Closeup of a person's hands folded, resting on a tableAddiction is among the most common mental health diagnoses, with estimates of 12 month addiction prevalence ranging from 15% to 61%. A 2011 analysis estimates that nearly half of all Americans experience some symptoms of an addiction within a 12 month period. More than 70,200 Americans died from drug overdoses in 2017. Most of those deaths were due to opioids such as heroin and prescription painkillers.

Rehab centers are an immersive and potentially life-changing treatment option for people struggling with addiction. Clinicians and other staff considering working in rehab face a range of challenges, but also have the opportunity to change—and even save—lives. In rehab, people work steadily to get sober, repair broken relationships, and build lives of purpose and meaning.

A variety of mental health professionals, including therapists, psychologists, psychiatrists, and social workers, may pursue careers in rehab. Some rehab facilities also employ lay peer counselors, addiction coaches, life coaches, or certified peer specialists. Addiction is a complex diagnosis, with many potential pathways to recovery, so there’s a potential role for virtually every mental health professional in rehab.

How Is Working in Rehab Different?

People in rehab face many of the same struggles as those in outpatient treatment—family difficulties, impulse control, anger management, self-esteem, body image issues, career frustrations, and more. They may have a range of diagnoses or no diagnosis at all.

What makes rehab different is that people in rehab have all reached a crisis point in their lives.

What makes rehab different is that people in rehab have all reached a crisis point in their lives. Many choose to go to rehab after a catastrophic loss, such as the end of a relationship or job loss. Rehab clients may also struggle with the physiological realities of withdrawal and cravings. This means that the average rehab client may:

What Are the Challenges of Working in a Treatment Center?

Rehab, like private practice, presents numerous challenges—transference, separating oneself from a client’s needs, vicarious trauma, feelings of inadequacy, and the difficulties inherent in supporting people through life’s immense challenges.

Working in a rehab facility comes with additional challenges. People in rehab are, almost by definition, often not thinking clearly. That’s because withdrawal alters brain function and causes physical discomfort. They may be more impulsive, more frustrated, and feel more desperate to get better. Even clients who form strong relationships with their therapists may blame or lash out at them.

Some clients feel so overwhelmed by withdrawal that they want to give up. Helping a client see the value of treatment and see a path to a better life is one of the biggest challenges of working in rehab. Clinicians must develop a close and trusting relationship with each client. This relationship offers insight into the unique motivators that can help each client stick with treatment.

Helping a client see the value of treatment and see a path to a better life is one of the biggest challenges of working in rehab.

Depending upon where you work, you may encounter clients who are not voluntarily in treatment. They will need additional support to see the value in treatment and build a path to sober living.

Working in rehab may also involve supporting clients as they develop life skills, including managing serious challenges such as massive debt, job loss, divorce, child custody disputes, and other issues. Therapists should not advise clients about topics they know little about. Instead, they should offer emotional support and a sympathetic ear. In many cases, rehab facilities can refer clients to additional resources, such as attorneys and financial advisers, when they need them. Take advantage of these resources so you can better support your clients.

Are There Any Risks Involved With Working in a Rehab?

The main risks of working in a rehab center include:

There is also a very small risk of being harmed by clients. People in rehab are facing immense pressure. Some may be unstable or have poor impulse control. In rare cases, this may cause a client to:

Before taking a job at a rehab center, therapists should ask questions about:

Why Work in a Treatment Facility?

Addictions are a leading cause of death among healthy young people. Substance abuse destroys families, erodes communities, and undermines public health. Joining the fight against substance abuse can save lives and even reduce health care spending. People with addictions can be functional and happy members of their community. There’s no need for addiction to destroy a person’s life. Proper treatment can help a person restore their family, live up to their potential, and give back to their community.

Working at a drug rehab center can be a rewarding career that opens doors to other opportunities. Some clinicians eventually become administrators, while others publish research based on their work or go on to teach at colleges and universities. For early-career professionals, rehab offers access to clients with a wide variety of needs and challenges. This breadth and depth of experience can be difficult to obtain in private practice.

The work can also be emotionally demanding, and not all clients thrive or even survive. Mental health professionals should practice self-care, seek support from loved ones, and consider attending therapy to cope with the ups and downs of life as a rehab worker.

References:

  1. Overdose death rates. (2019). Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
  2. Sussman, S., Lisha, N., & Griffiths, M. (2010, September 27). Prevalence of the addictions: A problem of the majority or the minority? Evaluation & the Health Professions, 34(1), 3-56. doi: 10.1177/0163278710380124

Waiting room in an officeThere are many different types of residential treatment centers (RTCs) that offer therapeutic care for a wide variety of behavioral and mental health issues. Choosing a center that is suited to your personal needs is important; however, with many options available, making a decision may be difficult. How can you decide which RTC is right for you? Consider these answers to ten frequently asked questions about RTCs, as well as insight from Darren Haber, MA, MFT, an expert on addictions and compulsions.

1. What is a residential treatment center?

A residential treatment center is a health care facility that helps people experiencing various substance dependency and behavioral issues. For some inpatient treatments, residents may be required to live at the facility for a period of time. Some facilities also offer outpatient treatment to help former residents avoid relapse and to provide options for people who cannot commit to living at the facility temporarily. In most cases, treatment lasts for one to three months.

“[The] average stays tend to be 30 days, but some stay longer, and some shorter. Thirty days seems to be the industry norm,” Haber said.

