Aftercare: Successfully Supporting Recovery
What happens after treatment? Are you left on the curb to navigate your new life of sobriety alone? Of course not. The aftercare plan is an integral part of any high-quality treatment program and seeks to meet your unique needs and offer crucial support as you begin solo recovery.
The aftercare plan is an individualized plan of action that is developed once treatment ends to help you navigate the early weeks and months post-rehab. A study published in the Journal of Studies on Alcohol and Drugs reports that for each consecutive month you engage in your aftercare plan, the likelihood of staying sober increases by 20 percent.1 Participation in aftercare is the single most important predictor of abstinence after treatment.
Aftercare for the Abstinence Stage of Recovery
Recovery occurs in three broad stages, according to an article published in the Yale Journal of Biology and Medicine.2 The first stage is abstinence, which begins when you stop using and lasts for one to two years as you focus primarily on staying sober. The second stage is the repair stage, during which you focus on restoring all areas of your life and sharpening the skills and strategies you need for long-term recovery. The final stage is the growth stage, which lasts a lifetime and involves striving for authenticity and authentic happiness in your life.
Foundation for Growth
The primary focus of the abstinence stage is on staying sober while learning to effectively cope with cravings, stress, and other relapse triggers. During the abstinence stage, you are working on several essential tasks that will provide the foundation for a lifetime in recovery, such as:
- Accepting that you have an addiction and that addiction is chronic and relapsing.
- Practicing honesty with others and with yourself.
- Developing and honing coping skills for dealing with stress, negative emotions, and cravings.
- Staying vigilant for signs of impending relapse.
- Developing a strong, positive support system and ending unhealthy relationships.
- Pursuing interests and hobbies.
- Becoming actively involved in a support group.
- Creating balance in your life.
- Developing a new identity as a non-user.
The aftercare plan is designed to guide you through the abstinence stage of recovery so that you can move into the growth stage with strength and resilience. The aftercare plan is dynamic, changing along with your needs in recovery, and it lasts as long as you need it to.
Components of the Aftercare Plan
The aftercare plan builds on the motivation and momentum gained in treatment. A typical aftercare plan will include ongoing individual, group, and family therapy, usually through participation in an intensive outpatient program (IOP) or outpatient program (OP). Participation in a support group like Alcoholics Anonymous or Smart Recovery is another universal component of an aftercare plan. Additional components are added to the plan as needed, depending on your unique needs and ongoing issues. These are some of the most common components of an aftercare plan:
Just as it takes time to develop thought distortions and unhealthy coping mechanisms that come with addiction, it takes time to learn how to think in healthier ways and develop essential coping skills. The purpose of therapy is to help you identify unhelpful thought patterns and understand how these affect your behaviors. This is a complex process, and it requires focus and attention. An IOP or OP will include a variety of therapies that enable you to continue working toward greater self-awareness and self-confidence as well as add to your arsenal of coping skills and strategies.
For families in recovery, ongoing therapy continues to improve the functioning of the household, which has an important impact on successful recovery.
Support Group Participation
Daily support group meetings are central to ongoing recovery once treatment is complete. A support group allows you to develop healthy relationships with peers in recovery, and it reduces feelings of isolation and loneliness, which are significant relapse triggers. Support groups promote personal accountability and honesty, and they increase motivation.
12-step programs like Alcoholics Anonymous and Narcotics Anonymous are effective, and they offer a full roster of meetings in most towns and cities. A popular 12-step alternative is Smart Recovery, which focuses on maintaining and building motivation, developing coping skills, managing emotions, and living a balanced life.
Family members will also benefit from joining a support group for loved ones affected by addiction. A support group like Al-Anon for adults or Alateen for younger family members gives them a safe place to get support, ask questions, vent, and celebrate. Family support groups help reduce feelings of isolation that may occur when a loved one enters recovery.
A study in the Journal of Psychoactive Drugs found that sober living communities promote long-term sobriety, increase employment, and reduce mental illness symptoms.3 Sober living homes are extremely important for people with an otherwise chaotic, drug-friendly, or dysfunctional living situation. Residents in a sober living home pay rent and share household duties, and they are expected to follow certain rules. This environment helps people new to recovery develop crucial life skills, and it provides a high level of support while offering more freedom than an inpatient treatment program.
