Ask a peer worker: What happens in residential rehab?

Patient Experience Week, an annual international event to celebrate the healthcare staff who dedicate themselves to improving the experience, outcomes and wellbeing of people in their care.

COL Patient Experience

This year we want to highlight our peer workers PnorkelPW and ScorpionPW, who use their lived experience to help other people who are struggling with problems related to substances. You can connect with them and other people who understand in our community forum. When it comes to recovery from substance use, peer support from other people in recovery is one of the most powerful tools to improve someone’s experience in treatment. Thank you to everybody who participates in our community for the invaluable support you offer each other.

A while back PnorkelPW hosted a Let’s Talk session about what to expect from rehab. Here’s a little of what he shared, with some new additions!

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What’s rehab all about and how do you know if it’s right for you?
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What’s rehab all about and how do you know if it’s right for you?

What is residential rehab?

Rehab programs provide a structured environment to try to change your substance use. In residential rehab programs, you stay onsite for the duration of your admission. You’ll be required to follow the rules and guidelines of the facility and the program. The length of the stay varies from a few months to more than a year.

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Are all rehab programs residential, or can I just go during the day?
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Are all rehab programs residential, or can I just go during the day?

Rehab day programs, often known as dayhabs, can be a good option for some. Dayhabs are a rehab program you attend each day whilst still living at your own accommodation and being free to do your own thing outside of program hours. Most dayhab programs run for 4–6 weeks

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How do I choose a program?
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How do I choose a program? 

Rehab and dayhab programs vary a lot so it’s best to do your research to see what suits you best. It’s ok to try different rehabs — it can be hard to know something doesn’t work before you try it! The best program for you is also heavily dependent on your stage of recovery.

What are the Stages of Change?

  • Pre-contemplative: You don’t really think you have a problem.
  • Contemplative: You’re thinking about the issue and knowing something needs to change.
  • Preparation: You’re getting ready and making a plan.
  • Action: You’re putting your plan in action to do something about the problem.
  • Maintenance: You’re continuing to act on the problem and maintain the change you’ve achieved.

Generally, the further you’re along in the stages of change, the more you will benefit from the program. Rehab requires an innate commitment from (and to) the self.

Rehab isn’t easy. People leave for many reasons but this does not make it a failed attempt. It doesn’t matter how many rehabs you go to, it’s what you learn from the experience that will help you down the track.

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How much does rehab cost?
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How much does rehab cost? 

Rehab costs vary, especially depending on whether you enter a public or private program.

  • Public: You can typically pay for public rehab with Centrelink payments. The program will take a percentage of approx 80% from your payment. If you’re self-funding, most public rehabs cost approximately AU$350–400 per week.
  • Private: Private rehab programs can start at approximately AU$10,000 per month. The expense does not necessarily mean that the program is “better”. The main advantage of private rehabs are that they can get you into the program faster, while public programs usually have long waiting lists. Private health insurance may cover some private rehab programs, but not all.
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What can I expect from a day in rehab?
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What can I expect from a day in rehab?

A standard day will start with a morning group meeting, followed by group activities, lunch, then groups again in the afternoon.

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What do you talk about in group?
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What do you talk about in group? 

Group content varies but can cover emotion regulation, relapse prevention, Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), conflict resolution, communication skills, art therapy, physical activities, effective relationships, living to a budget, health and wellbeing, mindfulness, meditation, understanding triggers, and much more.

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Do all rehabs use the same approach?
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Do all rehabs use the same approach? 

You can find rehabs to suit your requirements/needs, whether that’s religion-focused, LGBTQIA-inclusive, culturally safe for Aboriginal and Torres Strait Islander people, or mental health and AOD together (sometimes called dual diagnosis). It does pay to do your research to find the best one for you.

  • Some will focus on community integration and help you with your goals, whether that is getting back to work/study or connecting with family, while others will expect you to stay on-site under supervision for the duration of the program.
  • Some are based on the 12 steps and work a program heavily aligned with Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), whilst others suggest you attend these outside the program.
  • Some are run like a boot camp and have consequences or loss of privileges for things like not making your bed, being late to groups or disrespecting staff.
  • Some defer from a more hard-line approach and work with the individual to change behaviour patterns and responses to situations.
  • Some work on a Therapeutic Community model whereby the longer you are there the more responsibility is given. Over time you can become a peer leader. Therapeutic Community programs usually last 18 months or more.

How do you know what kind of approach a rehab uses? Their website will usually outline their philosophy, but if not, you can always ask!

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Where are rehabs located? Should I choose one close to home?
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Where are rehabs located? Should I choose one close to home?

Rehabs are located all over Australia. They can be in city, bush, beach or farm settings.

Many people choose to go to rehab within their state, but choosing a rehab elsewhere (interstate or overseas) can be beneficial in some circumstances. 

Creating distance from friends and family can allow you to concentrate purely on yourself, recovery and your program. Distractions from the outside world can be problematic and can contribute to people leaving rehab. Some rehabs monitor this by limiting access to phone use and calls.

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What does the rehab facility look like?
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What does the rehab facility look like? 

All rehab facilities are different, but some have video tours available on their websites. Here are a few public facilities you can check out!

Turning Point Eastern Treatment Services: 1 East and Wellington House

Here’s an introduction to the residential services at Turning Point Eastern Treatment Services in Box Hill, Victoria, including both detox and rehab facilities.

Windana: Maryknoll Therapeutic Community

Maryknoll is a residential facility that uses the Therapeutic Community model, located on a farm south of Melbourne. Learn more.

Lives Lived Well: Logan House

Lives Lived Well offer several rehab programs, including Logan House south of Brisbane. Find out more about the service.

Kamira

Kamira is a residential facility for women and children located in Wyong, NSW.

Watch the video tour on their website

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Is life in rehab challenging?
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Is life in rehab challenging?

One of the big challenges is the communal living factor. Rehabs can have anywhere from 5–80 beds. Sometimes you share a room, other times you may get your own.

Like any share house, balancing life with multiple personalities can be a struggle. There may be arguments around housework and dishes or general personality clashes.

What’s important to remember is your reasons you are there and focus on your own program and stick with peers who will lift you up and not drag you down.

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Will rehab kick me out if they find me using substances?
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Will rehab kick me out if they find me using substances?

Although most rehabs do drug and alcohol testing, some people smuggle drugs and alcohol onsite. Some people even get away with it for a while — but rehabs are not prisons. Some programs will give you more chances to change and others will kick you out straight away.

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What happens when I leave?
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What happens when I leave?

During the program you will work with a counsellor or case manager to establish a plan for your life once you leave rehab. It can feel relatively easy to stay clean during rehab, but maintaining your abstinence after you finish can be a challenge. Just remember: behaviour change doesn’t happen overnight. Mistakes will happen, the key is what you learn from them.

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Is rehab worth it?
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Is rehab worth it?

The evidence shows that overall, attending residential rehab improves participants’ wellbeing. The ultimate purpose of rehabs is to help create a life that doesn’t feel controlled by alcohol and drugs. If one doesn’t work for you, try another. There is no shame in doing multiple rehabs.

Rehab isn’t a magic bullet that will fix your addictions, but provides us a space to work through tough times and understand what is driving our addiction. It’s a challenge you’re taking on to give yourself the opportunity for change

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Are you thinking about going to rehab?
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Are you thinking about going to rehab?

So, let’s talk all things rehab. Join us in the community forum to let us know — are you thinking of attending rehab, or have you before? Do you have your own experiences to share? What programs have you found most helpful?

If you’d prefer to speak privately, chat online to one of our counsellors — free, confidential, 24/7.