What to Expect During Your Time at Rehab

Boris Mackey is a community outreach manager at Rehab 4 Addiction, a UK-based addiction and mental health helpline.

Rehabilitation or ‘rehab’ for short, is an integral part of successful, long-term recovery from drug and alcohol addiction. Studies have found that the additional long-term support that can be offered by a drug and alcohol rehabilitation service can lead to much longer periods of sobriety.

Rehab itself is difficult to define but it can be broadly understood to mean a set of processes or treatments that help you to understand your addiction and what triggers it in the hope that you can soon live a healthy life, free from addiction.

Typically starting with the detox process, rehab can be delivered in a variety of forms in public or private centres, outpatient or inpatient depending on your wants, needs and severity of your addiction.

Whilst there is the hope that you will only ever need access to rehab once, it is common that people come and go, potentially needing several episodes of rehab, highlighting that addiction is very much a chronic, long term condition.

You would be forgiven for being apprehensive about rehab, perhaps even considering makes you feel overwhelmed. It’s a difficult process demanding a huge overhaul of your life and perhaps its image hasn’t been helped by media coverage of celebrities having their rehab experience documented in a very public way.

However, when completed with dedication, it can make a real difference, getting you back on track, free to live life to the full.

This article will hopefully allay some of those worries and apprehensions by exploring what you might typically expect from rehab.

Insight into what to expect during the rehab process

The rehab process typically begins with you committing to an admission which may well happen when you are at the contemplation or preparation stage of recovery, according to the six steps of change or transcendental model.

The length of time needed in rehab again varies from person to person but an average range is between 28 to 30 days. Longer stays, on average 90 days, are common with severe cases potentially requiring 18-month visits.

Regardless of whether you choose an inpatient or outpatient service, the rehab process will probably start with a thorough assessment to gain an understanding around what your specifics needs are. This approach ensures that you can benefit from a personalised programme that is right for you as everyone’s needs are different.

As mentioned previously, the majority begin their journey through rehab with the process of detoxification, where you stop ingesting the substance you are addicted to. This gives your body time to flush out any of the harmful products that have built up in your body as the result of addiction, helping to end your physical dependence.

Throughout this time, you might experience unpleasant ‘withdrawal’ symptoms but with the help and support of professionals in the safe setting of a rehab facility, this should pass, typically in a week.

In some cases, withdrawal can make you temporarily very unwell, potentially causing seizures, confusion and fevers (a condition called delirium tremens). Again, highly trained staff at the rehabilitation centre will be on hand to act quickly and give you the assistance you require.

After passing this milestone, work begins on the psychological recovery from addiction. Approaches vary from centre to centre, but typically involve daily talking therapies and counselling sessions with trained professionals.

The work you do with therapists is tough, forcing you to confront the issues surrounding your addiction head on but soon, you can expect to see a change in your mindset, setting you up for recovery without alcohol and drugs.

Again, substance addiction is a long term, chronic condition so as you come to the end of your time in rehab, plans will be made to give you the best chance of sustaining your success for months and years to come, with minimal periods of relapse if possible.

A typical day during rehab

As highlighted, what rehab looks like varies from person to person as their wants and needs differ but each experience tends to share the same elements and flow following detox. A common daily routine in rehab is detailed below, which might offer you some reassurance if you or somebody you know is contemplating rehab.

  1. Nutrition and daily intention setting

They say you are what you eat which is why understanding nutrition is an essential part of the rehab process. Whilst this might not be immediately obvious, it is well documented that addiction and poor nutrition go hand in hand.
This can be for reasons such as spending all of your money on drugs and alcohol rather than food and binge eating, common when coming down from a high. These problems can leave you physically unhealthy and malnourished as studies have confirmed that bone problems like osteopenia and osteoporosis is overrepresented in the population with addiction problems.
Hopefully your time in rehab will show how healthy body can equal healthy mind and vice versa as you cultivate new habits. Feeding into cultivation of new habits, the start of the day is when you might set positive intentions, planning what you intend to work on that day.

2. Therapy types

Following a morning of nutrition teaching and daily positive intention setting, people typically then start their therapy sessions. This can take the form of group or individual sessions using a variety of techniques including:

          • Cognitive Behavioural Therapy (CBT)
            This is a talking therapy that helps you manage your issues by changing the way you approach them so that you can escape from the vicious cycle of negative thoughts that can make you feel trapped.
            Studies have shown that one of CBT’s outcomes is getting a person to unlearn destructive coping skills like alcohol and drugs and replace them with better ones which they can apply to circumstances that might trigger substance abuse.
          • Exposure Therapy
            Whilst typically thought of as a treatment for phobias, exposure therapy in conjunction with CBT can also can play a role in recovery from addiction.
            This approach recognises that a key part of the recovery process is learning how to handle stressful situations which you may have learnt to cope with using drugs and alcohol. Little by little you can be exposed to stresses in a controlled situation, realising you don’t have to turn to substances to cope.
          • Counselling
            Another type of talking therapy, counselling uses trained professionals who listen to you in a non-judgmental way and work with you to find constructive ways to deal with any emotional issues. The NHS has additional information on counselling if you feel this approach could benefit you.
          • Alternative treatment services
            In addition to the psychotherapeutic talking therapies mentioned above, afternoons in rehab might take a broader approach to boost both your physical and mental wellbeing, both of which are very much linked. Common activities can include music and art therapy, exercise sessions, music therapy and meditation.
            As before, therapy is highly customised to your needs so choose an activity that you get pleasure from. This activity and the relaxation and enjoyment it brings can help enhance stress management, helping you avoid triggering circumstances.
            Additionally, therapies classically outside of Western medicine like acupuncture have been sanctioned by the World Health Organisation in the treatment of addiction.
          • 12-Step Programmes
            As the day draws into evening, you are likely to have some free time. Many choose to use this time for further practice and reflection using 12 step programmes to help them do this.
            Originally developed by Alcoholics Anonymous (AA), but works for many other types of addiction, the 12 steps encourage the following: honesty, faith, surrender, soul searching, integrity, acceptance, humility, willingness, forgiveness, maintenance, making contact and service.
            Reflecting on these in the evening can help you think about intentions you might like to make for the next day. You can find out more about the 12 steps on the AA website.

What to expect after rehab

As your time in rehab draws to a close, the team of professionals supporting you will ensure that you are ready to start the next stage of your journey. The hard work doesn’t stop after you leave rehab, rather this is one of the most difficult stages where you have to maintain your new positive coping strategies and behaviours.

You aren’t alone though with most rehabilitation services providing post-rehab care out in the community. This may also involve attending peer support groups like Narcotics Anonymous. The charity Adfam has an extensive list of organisations that can offer you support after rehab.

Rehab is a highly effective tool in your journey to recovery from alcohol or drug addiction. Supported throughout the entire process by experienced professionals, you can begin to find better ways of dealing with life and the circumstances that it inevitably brings.

The recovery process is highly personal meaning whilst it might work in weeks for one, it might only work in months for another. This is completely normal, as is the need for repeated stretches of treatment. The point is, there is support available to help you get back up again if you fall.