For those in recovery who plan to return to school, educational assistance may be a part of their aftercare plan. Educational assistance may involve helping you find an educational program, applying for financial aid, and assisting you in the application process.
Many people leave treatment facing legal issues. The stress and financial toll of legal problems can be a trigger for relapse. Legal assistance helps those who need it to navigate the legal system, understand their rights, and find affordable representation.
A job has numerous benefits for people in recovery. It eases financial stress, gives your life purpose, and offers a productive way to fill the time. It allows you to develop healthy relationships with coworkers and gain self-confidence and self-esteem. Vocational assistance as part of an aftercare plan might include workplace skills classes; assessments to help you find employment that fits your personality, skills, and interests; help with writing resumes and preparing for job interviews; and interpersonal skills development classes.
Mental Health Monitoring
When a mental illness like depression or anxiety co-occurs with addiction, both the addiction and the mental illness need to be treated at the same time, each in the context of the other. If you have a dual diagnosis, ongoing mental health monitoring after treatment will ensure your symptoms stay under control and any medications you’re taking are available to you and working properly. Ongoing therapy in your aftercare plan will also help you manage symptoms of mental illness and develop coping skills.
If you are participating in medication-assisted treatment, your aftercare plan will include managing your medications under the supervision of a physician. Medication-assisted treatment for alcohol and opioid addiction can improve your chances of successful recovery by reducing cravings, helping to normalize brain function, and blocking the effects of alcohol or opioids.
Your aftercare plan will be overseen by a case manager who will be your primary aftercare contact. Your case manager will evaluate your plan periodically and make any necessary changes to address new and shifting needs.
The aftercare plan will include a plan of action in the event a relapse occurs. Getting back to recovery as soon as possible after a relapse is essential for maintaining your momentum in recovery.
Overcoming Challenges in Early Solo Recovery: What to Expect After Treatment
Early recovery is all about relapse prevention, and the aftercare plan provides support and resources to help reduce the risk of relapse. Triggers for relapse are abounding in early recovery, and while treatment is focused on helping you develop fundamental skills and strategies for avoiding relapse, it takes time to master them. Following your aftercare plan helps you weather these common challenges in early recovery, such as:
Stress is a major factor in developing a substance use disorder, and it is a major trigger for relapse. The body’s stress response includes changes in hormonal and brain activity that cause physical symptoms like sweating, increased heart rate and blood pressure, muscle tension and cravings.
Stress management techniques like meditation and deep breathing exercises help reduce stress on the spot. Addressing relationship stress through ongoing family therapy and reducing financial stress through employment and the development of money management skills will help reduce stressors in your life that can lead to relapse.
Negative emotions like fear, anger, frustration, and intolerance are powerful relapse triggers, and emotional coping skills are imperative for a successful recovery. Ongoing therapy after treatment helps you continue to develop and practice coping skills, and it helps you learn to be more comfortable with uncomfortable emotions. Most importantly, it helps you adopt healthier ways of thinking, which go a long way toward reducing the source of negative emotions.
Lack of coping skills
A lack of coping skills can lead to drug or alcohol abuse as a way to combat negative emotions, deal with unpleasant experiences, and reduce stress. Programs included in the aftercare plan promotes mindfulness in developing and practicing coping skills and strategies.
Coping skills are essential for preventing relapse during high-risk situations. Positive self-talk, calling a sponsor, and recognizing thought distortions are just a few of the many coping skills people develop in treatment and hone in aftercare.
Mental illness symptoms
Anxiety, depression, and PTSD commonly co-occur with addiction. Many people self-medicate symptoms of mental illness with drugs or alcohol, but these almost always make the illness worse. Ongoing therapy helps you learn to cope with your mental illness, and taking your prescription medications every day reduces symptoms.
Cravings can quickly erode your commitment to recovery, and you’ll probably experience them for some time after quitting. Participation in a support group has been shown to reduce cravings overall, and mindfulness meditation or deep breathing can help reduce them on the spot. Many strategies are used in relapse prevention programs to reduce the intensity and frequency of cravings and help you weather them with your sobriety intact.
