How Rehab Aftercare Positively Affects Recovery Outcomes

Author: Jessica Payne, LMSW, CAADC

When it comes to successful substance use disorder treatment outcomes, maintaining involvement for an adequate length of time is key.¹ Rehab aftercare is one of the essential components of effective treatment. One main goal of an aftercare program for addiction is to help reduce the risk of a relapse. Aftercare can decrease substance use and mental health symptoms compared to individuals who do not receive continuing care after rehab.²

What Is Rehab Aftercare?

Aftercare refers to any form of care that:²

• Continues to support your progress after addiction treatment
• Monitors your condition
• Responds to a reoccurrence of substance use or a mental health crisis
• Can be considered treatment on its own

Aftercare can also be identified as continuing care or relapse prevention. Rehab aftercare is included in treatment. It is one of the phases of treatment to optimize effective care.

For individuals who have co-occurring disorders (e.g., depression), aftercare can be especially crucial, given the probability of cyclical and recurring mental health symptoms.

A good aftercare plan connects you to services quickly and without obstacles. Aftercare will also outline when, who, and how you should contact these services.

Goals of aftercare include:²

• Helping you sustain abstinence
• Continuing your recovery
• Mastering living in your community
• Developing vocational skills
• Obtaining employment
• Deepening your psychological understanding
• Assuming and increasing responsibility
• Helping to resolve familial discord and difficulties
• Consolidating the changes in values and identities that likely occurred during rehab or earlier phases of treatment

Research shows that engaging in alcohol and drug rehab aftercare can reduce the chance of readmission to treatment and improve the likelihood of sustaining your recovery efforts.² Regarding co-occurring substance use and mental health disorders, aftercare was found to help reduce psychiatric symptom severity and improve functioning.

What Do Rehab Aftercare Services Include?

After rehab, your counselor will review your choices of aftercare with you. These can include the following.

Outpatient Treatment Centers

Outpatient treatment centers offer several forms of aftercare. Outpatient programs may include individual, family, and/or group therapy.

These centers can offer intensive outpatient treatment, which is a form of step-down treatment after inpatient rehab. You would attend the center a few hours multiple times a week to continue to learn about substance use and develop skills.

Support Groups

Support groups have a long-standing history of being effective in strengthening social support and assisting with maintaining recovery.

A few common support groups for addressing substance use disorders include:

• Alcoholics Anonymous (AA)
• Narcotics Anonymous (NA)
• Self-Management and Recovery Training (SMART) Recovery
• Celebrate Recovery
• LifeRing Secular Recovery
• Harm Reduction, Abstinence, and Moderation Support (HAMS)
• Secular Organizations for Sobriety/Save Ourselves (SOS) Sobriety

Each group has a different set of values and outlooks on substance use and recovery. If you are unsure which group is best for you, consider asking for recommendations from your rehab care team. It is also important to remember each group location can have a different feel due to the members who attend. If you do not feel like you fit in one, try some others! You may even consider attending online meetings.

Therapeutic Communities

The goal of a therapeutic community is to promote abstinence while developing autonomy and returning to the larger community.² Utilizing a therapeutic community typically consists of living in a transitional housing setting with many other individuals who are also in recovery. Many individuals will reside in this environment for 6-12 months.

Additional aspects of aftercare in addition to a therapeutic community can be especially beneficial, and research has shown individuals who were in therapeutic communities and participated in other continued care were less likely to relapse.

Aftercare is designed to help consolidate or even improve upon all of the skills learned throughout rehab while helping to prepare you for an increased level of autonomy.³

Outpatient Counseling

Outpatient counseling includes individual, family, and group services with a community-based therapist. Additionally, it may be helpful to ensure your outpatient counselor is well-versed in the treatment of alcohol and substance use disorders. If there are concerns about other mental health illnesses, it is important to be open and honest about your symptoms so your counselor can meet your needs.

Common types of therapy that have been established as evidence-based to effectively treat substance use disorders include:

• Cognitive-behavioral therapy (CBT)
• Contingency management
• Motivational interviewing

Recovery Monitoring

Recovery monitoring is a service conducted with the assistance of a recovery coach. Recovery coaches are similar to a sponsor in some ways but are specifically trained to help you.

