Importance of Aftercare in Addiction Treatment

Posted under Recovery on November 23, 2009
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Successful completion of a treatment program for addiction is a huge step on the road to recovery. But for most addicts, regardless of their type of addiction (drugs, alcohol, combination of drugs and alcohol, co-occurring disorder, gambling, eating, spending or sexual disorder), they’re not completely ready to function independently. They have fulfilled an important and essential part of their goal to overcome their addiction, namely the treatment program, but they still require ongoing support for some period of time. This critical phase is called aftercare, and participation in an aftercare program often makes the difference between abstinence and relapse.

Aftercare Defined

Aftercare refers to programs that are designed to provide counseling on an ongoing basis for patients (or clients) who have already completed treatment in either a residential or intensive outpatient program for addiction.

Most aftercare programs require clients to have been chemically abstinent for some period of time prior to admission. Usually, aftercare programs immediately follow treatment and are based on a personalized plan for the individual. The client’s counselor may have the individual set recovery and life goals while still in treatment, including writing out a sober plan of action for early sobriety.

Why Aftercare is So Critical

Overcoming months or years of addiction isn’t easy for anyone. Going through treatment for the addiction is often a life-saving blessing. But it’s just the first step in an ongoing process toward recovery. Addicts are never “cured” of their addiction. They learn to understand the basis for their addiction, contributing factors, how to cope with and manage cravings and temptations, and to develop more healthy behaviors that will sustain them on their path toward recovery.

While in treatment, clients become used to a certain structure, a regular schedule of activities, duties, even recreational time. Once treatment is finished, however, there’s often a vacuum. The person is now out in the world, having to deal with situations and feelings that they may not be confident enough they can handle. In fact, relapse is a concern during the first six months following treatment. For this reason, addiction professionals recommend patients participate in an aftercare program for at least six months after they’ve completed a treatment program. Referral to a sober living environment may also be advised.

Besides regularly scheduled meetings and counseling, aftercare includes group activities during which the individual in recovery interacts with peers. This peer support and the relationships formed during abstinence-based activities often prove invaluable to persons in recovery. Alumni-based and 12-step meetings in the community are also part of aftercare programs.

Types of Aftercare Programs

Many drug and alcohol treatment facilities offer aftercare programs as part of the personalized treatment program for the client. This could be a residential treatment program or an intensive outpatient treatment program. In effect, the aftercare program becomes a continuation or extension of the initial treatment. While each aftercare program is unique, depending on the philosophy and structure of the organization, common services provided include counseling, one-on-one and group meetings, lectures and educational discussion, recreational and social activities.

As to types of aftercare programs available, these also differ depending on the facility or entity providing the aftercare program. There are aftercare programs that are designed for adolescents only, or for adults only, or for men or women only. Some are specifically for those recovering from substance abuse, while others may include may include other addictions or disorders.

Aspects of a Typical Aftercare Program

Sessions or group meetings are scheduled on convenient days and times, in order to best meet the client’s schedule. Programs include interactive process sessions, practical instruction and group support.

Sessions may include the following (although this list is not all-inclusive):

• Relapse prevention skills
• Understanding the risks and problems involved in recovery
• Development of relationship skills
• Stress, anxiety and anger management
• Family dynamics
• Coping mechanisms for dealing with issues related to abstinence
• Addressing triggers
• Reminders of activities that are helpful to maintain serenity in a chaotic (or tempting) environment
• Learning from others who are successful in their sobriety how they achieved their goals
• Vocational education or job skills development

Some aftercare programs may include retreats and recreational activities throughout the year.
In addition, random and infrequent testing for drug and/or alcohol use may be part of the aftercare program.

Alumni/aftercare includes alumni of the aftercare program who are business people and community leaders. These individuals often serve as valuable resources to new clients in aftercare, helping them identify employment opportunities. Alumni also serve as role models to those newly enrolled in the aftercare program.

Adolescent Aftercare Program for Substance Abuse

Programs for young adults recovering from substance abuse focus on the unique needs of the individuals recovering from drug and/or alcohol abuse/dependence and who need to accept personal responsibility. Such aftercare programs emphasize recovery from the substance abuse/dependence, academic components, responsibility as an integral part of young adulthood, and recreation as an important element of a healthy, balanced life free of drugs or alcohol.

