A Guide to Successful Aftercare Planning

A Guide to Successful
Aftercare Planning

Once rehabilitation treatment is completed, aftercare helps support ongoing recovery.

Addiction is a chronic disease, which means that while a person can go into remission (sobriety), lifelong supports will likely be needed to stay sober. The illness of addiction has a relapse rate similar to hypertension and asthma. Hypertension and asthma have a relapse rate of 50 to 70 percent. According to the National Institute on Drug Abuse (NIDA), the relapse rate for addiction recovery is between 40 and 60 percent.1 This significant rate makes quality addiction aftercare programs vital for preventing relapse.

What Is the Purpose of Aftercare?

An aftercare program is made up of relapse prevention measures packaged into a comprehensive plan. Aftercare plans are the cornerstones of high-quality rehab programs and serve to educate and prepare those in early recovery about relapse. Aftercare plans provide skills and strategies to enjoy successful long-term recovery.

Here is how aftercare fits into the continuum of care for addiction treatment: 2

  1. Diagnosis
  2. Primary residential rehabilitation program
  3. An extended care program (e.g. partial hospitalization programs)
  4. Residential intermediate care (e.g. sober living houses)
  5. Outpatient care (diagnostic, primary and extended)
  6. Aftercare

Some people enter recovery at the residential program level, while others may enter at the intermediate or outpatient level. Which program a person initially enters is determined by the severity and length of his or her addiction. However, aftercare is a service recommended for everyone in recovery from addiction.

How Aftercare Programs Help Recovery

Aftercare programs include various classes, individual and group therapy sessions, as well as special events that help people in recovery develop a personalized arsenal of strategies, skills and techniques to help prevent relapse.

Regardless of specific modalities and programs, aftercare plan goals should include:
  • How to identify high-risk situations that can lead to substance abuse.
  • Ways to develop specific methods to avoid or cope with high-risk situations.
  • Lessons on how relapse occurs, and what relapse warning signs are associated with each stage.
  • A plan of action to follow in the event a relapse is imminent or occurs.
  • Lessons on how to experience discomfort without giving in to it.
  • Development of skills and strategies for coping with stress, cravings and other triggers.
  • Lessons on identifying self-destructive attitudes, thought patterns and behaviors, and how to replace them with healthier ways of thinking and behaving.
  • Addressing lifestyle factors that can lead to relapse.
  • Development of a strong support system to lean on in the early months of recovery.

Types of Aftercare Programs

Many different techniques can help individuals in recovery maintain abstinence despite the powerful triggers they may experience. Some of the most common and successful aftercare programs include:
  • Ongoing individual and group therapy once treatment is complete
  • Joining a recovery group for peer support, skill building and camaraderie
  • Taking up hobbies and activities
  • Developing healthy relationships with other non-users
  • Lifestyle changes: Exercising; eating a healthy, nutritious diet; getting adequate sleep
  • Using meditation, deep breathing exercises or other holistic approaches to ride out cravings
  • Medication-assisted treatment (MAT)

Medication Management Aftercare Programs(MAT)

You may need to take medications designed to stop or deter you from using drugs or alcohol again, or to lessen cravings or urges. Examples include taking Subutex or buprenorphine or Suboxone to treat opioid addiction. Another scenario could be taking naltrexone to help reduce alcohol cravings if you are in alcohol abuse recovery.

Group Therapy In Aftercare

12-Step Meetings

One of the most common group therapy tools that recovering individuals use for the rest of their lives are 12-step groups. The most well-known of these 12-step programs is Alcoholics Anonymous (AA). The 12 Steps were written in 1938 by the founders of AA.

One study found that participating in any 12-step activities was a good predictor of better outcomes. Especially attending meetings and having a sponsor were both shown to be consistently related to abstinence.3

SMART Recovery Meetings

SMART Recovery stands for Self Management for Addiction Recovery Training. Results have shown it is effective in treating addiction.4

The SMART Recovery 4-Point Program lists four main areas of improvement that the program facilitates:

  1. Building and maintaining motivation
  2. Learning how to cope with urges
  3. Learning how to manage feelings, thoughts and behaviors
  4. Living a balanced life

The SMART Recovery approach differs from 12-step programs. Rather than follow a 12-step program which emphasizes powerlessness, SMART teaches self-directed approaches and self-empowerment (rather than surrendering) including:

  • Lessons on how to find one’s own power and reliance
  • Attendance at educational, supportive and open discussion sessions
  • Encouragement for those in recovery to have satisfying lives
  • Education on methods for directing change from within
  • Support for the use of psychological treatments
  • Support for legally prescribed psychiatric and addiction medications
  • Consideration of abuse and addiction to substances as complex dysfunctional behaviors with possible physiological factors
  • Modifies itself as scientific research in addiction recovery advances.

It’s important to note, SMART Recovery approves of using 12-step programs, as well as other programs, because choosing other programs are considered self-directed and self-empowering choices by SMART.

How Can I Prepare for My Discharge?

You can prepare for your discharge by first understanding the details of your aftercare plan. Some plans have timelines for care, and if this is the case, it’s essential you follow that timeline for better treatment outcomes. Since most aftercare plans are mainly self-directed, it’s up to you to keep to it.

You should also prepare for the transition your counselor’s role will take after discharge. In most cases, counselor interaction takes on more of a monitoring function.

You can also make preparations in the areas that relate to your newly sober life, so you’re ready to function as independently as possible. Vocational training, looking for a job, and securing safe housing should all be arranged prior to your discharge. Your case manager (who may also function as your addiction counselor) will help you meet your needs, such as housing, a source of income and a support system. 5

What Does Quality Drug Rehab Aftercare Look Like?

Quality drug rehab aftercare uses evidence-based modalities that are easily accessible and affordable for the long-term. According to a survey done in 2017 by SAMHSA (Substance Abuse and Mental Health Services Administration):

  • 87 percent of all facilities surveyed provided aftercare/continuing care 6
  • 73 percent of all facilities surveyed used 12-step facilitation as a treatment method

Also, quality aftercare frequently takes a holistic or “whole person” approach.

How Long Can I Accept Aftercare Services?

There is no specific time limit on aftercare services.

Where Can I Live After Treatment?

Once treatment is completed, it’s time to decide where to live. One obvious choice is to return home, but many people who have successfully completed rehab prefer to continue their recovery by living in a sober living environment (SLE). An SLE is a good choice if you don’t have a home to return to, have no support network at your home location, or decide that you need further supervision while you transition into independent living.

One common reason for choosing an SLE is the person in recovery traveled to attend treatment. Once rehab was completed, to return to the original location would mean being immersed once again in the triggers and stressors that contributed to substance abuse in the first place. Also, the familiar places and people where drug or alcohol abuse occurred would be front and center.

Rather than having to overcome all these hurdles, a fresh start can begin in a new location. A sober living home is a good choice while establishing roots in a new area, and also continuing to have the help and support needed during this time of major change.

Finding Help

If you or your loved one does relapse, it doesn’t mean you’re defeated or that treatment was a failure. Rather, it’s the sign that it’s time to go back into treatment at a higher level of intensity. If you entered aftercare from an outpatient program, you may want to think about re-entering via an inpatient or residential program this time. Many people relapse at some point in their recovery, and if you do, don’t wait to seek help. Find a program that helps you get back on track to your life.


Resources

  1. https://www.drugabuse.gov/publications/media-guide/science-drug-use-addiction-basics
  2. https://www.ncbi.nlm.nih.gov/books/NBK64351/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3558929/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713880/
  5. https://www.ncbi.nlm.nih.gov/books/NBK64857/
  6. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/2017_NSSATS.pdf