When Do I Need Residential Rehab?

Entering recovery is a major life change. While you’re learning how to heal from addiction, you might need a lot of support. For many people, inpatient rehab is the right place to start.

In these programs, you’ll get daily attention from a team of trained providers. In most centers, you’ll also be living with other people who are also in recovery. You’ll be held accountable by your therapist, your peers, and maybe even a team of doctors. During your stay, you can focus all your energy on recovery. This lets you kick-start the healing process, and make real progress before you return home.

But everyone’s journey is different. Residential treatment might not be a good fit for you. Some people need to keep living at home because of work or school commitments. Others have a strong support system, and want to stay close to them. And some types of insurance only cover outpatient treatment. In any situation, it’s important to choose a program that suits your specific needs.

In this article, you’ll learn about several aspects of residential treatment. Any one of these might be a pro or a con for you, depending on your goals for early recovery. You can use this comprehensive guide to decide whether inpatient rehab is the right place to start healing.

Medical Detox

For most people, detox is the first step in addiction recovery. And sometimes, it’s important to get medical treatment during this process. Some residential rehabs offer detox services, so you can stay in the same facility the whole time. Otherwise, you might spend a few days in a detox center before going to rehab.

Benefits of Inpatient Medical Detox

If you’ve been using alcohol, benzodiazepines, or opioids, medical detox is essential. Withdrawal from these substances can be life-threatening. Talk to your doctor before you make any major changes. Their advice can help you know what to look for in a detox program.

Detox can be helpful for people with a dependence on any drug, and those who are in poor physical health. You’ll likely work with a therapist and a psychiatrist, as well as a medical team. By the time you start rehab, you’ll already have a sense of how to approach mental health treatment.

The average length of these programs is 3 to 7 days, but that timeframe can vary widely. And even shorter detox treatment can have a major impact on your long-term recovery. In one study, those who completed both detox and rehab had far better outcomes than others.

Limitations of Medical Detox

Medical detox isn’t necessary for everyone. If you’re quitting smoking, for instance, detox can be uncomfortable—but it probably won’t be a health risk. The same is true for behavioral addictions, like gambling. People with these addictions might benefit more from going straight to longer-term rehab.

Insurance doesn’t always cover detox. This may change depending on your length of stay, and whether you’ll stay in the same place for rehab. Make sure you check with your insurance provider before choosing a detox program.

Residential Rehab Has a Structured Schedule

When you live on-site at a rehab center, you’ll be following a fully scheduled treatment program. A typical schedule will include 1:1 therapy, support groups, and complementary therapy. Most programs include down time for you to process everything, either on your own or with your peers.

Pros of a Structured Schedule

Daily life is full of triggers. You might experience stress at work, friction at home, or social pressure to do drugs. And when you have an addiction, your substance use can disrupt your daily schedule. And in turn, a lack of structure makes it easier to justify harmful behavior. This is where residential rehab programs can offer unique support.

Following a set schedule can also reduce decision fatigue. In other words, you can put your whole focus on healing, instead of worrying about what you’ll cook for dinner. And what’s more, your schedule will be carefully curated to facilitate your recovery. In a sense, there will be only one item on your agenda: doing the hard work of changing your life.

Cons of a Structured Schedule

If you have pressing commitments outside rehab, a strict schedule might not be a good fit. For example, you might be unable to take time off work to attend treatment. Or, you might need to live at home to care for a family member.

Cost can also be a factor in choosing a residential program. Even if your insurance covers treatment, you may not be able to afford the lost income. Some programs allow you to work during rehab, but it’s not the norm. If you need to work during early recovery, talk to the admissions team to see if they can accommodate that. If not, you might consider an intensive outpatient program (IOP) instead.

And for some patients, a highly structured routine might feel too strict. If you’d like to move through the day in a more intuitive way, inpatient rehab might not be a good fit. But make sure that your desire for flexibility stays grounded in the goal of healing. Even if you don’t go to inpatient treatment, it’s vital that you get help from experts in addiction recovery.

Inpatient Treatment Offers Expert Support

You can connect with healthcare professionals whether or not you go to rehab. These providers will help you decide on a treatment plan that meets your specific needs. If possible, it’s best to get evaluated by experts in both physical and mental health.

