Extended Care Facilities
What are Extended Care Facilities?
Do you think one or two months is long enough to heal from the effects of substance abuse and start life anew? Extended care facilities are designed around the idea that this amount of time is not enough, and that recovery often takes more than three months in treatment.
Extended care facilities offer women the opportunity to fully recover from the effects of substance abuse and drug addiction while in a safe and supportive environment. They often provide educational and vocational support to help ease the post-rehab transition and set patients up for drug free life.
Substance abuse and addiction impact a person’s physical and mental health, behavior, and entire way of life. Long-term treatment is often needed to allow a person to heal all of these aspects of their life, and to help the transition into a substance-free lifestyle.
How ‘Extended’ are Extended Care Facilities?
Everyone’s experience with substance abuse treatment and recovery is different, and for this reason there is no set length of treatment. However, there are big differences in terms of the different lengths and the depth of treatment provided. It appears that in recent years 28-day programs are somewhat the norm, largely because insurance companies will not cover substance abuse treatment that is longer than that. However, this length is of limited effectiveness.
According to the National Institute on Drug Abuse (NIDA), most addicted individuals need at least 3 months in treatment to significantly reduce or stop their substance abuse. In another publication, they write that anything less than 90 days is of limited effectiveness, and that methadone maintenance treatment in particular should be continued for at least 12 months.
Extended care facilities are typically longer than 90 days, and can last for two years or more.
The Need for Long-Term Rehab, Extended Care Facilities
Addiction is a chronic, relapsing disease that infects many aspects of a person’s life. By definition, drug addiction involves compulsive drug seeking behavior as well as the continuing of drug use despite knowledge of the consequences to a person’s health and well-being, or actual consequences occurring. Given these factors, it is easy to see how drug addiction can impact a person’s entire life. Long-term treatment helps women and men alike adjust to a drug-free lifestyle while having access to the help and support provided at rehab.
In their outline of the Principles of Effective Treatment, the National Institute on Drug Abuse asserts that remaining in treatment for enough time is critical to recovery. Research suggests that the best outcomes occur with longer durations of treatment. They also discuss the potential for relapse, explaining that addiction recovery is a long-term process that often requires multiple episodes of treatment. For someone who relapsed after more short-term treatment, extended care rehab would be recommended.
Benefits of Extended Care Facilities
The main difference between extended care facilities and other rehab programs is time. Extended, long-term rehab programs are longer than others, and this extra time is beneficial to recovery in many ways. These ways include:
- Time to fully detox and undergo withdrawal. Depending on the substance a particular patient is in rehab for, they may experience a withdrawal syndrome as a result of abruptly stopping use of a substance the body had grown accustomed to. Detox and withdrawal are very serious and involve physically and psychologically destructive symptoms, especially for opiates, alcohol, and meth, and cocaine. Symptoms may last from one week to a few weeks. Extended care facilities accommodate for this time, and provide treatment for enough time afterward that it can still be effective. Programs that are 28, 60 and 90 days leave little time after withdrawal for a patient’s treatment.
- Time to meaningfully engage in treatment. Certain substances, especially methamphetamine, have long-lasting effects on a person. This, in addition to withdrawal, may mean that it will take some time for a person to be able to truly engage in treatment efforts like counseling and motivational therapy. As well, some people enter treatment against their will, and thus will need some time to adjust to and commit to being there and working on their recovery.
- Time to incorporate the skills learned in treatment and get used to a new, drug-free lifestyle. Especially for people who have had a long history of drug and alcohol abuse before treatment, it will take a fair amount of time to adjust to a new, healthy and productive lifestyle. Doing this in a rehab center, whether inpatient or outpatient, ensures that they have professional, trained support that can help them along the way. This can help prevent relapse as patients have time to truly integrate healthier habits into their lives.
- Time to recognize and care for any co-existing conditions. It is not uncommon for addiction to cause or accompany mental health or medical problems. Oftentimes, however, treatment is not long enough for a counselor to identify these conditions. They may believe the symptoms to be side effects of drug use when they are in fact conditions unto themselves which require attention and treatment. In long-term rehab there is a more sufficient amount of time to allow for this.
