Residential rehabilitation pathways: lived experience interviews

Executive summary

Accessibility, Referrals and Funding

• The majority of people interviewed experienced various challenges in accessing residential rehabilitation.
• Participants reported having heard about, accessed, and funded their placement in residential rehabilitation through a range of different pathways.
• Some described how they or their families had exerted considerable effort to try and secure funding for their placement, often having to contact multiple statutory and third-sector providers, but experienced difficulties in doing so.
• Those who had accessed residential rehabilitation through receiving money from their family described the feelings of guilt and shame which this created, and their inability to fund longer placements and aftercare through this means.
• Knowledge of residential rehabilitation and its availability was poor among individuals with problem alcohol and/or drug use, their families and, often, potential referrers.
• Participants reported varying degrees of motivation to attend rehab prior to entry, with some of those who had been less motivated before admission having found rehab an integral part in their recovery.

Pre-Rehab Phase

• Participants detoxed prior to their placement through various means, including self-directed home detox, structured community detox and inpatient detox at the rehab facility.
• Wide variation in preparatory work was reported, ranging from involvement in peer groups with current residents, to reducing intake, to no preparatory work.
• A woman who attended regular peer groups with current residents suggested that this was beneficial in helping to gain an idea of what rehab would involve, smoothing the transition into the programme, and allowing her to develop positive relationships prior to entry.
• One participant had accessed multiple detoxes unconnected to her eventual residential rehabilitation placement, and suggested that she had received no advice or signposting to rehab or other treatment services during or following these.

Residential Phase

Participants noted a number of aspects of residential rehabilitation which they found particularly beneficial, including through comparison with community alcohol and/or drug treatment services. These included the highly-structured nature of daily routines; the removal from their environment; learning about the nature of addiction; their needs being treated holistically; and the deep relationships formed with staff and peers, particularly those with lived experience.

• Challenging aspects of residential rehab, often acknowledged by participants as having been important to their overall recovery, included the intensive, communal living; the often sharp criticism given by peers in group sessions; and religious aspects of faith-based facilities.

Post-Rehab Phase

• Participants reported a range of substance use outcomes following residential rehabilitation, with some having achieved abstinence after one placement and others reporting up to four placements in residential rehabilitation.
• All of those who had attended aftercare spoke of its importance in helping them to sustain recovery following their placement, suggesting a number of mechanisms through which it did so.
• Importantly, two of those who had returned to problem substance use following their placement highlighted that this had been relatively brief, and that the strategies and tools which they had learnt during their rehab placement had been essential in helping them to quickly reduce and abstain from use.