Let’s recap the first two installments of this blog series on what to expect when you’re heading to a residential treatment center to address a mental health issue such as an alcohol use disorder, a substance use disorder, or an emotional disorder:
- Part One gave the you the heads up that the biggest thing that’s going to happen is you’re going to change the way you think about rehab (you’ll call it treatment), about your particular disorder (you’ll learn coping skills to manage it), and about life (you’ll realize recovery is an ongoing, lifelong process).
- Part Two gave you an idea about what your first day will be like. It covered what to bring (important stuff not to ignore on your packing list), what the intake process will be like (tons of questions, drug tests, luggage and body search), and orientation (where you’ll sleep and eat, where you’ll do therapy, where you’ll have downtime), and the people (your therapists, counselors, and recovery peers).
Now we’ve come to Part Three, where we’ll talk about what a typical day in treatment is like, what individual therapy is like, what group therapy is like, and how to get the most out of your time while you’re in treatment.
Residential Treatment: The Big Picture
Here’s another heads up: treatment days are long and tiring. It’s not often a person spends an entire day focusing on themselves, their issues, and how to unlearn old habits and create new ones. You may have heard or read this phrase somewhere:
“The unexamined life is not worth living.”
It’s typically assigned to the legendary 5th century Greek writer and philosopher, Socrates. His most renowned student, Plato, reports Socrates said these words during his trial for impiety and corrupting the youth of Athens – a trial which resulted in his execution. Morbid, right? We know. Weird that such a famous quote comes from such a bummer situation, but there you have it. Despite the origins, it’s totally relevant to what you’re about to experience. We’ll leave the conclusion as to whether the unexamined life is worth living to the philosophers – or maybe you’re a philosopher and can come up with a new take on the question– and focus on what it means to you, which is this:
You’re going to do a whole lot of life-examining during treatment.
Self-examination is the first step to creating new habits, new coping skills, new ways of thinking, and new ways of living your life. The idea is that if you don’t know what you’re doing – really know, as in examining your motives, the reasons for your actions, and their consequences – then you won’t have a good idea of how to change what you’re doing.
Treatment is nothing if it doesn’t lead to change. Change is the entire point. You’re going to treatment to exchange one way of living for another. You’re going to treatment to learn how to replace a life dominated by alcohol, drugs, or a serious mood disorder with a life free of alcohol and drugs, and in the case of a mood disorder, you’re going to treatment to learn how to handle your symptoms and process the uncomfortable emotions they bring in such a way as to make your life manageable again. Here’s the equation: treatment is about change, change starts with self-awareness, and self-awareness comes from self-examination.
So how does this whole self-examination to self-awareness to big life changes thing work on a daily basis?
Glad you asked – read on to find out.
A Typical Day in Residential Treatment
Here’s a sample daily schedule from a well-respected residential adolescent treatment center located in Southern California:
High-Quality Residential Treatment Center
Sample Daily Schedule: Monday – Friday
Art Therapy/Surf Therapy
Process Group/DBT Group (Dialectical Behavior Therapy) /Mindful Walk
Yoga/Self-esteem Group/Coping Skills Group
Anger Management Group/Yoga/Boxing
Evening Group Talk: Highs and Lows, etc.
Music Group/Ted Talks/12-Step (AA) Meetings/Cooking Group/Creative Expression
Mindfulness Activity: Journaling, Self-Evaluation, Group Discussion
Mindfulness Activity: Meditation/Relaxation.
High-Quality Residential Treatment Center
Sample Daily Schedule: Weekends
Saturday: House Cleaning/Health & Wellness
Sunday: Off-site hike/Hygiene/Body Checks
Saturday: Off-site outing
Sunday: Music Group/Family Visits/Recreation/Games/Swimming
Roses and Thorns
Saturday: Movie Night
Sunday: Game Night
As you can see, these days are long and chock-full of recovery programming from dawn until well past dusk. They can be exhausting, and when you come to lights out – even though ten o’clock might seem early to you now, you’ll be ready to lay your head on the pillow and go to sleep. You’ll discover that internal, emotional work can sometimes be more tiring than physical labor, sports, or working out in a gym.
Individual Therapy, Addiction Counseling, Group Therapy, and Process Groups
If you’ve never had counseling or therapy before, it’s a good idea to know what you’re getting yourself into. The following descriptions are quick and to the point. This is not clinical or graduate school level stuff – it’s meant to give you quick preview of what to expect from each element of your treatment.
