Everything Wrong With Luxury Rehab
Whats Wrong with Luxury Rehabs
The single most important thing about rehab, regardless of what is being treated or the facility used, is recovery. The only reason anyone enters rehab is to begin a new, addiction-free life.
A rehab facility will cover the first two phases of recovery from addiction. First, it offers an environment where the client can detox, ridding their body of the harmful toxins and manage their withdrawal symptoms. Alongside this, it will begin the rehabilitation process, helping the client understand their addiction, what caused it, the triggers and enablers that feed it, and how to manage stress and temptation in the future without resorting to addictive behavior.
Good rehab should offer professional, evidence-based treatment to help the addict start their journey towards a drug-free life. But it is a start, and most rehab facilities will offer ongoing support even after their client leaves, helping them adjust back into their normal lives, a process which might last long after their initial stay is over.
What is luxury rehab?
Most people will have no direct experience of rehab. This means that there is lots of room for speculation about what rehab actually is. Many assume that standard rehab is, actually, a grindingly austere experience. Perhaps driven by fictional portrayals, or outdated concepts of mental health treatment in which addiction was seen as a moral failure, they imagine a sterile environment, in which addicts detoxed while deprived of their liberty and doing menial chores.
At the opposite end, for those fortunate enough to be able to access it, was the luxury rehab offer. Here, clients would have a leisurely experience, rehab would be more akin to an extended break at a high-end resort than a medical treatment. Staff would be available for the menial chores, leaving residents able to enjoy spa treatments and a relaxing time, just without cocktails at the poolside.
But, just like any service, medical or otherwise, there is a range of rehab offers. And while many of the notions about non-luxury rehab are wrong, they have perhaps helped the rise of the luxury rehab facility that will boast as much, if not more, about the extras than the treatment. Luxury rehab sells itself as an option that makes the detox and rehabilitation process a lot more bearable and a lot more comfortable; many websites and brochures make them look more like hotel and resorts than clinical facilities, and may even give the impression that the choice is just as much about a status symbol as it is about treatment. Luxury rehabs have even spawned an industry, with crowd-funded listings websites such as luxuryrehabs.com vying to list so-called luxury rehabs.
Luxury rehab offers will highlight features like their facilities, usually boasting high-specification accommodation supplemented by on-site, perhaps even personal, staff to attend to the client’s needs. They will highlight their exclusiveness, making a virtue of the small numbers of clients at any time, possibly even nodding to the status of the people they treat. And, alongside this, they will highlight the privacy they offer, reassuring potential clients of the discreet and confidential service they will receive.
Perhaps the prime example of this would be a service like Rósglas Recovery in Ireland, who offer personal services. Starting at €95,000 for a two-week program, clients will be the only patient in a luxury residence with round-the-clock staff on-site, including a live-in therapist, chef, driver, and maid.
Do luxury rehabs work?
The most important question of any rehab should be about its effectiveness. While issues like luxury are subjective, the success, or otherwise, of rehab is a fairly binary measure. When an estimated 40-60% of addicts will relapse, the real question is whether there is any evidence that the perceived luxury of the rehab experience has any impact on those rates?
Unfortunately, luxury might be nice, but does not seem to have any bearing on outcomes. Although luxury rehabs will suggest that they are more effective, pointing to factors like having more tranquil environments or perhaps better staff, there is little research evidence to suggest this is actually the case. However, research has highlighted several factors, unrelated to luxury, that will impact on effectiveness. These include things like the length of treatment and aftercare, the therapies and medications used, the team involved in treatment, and the ongoing support network available to the addict. If budget was a factor in choice, then the research would suggest that it is better to forego some luxury in favor of stretching the length of support purchased.
Indeed, luxury rehab is not without its critics. Bob Forrest, who founded Alo House — is highly critical of some aspects of the model. Writing on the Alo House blog about a celebrity who might be entering rehab somewhere, he commented,
“the perverted nature of treatment in Southern California … is so sick with celebrity ass-kissing that he will get no help.” He continued to suggest that the focus might be on the luxury, and not the treatment: “He will know from the moment he walks in, and the owner is there to greet him, that he runs the show. It is so monetarily important to your typical Malibu treatment center to land a big celebrity client that the owners literally drool at the chance. I will not bore you with how disgusting it is.”
