Continued care means how a person coming out of a substance abuse rehab center will be engaged with others in their sobriety. Aftercare treatment is imperative for sustained recovery from drug and alcohol addiction. In transitionary phases, especially returning to one’s normal routine, the relapse percentage is exponentially high. Putting together a relapse prevention and post-treatment plan during residential care is essential for an individual to achieve optimal health upon discharging.
What does the recovery model look like after detox and residential?
The continued care treatment plan is started when a client admits to the facility when the complete assessment is made by the clinical team. The determination of an estimated length of stay, individual needs, and case management will be put in place in the first few days. The treatment plan is open to change as the client may reveal additional needs as the time in residential is spent.
The first part of treatment into detox a client and stabilize then physically. In residential programming, the client will receive several hours of treatment a day, 6 or 7 days a week, and closely monitored by staff.
Phase Two: Partial Hospitalization Programs (PHP)
PHP is a transitionary phase for people coming out of residential treatment or needing to have more monitoring from an intensive outpatient program. Most PHP are scheduled through the week at eight hours a day, and clients usually live away from the treatment center. When at the PHP level, clients will receive individual and group therapy, family therapy, may meet with a psychiatrist if needed, a medical doctor, and other interventions which the program has to offer.
Phase Three: Intensive Outpatient Program (IOP)
While some people attend IOP without being in residential, needing a little more structure than an outpatient program, many others find IOP an essential phase to the aftercare process of transitioning after residential treatment or PHP phases. The IOP can have flexible hours for people who wish to return to work or school while attending a part-time program. There is therapy offered at the IOP level, though it will be a few hours a week rather than daily programming. During the IOP phase, case management will be an important aspect of transitioning smoothly post-programming. It is advisable that people continue from the residential treatment phase into IOP in order to circumvent any triggers and prevent relapse.
Most residential treatment facilities will have their own PHP and IOP facility, and if not, will be able to refer a client to an appropriate facility when ready to transition. The gradual transition from inpatient treatment to returning to everyday life reduces the percentage of relapse. Aftercare from outpatient is also a reduction in statistics regarding potential relapse.
Continued Care and How it Works:
Substance abuse disorders can feel difficult, overwhelming, if not impossible to overcome, but with the help of others who understand the complexities of addiction. Finding a treatment center that starts with detox and residential care and that also incorporates continuing care in their program, will be the best-case scenario for staying sober long-term.
Currently, there is not one set standard for continued care after residential treatment, though many facilities follow the levels of transitional care as mentioned above and follow up after outpatient can be a week to a few years.
Follow up may consist of the individual therapist contacting the client to “check in” on a fairly regular basis, it may be that the client is asked to speak on an alumni panel or return to speak to the clients about their experience while at the treatment center. Some clients have been so moved by their sobriety that they return to school and get certified as a substance abuse counselor; becoming hired by the very place that helped them get sober.
Substance abuse, disorders and addictions, like chronic illness, require follow-up for the continuum of care to be successful. Continued care is the supportive plan after the initial treatment plan has been established and maintained. After the residential and IOP phases have been completed, the continued care will focus on short-term goal setting, solution-oriented work, and how the client sees their successes from the time of their admission until their present state.
Success will be measured not only quantitively- by the length of sobriety time- but also the emotional wellness, physical changes, and mental awareness that has transpired since they became sober. A spiritual “awakening” may also be part of the recovery process where the client has a paradigm shift or a change in their core belief where they now are able to let go of past ego controls and “turn it over” to a power greater than themselves. This is not to be confused with traditional religions, though there are addicts in recovery who have never left their beliefs and incorporate their new sobriety into their practice.
Continued Care Interventions
Treatment Models for Continued Care logistically can look like a blend of services or individual plans as follows:
- Clients will engage in structured continued care with drug testing, individual and group treatment. Clients may be integrated into the community as a support person for other clients recently admitted. This type of continued care shows the highest rate of sustained abstinence.
- Clients will receive incentives for biological samples, shows a reduction in substance abuse after residential and outpatient treatment.
- Telecare for clients who live out of the area, alternative or online continued care resources has shown help for the client who live rurally or find it difficult to attend meetings at a center.
- Extended support from friends, peers, family, and community resources prove to be a needed component for the continued care; one that is important to maintaining sobriety on a long-term basis and which has shown to be the highest element of abstinence for people in recovery.
Continued care, following up with those who have participated in rehab and residential treatment, is of utmost importance for preventative relapse and continued sobriety. While in residential treatment, there is a large amount of time adjusting, stabilizing, and receiving information. Retention of information and practicing what a client has learned in the beginning stages of treatment comes with time.
Continued care will assist in putting new skills and information received into practice. Professional and peer support is imperative to move out of theoretical ideas and into living a drug free productive life.