Benefits of Expert Support in Rehab

In rehab, your providers will work together to coordinate your treatment plan. And although you’ll be meeting them for the first time, they’ll have experience working together. This can simplify communication on all sides, and make your life much easier.

Your team may include a variety of professionals, including some or all of the following:

1:1 therapist
psychiatrist
group therapist
family therapist
medical doctors and nurses
nutritionist
complementary therapists, such as an art therapist, equine therapist, music therapist, massage therapist, etc.

During treatment, you may build strong therapeutic relationships with your providers. These dynamics—sometimes called therapeutic alliances—can be hugely beneficial. In fact, a healthy rapport between counselor and client can make recovery more likely.¹

Limitations of Expert Support

It’s very important that you get professional support, even if you don’t go to an inpatient program. But there are some reasons you might prefer to work with providers in a different setting.

Once you arrive at a residential rehab, you’re committed to working with their staff. You might connect with the staff psychiatrist, but not with any of their talk therapists. And as long as you’re on-site, you might not have the freedom to look for another provider.

And even if you form a bond with all your providers, it will probably be temporary. At many rehabs, you’ll have to stop seeing your therapist when you complete treatment. They’ll usually help you find another provider to see after you return home. But even so, it may take you some time to adjust to your new provider’s style.

Rehab Offers a Change of Scenery

Traveling to rehab is a unique experience, and many patients find it inspiring. But even if you don’t leave your hometown, living in a residential facility will give you a new perspective. Something as simple as a change of scenery can improve your mental health.

Pros of Leaving Home for Rehab

Changing your environment can have a positive impact on brain chemistry.² And according to one study, having new and interesting experiences can increase happiness.³ This data suggests that going away for addiction treatment might help motivate you to recover.

Physical space can also give you much-needed emotional distance. Early recovery is a great time to distance yourself from destructive relationships. For some people, this is the start of a permanent shift away from an unhealthy community. For others, it can be a break to regroup and consider your options. You can even take space from some people, and stay in touch with others.

A change of scenery can be helpful even if you’re not as focused on interpersonal dynamics. Triggers don’t always come from difficult relationships or situations. They can also be the mundane sights, sounds, or smells of your daily life. Taking a break from those triggers can give you insight into the basic, but sometimes unnoticed, habits of addiction.

Cons of Leaving Home for Rehab

Traveling to rehab isn’t financially feasible for everyone. In addition to the cost of treatment, you’ll have to pay out of pocket for travel expenses. This won’t be a concern if you attend an inpatient program close to home.

And even then, residential treatment can be isolating. You’ll likely have limited contact with your friends and family during your stay. You may also have less privacy than you’re used to, depending on the housing options at your facility. And living in close quarters with other patients might be a challenge.

Peer Support and Group Dynamics in Rehab

Most people attend rehab with a group of patients who share some part of their experience. The exact size of that group varies from one program to another.

The Value of Peer Support

A wealth of research shows that social support is important during addiction recovery.⁴ In one study, groups of people in addiction treatment inspired each other to focus on healing.⁵ By witnessing fellow members’ progress, they were drawn “into a culture of recovery.”

Your peers can support you in ways your healthcare providers can’t. Even if your therapist has a history of addiction, it would be inappropriate for them to share many details of their own life. By talking to other people in recovery, you can connect with people who understand you on a deep, personal level. This can help you work past shame and stigma.

These relationships also let you practice your interpersonal skills. Everyone in the group understands that you’re doing your best to face the challenges of recovery. They’re having the same experience, at the same time as you. This can make it a little easier to be compassionate when one of you makes a mistake.

Potential Issues With Group Dynamics

Chances are good that the shared experience of rehab will help you bond with the people around you. But, there’s no guarantee that you’ll connect. It’s natural to have concerns about how you’ll relate to the other people in your group. You can always use those concerns to help you choose an inpatient program.

For example, you might want to start treatment among people of your own gender. Many facilities offer women’s-only treatment, men’s-only treatment, and LGBTQIA+ affirming services. But in any of these specialized programs, you’ll still be isolated from your support network at home. That’s true even if you attend a program in your area.

