I’ve been to three addiction treatment centers as a client (third one was the charm) and have worked at four different addiction rehabs since becoming an addictions counsellor. As a result I feel I have a pretty good grasp of what works and what doesn’t. All treatment centers, especially residential treatment, have various rules and regulations. In my experience a lot of these rules are either outdated or make no sense at all. Here is a list of rules/regulations that I would change If I ran a residential treatment center, while keeping in mind that different programs work for different people.
1) No hats or beanies to be worn inside: Many treatment centers still have this rule. There was a time (decades ago) where wearing a hat inside was considered disrespectful. However, times have changed and most people no longer care if someone wears a hat indoors. I’ve found that it’s a pain in the ass enforcing this, and I don’t see the benefit in acting it in the first place.
2.) Movies, TV, and Music: Sometimes these aren’t allowed at all in treatment, but when they are, they most often ban anything that contains even the smallest of “triggers” for using or drinking. We must let people learning to stay sober, to get a taste of what it is like in the real world and learn techniques of distress tolerance. If you can’t practice these techniques in an organic setting while inside a safe environment (Rehab), then you’ll most likely fail once out of treatment. Last time I checked, I still hadn’t heard of a treatment center that blacks out their van windows in order to hide the beer billboards on the freeway. It’s entirely counterproductive because you can’t evolve a habit until you practice it.
Now often, patients come in with erratic schedules and no accountability, so its important to have them following a daily structure, but TV and music should be considered to be a part of that in a structured way.
3) No cell phones: Every rehab I’ve worked at has a strict Cell Phone policy. They do not allow clients to have cell phones on their person. As technology progresses it has become easier for clients to hide cell phones. One of the reasons behind this rule was to prevent clients from calling former drugs dealers and setting up drop offs. As a counselor, I understand the intent here, as once one person gets their hands on a substance, it can lead to an awful domino affect and it endangers the sobriety of everyone there. Still, I think there are ways to protect against this, that out weigh the problem of not having cell phone access.
Another, more pertinent, reason for no cell phones is that if someone is constantly in touch with the outside world they can be easily distracted from what they have come to treatment to work on – getting clean and sober. The former reason seems to be a moot point as clients often have access to either a pay phone or unsupervised access to a house phone at various times while in treatment. The best solution I have observed for this is to allow clients access to their cellular phones once or twice a day for a limited period. I feel this takes away the need for a client to hide his phone and gets rid of the burden placed on staff to constantly try to catch clients who have hid phones. Us addicts/alcoholics are pretty damn good at hiding things, although I’ve seen a number of patients drop the ball (or cell phone in this case). I remember a client’s cell phone going off during one of my group sessions. I couldn’t help but think that if you’re going to hide a phone at least turn the damn ringer off. In any case, allowing for times in which residents can use their phone under super vision, would in theory help curve the number of people that try to hide them.
4) No caffeinated coffee: To me this rule is a joke and a hindrance to recovery. For one, the coffee bar is the “watering hole” for almost every 12 step meeting (Unless there is a Caffeine Anonymous?)
The reasoning behind not allowing caffeinated coffee is so that clients who are addicted to stimulants (e.g. – cocaine; meth) won’t use coffee to try to simulate the effect these drugs gave them. However, the places I’ve seen who limit or ban caffeinated coffee still have tea so the clients who want caffeine just overload on that beverage. Or when clients go to a 12 Step meeting or have a pass they chug down loads of coffee or energy drinks. Coffee is an accepted social lubricant in North American society – a much less destructive drug than alcohol. I have yet to come across a person who is stealing, selling their bodies or ignoring their families to score a cup of caffeinated Joe. Let the clients have their caffeine (while you enjoy your own – as everywhere I work the staff regularly drink this caffeinated refreshment).
5) No cigarettes: If there is one thing people in recovery (especially at 12 step meetings) are known for (yes, even more than caffeine) it is nicotine. I’ve come across a number of rehabs that ban smoking and the use of nicotine of any kind. I agree smoking is drastic to your health, it’s one of the top killers in America, but the bottom line is that it’s legal, and that it’s prevalent throughout the world or recovery.
Why ban smoking, when you take patients to AA meetings that have actual smoking breaks built in? Why take away one of the small distressors to the people who need less stress. Especially when they are done with your program, you point your residents to (IOP) Intensive Outpatient Program or 12 Step, again, both of which build a lot of their community around talking to others while smoking on these smoke breaks .However, the early stages of recovery are extremely stressful and taking away a non-mind altering (in the intoxication sense) substance that helps relieve stress is cruel and unusual treatment. Not at all in line with the client-centered approach of best practices.
These are just few rules/regulations that, in my humble opinion, are antiquated and don’t present much value to the client. For those looking for a residential treatment center, you may want to take these rules into consideration before making your choice. After all, it can’t hurt to ask.