Hey Lindsay Lohan, Here’s What Really Happens in Rehab!

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Actress Lindsay Lohan is headed to rehab again, this time as part of a plea bargain for lying to authorities about a car crash last summer and for breaking her probation from a previous offense. The deal keeps the 26-year-old actress out of jail but requires a 90-day stint at what the press is calling a “locked-down rehabilitation facility.” It will be her sixth visit to rehab.

While we all have notions of what residential rehab is like based on movies like Sandra Bullock’s 28 Days and Michael Keaton’s Clean & Sober, here’s what experts say is the real story:

It’s not all high thread-count sheets and views of the beach
Lohan gets to choose where she rehabs and depending on where she goes it could be posh or it could be dorm-like, says Anne M. Fletcher, RD, who visited 15 rehab centers for her book Inside Rehab: The Surprising Truth About Addiction Treatment – And How to Get Help that Works. In her visits to several facilities that have a “celeb rehab” reputation, Fletcher found that some do give celebs preferential treatment but most do not.  “I have reason to believe that many celebs get the same kind of addiction treatment as other people—a one size-fits all disease-model 12-step-based treatment program,” she says.

Of course, some rehab facilities are luxurious—think Promises Malibu (where reports say Lohan did rehab in 2007)— but they’re typically not “fun places,” says Julie de Azevedo Hanks, who has worked with clients with addictions. “It’s not all ‘Let’s go lie out by the pool.’ Lindsay is going to have to show up physically and do the group therapy and the classes.” It’s likely she’ll be getting up and going to bed on a schedule (and a lot earlier than she’s used to!).

Rehab is not a “Get Out of Jail Free” card
“I think sometimes celebs and other famous people go to rehab because it’s what you do when you’ve been ‘naughty,’” says Fletcher. But using addiction treatment as a punishment is unfortunate and ineffective, she says.

Like serial rehabber Lohan, going to a treatment center may keep them out of jail in the short term, but it won’t necessarily get them well, says Fletcher: Checking in because of a crisis (i.e. a looming jail sentence!) is not the same as checking in because you’ve decided to quit using drugs or alcohol. That’s, in part, why some facilities go posh: They want to get their client-in-crisis to at least stay long enough to see the value in a life free from drugs or alcohol, David Sack, MD, CEO of Elements Behavioral Health, the company that owns Promises, told Fletcher.

Residential rehab isn’t for everybody
People always ask, why are celebs going in and out of rehab? The answer is that serious drug and alcohol use disorders are chronic conditions, just like diabetes, heart disease, or other mental health disorders like depression, says Fletcher.

“These conditions warrant on-going care—not short-term bursts of treatment. It makes more sense for people with drug and alcohol addictions to have on-going relationships with specialists whom they can see on an on-going basis—increasing the intensity of care when they need it, and decreasing it when things are going well,” she says. “Removing people from reality in a residential setting, where they are not learning how to deal with everyday life, is not the solution for most people, according to many experts I interviewed for my book.”

That’s probably why Lohan is also required to have 18 months of psychotherapy after her 90-day rehab stint.

Locked down doesn’t always mean locked up  
If you’re thinking rehab is like prison, think again. Lockdown can mean a lot of different things but it doesn’t mean barbed wire topped walls. In Lohan’s case, it means that on her sixth visit to rehab she doesn’t have day passes, as she’s had in the past. It may be that she won’t be able to have visitors either, says Julie Hanks. “Nobody’s going to be rehabilitated unless they want to,” Hanks says, “but it looks like the sentence is trying to put barriers in Lindsay’s self-destructive path.”

So what happens if Lohan leaves before her 90 days are up? No prison alarms will go off but the facility is required to report her departure to authorities and that means she’ll be back in court—and maybe real jail—soon.

Will Lindsay Lohan stay in rehab? Do you think celebs get preferential treatment in rehab?

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