28-Day Residential Treatment – What More Could You Want?

by Lisa Frederiksen

What more could you want? Short answer: so, so much more!

The common perception is that finally getting a loved one with a drug or alcohol addiction into a 28-day residential treatment program will take care of the “problem” and that all will return to “normal” as soon as treatment is done. Unfortunately, ALL is not well, nor does it return to “normal” for some time.

Why?

Because addiction – whether it’s an addiction to illegal or prescription drugs or to alcohol — is a chronic, often relapsing brain disease. The very nature of this disease is that it causes chemical and structural changes in areas of the brain that are vital to a person’s ability to think straight, behave normally and act responsibility. Those brain and behavioral changes, in turn, set up SHDD (secondhand drinking/drugging) impacts for family members and friends. Living and coping with SHDD, over time, causes family members and friends to suffer physical, emotional and behavioral changes, as well.

BUT -  the addict/alcoholic can make great progress in a 28-day residential treatment program. Also known as rehab, 28-day programs are one of the ways a person goes about beginning their recovery, which is defined as abstinence AND a joy-filled life. For you see, 21st century brain and addiction-related research now shows that treating addiction must follow the same treatment protocols as treating other diseases, such as cancer, diabetes or heart disease.  Instead of the old acute care model (i.e., 28-day rehab), treating addiction must follow the disease management model, which is a three-pronged approach and involves: 1) detox/stabilization, 2) rehabilitation (rehab) and 3) continuing care. 

Just as a person with diabetes, heart disease or cancer has a continuing care program/plan to help them continue their recovery once the acute care treatment (e.g., surgery, radiation, chemo) is complete, so too must the alcoholic / addict AND the family member/friend. These continuing care plans must go far beyond the “typical” drug testing and 12-step meeting attendance monitoring. They must include plans for how to integrate with the family; for how to deal with the fall-out of not dealing with “life” while in their addiction (e.g., credit destruction, parenting issues, relationships problems, foreclosure, lost jobs, lost friendships — the “life” situations than can trigger a person who is in early recovery (day 29, 30, 45 or 72, for example) to relapse; for what the family needs in order to help themselves and in that process, help their loved one.

Quoting from my most recent book, Loved One In Treatment? Now What!:

A More Detailed Explanation of Phase 3: Continuing Care

Because addiction is a brain disease, it is highly unlikely that all aspects of healing the brain can be completed in 10, 28 or even 60 days. Yes, a great start can be made, but a continuing care (a.k.a. an after care) plan that extends “treatment” for at least a full year is critical. This is not to be confused with being “in treatment” at a facility.

A continuing care plan is a specific strategy that outlines how the addict/alcoholic is going to maintain abstinence and a joy-filled life after the detox/stabilization and rehabilitation phases have been completed. Think of it as relapse prevention. And, “What does this mean?”

The addict/alcoholic’s embedded addiction-related neural networks will be triggered by any number of cues – sound, sight, memory, the smell of alcohol, an emotion, a stressful person or situation. Therefore, planning how to prevent and/or handle such cues is critical. Let’s face it, treatment for a heart disease patient or diabetic doesn’t stop after the person is stabilized, nor is it assumed a patient’s diabetes or heart disease goes away after the rehabilitation effort. Instead, those patients are counseled, provided education and behavioral modification strategies, and then they are given a continuing care plan and follow-up with further modifications, if necessary. This same approach must be used with treating addiction. For as you can imagine by now, healing, developing and changing neural networks takes time.

As with rehabilitation, there are a wide range of opportunities and options to include in a continuing care plan. These might include:________________________

… to learn more, order my book, Loved One In Treatment? Now What! An Essential Guide For Family Members and Friends Navigating the Path of a Loved One’s Addiction, Treatment and Recovery. I also provide consulting services (via Skype or in person) to families wanting to understand and/or design a continuing care plan.

• Important: It must be understood that not all addicts/alcoholics need go through a formal treatment program (referring to a 28-day residential or a 90-day intensive outpatient type program, for example) in order to recover. Not all can afford nor do they need such a program, and not everyone is open to it. Regardless of the methods chosen – residential, 12-step, outpatient, addictions specialist therapist, etc., – the objective remains the same: follow a disease management approach that involves detox/stabilization, rehabilitation and continuing care.

© 2010 Lisa Frederiksen, Excerpts from Loved One In Treatment? Now What!… by Lisa Frederiksen. All Rights Reserved.