Private rehab vs. State Funded Rehab

Private rehab vs. State Funded Rehab

The term “rehab” is short for the word rehabilitation and refers to a facility that offers treatment for drug abuse and addiction. Rehab sometimes includes a medical detox program that serves the purpose of helping alcohol- and drug-dependent people to ease completely off substances with less discomfort than going cold turkey, or stopping abruptly.  Another part of rehab is the inpatient program. This part of treatment involves therapy that addresses drug addiction behaviors and coping mechanisms to utilize in a sober lifestyle.


There are two types of rehabs: private rehab and state funded rehab. The main difference between these is the way in which the programs are funded.

Private rehab provides services by being funded either by out-of-pocket payment by the patient or by the patient’s health insurance plan. If you have private insurance through your employer or through your spouse’s or another family member’s employer, then more than likely you can attend a private rehab that is in-network with that plan and only have to pay a deductible, if the plan requires it. Some plans do not even have a deductible in which case you can attend a private rehab with no out-of-pocket cost to you.

State funded rehab is just that: its services are able to exist and be provided to those who cannot afford to pay for rehab or who do not have insurance with support of state funding through tax revenue and/or grants.

Services and Amenities

Another way in which private rehab and state funded rehab differs is in the quality and extent of the services that they provide.

Usually, private rehab offers many more amenities that can make your stay more comfortable. A private rehab provides a resort-like atmosphere with some “extras” besides room, board, and therapy. Oftentimes, they offer spa experiences, yoga, meditation, massage, acupuncture, chiropractic adjustments and so on.

State funded rehab provides adequate services that can help anyone get sober who is willing to do the work. It may not be as cushy as private rehab but it is sufficient and meets high standards of quality of care.

Types of Therapy

Both private rehab and state funded rehab offers therapy for substance abuse and addiction however, the type and intensity of the therapy differ between the two.

Private rehab offers alternative and holistic therapies such as Native American sweat lodges, music and art therapy, hypnotherapy, massage therapy, to name only a few. Private rehab also offers the industry standard of cognitive behavioral therapies in both one-on-one and group sessions.

State funded rehab also offer the widely accepted therapy approaches for substance abuse and addiction but often therapy sessions are in group settings because of funding and the growing demand for treatment by more and more people.


Other Considerations: Private Rehab vs. State Funded Rehab

You must be careful to do your research when considering a private rehab. Just because it is private does not mean that it is legitimate or accredited.

Because they must answer to state government and therefore taxpayers, state funded rehabs are strictly regulated. With state funded rehabs, at least you can be sure that treatment is uniform and meets industry standards.






Exposure therapy in addiction treatment

Exposure therapy in addiction treatment

Exposure therapy is a specific type of cognitive-behavioral psychotherapy technique that is often used in the treatment of PTSD and phobias, but exposure therapy is also used in addiction treatment. Exposure therapy in addiction treatment works the same way it does when it is used to treat PTSD and phobias.

Exposure therapy in addiction treatment, just like when it is used for patients with PTSD, is intended to help the patient face and gain control of their addiction. The way exposure therapy in addiction treatment does this is by literally exposing the addict or alcoholic to certain fears, triggers, traumas and stressors. Exposure therapy is done carefully so as not to flood the patient but rather build up to the most severe stressors. The point of this exposure therapy is to desensitize the addict or alcoholic to potential stressors and triggers.

There are many studies that point towards alcoholics and addicts having automatic responses to cues such as seeing as alcohol or places they may have used. Much like when someone who is hungry sees food wants to eat they believe that the alcoholic responds to alcohol in the same way. So in order to combat this exposure therapy in addiction treatment, literally exposes the alcoholic to cues that would normally create a response or want to drink in the alcoholic and gives the alcoholic or addict coping methods or techniques to use to combat and eventually no longer respond in the old way they used to.

Exposure therapy in addiction treatment is a very new concept that doesn’t have a lot of proof of effectiveness to back it up. The rates of relapse after someone has been through exposure therapy have not been studied. While exposure therapy for PTSD has been effective for the treatment of trauma and stress there has been no proof that it will work in addiction treatment. In fact, exposure therapy in addiction treatment could end up having the opposite effect, instead of helping actually hurting the alcoholic.

In one study this is what they had to say about exposure therapy in addiction treatment:

“There continues to be little evidence for the superior efficacy of Cue Exposure Therapy (CET) over other forms of substance abuse treatment. However, it should be emphasized that the efficacy trials did not find CET to be ineffective; indeed CET subjects improved significantly from baseline, though these improvements did not differ from the other active treatment conditions.”

