For many, the hardest part about addiction recovery is admitting you have a problem with drugs and alcohol. This time can be confusing, stressful, and full of uncertainty. Just don’t think it’s all downhill from there! After you admit your problem, it’s time to reach out and get in contact with the addiction experts.
But, where should you start? How do you know which rehab facility is right for you? And, which questions should you ask the Admissions Coordinator when you start doing your research?
Going to rehab isn’t an everyday occurrence so don’t expect to have it all figured out. At times, it can feel like information overload or that you’re learning a new language. Confusing terms like “inpatient” and “outpatient” or “ROI” and “VOB” might sound scary at first. That’s why treatment professionals, like myself, encourage you to slow down, do your homework, and ask questions.
So, grab your notebook and a pen, and let’s get started.
This article is intended to be used by any individual or family member looking to enter drug and alcohol rehab but is not sure where to start. My experience comes from running a drug and alcohol rehab near the Dallas / Fort Worth metroplex.
1. How long does your program last?
This is a great first question to ask for two reasons. First, it will help you understand the time commitment necessary to recover from years of drug and alcohol abuse. Second, it will key you into how facilities come up with their price tag.
Typically, rehab lasts anywhere from 30 to 90 days. But, other programs, like wilderness or extended-stay facilities, offer services lasting from 180 days and up to a year.
You should know that short-term facilities differ from long-term facilities in terms of:
(c) Success Rates
So, it’s important to know what you’re looking for and why. For instance, a short-term facility might be a good option for a rehab “newbie,” but a bad option for a chronic relapser. On the other hand, some families might be bound by financial, geographical, or timing constraints – all which influence your final decision.
Regardless of your situation, make sure you’re choosing your rehab facility for the right reasons! This is a must.
The biggest mistake I see families make in the treatment selection process has to do with motive. Families looking for a “quick fix” tend to choose short-term facilities out of convenience and price. They think this is the fastest and cheapest way to get well. Unfortunately, this mindset is extremely costly as you may end up paying more in treatment costs over the long run if your loved one relapses, or worse…
When it comes to price, long-term centers tend to be more costly than short-term ones. And the reasoning is pretty simple. It primarily has to do with the intensity and length of service they provide, the cost of hiring good clinicians, but more importantly, how insurance companies pay for treatment.
Let’s take a look at some billing data…
Our quarterly billing report for 2019 shows that payors, on average, cover 18 days of residential treatment (RTC). That’s an astonishingly small number! After that, they tend to bump clients down to a lower level of care like partial hospitalization programs (PHP) or intensive outpatient programs (IOP).
In other words, once you hit the 18-day mark, insurance companies would prefer you attend the cheaper, outpatient alternative. I understand that treatment is expensive and that insurance companies aren’t guaranteed a certain result at the end of it. But, c’mon… 18 days!?
By limiting the amount of RTC coverage, payors often expect patients to cover the remainder of treatment if they decide to stay at an RTC-level facility (i.e. overnight rehab facilities).
What do I mean?
Well, the reimbursement rates for lower levels of care – like IOP – typically range from $100 to $300 per day. Unfortunately, a couple Benjamins doesn’t cover the cost of food, room and board, overnight staffing, and effective therapy needed for recovery.
And until health insurance plans start putting addiction and mental health on par with other diseases, long-term treatment centers will have to adapt.
But, instead of shortening their programs to appease payors, directors at long-term facilities often ask for more up front. Now, although this isn’t ideal for your wallet in the short-term, you might just end up with a better return on investment in the long-run by doing so.
Hear me out…
Research shows that program length, or Length of Stay (LOS), is a major predictor of abstinent rates in the recovery community. In other words, the longer your stay in treatment, the higher your probability of success.
One study found that of those women who spent more than 6 months in treatment, 68% to 71% remained abstinent. In a field where success rates are marginally low, that stat should make your jaw drop! Additionally, these rates hold up for clients who only stay 90-days but adhere to a long-term after-care plan like sober living.
