The Benefits of a 90 Day Addiction Treatment Programme
The long-term treatment approach at Castle Health is usually referred to as 12-Step facilitation or Minnesota Model. This is a renowned abstinence-based approach introduced in the 1930s in the USA. It is based on the disease concept of addiction and integrates the 12 Step programme principles of Alcoholics Anonymous and Narcotics Anonymous.
Our second-stage treatment programme at Castle Health offers a comprehensive blend of therapies including group and individual therapy, various forms of cognitive behavioural counselling (such as Rational Emotive Behaviour Therapy and Reality Therapy), family therapy and aftercare planning along with life-skills work.
Individual therapy adopts an one to one approach, in which all clients work with a therapist on personalised treatment plans.
All patients also participate in a daily schedule of psycho-educational lectures that deal with recurrent problems such as anger and stress management, assertiveness training and formal instruction on relapse prevention and health promotion.
A high percentage of patients arrive with legal problems, debts and other financial problems. Many are homeless and socially deprived and these issues are addressed through liaison with lawyers, probation officers, housing officers and social services.
To provide continued support, Castle Health programmes offer aftercare group therapy held at Castle Craig, Scotland, Smarmore Castle Clinic in Ireland, Castle Craig Netherlands, Sweden and London. All clients are encouraged to attend at least one of these weekly aftercare group sessions on an ongoing basis for a period of up to two years after completing their residential treatment.
Evidence-Based 90 Day Addiction Treatment Programme
It has been shown that a stay of at least 3 months spent in specialised residential rehab treatment leads to better, overall physical and psychological recovery outcomes, maintained abstinence and an easier reintegration of the patient in his daily work and family life after being treated for their addiction.
Addiction is a primary and chronic disease. That is why successful recovery is a lifelong process. During residential rehab treatment, specialist psychotherapy addresses the far-reaching psychological correlations of addiction.
Three months in specialised addiction treatment is considered by Castle Health experts as the “gold standard” of addiction treatment because it allows the patient the optimal amount of time to restructure their negative thought patterns, learn new coping skills, reset and replace their compulsive behaviours with new, healthy mechanisms. Three months is the agreed minimum time period to recover physically, mentally and socially after struggling with the challenges of addiction.
Below you will find a review of several research papers and in-house outcome studies that supports Castle Health’s stance on 90 day treatment and that prove the effectiveness of long-term, second-stage addiction recovery treatment.
Research Papers Back Longer 90 Day Rehab Treatment
According to a 2017 research in Open Journal of Psychiatry, longer addiction treatment significantly improves patients’ long-term recovery. At follow-up after one year, out of the study sample of 72 patients treated for alcohol and drug addiction, those that participated in longer rehab programmes (over 30 days of treatment) had an84% success rate as opposed to those who underwent a standard 30-day treatment programme and showed a 55% treatment success rate.
“Aftercare is crucial once an individual has completed drug or alcohol treatment and is in recovery. There is a continuity of care that should be followed once initial treatment is completed. Our study shows that the absence of such treatment after 30 days significantly reduces the chances of the patient maintaining their sobriety,” confirms study leader Dr. Akikur Mohammad, of the University of Southern California.
The results of a 2019 joint research paper by the Institute of Neuroscience CSIC-UMH, in Alicante, and the Central Institute of Mental Health of Mannheim, in Germany, show that the damage that alcohol misuse inflicts on neuronal circuits and the changes in the white brain matter continue up to over six weeks after stopping drinking.
This constitutes another strong reason why secondary-stage addiction treatment is recommended after the patient is medically detoxed. The brain does not become receptive to the psychotherapy programme in the first few weeks of abstinence and therefore needs another 4 to 6 weeks of specialised treatment to help the brain recover its normal functioning. There is clear evidence that MRI scans can determine the extent of brain damage in patients suffering from a substance misuse disorder.
For example, if a patient goes through the standard 4-week programme in treatment, then the damage continues after discharge with likely relapse. This further supports our work in providing patients with severe brain damage with the right treatment of Hyperbaric Oxygen Therapy.
Hyperbaric Oxygen Therapy is an innovative type of therapy that helps clear toxins, increases tissue regeneration by intensifying oxygenated blood-flow to damaged tissue and generating new blood vessels, as well as growing stem cell production by 800%, which in turn regenerate damaged tissues in organs affected by alcohol and drug abuse, such as the pancreas, liver and brain.
