Recovery is a journey, not a destination. For some clients with Alcohol Use Disorder (AUD), rehabilitation plays a significant role in recovery as individuals attain sobriety and find inner peace. The journey doesn’t stop there, however. Aftercare is the next critical step as clients with addiction must exit the “treatment bubble” of rehabilitation and reorient themselves into the next chapter of their life.
The “Treatment Bubble”
From the moment they wake up to the moment they fall asleep, clients in rehabilitation or an inpatient or outpatient treatment program are entirely immersed in the recovery journey, as explained by Certified Interventionist and Recovery Coach John Roesch.
When enrolled in rehabilitation or a treatment program, an individual's entire day is scheduled for them. It is a cycle of meals, meetings, and therapy; their days are now purposely filled with activities that aim to help them achieve and maintain sobriety. The nature of these programs disallows many freedoms, and those enrolled are hyper-focused on getting help instead of fixating on the outside world.
The safety, security, and connection clients experience in these programs is often referred to as the “treatment bubble.” The “treatment bubble” makes those with AUD feel strong and in control of their addiction while eating, sleeping, and breathing addiction recovery. However, the momentum and motivation to stay sober may appear to be slipping away as their discharge date approaches.
For some suffering from addiction, it can be overwhelming to abruptly transition from a treatment program back to everyday life. Often, the positive changes that clients have made may be placed in jeopardy if they are returning to the same environment that they were in before detox or a residential treatment program.
The world outside treatment is unpredictable and possibly triggering for those with addiction. Leaving a program that promotes security and a consistent schedule creates many anxieties for those hoping to avoid a relapse.
To ease these anxieties and help maintain sobriety established in addiction treatment, it’s recommended to have a discharge plan in place. “It gives the client peace of mind, and their families, to know that there are treatment professionals ready to help make the transition as smooth as possible,” Roesch says. “The more time you spend putting the pieces of the treatment puzzle into place, the better the outcome.”
Fortunately, with a treatment plan and the utilization of aftercare programs, those with alcohol addiction can be prepared to tackle the unknown of the world outside of their treatment bubble.
What Is Aftercare or an Aftercare Program?
Aftercare, or treatment after rehabilitation, is the critical next step in clients’ discharge plans. Comprehensive continued care can help individuals ease into a more independent lifestyle and pave the road for sobriety after treatment.
Aftercare can be a multitude of resources an individual uses to remain sober, like utilizing alcohol monitoring or attending an Alcoholics Anonymous meeting weekly (both of which we will discuss later).
Aftercare programs are methods of comprehensive continued care, including sober living homes, therapy and counseling, and recovery coaches, all of which can help individuals gradually strengthen their confidence in themselves and rebuild others’ trust in them.
General aftercare and organized aftercare programs are extremely similar; however, aftercare programs tend to have a more considerable accountability aspect to them as an addict must relay their progress to an individual versus the possibility of only practicing self-accountability with something considered general aftercare. Both are beneficial to those fresh out of treatment.
The type of program that each client chooses, as well as the length of time they commit to it, will vary depending on their unique situation and needs.
How Long is Aftercare?
The length of time that clients may choose to spend in aftercare may vary depending on the avenues they choose and how confident they feel in their journey. Generally speaking, the duration of aftercare should extend for a minimum of three to six months, according to the Psychiatry Journal.
Participation lasting at least twelve months, however, can be critical for long-term recovery, the Journal continues. As AUD is widely accepted as a chronic condition that can often be cyclical with episodes of recovery and relapse, the Journal found that “continuing care over a protracted period of time, supplemented with routine monitoring, appears to be a more viable option than a series of independent treatment episodes.”
Though organized aftercare can have a time frame, it's important to understand that treating addiction is a lifelong process. As AUD is categorized as a chronic illness, those suffering from the disorder must treat it for the remainder of their lives, similarly to other chronic illnesses like diabetes.
Why is Aftercare Important in Addiction Treatment and Recovery?