Who Needs Extended Care Addiction Treatment?
Extended care rehab is not always necessary, but in some cases it is essential. People who are particularly suited for extended care facilities include:
- Individuals who have tried shorter-term rehab at least once and have returned to substance abuse
- Individuals with severe co-occurring mental health conditions, or dual diagnosis
- Those who have been abusing a variety of substances for a very long time
- People who started abusing substances very young and may be very lost in life without substance abuse
This list is not exhaustive, and people who would not necessarily be described by any of these statements would likely benefit from long term rehab, too. Of note, as well, is that the legal system sometimes will order long-term rehab as part of the sentencing for drug-related crimes.
Considerations to Make When Choosing an Extended Care Facility
Getting treatment for addiction in an extended care facility is a big decision that needs to be taken seriously. There are considerations to make and planning to be done concerning the type of facility you want to and can afford to be in, as well as where that facility will be.
It is important to consider these factors when choosing an extended care facility:
- Cost. Due to the length and intensity of treatment, long-term rehab tends to be more expensive than otherwise. Oftentimes insurance companies will cover part of treatment, but not always everything. Your coverage and your available financial resources are things to consider.
- Location. You can find extended care facilities that are close to home, or far away. If you have children and do not want to or cannot be away from them choosing a facility closer to you may be important.
- Inpatient or outpatient facility. An inpatient facility requires you to live there, and has around the clock care available to you. Outpatient facilities do not offer housing, and you go to the treatment center for appointed treatment times. If you have children who need you, a job you cannot part from for some time, or other things holding you back you may simply be unable to attend inpatient treatment. On the other hand, it may be what you need.
- All-female or mixed-gender rehab. Do you think your recovery would be hindered by the presence of males in treatment? Gender-specific rehab programs exist for those who do. On the other hand, a mixed-gender environment is more of a real-life environment, and this can help with the transition after rehab.
- Quality of and certification of treatment center. There are qualifications and certifications that set apart rehab centers and ensure that they are at a certain standard. It is important that the rehab center you are considering employs trained treatment professionals, and follows the standards of effective addiction treatment.
- Services offered at the center. You’ll want to know what kinds of services are offered at the extended care facility. If you have an existing mental health condition or health condition, for example, you’ll want to go to a facility that has the ability to care for that. Given the fact that long-term rehab is lengthy, it’s also helpful to have educational and vocational services that can keep you ready for work or school after treatment. Finding a center with those services can make a large difference in your experience in treatment, and afterwards.
Therapeutic communities (TCs) are a special form of long-term rehab. These communities first originated in the late 1950s when alcohol and drug addiction treatment was largely ineffective. They are simultaneously intensive and comprehensive sober living arrangements and treatment facilities that patients live in for about six months to two years.
Therapeutic treatment communities require every person to have some household responsibilities, and to participate in other goings on in the facility. They use peer pressure and mutual accountability to help people learn to work with others and overcome their previous behaviors. In this way, the community itself is a therapist and teacher for those in treatment.
Therapeutic communities view substance abuse as part of broader problems, and the structure of the programs allow these problems to be solved. According to the Substance Abuse and Mental Health Services Administration, the core goal of TCs is to promote a holistic lifestyle by identifying patterns of negative behaviors that lead to substance abuse. This goal is achieved by working with peers, staff members, and other treatment professionals.
Job functions, chores, and general facility management are used as vehicles for self-development and for helping people develop socially-productive lifestyles. The idea of self-help and mutual self-help is at the center of the therapeutic community. SAMHSA writes, “where AA says “let go, let God,” TCs take the view that “you got yourself here, now you have to get yourself out with the help of others.”
Otherwise, treatment you may find at a therapeutic community is similar to elsewhere, but TCs allow for treatment to go deeper due to the fact that most people live in these extended care facilities for over six months.
Treatment methods and services at TCs include:
- Medical services
- Mental health care
- Family therapy and education
- Educational services
- Vocational services
All of these treatments contribute to a person’s healing process. By using such a comprehensive model of treatment, TCs effectively help patients integrate into a life in recovery.
Some therapeutic communities invite both men and women, but gender-specific TCs exist as well.
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