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Rehab or Dayhab?

Why the high street can be the best place to start recovery

By Vernon Hartshorne BACP FDAP

Rehab or Dayhab? Why the high street can be the best place to start recovery.

Residential rehabs have only been around for a short period of time -  probably the most famous one being The Betty Ford Center, which opened in 1982.  Historically these have catered for the wealthy addicts and their families, using country estates, exotic locations, five-star luxury accommodation and medically supervised detoxification.

While doing my training as a therapist, I was told that 95% of therapists look after 5% of the population and I vowed I would never fall into this category, but over the years I have worked with clients who are wealthy and sometimes have a hard time with ‘entitlement’ issues.  

It can be really difficult to accept that you cannot buy your way out of addiction no matter how much money you throw at it.  Quite often clients say things like, “I've decided I've had enough”, and they naïvely believe this is the only requirement to recover as they have very little understanding of addiction, believing they have a choice. This can be where the trouble really starts because wanting something and achieving it are two different things.

I would always recommend paying for treatment if you can afford it.  I've used the analogy of someone walking backwards in a maze, wearing a blindfold, totally lost.  Good treatment can point you in the right direction, possibly take the blindfold off, and if you really work hard you might get some stepladders to allow you to get a better perspective.  However, 28 days or 3 months cannot remove you from the maze.  12-Step recovery can help you live more comfortably within the maze, and if you are going to war with addiction you will need an army of support – I suggest 12-step fellowship and I personally believe emotional sobriety can take up to two years.

I recently visited Los Angeles, and as someone in long-term recovery I attended a 12-Step Fellowship meeting one evening with more than 1000 other people; the energy was incredible it was like being at a rock concert.  I also visited some very expensive rehabs in Malibu; very nice.  But the most interesting place I visited was Twin Towns – a intensive outpatient programs (IOPs), also know as ‘Dayhab’. IOPs are very successful;  stats indicate that they are just as effective, if not more so, than residential rehabs. In the U.S, alcoholics and addicts and people with drug and alcohol problems are referred to Dayhab as a first choice, not because they are significantly more affordable than residential rehab. What’s more, studies show that relapse rates are substantially lower for Dayhab clients. The reason being that when a client return back to the ‘real world’ after weeks or months in rehab, it can be hard to adjust. But with Dayhab, recovery is built into daily life- the client can work, study on continue to care for family. This is especially helpful for functioning addicts and alcoholics, which make a up a huge proportion of those in need of treatment.

While in L.A I was told that if England was in the U.S the 12-Step movement would be ten times bigger than it is now.  Although I’m aware that 94.3% of all stats are made up in the moment  (I just made that up!) I started thinking why is it that in England we’re not ten times bigger? We have very expensive rehabs for the wealthy, and Government funded harm reduction agencies working within the criminal justice sector, but not much in the way of 12-Step abstinence-based treatment for the masses.  And this is where I believe the shortfall is occurring.

Until now, there has been no intensive Dayhab, like the U.S model, available in the UK. Help Me Stop is a breakthrough in addiction treatment. And I am very pleased to be part of this exciting new venture. Help Me Stop’s mission is to bring high quality intensive, affordable, accessible Dayhab to the high street.  And through this, I hope to become part of the 5% of therapists that look after 95% of the population, rather than the other way round.