So many rehabs advertise that they have an aftercare program, yet very few describe it, and usually in vague terms if at all. Why is that? It would seem that if they do have an aftercare program (instead of just an obligatory notion of one), it would be simple to describe their process in writing on their website. Surely it is not proprietary, and if they are proud of it, they have no other reason to keep the details of it hidden. Some talk of relapse prevention, others talk of ongoing support; but what does that mean, how will it ‘look’ when implemented for you or your loved one? Is there a fear of setting expectations early, such that the rehab will feel committed (libel) to a well-described aftercare program? Prove me wrong, but I bet the “aftercare” concept is more useful to the vast majority of rehabs as a way to sell their program and fill their beds rather than a serious module of their overall treatment plan.
There are two types of participants that need no aftercare, so any effort on them is just a waste of the rehab’s resources (staff and money). The first type is the one we all hope for: they are at a point in their recovery where they can self-sustain their clean and sober lifestyle without relapse. This person needs no further contact from the rehab, and, in fact, may do rather well without it as they have reacculturated themselves to a new addiction-free life. The other type of program alumni that wouldn’t benefit by a rehab’s aftercare is the one that we all fear: they relapse into their previous addictive patterns and will likely ignore and actively avoid all contact from the rehab. Aftercare then has its strongest benefit on those that fall somewhere in-between.
Some rehabs will refer the program graduate to a third-Party support or monitoring agency; this may best be described as an outpatient (although very little medical supervision, if any, is in place) service. Prosecutions of DUI’s and drug possession crimes have created a very large market of local services (available almost everywhere in the United States) that specialize in court-ordered education and group therapy programs with adjunctive services including random drug and alcohol testing. If the participant is compliant, it is easy to set up a program (you don’t need a referral from the rehab!). These services will help the participant and his family (or employer) monitor recovery and provide extrinsic motivation for relapse prevention. Your local phone directory, yellow pages, or online directory can provide listings under “addiction” "alcoholism" or "drug abuse." Any such outpatient program will be at an additional expense to the participant. Typical fees: drug testing (per urinalysis) $10-$20; Breathalyzer $5-$10 each; two hours group therapy $25-$40. An "intake" is required (fill out paperwork, brief interview) which usually costs $25-$50. The usual procedure for random drug and alcohol testing is that the participant calls the outpatient facility, everyday (although many are closed Sunday's and Holidays), to find out if he is required to come in that day to submit a breath or urine for testing. You can set up drug and alcohol testing for multiple times a week, once a week, twice a month, once a month, etc.
Before listing all the possible components of a continuing care program, a note needs to be made on 12 step rehabs aftercare programs. Many 12 step rehabs advertise aftercare, but further investigation reveals that it is nothing more than a referral to AA, NA, and CA meetings local to the participant. In some cases the facility itself will offer weekly AA meetings in-house. But unless the participant has a special affinity towards the rehab’s 12 step meeting, he may find other meetings in his area more conducive to the days and times he wants to attend. Also, different AA meetings have different ‘personalities’ so the person in recovery may find a meeting more to her liking elsewhere. If you are interested in going to AA meetings in your area, you do not need a referral from a rehab. Simply get in contact with the local AA chapter in your area. They can provide you with a directory of days, times, types, and places of meetings. Even in small communities, you will likely be surprised at the number of meetings held nearby on a weekly, and many times daily, basis. I would hope that 12 step rehabs don’t take advantage of this type of aftercare advertising (but many do), because it is free and available to anybody right now.
Here is a list of possible components in continuing care, each one followed by brief examples. Very few rehabs actually do more than a small number of these; this list is only meant to show what is out there.
Facility-initiated contact
-Regular contact by phone or email following a schedule that diminishes in frequency of contact over time (as recovery progresses and matures).
Meetings and group or individual counseling provided at the facility
-This is only potentially effective for those that live within a convenient travelling distance from the facility. There may be weekly group meetings or therapy, and one-on-one counseling by appointment or during “office hours.”
Participant-initiated contact
-The participant is given contact phone numbers and email addresses to use whenever she feels a need to talk to someone at the facility. 24/7 access to a live contact is most preferable; although some facilities state a return call or email within a certain time frame.
Facility-mediated family (or close friends) support
-This could be a hotline for pre-approved family members or friends to call if the participant is unable or unwilling to make contact. Aside from just providing someone to talk to, referral to local community resources is usually the protocol here.
Facility-tutored independent study or practical exercises
-The participant does assigned homework, then reports back to a contact at the facility for feedback and guidance. The assignments are to reinforce what was learned during the residential stay and provide a structured method of transitioning back into the participant’s community.
Facility-provided online resources
-Alumni access to part of the facility’s website that may host a discussion board, podcasts, videos, articles, and updates.
Scheduled events and social activities for alumni
-This is only potentially effective for those that live within a convenient travelling distance from the facility. Facility will let interested alumni know of special events and get-togethers to reconnect with other alumni (and sometimes program staff).
Alumni (peer) support
-The facility may provide a network (contact list) of alumni willing to stay connected for the purpose of supporting recovery.
And other support services: job search assistance, resume help, interview coaching, educational guidance counseling, anger or stress management, and other life skills.
No rehab will provide all the services above. Most will provide just a few if any. The more in-depth the aftercare and the more services that the rehab offers will come at a higher price; all the additional staffing and expenses are passed on to the consumer.
One sales gimmick that rehabs may try to use on you when you inquire about their aftercare program is their insistence that it is “tailor-made” or “customized” to the participant and so a plan is difficult to describe in detail to you. Demand a better explanation: have them go over best case and worst case scenarios until it is clear what the rehab will and won’t provide in aftercare.
If a rehab’s aftercare program is important to you, it is a very good idea to get ALL the details regarding their aftercare program in writing. Do this before making any commitment (ie… payment) to that rehab. If they truly believe in the services that they provide, this shouldn’t be too much of a problem.
I appreciate your feedback!
My email: betteraddcare@yahoo.com
Related: Residential alcohol treatment center, drug rehabilitation, addiction, substance abuse, alcoholism, 12 step rehabs, alternative to 12 step, recovery program
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