2. What are the most important things to look for in an RTC?

Check and confirm that the RTC and any programs you wish to attend are accredited and the treatment programs are being administered by licensed, qualified mental health professionals. Ask if the program has a clinical director and about his or her credentials. Learn as much as you can about the treatment center you’re considering through third parties such as the Better Business Bureau, online reviews, and any local consumer protection agencies. If you need it, ensure that an active aftercare program is in place to help prevent relapse.

3. What type of issues do residential treatment centers treat?

Because different RTCs specialize in treating different health issues, the structure, routines, and therapeutic methods used will vary from facility to facility. Some centers take a “lock-down” approach where residents are secured within the facility’s premises and their movements inside the center are restricted. Other RTCs may take an unlocked approach and allow residents to traverse the premises with some degree of freedom; however, residents may only be permitted to leave the center if certain conditions are met.

In recent years, the residential treatment field has expanded. At some centers, everything from substance abuse to sex addiction to codependence may be treated. There are also centers that focus solely on substance abuse or eating disorders, for example.

Issues treated at an RTC may include:

It should be noted, too, that some RTCs specializing in mental health treatment may not provide therapeutic care for substance dependency issues.

4. Why do people go to residential treatment centers?

“Usually because their condition or problem has reached the point where it needs containment—that is, 24-hour medical or psychological monitoring due to harmful behaviors or medical problems—and has become so acute that it requires an acute, sustained focus,” Haber said.

5. What kinds of services are provided by RTCs?

Residential treatment centers offer a variety of services, which may include 24-hour supervision, intensive recovery programs, individual counseling, group counseling, structured activities, educational services, social skills training, vocational training, and relapse prevention services.

6. What are the benefits of a RTC over other forms of treatment?

The environment in a residential treatment center is usually more comfortable than the sterile, functional setting of a hospital. The residents are able to focus solely on their healing and recovery programs as they are removed from the stresses of daily life.

Some treatments, such as chemical detoxification, may be life threatening. For those cases, RTCs provide trained medical personal to keep residents safe during such treatments. Residents also have the opportunity to explore the emotional and psychological underpinnings for their behaviors in counseling sessions with a qualified mental health professional.

“Some people also go for legal reasons, such as being ordered by a judge after a DUI or DWI, for example. Usually one goes to an RTC because living life day-to-day has become unmanageable or to the point where one’s well-being, job, or close relationships are threatened,” Haber said.

7. What is the experience of being a resident at a residential treatment center like?

“It’s really what the client or patient makes of it. Anyone who participates to the best of his or her ability can potentially gain much and grow and learn tools for lifelong use. If one has been forced in by family but doesn’t believe, for instance, that one truly has an issue with alcohol or addiction, it can feel almost like jail,” Haber said.

8. How can families or friends keep in touch with residents?

“It depends on the policy of the residential treatment center. Some encourage family contact and some don’t. Some RTCs prefer those in treatment wait until their detox is over, or that the person in treatment only meet family members with counselors present. I believe this is a crucial part of treatment that can easily be overlooked, since dysfunctional family systems often play a crucial role in the formation of the illness or addiction,” Haber said.

9. Are there any RTCs in my area?

With the number of treatment facilities currently providing care across the country, chances are there is a residential treatment center nearby. However, it is important to remember that your chances of recovery may be better if the chosen facility is well suited to your personal preferences and specific health condition.

10. How much does treatment at a residential treatment center cost?

“Some people also go for legal reasons, such as being ordered by a judge after a DUI or DWI, for example. Usually one goes to an RTC because living life day-to-day has become unmanageable or to the point where one’s well-being, job, or close relationships are threatened.”The cost of treatment at a residential treatment center will vary based on the condition being treated, services provided, length of treatment, and the location of the center. For example, The Betty Ford Center, one of the most well-known rehab programs, charges approximately $1,217 per day for inpatient alcohol addiction treatment at their Rancho Mirage, CA location. Other locations may charge more or less, and some may not offer a per-day rate. Most locations develop a program based on a person’s individual needs, which can drastically affect the cost depending on medication or other requirements.

Some facilities may be able to offer a sliding fee based on a person’s income, while some may be low or no cost. Others may offer luxurious settings and amenities. The types and costs of RTCs simply vary. If your personal health insurance covers residential care, even the more costly facilities may become affordable. Call your insurance company for more information regarding your covered benefits if you are in need of inpatient treatment.

References:

  1. The Addiction Recovery Guide. (2015). Drug and alcohol addiction recovery. Retrieved from http://www.addictionrecoveryguide.org/treatment/residential
  2. The American Residential Treatment Association. (n.d.). Types of programs. Retrieved from http://artausa.org/type_programs.html
  3. Federal Trade Commission. (n.d.) Residential treatment programs for teens. Retrieved from http://www.consumer.ftc.gov/articles/0185-residential-treatment-programs-teens
  4. Hazelden Betty Ford Foundation. (n.d.) Addiction treatment specialties. Retrieved from http://www.hazeldenbettyford.org/treatment/locations/betty-ford-center-rancho-mirage
  5. Mental Health America. (n.d.). In patient care. Retrieved from http://www.mentalhealthamerica.net/patient-care
  6. National Institute on Drug Abuse. (n.d.) Principles of drug addiction treatment: a research based guide. Retrieved from http://www.consumer.ftc.gov/articles/0185-residential-treatment-programs-teens
  7. Smith, M., & Segal, J. (2015). Choosing a drug treatment program: What to look for in substance abuse rehab. Retrieved from http://www.helpguide.org/articles/addiction/choosing-a-drug-treatment-program.htm
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