What Happens in Rehab?


What Is Rehab Like?

If you're considering a rehab program for yourself or a loved one, you may have lots of questions: What are these programs like? How long do they take? What are the rules?

This page covers the basics about going to a drug or alcohol rehab, including:


What Is Rehab?

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Inpatient or residential rehab is an intensive form of addiction treatment where you remain at a facility for a period of time and participate in group, individual and family therapy. Inpatient treatment may necessitate taking time off from work and/or school to live at the facility while you spend time working on your recovery.

Though there will be similarities in therapeutic approaches, outpatient treatment differs from inpatient treatment in that you attend regular group and individual addiction therapy sessions for a few hours a week. When not participating in scheduled sessions, people attending outpatient treatment usually live at home or at a sober living facility . Outpatient treatment offers people the ability to continue taking care of work, school and other commitments during treatment.

This article focuses on the experience at an inpatient program.


How Long Is Rehab?

Rehab stays can range from 28 to 30 days to 90 days or longer.
Short inpatient rehab durations typically start at 28 to 30 days . Other programs offer 60 days of treatment, and some long-term facilities offer treatment for 90 days or longer.

Some rehab programs offer a standardized program and require a minimum stay. Other programs offer an individualized approach and will assess your level of addiction, mental and physical health, and other factors to determine the best length of stay.


How Does Rehab Work?

Knowing what to expect before attending rehab can reduce some of the worry or fear about the rehab process. Most inpatient programs include the following elements.

Intake

Intake often begins with a brief phone consultation, where a counselor will assess whether you are an appropriate fit for the treatment program. This initial conversation provides a great opportunity for you to ask questions and learn more about the program. If the counselor determines that you and the program are a good fit, he or she will set up a time for the intake to take place in person.

The intake is a thorough assessment of your:

  • Past drug and alcohol use.
  • Medical and mental health history.
  • Family and social life.
  • Past treatments.
The intake counselor will provide information on the program and its rules, have you complete any legal documents and consent forms, and develop a treatment plan and goals. The intake process can take a few hours and may even be spread out over several days, especially if you are going through detox.

Detox

Detox is often the first step in the rehab process. Many rehab programs offer supervised detox services for people withdrawing from a range of substances such as alcohol, sedatives, opioids and stimulants. During detox, medical doctors and nurses administer medications to ease withdrawal symptoms.

The goal of detox is to minimize discomfort during withdrawal and prevent serious and potentially fatal side effects, such as seizures. Once you complete detox, you will transition into the daily treatment program and community.

Typical Day

A typical day at rehab includes individual therapy sessions, group therapy , 12-step or other recovery meetings and periodic appointments with doctors. Meals are offered 3 times per day, and short breaks are given in between therapy sessions. Time is also set aside for completing homework assignments, journaling, practicing yoga, exercising and reflecting on one's recovery.

Many programs offer sober activities on the weekends, such as trips to the beach, movies or family visits.

Rules

Rehabilitation programs have rules in place to keep the environment safe and drug and alcohol-free. Some common rules you can expect include:

  • No drugs, alcohol or paraphernalia.
  • No inappropriate conduct with other clients or staff.
  • No acts or threats of violence.
  • No leaving the property without the permission of a staff member.
  • Compliance with drug testing procedures.
  • Attendance at all therapy sessions and meetings.
Upon arrival, a staff member will search your belongings and take away any drugs, alcohol, paraphernalia and potentially dangerous items. You will also be assigned a room, and you will likely have a roommate. However, some rehabs, particularly luxury and upscale facilities, may offer private rooms.

Privileges and Rewards

Many rehabs will offer rewards and privileges as you advance through the program, remain sober and meet treatment goals. After a period of time, you may be given weekend passes or be allowed to go on unsupervised trips. These privileges provide an incentive for you to continue progressing in your recovery and set a good example for newly sober clients.


How to Prepare for Rehab

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Taking some time to prepare for rehab can increase your chances of success in the long run.

What to Pack

Items that you should bring include:

  • Driver's license or identification.
  • Insurance information and past medical records.
  • Alarm clock.
  • Toiletries.
  • Clothing.
  • Laundry soap.
  • Pictures of loved ones and other items to remind you of home.
  • List of current medications.
  • List of names, phone numbers and addresses of close family and friends.
  • Reading and writing materials.
  • Activities to pass the time, such as musical instruments, crossword books and puzzles.
Check with the program before bringing these items: electronic devices, nail clippers, razors, cigarettes, chewing tobacco and mouthwash (which can contain alcohol).

Also, you may only want to bring a small amount of cash and arrange for a family member or friend to send you additional money if needed. Be sure to leave any expensive items at home, such as jewelry and high-end clothing and handbags.

