Admission to Alcohol Rehab

The admissions process refers to the methods, regulations and systems put in place by rehab centres to enter clients into their residential alcohol rehab programmes.

This needs to happen before a person can commence their treatment for alcohol use disorder and physical alcohol dependence.

Admission to alcohol rehab processes require centres to demonstrate consistency in the way they treat all their clients.

A treatment contract is then developed between each client and the rehab centre offering the treatment. (3,6)

Who is suitable for admission to alcohol rehab?

The admissions process usually applies to patients seeking inpatient (residential) treatment for their alcohol use, this may apply to the following:

• Individuals who have been diagnosed with a severe alcohol use disorder who want to recover in an alcohol-free environment away from negative influences.
• People who have tried several times to give up alcohol but have been unsuccessful so far despite their continued presence at AA meetings and several attempts to stop.
• Individuals who would benefit immensely from receiving alcohol rehab treatment in a supportive environment.
• Individuals who have been diagnosed with a co-existing mental health condition as well as their alcohol use disorder (a dual diagnosis patient).
• People who drink alcohol excessively but live in a chaotic, unstable and unsupportive environment with many negative influences.
• People who have medical complications as a result of their alcohol use, although not all alcohol rehab centres have the resources to cater for patients who are seriously physically ill as a result of alcohol use.

Differences between clinics during admission to alcohol rehab

All admissions to alcohol rehab centres will vary slightly in the way they go about the process, although there are many common similarities between the approaches and methods used.

Different clinics may use different phrases and terminology to describe their process while completing the admission to alcohol rehab.

Here at Rehab 4 Alcoholism, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard can be to change your relationship with addiction.

Simply reach out to our 24/7, confidential hotline on 0800 111 4108.

The referral process

Anyone seeking treatment for alcohol addiction would usually require a referral from a GP, psychiatrist or social worker.

Some clients go through charities or statutory organisations such as The Westminster Drug Project.

Usually these patients are applying for NHS funding or have private health insurance to cover the cost of their treatment.

Clients who can pay for the cost of their treatment through their own private funds can refer themselves during an admission to alcohol rehab.

In this case, you may still need to allow the rehab centre access to your medical history to check you are suitable for treatment with them.

1. Initial contact

Initially, clients requiring treatment for alcohol addiction will contact the rehab centre after they have self-referred or been referred through a healthcare practitioner.

You will need to express an interest in having treatment and explain your current situation.

2. The screening process

The screening procedure adopted during most admission to alcohol rehab centres may reveal certain psychological, physical and social barriers that may prevent a patient from fully engaging with treatment.

They may be found to be an unsuitable candidate to receive treatment at that particular rehab centre.

The screening process can be conducted over the phone or in person depending on the wishes of the patient and the current demands placed on rehab staff.

It may be more beneficial to conduct the screening in person however as it is possible to view the physical appearance of the prospective patient.

Professionals can then read body language (posture, eye contact) and obtain certain clues about a person’s current mental state (e.g level of hygiene, anxiety levels, skin tone).

This can provide important clues about their suitability for treatment.

Each rehab centre will conduct a screening process with each patient as it is necessary to assess the suitability of each prospective patient for treatment at their centre.

Each centre has its procedures, regulations, services and resources that distinguish it from another rehab centre.

This helps to clarify whether the rehab centre is able to meet the treatment needs of each particular patient.

If not deemed suitable they can be referred to a service that has the means to satisfy the treatment requirements of the patient. (3)

3. Screening criteria for admission to alcohol rehab

When you initially contact the admissions team to enquire about receiving rehab treatment they will put you through a brief screening process to help assess if you meet the criteria for treatment at their centre. (2,6)

This may include:

• Checking you are aged 18 or older
• Establishing if you are mentally and physically able to engage in an alcohol rehab treatment programme
• Confirming you have been diagnosed with an alcohol use disorder, or are exhibiting signs, symptoms and behaviours that indicate you are physically dependent on alcohol and/or mentally struggling with heavy alcohol use.

The screening process also allows the assessor to investigate whether the client is in a position to fully understand the treatment process and the next steps open to them.

You will need to be displaying sufficient motivation and determination to improve your situation and be aware of how challenging it will be.

It may be necessary during admissions to alcohol rehab centres to review your medical history before they can decide on your suitability for treatment at their centre.

