As we saw in the last blog post, detox and rehab fall under ASAM’s level 4 of care. Level 4 (residential) is the highest or most intensive level of care, with Level 1 ‘outpatient counselling’ being the lowest. Many rehabs incorporate detox facilities on site and we explored what sort of drugs require detox and which require a ‘stabilization’ period. But what happens after detox and stabilization?
Detox and stabilization might take anything from 3 days to 2 weeks, dependent on the drug. After this stage, clients in rehab typically enter the psycho-social phase of treatment. This incorporates all the elements of rehab that people will be familiar with such as group therapy, one on one counselling and various adjunctive therapies such as mindfulness meditation, somatic experiencing, trauma-release exercise, auricular acupuncture or even art therapy.
WHAT GOES ON IN A REHAB?
In well run rehabs, there will be a treatment pathway, which whilst individualized to a degree, will seek to cover basic aspects of recovery for every client. Most centres will ask clients to make a timeline of their addictive behaviour or do written assignments which are designed to describe their addiction to others, both counsellors and peers in the community. Ordinarily this will be presented in a group format to allow the client the chance to ‘uncover’ their addiction with people who are suffering from the same compulsive behaviours. It gives us the chance to be challenged if we are not seeing all of the consequences of our behaviours, but also gives us a chance to gain identification with our peers.Other typical areas of group discussion and therapy might be;
- Building healthy boundaries with others
- Denial of our condition and reservations about recovery
- How to regulate dysfunctional emotional states
- Family issues and dynamics
PHASE ONE OF TREATMENT – DEALING WITH THE ADDICTION
Typically, phase one of treatment (post-detox) might last 2-4 weeks, and concentrate on the details of the actual addiction. What drugs did we use … how much, where, with who … do we think we can stop … costs and consequences, and so on. This may seem morbid but the general idea is to bring the shame of the addictive behaviour into the light, and transform it by way of honesty and acceptance.