How to choose the right rehab: A practical guide

Choosing a rehab can be overwhelming, especially when you’re in crisis or worried about someone you care about. South Africa has a wide range of facilities, from state-funded centres to private hospitals, and the differences between them are significant. 

This guide is here to help you cut through the confusion and find the best rehab option for your specific needs. You’ll learn what types of rehab are available, what to look for in a facility, how medical aid cover works, and what questions to ask, so you can make a confident, informed decision.

What type of rehab is right for you?

Not all rehab looks the same. The right option depends on how severe the addiction is, whether a medical detox is needed, and how much support the person requires.

Inpatient rehabilitation

Inpatient (residential) addiction treatment means staying at the facility full-time, typically for 28 to 42 days. This suits most people with a moderate to severe addiction, particularly where physical withdrawal is expected. You’re removed from your usual environment and have clinical support around the clock.

Outpatient rehab

Outpatient treatment allows people to attend therapy sessions during the day and return home in the evenings. This works well for people with a milder dependency, strong support at home, or commitments that make full residential care impossible.

Intensive outpatient rehabilitation

Intensive outpatient programmes (IOPs) sit between inpatient and outpatient treatment. These programmes typically involve several hours of therapy per day, across multiple days a week, and are often used as a step-down option after inpatient treatment.

Withdrawal from alcohol, benzodiazepines, and opioids can be serious. If there’s any risk of physical withdrawal, inpatient care with medical supervision is the safest option. Without the right clinical support, withdrawal from these substances can be life-threatening.

What to look for in a rehab centre

Once you know what type of treatment you need, the next step is evaluating specific facilities. This is where many people feel stuck. There’s a lot of information out there, and facilities don’t always make it easy to compare them fairly. Below, we’ve listed some of the most important selection criteria to take into consideration when weighing different rehab options. 

Accreditation and licensing

In South Africa, legitimate addiction treatment facilities must be registered with and licensed by the Department of Health. This is a legal requirement. Facilities without this registration are not subject to any clinical oversight, which puts patients at serious risk.

Beyond standard licensing, it’s worth checking whether the facility is also registered as a hospital. Houghton House holds dual licensing as both a rehabilitation centre and a private psychiatric hospital, which means patients receive hospital-grade clinical care. This designation also means medical aid schemes cover a broader range of services — including psychiatric care — at Houghton House than most other rehab centres.

Medical supervision and detox capability

For many people, the detox phase of treatment can be very physically demanding. Depending on the substance, withdrawal symptoms can range from uncomfortable to deadly. A medically supervised detox means going through the withdrawal process under clinical supervision, with qualified staff on hand to manage symptoms and prescribe medication where needed.

Not every rehab can offer medical detox on-site. If you need supervised detox, it makes sense to choose a facility that handles it in-house instead of sending you elsewhere for this stage of treatment. This way, you get the benefit of continuous care throughout your recovery, from the moment you arrive. The same clinical team oversees your detox and your treatment programme, with no handover between providers. 

A qualified, multi-disciplinary team

Addiction is complex. Recovery involves managing physical withdrawal, understanding the psychological drivers of addictive behaviour, addressing trauma where present, and rebuilding practical life skills. No single discipline covers all of this. 

The strongest rehab facilities bring together doctors, psychiatrists, psychologists, social workers, counsellors, and occupational therapists, among others, each contributing a different piece of the puzzle.                                                                                            

Staff qualifications are worth looking into carefully. Job titles don’t always tell the full story — what matters is whether the people delivering your care are registered with the relevant professional body, such as the Health Professions Council of South Africa (HPCSA). 

Many facilities publish this information on their website. Check out the Houghton House team to meet the clinical staff who’d be treating you or your loved one. 

Dual diagnosis treatment approach

Many people who struggle with addiction also live with an underlying mental health condition such as anxiety, depression, or PTSD. 

Treating only the addiction while leaving a condition like depression or anxiety unaddressed increases the risk of relapse considerably. Sobriety is much harder to sustain if the conditions that drove the addiction in the first place are still present. 

Dual diagnosis treatment addresses both the addiction and any co-occurring psychiatric conditions at the same time, with the help of a qualified team experienced in managing both. 

Check whether the facility you’re considering has genuine on-site psychiatric services, or just a referral arrangement. At Houghton House, psychiatric care is fully integrated into our holistic treatment programme. 

A clear aftercare plan

The period immediately after leaving a primary treatment programme is one of the highest-risk phases of recovery. Cravings, environmental triggers, and the stress of returning to everyday life can all challenge sobriety before new coping skills are fully embedded. What a facility offers after discharge is just as important as what it offers during treatment.

A solid continuing care plan typically draws on some combination of the following:

• A halfway house, which provides supervised transitional living for people who aren’t yet ready to return home.
• An aftercare programme with regular group and individual sessions to maintain momentum after discharge.
• Ongoing outpatient therapy, either through the facility or via referral.
• Integration into a peer support network, such as a 12-step programme or similar.

Ask whether aftercare is included in the treatment package or charged separately, and what the facility’s approach is if a patient struggles after discharge. A facility that has a clear answer to this has thought seriously about long-term recovery, not just the time spent in their care.

Family involvement

Addiction doesn’t only affect the user. Family members often carry their own burden of stress, confusion, and grief, and the dynamics within a family can sometimes enable addictive behaviour, without anyone intending it. Involving loved ones in the recovery process helps address these patterns and builds a stronger support network for when the person in recovery returns home.