4. Other possible screening criteria

Each clinic will be different in terms of its treatment ethos, resources and staff and this should be established during the process of admission to alcohol rehab.

The clinic may well enquire a bit more thoroughly into a potential client’s circumstances before deciding to accept them onto their rehab programme.

If the admissions team have concerns in the following areas then they may not accept you onto their treatment programme.

Any clients with a severe mental health condition(s) such as schizophrenia or anti-social personality disorder may not be suitable for some alcohol rehab centres.

This is because the clinic may not have the expertise and qualified staff to offer high-quality care for such patients.

If the admissions team feel after reviewing medical records that a patient has a history of violence and aggressive behaviour, then to protect staff and fellow patients they may decide that patients in this category are more suitable for treatment elsewhere.

Similarly, some patients may be assessed as a suicide risk and the centre may not feel it has sufficient support to provide care to these patients.

Some rehab centres specialise in alcohol rehab only and may not be able to treat people with multiple addictions well or vice versa.

If a person has been diagnosed with an alcohol-based disease such as delirium tremens or Wernicke’s disease then they may not be physically and psychologically equipped to deal with the demands of an alcohol rehab treatment programme.

Here at Rehab 4 Alcoholism, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard can be to change your relationship with addiction.

Simply reach out to our 24/7, confidential hotline on 0800 111 4108.

Understanding the terms and conditions of your treatment contract

As part of the admissions to alcohol rehab process, it is important to inform clients about the rules and regulations relating to their stay in residential rehab.

This involves informing clients about the boundaries of their stay and what is expected of them during their time there, and what they can expect from the staff at the rehab centre. (2,3)

They will also be presented with their personal timetable which will inform them of the way most of their days are structured, which will consist of various activities and interventions all designed to enhance their recovery.

How long is the treatment?

It is important to establish the precise terms of your rehab treatment, including your entry date, length of treatment and end date.

Most clients receiving residential rehab stay for a 28-day period, although some clients stay for longer depending on the severity of their condition, and their own personal financial situation.

This can be achieved during the initial screening although the treatment managers at rehab centres will not know all of the considerations that need to be accounted for in your treatment plan.

To determine this, you will need to first undergo a comprehensive assessment of your situation. (2)

What is expected of you in rehab?

This can vary between alcohol rehab centres but may include the following:

• Adherence to the no alcohol/abstinence policy
• Be honest and open about your feelings in individual and group therapies
• Do not attempt to deceive staff or fellow patients at all
• Keep a diary with all your appointments in and ensure to punctually attend all sessions with rehab staff
• Respect and tolerance towards all staff members and fellow patients
• Do not ask other patients to become involved in your recovery unless directed by rehab staff
• Do not enter other patients’ rooms
• Do not give advice or recommendations to other patients
• Full commitment to all aspects of the program
• Respect time boundaries for when sessions begin and end, adhering to boundaries is an important aspect of recovery

What should I bring during my admission to alcohol rehab?

This can vary between rehab treatment centres but some common things patients are advised to bring to rehab include:

• All the relevant medication that they are currently taking
• A range of comfortable clothes for a 4-6 week stay
• A small amount of money
• Several forms of ID
• A notebook/journal, and pens for your written work
• Your mobile phone
• Books

What you can’t bring to rehab

• Alcohol or any product(s) containing alcohol (e.g. mouthwash)
• Inappropriate clothing, ie. too revealing or features offensive or controversial statements, whether political or religious)
• Any object that could be used as a weapon
• Electronic devices, including televisions, games consoles, and iPads
• E-cigarettes
• Drugs
• Pornographic material
• A negative attitude

Payment processing

Payment for treatment is an important part of the admission to alcohol rehab centres, and usually, a deposit is required as soon as treatment is booked.

The deposit payment varies between each treatment centre, but expect to pay 5-10% of the overall treatment costs as a deposit which is usually non-refundable.

It is essential to get a full breakdown of treatment costs for your alcohol rehab, although it is likely that only an estimate is possible until you have gone through your comprehensive assessment.

Still, the admissions rehab staff should be able to give you a reasonably accurate guide to the cost of detox treatment and psychological therapies and the cost of a 28-day residential stay.

Payment options

There are predominantly three forms of payment for the alcohol rehab treatment, these are:

NHS Funding

It is unlikely that there will be many clients receiving inpatient rehab for alcohol addiction which has been paid for by NHS funding.

