What’s the difference really?

Thailand is famous for its luxury drug treatment centers but what a lot of people don’t know is that there are some affordable options too. Over the years we have seen a change in what people are looking for with regard to treatment here in Thailand. In this post-covid period many people have financial concerns. This is unlikely to change anytime soon. And given that rehab is something of a necessity (when you need it, you need it) this means there is a greater demand for affordable care.

So perhaps we should ask ourselves, “what do we really need from a treatment center?” What are the essential ingredients and what is just fluff?

Group Therapy

First and foremost in addiction treatment we need regular (daily) group therapy. Group work is where the dynamic is. Without feedback from our peers it is nigh on impossible to gauge our growth and recovery. Much more than other mental, emotional or behavioral health disorders, addiction requires fellowship. That means bonding with our peers, and supporting and challenging each other in a constructive way.

The modalities used by group therapists in addiction treatment should be abstinence oriented (e.g. run according to the principles of mutual aid support groups like Alcoholics or Narcotics Anonymous) but they should also incorporate other evidence based treatments such as Cognitive Behavioral Therapy, and Motivational Interviewing (MI). This combination of treatments has been found to be the most effective over the years, and is noted by famous research studies such as Project MATCH.

Group work with feedback from peers

One to One Counseling

Next up is good quality one to one counseling. It is essential that a majority of the counseling staff in a treatment center are in recovery themselves, but also that they have a basic level of training and experience in working with addicted people. This is all about striking a happy medium. Not everyone with a master’s degree knows what they are doing, and equally, not every recovering addict is an expert in residential mental health provision.

Therapist counseling space with minimal design

There are plenty of therapists who are highly trained on paper but have little clue how to work with addicted people because they lack the personal and professional experience of working in a residential addiction treatment center. Many treatment centers hire counselors regardless of whether they know anything about addiction or not.

You should ask your prospective treatment center how many of their clinical staff are in recovery themselves because this makes a huge difference. Equally, people are not qualified to counsel addicted people just because they are in recovery themselves. Staff should have at least basic counseling or health and social care qualifications.

Psychiatric Care

Third, is psychiatric care. You might think this would come first but the reality is that most people with addiction issues do not have severe and enduring mental health issues. 85% of the depression, anxiety, and attentional problems that addicted people face will clear up when they stop abusing substances. Likewise only about 20% will need detoxification, and much of this can be done outpatient.

For this reason, and for most people seeking recovery, it will be perfectly adequate for the treatment center to have a psychiatrist on staff once per week to oversee medication regimes. For the minority who have severe dependence on benzodiazepines, alcohol, or opioids, then of course, 24 hour nursing will be necessary.


Fourth, is food or nutrition. So many treatment centers (especially in the west) serve terrible food. How are people supposed to get well when they are eating garbage?

At One Step Rehab here in Chiang Mai we serve meal plans that are designed for athletes. The food is high protein, and relatively low in simple carbohydrates – or what we call the ‘dopamine diet’.

All food is sourced from local ingredients and served as Thai-western-fusion cuisine. It is so important to have tasty and nutritional meals when we are in early recovery, but it seems that the cost of producing high quality food in the west is prohibitive now.

Healthy meal with local ingredients served as Thai-western-fusion

This is why even relatively high end treatment centers in the west typically serve terrible food!

Wendy trains with coach at Thai rehab fitness camp

Physical Exercise

Fifth is physical activity or exercise. It is not uncommon in the west for treatment centers to place huge restrictions around physical activity while we are in early treatment. This is due to the mistaken belief that people can become addicted to exercise. Of course there are many issues around over exercising, especially for people with body-image issues and eating disorders. Nevertheless, it is not the exercise itself that is the problem but rather our relationship to it.

Given that adequate physical recovery is essential for longevity, as well as optimal physical and mental health, then it is imperative that your treatment center help you to negotiate this relationship with your body while you are in treatment.

So if those are the main essential ingredients of an effective residential addiction treatment program, then what is mere fluff?

Firstly, most holistic therapies such as sound therapy (sound bowls), breathwork, and ‘healing’ methods like Reiki are entirely optional. There is nothing wrong with these kinds of techniques, but their main benefit lies in the simple fact that they are relaxing. You can try all of these methods when you return home, but there is no need to pay over the odds for them in expensive addiction treatment centers because they are purely adjunctive (e.g. an add-on). They are not essential, nor indeed very effective in treating addictions.

What does work is traditional modalities like meditation and yoga. These disciplines are very ancient and powerful, and any treatment center can easily provide them at little cost. Many ‘new’ so called ‘body based therapies’ are really just repackaged versions of ancient meditation and yoga practices. Here at One Step Rehab Thailand we continue the local Thai tradition of teaching vipassana meditation as we have access to inexpensive and authentic local teachers.

Final Thoughts

Finally, you should consider whether the treatment center conducts a through clinical assessment on you before you enter. If they don’t then there is significant risk that you will be in treatment with people who are not appropriate for that service (e.g. too mentally ill) because they have not been properly screened before coming in. And likewise, does the center provide aftercare? Many treatment centers will tell you that they do aftercare, but it is often a mere afterthought as they have already extracted all of their fees from you.

At One Step Rehab we charge a small amount extra for aftercare in order to ensure that we can provide the best care for you while keeping the initial cost of treatment as low as possible. We find that this is a more realistic approach. We don’t want aftercare to be a mere afterthought. We want it to be a continuation of your treatment for as long as you need it.


Best regards

Alastair Mordey and The One Step Team.