What happens in rehab?

Posted by Mandy Donnison
on 23 Dec 2019

Successful, forward-thinking residential rehab is a place where people are received with kindness, treated with respect and supported to get well.

That support must take the form of allowing a person to flush alcohol, substances and addiction out of their system, discover what caused them to become dependent and find new coping mechanisms.

This may be achieved by any appropriate combination of:

Clinical detox, when required – for those who are physically dependent to alcohol or a substance and experience withdrawal symptoms
Counselling – one-to-one and in groups
Talking therapies – such as cognitive behaviour therapy and psychotherapy
Somatic healing – therapies that use body-focused techniques to help heal the mind and release tension, such as breathwork, reiki, massage, aromatherapy, Bowen technique
Transactional analysis – work around how people interact with others
Lifescript work – to uncover and work on the stories people tell themselves about their lives

What makes rehab effective?

To be effective treatment needs to be tailored to the individual, identify potential relapse triggers and allow people to develop strategies for dealing with things.

Rehab is also a place of interaction and collaboration, with staff and therapists, but also with fellow residents. Everything possible needs to be done to ensure these relationships can be positively built.

Practicalities such as meals and housekeeping elements need to be taken care of to a high standard to ensure they enhance the recovery experience and don’t cause unnecessary stress and frustration.

Rehab should always be about rebuilding a person, helping them to get well and preparing them to move forward in their lives free of addiction. It must focus on the whole person: physical, psychological and emotional.

A vital element of rehab ought to be helping a person to enhance and develop their understanding of themselves and to allow them to share what they know of themselves to help shape their recovery programme.

The stages of rehab

Traditionally rehab centres have put a lot of emphasis on rules, rigid timetables and uniformity but that is being revolutionised.

Some rehab treatment environments believe people who have become overcome by addiction need to be propelled into a new schedule of rising early and focused activity, which often centres around group work and counselling sessions. People are compelled to follow the rules and routine of a centre from day one.

What happens in rehab at Delamere?

Our ‘stop, start, grow’ approach is designed to recognise and respond to individual differences rather than shoehorn people into a predesignated one-size-fits-all schedule.

We believe in working with our clients to develop schedules and routines that work best for them and their recovery. Of course, these must be guided by clinical and specialist experience, but they need not be prescriptive.

Initially, the ‘stop’ phase sees people provided with a caring, compassionate and, where detox is necessary, medically-led recovery environment. This phase is likely to extend at least for the first week of rehab. There is often more harm than good done for everyone if someone is rushed into therapy sessions whilst they are dealing with physical withdrawal symptoms, which are best managed with thorough clinical attention.

Detailed assessment and two-way conversation around issues at play is included in the ‘stop’ stage as and when appropriate. Some hands-on work around anxiety management and trauma release may begin to help build skills and resilience for follow-on stages.

The ‘start’ phase begins when an individual is feeling stronger and healthier and more able to get the most from more intensive and structured work with peers and counsellors via group therapy and individual sessions. Tailored expert-led sessions and learning on appropriate themes will roll out including, perhaps, with focuses on stress, grief, trauma, shame and guilt. This is enhanced by tailored independent learning opportunities via worksheet, video tutorials and electronic tablet-based sessions.

Guest speakers may attend to enhance your experience and inspire.

A personal development plan, drawn up between individuals and clinicians, shapes the treatment each individual accesses and this is regularly reviewed to add or delete features as required.

Constant clinical review and collaboration on progress and challenges continue throughout.

The final stage of rehab with Delamere ‘grow’ centres on developing detailed plans and processes for continuing recovery at home and avoiding relapse.

Family involvement may be increased at this stage. It’s vital for families to feel supported too and brought-into the recovery process.

Reintegration into everyday life may be staggered via trial overnight stays at home and trips out, with follow-up analysis to uncover unidentified triggers and ensure coping mechanisms are in place.

Fun in rehab

Rehab should not be a place of blame, shame, punishment and retribution – those are the negative emotions of addiction.

Recovery is about rediscovering positive emotions and feelings and there should be laughter, fun, serenity, connection and calm amidst the hard work and emotion that’s inevitable.

Activities included in therapy such as exercise, yoga, art therapy, equine therapy (interaction with horses) help to promote these things as does an enabling and positive environment.

Having numerous different spaces to socialise with peers, a room where you feel comfortable to enjoy some privacy, access to and views of mood-enhancing outside space and air and defined areas for downtime, clinical care and therapy support this.

Effective rehab needs to be immersive to allow recovery to begin during residency and transformative in a way that allows it to be sustained when individuals leave.