Should You Go to Rehab? Use a Decisional Balancing Exercise to Decide

One minute you know it’s the right decision and a minute later you feel like you’re overreacting.

Going to rehab: it’s a huge decision, it’s going to disrupt your life and the lives of those close to you in significant ways, it can cost a lot of money and you’re probably not even sure it’s what you need…what do you need?!!

Well, no one else can tell you what’s right for you. You know your body and you know your addiction best, but if you’re having trouble weighing the pros and cons of going to rehab, try this easy exercise to structure your thoughts.

Decisional Balancing

One tool that substance abuse counselors and other mental health professionals use to help their clients make difficult decisions about behavioral change is an exercise called decisional balancing.

Making a decision to change the course of your life is rarely simple, and although one big part of you probably wants treatment, another part of you might wonder if you’re ready, or if you even can achieve lasting change.

• Ambivalence to change is normal and life is rarely black and white, which is why making major decisions about behavioral change, like about going to rehab to quit drugs or alcohol, can be so hard
• Structural barriers (like financial difficulties) can further complicate the decision making process

Decisional balancing exercises help you to identify and structure all the shades of grey – both pro and con – that weigh down the balance of any major decision.

And once you’ve identified all the pros and cons of both action and inaction and written them down in an easily comparable arrangement, you’ll have a more structured framework to base a decision upon.

What was an impossible decision sometimes becomes an obvious choice by the end of a decisional balancing exercise.

An Example of a Simple Decisional Balancing Chart

Write out rough table of 4 squares and label the squares with the titles:

1. Benefits of Going to Rehab
2. Costs of Going to Rehab
3. Benefits of Not Going to Rehab
4. Costs of Not Going to Rehab

And under each title, brainstorm for examples of likely costs/benefits. For example:

Ready to Try a Decisional Balancing Exercise for Yourself?

So are you grappling with a decision about rehab or addiction treatment – or about any type of major behavioral change? If so, why not sit down with a pencil and paper and take 10 minutes to write out the pros and cons of both sides of your dilemma.

If it doesn’t clarify things then you’ve wasted nothing more than a few minutes of your time, but you’ll likely find it easier to choose a course of action once you’ve structured things to enable a side by side comparison of the costs and benefits of both action and inaction.

And if it does work and it does transform ambivalence and indecision into motivation for action, then it is 10 minutes very well spent indeed.¹