiving intensive support from the residential treatment program.
When people enter the centers, they undergo a battery of physical and mental tests to determine their diagnoses and treatment protocols. Many patients will have dual diagnoses, that is, more than one illness. If the problem is substance abuse, the first phase of treatment is chemical detoxification, in which patients clear their bodies of all traces of the chemicals they have been abusing. Usually, physicians and other medical professionals monitor their withdrawal processes and help ease physical symptoms with medications.
In most residential treatment centers, each day is highly structured with different activities designed to help people learn how to live drug-free lives or overcome their eating disorders or any other psychological problems that they are facing. There will be activities scheduled on an hour-by-hour basis. A typical morning may include an hour of outdoor exercise, breakfast, a one-on-one session with a personal therapist, classes about drug abuse, nutrition or other relevant topics, followed by lunch. Afternoon and evening activities might include relaxation classes such as yoga, drama or art therapy, group therapy, family therapy, cultural or sports outings, outdoor activities, journaling, and a 12-step meeting. One big advantage of residential treatment is that each person works with a team of therapists who help him achieve maximum physical and mental health. Before the person returns home, his case manager will arrange for after-care treatment within his local community that might include 12-step meetings, individual and family therapy, and other support.
Therapeutic boarding schools for teens and children have similarly structured days, except residents will attend classes and have study sessions along with their therapies. Wilderness programs usually last three months. Young people, usually in a group of seven or less, explore nature with professional therapists and adults experienced in outdoor survival.
Most residential treatment is voluntary. Only rarely is a person forced into residential treatment, although it may occur as the result of a court order.