30 Days of Treatment
We send someone off to rehab with the expectation they are going to get better. The truth is, 30 days treatment is not a cure-all. The National Institute of Drug Abuse states “research indicates that most addicted individuals need at least three months in treatment to reduce or stop their drug use significantly, and the best outcomes occur with longer durations of treatment.”
Healing a sickness, like addiction, takes longer than four weeks; especially when a person has a long history. We are not saying that 30 days of treatment is not needed in some cases. Some people need total hospitalization and detachment from society to begin a road to recovery, while others just need a community of individuals and a 12-step program. The main take away from this is that what works for some may not work for others. It is a case by case situation.
30 days of treatment is the standard amount of time for inpatient care, and most 30 day programs focus heavily on Cognitive Behavioral Therapy (CBT). CBT is the process of identifying learned behaviors in regards to how they play a role in one’s actions. Most of these learned behaviors started in early childhood through formative events, these events lead to automatic thoughts which play a major role in how the individual performs in everyday situations. An understanding of CBT is an achievable goal for short term treatment, and helps to build relapse prevention tools.
We can see that treating an addict is not solely about stopping them from using. We must address the core issues. Society’s misconception that rehab will fix the alcoholic in 30 days is not realistic. Here is a more accurate representation of an all encompassing treatment program.
Take for example a young woman named Sarah. She was molested as a child by her uncle, her mother and father rage at her, and she grew up never knowing if she would have dinner on the table, these are her formative events. From these events she has developed a fear of abandonment, financial insecurities, and personal insecurity. These events and fears have coalesced to form Sarah’s automatic thoughts and how she sees and reacts to everyday events. Everywhere Sarah goes she feels afraid and uncomfortable until one day she comes in contact with drugs or alcohol, and all that pain, fear, and insecurity disappears while she is high. Substances become her coping mechanism and develop into a full blown addiction. She finally gets treatment, and the therapist is using CBT to address her behavior which is using drugs and alcohol. Sarah recognizes these behaviors are harming her and she formulates a comprehensive plan to combat her negative performances such as using. She leaves treatment after 30 days with a new understanding of her thoughts and behaviors. She has genuine desire to implement all that she has learned in her daily life. Here is a common problem that occurs to individuals who are just out of treatment, those feelings of insecurity, fear, and pain return and she hasn’t established herself in a 12-step fellowship. Sarah no longer has the support of her peers in treatment as well. She becomes overwhelmed by these feelings once again because she does not have anyone to reach out to. She believes that is just the way she is, after all, she’s felt this way since her childhood. She eventually seeks comfort in the only thing that has ever worked which is drugs and alcohol. She will repeat the cycle of treatment and relapse until she becomes involved with a 12-step fellowship and addresses these issues. If that does not happen she may never recover. This scenario helps to realize that Sarah is using because of her unaddressed issues, which stems back to the trauma she endured as a child. It is apparent that in order to fully treat her, these emotional injuries must be attended too.
Already we can see that 30 days treatment is only going to scratch the surface in regards to Sarah’s trauma. It could even be dangerous for her to bring these issues to light, and then releasing her into society without the proper skills to deal with these traumatic events.
Here is another example that we commonly see. William has never experienced any substantial traumas in his life, and he comes from a very successful family. William’s father is well known for his achievements as a medical doctor, and William loves and admires his father dearly. William wants to follow in his father’s footsteps however, he has a learning disability. William develops feelings of inferiority and insecurity. He feels pressured to be successful like his father, but he is unable to meet these expectations. He lives his life with the incessant thought to “become somebody”, and has developed anxious habits like biting his nails. He carries anxiety with him everywhere, and he doesn’t understand why. Like Sarah his experiences programmed his brain before he had the ability to recognize what was happening. The only thing he knows is that when he drinks all of his problems go away. The voice inside his head that tells him “you’re worthless” disappears. He turns into an alcoholic and one day finds himself in treatment. He is very responsive and thrives in his thirty-day program and even after treatment shows a promising future until he begins to feel that pressure to “be somebody” once again. William hasn’t addressed these feelings completely, but he regularly attends a 12-step program and works with a sponsor. He does his fourth step, but he can’t explain that constant pressure and anxiety he has to live up to his father’s successes. He is successful in not drinking, but continues to struggle with his anxiety, which leads to depression. Isolation begins, and he stops working his 12-step program because he feels he’s doing something wrong, he wonders why he is still plagued by these feelings. He comes to the decision that he will drink or end his own life.
In both of these scenarios, you can see how the patients underlying issues were not treated properly, and how it’s almost impossible to do so in a 30 day treatment program. There are long-term treatment programs that are designed to address childhood traumas. Unfortunately, insurance usually doesn’t pay for them. This is why developing an aftercare plan is imperative. Finding a program with next level care whether it is PHP, IOP, or OP is crucial in regards to maintaining sobriety. You may have also noticed that both Sarah and Williams issues derived from their families and homes. Family therapy is a huge component in assisting both the addict and the family address these issues.
Our hope is that this article helped paint a picture of how 30-day treatments may help an addict on their road to recovery, but cannot truly heal the underlying issues that create their desire to abuse a substance.
“In-Depth: Cognitive Behavioral Therapy.” Psych Central, 17 July 2016, psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/.