Why Couples Rehab Could Be a Good Idea

Why Couples Rehab Could Be a Good Idea

Authored by Pin Ng PhD

Edited by Hugh Soames

Reviewed by Michael Por, MD

Can Couples Go To Rehab?

Couples rehab is an opportunity for a couple, who share an addiction or substance misuse problem, to go through the rehab process together. Traditionally, this was avoided, since the conventional view was that addiction was an individual problem best treated without the distraction of a partner. However, modern treatment and therapy recognizes that, although addiction is individual, the problem exists in a dynamic that includes other people1https://journals.sagepub.com/doi/10.1177/1066480716678621.

Couples rehab can, therefore, be beneficial in some cases. When effective, it can help address not just an addiction problem, but help with other problems that might exist in the relationship, and move the couple to a situation in which recovery is more likely.

Why might couples rehab be a good idea?

There are several arguments in favor of couples therapy. One of the most powerful is that can effectively tackle some of the other problems that surround addiction within a relationship, like co-dependency or enabling behaviors. By addressing these as a couple, it helps improve mutual understanding and makes a long-term recovery much more likely.

Couples rehab can also help to address other problems within the relationship2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844162/. These might have been among the causes of the addiction, or a result of the addiction; addiction is frequently linked with communication problems, arguments, and domestic abuse and violence. But whatever the cause, if left unresolved, the problems or behaviors would have harmed the relationship or increased the chances of a relapse.

To work, both partners need to commit to the rehab process. And they need to be committed to their relationship. If the relationship centers purely around the addiction, and has no foundation without it, then individual rehab would be the best option.

Why might couples rehab not be a good idea?

Couples rehab is not right for everyone. The obvious times when it is not suitable are when only one partner is committed to rehab, or the partners lack commitment to each other. However, there are several other factors that would indicate individual treatment would be better.

It might be that the clinical needs of one, or both, partners. For example, a complex co-occurring condition, such as a personality disorder, mean it was best addressed individually.

Ongoing domestic abuse and violence might also make couples rehab inadvisable. Even when both are committed to overcoming this, the difficult detox and withdrawal phases might be triggers for ongoing violence. It might also be that one partner carries physical and mental scars that cannot be healed.

In some cases, where couples rehab is not an option, couples therapy might still be useful. This would involve the partners living separately, perhaps in different quarters or even different facilities, but coming together for therapy sessions.

Finally, even when both partners enter rehab with positive intentions towards each other, it can sometimes result in the failure of a relationship. Addiction changes people, and recovery will change them again. Even if they met before developing addictions one, or even both, partners might find the self-discovery of recovery changes them, leaving them no longer fulfilled by the relationship.

What does couples rehab look like?

In many ways, couples rehab is similar to any other recovery journey. Rehab and recovery is different for everyone, and a facility should create an individualized program that covers their needs of their clients. Couples rehab is, therefore, no different. Each partner will have an individualized program, the key difference from other clients is they will have an element of couples therapy as part of their treatment.

Couples therapy will sit alongside individual and group sessions. The sessions, likely to be behavioral couples therapy (BCT), will address issues like communication, anger and conflict management along with mutual support and accountability. BCT is an evidence-based therapy and, like cognitive behavioral therapy, helps the couple understand the causes of their negative behaviors while also developing coping strategies to help remain clean after rehab.

According to Philippa Gold, Chief Clinical Officer of Physis Recovery, While the rest of rehab and recovery will look very similar to an individual journey. Couples may find that there are some benefits in undergoing it together. The process will create a shared experience, which might enrich their relationship. Indeed, some of the additional activities that are often available in rehab, such as art therapy or yoga, might have additional meaning as a shared activity they can continue during recovery.

What happens after rehab?

Although couples will have the benefit of each other — and they will have a profound understanding of the journey their partner has been on — aftercare will be just as important for them as it is for any recovering addict. Relapse is still a possibility, and in just the same way as couples might support each other to stay clean, there is the risk that should one partner relapse, it will be a trigger for the other partner to relapse too.

Aftercare will, therefore, continue. This will usually include the continuation of therapy with the facility and membership of a twelve-step group or something similar. This might be a substance-based support group, but in some areas there may also be a recovering couples anonymous group.

Is couples rehab the best option?

Even if couples rehab is a possibility, there is still some debate whether it’s the best option. Although there may be benefits to the mutual support, it can carry risk. There is some argument that makes recovery more complex and difficult, since it can mean that each addict carries both their own, and their partners’, problems and issues. The couple will need to decide whether couples rehab is the best option for them.

Couples considering the option need to be aware of the risk, and ensure not only that their facility can cope with the potential problems, but that they also feel they both will have the self-awareness, flexibility, and commitment to undertake the journey towards recovery together.

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References: Couples Rehab

  1. Substance Abuse and Mental Health Services Administration (SAMHSA) Improving Cultural Competence. Treatment Improvement Protocol (TIP) Series No. 39. HHS Publication No. (SMA) 05-4006. Rockville, MD: SAMHSA; 2004. p. 1. []
  2. Jeevitha K, Suman LN. Marital relationship, psychological distress and perceived social support among spouses of alcohol dependents. Indian J Clin Psychol. 2010;37:127–135. []
  3. Michel N, Suman LN. Psychological distress, self-esteem and relationship with parents among adult sons of alcoholics. Journal of Psychosoc Res. 2009;4:231–244. []
  4. Anand T. Bangalore: MPhil dissertation submitted to NIMHANS; 2016. Perceptions of self, recovery and future among men with early onset substance use disorders. []
  5. Birchler GR, Fals-Stewart W, O’Farell TJ. Couples rehab for alcohol and drug abuse. In: Gurman AS, Lebow JL, Snyder DK, editors. Clinical handbook of couple therapy. Guilford Publications; 2015. pp. 523–544. []
  6. Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Improvement Protocol (TIP) Series No. 51. HHS Pub. No. (SMA) 09-4426. Rockville, MD: SAMHSA; 2009. Substance abuse treatment: Addressing the specific needs of women; pp. 5–6. []
  7. Hemovich V, Crano W. Family structure and adolescent drug use: An exploration of single-parent families. Subst Use Misuse. 2009;44(14):2099–2113. doi: 10.3109/10826080902858375. []
  8. Burstein M, Stanger C, Dumenci L. Relations between parent psychopathology, family functioning, and adolescent problems in substance-abusing families: Disaggregating the effects of parent gender. Child Psychiatry Hum Dev. 2012;43(4):631–647. doi: 10.1007/s10578-012-0288-z. []
  9. Greenberg, L., & safarn, J. (1987). Emotion in psychotherapy: Affect, cognition and the process of change. New York: Guilford Press. Google Scholar
  10. Johnson, S.M., Bradley, B., Tilley, D.G., Woolley, S.R., & Palmer, G. (2005). Becoming an emotionally focused therapist: The workbook. New York: Brunner-Routledge. Google Scholar
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Summary
Couples Rehab
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Couples Rehab
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In many ways, couples rehab is similar to any other recovery journey. Rehab and recovery is different for everyone, and a facility should create an individualized program that covers their needs of their clients. Couples rehab is, therefore, no different. Each partner will have an individualized program, the key difference from other clients is they will have an element of couples therapy as part of their treatment.
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