Every Step in the Continuum of Care in Alcohol Rehab Programs
Admitting that you need help with alcohol misuse or addiction is arguably the most challenging step toward recovery, but once you have admitted you need treatment, you can begin the process of working toward sobriety, wellness, and long-term recovery. Alcohol rehab programs can help put you on that path.
In this article:
Levels of Care at Rehab Centers
When you begin your recovery journey, you will be assigned to a certain level of care at the rehab facility. Levels of care are a therapeutic necessity, allowing your care team to identify the type and amount of attention you need. You may be evaluated by a therapist, medical doctor, or other licensed personnel at the facility.
The necessary level of care depends on your addiction, including the severity of your substance use disorder (SUD) and any progress you have already made in achieving sobriety.1
Levels of care include the following.1
If you have developed a physical dependence on alcohol or another substance, you may need to undergo detox. If you begin treatment after a medical crisis, such as alcohol poisoning, you may be admitted at the emergency room and receive intensive care at the hospital before you go to a residential facility for medical detox. To begin detox in a residential facility, you must first be medically stable. 2
Detox in residential facilities includes medical oversight by a physician and a psychiatrist who help ensure that you remain stable through the withdrawal process. During medical detox, medication is used to manage withdrawal symptoms.2
Some patients may choose not to complete medical detox, meaning they do not wish to use any medications through the withdrawal process. Some rehabilitation facilities do not offer medical detox and simply offer supportive care for those going through withdrawal symptoms, known as non-medical detox.2
Always speak with your medical doctor if you are unsure if you need to undergo medical detox as detoxing from certain substances can be dangerous and even life-threatening.2
Inpatient treatment is a step down from the detox phase, where you will begin a residential stay in an addiction recovery facility. Traditionally inpatient rehab stays last 30 days, but the duration of some residential alcohol rehab programs is dependent on the recommendations of your care team. Inpatient treatment can be completed in a facility of your choice, allowing you to research and compare rehab centers.2
Medical and non-medical detox is often done in the same rehab facility that you choose so you do not have to transition between treatment centers after you step down from detox. 2
Treatment and care received in an inpatient rehab facility include individual psychotherapy, group therapy, and medication management by a psychiatrist.2 Here you will work with your care team to start building sustainable sobriety and to stabilize your medical and psychiatric symptoms enough to step down in care.2
Partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs) are similar in their treatment methods and goals. Both are offered to individuals who have completed residential treatment and stepped down to live in and re-engage in the community with continued therapeutic oversight. In some cases, this involves living in a sober living environment during the outpatient program.3
Occasionally, some people may not require residential treatment and are immediately accepted into a PHP or IOP to begin their recovery process.3
PHPs and IOPs usually meet at a residential facility but in a specific room in the building and not the residential living spaces.3
At PHP and IOP meetings, you will engage in classes to continue your understanding of addiction and attend group therapy sessions, where you will get to know peers who are also seeking long-term sobriety.3
Some PHPs and IOPs offer individual sessions, but they are not as frequent as the sessions offered in residential treatment.3
The difference between PHPs and IOPs is the frequency and duration of the meetings. A PHP is a small step above an IOP, so they traditionally meet four days a week for three to four hours a day. An IOP traditionally meets two to three days a week for two to three hours a day. Like residential treatment, the frequency and duration of PHP and IOP sessions may depend on your program or on the recommendations of your care team.3
Once you have completed your PHP or IOP program, you may step down to outpatient care. With outpatient care, you live at home and engage with your community while continuing to see a therapist for your addiction recovery needs.3
Outpatient is often a necessary step in the recovery process. If you have gone through inpatient and PHP or IOP treatment, you have received support to help you begin to learn your triggers and manage your urges to misuse substances. Your outpatient therapist will be able to help you continue to navigate your new sobriety in a healthy way to maintain long-term recovery.3
The maintenance phase is not a formal level of care, but one that is necessarily included in your treatment plan. It may include a formal aftercare plan created by your care team. In the maintenance phase, you will have completed every other level of care deemed necessary by your care team and be solidly on the path toward your recovery.4
At this stage patients are strongly encouraged to attend support groups or 12-step meetings in the community, such as Alcoholics Anonymous or Celebrate Recovery. With these 12-step meetings, you will be continually immersed in a sober support network while hearing and discussing the recovery mindset and sober lifestyle.4
The maintenance phase is the longest phase of recovery and one that you will participate in for the rest of your life in some capacity. Choosing a community in which you feel most comfortable will be crucial to ensure that you maintain long-term sobriety.4
Types of Treatment Facilities
Each residential facility offers different specializations, amenities, and opportunities. Most rehab centers focus on one type of addiction or on a specialty such as dual diagnosis.
