Once drug or alcohol rehab is over, many people have the same question: What’s next? Some people may be worried that they’re not ready to face their old lives without the abstinence support they received at rehab. Others aren’t sure how to start over if they can’t return to their prior lifestyles. Still others may be ready to return to daily living, but might need a little nudge of support now and then.
In order to manage these concerns and navigate life after rehab, recovering individuals benefit from aftercare, which provides services and support to individuals who are transitioning from structured treatment to living on their own again. Aftercare provides a number of helpful services. It is a vital aspect of the continuum of care for people who are being treated for alcohol or drug abuse.
What Is Aftercare?
Aftercare is part of a comprehensive substance abuse treatment program. It consists of the support and services provided to people after the treatment program has been completed. The main, overarching purpose of aftercare is to prevent relapse, making it more likely that sobriety will be maintained for the long-term.
According to the National Institute on Drug Abuse, substance abuse and addiction are similar to other chronic illnesses because of the high likelihood of relapse. In general, 40-60 percent of people struggling with addiction relapse, as compared to 50-70 percent of people with diseases like hypertension and asthma.
On the other hand, an article in Psychology Today shows that the longer a person can go without relapsing, the more likely that person will be able to continue to avoid relapse in the future. This is the basic intent behind the various elements of aftercare: to help people avoid relapse until they are more confident in their skills and abilities to stay sober on their own.
One of the most well-known concepts in drug treatment is that of the 12-Step group or similar types of peer support groups that meet regularly to provide empathy, support, and motivation for maintaining sobriety. While not all people benefit from mutual self-help groups like this during regular treatment, research from the Journal of Psychoactive Drugs demonstrates that up to a quarter of people who have achieved and maintained recovery from substance abuse credit at least part of their recovery to 12-Step or similar groups.
This is one aspect of aftercare that can be easily maintained for as long as needed after treatment is over. While the study above shows that people tend to attend meetings less the longer they remain abstinent, it is always possible to return to these groups even after a time away if the person needs renewed support.
Sober living homes are sometimes required for people who have a higher risk of relapse, such as those who:
- Have a long history of substance abuse
- Have relapsed previously
- Are struggling with co-occurring mental health disorders
- Are unemployed or homeless
- Lack family or social support
These types of homes offer a more structured environment that provides some degree of isolation from sources of drugs or alcohol in a supportive living environment with others who are recovering from substance abuse. These homes often require the person to follow rules of abstinence and perform chores to contribute to the overall maintenance of the home. Still, residents can also come and go to a certain degree, offering them more control as they transition out of rehab.
More research from the Journal of Psychoactive Drugs demonstrates that these types of homes can be an integral part of an aftercare program, particularly for those who do not have a safe home to return to or who do not otherwise have supportive living environments.
Therapy and Counseling
There are many types of therapy and counseling that can continue to provide motivation to stay sober after the main treatment program has been completed. These can include family counseling, individual sessions, and specialized therapies, such as:
- Cognitive Behavioral Therapy: This brain-training type of therapy has been shown to improve post-treatment outcomes over the course of the year after treatment, improving overall long-term abstinence, according to research from Archives of General Psychiatry.
- Family therapy: This therapy can help families build and maintain a supportive environment for the person who has completed treatment.
- Interpersonal therapy: The intent of this type of therapy is to build social networks that support abstinence and motivate people to avoid relapse. One study in Substance Abuse showed that women who had this therapy were able to maintain recovery over 32 weeks, increasing their chances for long-term sobriety.
- Motivational therapy: Some of these motivational programs reach out to former clients while others encourage the client to call in to track progress, report any periods of high risk for relapse, and get feedback and encouragement to maintain sobriety.
- Contingency Management: In certain cases, people are more likely to do well when they receive rewards for achieving certain milestones in recovery. Contingency Management provides vouchers for goods and services or other rewards to motivate people to avoid relapse. Oftentimes, vouchers are given for negative drug tests or continued attendance at therapy sessions.
Intensive Outpatient Programs
For some people, a continued form of treatment provides a higher level of structure that keeps recovery in the forefront of the mind. Intensive outpatient programs can often be used in this way, as a follow-up to inpatient treatment. These programs require the people being treated to attend a certain number of meetings, sessions, and other events each week to continue to practice the skills learned in rehab while also returning to their everyday lives.
Intensive outpatient treatment may include a combination of many of the types of treatment described above, worked into a comprehensive program. At least nine hours per week, a person in this program will participate in sessions that may include:
- Peer support meetings, like 12-Step meetings
- Individual or group counseling sessions
- Educational courses
- Practical therapy to practice relapse avoidance skills
This type of regular participation keeps treatment support and motivation fresh on a daily basis while the person goes to work or school, making it easier to avoid relapse.
Other elements of aftercare that may be used include alumni reunions for treatment center clients, giving the people who have completed treatment a chance to stay connected with the treatment center staff and each other. These connections can be a strong part of the social support structure that keeps people motivated to avoid relapse and maintain recovery over time.
With all the types of support available through aftercare, people who complete drug or alcohol abuse treatment can stay connected with the reasons they decided to seek treatment, helping them to move forward with a continued commitment to recovery. Most people in recovery maintain some level of aftercare participation for years or even for the rest of life to keep commitment to recovery strong.