The Ultimate Guide to Enrolling in a 28-Day Rehab

Addiction is hard. But getting clean is even harder. It’s intimidating whether you voluntarily walk through that door or by legal order.

You are not alone in this battle. Close to 19 million aged 12+ needed substance abuse treatment in 2018. (Rehab Statistics – Addiction Group) It just takes that first baby step.

You might not know what to expect. And that’s okay!

Let me demystify the process for you.

Every facility share some commonalities on what you can or cannot bring with you.

Here’s a list of things you typically CAN bring:

·       Clothing (check for any dress code specifications)

·       Toiletries (the basics for personal hygiene)

·       Prescription medications (these will be kept with the nurse or MHT and be given to you at the correct times)

·       Insurance & identification (or any other pertinent paperwork)

·       Books/reading material/crosswords/etc (non-triggering content only)

·       Journals/notebooks (this is encouraged for therapy and self-healing)

·       Pictures of loved ones (these provide comfort—no frames)

Here’s a list of things you typically CANNOT bring:

·       Illegal drugs/ Alcohol (They search your belongings extensively)

·       Weapons or dangerous items

·       Over-the-counter medications & supplements (they will approve something if it is vital you take it)

·       Electronic devices (cellphones, tablets, laptops, ipod, etc)

·       Jewelry or expensive items (this varies from facility to facility)

·       Inappropriate clothing/materials (offensive, triggering, foul language, etc)

·       Food/beverages (they provide food/snacks)

·       Aerosol products (due to safety concerns, though many allow some within reason)

Upon arrival you will undergo an intake process. This tends to be a little lengthy, so be patient.

They tailor your treatment plan based on what you relay to them. It’s crucial to be upfront about your medical history, substance use, and any co-occurring mental health conditions.

Be honest—no one will judge you. But to truly recover, you must be forthcoming and truthful. You get out what you put in, so keep that in mind.

This follows Intake. You will learn about the rules, routines, and expectations at the facility.

You will receive your daily schedule. With this, you will receive guidelines about personal belongings, lodging, and laundry/chores. Staff will also explain group sessions, therapy, and AA/NA meetings.

There will be tons of information thrown at you on day one. No worries! A fellow patient or staff member will help you remember everything.

The first five days are the hardest, but it does get better, and with an open mind you can find it a fulfilling experience. There is a camaraderie among fellow clients. They remind you that you’re not alone in your struggles.

A full assessment is necessary to determine your physical health. For residential facilities, nurses or administration may not be working on the weekends. For your wellbeing, a full medical summary will be done. This ensures your safety to commit to the full length of stay.

The MHT staff on the weekend are well trained. They dispense medications, check vitals, perform CPR, etc. They are knowledgeable in handling emergency situations. This includes low blood sugar levels, seizures, hallucinations, suicidal ideation, withdrawals, and more.

Your staff will know what to do, but this is the time to disclose anything big or small so your safety is guaranteed.

Facilities have different policies on whether they allow patients to detox there. Some facilities have 24-hour nurses on-site, but a lot do not have this luxury. They may ask you to detox before admission.

Be aware of the potential dangers of withdrawals. Have someone with you when you go through the process.

For some it’s hard to open up about addiction. Often, substance use starts from an urge to escape from past trauma or as a coping mechanism. Some form of therapy will be utilized to overcome your addiction. Individual, family, group, or a combination of the three helps pinpoint the cause behind use. There are many different modalities counselors may use. These may include:

            Behavioral therapy– focuses on identifying and changing problematic behavior associated with substance abuse.

            Family therapy– family participation in sessions to help improve family relationships and communication.

            Art therapy– use of creative expression to cope with emotions, trauma, and stress related to addiction.

            Medication-assisted therapy– use of medications such as methadone, buprenorphine, or naltrexone with counseling & behavioral interventions.

            Cognitive behavioral therapy– addresses problematic thoughts and feelings to overcome addiction.

            Dialectical behavior therapy– teaches skills for emotion regulation, distress tolerance, and behavior change.

You will meet with your counselor weekly or even biweekly for private sessions, but group sessions and activities are facilitated as well. The counselor might give you “homework” for the weekend, but don’t let this overwhelm you. It will always be something the counselor deems significant for your recovery.

You should receive education about addiction, recovery, and coping skills. Counselor- or staff-led groups are very normal. These groups might include topics like relapse prevention, stress management, communication skills, etc. You may be asked to work through the steps of AA/NA with the help of your counselor or sponsor during your stay. However, that alone does not defeat addiction. There is a lot of work put into recovery, but the effort is very worth it, so keep an open mind.

These group sessions may be a movie with subsequent questions on addiction regarding the film. They might include Father Martin’s Chalk Talk, and please don’t snub it. I watched his videos every weekend with my clients for more than 4 years and always enjoyed it. He simplified addiction and recovery, as he was a recovering alcoholic and spent a vast majority of his later years helping other addicts.

Some of these group sessions will be more difficult. You may be asked to share your story, or a regret, or what you desire to get out of the experience. If you feel too ashamed to share your story, I promise it’s not the worse one your staff or counselor has heard. There will be no judgement, no matter what. When you are ready to share with your counselor or your peers, you will be received with understanding and acceptance. You are not alone.

A key factor for a successful stay at rehab is interaction with peers in a supportive environment. Once you choose recovery, this means you also incidentally choose different people to have around you. It’s a lifestyle change. Your fellow patients can have a profound impact on your future.

