Treating patients with a Dual Diagnosis — a mental health condition combined with an addictive disorder — requires an intensive, integrated approach to therapy. Residential rehab facilities provide a structured environment for these individuals who face special challenges in their journey to recovery. At a residential treatment center, where the stressors and distractions of daily life are removed, you can devote all your time and attention to learning new coping skills and building a stronger sense of self-worth.
These residential communities are ideal for patients who need a long-term course of treatment to restore their emotional and psychological health.
It’s not always easy to recognize that you or someone in your life needs treatment for drug or alcohol addiction. With Dual Diagnosis patients, the presence of a mental health disorder like bipolar disorder, depression or post-traumatic stress disorder (PTSD) makes it all the more difficult to recognize the symptoms of addiction. People who struggle with a mood disorder or chronic depression may manage their moods with drugs or alcohol, a form of self-medication. When a Dual Diagnosis is involved, it can be hard to distinguish between the symptoms of a psychiatric illness and the signs of drug or alcohol addiction.
According to Dual Recovery Anonymous, a 12-step group for individuals who suffer from psychiatric and substance abuse disorders, identifying a Dual Diagnosis patient can be challenging for several reasons:
When in doubt, it’s always best to be on the safe side — if you have any reason to believe that someone you care about needs treatment, contact an addiction specialist for an evaluation. Your decision to help someone in your life get into residential rehab may help prevent the serious consequences of substance abuse, such as incarceration, loss of key relationships or incarceration.
What makes residential treatment so effective for patients with a Dual Diagnosis, or a co-occurring disorder? At a residential facility, fully integrated care may be easier to provide. Integrated care refers to combined treatment for an addiction and a psychiatric disorder. When both conditions are treated at the same time, the patient has a greater chance of making a full recovery, according to the National Alliance on Mental Illness (NAMI).
In a study published in Drug and Alcohol Review, researchers at Dartmouth Psychiatric Research Center compared the effectiveness of residential treatment programs with outpatient programs for Dual Diagnosis patients. Their study showed that outpatient care was less effective than residential treatment in up to 50 percent of cases. Participating in outpatient rehab requires a higher level of motivation and compliance, which may not be present in a patient who has a severe mental illness. The structured setting of a residential community provides a sense of security and safety that isn’t available in an outpatient clinic or treatment center.
Pharmacological therapy is a vital component of residential Dual Diagnosis treatment. In a residential treatment program, patients undergo thorough evaluation to assess their recent history of substance abuse, their psychiatric history and their current symptoms. Medications may be prescribed to relieve the symptoms of anxiety or depression, to control flashbacks, or to reduce cravings for drugs or alcohol. Prescription drugs used to support recovery from a Dual Diagnosis include:
Therapeutic strategies for addiction treatment have changed in the past few decades. At one time, therapists practiced a confrontational style with substance abusers. Today, that aggressive approach is no longer supported, especially in Dual Diagnosis patients. Therapists and their clients attempt to develop a collaborative relationship that focuses on improving the client’s sense of competence and self-esteem. Instead of “breaking through denial” or “tearing down the ego,” therapy centers on helping clients strengthen their internal motivation and build a stronger sense of self-worth. At a residential treatment program, individual therapy sessions may be modeled on one or more of these therapeutic schools:
Entering a residential rehab facility can be a scary prospect, especially for those with a Dual Diagnosis. Depression, anxiety and emotional instability can create an intense fear of the unknown. Patients with social phobias may be terrified of group meetings, while those with obsessive-compulsive disorder may have difficulty living in an unfamiliar environment. At a residential facility that specializes in Dual Diagnosis treatment, staff members are trained to expect these responses and to provide the most comfortable atmosphere possible.
Assessment and evaluation are the first stages of the rehab process. When you enter a facility, you’ll be evaluated by an addiction specialist (a psychiatrist, psychologist, counselor or social worker) who will gather information about your recent substance use, your current and past medical history, and your psychiatric symptoms. The assessment phase is crucial for developing an individualized treatment plan that addresses both your mental health condition and your substance use disorder.
Residential facilities are tailored to the needs of patients who require long-term recovery services. At a quality facility, accommodations are comfortable and home-like, with areas dedicated to counseling, group meetings, dining, exercise therapy and recreation. Many residential facilities offer areas for quiet meditation or worship. Depending on your living arrangements, you may have a private room or share your living quarters with a roommate. Nourishing, balanced meals are provided to counteract the effects of substance abuse and help you restore your nutritional status and hydration.
Patients in residential rehab usually receive a weekly or monthly schedule of activities. Your days will be filled with individual counseling sessions, group therapy and recreational activities. You may have a choice of holistic activities like yoga, massage or tai chi, as well as the opportunity to participate in creative therapy through art, music or dance. Family counseling sessions with partners, spouses or children are an important part of your recovery as well.
A residential rehab facility provides a structured living environment to help clients focus on their rehabilitation. There will be certain rules and guidelines to follow, such as avoiding all use of illicit drugs or alcohol, attending meetings and counseling sessions, remaining on the grounds at designated times and following curfews. Access to telephones, television and the Internet is often limited to certain times of the day. Regulations vary from one facility to another, and it’s important to find a level of supervision that you can live with comfortably as you recover.
When you’re admitted to a rehabilitation facility, you’ll need to bring certain personal items to make your stay more comfortable. You may also be presented with a list of prohibited items.
Cameras, clothing that advertises drugs or alcohol, incense, candles and cigarette lighters are not allowed at some facilities. The use of cell phones and laptop computers may be limited, but most facilities will allow you to bring these items with you. Your admissions team will advise you on what to bring to the facility before you enroll.
Integrated Treatment of Substance Abuse & Mental Illness