Another study by the U.S. National Institute on Drug Abuse (NIDA) determined that long-term drug rehabs (of 90 days+) have a 70% success rate versus short-term centers which have a 16-20% success rate.
So, yes, although it might be a little bit more cumbersome to enroll in a long-term program, don’t knock the efficacy. And, for those of you who just can’t afford to additional out-of-pocket expense, make sure you take part in a long-term after-care program. Nothing beats surrounding yourself with a group of guys (girls) trying to get sober together.
Lastly, your addiction didn’t take 30 days to manifest, so don’t expect to be fully healed in such a short amount of time. It takes a long time before addicts feel fully recovered. And, even so, my peers with decades of sobriety are still working their program, going to therapy, and improving themselves day-in and day-out.
…Next question, professor!
2. What does a typical day look like at your facility?
You wouldn’t accept a job offer if you didn’t know what your daily schedule and job tasks looked like, would you? Treat rehab the same way.
This question is a great way for you to peek under the hood and get a grasp of what really goes on in treatment. It’s well-documented that rehab centers offer individual and group therapy, recreational activities, and even some quiet time. But, when do these happen? And, for how long? Does the Monday schedule look different from the one on Tuesday? And, why is that?
So, take a sip of water and get ready to grill your Admissions Coordinator!
If they’re worth their salt, they’ll be able to answer just about anything. Most of these guys (and girls) on the phone have been through the rehab process themselves, so they’re more than familiar with what goes on day-to-day. If they can’t answer your questions or seem vague, then hang up the phone and move on. They’re not a place you’d want to send your loved one to.
Overall, I’d recommend you find out the schedule of 3 things:
2) Non-therapeutic activities
First and foremost, you need to find out how much time you, or your loved one, will spend with a licensed clinician. These masters-level brain whisperers have spent years studying the psychological patterns of the brain and are well-versed at sussing out the underlying issues at the heart of your drug and alcohol addiction.
Therefore, it’s tantamount you maximize your therapist’s time. Find out how much individual therapy is given per week, how much time is spent in group therapy, as well as if your program offers more one-on-one time if more severe mental health issues persist.
Bonus Tip #1: Sign an ROI so you can get personalized updates on your loved one’s progress in treatment.
Now, if you really want to impress your Admissions Coordinator, ask which type of therapy their therapists provide. The main two categories are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). These are both forms of “talk therapy” with slight differences.
Cognitive behavioral therapy (CBT), for instance, teaches you how your thoughts, feelings, and behaviors influence each other as well as how you can use these to induce positive change. Dialectical behavioral therapy (DBT), on the other hand, focuses more on the emotional and social aspects of your experiences all the while advocating for acceptance, regardless of any challenges you may face.
Both are evidence-based approaches with decades of research supporting their benefits, so you really can’t go wrong with either. And ultimately, it comes down to personal preference.
After you understand the therapeutic approach to your rehab facility, it’s time to see what else they offer. There’s more to treatment than just talking to a counselor, so let’s find out what other non-therapeutic classes are on the daily schedule.
Bonus Tip #2: Ask the Rep who their most popular clinician is and see if you can’t get assigned him (or her) as your primary therapist.
Some primo facilities tout high-class ancillary services, like acupuncture, yoga, or massages, but those can add a couple of zeroes to the price tag. Other centers offer more informative classes like chemical dependency education or a speaker series.
So, decide how you want your loved one spending their time in treatment. But most importantly, ask why your rehab center offers that service. If there’s no proven health benefit to it, then it might be a waste of your time… and money.
One program you should be aware of is the 12-Step Program. You might have heard it called Alcoholics Anonymous (AA) or Drug Addicts Anonymous (DAA). These are self-help meetings where attendees discuss their failures and successes, open themselves up to a spiritual relationship with a Higher Power, and provide accountability to peers.
It’s all aimed at improving yourself and staying sober, and frankly, it works.
