05/15/2014 12:53 EDT | Updated 07/15/2014 05:59 EDT

What It's Really Like in Rehab

With the recent media focus on addiction issues, one of the most common questions emerging is: What is rehab really like?

Having worked in the field of addiction and residential treatment facilities for 34 years, I have had the privilege of working with many individuals battling addiction, and have also had opportunity to create the treatment programs themselves.

The treatment approach at Bellwood Health Services is holistic and multidisciplinary. In order to recover from addiction, one's biological, psychological, social and spiritual self must be considered. The phrase "it takes a village" would be a good metaphor for the multidisciplinary approach at Bellwood, where psychologists, physicians, addiction counsellors, nurses, nutritionists, fitness instructors, spiritual guides and volunteers all work together to help the client develop the understanding and coping tools necessary for recovery.

I recently posed the question of what rehab is like to a group of clients in our inpatient program. Their responses were interesting and could be seen as revealing of how that person is also doing within the treatment environment. For example, some responded that rehab is a "bubble of safety" -- a place where they can feel freedom from the condemnation they anticipate might await them in the outside world. With that sense of safety, they are able to express themselves without censure and receive support from staff and clients alike.

Many clients when leaving treatment express their deepest gratitude towards their fellow clients -- a tribute to the importance of having a sense of a caring community within the treatment milieu. This sense of safe community hopefully continues after discharge through 12-Step groups, aftercare groups, and personal supports. For those who view rehab as a safe haven, there is a positive attitude towards the treatment modalities offered and a better prognosis for successful recovery.

Other clients have identified rehab as like being in a "prison." The specific rules, limitations of usual personal freedoms, and schedules each day contribute to this sense that they are being held against their will and have lost control of their daily life. It is true that there are specific rules, such as the requirement that all cell phones, computers and car keys must be handed in when admitted.

However, the rules are set to create as much safety as possible and to allow clients to focus only on their treatment process. There are clients who don't want to be in treatment or don't believe they have an addiction, and spend an inordinate amount of time and energy breaking the rules or devising ways to sneak past the rules.

For these individuals, the battle with the institution's expectations becomes their focus and unfortunately, their way to avoid dealing with their addiction. Indirectly, it also gives the client some sense that they still have their own power, albeit a destructive power. As a therapist, it is very helpful to know whether a client considers rehab a safety zone or a prison, because the client's viewpoint is the only logical place from which to start.


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