And of course there are all the other problems that anyone who is in the addiction treatment field knows: “Studies investigating Cue Exposure Therapy continue to be challenged by a number of methodological problems, including small sample sizes, high dropout rates, lack of objective measures of substance use and lack of procedures for preventing substance use between extinction sessions.”

The truth about addiction and alcoholism most likely is that any kind of addiction treatment is better than no treatment at all. But when it comes to treating alcoholism and addiction, in my opinion, how can you possibly expect an alcoholic to want to stop drinking by exposing them to things that make them want to drink; even with the better tools to cope with it etc.


Dialectical Behavioral Therapy for Addiction

Dialectical Behavioral Therapy for Addiction 

Dialectical Behavioral Therapy for Addiction (DBT) is a comprehensive treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. It combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. Research indicates that DBT is effective in treating patients who present varied symptoms and behaviors associated with mood disorders, including self-injury. Recent work suggests its effectiveness for treating chemical dependency.

When dialectical behavioral therapy for addiction is successful, the patient learns to envision, articulate, pursue, and sustain goals that are independent of his or her history of out-of-control behavior, including substance abuse, and is better able to grapple with life’s ordinary problems. The fundamental principle of DBT is to create a dynamic that promotes two opposed goals for patients: change and acceptance.

The treatment includes five essential functions:

  • improving patient motivation to change
  • enhancing patient capabilities
  • generalizing new behaviors
  • structuring the environment
  • enhancing therapist capability and motivation

History of Dialectical Behavioral Therapy

DBT was initially used as the standard behavioral therapy of the 1970s to treat chronically suicidal individuals. Subsequently, Dialectical Behavioral Therapy for Addiction was adapted for use with individuals with both severe substance use disorder (SUD) and borderline personality disorder (BPD), one of the most common dual diagnoses in cases of addiction. DBT includes explicit strategies for overcoming some of the most difficult problems that complicate treatment of both conditions.

Dialectical Behavioral Therapy for Addiction

The ultimate goal in dialectical behavior therapy for addiction is to aid patients in their efforts to build a life worth living. When DBT is successful, the patient learns to envision, articulate, pursue, and sustain goals that are independent of his or her history of out-of-control behavior, including substance abuse, and is better able to grapple with life’s ordinary problems.

The all-encompassing embrace of both acceptance and change in dialectical behavior therapy for addiction is consistent with the philosophical approach found in Twelve-Step programs, expressed in the Serenity Prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

Like other behavioral approaches, DBT addresses the most detrimental to the least detrimental behaviors in that order. This is used to decrease behaviors that are imminently life-threatening (e.g., suicidal or homicidal); for substance-dependent individuals, substance abuse is considered the most important target within the category of behaviors that interfere with quality of life. Dialectical behavioral therapy for addiction targets include:

  • decreasing abuse of substances (both illicit drugs and legally prescribed drugs taken in a manner not prescribed);
  • alleviating physical discomfort associated with abstinence and/or withdrawal;
  • diminishing urges, cravings, and temptations to abuse;
  • avoiding people, places, and things associated with drug abuse, deleting the telephone numbers of drug contacts, getting a new phone number, and throwing away drug paraphernalia;
  • reducing behaviors that encourage drug abuse;
  • increasing reinforcement of healthy behaviors, such as making new friends, rekindling old friendships, pursuing social/vocational activities, and seeking environments that support abstinence




History of Therapy: Albert Ellis

History of Therapy: Albert Ellis

Albert Ellis, Ph.D., was born in Pittsburgh, PA on September 27, 1913 and was raised in New York City. He held an M.A. and Ph.D. in clinical psychology from Columbia University. Albert Ellis held many important psychological positions that included: Chief psychologist of the State of New Jersey and professorships at Rutgers and other universities. More importantly, Albert Ellis was the founder of Rational Emotive Behavior Therapy (REBT), the first of the now popular Cognitive Behavioral Therapies (CBT).

In 1954, Ellis began teaching his new techniques to other therapists, and by 1957, he formally set forth the first cognitive behavior therapy by proposing that therapists help people adjust their thinking and behavior as the treatment for emotional and behavioral problems. Two years later, Ellis published ‘How to Live with a Neurotic’, which elaborated on his new method.