This is because most NHS funding is diverted to outpatient treatment services. Patients need to meet strict criteria to be eligible and the spaces can be limited.

However, if you are fortunate enough to have your alcohol rehab covered by NHS funding, then please ensure you are aware of which aspects of your treatment the funding covers.

Any facilities or activities not provided for will need to be covered by you personally.

It is important to liaise with the admission to alcohol rehab treatment team so that they can arrange a treatment package that fits in with your funding allowance.

Health Insurance

Many patients will be able to have their admissions to alcohol rehab treatment covered by a health insurance policy through specialist healthcare insurers.

These include BUPA and AXA, and may be either organised themselves or received as part of their remuneration package through their employer.

Before contacting a rehab centre’s admission team, it is imperative to establish the precise terms and conditions of your healthcare policy and check which specific forms of alcohol rehab treatment it will cover.

This will vary between providers and even individual policies, so check with a representative from the health insurer to set down exactly what their policy coverage will pay for.

Any policy should cover the basics such as detox treatment, a specific number of psychological therapy sessions, assessments and medication.

However, it is unlikely to cover holistic therapies and certain types of psychotherapy or trauma therapy, even though they may be beneficial for you.

Private funding

Privately funded clients can gain admission to alcohol rehab very swiftly, usually in a matter of days due to their ability to authorise payment immediately.

This avoids any bureaucratic delays or queries about which forms of treatment they are covered for.

Day of admission

When initially going through admission to rehab, clients will be settled into their accommodation and tie up any loose administrative ends.

They will then complete a comprehensive assessment to identify their individual treatment needs in more detail.

Here at Rehab 4 Alcoholism, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard can be to change your relationship with addiction.

Simply reach out to our 24/7, confidential hotline on 0800 111 4108.

Comprehensive assessment – ASAM Criteria

The alcohol practitioners carrying out the patient assessments as part of the process of admission to alcohol rehab andwill refer to the guidelines set down by The American Society of Addiction Medicine (ASAM).

This lays out the standards for organising and delivering treatment for addictive disorders. (4)

It is vitally important for treatment assessors to gather as much information about the incoming client to develop an accurate and appropriate treatment programme for their alcohol use.

In line with ASAM’s 6 dimensions, assessors seek to gather information in the following areas to build a full profile of the client.

These dimensions cover the biological, psychological and social factors that will help to develop a detailed and appropriate treatment plan.

The 6 ASAM dimensions of admission to alcohol rehabare shown below:

• First dimension – This relates to the patient’s current level of intoxication and/or withdrawal, it is important to establish their recent and current drinking patterns to assess if they require detoxification treatment
• Second dimension – The second dimension relates to any underlying medical conditions and health complications they may have that may need to be factored into their treatment programme. For example, a patient diagnosed with diabetes would require care and support from a specialist nurse as part of their care plan
• Third dimension – This dimension seeks to investigate any emotional, behavioural, or cognitive conditions the patient has, it could be they are a dual diagnosis patient that has also been diagnosed with anxiety, depression, PTSD or schizophrenia
• Fourth dimension – The dimension assesses the client’s readiness to change, does the client appear to be motivated and determined to take on the challenge and commitment of a 1-2 month alcohol treatment programme, or does the assessor feel that they lack enthusiasm for the treatment and will be unable to cope with any adversity along the way
• Fifth dimension 5 – The fifth dimension of admission to alcohol rehab is concerned with how much of a relapse risk the patient is, it may be they live in an unsupportive environment and have little or no social support or they may have attempted to give up alcohol previously on several occasions but were unsuccessful each time
• Sixth dimension 6 – The final dimension focuses on the patient’s recovery/living environment and whether they are facing any social, employment or legal issues that may cause them a great deal of psychological distress and negatively impact their engagement with treatment. This may include not having anywhere to live, a custody battle and relationship break up, a criminal court case or job redundancy

After conducting an assessment interview the assessor will allocate a risk rating for each dimension ranging from 0 (no risk) to 4 (high risk).

The risk rating attributed to each dimension will help medical practitioners develop a course of treatment to address this area (if necessary).

If a person is attributed a higher rating then extra consideration should be given to this dimension when formulating their treatment plan. (4)

Establishing the severity of patients’ Alcohol Use Disorder

The treatment team needs to assess the severity of each client’s alcohol use disorder when formulating their treatment plan to ascertain their precise treatment needs.

