A residential treatment center (RTC), sometimes called a rehab, is a live-in health care facility providing therapy for substance abuse, mental illness, or other behavioral problems.
ADAA has compiled a Q&A flyer based on typical questions from the public that we receive via email or phone regarding the selection of in-patient residential treatment centers.
Please note that there are very few in-patient residential treatment centers that focus on anxiety and depression. Most centers focus on substance abuse. ADAA has compiled a list of those in-patient treatment centers that focus on anxiety disorders and depression.
ADAA also recommends reaching out to support groups, such as ADAA's free online peer-to-peer support group and suggest that you engage your peers for recommendations about a specific facility. There are also therapy and medication options that might be appropriate for you/your family to explore prior to seeking out in-patient residential treatment centers.
We asked two experts about residential treatment for obsessive-compulsive disorder (OCD) and related disorders.
Bradley C. Riemann, PhD (Clinical Director, OCD Center & CBT Services at Rogers Memorial Hospital) and Thröstur Björgvinsson, PhD (Program Director, Houston OCD Program) answered our questions.
What is residential treatment and how is it different from other levels of care?
Residential treatment provides 24-hour staffing, and it is for treatment. Typical lengths of stay are 60 days or more and it is appropriate for someone who is not at risk to him- or herself or others. It is also provided in a homelike environment, which makes residents more comfortable and allows for exposure-treatment opportunities.
Inpatient care is for very acute situations where someone may be considered a risk to him- or herself or others, and the length of stay lasting four or five days is meant to stabilize a mental health crisis.
Dr. Björgvinsson: And partial hospitalization, sometimes called day treatment, typically provides five to six hours of treatment a day, five days a week. Average lengths of stay may be three to four weeks. This level of care can be close to the dosage of treatment someone would get in residential, but it doesn’t provide the 24-hour support or treatment seven days a week.
Is OCD the only thing you treat in these residential programs?
Dr. Björgvinsson: The vast majority of our residents have a primary diagnosis of OCD. However we also treat patients with OC-related disorders such as trichotillomania and body dysmorphic disorder, as well as patients who struggle with severe forms of panic, social anxiety, and other anxiety disorders.
When should a mental health professional, family member, or someone suffering from an anxiety disorder or OCD consider residential treatment?
Dr. Riemann: Typically we look at the severity of the condition and how it affects functioning. And we consider the complexity within the condition itself and other diagnoses that may co-occur with OCD, such as depression, anxiety disorders, and perhaps even some eating-related issues. Co-occurring disorders is the rule in residential treatment. We also look for failed attempts made at outpatient or intensive outpatient treatment. If this describes someone you know, it may be time to look into residential treatment.
What happens after people leave residential treatment?
Dr. Björgvinsson: Usually we place someone in a lower level of care, depending on the individual’s circumstances: partial hospitalization, intensive outpatient, or outpatient services. Our goal is for people to continue treatment to help maintain the gains they made in residential and to re-integrate into their communities.
Dr. Riemann: This is a very important step. Unfortunately it can be hard to find quality services to step down to in some areas of the U.S. Discharge planning starts basically from the day people start residential so we can make sure we connect them with a high-quality provider and at the right dose of treatment.