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Long Term Rehab

In order to manage a mental illness, or learn to keep an addiction relapse from occurring, a person needs to:

  • Understand the disease process as a concept
  • Identify how that disease has impacted the person’s life
  • Develop methods that can be used to manage the disease
  • Identify and work through life issues that could lead to mental health problems or temptation to abuse drugs or alcohol
  • Know what to do if a reemergence of symptoms occurs


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There are many steps included here, and some people simply take more time to learn these lessons than others do. Where a short-term residential program might provide a foundation for these lessons, it may not provide enough support to truly help the person take the lessons to heart and apply them in his or her life. These people may benefit from long-term residential treatment programs instead. Here, they receive intensive support over an extended period of time, and that may help lay the foundation for long-term healing.

A Quick Definition

According to the National Institute on Drug Abuse, a residential long-term program provides around-the-clock care for an extended period of time. Where a short-term residential program might require people to participate for several weeks, a long-term program can last for a year, or perhaps even longer. In a way, these programs work as a halfway house for vulnerable people, allowing them a period of respite between intensive therapies that are tightly controlled by doctors to living alone where no supervision at all may be provided.

The most common form of long-term residential rehabilitation program is the so-called “therapeutic community.” Here, the person learns how to manage his or her disorder while interacting with an entire community of people who also have their own issues to deal with. Some programs require all participants to share one house, while other programs provide a series of apartments joined by one shared space. Still other programs take place within residential treatment facilities that are typically associated with short-term rehab programs. Some patients may leave these programs within 30 days, while others live at the facility for a much longer period of time.

Long-term programs can vary significantly. For example, some experts suggest that long-term programs must provide eight hours per week of counseling, and seven hours per day must be spent on structured activities. By contrast, some programs provide more activities than this, and others provide less. Some programs require residents to abide by a strict and structured set of rules, or else they will be asked to leave immediately. Other programs are much more lenient, even allowing residents to work outside the community and spend some nights in the homes of friends and family members.

Long-Term Care in Addiction

According to the American Society of Addiction Medicine, addiction is a chronic condition that must be carefully monitored throughout the person’s life. Programs strive to decrease the likelihood of relapses and help the person function well when no relapses are evident. In a way, all rehabilitation programs for addiction are long-term programs. A person recovering from an addiction may never truly be through with treatment.

Given that this is the case, some people might wonder why long-term residential programs for addiction are even necessary. Couldn’t the person just complete a short-term program and then complete an intensive outpatient program instead? While some people do follow this model, there are some people who truly do need to spend more time in an inpatient program. Their recovery skills are weak, and they need extra help before they can handle the demands of the addiction on their own.

These people could include:

  • Those with mental illnesses in addition to addiction
  • People who have relapsed to drug use soon after completing an inpatient program
  • Those with stressful homes or neighborhoods full of temptation
  • People who started drug use young, and don’t know how to structure the day without use

Extended Care in Mental Health

Extended Care in Mental HealthAgain, almost all programs used to help people with mental illnesses could be considered long-term programs, as the person is likely to need access to care throughout his or her life in order to stay healthy and free of symptoms. But, according to the Residential Care Treatment Association, many people with mental illnesses need the care that can be provided in a long-term residential program in order to start the healing process. When these people are released from short-term programs, they may withdraw into social isolation, neglecting their health and refusing to take their medications. They may not keep appointments with their therapists in this outpatient setting, and they may slip back into severe dysfunction. They simply need a longer period of care to help them develop new habits.

In a long-term residential program for mental health, the person has access to a therapist and a community of other people with similar conditions, but in addition, the person is required to take his or her medications. Some medications for mental illness take weeks or months to truly take hold. By allowing themselves to stay in treatment for a longer period of time, these people may allow their pharmacological treatments to do their work to help them feel better.

Who Succeeds?

While it may be true that long-term residential programs can provide real help for some people, it’s also true that some people do not like the programs. For example, a study produced by the Substance Abuse and Mental Health Services Administration found that 15 percent of people dropped out of short-term addiction programs, but 31 percent dropped out of long-term programs. The report doesn’t specify why people dropped out of their programs, but it could be that they felt uncomfortable, wanted to return home, felt they needed to focus on work or they simply ran out of money to pay for the programs. It’s clear that the long-term residential approach isn’t right for everyone.

A study in the Journal of Offender Rehabilitation found that people who were highly motivated to complete an addiction program were more likely to actually complete their inpatient rehabilitation program. People who were forced to enter these programs by the legal system were also likely to stay involved. But, people who were pressured to enter by friends and family members but who didn’t see the value themselves were more likely to leave before the program was complete. It could be that people need to be committed to staying in the program – for whatever reason – in order to succeed, and those who are not, will not.

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It’s important to point out that many long-term rehabilitation programs provide a significant amount of rules that the person must follow, each and every day. As people get stronger and feel their illness abate, these rules may begin to chafe. They may not want to attend group meetings every night, for example, or they may resist the idea of having a curfew that they must follow at all times. It’s quite possible that people with a resistance to authority and a need to push boundaries will struggle in a long-term facility with a significant amount of rules. They’ll be too tempted to push those rules, and they may be expelled or encouraged to drop out as a result.

A study in the Journal of Substance Abuse, by contrast, found that women in a long-term residential program improved substantially during treatment, feeling less alienated and mistrustful as treatment progressed. For these women, a long-term approach was needed.

A patient’s doctor or therapist may have an opinion on whether or not a long-term residential program is the best choice for that person at that time. The person may also have a strong opinion on the matter. It’s important to listen to the patient’s thoughts on this matter. People who are not committed, as demonstrated, tend not to succeed in these programs, so other avenues should be explored.

Progression of Treatment

According to a report published by the U.S. Department of Health and Human Services, recovery from addiction isn’t complete until the person has experienced a full return to physical, mental and social health and functioning. It’s likely that many mental health specialists would say the same about recovery from mental illness. It’s unlikely that someone would be able to achieve this sort of complete turnaround in a few months to a year. In fact, as mentioned, it may take a lifetime for the person to truly manage the disease.

For this reason, even long-term residential programs aren’t considered the last stop when it comes to therapy. When the person and his or her therapist decide that it’s time for the person to leave the program, he or she will likely then progress to an outpatient program. The person might meet with the counselor, take job skills courses, attend group meetings in the community and even more in order to continue on the path to wellness. While a long-term residential program can provide benefits, it’s only part of the process the person needs to complete.

For more information on long-term rehabilitation programs, contact us today. We are here to answer any questions you may have.

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