The majority of recovery coaches are in recovery themselves and can help navigate the ins and outs of securing resources. Recovery monitoring may also involve services that monitor your substance use through urine drug screens.

Substance Abuse Assistance

Substance abuse assistance is similar to recovery monitoring in that they utilize peer-to-peer services and focus on relapse prevention.

Family Support

Family support is utilized to link you with childcare and parent education. It can also include resources to help child development and family/couples education and support.

Education and Job Skills

Education and job skill services can help link you to life skills such as employment and education training. Aftercare focusing on education and job skills can help you identify goals and works towards furthering your occupation or developing skills to gain employment.

Ancillary Services

Ancillary services are those that are designed to link you with resources to help with housing assistance, transportation, or individual case management as needed. These services may include transitional housing even if you do not live in a therapeutic community. These services can include forms of government assistance and case managers. These services are based upon your unique needs and may be determined by social services.

When these services are combined, many positive outcomes are seen. These outcomes are especially likely when resident treatment was available and combined in-house accommodations for the dependent children and included family therapy.²

What Are the Recommendations for Aftercare Following Rehab?

Research supports the following recommendations for individuals after they are discharged from residential treatment:^2,5,6

• You should be engaged in aftercare services for a minimum of 3-6months following your discharge.
• Appointments for aftercare services should be scheduled before your discharge and confirmed before you leave inpatient care.
• The residential program you leave should implement follow-up procedures to help you maintain contact with staff members at regular intervals for at least 12 months.
• You should be educated on the importance of rehab aftercare and the availability of various forms of aftercare, including the use of psychopharmacotherapy.
• Your residential staff should introduce you to outpatient providers before your discharge to aid in your level of comfort and help foster the beginning of a productive therapeutic alliance.
• Your residential program should offer you a wide range of aftercare services that can meet your unique needs.
• Lastly, your residential program specialists should help link you to mutual-support programs and community-based supports and resources.

What Happens in a Continued Aftercare Program for Addiction?

Aftercare is an essential part of maintaining your recovery. The rate of substance and alcohol relapse is similar to the rate of relapse for any other chronic disease, such as diabetes or asthma.¹ This rate is approximately 40-60%, with many individuals relapsing shortly after leaving residential treatment.

Aftercare helps address important relapse risk factors. Some of these specific factors are included in various aspects, such as:⁴

• Cognitive risk factors, such as intrinsic motivation
• Emotional risk factors, like coping skills
• Behavioral risk factors, such as engaging in positive prosocial behaviors
• Social support

Towards the end of your specialized substance use disorder treatment and during aftercare, you will complete a relapse prevention plan. Aftercare services are an essential component of your relapse prevention plan.

The relapse prevention plan will help you utilize aftercare services and can also help you:²

• Explore positive and negative consequences of relapse
• Recognize high-risk situations that could influence relapse
• Develop skills to avoid high-risk situations or develop coping skills to deal with them when they occur
• Develop a “relapse emergency plan” that will assist in “damage control” if a lapse occurs
• Enhance skills to deal with cravings

Call us at 800-963-1579 (Who Answers?) to speak with a specialist who can help connect you to addiction treatment options.

Resources

1. National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (Third edition).
2. Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment for people with co-occurring disorders.
3. Schnieder, M. K. (2017). Acceptability and impact on an ACT based aftercare treatment for clients suffering from substance abuse. University of Twente Student Thesis.
4. Gonzales-Castaneda, R., McKay, J., Steinberg, J., Winters, K. C., Yu, C. H., Valdovinos, I. C., Casillas, J. M., & McCarthy, K. C. (2022). Testing mediational processes of substance use relapse among youth who participated in a mobile texting aftercare project. Substance Abuse, 43(1), 1-12.
5. Proctor, S. L., & Herschman, P. L. (2014). The continuing care model of substance use treatment: What works, and when is “enough,” “enough?” Psychiatry Journal, 692423.
6. Rubinsky, A. D., Ellerbe, L. S., Gupta, S., Phelps, T. E., Bowe, T., Burden, J. L, & Harris, A. H. S. (2017). Outpatient continuing care after residential substance use disorder treatment in the US Veterans Health Administration: Facilitators and challenges. Substance Abuse, 39(3), 322–330.