At the end of 2019, Vista Research Group in the USA published their findings from 3 years of addiction treatment outcomes research after monitoring the progress of more than 23,000 patients attending a wide variety of high-quality substance use disorder treatment facilities. They concluded that “the length of time a patient remains in treatment has a major impact on their ability to remain abstinent post-treatment.” Their studies showed that patients who remained in treatment for more than 90 days were almost twice as likely to be abstinent six months later than those who completed a standard 21 days treatment programme.
Castle Health Extended Treatment Outcomes
We conduct our own treatment outcome studies, which have consistently supported the argument that longer rehab programs give better results.
Oliver Barnes, a psychologist who reviewed our recent outcome studies explains: “Christo Research Systems’s independent study, which was conducted for our clinic Castle Craig in 2007 showed that patients who completed the entire programme, rather than just detox, had a 45% better abstinence rate after 3 to 5 years. Furthermore, Christo’s 2015 study for Castle Craig found that patients who were readmitted for a second attempt at treatment had better outcomes than first-time clients. You could argue from this that repeated, longer term rehab does seem to be more effective.”
Results of our follow-up study on cocaine addicted patients (May 2007)
Our study of cocaine-addicted patients was conducted in 2007 and reviewed questionnaires sent to 89 patients admitted between August 2002 and February 2004 for severe cocaine dependence, and yielded a 75% response rate.
All patients achieved good outcomes despite their high severity of dependence, their severe psychological and physical health problems as well as other issues like previous attendance of numerous out-patient programmes.
The analysis of results showed that:
- 66% of those who completed treatment were totally abstinent from all drugs or alcohol at follow-up (after 3-5 years).
- 46% of those who completed detox (but not necessarily the full treatment programme) were totally abstinent on follow-up.
- 78% of those questioned achieved low-problem severity.
- 84% of those questioned showed a reduction in levels of dysfunction.
- Those patients who entered the long-term treatment programme at Castle Health were significantly more likely to have a good outcome.
- The average treatment duration (16.2 weeks) of the 84 good outcome patients was significantly longer than the average treatment duration (9.9 weeks) of the 57 poor outcome patients.
- Patients completing treatment were significantly more likely to have a good outcome. Future patients who want to quit treatment early should be made aware of these statistics.
Results of our follow-up study over a two-year period (1997-1999)
The study group was composed of 128 males and 78 females, making a total of 206 passing through treatment over a 2-year period between 1997 and 1999. 123 of them were diagnosed as alcohol dependent and 83 were diagnosed as drug addicted.
The profile of patients usually referred to Castle Health second-stage treatment is of a severely dependent group who have undergone previous in-patient and out-patient treatments. 87% of the study group were classified severely dependent, 85% having undergone previous in-patient and out-patient treatments and 75% of the clients had had repeated hospitalisations for alcohol or drug-related problems.
The average length of stay for those who completed treatment was 118 days.
48% of the group of treatment completers maintained unbroken continuous abstinence (from all drugs including alcohol and cannabis) and a further 14% were in a good outcome category abstinent at the time of follow-up. The abstinent and improved outcome figure for this group was 62%. The results, therefore, for this group of clients who completed an average of 17 weeks in extended care are very good.
31% of the total group had achieved continuous unbroken abstinence, and an additional 13% of the total group were classified as in a good outcome category. The overall figure was 44% of abstinent/good outcome. Marked improvement in physical and mental health and quality of life was characteristic of those in this group. 47% of the total group of alcohol-dependent clients were in an abstinent/improved category and 41% of the drug-dependent clients were in an abstinent improved category.
Treatment Effectiveness for Long-Term Treatment
Our studies demonstrate the effectiveness of long-term addiction recovery treatment.
Secondly, it shows that the longer our clients spent in treatment, the better the outcome. 24% of non-completers compared to 62% of those who completed treatment were abstinent at the time of follow-up.
Research has shown that therapeutic communities and other types of residential programmes are effective in reducing drug use, unemployment and antisocial behaviour and length of time spent in treatment is an important predictor of patient outcomes from these programmes
The results for drug misusers i.e. 41% abstinent in the Castle Health study compare favourably with the 2-year outcome figures from NTORS (Bulletin 4), the largest ever UK study of treatment outcomes for drug misusers. This study reported that 37% of clients who had received residential treatment were abstinent from all illicit target drugs at a 2-year follow-up. The NTORS report further concluded “that clients in residential programmes presented with some of the most severe problems and complex needs and these clients made some of the greatest treatment gains”.
For more evidence-based research on why longer treatment produces better recovery rates, please check the information on programme options.