Different alcoholism treatment programs offer varying amenities, depending on the level of care provided. Public programs tend to be more bare-bones options with few amenities provided; conversely, luxury programs offer a bevy of plush amenities, such as spa services, gourmet meals, private accommodations, recreational activities, and health and wellness opportunities. Certain amenities can augment a treatment program, keeping clients engaged and comfortable, and increasing the likelihood that they will complete the program.
Vice News/Vice Reports produces documentaries and essays through Vice Media’s website and on YouTube. An interesting Vice Report looked at the substance use disorder rehab industry and identified many of the extravagant amenities that are often used in the treatment of substance use disorders. In some cases, the use of certain amenities is contrary to the goals of empirically validated approaches that are recommended by sources, such as the National Institute on Drug Abuse (NIDA). While there is nothing wrong with a spa-like environment, the focus in recovery should be understanding the substance use disorder, learning to handle triggers, developing coping skills, and implementing a relapse prevention program.
Are Amenities Necessary?
While luxurious amenities are not necessary for treatment, they may be useful. The quality of a treatment program comes from the clinical services provided by trained staff members who are licensed and qualified in their field. Trained, licensed, and accredited staff members are requirements for effective treatment programs. The addition of amenities, such as spas, golf courses, tennis courts, gymnasiums, pools, etc., may provide distractions and additional ways to cope with the stress of recovery, but these are not necessary and do not directly address issues with the alcohol use disorder.
Insurance companies will often not pay for services that do not have empirical validation for substance use disorder treatment. They will often contest any charge for a treatment that is not empirically validated to treat the issue in question. Thus, any charges for massages, acupuncture, golf sessions, saunas, etc., might end up being out-of-pocket expenses for clients. The use of some of these amenities for recreation and relaxation could certainly be warranted, but these amenities should not be considered treatment interventions.
There is a difference between a treatment center offering a quality environment for its clients in alcohol use disorder recovery, and a treatment center with facilities that are substandard or unsanitary. When choosing a residential program or an inpatient treatment program, make sure the program is certified by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). JCAHCO certification requires that the facility meet specific standards regarding the quality of their services, including cleanliness and suitability for intended purposes.
Inpatient treatment programs and residential programs for substance use disorders are regulated by the state they are in, but they are also often listed as private enterprises. This means that the services offered by different facilities may vary greatly from facility to facility.
According to NIDA, the approach to treating a substance use disorder should address the psychological and physical issues associated with recovery. Core services included in nearly all type of programs for alcohol use disorders most often include:
- Withdrawal management or detox services
- Medication-assisted treatments, as required in the particular case
- Counseling, individual psychotherapy, and/or group psychotherapy
- Peer support group meetings, such as 12-Step meetings or participation in some other support group
- Drug and alcohol testing/screening
Some of these services may be offered off site in affiliation with particular outside providers (e.g., 12-Step groups), but the majority of them are typically offered on site. Treatment effectiveness is not necessarily a matter of cost, meaning that individuals who attend treatment programs that cost more do not necessarily get better or more effective treatment. Instead, the effectiveness of a treatment center depends on the quality of its staff, its ability to personalize its program for any specific needs of the person in treatment, and its ability to implement the above services in a safe and efficient manner.
NIDA offers a list of the principles of effective treatment for substance use disorders based on empirical research findings and treatment outcome studies. None of these principles involves the use of amenities that are commonly used as marketing tools or selling points to attract prospective clients.
Complementary and Alternative Interventions
Many recovery centers offer numerous complementary and alternative treatments that are not typically seen in standard substance use disorder treatment protocols. These complementary and alternative treatments are offered an attempt to employ a holistic approach to treatment, and they are aimed at boosting overall physical and mental wellbeing, instilling a healthy attitude, and offering variety in treatment. These interventions are not designed to take the place of the above-mentioned components of effective treatment programs for an alcohol use disorder. The types of amenities and alternative interventions provided differ from facility to facility.
Some of these amenities can include:
- Massage therapy
- Yoga and meditation
- Music therapy or art therapy
- Animal-assisted therapy, such as the use of therapy dogs or equine-assisted treatment
- Nutritional therapy
These services are not essential in the treatment of an alcohol use disorder, and provide limited treatment utility above and beyond standard approaches to treatment. Psychology Today warns potential clients that these treatments often have little utility in the treatment of substance use disorders. Some of these interventions have no documented empirical evidence to suggest they offer anything in recovery from substance use disorders (e.g., Reiki); others have questionable research evidence; and others can be useful, such as animal-assisted therapy, yoga, music therapy, art therapy, psychodrama, etc.
The utility of these approaches is often in their ability to provide distraction, relieve tension, and offer variety. Research indicates that they have very little direct effect in addressing issues that occur in people with alcohol use disorders or other substance use disorders, and they should only be used as adjunctive treatments to standard treatment protocols.
Special mention should be made of nutritionally focused interventions. There is no doubt that eating healthy is an important aspect of recovery. Proper nutrition can help an individual in a recovery program, make them more alert, give them energy, and help them focus on their recovery. People with poor dietary habits who continue to engage in unhealthy dietary practices may not be able to experience the full benefits of a recovery program. However, the sole use of vitamin therapy, smoothies, herbal teas, etc., as a standard approach to treating a substance use disorder has no empirical validation to suggest that it should be a primary treatment intervention. Instead, rehab programs should offer good nutrition as part of the overall package.
Finally, one of the most effective amenities that any recovery program can offer its clients is access to an effective aftercare program. NIDA reports that relapse rates in recovery from substance use disorders remain high even for individuals in treatment, and nearly half of the individuals who complete some form of inpatient or residential treatment program do not become involved in an aftercare program. The American Society of Addiction Medicine reports that nearly everyone who completes an inpatient or residential treatment program and does not go on into an aftercare program will relapse.
Even though access to an aftercare program is not generally defined as an amenity, prospective clients should see if a program in question can provide aftercare treatment, or transition clients into aftercare treatment programs after their participation in the residential or inpatient program has been completed. Most often, aftercare is performed on an outpatient basis, but some aftercare programs may be residential-type programs.
Some potential avenues for aftercare include:
- Sober living homes
- Intensive outpatient treatment services
- Peer support groups, such as Alcoholics Anonymous
- Regular psychotherapy as an outpatient
Following inpatient or residential treatment, active participation in an aftercare treatment program is the most important aspect of continued success in recovery.