Generally we tend to think about treatment for alcohol abuse, dependence, or addition as falling into one of two categories: inpatient or outpatient. However, just as there is enormous variation in inpatient or residential treatment styles, so too are there differences in outpatient offerings. Most of these differences - beyond the obvious 12-Step or Alternative orientations and frameworks - boil down to intensity, duration, and communication preferences.

First a brief review of the inpatient/outpatient decision. For most people with alcohol problems outpatient is the obvious choice. It is far more cost effective, less disruptive, has greater assurances of confidentiality, occurs as a part of your real life, can easily adapt to the changes that inevitably occur in other parts of your life, and isn't artificially time limited. Unless you're a celebrity in need of absolution or publicity, or someone with a need for sanctuary rivaling a witness protection couples rehab program, you'll probably do fine in outpatient.

Outpatient is generally most effective when it begins as an intensive process that decreases over time. Ideally the first stage would last three to four weeks and focus on assessment of the degree of alcohol involvement, medical condition, related circumstances, strengths, and interests. The following eighth week should concentrate on implementing systems for reaching the short-term treatment goals. Anywhere from three to nine months of follow-up may be necessary to cement gains made during the first three months.

That's the ideal time frame for most people and takes into account the usual processes for effecting behavioral change that lasts, not a temporary phase that soon fades into relapse. But it is possible to manage the process under less than ideal circumstances.

Alcohol problems aren't going to find couples rehab services readily available

It can be a matter of distance, or a lack of confidentiality (who wants to be seen parking their vehicle outside the local rehab storefront?) a difference in philosophy, or any of a dozen other reasons. That leads to seeking help from afar and that precludes a year's ongoing physical involvement.

Happily, intensive work and anti-craving medications have opened up some new possibilities. Accelerated outpatient treatment means cramming the first ninety days into ten and conducting follow-up by phone, fax. e-mail and internet. It's even a realistic option that, if pursued conscientiously, can have remarkably good results. In addition to being time and cost effective, it even offers the client a brief respite at a quarter the cost of a residential stay, and some assurance that folks back home will mistake your two week absence for a vacation. In some ways they'll even be partially right.

Look for a suitable program in an agreeable location with a matching philosophy. Call and talk to them and see how comfortable you are - the phone will be your best connection after the intensive on-site portion - if it doesn't feel right now, it probably won't then. Visit if at all possible. You're investing your future, don't do it haphazardly.

Your success is primarily a product of your motivation and acceptance of responsibility for overcoming your problems by changing your behaviors. This will be most effectively and efficiently accomplished with good short-term help. Look for help that is professional, respectful, and open to diverse processes and outcomes. Again, it's your life, don't diminish it unnecessarily.