Perhaps you, like many people struggling with an addiction, believe that once you successfully complete a treatment program, you are cured. But addiction is chronic, and recovery from addiction requires a long-term commitment to sobriety to avoid relapse. Aftercare is a necessary part of treatment that lasts much longer than an initial rehab program. A carefully curated aftercare regimen can provide a coordinated network of support to help you maintain and build on the progress you made in your first phases of treatment.
What Should I Look For?
Aftercare options vary, and it may take a bit of research to find the best one that meets your specific needs. Some residential rehabs that offer their own aftercare services invite treatment center alumni to return to speak with current recovering residents, providing a unique opportunity for them to share their stories, offer hope, and act as role models and inspiration for others.
Many aftercare programs follow a format that relies heavily on group sessions that focus on relapse prevention, job skills, and relationship skills. Improving your relational skills is especially important to help you repair any relationships that were damaged through the course of your addiction. And having the support of your family while in the aftercare phase of your recovery greatly improves your odds of staying clean—as does having a clear and meaningful purpose (such as a job or a cause you believe in) and a safe place to live.1 Programs that address your practical recovery needs—such as childcare, money management, housing, and job assistance—also tend to be more effective than those that don’t.2
Another important component to effective aftercare is related to how long you participate in it. This is a sticking point for many aftercare programs, where the drop-out rate hovers around 50%.3 Some factors that help increase retention in aftercare programs include the staff offering transportation services to the program, as well as ongoing counselor support throughout the duration of the program.
There are many ways you can find a high-quality aftercare program, including word-of-mouth, a detailed internet research, and searching for facilities through accreditation sites. That last point is especially important. When doing your homework, be sure to ask if a program is accredited, since it offers the expectation of adherence to a certain standard of quality, which many aftercare programs either lack or blatantly disregard. Reputable accrediting bodies include the Joint Commission, the Council on Accreditation (COA), and the Commission on Accreditation of Rehabilitation Facilities (CARF). Other factors to inquire about are the frequency of staff turnover, the number of licensed professionals on staff, and what their experience and professional certifications are.
Types of Programs
Two commonly used forms of structured aftercare are outpatient treatment programs and sober living or halfway houses. Both of these allow for continued recovery work following completion of a residential or inpatient detox and treatment.
Outpatient treatment programs typically take place in a clinic or office location where daily therapeutic and educational groups are held. Often, when you first leave inpatient treatment, the recommendation is that you attend five days a week and then step down to two or three days a week as you progress. You live at home while you attend your outpatient program, and many people go back to school or work on a very part-time basis at this point too.
Halfway houses and sober living houses are more structured living settings that provide a safe and drug-free environment to transition into. Certain homes are for those who are court-mandated to live there, or for people recently released from prison, to help them transition better into everyday life, but the vast majority are for people for whom safer or more supportive living environments don’t exist.
These aftercare programs are usually closely monitored to ensure that you don’t relapse. Many of these facilities have counselors on staff to assist your recovery efforts, and almost all of these programs require involvement in some sort of 12-step program.
One downside is that many of these programs are often independently run and are generally unaccredited. A governing body doesn’t exist to regulate sober living and halfway homes, so it is essential to thoroughly research any aftercare program you may find. Ask a lot of questions and walk away if anything seems shady.
Aftercare for Adolescents
The aftercare needs of teens and adolescents are somewhat unique, since they face issues with family and peer groups and are at a completely different developmental stage than adults. As a result, this demographic may benefit from specialized treatment that focuses on social skills and self-esteem issues in addition to the more standard issues around staying clean and sober. And while most adolescents don’t have a significant romantic partner (like an adult may with a spouse), they do have a hierarchical relationship with their parents that adults do not. So a strong family therapy component of adolescent aftercare is critical.
