The definition of rehabilitation (Rehabilitation means reinstating functionality) in narcology (as per the recommendations of WHO) this stage follows the initial phase of treatment (detoxification and medicinal treatment) and can include group or individual psychotherapy in various fields, involvement in groups for mutual help, accommodation in therapeutic societies, professional training and involvement in practical work. Rehabilitation activities in modern narcology assumes systematic approach to the development of rehabilitation-treatment process, formation of therapeutic atmosphere and differential therapeutic strategies.

 

During the detoxification process the addict goes through at least 3 problems. First one is the so called post-abstinence syndrome, which emerges as constant insomnia, worsening of mood, irritation, weakness, head aches and others. Second one is the time to time crave for narcotics or alcohol. The third one is the facing of those problems and factors, which brought you to addiction in the first place. Any one of these conditions can bring you to a breakdown. The complex program of treatment and medical rehabilitation used at the BEKHTEREV center enables the patient to develop a strong immunity to the factors pushing to addiction of any kind and at the end of the day lead to full recovery. The BEKHTEREV's medical center is rightfully proud of the used methods, which are based on the global medical achievements and unique experience gained during the 17 years of the center's functionality. The use of latest medications enables to quickly reinstate sleep, better the mood and lower the craving for the item of addiction at the maximum. The unique psycho-therapeutic and training methods make the patient prone to any of the provocative situations and also educate him/her to live a sober life and enjoy it. The individual approach and use of most effective medical technologies enable us to achieve good results in very short time. At the BEKHTEREV center the process of rehabilitation is conducted by the doctors, specializing in narcology, psych-therapy and medical psychology. The individual approach enables us to treat the patients who have just started consumption as well as those who have tried time and over again unsuccessfully to get rid of addiction.

 

The resistance to remission is enhanced if the patient knows the ways and techniques to solve problems or the so called copping strategies: “shift of attention”, “self control” and “discipline” and analysis of addiction triggering mechanisms (triggers).

 

The prime goal of drug addict rehabilitation is the formation of life experience without drugs and the development of resistance to surrounding drug using atmosphere. Therefore it is necessary to conduct the following processes in rehabilitation:

 

To form strong motivation for going through, it is necessary to create the following conditions:

It is generally accepted to divide the rehabilitation process of the narcotics addicts into 3 stages: adaptation, integration and stabilization.

The adaptation stage of rehabilitation is meant to acquaint the drug addicts to the conditions of stay and the regimen of the rehabilitation center.

The integration stage includes the engagement in the rehabilitation program including medical, psychological, psycho-therapeutic and social aspects.

 

The stabilization stage is meant to reinstate and stabilize the physical and psychological condition of the patient.

The accent is turned to the psycho-social aspects of rehabilitation after achieving the basic goals – reinstatement or formation of normal personality of the patient returning him/her to family and society.

 

In our case the adaptation stage prolongs for 2 weeks and the integration stage prolongs for 1 month. At the stabilization stage, after checking the patient out, we conduct individual and group supportive psycho-therapy.

Considering narcotics addiction as bio-psycho-socio-spiritual disturbance, the therapeutic methods used at our clinic are directed to increasing the socio-psychological adaptation of the patient. The refusal of psychotropic elements is considered as the result of deep analysis of the patient's personality and the system of his/her values.

 

In the beginning of the hospital treatment the patient goes through a series of diagnostic procedures. They include the anamnestic interrogation by the narcologist, clinical-therapeutic interview by the clinical psychologist (including life history), check-up by the therapist, neurologist and other experts.

 

The therapy is directed to mobilize resources and develop the patient's personality .i.e. addressed to normal compensatory personality processes. It is characterized not as directory but partner style discussions, development of a dialogue and the maximized use of the effects of group and inter-personal interactivity. The aim of the psycho therapy is to amplify the ability of the patient to face difficulties. The core of the psychotherapy is to first of all help the patient achieve his/her goals, which should be the reliance point for the psychotherapist and the patient. In the course of the intensive therapeutic program each patient gets an individual rehabilitant card, where the necessary stages of training and individual homework are noted.

 

The members of the rehabilitation team define the individual treatment program for each patient. The treatment program is planned individually keeping in mind the abilities and needs and can be altered or amended in the course of the treatment if it seems necessary. This way the patient is involved in different group activities, which gives an opportunity to monitor different aspects of his personality.

In hard cases the patient is invited to a clinical-therapeutic council of therapists comprised of all the staff involved in the treatment of the given patient: professor, key specialists, attending doctors, psychologist, social worker, group psychotherapist and the staff. The patient goes through detailed psychological analysis. All the members of the council file their reports about their view of the problems and the patient's improvement. The resources, strong sides and the potential possibilities are of utmost interest, making up the future prospects of the patient after his discharge. To evaluate the improvements from rehabilitation it is necessary to understand the bogging down in the performance of tasks, constraints, personal reflexes as well as the use of apparent ego (self criticism). The main concerns are: Is the speed of the rehabilitation concurrent with the abilities of the patient? Are there any corrections needed? Is the patient understood in the aspect of the given diagnosis? What hinders the establishment of therapeutic relation between the patient and the members of the therapeutic team? How to personalize the treatment program for the patient?

 

Often the relationship between the patient and the people surrounding him bears immature and conflicting face and is very typical for addicts. Because of this the parents if possible, are also invited to join the council of therapists, because the readiness of the family system to change is and important factor in overruling relapses. On the other hand in case of “non standard patients” the parents must be supplied with detailed information, because the family often pays for treatment. Despite the fact that early exit and the following relapse are more of a rule rather than exception in such programs, the group of experts came to the conclusion that even short term intensive programs are very effective and necessary for most of the patients. Due to the repeating character of addiction, return to therapy is considered as a positive sign of commitment to treatment, because staying with the program in most cases betters the results (In English the word relapse literally means repeated mistake(“another blunder”), therefore it has to be undone).

 

Currently most of the specialists consider that the basis for the narcotics and alcohol addictions is not the self destruction impulse, but the lack of adequate development in the parental family and as a result the destruction of self-defense ability. Therefore family therapy occupies a prominent place in the treatment-rehabilitation process. This solves the problem of pathological codependency of the members of the patient's family, harmonization of family ties and extension of psychological help for the families. It has been noted that in those cases where the family members actively cooperated with the staff of the rehabilitation center, the results for the rehabilitant were a lot better. 

 

At the BEKHTEREV medical center's rehabilitation department the so called “rehabilitation atmosphere” is created. This means that everything from the interior design and daily routine to treatment activities is directed to solve the problem of addiction. Comfortable conditions, benevolent atmosphere, organized recreation and sports activities allow the patients to not feel being at a hospital.