You’ve begun a course of residential substance abuse treatment in order to gain control over your alcohol or drug addiction. You or your loved one has committed a good length of time to commit to residential treatment. So why is your counselor telling you that once you graduate from your residential program you must then begin a course of aftercare treatment?
This question also comes up from the family members of those who are in treatment. The people closest to the addict spend a lot of time participating in family programming including family group sessions, individual sessions, and visitation. You are the people who have ensured that your loved one has everything he requires while he’s there, making special trips when he needs trousers in a new size or if she runs out of toiletries. It seems, after everything you’ve all been through leading up to residential treatment, that the addict’s graduation from residential care should be a release for you. So why does the person have to continue with outpatient treatment or extended care programming?
Think of addiction as a serious long-term illness—because it is. If you grandmother had to undergo open heart surgery, she would go from surgery directly into a cardiac intensive care unit. She would next go to a room on the regular floor of the hospital or a step-down unit and only after that would be discharged home. While she’s in intensive care, she’s still in immediate danger, but in the step-down unit she learns what she must do to maintain her recovery.
It’s very much the same thing for patients suffering from substance use disorder. As you know, residential substance abuse treatment works because it virtually interrupts the addict’s life so he can get it back on track. But when he reaches the end of the residential program, it will be a big shock for him to simply return to the social and family environment where he previously lived and used alcohol or drugs. That’s why an extended care facility or an aftercare program constitutes such an important part of treatment.
In an extended care facility, the person reports there on a daily basis or he lives there around the clock under supervision. He is, however, free to participate in volunteer activities within the community or go back to work part-time. He will continue to undergo therapeutic group and individual counseling sessions, and his comfort level with 12-step groups will be reinforced. After he has interrupted his life, undergone detox, and begun his journey toward recovery in residential care, he will now, in an extended care facility, learn how to go back out into the world and remain clean and sober.
Outpatient aftercare programs are different because the person actually does go back home. You can expect your loved one to experience some adjustments to being back in his home environment. Many addicts report that they wake up in the night and take a moment to realize that they are once again back home. Just like the weird dreaming that they experienced when they began treatment, they once again will have some weird dreams because their life once again has changed so much.
Aftercare programs require a commitment to individual or group counseling sessions three times a week, usually, for two to three hours per session. As with extended care facilities, the person learns to be back out in the world again. He will maintain close contact with his residential facility counselor if he likes.
When you first think about it, the idea of aftercare seems like a pain in the neck—or parts more southerly located—to both the addict and his family members. However, extended care or aftercare outpatient programming is every bit as important for your loved one’s recovery. You’ve traveled the recovery journey this far; you can keep going along this new route, as well.