Is non-luxury rehab that bad?
In fact, returning to those factors that luxury rehabs offer to differentiate themselves, many will be present in any rehab environment.
Rehab environments are invariably comfortable. There is, of course, a degree of individual perception in this. Two clients might see the same facility in different ways. However, the old-fashioned view of addiction as a moral failure has been abandoned. Addiction is now recognized as an illness, and rehab facilities treat it as such. Like any medical treatment, it is important that patients are comfortable.
Anyone booking into a ‘non-luxury’ rehab would, therefore, still expect to have a comfortable experience. They might not have a maid, and some facilities might, as part of their treatment ethos, expect some contribution towards upkeep of living areas, but they would not be a penury that has to be endured.
And any rehab would have the privacy at their core. Confidentiality is central to any medical treatment, and rehab is no different. There is no premium that can be paid to ensure privacy, simply because it will come as standard with every rehab.
The main benefit that luxury rehab can offer is the exclusivity. However, that is largely a function of the cost. The more expensive a rehab is, the fewer people can afford it. In the same way as far more people can afford t-shirts from Walmart than can afford t-shirts from designer labels, the same is true of rehab. Some might feel that exclusivity is worth the price, but it is not a factor that affects rehab outcomes.
Whats wrong with single client rehab?
Loneliness and isolation kills. Stop and think about it. Single client rehab might seem like a good idea. Who wants ‘other‘ people around during this difficult process? Individual therapy is great, but of course lets not forget that non sole occupancy rehabs do offer an amazing array of individual therapy as part of their treatment program. The biggest thing wrong with single client rehab is that you are alone for the whole length of the rehab. No friends, no family, no banter, no laughs, certainly no humor in the face of adversity… something most (if not all addicts possess in spade!). There’s no chance to learn from others’ stories and no way to spot the similarities in yours.
Single client rehab sounds indulgent but rehab can also be very, very boring. Imagine being locked away from 30, 60, 90 days or longer with your only buddies being people paid to talk with you. Paid to exercise with you and paid to wait on you. At single client rehab your only friend is the rehab owner (who is getting rich off you) and the therapists (not getting so rich but still paid to be there).
Luxury or not, rehab should be evidence-based. Ironically, in some cases, the evidence might suggest that luxury rehab, especially at the very high end, might not be the best option.
While there are many bodies around the world that offer practice guidelines and regulation on medical treatment, they tend to broadly agree on what effective treatment looks like. While this changes and adapts in light of new research, the treatment model is largely settled.
Good rehab, therefore, is likely to look the same regardless of location. It will tend to have an inpatient stay, which will cover the detox period and the start of recovery. This will provide the foundation of recovery, getting the patient’s system drug-free and past the initial withdrawal and cravings. This will be followed by tapering support afterwards, during which the client can adapt to normal life, gradually becoming more self-reliant. The National Institute on Drug Abuse’s research suggests that for most people, these should total at least 90 days.
And through both periods, therapy will be an integral part of the process, with a combination of individual and group sessions the most effective, allowing the client to understand their addiction on a personal level as well as gaining additional perspective and support from the group. And, underpinning this, both periods should be supported by addiction professionals who are working together in a multi-disciplinary team.
Arguably, this might suggest model like Rósglas’s individual treatment might not be the best, since it lacks any group work, may miss out on the benefits of not having a consistent team (they will assemble available therapists and a luxury property when they have a client), and with no permanent facility, ongoing support, if it can be afforded, may lack consistency.
Is luxury rehab best?
The best rehab is the one that works. There are many factors that will contribute to that, but luxury is unlikely to be one of them, and in may even come with disadvantages that create barriers to recovery.
The first and most important step in recovery is accepting the need for help. The choice of rehab that follows that should be guided by therapeutic need. It might be nice to have a maid, but if it means a rehab where valuable group work is not possible, or aftercare is unaffordable, then the price for that luxury is probably not worth paying.
Luxury is nice for a holiday, but when it’s for rehab, it should come second to recovery.