A big part of the aftercare program involves recovery. The young person needs to:

• Understand their addiction and learn relapse prevention skills
• Learn to recognize their emotions and regulate emotional responses to triggers
• Become aware of irresponsible thinking patterns and the connection to substance abuse
• Participate in recreational activities to stave off boredom

Developing a sense of personal responsibility includes:

• Understanding how their emotions interact with the family
• Developing healthy habits and behaviors based on a daily structure – which also helps develop skills for independent living
• Goal-setting and rewards – to help develop positive self-esteem and a sense of accomplishment
• Developing health personal habits – to promote self-responsibility for physical and emotional health

Recreation is an essential part of the aftercare program for adolescents and young adults since boredom is one of the chief triggers to relapse. Aftercare recreational programs teach clients how to have fun without alcohol or drugs. With year-round recreational programs, clients can develop regular exercise routines, learn new hobbies or develop new interests – all in an effort to promote a healthy sense of self and positive mental health.

Lifetime Aftercare

Individuals who have completed primary care at certain treatment facilities may participate in what is known as lifetime aftercare, or weekly aftercare meetings. Such clients have usually completed residential, day or outpatient treatment programs.
Lifetime aftercare generally consists of weekly (or regularly scheduled) group meetings facilitated by an experienced counselor. The facilitator assists clients in meeting their individual recovery plans and offers guidance in their recovery efforts. The group meetings provide clients with support and feedback from the facilitator and other participants, and a forum in which they can explore obstacles and issues they face on a daily basis as well as successes.

Alumni meetings and events, including picnics, activities and new-client sponsorships are also part of many lifetime aftercare programs. Ongoing support in lifetime aftercare programs involves alumni, staff, clients, families and the community.

Best Outcomes of Aftercare Programs

The most important part of a successful aftercare program for the individual who’s involved in it is how it helps prepare them to stand on their own. They need to find empowerment that they can live their own lives free of being dependent on any chemical substance or addiction. They need to know that they are the ones who control their own destiny, who chart their own future – and that they’re not relegated or destined to a prescribed scenario as envisioned by others.

Just as no one else but the addict can choose to become sober, only the recovering addict can choose to remain in sobriety. No amount of treatment, lectures, peer influence or family exhortations can make the ultimate difference. It’s the individual who chooses. In this sense, aftercare programs that foster this sense of self-confidence and self-esteem in the recovering individual provide the opportunity for the best outcomes.

Statistics show that individuals who regularly attend aftercare, therapy and 12-step meetings are significantly less likely to return to former self-destructive behaviors than if they only participated in one of these.

What Happens When Aftercare is Done?

Unless the client is involved in a lifetime aftercare program, sooner or later (6 months to a year or longer) the program is done. The client is now completely on their own, left to struggle with daily challenges, temptations, obstacles and triggers. Or are they? Actually, there is always additional support that comes from continued attendance and participation in 12-step group meetings. In fact, 12-step meetings are almost always part of aftercare programs and, although the aftercare program ends, the 12-step meetings can and should go on for an extended period of time.

Some individuals in recovery report that they continue to participate in 12-step meetings as a way of giving back. They seek to provide support to other individuals new to recovery – just as they received support in their early days of sobriety. Others regularly attend meetings, whether at home or around the world when traveling for business or pleasure, as a means of reinforcement, or a way of staying connected and grounded to what’s important in their lives – sobriety.

Sometimes, individuals just need a friend, someone who understands, and someone who’s been through the same type of experience. Whether it’s today, next week or next year, something may happen that rocks the carefully-established foundation of sobriety and the person in recovery needs help. Again, help and support – or an understanding ear to listen – is always available in the appropriate 12-step group. Friends, sponsors and those the recovering addict meets during these meetings may be the lifeline that keeps them firmly rooted in sobriety – or helps them out during periods of crisis.

What Should Be Hoped For?

Life should be about joy and discovery. Following treatment and participation in aftercare, the individual in recovery should make plans for the future that continually evolve. Once certain short- or long-term goals are met – make new ones. Enrichment, personal satisfaction, realization of long-held dreams, meeting someone with whom to have a lasting romantic relationship – all of these and more are what the recovering addict should hope for.

In other words, have faith that you can achieve the dreams, plans and goals that you set for yourself. Rediscover the joy in daily life that you may have missed or overlooked during your addiction. Find the love that is ready and waiting for you once you are open to receive it. What are your limits? There are none, really. Open yourself up to all the possibilities and embrace your future in sobriety.

In summary, individuals who are nearing completion or are about to complete treatment should work with their individual counselor to develop a personalized aftercare program. Plan to participate in the aftercare program for a minimum of six months following treatment – or as long as the client feels necessary. Attend 12-step meetings in conjunction with and following aftercare programs. Create goals and constantly revise them, adding new ones as opportunities arise. Be open to new possibilities and be ready to embrace them.