Residential rehabilitation: literature review

Reviews the existing evidence from the Scottish, wider UK and international literatures pertaining to various aspects of residential rehabilitation as well as identifying research gaps. Part of a wider suite of research exploring residential rehabilitation across Scotland.

2. Methodology

A review of literature regarding residential rehabilitation was undertaken. Literature which fulfilled the following criteria was searched for:

  • research with a date of publication between 2001 and 2021;
  • publications in English;
  • systematic reviews, evidence reviews, literature reviews and journal articles; grey literature such as theses, government reports and guidance documents;
  • research which placed focus on;
    • effectiveness of residential rehabilitation in improving outcomes across substance use and other life domains;
    • evidence and outcomes relating to a range of residential programmes such as residential facilities, stabilisation services, day programmes and therapeutic communities;
    • comparisons of residential rehabilitation outcomes with other treatment modalities;
    • best practice for aspects of residential rehabilitation relating to candidate selection, assessment, detoxification, programme length and structure, approaches to abstinence, and continuity of care;
    • cost effectiveness of residential rehabilitation;
    • and experiences and perspectives of people who have accessed residential rehabilitation.

Initial search was undertaken through Google Scholar. A number of keywords were used, which included, but were not limited to "residential rehabilitation" "residential rehab" "rehab" "Therapeutic Communit(y/ies)" "12-Step"; "preparatory care"; "continuing care"; "aftercare". From the literature which was found through this initial approach, including systematic reviews, were then used to identify further literature. Academics published in the field were also contacted in order to identify relevant literature. A meta-analytical approach was undertaken alongside a thorough literature search. As well as a thorough search of the primary literature, this involved drawing out pertinent themes from previous literature reviews, including systematic reviews.

The focus of the review was in determining what is known in the Scottish and international contexts, and what remains to be better understood through research within the Scottish context. Due to the non-systematic nature of this review, it is acknowledged that some relevant literature may be missing; particularly from across the international literature. In identifying and reviewing a wide evidence base, inclusivity was prioritised, with randomised, non-randomised and qualitative studies included. It is therefore acknowledged that the quality of studies varies, which has been noted where applicable. Further, it must be noted that an in-depth review of the literature and evidence base pertaining to specific components of residential rehabilitation programmes (including aspects such as cognitive behavioural therapy (CBT), motivational interviewing, and individual and group therapy) or of aftercare (including aspects such as involvement in Lived Experience Recovery Organisations) are outwith the scope of this review. Services specialising in detoxification or stabilisation are similarly beyond the scope of the review. It must also be noted that the different contexts surrounding residential rehabilitation internationally will affect pathways into, through and out of rehab, the socioeconomic and demographic make-up of those attending rehab, and outcomes across a broad range of domains.



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