What Is Rehab? Types, Treatment Options, & What to Expect

Types of Rehab

There are several different types of rehab facilities that provide treatment to people in recovery from addiction, including inpatient, residential, intensive outpatient, and ongoing outpatient care. The types of rehab available are largely dependent on the severity of a person’s addiction and the level of support they need in treatment.^1,3,4

Below is a broad overview of some of the main types of rehab available, starting with the most intensive levels of treatment:

Inpatient Rehab

Inpatient rehab is what a lot of people imagine when they think of drug or alcohol rehab. These facilities provide 24-hour treatment to people in recovery. Some inpatient rehabs offer medical detox services, which include a short term stay to help people safely withdraw from substances under medical supervision and care. These centers are best for people who are at high risk for complications during withdrawal, including people withdrawing from alcohol or benzodiazepines.^3,4

Other inpatient rehabs provide longer-term treatment which can range from a few weeks to a few months, and sometimes even longer. These programs may not provide medical detox, but still are highly structured and secure drug-free environments where patients are supervised.⁴ Also, inpatient rehabs provide addiction treatment to people during the course of their stay, including teaching them skills to overcome cravings and create a relapse prevention plan.

While each inpatient rehab facility is a little different, here is what you can expect at most inpatient rehab facilities:^1,4

• A full clinical evaluation before being admitted
• Discussions about insurance coverage, costs, and payment plan options
• To be oriented to treatment by a staff who goes over rules and expectations
• To have sharp objects, cell phones, laptops, and any medications confiscated
• To be in a secured facility with individual or shared rooms and common areas
• Dedicated recreational facilities on site (i.e. pools, tennis courts, game rooms, etc.)
• Private offices for individual therapy or family therapy and larger rooms for groups
• A structured schedule with therapeutic activities, visiting hours, leisure and free time
• A therapist who will make a treatment plan and offer regular therapy sessions
• To meet with a doctor or prescriber for medication
• Case management services to arrange aftercare and plan for discharge
• To have a designated discharge date based on the progress you make and to work closely with your therapist and other staff to make a transition plan that includes aftercare (i.e. an IOP program, 12 step meetings, etc.)

Medically Monitored Detox

Medically monitored detox centers provide a place to safely withdraw from addictive substances like alcohol, benzodiazepines, heroin, or other opioid pain killers.³

In medical detox, people can expect:^1,3,4

• To be provided with short-term, intensive care similar to what you would expect in a hospital setting
• Nurses, doctors, and other licensed professionals providing 24-hour care, including supervision during the detox process
• To receive medication to ease withdrawal symptoms or ensure the safety of the detox process
• To be discharged from the detox center and recommended to transition to another level of care (i.e. inpatient or outpatient rehab) after about a week

Residential Rehab Treatment

Residential rehab is somewhat similar to inpatient rehab, but is provided in a less structured and secure environment. For example, while many inpatient rehabs resemble hospitals, residential rehab programs are usually provided in places that look and feel more like homes. These programs are designed for people who are working to establish long-term sobriety while also becoming more independent.⁴

Many programs require residents to get jobs, pay rent, do chores, and also attend drug treatment programs. As long as a person follows these rules and remains drug- and alcohol-free, they may be able to stay in the residential program for a year, or sometimes even longer. Each residential rehab center has a certain number of beds available, and it’s common that people will share common areas and sometimes bedrooms with other residents.

While each residential program may be a little different, most people in residential rehab programs can expect to:^1,4

• Have an initial interview with house managers or residents
• Be in a residential setting with shared common areas and rooms
• Be allowed to stay long-term in the residential program
• Be expected to follow rules and guidelines related to remaining sober
• Be expected to seek and maintain employment and pay rent
• Have a structured, sober environment and random drug screens
• Be expected to remain in addiction treatment
• Share household tasks, chores, and responsibilities
• Have a staff member or manager oversee the house
• Be able to leave the facility for scheduled appointments, work, or other activities

Intensive Outpatient Rehab

Intensive outpatient programs for addiction (sometimes called IOP’s) offer group and individual treatment at a facility 3-5 times per week. Clients enrolled in these programs are expected to attend regularly, usually for group therapy and skills groups that last about 3 hours per day (or 9 or more hours per week).⁴

