Residential Rehabilitation Programs

Residential rehabilitation programs (sometimes called therapeutic communities) are usually long-term programs where people live and work in a drug and alcohol-free community of other substance users, ex-users and professional staff. Programs can last anywhere between 1 and 24 months (or more). The aim of residential rehabilitation programs is to help people develop the skills and attitudes to make long-term changes towards an alcohol- and drug-free lifestyle. Interventions available to residents in these programs tend to vary depending on the length of program and model in use. They generally include alcohol and other drug withdrawal or maintenance management, individual or group psychological support, peer self-help, and assistance with re-integration into the community. 

Chapter Recommendation Grade of recommendation
9.11 Residential rehabilitation programs may be of benefit for patients with moderate to severe alcohol dependence and who need a structured residential treatment setting. D

Programs usually include activities such as employment, education and skills training, life skills training (such as budgeting and cooking), counselling, group work, relapse prevention, and a ‘re-entry’ phase where people are helped to return to their community. Some programs are based on 12-step Alcoholics Anonymous (AA) approaches (see Chapter 11). An extended period of abstinence can be beneficial in reversing cognitive and physical harm arising from chronic heavy alcohol use. 

Few studies have examined the effectiveness of residential rehabilitation for alcohol dependence. While there is some evidence that components of residential treatment (including therapeutic communities) reduce substance use, the body of evidence remains characterised by significant methodological shortcomings that preclude firm conclusions about effectiveness.