While in residential treatment, many of the external stressors and triggers are removed, therefore upon transitioning back into a regular routine out of constant care and observation, attending continued care programs such as counseling, case management, therapy, and support meetings is the recipe for good aftercare.
Returning to one’s environment may be tricky. Running into friends that a client used with, drug dealers, and specific geographical areas such as liquor stores, clubs, and drug houses can trigger the addict newly in recovery. The client will have to apply the tools they recently learned from being involved in a treatment program and sometimes it becomes overwhelming. Having a continued care plan in place: checking in with a sponsor from a 12 -Step program, attending therapy, involvement in stress reduction like an exercise program, and having daily peer and family support will be an important part for relapse prevention during this tenuous transition phase.
Family Involvement in Continued Care
Families can be a large part of the client’s recovery, if they can be involved with the treatment plan and become educated with what to do during the transitionary periods. Some families have their own set of addictions, and my find that instead of pointing the finger at the client, they find in themselves the need for change. Other families have members who realize that they have had poor boundary issues, have been enablers, or punishers who didn’t understand fully about the disease of addiction. Whatever the family structure is when the client admits into treatment, they have the opportunity to take a position in helping the client get through the process smoothly.
Some clients are estranged from their immediate family and turn to extended family members and close friends to act as the immediate support people. Scheduling sessions while the client is at residential treatment is a great help to sustaining a drug and alcohol-free life after rehab.
Family members can learn a new way of communication. Husbands and wives can and should often engage in couples therapy after residential treatment in order to redefine rules and roles int heir relationship. The follow up plan for an individual working on their sobriety should include the family, in whatever the definition of that be in order for a better chance of sustaining a healthy lifestyle.
Support Groups for Continued Care
Continued care in the form of groups is often where addicts in recovery find their peers who help maintain long-term sobriety. One of the most popular is the international 12-Step organization started as Alcoholics Anonymous in 1935 and which has grown to over 30 different specific groups including Narcotics Anonymous, Overeaters Anonymous, Adult Children of Alcoholics, Debtors Anonymous and many more. There is most likely a 12-Step group in every area of the country, and if not, there are regular meetings online. 12 -Step groups have a large fellowship and suggest that members obtain a sponsor (someone who has recovery time in the program and has completed the steps). The only requirement, as the traditions state is a “desire to stop drinking /using, etc.” 12-Step attendance is free of charge (usually people give a $1 donation each meeting) and has no religious affiliation. There is language in the Big Book of A.A. and others which talks about a “power greater than yourself,” also called a “Higher Power” and sometimes interchanged with the word “God” to denote a spiritual aspect of the program. However, there are a few meetings designed for agnostics and atheists who enjoy the 12-Step model.
The 12-Step model is structured and a good transition for those who need a similar approach s a treatment center set-up but want to do it on their own time. Some people consider it a free alternative to outpatient therapy and find it very helpful. As 12-Step philosophy states, “you get out of it what you put in” and there can be as little or as much work as you want to or need to do for continued sobriety.
Many models of treatment centers will follow a 12-Step based program, and often incorporate the principals of the steps, especially the first 3 while in residential treatment.
There are organized groups that also offer different models such as: Smart Recovery, Save Our Selves, Artists in Recovery, and religious based sober groups that offer ongoing support, understanding and continued care in addition to outpatient treatment.
Continued care allows people to stay connected to the other social supports that they met during residential treatment. Many clients who go through the residential process end up having long-term relationships as part of their support network, even if they live in other areas. Some clients find that they get along so well that they live in a sober house together, become roommates, and even start businesses together. There is something similar to being in the military and being in the recovery “trenches” together that creates long lasting peer support.
Continued Care in Research
There needs to be additional research for the specific assistance that continued care gives a recovering addict in regards of how it plays into the recovery model. However, there is an agreed concept in treatment literature and studies which prove substance abuse as a chronic and cyclical episodic disease which fluctuate between abstinence and relapse. Substance abuse treatment is therefore seen as a treatment process in two phases: in-patient or daily treatment and aftercare programs. The continuing care model is mostly successful showing positive outcomes when it is utilized for 12 months post- residential treatment that full recovery is considered. A minimum of 90 days to 6 months continued care shows moderate to good positive outcomes, while no aftercare from residential has a 95-99% relapse percentage rate.
If a client has gone through the hardships of detox and the beginning of a recovery in residential treatment, it only makes sense to engage in a continued care program.
Continued Care Assistance
Designing a long-term plan that uniquely suits your life while ensuring ongoing growth and healthy living is vital to long-term recovery. The work you’ve done while in treatment must be further developed so that you can continue to grow and experience the life you want. We work hard to collaborate with other professionals in your area and to put in place the support structure you’ll need for long-term success. 100% of our clients are set up with an aftercare plan. We believe this is vital, whether it is a medical aftercare plan or a psychological/mental health plan. To learn more about our world-class program and luxury approach, call 1-877-437-6408 today.