Albert Ellis established the Albert Ellis Institute in 1959. The Albert Ellis Institute is a non-profit organization whose mission was to promote Rational Emotive Behavior Therapy as a educative and preventative theory. The Albert Ellis Institute promoted Rational Behavioral Therapy’s practice and theory through training professionals and the public. Initially Albert Ellis ran everything from his own private practice as a psychologist. Then Albert Ellis purchased a six story townhouse in Manhattan in 1964. He took that town house that had previously been occupied by The Woodrow Wilson Institute and used it for his work. Albert Ellis donated the earnings of his books to purchase the building and to fund the running costs of the Institute.

Albert Ellis practiced psychotherapy, marriage and family counseling as well as sex therapy for over sixty years at the Psychological Center of the Institute in New York. Albert Ellis also served as president of the Division of Consulting Psychology of the American Psychological Association and of the Society for the Scientific Study of Sexuality. He also served as officer of several profession societies including the American Association of Marital and Family Therapy, the American Academy of Psychotherapists, and the American Association of Sex Educators, Counselors, and Therapists.

Albert Ellis was ranked one of the most influential psychologists by both American and Canadian psychologists and counselors. He also served as consulting or associate editor of many scientific journals. He published more than eight hundred scientific papers and more than two hundred audio and video cassettes. 

During his final years he collaborated with Michael S. Abrams, Ph.D., on his only college textbook Personality Theories: Critical Perspectives. Albert Ellis also wrote an autobiography entitled “All Out!” published by Prometheus Books in June 2010. The book was dedicated to and contributed by his wife Dr. Debbie Ellis who Ellis described as “The greatest love of my whole life, my whole life”. He also entrusted the legacy of REBT to her. In early 2011, the book Rational Emotive Behavior Therapy by Dr. Albert Ellis and his wife Dr. Debbie Ellis was released by the American Psychological Association. The book explains the essentials of the theory of REBT and is considered an excellent basic guide in understanding the REBT approach for students and practitioners of psychology as well as for the general public.


Schema Therapy

Schema Therapy


Schema Therapy

Schema therapy is better known as Schema-Focused Cognitive Therapy. Schema therapy is a mix of the best parts of cognitive-behavioral therapy, experiential, interpersonal and psychoanalytic therapies into one. Schema therapy is good for helping people change negative patterns that they have learned.

Schema therapy was developed by Dr. Jeff Young, who worked closely with the founder of cognitive therapy. In working on people with cognitive therapy he realized that not everyone was benefiting from the normal approach. What he realized was the people who weren’t benefiting from the normal approach had long-term patterns or themes in thinking, feeling, behaving and coping that required something different. So he turned his attention towards helping to change the deeper patterns or themes which are also known as “schemas” or “life traps”. We view the world through our schemas. Schemas are important beliefs and feelings about oneself and the environment which the individual accepts without question.

So the whole point of schema therapy is to focus on schemas that don’t go away and are self-defeating patterns that typically began early in life. The schemas, or patterns, are made up of negative or dysfunctional feelings such as “I am a failure”, “I am not important”, “I am unlovable” etc. Most of the time these schemas are developed early in life during childhood and teen years but schemas can also develop in adulthood. What schema therapy is trying to do is to break the negative patterns of thinking, feeling, and behaving and create healthier things to replace them with.

Schema therapy is broken down into three stages.

  • The first stage of schema therapy is the assessment phase. During this stage schemas are merely identified after a few initial sessions with a therapist. Quizzes and talks can and may be used to get a good idea of what patterns are going on.
  • The second stage of schema therapy consists of emotional awareness and experience. The second stage is when patients get in touch with their schemas and learn how to spot them when they are going about their daily life.
  • The third stage of schema therapy is the actual behavioral change. During the third stage of schema therapy the patient becomes very involved with replacing their negative thoughts, feelings, and actions with the new healthy and more positive ones.

Here are some concrete examples of what schema therapy can help with and what a “Schema” is:

Abandonment or Instability – The belief that those who support them are unstable or unreliable. Believes that significant others won’t be able to support them due to imminent death.

Mistrust or Abuse – The expectation that others will hurt, abuse, humiliate, lie, cheat or manipulate.

Emotional Deprivation  -Expectation that one’s desire for emotional support will not be adequately met,

Defectiveness or Shame – The feeling that one is bad, unwanted, inferior, or invalid in important things. That one is unlovable. Shame around their flaws.

Social isolation or Alienation -The feeling that one is isolated from the rest of the world or different from people.

Enmeshment or Undeveloped Self-Excessive emotional involvement and closeness with one or more significant others at the expense of losing themselves. They often believe they cannot survive or be happy without constant support from the other.

Failure – The belief that one has failed, will inevitably fail, or is fundamentally inadequate to one’s peers. Often believes that they are stupid, inept, untalented, ignorant, and less successful than others.

