The most involved form of addiction therapy for any type of substance abuse is a thirty to ninety-day inpatient stay at a rehabilitation facility. Unlike day and night programs, which involve daytime treatments and supervised evenings at home, or outpatient programs, which only consist of therapy during morning or afternoon visits, inpatient treatment requires an addict to live at the treatment facility for this entire period. During this time, inpatient alcoholics receive fifty or more hours of intensive therapy per week. This is an intense form of treatment, and those seeking help must understand what awaits them if they choose it.

Detoxification is typically the first step of addiction treatment. In fact, alcoholics are required to detoxify before they can even begin an inpatient program. This phase usually takes place in an off-site medical facility and lasts anywhere from five to fourteen days, depending on the severity and nature of a patient's addiction. Unfortunately for those who relapse, this painful but necessary process tends to take longer with each successive recovery.

While nothing can completely cure a patient's addiction, a successful detoxification will drastically reduce an alcoholic's physical dependency. After getting over the hurdle of the initial withdrawal, alcoholics must engage the challenges of Post Acute Withdrawal Syndrome, or PAWS, during their inpatient treatment. The symptoms of PAWS often cause addicts to relapse, sometimes before their treatment is even complete. To mitigate this risk, alcoholic inpatient centers use one-on-one counseling and occasional medication to cope with memory loss, loss of coordination, depression, and other common PAWS symptoms. Clinicians also use the counseling sessions to explore an alcoholic's addictive behavior patterns and uncover their underlying causes. They then form strategies for dealing with environments, people, and objects which trigger an alcoholic's compulsion to drink.

Another critical component of inpatient treatment for alcoholics is denial management. Unlike the physiological burden of addiction itself, denial is a psychological problem. Addicts in denial make justifications and excuses to convince themselves that they don't actually have a substance abuse problem. In some cases, addicts practice what is called "open denial," a state in which they understand their problem but have no desire to change. Rather than tricking themselves into the belief that they are well, they will simply hide their drinking habits from others to avoid confrontation.

As is often the case during inpatient treatment, clinicians use evidence-based, one-on-one counseling to help alcoholics in denial. However, group and family therapies can also be very successful. It becomes much more difficult for alcoholics to avoid their problems when people who care for them tell stories of the pain and suffering their addictive behaviors have caused.

Reality and cognitive behavioral therapies are also extremely effective during inpatient stays. Reality therapy teaches alcoholics how to recognize the differences between situations they can and cannot control, positively act when they can, and accept their circumstances when they cannot. Cognitive behavioral therapy assists alcoholics in fostering positive and meaningful interpersonal relationships, which are crucial for long-term sobriety.

Overall, alcoholic inpatient programs are highly individual. Though the duration of attendance varies, even a ninety-day stay at a facility is nothing compared to the lifelong journey of coping with alcoholism. What really matter are the quality and effectiveness of the therapies administered during the treatment phase. Of equal importance is a patient's willingness to engage his treatments with a positive attitude and desire for healthy lifestyle changes.