The statistics tell us that adolescents often relapse within 90 days after leaving treatment, that roughly 76% of adolescents don’t complete 90 days of treatment, and very few ever attend even one session of aftercare.4,5 So an approach called Assertive Continuing Care (ACC) was developed to send counselors into the school and home, and has proved effective in increasing rates of adolescent abstinence.5 With ACC, counselors focus on cognitive behavioral therapy in their interventions and facilitate positive social activities to improve the adolescents’ communication skills and teach them relapse prevention techniques. They provide individual sessions, as well as sessions for parents and other caregivers.
Adolescent aftercare treatment may include contingency management (CM) as well, which is an approach that uses incentives like gift certificates and other prizes to reward adolescents for completing sessions and staying sober. Using CM alongside ACC has shown to be promising in increasing abstinence rates too.5
Brief Strategic Family Therapy is another approach that typically lasts 12 to 16 sessions and addresses any family interactions that may maintain negative behaviors. It has been shown to be more effective than standard treatment in some clinical studies.5
Depending on the specific needs of the adolescent, some also receive case management to assist with getting a GED, learning to manage money, and other life skills.4 Newer approaches are finding success, too, such as supportive texting, which has shown to reduce relapse rates when used strategically. 4 Gender-specific adolescent treatment programs are also available to address the needs of males and females separately.
What Comes Next?
After you have completed an outpatient or sober living or halfway house aftercare program—typically 6 months to 1 year after you completed inpatient treatment—you still have many options to find ongoing support to stay clean. Though you will like struggle with daily temptations, challenges, triggers, and obstacles, it does not have to be impossible or overwhelming.
Lifetime aftercare is one such option that typically involves weekly or regularly scheduled group meetings that are facilitated by an experienced substance abuse counselor. The counselor helps you meet your unique recovery plans and provides guidance as you examine your recovery options moving forward—and you get the feedback and support of not only the counselor, but also the other participants. Others who may contribute to your lifetime aftercare program include alumni of treatment programs, families, and the community.
Additional support can always be found by continuing to attend 12-step meetings. Many people in recovery continue to attend 12-step meetings as a way to help others—they want to provide support to people who have just began the path to recovery, just as they found support when they began their journey to sobriety. You may choose to attend meetings for recovery reinforcement, and to remain connected to the supportive community you became part of while in your aftercare program.
Life is about discovery and joy. During and after your addiction aftercare treatment program, take time to plan for your future—both the short-term and long-term. Your plans may evolve over time, and that is okay. Once you meet all of your short- and long-term goals, consider immediately setting new ones. Finding personal satisfaction, enrichment, the realization of lifelong dreams, and potentially meeting someone with whom you can have a healthy, lasting relationship are all things that could enrich your experience of life.
Recovery is challenging, but not impossible. Millions of people have found long-lasting recovery after suffering a period of severe addiction. Staying committed to treatment and following through with an aftercare program in the best way to ensure that you remain in recovery and avoid relapse. Change is more than possible.
- Substance Abuse and Mental Health Services Administration. (2016). Recovery and Recovery Support.
- Arbour, S., Hambley, J. & Ho, V. (2011). Predictors and outcome of aftercare participation of alcohol and drug users completing residential treatment. Substance Use & Misuse, 46(10), 1275–1287.
- McKay, James R., & Hiller-Sturmhöfel, Susanne. Treating Alcoholism as a Chronic Disease: Approaches to Long-Term Continuing Care. Alcohol Research & Health, 33(4).
- Gonzales, R., Hernandez, M., Murphy, D. A. & Ang, A. (2016). Youth recovery outcomes at 6 and 9 months following participation in a mobile texting recovery support aftercare pilot study. The American Journal on Addictions, 25(1), 62–68.
- Godley, M. D., Godley, S. H., Dennis, M. L., Funk, R. R., Passetti, L. L., & Petry, N. M. (2014). A randomized trial of assertive continuing care and contingency management for adolescents with substance use disorders. Journal of Consulting and Clinical Psychology, 82(1), 40.