Most IOP programs are structured treatments that last between 3-6 months. The groups are usually led by certified or licensed substance abuse professionals, who are sometimes also in recovery from an addiction. The facilities where IOP’s are provided are often similar to outpatient medical clinics because they are usually in large office-based facilities. In addition, many IOP’s also provide individual therapy, case management services, and psychiatric medication management.^3,4

While each intensive outpatient rehab program may be slightly different, most people entering into an IOP program can expect treatment to involve:^1,3,4

• A multidisciplinary team of licensed mental health and addiction counselors, a psychiatric medication provider, and certified substance abuse group facilitators
• Structured group therapy meetings 3-5 days per week where clients learn about addiction, coping skills, and ways to strengthen their recovery and prevent relapse
• Some individual services which may include counseling sessions, case management services, or meetings with a psychiatric medication provider
• A structured treatment program that clients progress through, as well as individualized treatment goals and plans
• To be expected to comply with regular drug screens and maintain sobriety throughout treatment
• To be taught recovery and coping skills to manage urges and cravings and maintain sobriety
• To have treatment last between 3-6 months, which may be partially or completely covered by your insurance
• To have a set discharge or graduation date with the expectation of stepping down to outpatient rehab or a lower level of care<

Outpatient Rehab

Outpatient rehab often involves regular counseling sessions online or in an office-based setting, but the focus of sessions is on addiction recovery.⁴ Many counselors who provide outpatient counseling to people with addictions have special certifications or secondary licensing in addiction counseling. Some work in specialty addiction rehab clinics and others work independently in group or private practices.

Outpatient counseling is the lowest level of care for addiction treatment.^3,4 It’s usually best for people who have either very mild addictions or those who have been clean and sober for a sustained period of time.^1,4 Outpatient rehab is often combined with other services like 12 step recovery groups, meetings with a psychiatrist, or for people living in sober living residential rehab facilities.

The kind of treatment provided in outpatient rehab depends largely on the counseling style, training, and experience of the counselor, but most people can expect:^1,3,4

• Individual, group, or family counseling sessions on a weekly basis
• Therapy sessions and/or medication management at less than 9 hours per week
• An individualized treatment plan with recovery-oriented goals
• Support achieving treatment goals through psychoeducation and skill-building
• An opportunity to work on underlying issues like trauma, grief, or mental illness
• The option to meet in a counseling office or do online therapy
• Having an individualized treatment plan to focus on addictions and any other issues
• Not having the monitoring, structure, and supervision that other types of rehab provide
• Being more accountable for your own recovery and using skills outside of sessions
• Having less frequent sessions or stopping therapy when you make progress or achieve your treatment goals

Stages of Addiction Recovery

There are specific stages of recovery that people working to overcome addictions go through. At each stage, a person will have different needs which can be met by different kinds of treatment.

Here are the 4 stages of addiction recovery and the treatment needs of the client in each stage:¹

Stage 1: Treatment Engagement

In the first stage of addiction recovery, a person is usually in active addiction, and has not yet taken any steps towards sobriety. Their resolve for recovery is not strong, which is also why they are most likely to drop out of treatment in this stage.¹

In response to this risk, the primary treatment needs of people in stage 1 include:¹

• Receiving a clinical evaluation to determine level of risk and appropriate type of rehab
• Being recommended for inpatient, residential or intensive outpatient care
• Becoming more committed and motivated for treatment
• Stability in the form of withdrawal/detox or ensuring basic needs are met
• Becoming oriented to treatment and forming relationships with treatment providers & peers
• Working on building a support system including family and loved ones

Stage 2: Early Recovery

Early recovery is usually defined as the first 30-90 days of sobriety, when the rate of relapse is still very high. People in this stage have engaged in some kind of treatment or self-help, and have established early sobriety, but still need support and detailed maintenance.

