Why is Residential Rehab better than outpatient addiction treatment?

Jason Sheirs
Author / Jason Shiers / Dip. Psych MBACP

If you are having trouble controlling your substance use or are concerned about a loved one, you may be considering treatment programmes, and deciding between residential rehab facilities or outpatient treatments. Each type of treatment setting has advantages and disadvantages to take into account:

Residential Rehabilitation Programme

A residential rehabilitation centre is typically private and able to offer you a haven to focus on your recovery away from triggers and stresses. Most substances such as alcohol require a alcohol detox which is better managed in a residential rehab setting as well as enabling easier integration into your treatment programme.

What determines a ‘Good’ residential rehabilitation facility?

A rehab centre that best suits your individual needs, the severity of addiction and offers the best treatment plan for you takes some consideration:

  • Where are they located? Being away from your environment may be more beneficial with less temptation
  • Is the treatment team credible, certified and experienced in dealing with addiction?
  • Medical – Does the treatment centre offer medical assistance to aid your recovery? Can the centre provide medication to assist with your withdrawal?
  • What do past clients have to say? Having excellent reviews from past clients should also be in abundance and available for you to view.
  • Do they have a decent CQC rating? All residential treatment centres in the UK are regulated by the Care Quality Commission (What we do | Care Quality Commission), the independent regulator of health and social care in England. All centres are individually rated to ensure that they meet the fundamental quality and safety standards for your care and treatment. Their findings and ratings are published on the CQC website available for anyone to see.
  • Does the centre offer a treatment program that you like? different treatment centres utilise different therapeutic models:
    1. 12 Step Model -A spiritual abstinence-based programme pioneered by Alcoholics Anonymous (AA) where the belief is that addiction is a disease. The programme focuses on your motivation to change your addictive behaviours within the treatment and recovery process.
    2. Non 12 Step Model – These programmes focus on addiction’s multifaceted issue and offer a treatment programme that includes both physical and psychological therapy.

Why should you choose to receive treatment as an inpatient?:

You require concurrent detox treatment for more than one substance & require a high level of expertise.
A good residential rehabilitation facility has fully integrated programmes tailored to your needs and is capable of treating poly-drug use, mental health issues and concurrent behavioural addictions (10 Things You Should Know About Dual Diagnosis Treatment)

You will receive 24-hour supervision by trained staff and therapists;
Enduring withdrawal symptoms whilst addressing the causes can be uncomfortable, at a residential facility you are never alone while battling your addiction. You will encounter an incredible team of supportive and caring professionals and staff whose aim is to see you in long-term recovery free from your demons.

You are just starting out on your addiction journey and could benefit significantly from a residential rehab during and after detox. Or you have tried to quit in the past on your own and need a more structured environment.

The environment you reside in is not conducive to your recovery
Recovery requires a supportive, safe environment to give you a better chance at a positive outcome. If you don’t have a stable home life or someone to assist you as you detox and go through withdrawal, you may be tempted to re-use to relieve the symptoms.
If you do choose to detox at home, at the very least consult with your doctor who can assist you as best he can.

Being able to fully focus on your recovery without your normal life stressors
Addiction is very rarely about the substance or behaviour, the underlying causes, be it trauma, loss, mental illness etc, will start to re-emerge as your mind gets used to not having the addiction as a shield. Whilst there is a need to address and treat these underlying causes, being in a safe environment with no personal stressors will help you stay committed.

Less risk of coming into contact with or be tempted by the substance you are addicted to
When you are in your familiar environment, your risk of encountering your drug of choice, a fellow user or any other temptation is high. A residential rehab has strict rules that prevent you from coming and going as you please. Whilst this may seem a ‘con’ it is a huge positive.

Shorter programs due to the full-time intensive treatment
Whilst the recommended stay in residential rehab is 28-days, this can often be extended if needed, the treatment is intensive and may involve a mix of therapies:

  • Cognitive Behavioral Therapy (CBT) – the tenet of CBT is that all humans’ core beliefs can be summed up in three categories: self, others, future. (Cognitive Behavioral Therapy (CBT): Definition, Types, Techniques, Efficiency)
  • Rational emotive behaviour therapy (REBT) – identifies irrational beliefs, actively challenges these beliefs, and teaches you to recognise and change these thought patterns.
    (Different approaches to psychotherapy)
  • Acceptance & Commitment Therapy (ACT) is compatible with the 12 step program, both approaches enforce acceptance of your addiction and a broad life reorientation as opposed to just elimination of the substance use.
  • Dialectical Behaviour Therapy (DBT) – DBT is about developing a therapeutic alliance between you and your therapist through unconditional acceptance within a climate of loving-kindness.
  • Multimodal Therapy – Also known as Combination Therapy, where a dual diagnosis is made (mix of mental health issues and substance abuse) there may be a need to treat both issues simultaneously, since trauma, family history, depression, etc may have led to your addiction developing, just treating the addiction is not enough, your mental health also requires treatment to prevent relapse. (Multimodal Therapy: Overview of Principles, Barriers, and Opportunities)

Secondary Addiction Treatment

Once your initial treatment (generally a 28-day inpatient programme) has been completed, most residential rehabilitation facilities have ongoing support available for you and your loved ones, this may include an extended stay as a resident or a continuation of your treatment as an outpatient.
Secondary Addiction Care Service can assist you with:

  • Reintegration back into your daily life
  • Relapse prevention
  • Reestablishing a support network within your community and family
  • Continuation of therapy
  • Rebuilding your daily life skills
  • You will receive referrals to support groups in your area to assist you in staying sober.

All that being said, there are some advantages to seeking treatment as an outpatient:

Pros:

You can recover at home, provided the environment is safe and you have supportive loved ones, recovery at home may feel more comfortable and familiar.

It is usually cheaper & you can continue working during treatment, financial constraints may be preventing you from seeking treatment in a private facility, there are sober management programmes, private therapy sessions and even programmes run from rehabilitation centres that can assist you.

You can control your schedule whilst in residential rehab, you are in a structured environment that dictates when you get up in the morning when you eat, when you have counselling sessions and when you have free time. This may feel too constrictive.

No need for childcare choosing an outpatient programme means that to a great extent you can continue with your day to day responsibilities.

Cons:

Your risk being exposed to the same influences,
The risks and triggers that pushed you towards drugs or alcohol are still a part of your day to day life.

You may still have access to drugs/alcohol

Daily life distractions could keep you from focusing on recovery
Choosing to recover at home takes a lot of focus and willpower to prevent relapsing. In rehab, you are supported 24/7 and have daily tasks, therapies and activities structured around keeping your focus on recovery

Access to your counsellor is more limited than in a residential facility.
As an outpatient, your therapy will have scheduled appointments, maybe only once a week. Whereas in residential rehab, your therapist will see you daily, you will be involved in group and family therapies as well as having 24/7 support on hand.

Group therapy
Whilst in residence you will develop bonds with other people in treatment that may later become part of your sober support network. As an outpatient, you do not spend as much time with others in treatment, which makes building the foundation of this support network more challenging.