To achieve this it is helpful to consult with the patient’s medical records.

Clinics may have qualified psychiatric and medical staff available who will be able to use the 11 DSM criteria for alcohol use disorder (AUD) to determine if the patient has a mild, moderate or severe AUD. (1)

As well as establishing the severity of the patient’s alcohol use disorder, staff completing the admissions to alcohol rehabmay also wish to record which of the 11 criteria set down by DSM5 the patient met.

Here at Rehab 4 Alcoholism, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard can be to change your relationship with addiction.

Simply reach out to our 24/7, confidential hotline on 0800 111 4108.

Medical Examination

It is also necessary for all patients completing admission to alcohol rehab to undergo a medical examination.

This will check their current level of physical health and record a range of physical statistics that need to be carefully monitored.

This will help identify any changes in their physical health and to ensure they are as yet, no undiagnosed medical issues/concerns that may arise that could complicate their detox treatment.

Assessing the client’s level of intoxication at this stage is important as it provides valuable information that can be used to help prepare the client’s detoxification (detox) treatment.

Psychiatric examination

Heavy alcohol intake can wreak havoc on a person’s mental health as it interferes with brain chemistry and functioning,

It is important to gain an accurate state of a person’s mental health as they may be displaying symptoms of an undiagnosed mental health condition.

This may require immediate attention before it impedes their ability to fully engage with admission to alcoholrehab.

Any patients who show symptoms of mental health conditions will receive a full diagnosis and the rehab centre’s dual diagnosis team will be made aware of their situation. (2.6)

Here at Rehab 4 Alcoholism, we offer free advice from a team of non-judgemental professionals, many of whom are in recovery and understand how hard can be to change your relationship with addiction.

Simply reach out to our 24/7, confidential hotline on 0800 111 4108.

Patients’ close family members are supported right throughout the process

Most alcohol rehab centres pride themselves on the support and guidance they provide for family members of patients undergoing admission to alcohol rehab.

They realise that this is a worrying and stressful time for loved ones as well.

Family members are informed right throughout the process and admissions and treatment staff are always on hand to answer any questions or address any concerns about any aspect of their relative’s treatment programme.

Post comprehensive assessment meeting

As soon as the comprehensive assessment is complete and the senior alcohol practitioners have reviewed the information gathered, they will start to create your treatment plan.

Your individualised plan will be based on the treatment needs identified across each of the 6 ASAM dimensions.

The practitioners will then go over the recommended treatment plan with you which is likely to include your detoxification treatment schedule. This usually takes between 7-10 days.

They will also draw up your individual psychosocial therapy plan during admission to alcohol rehab, which is likely to include the following:

• A range of 1-1 sessions including Cognitive Behavioural Therapy, Dialectical behavioural therapy, specific alcohol addiction counselling, group therapy, family therapy (if applicable) and 12-step therapy (5)
• If you are a private client then they may discuss the range of holistic therapies and recreational activities that may benefit your psychological and physical well-being and make your stay more comfortable

As soon as this is complete then the admissions team will be able to provide you with a full detailed breakdown of the cost of treatment.

At Rehab 4 Alcoholism, we offer free advice about your admission to alcohol rehab.

We have a team of non-judgemental professionals, many of whom are in recovery and understand how hard can be to change your relationship with alcohol.

Simply reach out to our 24/7, confidential hotline on 0800 111 4108.

References

(1) Black, D., Grant, J. (2013) DSM5 Guidebook: The Essential Companion to Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition. APP. London.

(2) Mack, A, Harrington, A, Frances, R. (2010) Clinical Manual of Treatment of alcoholism and addictions. American Psychiatric Publishing. Washington D.C.

(3) McBride, A (2003) Client Assessment. In Peterson, T. and McBride, A. (ed) Working with Substance Users: A guide to theory and practice. Routledge. London.

(4) Mee-Lee, D. (2013) The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related and Co-occurring Conditions. American Society of Addiction Medicine

(5) Rassool, G.H. (2011) Understanding Addictive Behaviours. Palgrave MacMillan. New York.

(6) Sibley, L. (2013) Screening and Assessment practices in Herie, M., Skinner, W. (ed) Fundamentals of Addiction: A Practical guide for counsellors. CAMH. Canada.