Identifying the most appropriate rehabilitation centre for substance use disorder, or alcohol use disorder, or indeed any other form of addiction, requires careful consideration of various factors. Here are some of the key factors to consider:
- Medical detox: If you have been using substances or alcohol for an extended period of time, you may need medical detoxification to safely manage withdrawal symptoms. Look for a rehabilitation centre that offers medical detoxification services, which may include medication-assisted treatment to help ease withdrawal symptoms.
- Accreditation and licensing: Make sure the rehabilitation centre you choose is licensed in the country they are operating in, such as the Commission on Accreditation of Rehabilitation Facilities (CARF)[1] or the Joint Commission International (JCI)[2]. These accreditations indicate that the rehab centre meets certain standards for quality care. Be aware that affiliations are not the same as accreditation.
- The Program: are the staff qualified to be delivering what the rehabilitation centre offers – such as Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Trauma therapy? If staff are not listed with their qualifications on a website, then this a red flag.
- Holistic activities: Substance use disorder and/or alcohol use disorder affects the whole person, so it is important to look for a rehab centre that offers holistic activities to address physical, emotional, and spiritual needs. These activities may include yoga, meditation, art therapy, and outdoor activities.
- Psychiatric help: Many people with substance and/or alcohol use disorder also have co-occurring mental health conditions, such as depression or anxiety. Look for a rehabilitation centre that offers psychiatric care and therapy to address these underlying conditions. Be sure to ask if the psychiatrist is on site, or whether this is simply an affiliate on the website. Some of the less scrupulous rehabs have staff listed who are consultants only and are not involved in delivery of treatment.
- Staff qualifications and experience: The qualifications and experience of the staff can greatly impact the quality of care you receive. Look for a rehab centre with licensed and experienced medical professionals, therapists, and support staff. All staff should be members of their own governing bodies, and will therefore be accountable to the ethics, policies and procedures of those bodies.
- Treatment approach: Consider the treatment approach of the rehab centre. Some rehab centres may focus on traditional 12-step programs, while others may offer alternative approaches, such as cognitive-behavioural therapy or motivational interviewing. Do some research into what type of approach would best suit you or your loved one.
- Continuum of Care: Does the centre offer any service prior to arrival – such as meeting your therapist before you arrive? What about post treatment options? Is there an aftercare program – such as online groups and follow up sessions with your assigned therapist, or an aftercare counsellor? A very comprehensive study in the UK found that “there was no difference in sustained abstinence among treatments in the aftercare arm. However, outpatients who received 12-step facilitation were more likely to remain completely abstinent in the year following treatment than outpatients who received the other treatments.” [3] Does the treatment centre promote 12 step affiliation?
- Cost and insurance coverage: The costs of rehabs can vary widely, so it’s important to consider your budget and whether the rehabilitation centre accepts insurance or offers financing options.
- Inpatient or Outpatient: Do you really need to go to an Inpatient facility? There are many programs that could enable you to do the same work, whilst still working and staying with your family. Talk to an addictions therapist. Using placement criteria such as the ASAM placement criteria[4] they will be able to make their best recommendation.
By considering these factors, you can identify a rehabilitation centre that meets your specific needs and preferences. It is also important to consult with a healthcare professional or addiction specialist for guidance on selecting the most appropriate rehab centre for your individual needs. A trusted addiction specialist should be able to give you impartial advice. For instance, the staff at Visions by Promises have many years of making professional referrals to rehabilitation centres around the world.
Beware of Centres claiming statistics for success rates. As one study suggests: “demonstrating the association between residential rehabilitation and specific outcomes is complicated by the widely varied nature of provision in terms of programme length, treatment philosophy, the provision of throughcare (including preparatory work and aftercare) and quality”[5]. A lot of these outcome measurements can be addressed by asking the above questions before making what can be a large financial investment for many. Another study also makes the point that “results suggest that best practice rehabilitation treatment integrates mental health treatment and provides continuity of care post discharge.”[1]
Most importantly, remember that you are going to a rehabilitation centre to get well, not for a holiday. If the centre is asking for a restriction on use of mobile phones for instance, they are doing this for a therapeutic reason; ask them to explain their rationale.
Wherever you end up seeking treatment, make the most of it. Rehabilitation offers an opportunity for complete and long-lasting change; however a huge component of success is your willingness to make the most of what is on offer.
_________________________________________________________________________________
[1] http://www.carf.org/home/
[2] https://www.jointcommissioninternational.org/
[3] U.S. Department of Health and Human Services. (n.d.). NIAAA reports project match main findings. National Institute on Alcohol Abuse and Alcoholism.[4] https://www.asam.org/asam-criteria/about-the-asam-criteria
[5] Scottish Government. 2020. Residential Rehabilitation Working Group: recommendations on drug and alcohol residential treatment services. Scottish Government
[6] de Andrade D, Elphinston RA, Quinn C, Allan J, Hides L, The effectiveness of residential treatment services for individuals with substance use disorders: A systematic review, Drug and Alcohol Dependence (2019), https://doi.org/10.1016/j.drugalcdep.2019.03.031