Rehab Red Flags: What to Avoid in Treatment Programs

“Well, I’ve got to do something or I’m going to die.”

That’s how author and longtime Chicago Sun-Times journalist Neil Steinberg summed up his experience of deciding to go to rehab and recover from alcohol addiction.

If you’re realizing that you need to go to treatment in order to save your own life, then of course you want to choose your rehab wisely. But what should you look for in a program? What are the red flags to avoid?

In this post, we’ll tell you about the top warning signs that a rehab program is all hype and no substance. We’ll offer informed tips for how to recognize a truly substantive addiction recovery program (and yes, they do exist).

Consider this your crash-course guide to what you should seek and avoid in residential addiction treatment.

Red Flag #1: Lack of Structured Treatment Approach

It should go without saying: If an addiction treatment representative won’t give you a direct answer as to the therapeutic approach they use, steer clear.

It’s fine if a facility uses a variety of treatment approaches; many top programs do. However, don’t just accept a generic answer such as, “We use a lot of different approaches.” Get specific: Which treatments can you expect during your stay?

If all you’re getting in a month of inpatient rehab is 12 Step meetings and a very small handful of professional counseling hours, then it’s probably not worth your time or money. You can get those same services for much less in outpatient settings.

Red Flag #2: No Evidence-Based Treatment Modality

Treatment modality is another way of saying “approach” or “type” of addiction treatment. Once you have a clear answer as to the treatment modality, your next step is to discern whether or not it’s evidence-based.

Here, a word of warning: Just because an approach is popular doesn’t mean that research supports it. For example, nearly three-quarters of all addiction treatment programs in the United States today are 12 Step based. But there’s a distinct lack of scientific support for the efficacy of the 12 Step Model. The Cochrane Collaboration’s 2006 review found that: “No experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.”

Yes, 12 Step programs have helped a lot of people…but you might not be one of them.

So, what approaches are effective? One classic point of reference is The Handbook of Alcoholism Treatment Approaches by Reid Hester and William Miller, which lists 48 different types of addiction treatment modalities and ranks them by efficacy.

Since the reading is rather dense, you can find a table with summarized results here: Treatment Modalities: Which Ones Really Work? In brief, you’ll want to look for treatment modalities that promote healing on all four levels of self: physical, mental, emotional, and spiritual.

Red Flag #3: No Clarity on the Amount of Professional Counseling Provided

When you’re investigating treatment facilities, always ask to see a copy of the daily schedule. Take a close look at exactly how participants spend their time. Is the calendar entirely filled up with field trips, games, and glorified babysitting? Sure, some fun activities in the evenings are great – sober karaoke is a hoot! – but you want to keep the focus on treatment and recovery.

Similarly, get a clear answer on the amount of professional counseling provided to each participant. Counseling will likely take place in both individual and group format, but you want to make sure that sessions are frequent and that they’re led by a qualified, licensed mental health professional. This is the time when you’ll actually work on healing the underlying core issues – the depression, anxiety, and trauma – that led you to use in the first place.

It’s shocking but it’s true: Some states do not have any requirements for addiction “counselors”, and some programs offer the minimum number of state-mandated professional counseling hours … often less than a handful per week! Don’t end up in a treatment program that doesn’t actually offer substantive treatment.

Red Flag #4: No Admittance Criteria; A Chaotic, Unsafe Environment

Watch out for an inpatient program that lacks clear admissions criteria. If you go to a program that welcomes anyone – including court-ordered participants who don’t actually want to be there at all – then chances are you’ll have a more stressful and challenging experience.

Instead, seek out a program with a more rigorous admissions criteria. Look for a facility that actually turns away participants who aren’t a good fit! You want to work with a group of people who are dedicated to healing and wholeness, not a group who is resistant to treatment.

On a similar note, seek out a safe learning environment, one that’s geared toward your success. While most programs have participants coming and going at all different times, my experience is that this rolling admission is disruptive to the learning process. In the program I co-founded, we have all participants start and end at the same time so as to promote greater stability, learning, and interpersonal connection.

Red Flag #5: An Unnecessary Degree of Personal Restriction or Dehumanization

Some rehab facilities take away a great deal of your personal freedom. They restrict access to food and beverages, they don’t allow for privacy and solitary time, and they treat you less like a person and more like a number on a spreadsheet.

By contrast, the best programs will treat you with kindness and compassion. They’ll ensure that you have access to healthy snacks, water, and comfortable amenities. They’ll make sure that you feel seen, heard, and respected. Many will offer the option of choosing a private room and bathroom to give you the level of privacy that feels comfortable for you.

In addition, they’ll likely give you at least some access to your devices, so that you can stay connected to friends and family during your stay. For example, participants might have access to their devices at least every other day for set two-hour windows. This allows them to keep in touch with loved ones while still focusing on their recovery work.

Conclusion: Heal Underlying Core Issues

Finally, don’t get discouraged if the first few programs you investigate aren’t right for you. Be willing to make calls to at least a handful of treatment centers. There are thousands of treatment programs available, and if you’re willing to search, you can find one that is the real deal.

The most important truth to remember in recovery is this: It’s not about the substances. Meaning, your addiction isn’t about the drugs, the alcohol, or the pills. Rather, it’s about the depression, anxiety, self-loathing, hopelessness, despair, loss, and trauma that prompted you to use in the first place.

If you choose the right residential addiction treatment to heal those underlying issues, then you’re well on your way to recovery.