Exactly what happens in an alcohol rehab program depends on what kind of program it is -- for instance, whether it's a live-in program or an outpatient one. But there are certain elements that are common to all.
Initial assessment. When a person is first admitted to an alcohol rehab program, that person receives a thorough clinical assessment. The assessment is then used to help determine the best approach to treatment. It is also used to help develop the treatment plan.
During the initial assessment a counselor will ask questions about:
* The amount of alcohol a person drinks
* How long the person has been using alcohol
* Cultural issues around the use of alcohol
* The effect alcohol has had on the person's life
* Medical history
* Current medical problems or needs
* Medications being taken
* Mental health or behavioral issues
* Family and social issues and needs
* Legal and financial issues the person is confronting
* Educational background and needs
* Current living situation
* Home environment
* Employment history, stability, problems, and needs
* Previous experience with rehab or attempts to quit using alcohol
If it's determined during the initial assessment that there are urgent medical issues that need to be addressed or that the person needs a detox program, the person will be referred to a doctor who will oversee this part of the person's care.
Development of a plan. Following the assessment and provision of medical care, the person will be assigned a counselor or case manager. Together they will work out a detailed treatment plan. The plan will identify problems, goals, and details about how to address the problems and reach the goals. That plan will be carried out by a team of trained individuals that can include a social worker, counselor, doctors, nurses, psychologist, psychiatrist, or other professional.
Group and individual counseling. Counseling is an integral part of the treatment for alcoholism. Counseling gives the individual in rehab tools to accomplish important goals:
* Overcome denial
* Recognize problems
* Become motivated to solve problems
* Address mental health issues such as depression or anxiety disorders
* Change behavior
* Re-establish healthy connections with family and friends
* Build new friendships with people who don't use alcohol
* Create a recovery lifestyle
Individual assignments. Throughout the rehabilitation process, the patients will be given material to read and tapes and videos to listen to and watch, asked to write about their experiences or their responses to treatment, and new behaviors to try.
Education about substance use disorders. Often people who have a substance use disorder like alcoholism are in a state of denial. They actually believe the way they drink is normal. In order to progress in recovery they need to confront the fact that they do have a problem with alcohol and acknowledge the dangers that problem presents.
Life skills training. When someone who has been dependent on alcohol goes into recovery, he or she may need training in these areas: managing anger, stress, or frustration; employment skills; goal setting; spending leisure time; developing social and communication skills; and managing money and time.
Relapse prevention training. It's important that the person recovering from alcoholism learn to recognize situations that can trigger a relapse and how to avoid them.
Orientation to self-help groups. Most alcohol rehab programs require participants to join a self-help group after the program ends for help in continuing on the path of recovery. Taking part in a self-help group is not considered part of treatment, but rather an essential part of maintenance.
Most people are familiar with 12-step programs like Alcoholics Anonymous, which has been highly successful at helping people stay sober. But there are people who don't like the 12-step approach for a variety of reasons, including its spiritual or religious overtones. So most rehab programs include orientation to other programs such as SMART, which uses cognitive methods to help people stay sober, Women for Sobriety, which is a support program for women that focuses on issues that are specific to women in recovery, and Moderation Management, which is a program for people who want to moderate their drinking rather than stop. Moderation Management does recommend abstinence for people who aren't successful at moderation.
In addition to the above elements, many programs also include treatment for mental disorders.
Medications are also sometimes used to help with staying sober, such as disulfiram (Antabuse), which causes unpleasant side effects if a person drinks while taking it, or naltrexone (Vivitrol, ReVia), which reduces the craving for alcohol.
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