At our facility, we turned the radio on during cleaning, watched TV, played board games, colored, sang songs, played cards, and took walks. Sometimes I would sit on the back porch with my female clients and just talk. Sometimes they couldn’t sleep and just needed an ear. You will find that most places have workers with experience in addiction in their personal lives and most staff are genuinely invested in your recovery.

Your peers can help with accountability and focus. A lot of facilities host AA and NA on-site or drive patients to a meeting site. There you will find even more peers who are willing to help you. If you’ve never been to one of these meetings, expect a lot of coffee, cigarettes, and an immediate and warm welcome. Even as a staff member, I was hugged by and held in warm regards by those who regularly attended meetings at our location. You might even find your sponsor at one of these meetings. Typically, you will not be asked to speak at these meetings as you are currently in treatment and will have enough on your plate. These meetings are utilized to help integrate you into the atmosphere you will hopefully immerse yourself in once you leave your rehabilitation facility. Listening to other stories give you perspective on your past and future. No one else could come close to identifying with you and your life than those individuals.

Some rehabilitation facilities like to incorporate therapies such as yoga, meditation, art therapy, exercise, and/or religious events. Our facility held weekly church services on Sunday with a handful of pastors who rotated coming to preach. These individuals almost always will be recovering addicts. You will never be forced to interact or attend these services if they are against your beliefs; instead, your counselor will more than likely give you an assignment to work on during that hour.

These should be discussed in your intake and orientation if it’s an issue. These programs are for your overall wellbeing and the target will not simply be your addiction, but a deeper search into your inner trauma, anxieties, medical conditions, and psychological diagnoses.

Most rehabilitation facilities will sponsor some kind of exercise regime and could include a small gym. Our facility was smaller, so we were only able to house a ping pong table and a volleyball court. However, I would take my clients on nature walks around the grounds as it was tucked away on some private land with fields, trees, and plenty of sunshine.

As for nutrition, it will depend on facility funds on what this looks like, but across the board, you will receive home-cooked meals with your basic food groups and they usually house soda and snack vendors for in between meals. Addiction affects your entire being, so this means that all aspects of your health will be addressed to begin the healing process—this includes diet.

Your privacy, personal information, and treatment is strictly protected with unyielding policies. Confidentiality is taken very seriously for every client, in every facility. If it is not, you do not want to use their facility for your treatment. Staff are held to a moral and professional standard so as to never compromise a client’s confidentiality, during or after their stay.

A nursing staff should be on-site. Your mental and physical health impact your treatment plan. Addiction can affect your mind and body in ways you may not even be aware of and once you stop, your body goes through a process of detoxing.

After detoxing, you might find that your health has declined. Many clients use drugs to address a medical disorder they already have and once they quit, their body is thrown into chaos. The MHT staff will be trained to cope with medical crises and psychological emergencies.

Recovery is a marathon, not a sprint. You may go into it with reservations but after those first difficult days find yourself feeling more optimistic. However, you may start out with excitement and after a few days develop feelings of being overwhelmed. Recovery is a lifestyle change, a cognitive switch, and takes strength of will that exhausts you. This is why residential treatment is the recommended way to begin your treatment.

Sustaining a life change on this caliber takes a lot of determination and resources that are hard to come by on your own. I never had one client who made it to the end of their treatment say they regretted the experience. In fact, on their graduation day, they felt a sense of peace and joy addiction had never been capable of providing. Their worse day in recovery was better than their best day in their addiction. There will be feelings of frustration, sadness, elation, and even fear. Remember, these feelings won’t last forever and are normal. Always, always, communicate these feelings to your staff, therapists, and peers. Recovery is not something you do on your own; surround yourself with those in recovery and they will help carry you through your journey.

A good facility will convey their genuine lack of judgement. Those seeking help from addiction carry a sense of shame and guilt. Your facility should create a space that is safe and judgement-free for you to discuss your struggles comfortably and openly. Your staff are educated in mental health and addiction, and because of this will understand your struggles and needs.

Depending on your history with family, a treatment facility will provide family interactions via therapy sessions, visitation, phone calls, or workshops. If family is detrimental to your recovery, this will be considered. However, if familial ties need to be repaired, this is a great time to address it. Your therapist can act as a mediator for conversation and help your family understand you and vice versa. Addiction is a family disease; it affects the entire family and those who surround an addict will need some form of treatment as well.

These activities usually will not be offered until after you have been in the program a certain length of time, often five to seven days. Support is essential for recovery and you will want to surround yourself with family (blood-related or not) that will support you.

If the facility is good, it will have an in-depth aftercare plan that will prepare you for life after rehab. It gets harder after you walk out the door after the completion of your program. Your counselor should focus your attention on this towards the end of your stay. Aftercare can involve outpatient therapy, support groups, transitional housing, and more. Their job is to prepare you for the outside world, so whatever specific needs you have should be key.

It’s important to remember that every rehabilitation facility is different. The mental health world is always changing and expanding. You can never be sure to know all the facts going into treatment. The only thing you can do is educate yourself so that your informed decision-making will set you up for success. It is critical to research facilities so that you find one that aligns with your needs and preferences.

For a successful recovery, you must be willing to keep an open mind and a positive attitude. Half the battle is wanting help, then seeking it. Best of luck in your journey. Remember this moment in time: you don’t feel strong enough to win the war against addiction. WHEN (not if) you win it, you will finally see how strong you’ve been all along.