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When it comes to selecting an appropriate treatment option for addiction, it’s important to know what your options are, and who they are best suited for.

William Downie Highlights Various Addiction Treatment Options

William Downie is living proof that addiction can be overcome with the proper support. After years of suffering, Downie lives a sober lifestyle based on the 12-step principles. Although there are a myriad of successful programs for treating addiction, Downie chose Alcoholics Anonymous (AA) and remains active in his 12-step program for recovery.

William Downie credits the help of his one-on-one sponsor for helping to lead him through the steps of his recovery, which ultimately led to his spiritual awakening. Now, Downie chairs AA meetings and sponsors other men who are struggling to live life on life’s terms, as he once struggled.

After spending eight years practicing dentistry, William Downie switched gears and is now enrolled in classes to complete his Master of Science in Clinical Mental Health Counseling. 

When it comes to selecting an appropriate treatment option for drug or alcohol addiction, it’s important to know what your options are, and who they are best suited for.

Types of Rehabilitation

When people hear “rehab” they usually think of residential rehabilitation, but rehabilitation options are much broader.

Treatment types vary, but the main ones are residential rehabilitation, day rehabilitation, and outpatient treatment. 

Residential (live in) rehabilitation

Residential rehabilitation is the most intensive of the three and requires a high level of commitment. It can last from a few weeks to a year or more, and much of the day is spent in either group or individual therapy or working in the center.

Some people may be ready for treatment but not for the level of intensity that requires them to live and negotiate interpersonal relationships with people they don’t know; and to be without the day-to-day support of family or friends.

Residential rehab can be a good option for people who don’t have a stable home situation, who need a complete break from their environment, or as a step up when less intensive treatments have not been effective.

Day rehabilitation

This is a situation in which a person lives at home but attends treatment typically three to five days a week, for around six to eight weeks. The program is usually similar to residential rehabilitation, except you go home in the afternoon.

This can be a good option when someone doesn’t need or want the intensity of residential rehabilitation, has commitments that make it difficult to be away from home for long periods (such as kids), or as a step down when residential rehabilitation has finished.

Outpatient treatment

The most common outpatient treatment is counseling (group or individual talking therapy, typically occurring once a week for an hour at a time, for six to 12 weeks). It may also include case management (help with accessing other services such as housing, medical, or mental health services) or pharmacotherapy (prescribed medicine, such as methadone for opiate dependence).

Outpatient treatment can be a good option for people who don’t want or need intensive treatment, have daytime commitments (such as work), or as a step down when day or residential rehabilitation has finished.

People with quite severe and complex problems can still do well in outpatient counseling, especially when they have good professional, community, or family support. The severity of the dependence isn’t a consistent predictor of treatment outcome.

The exact nature of these treatment types may differ between providers, whether they are in the public or private sector. So it’s worth knowing what evidence shows works when making a choice of treatment type and provider.

What We Know Works

It may take a few attempts, but with the right treatment, most people recover from alcohol or other drug problems.

An average of about three months of residential treatment seems to be most effective. The optimal treatment time seems to be similar in non-residential treatment, suggesting a combination of residential and non-residential treatment might be effective over that time. But completing the treatment program and actively participating seem to be more important than treatment setting or length.

Programs that are one-size-fits-all or have overly punitive rules are less likely to be successful.

We know with the right treatment, drug rehabilitation does work.

Program content

A small number of therapies have been well researched, so we know they are effective in alcohol and other drug treatment. These include cognitive behavior therapy, which helps to strengthen skills to manage cravings and difficult situations or emotions that might trigger a relapse and motivational interviewing, which helps to develop and strengthen the motivation to change, is also effective.

These interventions have been tested hundreds of times in different groups of people with good outcomes, so we have some confidence when a service uses these strategies that they will be effective.

If a program doesn’t include these types of approaches, or claims to use “new” strategies, ask to see an independent evaluation of their program outcomes. An evaluation should measure whether the service has had a positive impact (on drug use, dependence or mental health) and what the completion rates are. It can be conducted by independent specialists, or sometimes by the service itself.

There should be regular individual counseling available, even when the program is primarily based on group therapy. Individual counseling is associated with better retention.

Involvement of families and partners in a person’s treatment generally results in better outcomes, so look for a program that has a well developed and integrated family program, beyond just information sessions and visits for family members.

Twelve-step groups like Alcoholics Anonymous are peer support groups. They aren’t considered a treatment, and don’t need to be a compulsory part of a program. But they may be offered as additional support, which can be helpful when treatment is finished.

Practice Progress, not Perfection

When confronting addiction and entering recovery, it’s critical that you follow the steps of your program and remain an active and willing participant. Downie described the process as “exhausting and at times very painful.” Effective treatment can take months or years, and for many continues to be a constant battle.

William Downie recommends practicing progress, not perfection, as well as the principles of honesty, willingness, and openness in all of your affairs. You can utilize both past experiences and the strength and hope that you can acquire from being active in recovery to add value and positivity to all aspects of this life.

Being in recovery often connects people with the spiritual aspects of life. You can lean on a higher power of understanding to help guide you on your path, doing the next right thing and humbly reminding you to always have acceptance and to be grateful for the second chance at life that has been given to you.

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