Full disclosure: we’re big 12-Steppers! And, we’ll always encourage our clients, alumni, and recovery peers to become very involved in this community. Even family members of addicts can go to a version of this called Al Anon.
Lastly, you might want to ask what a rehab facility’s visitation policy looks like. Some centers are stricter and limit outside access in hopes of encouraging more self-introspection for their clients. Others are a little more fluid and invite family participation in the recovery process.
We are somewhere in the middle.
We definitely want family involvement in the addiction recovery process because we believe the home environment plays an important role in our clients’ post-discharge success. That’s why we offer a Two-Part Family Program to help our families understand more about addiction and the recovery process.
However, we do limit family visitation to once a month as we want our clients to have a safe, private atmosphere where they can dive deep into their underlying issues. We think we found the right mix! But, it’s an important question to ask, so don’t skip it.
3. What happens if my insurance stops paying for treatment?
Last, but certainly not least, it’s time to talk about finances.
With healthcare costs steadily increasing in the U.S., the cost to attend a high-quality treatment center can often seem out of reach. However, if you have good insurance, you might be able to enroll at a fraction of the price.
Thanks to the Mental Health Parity and Addiction Equity Act (MHPAEA), insurance providers are now required to cover mental health and substance abuse disorders (MH/SUD) on par with other medical conditions.
In other words, your health insurance provider can’t impose any annual restrictions, like lifetime dollar caps or treatment limitations, just because you are struggling with drug or alcohol addiction. That’s something both clients and addiction treatment centers, alike, can rally around!
But, don’t get too excited…
Once you are enrolled in rehab, you’re subject to something called Utilization Review. This is where your insurance provider and treatment center hop on a phone call every 3-7 days to discuss your progress in treatment.
Unfortunately, once your insurance provider feels it is no longer “medically necessary” for you to be in rehab, they’ll either bump you to a lower level of care or stop paying altogether.
So, what happens then?
Frankly, it all depends on your treatment center’s philosophy. Some treatment centers will kick you out as soon as your insurance terms. Others will send you a bill for the remainder. But, the good ones will honor their commitment they made to you on the phone and keep you for the agreed upon amount of days.
Just because you agree to send your loved one to a 30-day facility, doesn’t mean you’re guaranteed 30 days of care. So, ask questions and know what happens if your insurance policy taps out.
On a personal note, that’s why I love working for Stonegate Center. They’re one of the few centers that won’t kick you out just because your insurance decides to quit paying. We feel kicking someone out prematurely is poor client management, and we wish other centers would follow suit.
Speak with an Admissions Specialist Today!
I hope this article gave you a good framework with which to start your treatment selection process. Regardless of where you end up, it’s important you do your due diligence and ask questions.
I once had a gentleman sit in my office for two hours and ask me question-after-question from a list him and his wife prepared prior to their tour. It’s families like those – those that take this process seriously – that are best suited to help their loved one. And, I’m happy to spend late nights answering any question they have.
If you or a loved one is struggling with drug or alcohol addiction, give our team a call at (817) 993-9733. Our Admissions team is happy to answer all your questions, so feel free to grill them! If you’d prefer to talk offline, shoot our team an email at email@example.com and we’ll get back to you shortly.
We look forward to being a great resource for our families and friends looking for a drug rehab near the Fort Worth area. And although our center is located just outside the Dallas / Fort Worth metroplex, we’ve catered our services to help families from Texas, Oklahoma, Arkansas, Louisiana, New York, Florida, and more.
Look forward to answering your questions!
John Eckelbarger is a Business Development Representative for Stonegate Center. With a BSA in Chemistry from the University of Texas at Austin, he has an interest in the neurobiology of addiction as well as the pharmacology of drugs. He hopes to bolster Stonegate Center’s status at the forefront of addiction medicine through bold, innovative content creation. He is currently pursuing his MBA in Finance from Texas Christian University.