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Inpatient Alcohol Rehab: How it Works

Understanding what to expect at an inpatient alcohol rehab center can help make the process less worrying and ultimately more effective for those seeking inpatient treatment for alcoholism. But while the type of therapies employed might vary among treatment centers, the alcohol rehab centers with the highest success rates generally utilize similar protocols such as reality based therapies, evidence based practices, management of Post Acute Withdrawal Syndrome and denial management. However, anyone considering treatment should know that just as alcoholism is a very individual condition, treatment for alcoholism is also exceptionally individualized according to the needs of the patient. In fact, the therapies and treatment modalities employed will seek to uncover exactly what those needs are and develop a plan in conjunction with the patient to address those needs directly throughout the course of their inpatient alcohol rehab program.

Most inpatient alcohol rehab centers require that their clients complete the detox stage prior to enrolling. This is partly because the issues faced by persons experiencing Acute Withdrawal Syndrome are different and often more severe than the issues faced during subsequent treatment, and partly because most treatment centers are not equipped to provide the medical support that alcohol detox requires. Many consider detox to be the first step in treatment for alcoholism. According to the National Institute on Drug Abuse;

Detoxification is the process of allowing the body to rid itself of a drug while managing the symptoms of withdrawal. It is often the first step in a drug treatment program and should be followed by treatment with a behavioral-based therapy and/or a medication, if available. Detox alone with no follow-up is not treatment.” (1)

In many cases patients transfer directly from the detox center to the alcohol inpatient program where treatment will focus on reality based therapies. This refers to the fact that patients live in the same place where they receive treatment, and will be required to cook and clean for themselves, attend appointments and live in a college dorm-like environment that mimics real life as closely as possible while still providing a secure and supervised environment. However, reality based therapies also refers to a set of practices that helps a patient take responsibility for their own treatment. Reality therapy in psychoanalysis was pioneered by William Glasser, who held a different view on treatment than his peers:

“Glasser holds the view that people who are behaving in inappropriate ways do not need help to find a defense for their behavior. Instead, they need help to acknowledge their behavior as being inappropriate and then to learn how to act in a more logical and productive manner.” (2)

This type of accountability for behaviors empowers alcoholics to take control of their own treatment and hold themselves totally responsible for the success – or failure – of their treatment for alcoholism.

Reality therapies are best employed in an alcohol rehab center that focuses on evidence-based practices. Evidence based practices are a group of therapies or treatments that have been tested and proven in a number of ways utilizing what amounts to the scientific method. Also referred to as empirically-supported treatment, evidence based practices are a required part of inpatient alcohol rehab programs. Like reality based therapies, EBP or EST focuses on helping the patient to properly control the things they can and cope with the things they can’t. In a survey of treatment specialists, the overall trend that emerged was that EST:

1) Focus on skill building, not insight or catharsis
2) Involve continuous assessment to monitor a client’s progress
3) Are problem-focused (3)

Evidence based practices guide patients in dealing with the future – not the past – and do so in a way that accurately permits the patient to take credit for their own progress.

Both reality based therapies and evidence based practices are used to manage the most critical aspect of long term recovery from drug addiction or alcoholism: Post Acute Withdrawal Syndrome or PAWS. PAWS is a set of symptoms that begin immediately after Acute Withdrawal or detox. These symptoms can range from sleeplessness to memory problems to cravings for alcohol that decrease in severity over time. According to Debbie Davis of Recovery First’s Florida alcohol rehab center:
“The most important thing to consider when it comes to PAWS is that it is completely normal – it happens to everyone who has ever recovered from any substance addiction. The symptoms are usually transient in nature so there is frequent relief, and some symptoms are very mild. Many people report freedom from PAWS symptoms in as little as a few weeks, while others have experienced lingering effects for years.” (4)

But while it might be normal to experience PAWS symptoms, patients still need to develop skills to cope with them.

Successful inpatient alcohol rehab programs also help an alcoholic to deal with and manage denial. Denial is a common trait among substance abusers and alcoholics and is often the very mechanism by which alcoholics continue to justify their drinking. However, denial permeates deep into the psyche of a person afflicted with addiction or alcoholism and in many cases the patient may be completely unaware of these issues. Reality based therapies and evidence based practices such as individual therapy, group therapy, cognitive-behavioral therapy and biofeedback all help an alcoholic to face the truth about their drinking and the future of their recovery.

Most alcohol rehab programs last for about 30 days, but in some cases a person may need as long as 60 or even 90 days in order to feel secure enough to return to their communities with the skills, resources and support networks required to live a life of lasting recovery, one day at a time.

If you or someone you love is suffering from a drinking problem, you can get the help you need right now simply by picking up the phone. Call the number at the top of your screen and speak confidentially to an alcoholism counselor about starting an inpatient alcohol rehab program today.

(1) National Institute on Drug Abuse What is Detoxification or Detox?
http://www.nida.nih.gov/tools/faq.html#Anchor-What-16877
Accessed 09/20/2011

(2) WikED Reality Therapy, William Glasser
http://wik.ed.uiuc.edu/index.php/Reality_Therapy
Accessed 09/20/2011

(3) William O’Donohue, Ph.D., Jeffrey A. Buchanan, M.A. and Jane E. Fisher, Ph.D. Characteristics of Empirically Supported Treatments November 22, 1999. From the Department of Psychology, University of Nevada, Reno http://jppr.psychiatryonline.org/cgi/content/full/9/2/69
Accessed 09/20/2011

(4) Davis, Debbie The Symptoms of Post Acute Withdrawal Syndrome Recovery First.ORG
http://recoveryfirst.org/the-symptoms-of-post-acute-withdrawal-syndrome.html/
Accessed 09/20/2011

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