Individual Therapy is typically a one-on-one session with either a psychiatrist or an addiction therapist. During a therapy session, you spend time talking about your issues and connecting thoughts and feelings to actions and their consequences. You often take a deep dive into your past so you can understand how different life events affect you in the present moment. Before you head to your first therapy session you should be ready to face uncomfortable emotions and talk about things you’ve never talked about with anyone. You might cry. You might get angry. You’ll probably feel every emotion in the book, but it’s worth it: during therapy you start to get an understanding of why you do the things you do – and that’s the first step to making change.
Addiction Counseling is like therapy, but with an important difference. In therapy sessions, you tend to look back at past events. In counseling sessions, you tend to look at the here and now. You learn how you can use the awareness gained from therapy (that whole self-examination thing) to change your behavior in the moment. Then you lay the groundwork for changing your behavior in the future. You may do some of this during therapy, but during counseling you spend more brainstorming ways to change the disruptive patterns of addiction/mental health disorders in the present and future than you will looking back at the events that caused those patterns.
Group Therapy is like individual therapy, but it happens with a psychiatrist/therapist and a small group of your peers. It’s beneficial on multiple levels, but mainly because you learn you’re not alone. You learn other teens struggle with similar issues, and sometimes you discover their experiences are so close to yours it’s uncanny. Group therapy often helps because it’s not only adults talking at you – which even the best therapy sometimes feels like – but it’s people your age going through some of the same things you’re going through.
Process Groups are not therapy or counseling. Sometimes they’re like both, and sometimes they’re nothing like either one. A typical process group helps you understand how to apply everything you learn in therapy and counseling to your life and your recovery. You hear how your recovery peers apply their new knowledge and coping skills, compare it to how you plan to apply your new knowledge and coping skills, and adjust your plan if you need to, based on what you hear. Therapists and counselors teach effective communication and problem-solving strategies, and peers give you feedback on how your behavior and communication style affects them. Sometimes the most valuable insights come from peers who tell you honestly how you come across – you may be surprised to find the difference between how you think people see you and how they actually see you.
You’ll receive other types of counseling and therapy during treatment, like Family Therapy, for instance, but they all follow similar patterns to what we describe above. They have a common theme: straight talk about hard issues with a focus on developing true awareness, which in turn leads to practical strategies you can apply to your recovery in the here and now.
How to Get the Most Out of Treatment
This may sound obvious, but the best way to get the most out of your time in residential treatment is to show up, be present, and participate fully in every session and activity on your schedule. Even if – especially if – you think it’s a waste of your time and energy. Think you don’t like yoga? Try it anyway. Think talking during AA meetings isn’t for you? Share anyway. Think morning exercise is the worst idea ever? Give it a shot. Do it all. Do it all the way. You never know whether something is going to work for you or not unless you try it. And yes, we’ll go full Yoda on you here: there is no try, there is only do. Your time in treatment is your time to work on yourself, get to the root of your issues, and learn skills you can use for the rest of your life.
That won’t happen if you’re mentally checked out. Don’t sleepwalk through treatment – treat yourself to treatment during treatment. It’s an opportunity that may not come along again, so it’s in your best interest to take full advantage of every moment.
Sure, some days you’ll be tired. You won’t be up for it. You’ll wake up and the last thing you want to do is face another day of treatment. Here’s a tip: those are the days it’s most important to bring yourself fully to whatever is on the agenda. In sports, top-level athletes always say it’s the days they didn’t want to train that made them into the successful athletes they are. In treatment and recovery, it’s the days you don’t want to be there that count the most. The days you want to hide under your covers, not talk to anyone, curl up in the fetal position, and pray everything and everyone would just go away.
But guess what?
Those are the most important days to show up.
Chances are those make-it-all-disappear feelings are not too different from the ones that led you to alcohol or drug use and kept you from managing your emotional or mood disorder, if that’s what you’re in treatment for. There will be days during treatment and after discharge that you don’t want to be sober, don’t want to do the work of recovery, and don’t want to face your emotions. During treatment you get to learn how to face those days and not only make it through them, but totally crush them. That way you can do the same when you’re out in the world, walking the tightrope of recovery without a net: you know you can make it, because you’ve made it before – not only can you make it through them, you can make them into some of the best days of your life.
Angus is a writer from Atlanta, GA who writes about behavioral health, adolescent development, education, and mindfulness practices like yoga, tai chi, and meditation.