Stage 2 usually involves:¹

• Working on maintaining abstinence and preventing relapse
• Usually getting a recommendation for intensive outpatient care or residential/sober living facilities
• Identifying triggers for relapse and skills to cope with them
• Increasing engagement in treatment and work on strengthening resolve & support
• Building healthier routines and habits that facilitate long term sobriety
• Establishing housing, financial, and legal stability
• Developing relapse prevention skills

Stage 3: Maintenance

In the maintenance stage, a person has usually achieved early remission from their substance use disorder, which is at least 90 days of sobriety, but haven’t achieved sustained remission (1 year or more).⁵

The goals of treatment at the maintenance stage include:^1,3,4

• Working to achieve sustained remission from their substance use disorder
• Receiving a recommendation to engage in outpatient rehab (step-down from inpatient or IOP)
• Addressing underlying issues like trauma or mental health concerns
• Working to improve their social and emotional wellbeing
• Building confidence in their ability to remain clean and sober in non-controlled settings
• Working to make lasting and sustainable lifestyle changes that support sobriety

Stage 4: Community Support

In the final stage of recovery, a person has normally achieved sustained remission from their addiction, which is one year or more of sobriety.⁵ At this stage, they may continue to receive care in an outpatient rehab center or they may opt for self-help and support groups like AA, NA, or SMART recovery.

The needs of people in stage 4 of addiction recovery include:^1,4

• Working to lessen their reliance on treatment programs
• Improving their independence in maintaining sobriety
• Working to maintain healthy relationships and sober lifestyles and routines
• Continuing to engage in self-help and support groups
• Obtaining medication or therapy as needed
• Working on maintaining stable housing and employment
• Developing the self-awareness and skills to manage stress & overcome urges to use

Common Questions About Rehab

Here are answers to some of the most common questions people have when they’re considering which type of rehab is right for them:

1. How do I find out what kind of rehab I need?

In order to get admitted in an inpatient or outpatient rehab of any kind, you will first receive a clinical evaluation. This is normally conducted by a licensed professional who can assess the severity of your substance use and make recommendations based on your needs.^3,4 Still, it’s also important for each person to play an active role in determining what type of treatment is best suited for them. For example, research has demonstrated that it is possible for people to achieve long-term sobriety without formal treatment, instead relying on self-help and other support resources.⁶

2. Where do I find an inpatient, outpatient, or residential rehab program?

There are several ways to find an inpatient, outpatient, or residential rehab program. Using an online therapist directory can be a helpful starting point, but many people also just conduct an online search for “addiction rehab near me” or “addiction treatments in ____.” If you’re looking for a rehab program that accepts your insurance, try calling the number on the back of your insurance card, or logging in online to find a provider.

3. How much does rehab usually cost?

The cost of rehab varies a lot depending on whether it’s an inpatient, intensive outpatient, or normal outpatient program. Location and specific types of treatments offered also factor into the cost, as well as whether the program is private or publicly funded. For example, the average monthly cost in a publicly funded inpatient rehab is just under $6,000, but the average monthly cost for a private luxury rehab stay is over $17,000.⁷

4. How long do I need to remain in rehab?

The length of time you will need to remain in treatment varies depending on the program, type of treatment provided, and how quickly you make progress. Many inpatient rehab programs advertise a 28 or 30 day treatment protocol, but some can be extended up to 90 days. Intensive outpatient programs are usually 3-6 months and outpatient therapy can be even longer-term, with some people remaining in treatment for years.^3,4 There’s some research that shows that staying in treatment longer leads to higher rates of long-term sobriety.⁸

5. What if I relapse in rehab?

Almost all drug and alcohol rehab programs require patients to remain clean and sober as a condition of their enrollment. Because over half of people in recovery will relapse at least once, many programs have built some flexibility into their protocols.^6,8 The specific policies of each rehab program vary, but will be reviewed with each client prior to admission. Also, research shows that even factoring in high relapse rates, people who get treatment are more likely to achieve long term sobriety than those who do not.⁸

Final thoughts

There is no “one-size-fits-all” treatment for people who struggle with addiction. People who have more severe addictions or are in need of medical detox may require inpatient care before stepping down to lower levels of care.^1,3,4 Still, the most important aspects of recovery include a person’s commitment to sobriety, developing a support system, and working to make positive changes that improve their quality of life.^6,8 Most rehab centers support all of these goals, which is why they can all be effective options for people wanting to overcome an addiction.