Continued care options help ensure individuals feel supported in their recovery journey instead of overwhelmed by leaving structured addiction treatment. As the first year of sobriety can often be the most challenging, aftercare for those fresh out of addiction treatment is essential to hold individuals accountable and set them up for long-term recovery.
Director of Recovery Management at Hazelden Betty Ford Dr. Michael Tkach explains that obtaining sobriety is the first of many achievements in the sobriety journey. “Thriving in recovery becomes a string of successes, engaging in support, and experiencing improved quality of life that continues to unfold throughout the recovery journey, which is a life-long process,” he adds.
Roughly 25 million US adults are in remission or recovery from drugs or alcohol, according to the Surgeon General’s Report on Alcohol, Drugs, and Health. Individuals in the general population run a 15% risk of developing a Substance Use Disorder in their lifetime. It can take individuals who are in recovery up to five years of sobriety before their risk of relapse drops to 15%. As a result, “A person with a serious Substance Use Disorder often requires ongoing monitoring and management to maintain remission and to provide early re-intervention should the person relapse,” the report continues.
Just as rehabilitation is a dynamic process – one that requires continuous effort, growth, and commitment – life after the general 30-90 day stay should remain that way, as well, to maintain momentum and avoid possible relapse. After leaving the security and familiarity of treatment, an individual may experience an array of challenges, including:
- Loss of routine
- Cravings and urges
- Reappearance of external or internal factors
- Feelings of stress or loneliness
- Difficulty coping or breaking previous behavioral patterns
- Loss of pre-rehabilitation community
For those with addiction, providing motivation is a newfound territory, and recovery-oriented systems of care can help emphasize the reality and hope of long-term recovery. With this system of addiction management, AUD is treated with a chronic care management model that includes not just initial recovery but long-term outpatient care. This ensures that any bumps along the road to recovery are accepted as part of the process and not a signal to revert back to what’s familiar.
Aftercare Options
As AUD is a unique and individualized disease, those coming out of treatment must also have an aftercare plan unique to them and their addiction. There is no “one size fits all” in recovery, and the more care you take in finding out what aftercare resources are realistic for you to utilize, the more likely you are to have success during recovery.
The following are a few resources to include in your aftercare plan to help ease into the transition of life after a treatment center:
Remote Alcohol Monitoring for Accountability
For those looking to implement accountability into their or their patient’s recovery, utilizing Soberlink’s alcohol monitoring system is beneficial to all emerging from the treatment bubble. More than just a remote breathalyzer, Soberlink’s comprehensive system allows users to schedule tests and receive real-time results that can be shared with both treatment professionals and others in their Recovery Circle, like friends and family.
This aftercare resource, which is favored and trusted by thousands of Addiction Professionals and treatment facilities nationwide, allows users to see daily, weekly, or monthly reports using an easy-to-read color-coded system. This shareable report helps boost motivation and momentum by allowing users to celebrate their daily, weekly, and/or monthly goals of sobriety. The visualization of their progress combined with the real-time results feature is proven to assist those with addiction to avoid relapse post-treatment.
Why Choose Soberlink?
‘A psychological safety net. The best, most convenient option. An amazing piece of technology.’ These are all phrases that Soberlink clients have used to describe the comprehensive alcohol monitoring system. Combining a breathalyzer with wireless connectivity, Soberlink documents proof of sobriety in real-time to help keep clients connected to their Recovery Circle. With this tool, clients and their support systems can take a holistic view of their sobriety, rebuild trust, and celebrate progress.
Unlike urinalysis, Soberlink allows clients to conveniently send tests in real-time without disrupting their daily lives. Linking sobriety with technology, the Soberlink system offers custom testing schedules, specific notifications, and automated reporting settings.
Allowing clients to send test results to their recovery coaches, recovery professionals, or family members helps to strengthen clients’ support systems. Using technology to share results and connect with loved ones is of utmost importance, as alcohol is a substance that is highly prevalent in everyday life. It allows a user to feel pride over their results and allows those close to them to help them celebrate their successes.