A facility with a dedicated family support programme treats recovery as something the whole family works towards, not just the individual. This makes a real difference to outcomes on both sides.

An environment conducive to recovery

Part of what makes inpatient treatment effective is the fact that it removes you from familiar environments, routines, and social circles associated with substance use. It’s much harder to break old patterns when the triggers that reinforce them are still present. As such, the environment a facility provides isn’t just a backdrop to treatment, it’s an active part of it.

This doesn’t mean comfort is unimportant. A calm, well-maintained, and professionally-run environment supports the focus and reflection that recovery requires. 

However, rehabilitation facilities that compete primarily on lifestyle may be prioritising the wrong things. Unrestricted phone and internet access, minimal daily structure, luxurious meals and hotel-style amenities are all distractions that can be counterproductive to your recovery. 

The goal of rehab isn’t to make the experience as easy and familiar and comfortable as possible — it’s to create the conditions for real change. 

A proven track record

Experience counts in addiction treatment. A facility that has been operating for many years has refined its approach, built a skilled team, and seen what works over time. 

Look beyond the marketing and ask how long the facility has been operating, what its outcomes look like, and whether former patients are willing to share their experiences publicly.

Success stories are one of the most honest signals a facility can offer. At Houghton House, we’ve been helping people recover from addiction for over 30 years. You can also read the success stories of people who’ve been through our programme to get a sense of what treatment here looks like in practice.

Reviews and reputation

Word of mouth still carries weight. Check Google reviews, TrustIndex, Hello Peter, RecoMed, and any other platforms where the facility has a presence. Look for patterns rather than individual comments. A consistent thread of positive experiences is more meaningful than a handful of five-star ratings with no detail.

Be cautious of facilities with suspiciously perfect scores and no substantive feedback, or those that respond defensively to criticism. Equally, a facility that has been operating for decades and has a strong reputation in the industry is unlikely to have built that through marketing alone.

No single factor will tell you everything you need to know. But a facility that scores well across accreditation, clinical staffing, dual diagnosis capability, and aftercare is likely to offer a meaningfully different standard of care from one that doesn’t.

Does medical aid cover rehab?

If you have medical aid, there’s a good chance your treatment is covered. Under South African law, substance use disorders are prescribed minimum benefits (PMBs). This means all registered medical aids must fund addiction treatment. 

Where a facility is also licensed as a private psychiatric hospital, as Houghton House is, patients may be able to claim for additional psychiatric services for co-occurring conditions that qualify under psychiatric PMBs. The specifics vary by scheme and plan, so speak to our admissions team to confirm what your cover includes. 

However, medical schemes are allowed to specify which facilities qualify for full treatment cover. This means they may charge a co-payment if the rehab facility you choose is out-of-network or isn’t on your medical scheme’s designated service provider (DSP) list. This copayment is usually 20-30% of the full cost of treatment, which can be a considerable amount. 

It’s worth noting that Houghton House typically absorbs this shortfall instead of passing it to the patient. 

You can find more information on how specific medical aids cover treatment at Houghton House on our medical aid rehab cover pages. 

Red flags to watch out for

Not every facility that markets itself as a legitimate rehab centre delivers care to an appropriate standard. Some use polished branding to paper over gaps in clinical quality. 

Warning signs to look out for include: 

• No verifiable registration with the Department of Health.
• Pressure to sign contracts or pay before a full assessment has taken place.
• Promises of guaranteed recovery or unusually fast results. No ethical facility makes these claims.
• Claims about proprietary or “revolutionary” methods not found elsewhere. Established approaches like CBT, DBT, and 12-step programmes have decades of research behind them. Distance from these in favour of something unproven is a cause for concern.
• Unusually low fees. Treatment quality varies significantly at different price points, and cut-price care often reflects corners cut in staffing, facilities, or clinical oversight.
• Vague answers about staff qualifications or who will be involved in treatment.
• More focus on luxury amenities than on a clinical approach.
• Suspiciously perfect online reviews with no detail, or a pattern of legal complaints.

If a facility can’t clearly answer basic questions about its licensing, staff, and treatment approach, look elsewhere.

Questions to ask when you call a rehab

A short phone call can tell you a great deal about a rehab centre. If a facility can answer your questions clearly and without hesitation, it’s an encouraging sign. If it deflects, overpromises, or can’t give you specifics, look elsewhere.

Here are some questions worth asking:

• Is the rehab registered with the Department of Health, and is it licensed as a hospital?
• Is medically supervised detox available on-site?
• Does the team include a psychiatrist or psychologist, and are they HPCSA-registered?
• How is dual diagnosis managed if a co-occurring condition is identified?
• What does a typical week of treatment look like?
• What aftercare or continuing care is available after discharge?
• Does the facility work with my medical aid, and what should I expect to be covered?

The quality of that first conversation is worth paying attention to in its own right. A well-run facility will answer clearly, ask informed questions about the person’s situation, and not push for a commitment before a proper assessment has taken place. 

Choosing a rehab in Johannesburg

Houghton House has been helping people recover from addiction in Johannesburg for more than 30 years. 

As a dual-licensed rehabilitation centre and private psychiatric hospital, we offer a level of clinical care that goes beyond what most rehab facilities can provide: a full multi-disciplinary team, 24-hour nursing care, on-site medical detox, and a comprehensive continuing care programme, all under one roof.

Our admissions team is available around the clock for a free, confidential assessment. We’ll help you understand what level of care is right for you, what treatment would look like, and how your medical aid cover applies.

Call us on +27 79 770 7532 or get in touch online. We’re here whenever you’re ready to take the next step.