WHEN they hear ‘rehab’ most people think of residential rehab, but there are also non-residential options in the form of day programs and outpatient counselling says Nicole Lee.
Dr Lee is an expert in methamphetamine policy and practice, alcohol and other drug dependence and co-occurring mental health and substance use.
The director of 360Edge said residential rehab was very intense and not everyone was ready for that kind of intervention.
She advised people to look for a rehab offering a good preparatory program if they were new to residential rehab.
“Most people choose outpatient options – they can (then) remain with their family and friends for support and the length of treatment is more tailored,’’ she said.
The National Drug Research Institute adjunct associate professor said detox was a completely different option altogether – it wasn’t considered to be treatment on its own, but was the first step in treatment.
“ Many people withdraw from alcohol and other drugs on their own but people who are severely dependent or who have had adverse reactions when withdrawal previously should be admitted to a supervised medicated detoxification unit.
“All government funded treatment programs need to meet accreditation standards set by one of the major health accreditation bodies like the Australian Council on Healthcare Standards or the Quality Improvement Council.
“Private residential and non-residential rehabs are not required to hold this accreditation so first thing is to look for accreditation.
“It doesn’t guarantee anything but it at least means that there are systems and mechanisms in place that enable good, safe and ethical practice.
“Hospitals have a registration system in each state and also usually hold accreditation.
“So I’d ask to see evidence of accreditation.
“If it were me, I’d also be asking to see some kind of evaluation of their program, although few services would have undertaken any independent or external evaluation – some have.
“I’d like to see confirmed rates of drop out and completion and then some kind of follow up post treatment.’’
Dr Lee said rehab centres should be using some kind of evidence based intervention and staff should be skilled in some form of cognitive behaviour therapy (most commonly relapse prevention) and motivational interviewing.
“The balance of drug versus other activity in the program should be weighted towards alcohol and other drugs and mental health intervention – things like vocational training, work in the rehab, leisure activities are important adjuncts but are not sufficient for drug treatment.
“Offering services for families including parenting, family support and couples work can be helpful.’’
She said there were better outcomes when people had one-on-one counselling in addition to group in residential settings – although many residential rehabs rely on group interventions only.
“Women do better in single sex services – those are rare.
“The evidence for AA and NA is very limited, so I don’t support compulsory attendance at these meetings, but having them as an option can be helpful for some people.
She said SMART Recovery: https://smartrecoveryaustralia.com.au/
was another mutual support group, which had better evidence of its effectiveness.