Taking Care of Responsibilities

Before leaving for rehab you may also want to take care of home, work and school responsibilities, such as:

  • Arranging to take a leave of absence from school and/or work.
  • Arranging for pet and childcare while you are away.
  • Setting up automatic bill payments.
  • Providing a spouse or other family member with account numbers and passwords if they will be overseeing your finances while you are away.
  • Letting family and friends know that you will be going to treatment (if you feel comfortable).
The Americans with Disabilities Act forbids employers from discriminating against employees who have participated in substance abuse treatment. The Family and Medical Leave Act (FMLA) allows employees to take up to 12 weeks per year of leave for treatment of medical conditions, including addiction.

For more information about your rights, please see the Center for Substance Abuse Treatment's publication Are You in Recovery from Alcohol or Drug Problems? Know Your Rights . 2

Reducing Temptation

Some "housekeeping" tips to reduce temptation when you return home include:

  • Getting rid of drugs, alcohol, and paraphernalia. Do a thorough sweep of your home and be sure to check any secret hiding spots.
  • Deleting phone numbers of drug dealers or any people associated with using drugs and drinking.

What to Expect After Rehab

Many people mistakenly believe that completing a treatment program is the end of recovery. The truth is that recovery is an ongoing process that takes time and effort. One way to increase the likelihood of remaining sober is to have a good aftercare plan .

Aftercare planning is one of the final steps during treatment. Typically, a counselor and/or case manager will work with you to develop a plan for transitioning out of the structured treatment environment and back into the "real world." They can help you find other treatment providers, set up appointments and provide you with information on local self-help meetings.

Having an aftercare plan is essential because it increases the chances of long-term recovery and decreases the chances of relapse. 3

Types of Aftercare

Each person's aftercare plan will be different, and a counselor can help you determine what will be most helpful for you after treatment. Your aftercare plan may include one or more of the following:

  • Sober living homes or halfway houses allow people to live in a drug- and alcohol-free environment. They are less restrictive than rehab programs because residents are able to leave the home during the day. Many sober living homes have curfews, mandatory drug testing and rules in place to keep residents safe and prevent relapse.
  • Recovery meetings are free self-help groups for people struggling with drug, alcohol and other addictions. The most popular recovery meetings are 12-step groups, which include Alcoholics Anonymous and Narcotics Anonymous . Twelve-step groups encourage members to share their struggles with addiction, find a sponsor to guide them through the 12 steps and develop a sober support system. Other recovery meetings that do not fall into the 12-step category include SMART Recovery , Women for Sobriety , LifeRing and Secular Organizations for Sobriety .
  • Outpatient treatment is also an option after completing a residential program. Some clients find that the additional support that outpatient provides is a good transition after being in an intensive program. Outpatient rehabs typically offer group and individual therapy for a few hours per week.
  • Psychotherapy or counseling can be provided by a psychologist, social worker or counselor who specializes in addiction. Therapists usually see clients for 1 to 2 sessions per week. But the number of sessions can vary depending on your needs.
  • Medication management involves a physician or psychiatrist prescribing and closely monitoring medications for drug and alcohol cravings and mental health symptoms. Doctors may meet with you 1 or more times per month to assess for any side effects and determine if medications need to be adjusted.

Relapse Prevention

Relapse is a concern for many people leaving rehab. It is common to feel bombarded with triggers and mixed feelings as you transition from a structured and safe environment back to everyday life. Fortunately, you can take steps to reduce the risk of relapse and begin to build a life without drugs and alcohol. These include:

  • Discovering new hobbies such as sports, reading, writing and traveling. You can also consider returning to old hobbies that you might have neglected while using drugs.
  • Creating a support network of sober people. Recovery meetings offer one way to connect with like-minded individuals.
  • Beginning a new exercise routine. Consider trying weight training, yoga, Pilates or tai chi.
  • Consuming a healthy diet of protein, vegetables, fruits and complex carbohydrates. Avoid excessive sugar, salt and processed foods.
  • Volunteering your time at a homeless shelter, soup kitchen or nursing home.
  • Managing stress by practicing coping skills that you learned in rehab, such as meditation and deep breathing.

Visiting Someone in Rehab

Visiting a family member or friend in rehab can be beneficial to your loved one's recovery. Visits remind those in rehab that they are supported and also provide them with positive reinforcement for staying sober.

Most programs also offer the opportunity to participate in a joint therapy session during visits. A therapy session can allow family members to express their concerns, work through problematic family dynamics and improve communication.

Visitation Policies

Programs differ in their visitation policies.

  • Some programs only allow weekend or night visits during certain hours.
  • Some rehabs only allow a client to have visitors after he or she has been in treatment and followed all the rules for a period of time. This "black out" period limits contact with family and friends in order to get the client through detox and assess his or her motivation for change.
  • Other programs only allow visits if family members and clients agree to participate in family therapy.
Be sure to ask the treatment center about its policy before you visit.

