Reading Time: 10 minutes
Before starting an alcohol or drug treatment program, often referred to as rehab, take some time to consider what to know before going to rehab. Adequate preparation can help you remain fully engaged throughout the treatment process.1
Preparing for rehab is not just about making a list of what to pack or checking with your insurance company to see which services are covered. Getting ready for drug rehab involves a thorough understanding of the different aspects of treatment to plan effectively. Some experts suggest creating a rehab checklist before starting treatment.
What to Know Before Going to Rehab
Substance use rehabilitation (rehab) refers to treatment programs that help individuals transition to long-term sobriety after living with substance abuse, dependence, or addiction.1 Understanding your treatment options, costs, housing needs, and other factors can help you make informed choices about the program that is right for you.
An effective substance use rehab program provides an individualized plan of care, avoiding the “one size fits all” approach.1, 2 The following considerations will give you an idea of what to know before going to rehab and help you effectively engage in the treatment process.
Consider the Cost
Understanding program costs, including how your insurance benefits work, can give you insight into what to expect to pay for treatment.3 Your insurance carrier or plan may cover certain facilities or program types differently. For example, some insurance carriers cover inpatient rehab—also called residential rehab—only for a specified period before expecting you to transition to an outpatient setting.
Certain services, including medical care, medication management, lab tests, and therapy, may incur additional costs or need to be processed by medical providers outside of the rehab facility to be covered by your plan. Some services may require preauthorization before your insurance carrier covers them. Getting preauthorized involves one of your medical providers, like your primary care doctor, establishing that you have a medical need for the service that meets the standards set by your insurance carrier.
Knowing what your insurance plan covers and where to get additional funds can help you effectively navigate the financial aspects of the recovery process. Speak to your insurance carrier’s membership services, an insurance case manager if you have one, and to the intake staff at prospective programs to learn more about costs.
Some rehab programs also offer alternative payment methods, such as sliding scales and discounts for patients without insurance, to make their programs more accessible.
Know What You Need
People with substance use disorders may also have mental and physical health concerns.1 When physical and mental health concerns beyond those directly related to substance use exist, you may be able to choose a program that specializes in treating co-occurring conditions.1,3 A physician can address physical health issues during treatment.
When screening potential rehab programs, ask about available health care providers, including those qualified to manage mental health and medical problems. Even if you do not have a conventional co-occurring diagnosis, some rehab centers are better suited to accommodate individuals who need consistent, stable medical care. For example, if you live with a chronic health condition like diabetes, need regular medication or lab work to monitor metrics like hormone levels, or need treatments at regular intervals like physician-administered injections, check if these services are available at the facility.
Learn About Types of Rehab Programs
Although each rehab program may differ in the treatment, evidence-based treatment modalities are considered the gold standard of substance use rehab treatment. Evidence-based modalities are backed by quantitative scientific evidence that has indicated that the treatment improves recovery outcomes.
Examples of evidence-based treatment modalities used by many rehab programs include:1, 3
- Medication management—Medication-assisted therapy or medication management involves medical supervision and administration of drugs like Antabuse for alcohol addiction and methadone for opioid detox to reduce withdrawal symptoms and the risk of relapse.
- Cognitive-behavioral therapy (CBT)—CBT challenges negative thoughts to produce desired behaviors, promote emotion regulation, and teach coping strategies and problem-solving skills.
- Motivational interviewing—Motivational interviewing is a counseling approach that helps individuals who have not yet found their internal motivation for pursuing recovery. This modality is appropriate for individuals who enter rehab as part of a court-mandated program, after receiving an ultimatum from loved ones, or due to any other external motivators.
- Family therapy—Many rehab programs include psychotherapy sessions involving spouses or partners and other family members.
- Brief interventions—Brief interventions are short counseling sessions offering advice and feedback.
- Mindfulness-based interventions—Mindfulness is incorporated in different capacities into many rehab programs. Mindfulness-based interventions are an approach that teaches people how to stay focused in the present moment without judging their thoughts or feelings.
- 12-step and mutual support groups—The 12-step peer support format created by Alcoholics Anonymous (AA) may be included in the programming in rehab treatment. These groups may be facilitated by a counselor or may be community-based peer support groups as AA and Narcotics Anonymous (NA) meetings traditionally are.
- Contingency management programs—Contingency management utilizes motivational incentives to help individuals complete recovery-focused goals set with the help of their care team.
Knowing which type of services a program offers before you participate can help you prepare to engage in the work that promotes long-term recovery. 1
Ask About Program Qualifications
Licensing and accreditation standards determine whether a rehab facility meets the qualifications for clinical quality of care.3 The specific requirements are established by the government in the state where the facility is located. For a treatment facility to meet these requirements—and receive accreditation—an independent board reviews its practices and determines whether it meets the state’s standards.
When you contact the prospective or chosen rehab facility, ask about the qualifications of counselors and other staff members, including physicians, therapists, and psychiatrists who provide treatment services.3 The professional staff members should hold current licensure and up-to-date training on best practices for treating substance use disorders.
The facility’s accreditation and the qualifications of individual staff members you work with may affect whether your insurance carrier approves services from the program or provider.
Understand Program Expectations
Each rehab program has different rules, expectations, and structures.3 For example, most programs have set expectations regarding attendance and participation in sessions and “homework assignment” completion.
Individual counseling sessions can take place weekly or more frequently. Group sessions can take different formats. Substance use counselors lead many other types of groups, including educational groups, support groups, and relapse prevention groups. A clear understanding of group size, facilitators, and the type of work to be done (e.g., journaling, 12-step work, etc.) can prepare you for the program.