The end of treatment often finds people in recovery highly motivated to stay sober. You’ll leave treatment armed with the skills you need to start a life of sobriety, and at first, abstinence may seem like a piece of cake. But once you leave the supportive environment of treatment and solo recovery begins, overconfidence can set you up for relapse. That’s why maintaining a strong support system and attending daily meetings is so important, especially early on.
With overconfidence comes the problem of entering high-risk situations unprepared. Aftercare therapy and support groups put a heavy emphasis on knowing your triggers and having a detailed plan in place for navigating high-risk situations. Some of the strategies include taking along sober support, checking in with yourself frequently, and having an out. Attending a meeting before entering a high-risk situation can help bolster your self-confidence and boost your motivation.
During treatment, a variety of therapies are used to help you identify dysfunctional thought patterns, such as negative self-talk, black-and-white thinking, or catastrophizing, in which you blow things out of proportion. These and other thought distortions are often at the heart of relapse, and identifying them and replacing them with healthier ways of thinking is at the heart of recovery. Ongoing therapy and feedback from a support group help you stay aware of your thoughts and emotions so that you can turn around negative thinking more quickly.
Unhealthy Lifestyle Choices
Self-care is another important foundation of recovery. People who practice good self-care are far more likely to stay in recovery and enjoy a long life of sobriety. Good self-care means eating healthy food, getting plenty of sleep, exercising regularly, and spending time having fun and relaxing each day. The components of the aftercare plan provide support and assistance as you settle back home and create new routines.
Whether you live with your family, have roommates or have been homeless, returning to a dysfunctional living situation after treatment can quickly lead to relapse. Family therapy during treatment helps to stabilize the household, but continuing with therapy after treatment can transform familial relationships and bring true peace to the home. For those who would otherwise return to a high-risk living situation, sober living will be a major part of the aftercare plan.
Having fun and keeping busy is important in recovery. Boredom is a common relapse trigger since it gives you time to nurse negative thoughts and emotions. The desire to escape boredom can lead back to drug or alcohol use. The aftercare plan strives to ensure you’ll stay busy in early solo recovery, and it helps you stay connected to the recovery community. You’ll be encouraged to find employment and engage in hobbies and activities you enjoy. Your support system is instrumental in helping you stay busy and engaged in fun and productive pursuits.
Isolation and Loneliness
Isolation is another powerful relapse trigger. Feelings of isolation can lead to drug or alcohol use for solace and comfort. By contrast, feeling like you’re a part of something and belong somewhere has incredible benefits for recovery. Your support group and group therapy sessions will help combat isolation and loneliness. Reach out to peers in recovery, and keep expanding your support system through employment, volunteer work, and hobbies.
Relapse as a Normal Part of Recovery
These days, relapse is considered to be a normal (even expected) part of the recovery process. According to the National Institute on Drug Abuse, 40 to 60 percent of people in recovery will relapse at some point.4 While the aftercare plan is aimed at preventing it, relapse can still happen. If it does, contact your sponsor and your aftercare case manager right away. Be sure to go easy on yourself. If you approach your relapse with a positive outlook and focus on the progress you’ve made so far, you’ll be more likely to get back on track with recovery quickly.
Relapse doesn’t mean that treatment didn’t work. Rather, it’s a sign of one or more missing coping skills. Maybe stress got to you, or you couldn’t beat the intense cravings. Maybe you spiraled back into negative thinking patterns or experienced a life event that felt too difficult to weather sober. Whatever led to the relapse, getting back to recovery will involve developing the skills you need to get through it next time. After a relapse, most people return to recovery stronger and more motivated than ever to make it work. Changes to the aftercare plan following a relapse may include an increase in the number of therapy sessions or meetings you’ll attend each week.
Aftercare Can Help You Stay Sober
It can take a year or two after treatment to feel like you’ve really settled into sobriety. During that time, there will be challenges and there will be setbacks, but there will also be growth and milestones reached. Following your aftercare plan and fully engaging with each component dramatically increases your chances of a successful recovery and promotes a happier, healthier life for the long-haul.