Residential Treatment for Substance Abuse?

Residential treatment programs for substance abuse are believed by many to be the solution to the problem of drug and alcohol addiction. However, much of what is believed about the effectiveness of this type of programming does not appear to be true and is also based on an unsound foundation. It appears that the cost and relapse rate for residential treatment programming are both very high.

When residential treatment programs are promoted as something that will help an individual end their addiction to drugs and alcohol, there are at least two problems that must be considered. First, real and lasting change simply does not take place in 30 days. While most individuals who attend residential programs will most likely feel better physically after 30 days of not using drugs or drinking alcohol, they tend to also create the irrational belief that they are better.

Second problem for residential treatment has to do with a concept called generalization from behavioral theory. Generalization is a problem for residential treatment programs in that newly learned skills and behaviors do not tend to transfer outside the treatment situation to settings in the clients' life. Simply stated, what is learned in residential treatment programs does not tend to transfer to life after treatment. Treatment centers are not life on life's terms.

It is my belief that those seeking counseling and treatment should be told that change takes time, at least nine months to one year in committed psychotherapy. Second, they should also be informed that the real change that they seek has to be done in the community in which they live. It is my belief that outpatient counseling is both the most effective and most difficult type of treatment because it takes time and commitment and also the individual is has to deal with life on life's terms, something that was resisted or even ignored in the past.

Some of the treatment in residential programs is built upon a smoke and mirrors approach to marketing. For example, I found the image below on a website that was marketing a variety of residential treatment programs. Curious about whether it truly reflected any of the programs being marketed I did a image search. It appears that the image belongs to an underfloor heating company. I found this discovery very interesting. While trust and honesty comprise the foundation of recovery, I believe that they should also be the same for counseling and treatment programs as well.

Dr. Harry Henshaw