Traditional Rehab Centers
Traditional rehab facilities are the most well-known type of rehab, as they have existed the longest. Most offer the full spectrum of treatment options, from medical detox to outpatient treatment.2
Traditional rehab facilities focus on the psychotherapeutic aspects of recovery, where each patient is offered one-on-one therapy and psychiatric care.1 Additionally, most traditional rehabs offer group therapy sessions where patients can build support with other people seeking recovery.2 In many rehab centers, each patient is also asked to engage in family therapy sessions, as healing interpersonal relationships and receiving the support of loved ones can be crucial for successful addiction recovery.1
Traditional rehab facilities have communal living where you are assigned roommates.1 You live in a specified unit within the facility. Depending on the size of the center, you may have a chance to get to know many of the clients who are also receiving treatment or you may mostly interact with your unit. Your unit will eat together in a cafeteria, participate in group therapy together, and enjoy family visitations at the same time.2 Many people find this communal aspect of recovery appealing, as addiction can create or encourage isolation.
Services at traditional rehab facilities are often accepted by most major insurance plans and many rehab centers offer a discounted rate for individuals paying out of pocket. This can make them an affordable choice for receiving the care you need.2
Luxury rehabs are becoming more popular as addiction treatment moves away from the institutional settings of some traditional addiction programs.2 Most luxury rehabs maintain the same traditional addiction model of stepping down levels of care, from medical detox to outpatient rehab.5
Luxury rehab centers often offer more private accommodations where clients have their own room. Like traditional rehab centers, luxury rehabs offer individual therapy and group therapy.5 Luxury rehabs are often located in vacation-like settings. Many luxury rehabs are found at beaches or in the mountains, which many people seeking recovery find appealing.5
Luxury rehabs may also offer amenities including swimming pools, yoga sessions, animal-assisted therapy, and gyms.5
Luxury rehabs are more expensive than traditional rehab centers due to their locations and amenities. You will want to make sure that the luxury rehab you are considering is covered by insurance or within your price range.5
Holistic rehabs are one of the newer forms of addiction treatment. These rehab centers shift the focus away from treating addiction with medical interventions to treating the whole person.6 Holistic rehabs work to complement traditional and homeopathic methods of recovery by treating both the physical and emotional symptoms of addiction and withdrawal.6
Holistic rehabs typically have a communal feel to them where individuals seeking treatment live in community with peers.6
Therapy in a holistic rehab is less focused on conventional psychotherapy and psychiatric interventions and more focused on wellness modalities such as somatic—or body-focused—therapy, mindfulness meditation, and trauma reprocessing therapies like eye movement desensitization and reprocessing (EMDR). Holistic rehabs also focus on nutrition, movement (e.g., yoga and Tai Chi), and self-awareness.6
Holistic rehabs may be covered under insurance, but you may have a more difficult time finding coverage since many facilities are newer and some of the therapies used alongside conventional therapy are considered “alternative.” Out-of-pocket payment is an option for any rehab facility, so even if your insurance will not cover the cost, you can discuss your needs with facility administrative staff to see if it is a good fit.6
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How to Choose a Rehab Center
Choosing a rehab facility is an important step toward recovery, but one that can feel daunting. There are many rehab centers in the United States, but there are some quick ways to pare down your options.
You can start narrowing your choices by only considering rehab facilities that:
- Accept your insurance—To find out more about your insurance benefits, call your insurance membership services. On this call, you can find out the type of treatment options covered, as well as whether a specific facility is in-network. If the facility is not in-network, you may be able to have the services preauthorized based on your medical need. Your doctor can help you complete this process. If you do not have coverage, you can pay out-of-pocket for the level of care you need. Some facilities negotiate a reduced rate for self-pay patients. 2
- Offers the treatment you need—If you need detox services, look for a facility that offers medical or non-medical detox.2
- Treats patients with your needs—If you are looking for treatment for alcohol, another substance, or for polysubstance misuse, look at the facilities’ specializations to see if they match your needs. Some facilities specialize in alcohol rehab programs while others focus on treating other addictions, so check with the facility or look online before making a final decision.2 Some facilities treat specific demographics, such as women, LGBTQ individuals, or teenagers with alcohol use disorder.
- National Institute on Drug Abuse. (2020). Types of treatment programs.
- Weinstein, Z.M., Wakeman, S.E., & Nolan, S. (2018). Inpatient addiction consult service: expertise for hospitalized patients with complex addiction problems. Medical Clinics of North America, 102(4), 587-601.
- Allison, M., & Hubbard, R.L. (1985). Drug abuse treatment process: a review of the literature. International Journal of the Addictions, 20:9, 1321-1345.
- Bogenschutz, M. P., Geppert, C. M. A., & George, J. (2006). The role of twelve-step approaches in dual diagnosis treatment and recovery. American Journal on Addictions, 15:1, 50-60.
- Firestone, C. (2008). Killing the buzz: The real story on rehab. University of Southern California.
- Molfenter, T., Capoccia, V. A., Boyle, M. G., & Sherbeck, C. K. (2012). The readiness of addiction treatment agencies for health care reform. Substance Abuse Treatment, Prevention, and Policy, 7(1), 1-8.