Rules for Visitors

In order to ensure that the rehab remains a safe drug- and alcohol-free environment, visitors are expected to abide by certain rules and procedures:

  • Visitors are forbidden from sneaking in alcohol and drugs. They also may not be allowed to bring in unsealed drinks, which could have alcohol hidden in them.
  • Visitors and their belongings may be searched before the visitor can enter the facility.
  • Visitors may not be allowed to enter certain parts of the facility. This is especially true for clients' bedrooms or anywhere that cannot be monitored by staff members.
  • Staff members may provide a tour of the facility and a brief overview of the treatment program. The goal is for visitors to get a sense of what the treatment experience is like for their loved ones.
  • Joint counseling sessions may be voluntary or mandatory for visitors. If you are planning to participate in a therapy session, you may want to think about what you would like to say beforehand. Prior to your visit, most counselors will prepare you for what to expect during the therapy session.

Preparing for a Visit

Visiting a loved one in rehab can cause mixed feelings that can range from excitement and happiness to worry and anger. Many family members and friends become used to negative interactions when their loved ones are using drugs and alcohol. Visiting someone in rehab is the first step in practicing healthy communication. Negativity and hostility can hinder a person's progress in recovery.

The Community Reinforcement Approach (CRA) is a well-studied and effective form of treatment for clients and family members experiencing addiction. The approach seeks to improve healthy communication among family members. 1

Some CRA tips for improving communication include:

  • Offer empathy and understanding. Empathy involves putting yourself in the other person's shoes.
  • Avoid blame, criticism and arguments. Focusing on all of the negative things a person has done during addiction can increase feelings of guilt and shame, which further triggers a desire to use drugs and alcohol. Most likely the person is aware of the wrongs that he or she has committed. Instead, focus on your loved one's current progress.
  • Problem-solve ways to help and be an active part of your loved one's recovery. Ask your family member what you can do to be most supportive of his or her sobriety. Family involvement in treatment is linked to higher success rates.

Frequently Asked Questions

What Happens if You Use Drugs in Rehab?

Using drugs or alcohol in rehab goes against the rules of treatment programs and can comprise the sobriety of other clients. While each program differs in how it handles relapses in rehab, most programs have consequences, which can include:

  • Loss of privileges, such as weekend passes and access to electronic devices.
  • Additional assignments or therapy sessions.
  • Termination from the program.
Many rehabs will discharge or terminate clients after 2 or more relapses.

Can You Bring Your Phone or Computer to Rehab?

Each program has different rules for electronic devices. Some rehabs allow phones, computers and other electronic devices during a client's entire stay. However, other programs forbid these items or only allow them after you have been in the program and stayed sober for a certain period of time.

These programs may also take away the privilege to use a phone or computer if you relapse or break the rules.

Can You Make Someone Go to Rehab?

You cannot force a person to go to rehab. But if you are concerned about a loved one's drug or alcohol use, you can help them consider the benefits of treatment.

One approach to getting loved ones into treatment is Community Reinforcement and Family Training (CRAFT). 4 In several research trials, CRAFT demonstrated effectiveness in getting a family member to commit to treatment. This approach uses behavioral interventions to reinforce sobriety and discourage substance use.

A trained psychologist or counselor can implement CRAFT. Therapists trained in CRAFT can also work with families without the addicted family member present if that person is not ready or willing to participate.

Can You Leave Rehab Early?

Leaving rehab early without completing the program is not recommended. This is often called leaving "against medical advice" or "AMA." When you leave rehab prematurely, your risk of relapse increases.

If you are considering leaving rehab early, discuss your concerns with a counselor, who can help you think through your decision.


Find a Program Near You

If you or someone you know is struggling with addiction, call our helpline today at 1-888-319-2606 to speak with a recovery support specialist. Our representatives are available to assist you with finding a treatment program and verifying insurance coverage.

Sources

[1]. Meyers, R. J., Smith, J. E., & Lash, D. N. (2002). The Community Reinforcement Approach . Recent Developments in Alcoholism (pp. 183-195). Springer, US.

[2]. Center for Substance Abuse Treatment. (2004). Are You in Recovery from Alcohol or Drug Problems? Know Your Rights .

[3]. Center for Substance Abuse Treatment. (2015). Detoxification and Substance Abuse Treatment . Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Substance Abuse and Mental Health Services Administration.

[4]. Meyers, R. J., Smith, J. E., & Lash, D. N. (2005). A Program for Engaging Treatment-refusing Substance Abusers into Treatment: CRAFT . International Journal of Behavioral Consultation and Therapy, 1(2), 90-100.

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