Inpatient services can be delivered in a broad range of settings for substance abusers providing clinical and psychosocial interventions for detox and the management of withdrawals, rehabilitation, and recovery support.
The complexity and special needs of some individuals often requires a more structured, safe, and therapeutic environment than an outpatient rehab provider can offer and where the issues at hand and around the clock are simply a matter of staying focused on getting well. For most people, this void of negative outside influences and the therapeutic alliances they make with the inpatient service providers and others gives them the ultimate hope they need for a brighter future.
Evaluating Treatment Needs
The first step in determining how inpatient services work is evaluating treatment needs and matching them to the right treatment settings.
Detox safety and comfort is a considerable element of inpatient rehab and typically the beginning of the relationship with the inpatient services provider. Hospital services are often necessary for acute detox and psychiatric needs when significant dangers to self or others are possible.
Although the intensity levels and inpatient services may vary per person and facility, evaluating and addressing the biomedical and psychosocial issues of the individual is crucial to strategizing the appropriate treatment plans. The inpatient service provider must assess:
- General health histories including medical and psychiatric histories, medications, allergies, history of seizures, assessing the risks of infectious diseases, and other influential aspects such as pregnancy or special dietary and nutritional needs.
- Mental health status including cognitive disabilities and behavioral or mental health disorders that would limit treatment engagement and focus.
- Substance abuse history including previous treatment attempts, usage patterns, poly-substance abuse, duration, and routes of administration.
- Living conditions and support networks including family and childcare relationships and needs, homelessness, or lack of safety and abstinence encouragement at home.
- Demographic features such as age, gender, ethnicity, culture, race, language, and education levels.
Integrating Services and Coordinating Care
Psychological dependence, co-occurring psychiatric and medical conditions, social supports, and environmental conditions critically influence the probability of successful and sustained abstinence from substances.
Individuals in need of inpatient services typically display poor health, relationships, social skills, and high risk behaviors that reduce their quality of life and leave them unable to reconstruct their images of self-worth even when they are able to detox from drugs or alcohol. When these needs remain unmet the individual’s ability to focus on recovery efforts can become compromised.
Integrating inpatient services of counseling, support, education, medical, and psychiatric care in continuum with psychosocial services improves social functioning and encourages a healthy lifestyle while motivating treatment engagement. As recovery progresses, the motivations, goals, and needs of a patient are bound to change. Coordinating care and modifying treatment plans accordingly and in a timely manner optimizes the successful outcomes.
The duration of inpatient services generally last for 28 days or longer for the necessary time it takes to overcome the obstacles that predominately affect the patient’s abilities to change their lives for the better. Some problems, however, take longer than others and if the patient feels like their needs are being met and recognizes the progressions, even in some areas over the others, they can still gain the much-needed confidence that promotes treatment retention.
Overlapping Treatment for Mental Health and Substance Abuse
The majority of adults who have mental health or substance use disorders do not get corresponding treatment. Because a majority of substance abusers have co-existing mental health disorders such as depression and anxiety, addressing mental health concerns at the earliest opportunity and in continuum with other inpatient services affords the most promises in preventing a relapse.
Substance dependency, itself, is considered a mental health disorder that involves changes in brain chemistry and anatomy and makes it difficult to simply stop using the drugs or alcohol without treating underlying mental health conditions that may have caused or exacerbated the substance abuse and vice versa. Inpatient rehab centers can provide a higher degree of specialized and intensified services to directly target the most problematic issues with overlapping treatments tailored to the unique needs of the patient.
Counseling and therapies make up a large portion of the rehabilitation phase of treatment. Having ease and immediate of access to interventions when needed is one of the primary benefits of inpatient services.
Different facilities offer different treatment approaches. The most commonly used psychotherapy interventions are counseling and cognitive behavioral therapies which “emphasize learning to recognize and change maladaptive thought patterns and behaviors, improve how feelings and worries are handled, and break the cycle of dysfunctional habitual behaviors.”
Other forms of psychotherapy may include:
- Interpersonal therapy
- Family consultations and therapy
- Group education and therapy
- Motivational therapy
- Recreational or complementary therapies
- Meditation and relaxation therapies
- Contingency Management
- Dialectical Behavioral Therapy
Another important aim of inpatient services is to provide the tools and resources a person can use to prevent relapse once formal treatment ends and to know what to do if it happens. Many people have the most difficulty in coping with cravings and triggers to relapse when home environments remain unchanged and transitioning into an extended sober-living facility may be needed.
Inpatient services also encourage participation in recovery groups as a way to build healthy relationships for encouragement, and support in recovery efforts. Groups such as Alcoholics Anonymous and Narcotics Anonymous are advocated sources to help maintain sobriety and abstinence in the long run.