When you talk with a prospective or chosen rehab program, ask about specific expectations and rules.3 They can give you a list of items you need to bring and those to leave at home. There may be rules about cell phone usage, curfew in common areas, substance testing, and so on. Other information to gather in advance includes how family members participate and how the program manages non-adherence to expectations.
Manage Your Expectations
You may contact several rehab facilities or be referred to multiple programs by a provider before deciding on a program best suited for your background, treatment goals, and recovery progress. 3 There may not be a program that meets every expectation, and many programs have a limited number of “beds”—or individuals it can accommodate—so you may not find your “perfect” program.
Make a list, prioritizing which of your expectations are most important. Then select the program that meets your needs best. In some cases, this may mean going to the first facility with an opening because you need the help as soon as possible—doing so absolutely can be the right choice based on your circumstances.
Recovery from addiction is a time of hope for many people recovering from substance abuse. Keep in mind that it probably won’t happen overnight. Recovery is a journey that involves good days and bad days. You may see quick progress at the beginning of your treatment journey, only to find that it doesn’t feel as rapid in the following days. It’s vital to check your expectations along the way, take it a day at a time, and remember that sobriety is a lifetime effort.
What to Know About a Rehab Checklist
Learning about potential challenges that could affect your full engagement in treatment is essential to know before you go. A case manager can help you navigate some of these challenges; starting a rehab checklist may help you manage these concerns on your own before treatment begins.
The following rehab checklist includes some common considerations to address before starting treatment, when possible. Each person has unique needs. The list offers suggestions for addressing some of these needs. However, only an assessment by a trained and qualified treatment provider, such as a licensed substance abuse counselor, can provide a complete picture of the steps to take before starting a treatment program.1
Knowing your financial obligations and making arrangements to meet those obligations can help you focus on the treatment process. Many people set up automatic bill pay to ensure important bills such as the rent and utilities at home are paid on time. Make a list of money owed while you engage in treatment. Talk with a treatment provider about managing financial obligations, such as by setting up a payment plan, taking advantage of a cash patient discount, or qualifying for a sliding payment scale. Alternatively, you can turn to someone you trust or consider a personal or medical loan to help you with financial concerns.
Each person is different when it comes to housing needs. You may need to appoint someone to take care of your residence while you engage in treatment. Taking care of your home may mean visiting to ensure it remains secure, watering the plants, or clearing out substances and paraphernalia that may increase your risk of relapse.
If you have concerns about a lack of housing or an unsafe living environment after inpatient rehab, get support from a treatment provider. Ask your program representative how their case management services can help you secure safe, affordable housing. Some individuals transition to sober living housing before returning to living independently or with their families after a residential stay.1
Personal Needs and Family Support
Advanced arrangements need to be made to ensure the safe care of dependents or pets while you are in residential treatment. Trusted loved ones might be able to help, especially with short-term arrangements. If you do not have a person to care for your children, talk to a program case manager or a social worker for help. If you need a case manager, ask a treatment provider about how to go about the process.
If you have someone already taking care of your residence, whether they are a loved one or professional, they may offer care for some pets depending on their experience, comfort level, and daily availability. Kenneling or stabling pets through a vet service, local animal center, or local stable are options for pet care during your absence.
Employment and Education Support
You are not required to disclose that you are going to rehab to your employer or your school. The Family and Medical Leave Act (FMLA) includes provisions that may allow you to take paid or partially paid medical leave from a full-time position with your job guaranteed when you return. If you have paid time off (PTO) accrued with your employer, you can use this to supplement what you are paid during medical leave. Note that while you can take FMLA leave for addiction treatment, you can’t take FMLA to recover from the effects of substance abuse.
If you are not eligible for FMLA leave, discuss the need to take time off for medical treatment with your employer. This may be your situation if you are a part-time, seasonal, or new employee. Being specific about the time you anticipate taking can help protect your job but does not necessarily guarantee that your employer will hold the position.
Note that if you decide to disclose your history of substance abuse, your employer cannot terminate your employment. A company cannot withhold future employment based solely on this history due to the Americans with Disabilities Act (ADA), as substance use disorders are a protected condition. However, your employment can be affected by your behavior or performance while using substances—this is not protected under the ADA.
If you go to school, reach out to your instructors or school administrators to discuss your availability for classes. Some colleges may offer support to people who receive extended medical care. See which departments can help you navigate these resources or have a case manager reach out to your educational institution on your behalf.
Many high schools and colleges offer alternative learning programs that would allow you to continue classes in rehab if your care team believes this is appropriate and would not be detrimental to your recovery. Most educational institutions have official policies allowing students to take leaves of absence if the need for medical care substantially impacts their ability to complete coursework, such as if your rehab stay is 60 or 90 days. Discuss these options with your guidance office.
If at any time your employer or educational institution asks for more details about your rehab treatment than you feel comfortable providing, you can sign a release of information for a provider to speak in broad terms about why you need to take medical leave.
If you have legal concerns like a court date, probation, or warrant, coordinate with the involved legal entities. If you need support navigating legal matters, talk with your program representative to ensure their case management services have adequate resources to help you through that process.
What to Pack
Every program has different rules and expectations about what you can bring to treatment. You will need to pack essential items such as clothes, accepted toiletries, medication, and money. Your chosen or prospective program may have different rules and resources regarding entertainment items like books or electronics. Discuss the program’s guidelines with a representative to determine what’s allowed and what’s not allowed.
What to Know About the Next Steps
With your rehab checklist in hand, follow up with your support system and program representative to ensure everything on the list has been adequately taken care of before you start treatment.
- Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals. The Guilford Press.
- National Institute on Alcohol Abuse and Alcoholism. (2019, February 21). Why do different people need different options?
- National Institute on Alcohol Abuse and Alcoholism. (2020, November 23). Step 2 – Ask 10 recommended questions.