NOTE: Quotes are presented word for word apart from minor editing for readability and clarity. Identifying details have been removed. Square brackets show text that has been added, e.g. ‘I want to maintain [my current level of drug use]’. Ellipses within square brackets […] show where text has been removed, e.g. ‘Counselling was good but […] I would have liked more information about other treatment options’.
Many of the people interviewed for this website talk about changing their patterns of consumption by seeking formal treatment. One of the treatments commonly described is residential or inpatient treatment (often called ‘residential rehabilitation’ or ‘rehab’). Residential treatment facilities vary but usually offer 24-hour a day care, including on-site housing and medical attention. Clients are required to live at the treatment centre for between one month and one year, depending on the length of the program. Residential facilities use different treatment approaches such as 12-step self-help programs, peer support, counselling and skills training. Many use group work as part of a structured program.
In Australia there are different types of residential treatment including long-term residential treatment (three to twelve months), short-term residential treatment (one to three months), therapeutic communities, and supervised short-term housing offering extended care (sometimes called ‘recovery housing’). Longer term residential treatment usually includes medical care, counselling and professional support in an alcohol and other drug-free setting. Short-term residential treatment often involves a medically supervised withdrawal program, initial intensive counselling and preparation for treatment in a community-based setting. Therapeutic communities are long-term treatment programs that use a self-help abstinence-based approach in which both staff and other residents assist with treatment. Short-term or ‘recovery’ housing provides supervised housing where clients are supported to live semi-independently, often following other types of inpatient or residential treatment. Short-term supervised housing can help people make the shift to living outside a residential treatment setting.
Some of our participants underwent longer term residential treatment, while others completed short-term residential treatment, or treatment in a therapeutic community. Several have experiences of more than one type of residential treatment. Due to the high demand for treatment, a few say they had to wait several weeks or even months for an opening in a residential treatment facility. Others say they had to contact more than one facility to secure a place. As Dawn (F, 38, unemployed, alcohol) explains, ‘I had to ring different rehabs and just wait to see where there was a vacancy or opening. So yeah, I waited for say about three months and then I got into this [one]’. Those with experiences of either short-term or longer term residential treatment say it offers a range of benefits such as medical care, counselling and the opportunity to learn life skills and coping strategies. Those who participated in a therapeutic community say its benefits include a ‘caring environment’, supportive staff and the opportunity to make new friends.
Negative experiences are also described, and a number of drawbacks of residential treatment are identified. These include the highly structured nature of some programs, the limitations of 12-step abstinence-based approaches and the rules and regulations of many residential facilities. A few say they found it hard living with people they didn’t get along with. Having little or no contact with loved ones for the duration of their stay is described by some as a big challenge of residential treatment.