One of the most frequently asked questions we get here at The GateHouse concerns the distinction between our Residential Treatment programs and our Transitional Living Housing services.
What’s the difference between them? What does “halfway house” mean? What happens at each of these types of services?
While the confusion is understandable, the main difference between the two is that our Residential Treatment program focuses on continuing recovery treatment while re-learning and developing the life-skills necessary to reintegrate into society. Meanwhile, our Transitional Living services focus on putting those skills into practice while continuing to maintain a recovery mindset.
While neither service offers the kind of medically managed treatment that occurs in the first stages of recovery (detox and rehab), those who are on sustained Medical Assisted Treatment (MAT) are welcome in both our residential treatment programs. Those on MAT can coordinate services with any one of the many local medical providers we partner with.
The best way to differentiate between Residential Treatment and Transitional Living is to start at the beginning.
The Recovery Treatment Journey
The first step for an addict entering treatment is to begin with a stay in rehab, where the initial detoxification of addictive substances takes place. This can last anywhere from 28 to 30 days. While there are rehab facilities that have a shortened detox time of only 5 to 10 days, we recommend a longer detox period before entering one of The GateHouse residential programs.
Upon leaving the detox facility, the recovering addict moves into one of our Residential Treatment centers, also known as a “halfway house.” This is where some of the initial confusion occurs. Very often, people unfamiliar with the recovery process will lump residential and transitional living services together as “halfway houses.” This term, however, has been used solely in accordance with Residential Treatment facilities for many years. According to the American Society of Addiction Medicine, the official definition of a halfway house is “a clinically managed, low-intensity residential service.”
Upon meeting the goals laid out at the Residential Treatment program (which we’ll dive into below), the recovering addict then moves into one of our Transitional Recovery Housing facilities. As the name sounds, this is where residents continue practicing the life-skills they learned in Residential Treatment and actively transition back into the community.
What Happens at a Halfway House?
The average stay in one of our Residential Treatment programs is about three to six months and is for people who have undergone primary detox at a rehab facility. During their stay here, residents will start the process of rebuilding their lives in three phases.
In Phase 1, the new resident will meet with his or her counselor on a regular basis, and any medical treatment that’s necessary will be supervised by licensed professionals in coordination with outside medical providers. Residents have access to recreational facilities, but the days are busy with group counseling, one-on-one therapeutic counseling, daily 12-step meetings, life skills training, health and nutrition education, and developing personal goals to help guide the recovery process. During this initial phase, halfway house residents remain at the facility around the clock and are not permitted to leave unless given permission by the staff for very specific reasons.
Phase 2 of Residential Treatment offers a little more freedom—leaving the facility is permitted with a pass, and attending sober groups, finding 12-step meetings, and connecting with sponsors are all encouraged. There is still a lot of work to do in this phase, however. After meeting their goals from Phase 1, residents start working with The GateHouse team to begin developing a healthy daily lifestyle. This includes developing vocational skills and looking for work, preparing for life outside the facility, and identifying and working toward personal goals and priorities.
To get to Phase 3, the resident has to have obtained a job. Residents have a little more freedom than the previous phases, as well. Nevertheless, they must still demonstrate progress, and are asked to continue to meet with peer groups, remain employed, and attend 12-step meetings. One of the most important parts of completing Phase 3 for our halfway house residents is putting together a recovery support system they can access outside of the facility.
The average stay in our Residential Treatment facilities is usually about 90 days due in part to time restrictions put in place by insurance companies. Under certain circumstances, however, longer stays are permitted and may even be covered. The GateHouse team can help with this process.
Transitioning to Transitional Living
Upon leaving Residential Treatment, recovering addicts are typically ready to reside at one of our Transitional Recovery Houses to continue practicing their recovery skills in the community. While it’s ideal for recovering addicts to have first gone through our Residential Treatment program, it is not a requirement. Nevertheless, the benchmarks identified in Phase 3 of Residential Treatment still extend to anyone interested in residing in our Transitional Living Housing.
The most important requirement for Transitional Living is employment and a desire to continue to remain in recovery. You must either have a job upon entering one of our Transitional Recovery Houses or you must have gotten one within two weeks of staying there.
What Happens in Transitional Living?
The first phase of Transitional Living is a two-week orientation period, where your ability to come and go will be restricted. New residents have a 5 o’clock curfew and, as part of the acclimation process, are asked to attend at least one meeting with a housemate.
After the orientation period, The GateHouse team will help you refine the life skills you learned in Residential Treatment. This means putting those life skills into practice, having accountability, and paying rent. This last item is actually very important, because it not only empowers the resident to pay for his or her own recovery process, it also allows them to break free from the insurance safety net. Insurance may still cover other elements of recovery, such as outpatient services, but the goal is to become self-supporting and self-sustaining for the majority of the stay in Transitional Living.
Because insurance is no longer providing financial compensation for recovery housing, Transitional Living residents are encouraged to stay in the program for at least a year. Sometimes residents will earn the privilege of becoming a house manager, and in those cases, they’re allowed to stay in Transitional Recovery Housing for up to 18 months.
Throughout their stay in Transitional Living, residents continue to build a strong foundation for the rest of their lives. They have the time and assistance to work on their recovery support system, and they receive help from staff in developing and working toward short- and long-term goals.
Not only does The GateHouse team help with life skills, coping mechanisms, trigger recognition, and recovery, they also provide assistance with developing a household budget, working through financial challenges and obligations, and rebuilding credit. Residents will set up bank accounts, save money, and even start pursuing a career.
Understanding the Differences
Verlina Velazquez-Millings, our Director of Programs here at The GateHouse, says the dynamic between Residential Treatment and Transitional Living is very complementary. Residential Treatment, she says, is highly structured and more intense than Transitional Living, because residents there are under 24-hour care as they work toward rebuilding their mental and emotional outlook and meeting a set of clearly defined character-building benchmarks.
“The requirement for completion is to work with a sponsor, have a job, develop an aftercare plan, and demonstrate the ability to manage all this while still maintaining a focus on recovery,” she says. “Sustaining ongoing recovery is the absolute priority.”
Lori Fallon, who coordinates our Transitional Recovery Housing program, says the goals in Transitional Living are geared toward maintaining a healthy lifestyle and staying focused on recovery, while also living on their own in a structured environment.
“People in Transitional Living have a lot of freedom,” she says. “Some folks don’t take that well; others do. Either way, we’re here to help them through this important transition as they continue to work toward recovery and building a new life for themselves.”
Exiting the Program
One of the most important things to understand about Transitional Living is that clients need to buy into the program and have a stake in their own success. Counselors and case managers may encourage residents to stay or leave the program depending on their level of readiness.
For the most part, however, the time will come to leave our programs, and when that happens it is often bittersweet, but necessary.