_edited.png)
You’ve probably heard of rehab. In California, they’re everywhere. And for good reason: a lot of Americans struggle with addiction. While it’s great that there is so much access to treatment, what isn’t so great is the treatment itself. Why? Well, most rehabs are not particularly effective. The majority of patients relapse shortly after discharge. Ask anyone in recovery, and they’ll probably tell you that they cycled through several rehabs over the years. As an addiction therapist who has worked at numerous rehabs throughout the Los Angeles area, here’s why I think most rehabs fail and how you can find effective treatment.
They’re Way Too Short
Most rehabs offer a 30 to 90-day treatment plan. Inpatient rehabs are usually 30 days, and outpatient programs average around 60. While that may sound like a good chunk of time, it’s not—particularly when you’re treating something as insidious as addiction. Change takes time—and consistency. Sure, we can intellectually learn some new skills in a short time, but implementing them, practicing them, and mastering them? There’s no way anyone can accomplish that in such a short window. Imagine being tasked with learning Chinese in 30 to 90 days. Can you learn some of the basics? Yes. Will you be fluent? Absolutely not.
They’re One Size Fits All
Most programs catch a wide net of folks, so they resort to using a lowest common denominator approach to care. On one hand, it makes sense. They need to provide care that will appeal to as many people as possible, and to do so they have to appeal to general trends. But what if you’re an outlier? For example, what if you need more EMDR than CBT? Well, most programs stick with CBT because it’s the most universally effective. But that doesn’t mean it will be the most effective for you. In fact, key elements of your treatment can be missed altogether. So while rehabs do offer “evidence-based” care, you will likely receive cookie-cutter therapy rather than treatment customized to your needs.
They Miss Co-Occurring Disorders
The vast majority of addicts also struggle with co-occurring disorders like depression or anxiety. This makes sense to almost everyone. Most folks will agree that they drink and use substances to self-medicate some sort of emotional distress. So identifying and treating these co-occurring disorders is essential. However, these disorders often don’t present themselves until after treatment is over. Truly, you need several months of sobriety to rule out secondary diagnoses. Why? Substance use can camouflage symptoms, and it takes months of continuous sobriety for someone to return to their organic psychological brain chemistry. So, shockingly, many folks discharge from rehab without a clear diagnosis. How can we expect them to be successful managing their mental health if they don’t even know what mental health conditions they suffer from?
The Vacation Effect
Another huge problem is something I call the vacation effect. Not all rehabs are luxurious, but most have some degree of pampering. It’s not the massages or horseback riding that I find problematic. You know how you feel great on vacation? You get away from your real life, your job, most of your stress, and suddenly you just feel . . . better. Well, the same thing happens at rehab. At rehab, you’re not dealing with your real life. With all of these stressors removed, a lot of folks experience a sudden flight to health—similar to a trip to Hawaii. But, as we all know, vacations eventually end, and we come home to find our problems waiting for us. So while a lot of people feel better at rehab, they find themselves immediately declining as soon as they return home.
A Broken & Expensive Model
Unfortunately, we continue to use the same broken treatment model and wonder why folks aren’t getting better. At worst, many feel that rehab programs are a colossal waste of time and resources—particularly money. Unless your insurance covers the treatment, rehabs are enormously expensive. To be fair, they do require a robust operating budget to stay up and running. But costs for residential treatment can easily hit $80K per month, and luxury programs can go way above six figures. Again, this is just for 30 days of treatment. You’ll still have to pay for outpatient programming, sober living, and ongoing psychotherapy and psychiatry.
Finding an Addiction Therapist in Los Angeles
Luckily, there are some rehabs that do stand out. The trick is finding them. Before you choose a rehab for yourself or a loved one, do your research. Don’t be fooled by pretty websites or Google ads. Find someone who can actually vouch for the clinical acumen of the facility. This can either be a former client who actually went through the program or a mental health professional who can attest. If you are struggling, please reach out, and I can happily connect you to a resource that will hopefully work for you. I have strong relationships with treatment programs in the LA area that I wholeheartedly believe in, such as CAST Centers. You can also learn more about my treatment perspective for alcohol use and substance use. Remember: there is hope, and we do recover.
Comments