These are just a few examples of schemas. There are many more that schema therapy can help with.



Why Therapy Works

Many studies have shown that therapy works in healing the mind and body. It improves social functioning, decreases depression and anxiety, and increases general satisfaction with life. Whether you are seeking therapy for emotional distress, anxiety, marital strife, fears, a significant loss, or a clinical disorder, therapy has been shown to work.

Part of why therapy works is that it addresses our needs as human beings to talk to someone about our problems. Humans want to relate and be validated by others, and talk therapy gives us the opportunity to do this. Scientifically, interpersonal relationships (relationships with others) have been shown to affect the structure and function of the brain. Interacting with others affects our moods, behaviors, and reactions. Isolated individuals have been shown to have negative behavioral and emotional effects as a result of their lack of relationships. Humans need to have interpersonal relationships. It is part of how we operate. We are social creatures.  One of the reasons why therapy works is that it gives us that interpersonal interaction that we crave.

Another reason why therapy works is it allows us to examine our cognition, which is the way we think. Often the way we think about certain behaviors or situations is influenced by our past and our environment. Certain family aspects play a part in how we think, as do experiences and trauma. Sometimes we have automatic thoughts that cause anxiety, fear, and other negative emotions. Therapy works by having us examine the way we think and how we can change the way we think. It allows us to recognize negative cognitions and their effects, which can help us change them.

A third reason why therapy works is that it allows you to look inside yourself. Insight that comes from introspection allows you to change old patterns of behavior. Outside of therapy, few people take the time to really think about the way they behave. Practicing awareness or mindfulness is a big part of why therapy works. The practice of mindfulness has been shown to increase overall happiness. It also allows the patient to recognize core experiences. An example of a core experience is a person that was not shown physical affection as a child. They may develop a core belief that it is not safe to allow physical intimacy. Mindfulness allows them to connect with the core experience and recognize the way that it has shaped their life in the present. When we are truly connected with a core experience, we begin to change the way we think about situations as a result of that core experience.

These are the core reasons why therapy works, but therapy can work for an individual for a myriad of reasons. It can build trust for a person who is lacking it. Therapy can give people suffering a relationship problem an outside perspective that can be invaluable. It can help an anti-social child the opportunity to come out of his or her shell and connect with someone. Whatever the reasons why therapy works, it is certain that it does, in fact, work.

Cognitive Behavioral Therapy for Insomnia


Insomnia affects millions of people every year. Insomnia is most often thought of as both a sign and a symptom that can accompany several sleep, medical, and psychiatric disorders, characterized by persistent difficulty falling asleep and or difficulty staying asleep or sleep of poor quality. The inability to sleep can impact your overall physical health, as well as your mental state. Chronic insomnia can contribute to health problems such as heart disease, high blood pressure, and diabetes. Cognitive behavioral therapy is the only proven treatment for insomnia besides medication.

There are different types of insomnia based upon how long the period of insomnia lasts. Transient insomnia is classified as insomnia lasting less than a week. Acute insomnia is difficulty falling asleep or staying asleep for less than a month. Chronic insomnia is insomnia lasting more than a month.

Cognitive behavioral therapy focuses on changing sleep patterns and behaviors to improve sleep habits. Cognitive behavioral therapy also works to change your ideas about sleeping and insomnia. It includes sleep education-learning about the different cycles of sleep and the importance of each cycle. The sleep education portion of cognitive behavioral therapy also involves learning how beliefs, behaviors and outside factors can affect your sleep.

Cognitive behavioral therapy also includes psychotherapy and cognitive control. In this part of cognitive behavioral therapy, an individual addresses and learns to control negative thoughts and influences that may be affecting sleep.

An important part of cognitive behavioral therapy for insomnia is sleep restriction. This portion of cognitive behavioral therapy teaches a person good sleeping habits. Good sleeping habits include having a regular bed time and wake time every day, cutting out caffeine after a certain time, and eliminating naps from your schedule. Also, cognitive behavioral therapy teaches you how to design and eliminate a bed time routine. A bed time routine includes creating a calm relaxing environment to sleep in and activities to relax you before you go to bed, such as bathing or listening to music.

Usually, to understand how to best treat your insomnia, your sleep therapist may have you keep a detailed sleep diary for one to two weeks. You will record your sleeping patterns, such as what time you go to sleep, what time you wake up, how long it took you to fall asleep, and whether or not you woke up during the night. Your therapist will examine your sleep diary and determine the next step in cognitive behavioral therapy.