Does Outpatient Rehab Really Work?

Does Outpatient Rehab Really Work?

Outpatient rehab is a very popular path that many individuals take when addressing their drug or alcohol problem. Dealing with addiction on a non-residential basis, being able to continue going to school or work, and gaining regular access to therapists and doctors can be an effective option when it comes to getting help.

This is where outpatient rehab excels. Many individuals have responsibilities and obligations that prevent them from taking the step away from daily life that residential rehab requires. Outpatient rehab facilities often offer comprehensive treatment teams, group dialectical behavioral therapy, and integrated medical support with a doctor who specializes in addiction and co-morbid issues. For some, specifically older, highly motivated adults, who have careers and families, this can be a great choice for treatment.

Young adults and teens however, can sometimes have age specific struggles when it comes to outpatient rehab. Some of the things that can potentially hinder success for young adults include less focus on accountability, a less intensive community component, the potential for manipulating doctors with drug seeking behavior, and the lower level of commitment outpatient rehabs require.

Outpatient Rehab Is More Effective When Individuals Are Personally Accountable

 

When I attempted outpatient rehab myself, I lacked the personal accountability which would have allowed me to take full advantage of the services they offered. If I had been willing to meet the staff halfway, this could have been a much different story. I wanted to ask some other sober individuals who had also attempted outpatient rehab what their experiences were. One of the common responses was that the individual’s lack of willingness to follow the rules of the outpatient facility directly effected their ability to stay sober throughout the program. Matt L., who has almost 2 years sober, said,

“When I tried outpatient rehab I was still missing a lot of willingness and honesty. I didn’t think it was important to follow the rules the program had put in place. Since I wasn’t accountable to anyone for most of my week, only while I was at the outpatient, I could lie and tell them everything was great and they would believe me. It was an easy way to get my parents off my back because they thought all was good because I was in a form of treatment. If I had been willing to give it an honest shot, I would have had better chances of staying sober.”

Most outpatient rehab programs only have patients spending a few hours a day inside of the facility or group setting. There is often a drug testing protocol as well as other deterrent methods in place to prevent using, but these can unfortunately be subverted by determined addicts. I personally had to undergo almost weekly testing but chose to use a variety of methods to falsify my results. Early in recovery, I was still unwilling to say no when outside of the facility. With so much free time and the mentality that this was just one more hoop I had to jump through, I managed to get around restrictions and stay high throughout the almost 6 months of treatment. Now, for older individuals with families and a much higher drive, this problem is not as obstructive to one’s sobriety. If I would have made the decision to not falsify drug tests and take my counselors suggestions of attending AA meetings and picking up the phone when struggling, the results could have been different. But for young adults, the accountability is a key factor in getting through those difficult first few months of recovery.

Recovery Community

Community is Crucial for Young Adults

 

Another point a lot of the individuals interviewed brought up was the importance of a peer community. For older, more established individuals, this is often found in the family structure and is not as crucial in getting and staying sober. Some young adults found that they needed more emphasis on community than outpatient rehab provided however. Pashka K., who now has 3 years sober, said,

“I didn’t allow outpatient to work for me because I was still surrounded by a community of people who weren’t involved in recovery and who weren’t inspiring me to live a different life of sobriety. I wasn’t forced or motivated to change my behavior.”

Young people are heavily influenced and guided by the behavior of their peers. This is not necessarily a negative thing, if it is utilized effectively and directed in a healthy way. In an outpatient setting however, there can be less of an emphasis on that community. It is possible to use outpatient as a check in and check out scenario. A lot of clients have busy lives outside of the treatment setting, and there are a wide range of ages who participate. This makes outpatient especially effective as a tool to help someone get grounded and refocus on their recovery at the beginning or end of an otherwise busy day. In my case though, I didn’t have many other healthy or productive activities going on in my life, and still chose to hang out with friends that were drinking and using. This led to me being uninspired on sobriety and ultimately drinking and using again. Conversely, there were clients in my program who chose to take the counselor’s direction and stay away from unhealthy influences and friends, which allowed them to have much more success.

Making a Commitment to Sobriety is Important

 

Cory N., who has almost 2 years sober, had another take on his time in more than one outpatient rehab.

“Well, I have been in outpatient rehab twice. Both times I relapsed before I could finish the program. It didn’t work for a few reasons. I would leave rehab every day and go home to living the exact same way with the same people around me. The outpatient required a signature from “x” number of AA meetings a week, which I chose to forge. I wasn’t dedicated to outpatient because I didn’t want to commit to anything too crazy. I found that for me to be successful, sobriety required a commitment to a different life.”

For some, outpatient rehab can allow a lack of commitment towards changing one’s life. This can be a dangerous mentality for young people trying to get sober. For individuals who have already made that commitment however, outpatient can be a great platform to provide added medical and recovery based support. When someone wants to be finished with drinking and using and they don’t need that much additional support, outpatient rehab allows life to continue without too much disturbance, while still teaching new tools and skills that are effective at preventing relapse. For young people that are still on the fence about their sobriety however, the more noncommittal approach of outpatient treatment can be abused and taken advantage of, with more free time outside of supervision, and more personal willingness to engage in healthy behavior being required.

Choosing Whether or Not to Take Advantage of Recovery Services

 

My own experience with outpatient rehab was very similar to many of the guys who I spoke to. I was given a wide range of tools to take advantage of but chose not to. The outpatient rehab program that I participated in offered a wide range of services including group dialectical behavioral therapy, individual and integrated medical doctor’s appointments, a comprehensive drug testing protocol and a high level of relapse prevention education and trigger identification work. If I had honestly utilized any of these, I could have gotten much different results. I lacked the willingness or desire however, to commit to a life of sobriety. I chose to manipulate the doctors and counselors in my outpatient and engaged in drug seeking behavior, rather than be honest about how I was feeling. I got faked drug tests and would drink alcohol and use other drugs which would not show up. Without increased peer accountability, a new community, or internal motivation to do anything different, I kept acting and using the same way I always had.

There is No One Size Fits All With Treatment

 

The reality is that there are a lot of different factors that go into choosing the appropriate treatment direction for any individual. There are situations where they can be very effective, especially when dealing with adults that may have responsibilities to families, long-term careers, and a much higher internal motivation to get help with their addiction. For some young people seeking help however, a heavier focus on community, accountability, and a larger amount of oversight than is found in many outpatient rehab programs can be more effective. Outpatient rehabs often offer a wide range of important services and can be helpful in allowing busy individuals with existing commitments to integrate a new set of tools and recovery techniques into their lives. The freedom that makes them effective with one demographic however can make them less effective with another that may need more structure. Because of this, the answer to whether or not outpatient rehab really works is highly dependent on the client trying to get sober and where they are at in their life.

 

1Comment
  • Debbie O-A
    Posted at 18:13h, 16 January Reply

    Great message Avi. I will suggest this read to people I know who are contemplating sending their kids to outpatient programs. Sounds like the ability for the person to maintain sobriety ultimately rests not with the program, but the individual…which although it would seem common sense, is not always apparent because parents are often looking for the quickest, least expensive and intrusive program that their child is willing to participate in.

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