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What is the difference between a faith-based program and others?

The idea of faith-based treatment for alcoholism comes out of the AA movement but is more religiously based and historically Christian in its orientation. Unfortunately, "faith-based" has become a politically charged term, suggesting on the one hand a zealous, narrow-minded approach to care, and on the other an excuse to cut government funding for addiction treatment. This is the work of politicians and not the work of the treatment centers. "Faith-based" programs support an underlying religious belief and commitment to specific doctrinal principals. Faith-based programs do not view addiction problems as simply a crisis of faith that can be remedied just by the word of God alone. Typically, the concept of dual diagnosis is understood, including both the medical and psychiatric co-morbidities, and the need to appropriately treat them. Although the primary goal is addiction treatment, faith-based programs have the ultimate goal of demonstrating the power of the word of God and the power that faith plays in one's life, not just in terms of addiction but also in other aspects of life. "Faith-based" programs are an important option for anyone considering treatment.

Although the primary goal is addiction treatment, faith-based programs have the ultimate goal of demonstrating the power of the word of God and the power that faith plays in one's life, not just in terms of addiction but also in other aspects of life.

Therapeutic communities the environment on an inpatient unit that is developed to be a healthy milieu for staff and patients and that facilitates the development and implementation of treatment.

Does it matter how long I stay in an inpatient program? How successful are they?

Although the evidence demonstrating "treatment" efficacy in alcoholism is overwhelming, the type of treatment or the environment of care remains debated. Any intervention is better than no intervention, but exactly what that intervention should constitute beyond some key elements is unclear. Studies have shown little difference in success rates between outpatient and inpatient rehabilitation programs. The patient placement protocols described in Question 36 help clinicians to determine which care setting will have the greatest chance of success for a particular patient. They outline a general structure and setting with parameters on frequency and intensity of treatment without clearly specifying duration. Regardless of setting, the duration of care clearly improves abstinence rates. It is not clear whether the environment of care (i.e., inpatient versus outpatient) plays a role in that. The two long-term inpatient programs can be divided into residential programs that follow a 12-step model and are generally shorter stay programs and therapeutic communities, which are greater than a year in duration and often expect patients to seek employment as part of their recovery program. Intuitively, it would make sense that the longer one is out of the environment that supported one's addiction the better the chance of success when one eventually returns to that environment.

Unfortunately, no real "geographical cures" are available for those struggling with addiction. Thus, it appears that the critical factor is length of successful treatment rather than length of stay

How successful are the various treatment options?

Regardless of the type, it is well known that treatment works. In fact, in a large California study, it was found that for every $1 invested in treatment, $7 in lost revenue was saved from various illnesses, accidents, hospitalizations, and loss of productivity. In a study on three types of treatments, including cognitive behavior therapy, motivational enhancement therapy, and 12- step facilitation, the number of drinking days over a 12-month follow-up was reduced from a baseline of 78 to approximately 20. The number of hospitalizations for physical health problems, overdoses, and mental health problems was also reduced by as much as 60%, and the number of doctor visits, emergency room visits, and hospital days was reduced by as much as 40%.

A large study of 65,000 patients conducted in 1994 demonstrated that 60% of those who completed treatment maintained sobriety a year later. With respect to AA attendance, of those who attended at least weekly, 73% remained abstinent; of those who attended occasionally, 53% remained abstinent, and of those who dropped out, 44% remained abstinent. Duration clearly had an effect as well; 85% who remain in treatment maintained abstinence. For those who dropped out between 6 and 12 months, 70% maintained abstinence. For those who dropped out in 5 months or less, 55% maintained abstinence. In a random survey of AA members, 35% were sober for more than 5 years, 34% between 1 and 5 years, and 31% for less than a year.

Cognitive behavior therapy a therapeutic intervention that reinforces "positive thinking" and extinguishes "negative thinking" (i.e., changing undesirable cognitive functioning).

Motivational enhancement therapy cognitive interventions are used to enhance the substance abuser's desire to stop using.

Over half of all individuals struggling with alcoholism are also struggling with some other underlying psychiatric disorder.

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