What Is the Criteria for Inpatient Rehab? How Will You Know What’s Right for Your Family?
In the case of inpatient or residential treatment, separation and insulation are powerful conditions for successful recovery. An intensely supported 24/7 program can serve to halt addiction and jumpstart the road to recovery. But what is the criteria for inpatient rehab? Is it right for you? And what about your family?
As an intensive intervention, inpatient rehabilitation or residential treatment may mean the difference between continued substance use and cessation with subsequent recovery. It is a key step in the gradually advancing continuum of care which starts with intensive, heavily supported and accountable inpatient treatment programs and transitions progressively to more flexible, increasingly independent outpatient contacts.
If you are struggling to decide where you or a family member fits on that treatment continuum, there are some important considerations. Examining the admissions criteria for inpatient rehabilitation will help you understand the medical requirements and to determine what’s right for you and your family.
Clearing the First Hurdle: A Medical Detox Program
In many cases, the first step in the treatment of drug or alcohol addiction will be detoxification and stabilization. Generally, successful detox programs involve inpatient care, including experienced clinical support. Client’s vital signs can be monitored around the clock, and medical staff may offer appropriate support for symptoms.
This support can make the withdrawal process more comfortable and also help to manage cravings that might lead someone to use again. Typically, within a week or two, the worst symptoms will have passed, and medical stability will be achieved. Getting through withdrawal successfully can be the first hurdle on the road to recovery, but additional treatment is needed.
While the state and the insurance company may have official criteria to determine when inpatient rehab is appropriate, there are other specific factors you should consider in order to decide what type of treatment is best for you or a family member.
What Criteria Do You Meet for Inpatient Rehab?
Once the physical dependency has ended, it is time to address the psychological dependency. For many, the best choice will be an inpatient program that offers a greater degree of support and accountability. Inpatient rehabilitation refers to a 24/7 residential treatment program where an individual takes a break from their day-to-day life and moves into the facility. This allows a person to give their full attention to recovery but requires them to step away from family, school, and work responsibilities.
Deciding whether inpatient rehab is the appropriate next step will involve consideration of several key factors. These criteria will be used by medical professionals in determining the best course of action and will also factor into the insurance carrier’s decision as they authorize treatment coverage.
The Texas Administrative Code specifies:
- A diagnosis of chemical dependency is the first criterion. Symptoms must have persisted for at least a month or have occurred repeatedly over a longer period of time.
- The individual must be medically stable and not in active withdrawal. Detoxification must precede inpatient or residential rehab if necessary. An assessment will be conducted to ensure that there are no medical complications.
- There are family, social, or environmental factors to impede the potential success of outpatient treatment. If an individual is experiencing severe social isolation or has a family situation that is chaotic, unsupportive of or opposed to treatment, or there is substance abuse in the home, inpatient treatment may be preferred. Proximity to the treatment center will also be considered.
- The individual has the emotional bandwidth to participate with rehabilitative therapies in a meaningful way. There must be coherence and the ability to understand and participate willingly in the recovery process. Inpatient rehab must be guided by documentation with treatment goals and interventions that convey a reasonable expectation of improvement.
- Treatment must be timely for recent substance use. The individual’s use must be excessive with most or all daily activities revolving around obtaining, using, and recovering from substance use. Previous attempts to stop using must have been unsuccessful.
How the Criteria for Inpatient Rehab May Affect You
While the state and the insurance company may have official criteria to determine when inpatient rehab is appropriate, there may be factors you should consider in order to decide what type of treatment is best for you or a family member. Experts offer these suggestions for consideration.
- Have you used within the past three days? If you have achieved a week of sobriety, perhaps you have the self-discipline and motivation for an intensive outpatient treatment program.
- Have you tried outpatient treatment programs without achieving success? Maybe an inpatient program will provide the structure and accountability you need to get you started on the right path.
Finding a rehab center with an integrated treatment pathway will give you a strong chance for long-term success. In this scenario, the center has a complete continuum of rehabilitation services that include medically-assisted detox, inpatient/residential care, day treatment, intensive outpatient, and post-discharge programs. A patient can enter the continuum at the corresponding point and move along the pathway at their own unique pace, stepping down as appropriate to their own progress.
The value in this type of program is the overlap and coordination that occurs between the different levels of care. This coordination allows staff to plan for and manage transitions between programs for greater success for their clients. A warm handoff occurs when a client has met and interacted with members of the multidisciplinary team in the next stage of recovery. Transitioning with this level of continuity and support increases the likelihood of success and continued engagement regardless of your entry point on the continuum.
