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Should Couples Go to Rehab Together?

Your addiction can become a focal point of your habits, your finances, and the time you spend together as a couple. Separating your love from your drug abuse is hard work, and it is easier to do that job together. That’s why when it comes to rehab, couples should stick together.

But why haven’t you heard of couples rehab before?

This form of treatment is relatively new. While research suggests it is effective, it has not been pulled into the mainstream quite yet. Also, it is not the right treatment for all couples and all addictions.

Is it right for you?

Let’s dig into the background, the theory, and the research about this type of rehab, so you’ll know if this is the best option for you.

Addictions Can Twist Relationships 

Marriage is typically associated with good health, and it’s not unusual for married couples to have healthier habits than their single counterparts. For example, research suggests that couples are much more likely to meet reasonable drinking standards compared to singles. But couples can also reinforce one another’s addiction.

It’s a bit like peer pressure. Couples spend the majority of their free time together. They share a household, a budget, and a schedule. When one partner builds addiction into that lifestyle, it’s easy for the other to join in. In some ways, sharing an addiction makes life easier.

When one partner uses and the other does not, fights are common. That conflict can even reinforce the addiction.
One person uses, the other grows angry, the user takes in more substances to soothe pain from the fight, and the cycle continues. For some couples, the only way out involves joining in. 

Couples Therapy Breaks Down Habits 

Couples must eliminate shared habits that spark substance abuse to recover successfully. But they must also create a safe space for their new, sober relationship. Couples therapy can help with both goals.

The early days of the recovery process can be traumatic. Couples may have years of resentments built up during the time in which they both used substances. They may not have the skills to help them work through those conflicts.
Without the help of a therapist, their time together can be stressful, and that can function as a relapse trigger.

In couples therapy, the two have a chance to work through those resentments and develop a new relationship built on sobriety. Therapists also use a technique called “Rituals of Connection” to help create predictability even during stressful times (like holidays). Rather than celebrating an evening happy hour, for example, couples might read together.

In private, individual therapy, people may also develop habits and rituals. But a couple must then come together to share notes. They must debate about which approach or idea might be right to incorporate into their lifestyle.
It’s an inefficient system that involves a lot of negotiation — which people may not be willing to do early in recovery. Couples therapy skips that middle step.

Therapy can also help people to break down the habits they use to support the other’s addiction. In a groundbreaking study from 2006, researchers found that couples with addiction work as co-conspirators:

  • They build drugs into the budget.
  • They purchase drugs together for household use.
  • They deliver drugs when one partner is in withdrawal.
  • They cover up drug consequences to keep the household running.

These couples want the love and security associated with marriage. But they consider drugs an integral part of getting what they want.

Therapy can help couples learn how to care for one another — and how to reach a common goal — without the use of drugs. When couples work together, one partner isn’t vilified. They’re treated as one organism: a family. 

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Couples Rehab: Step by Step 

Both partners may share an addiction, and they’re united as a family. But they’re also individuals with different bodies and metabolisms and histories. That means couples may spend a bit of time apart before they come together to address the issue.

Detoxification starts the recovery process, and it involves allowing the body to grow accustomed to the lack of drugs. This is a personal process, and it’s deeply connected to your overall physical health. You may need to complete this process independently, and then connect with your partner when you’ve achieved sobriety.

When you’re ready to move on to rehab, you can choose from:

  • Residential facilities, in which you live with your partner in a treatment facility
  • Outpatient programs, where you live at home and get treatment in appointments
  • Intensive outpatient programs, in which you spend most of every day addressing your addiction while you continue to live at home

No matter what model you choose, couples therapy can direct your treatment program. During your sessions, you’ll work on a recovery contract. You’ll reaffirm your decision to stay sober, you’ll work through your difficult past, and you’ll build your communication skills. Through it all, you will support and be supported by your partner.

You may use a calendar to record the completion of:

  • Trust discussions, in which you talk about your desire to stay sober that day, and you promise to support one another that day.
  • Recovery activities as a couple including taking medications and going to support group meetings.

You may have independent work to do. For example, you may have an underlying depression issue that your partner doesn’t share. You may need medications for your depression and therapy for that issue, while your partner does not.

Typically, however, your focus involves trusting and supporting your partner as you work together toward recovery.

Does Couples Rehab Work?

Yes, it does. Researchers have examined this type of treatment, and they found that couples that get treatment together recover just as well as pairs with only one partner that has an addiction. In other words, if you get treatment together, you’ll do just as well as you would if only one of you had the problem. Even though you have twice the issue, you’ll recover at the same rate.

It’s important to note that relapse is a part of the recovery process.

When you lapse back to drugs or alcohol, it doesn’t mean your treatment didn’t work. Instead, this slip helps you identify issues you need to keep working on in your recovery.

When you’ve both been through rehab, you’re likely to know one another’s relapse risks intimately.

Your partner can help you to make a course correction before you slide back into regular use. Your work done in therapy can help you both perform as recovery coaches.

How to Find a Program 

Both your partner and you have opinions about what’s best for your recovery. You’ll need to do your shopping together, and you’ll need to agree on one provider to help you recover. There are a few crucial points to keep in mind as you search.

When choosing an addiction treatment program, you should consider:

  • Your mental health. Do you or your partner have another mental health condition? Depression, eating disorders, anxiety, PTSD, and other mental health challenges can complicate your recovery. You’ll need a program that can treat these health issues too.
  • Insurance coverage. If you’re planning to lean on health insurance to pay for care, you’ll need to work with a company that is connected to your plan. Not all addiction providers are
  • Your budget. Even with insurance, you may have copayments to tackle. Make sure you can afford the program that appeals to you
  • Your environment. Can you stay sober while living at home, or is a residential program right for you?

Take your decision seriously, but don’t let it delay your recovery. Motivation to get sober can wax and wane, and if you wait too long, you might lapse back into bad habits together.

Your partner can be your best asset as you work toward recovery. You may emerge from your program feeling healthier, more connected, and more likely to spend the rest of your lives together in happiness.

Sources

(February 2018). Do Singles or Couples Live Healthier Lifestyles? Trends in Queensland Between 2005-2014. PLOS One. Retrieved February 2019 from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192584

Substance Abuse and Intimate Relationships. American Association for Marriage and Family Therapy. Retrieved February 2019 from https://www.aamft.org/Consumer_Updates/Substance_Abuse_and_Intimate_Relationships.aspx

(May 2018). Can Couples Recover from Addiction Together? An Interview with Dr. Robert Navarra. The Gottman Institute. Retrieved February 2019 from https://www.gottman.com/blog/addiction-interview-robert-navarra/

(February 2006). I Love You … And Heroin: Care and Collusion Among Drug-Using Couples. Substance Abuse Treatment, Prevention, and Policy. Retrieved February 2019 from https://www.researchgate.net/publication/7059359_I_love_you_and_heroin_Care_and_collusion_among_drug-using_couples

(January 2012). Behavioral Couples Therapy When Both Partners Have a Current Alcohol Use Disorder. Alcohol Treatment Quarterly. Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3524982/

(December 2014). A Randomized Clinical Trial of Behavioral Couples Therapy Versus Individually Based Treatment for Women With Alcohol Dependence. Journal of Consulting and Clinical Psychology. Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/pubmed/25045910

(September 2017). Finding the Right Addiction Treatment Program. American Academy of Family Physicians. Retrieved February 2019 from https://familydoctor.org/finding-right-addiction-treatment-program/

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