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First Contact and Intake Paperwork
An intake nurse may perform your medical exam to determine if you have any medical problems that need to be addressed during treatment. The nurse also asks questions about your health, including any pre-existing conditions, to assess your physical health.
The client may meet with a counselor at the rehab center for the first time during intake. If this occurs, the counseling session can focus on the client's readiness and motivation for treatment.
The intake interview helps establish goals for recovery and develop a plan of care. This includes an assessment of readiness for change or treatment.
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Assessment and a Written Care Plan
Providers match services to medical and social needs, which are determined by the initial assessment. When someone enters alcohol rehab, they undergo an assessment that helps match them with their specific needs. This includes a full evaluation of health and other areas of life (including family support, employment status, social situation, and more). The results inform the treatment plan.
The assessment should take into account a range of factors that are relevant to the individual. It will include:
A review of previous treatment episodes, if any.
The severity of the person's problem with alcohol (including physical dependency).
Their psychological needs, for example, they may be depressed or anxious.
Any other health problems they have.
Their social situation and support network.
A discussion about their motivation to change their drinking behaviour. This is very important because it can affect how well treatment will work.
After the assessment, the person will be offered a course of treatment that meets their specific needs. The care plan will contain information on what is expected from them (for example, attending groups) and what support they can expect (for example, individual counselling sessions).
Written care plans are updated when needs change, to ensure that the plan remains appropriate to an individual's changing needs.
The care plan is based on a thorough assessment and includes a discussion with the client about goals and expectations from the program. The care plan should also include the client's strengths and other factors that may help recovery.
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Detox When It Is Needed
Mild withdrawal may be managed in outpatient settings with supportive measures and medications as needed. Outpatient care can include monitoring for signs of worsening symptoms; medical treatment for complications; counseling; social support; and, when necessary, hospital or residential treatment. If a patient is unable to tolerate an outpatient detox program and becomes unstable, they should receive admission to the 3.7-WM or 4-WM levels.
Severe withdrawal needs nursing and physician oversight.
Sometimes people with alcohol addiction need help detoxing in a medical setting. During these programs, you'll stay under supervision as the alcohol leaves your body.
Some people go through the withdrawal process on their own. However, they can have complications during the process. Detox centers provide support and help with any issues that arise. They also keep you safe from other risks associated with alcohol withdrawal. They include dehydration, seizures, and delirium tremens.
Detox isn't a treatment for alcohol addiction, though. It prepares you for treatment.
Delirium tremens is an acute complication of alcohol withdrawal that requires emergency care, and can include:
- severe agitation
- hallucinations (seeing or hearing things that aren't there)
- seizures
- extreme confusion
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Individual and Group Sessions
Motivational sessions help someone set drinking goals. The goal of motivational enhancement therapy is to help you realize why it's important to reduce your drinking. Then, with a therapist's help, you'll set a plan for changing your behavior.
In the first session, a therapist will assess how much alcohol you drink and what problems it causes. You'll also talk about why you want to change your drinking habits. Together, you'll set goals for change and decide on a plan.
Motivational enhancement therapy helps people build up their motivation to change. They learn to identify the pros and cons of seeking treatment for their drinking problem, develop a plan for changing their drinking behavior, and work on improving their confidence and skills to stick with the plan.
Individual treatment consists of one-on-one counseling between a client and counselor. In individual treatment, the counselor may involve another person, such as a spouse or significant other. Sometimes families are counseled together.
You can also choose to participate in a group therapy session. A therapist facilitates these sessions by discussing issues that affect everyone in the group, including anger management and coping with triggers for alcohol use. You can learn about your drinking behavior from the experiences of others in the group and provide feedback on their experiences. The focus is not just on learning new skills but also on practicing those skills in a safe environment.
Many different types of counseling are used in alcohol rehab. Most involve a combination of individual and group therapy. There may also be other forms of therapy based on specific needs. For example, if your family has been affected by alcoholism, family members may be included in sessions.
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A Typical Program Day
Therapeutic communities use the whole setting as treatment material: the food, work, housekeeping chores, and other daily activities that residents must handle on their own are all therapeutic instruments used to help them become self-supporting and self-directed.
Education: Some programs offer classes or tutoring in basic skills, such as reading, writing, math and computer usage.
Housekeeping: Learning how to live with others requires certain social skills and responsibilities that some people have never learned, while others may have lost these abilities during their dependence on drugs and alcohol.
Structured days in residential alcohol care include scheduled meals and therapy sessions. The exact format will vary from program to program.
After an overnight stay at the facility, residents wake up and eat breakfast together. Afterward, they attend one or more group therapy sessions or individual counseling.
Group therapy includes discussions and activities with others who are working towards recovery from alcohol addiction or other substance addictions. Group therapy can help clients build relationships, learn about themselves better through sharing experiences with others and gain insight into their own behaviors as well as those around them in the program environment.
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Family Meetings
Relatives invited into family sessions learn about substance use disorders and how to support their loved one's recovery. The goal is to improve relationships with the person in treatment, reduce tension and conflict between family members, and increase feelings of self-worth.
Family meetings help families understand addiction better so they can be more supportive. This gives you a chance to talk about feelings and problems. It also can give you new ways to communicate with each other.
Family-based therapy helps family members understand the dynamics and underlying causes of addictive behavior. The goal is to reduce conflict by changing ineffective interactions between the alcoholic client and his or her family.
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Discharge Planning and Aftercare Links
Leaving rehab with a written aftercare plan means having a structure in place for staying healthy when you're back home. When you leave the treatment facility, you'll likely receive some kind of aftercare planning from your counselor or other staff members.
The patient should expect to have a follow-up care plan established before discharge from the program, including recommendations for ongoing support such as continued involvement in mutual-support groups, self-help activities, and continuing with outpatient or intensive outpatient therapy.
Outpatient counseling allows an individual to see a therapist outside of the residential setting and gives them a chance to adjust to living at home while still receiving support and guidance from a professional.
After an individual completes his or her program of treatment and care at a substance abuse treatment facility, he or she is typically referred to community-based services that are designed to maintain the recovery gains made while in residential treatment. These programs are often known as aftercare, continuing care, or discharge planning.
Mutual-help groups extend support after discharge from treatment. The most common mutual help group for alcohol problems is Alcoholics Anonymous (AA). Other mutual-help groups include Women for Sobriety, LifeRing, SMART Recovery.
Alcoholics Anonymous (AA) and other mutual-help groups can complement and extend the benefits of professional treatment. Members of AA or similar organizations share their experiences getting and staying sober.
In addition to the many health risks associated with alcohol misuse, a patient may experience an array of problems related to his or her social, financial, employment, family, legal, educational, physical, emotional, and spiritual needs. Many patients require referral to other community services before and after treatment to address these issues in their lives.