If you have a strong local community, you might want to stay in touch with them throughout recovery. Some centers allow for this, but many ask you to take a break from contacting loved ones. Make sure you know your rehab’s policy well in advance, so you can make the decision that meets your needs.

It’s also ok to prioritize your mental health over your relationships. As tempting as it might be, don’t stay in touch with someone during rehab because you think they need you to. In the end, your recovery will improve the relationship more than a few phone calls ever could. Take advantage of your time in treatment. This is an opportunity for you to get to know yourself again—whether you attend inpatient rehab or not.

Complementary Therapy During Inpatient Treatment

Complementary therapies are used in combination with mainstream approaches,⁶ not instead of them. These treatments may include creative pursuits, sports, and outdoor adventures. Different rehab programs offer a wide range of complementary therapy techniques.

Benefits of Complementary Therapy

Recovery is more than an end to substance abuse. It’s also the start of your finding new, healthy ways to enjoy your life. Complementary therapies can help you build confidence while you learn a new skill. They can also turn into long-term hobbies after you leave rehab. These are some of the many therapies you might try during inpatient treatment:

massage
music therapy
art therapy
hiking
acupuncture
yoga
adventure outings, like swimming with dolphins or going on safari
sports, like volleyball or tennis

These activities are both fun and therapeutic. By trying something new—or something you haven’t done in some time—you can break out of old patterns. And by taking a break from talk therapy, you’ll be able to process your feelings from a different point of view.

Limitations of Complementary Therapy

Every rehab program offers a unique set of complementary therapies. If you have your heart set on a certain activity, make sure your program offers it. Depending on what else you need from treatment, you may have to prioritize other therapies when you’re choosing a center.

This is especially important for patients with ongoing medical issues. You might have a chronic illness, or need treatment for health problems due to addiction. In that case, even if your program offers a certain type of therapy, you may not be able to participate. But over time, as your health improves, that may change. You may even be able to join in before you complete residential treatment.

Get Help Planning for Aftercare

Recovery doesn’t end when you complete inpatient treatment. According to the U.S. National Institute of Health, continuing care is an important way of “sustaining the positive effects” of rehab.⁷ With that in mind, residential rehab facilities may help you plan for aftercare.

Get Help Planning for Life after Rehab

Your providers will try to set you up for success before you leave treatment. They may help you connect with one or more of the following resources:

individual therapy
partial hospitalization programs (PHPs)
intensive outpatient programs (IOPs)
support groups (12-Step and non-12-Step)
sober living environments
activity- or interest-based groups

You may also make a plan for relapse prevention, and discuss any other issues you’re concerned about. These conversations will help you prepare for your transition back to daily life.

Limitations of Planning for Aftercare

No matter how well you plan for life after rehab, you’ll go through an adjustment period. Most patients will have to start seeing a whole new group of providers, who may or may not know each other. It might take some time to establish relationships with them.

During that time, you’ll be going through many other changes. Whether you return home or move somewhere new, you’ll have to settle in. You’ll also be surrounded by a different group of people. And, no matter where you are, you might be getting back in touch with those you took space from during early recovery.

Many of these transitions are unavoidable, no matter how you approach treatment. But if you choose to do an outpatient program, they can take place more slowly. You’ll still make big changes to your life, but you might have more control over the timeline.

Exploring Your Options for Residential Rehab

When you first start recovery, it’s important to get the help you need. That means something different for everyone. Some people thrive in residential treatment. But inpatient rehab can be inaccessible, for many reasons. If your insurance won’t cover these programs, or you can’t step away from work and family, you can still heal from your addiction.

Learn about inpatient treatment options, including their pricing, types of therapy, and aftercare programs, on our list of rehabs that treat addiction and mental health.

Reviewed by Rajnandini Rathod

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Complementary, alternative, or integrative health: What’s in a name? (n.d.). NCCIH. Retrieved from https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name [↩]
McKay, J. R. (2009). Continuing care research: What we’ve learned and where we’re going. Journal of Substance Abuse Treatment, 36(2), 131–145. https://doi.org/10.1016/j.jsat.2008.10.004 [↩]

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