A Soberlink Success Story
A study by the Journal of Political Sciences and Public Affairs provides evidence that alcohol supply and relevancy have a direct impact on alcohol consumption. “This makes it impossible for clients to avoid triggers in the same way they may be able to do with other substances,” says Ward Blanchard, Founder and CEO of The Blanchard Institute, a detox and rehabilitation center located in North Carolina.
While inpatient treatment can aid in the sobriety journey, the temptation to drink once a client enters outpatient care can quickly become present when stress, triggers, negative emotions, or simply proximity occurs. To ease these triggers, Soberlink allows for scheduled testing to encourage clients to avoid the temptation of drinking and to allow treatment professionals the opportunity to connect with their clients immediately after a test is missed or failed.
After struggling to manage impulses during outpatient care, one of Ward’s clients found that Soberlink was the accountability tool that was blatantly missing in her recovery journey. “She began Soberlink, and from that point forward, was able to use the knowledge of her impending tests as a tool to reset and reframe her thinking when experiencing cravings and urges, leading to her celebrating a full year of sobriety,” Ward says.
Along the sobriety journey, connection and accountability are two objectives that cannot be replaced. Used by hundreds of inpatient and aftercare programs, Soberlink’s discreet and convenient alcohol monitoring helps provide both of those objectives, instilling confidence in clients and promoting peace of mind for the people they love.
Sober Living Homes
Providing a recovery option that is in between an inpatient facility and everyday life, sober living homes are live-in residential facilities that allow individuals to reintegrate into the “real world” gradually. While each home operates differently, sober living facilities will typically help clients develop their daily routine, take on commitments and responsibilities, and either return to work or help them obtain a job. Depending on an individual, finding the right sober living home may be crucial to an aftercare plan.
There are four different types of sober living homes, each with a different level of authority:
- Peer-run sober living home: These are homes without a clinical persona or someone
“in charge.” They run democratically, with all its occupants holding one another accountable, usually with weekly testing and group meetings. - Monitored sober living home: These homes are similar to peer-run institutions, except there are one to two paid positions that act as supervisor(s) over the household. Weekly testing and meetings are also common.
- Supervised sober living home: These homes have an organized structure with a multitude of paid clinical professionals keeping those in the home accountable. Supervised homes do promote a healthy transition into life after treatment, but they also provide other services like skill development and other clinical services that are non-addiction related.
- Integrated sober living home: These homes are the most institutionalized and run closest to an organized program, like rehab. All of the staff receive credentials, and the occupants receive the most amount of transitional help in these environments.
An example of a successful sober living home is Cassie’s Cottage, a women’s sober living home in Connecticut. Cassie’s Cottage emphasizes two critical aspects of the recovery journey: connection and accountability.
To support both, residents are encouraged to use the Soberlink Alcohol Monitoring System upon both intake and release. The founder of Cassie’s Cottage, Beth Lipovich, says that Soberlink can provide an added layer of support in recovery and provides peace of mind for both clients and their loved ones. “For their three [or plus] months at Cassie’s, clients are answering to us as their support system, but when they walk out with Soberlink in hand, I feel so much more confident that their success is going to be that much stronger,” Lipovich says.
Generally, stays at sober living homes last at least 90 days, but residencies can be arranged to be as long as necessary, depending on the client’s comfort level and situation. At Cassie’s Cottage, a minimum stay of three months is required.
Are Sober Living Homes the Same as Halfway Houses?
Though they do have similarities, sober living homes are not the same as halfway houses and may be confused with one another.
For those coming out of a treatment program, a sober living home is most likely for you as they are often a voluntary choice and run by private institutions. In contrast, those who reside in halfway houses are usually court-mandated to be there and run by the state; those who live there may not be in addiction recovery, and that can be harmful to someone looking to remain sober.
While both have readily available resources like mental health services, those looking for recovery may find sober living homes to be more beneficial to their growth than halfway houses.
Therapy and Counseling
During inpatient treatment at a rehabilitation center, therapy and counseling sessions are regularly held at least once daily; this contributes to the safety and security felt in the “treatment bubble.”
Continuing this counseling after leaving rehabilitation can be a critical part of the recovery process because it helps patients continue to address and find ways to overcome triggers, manage difficult emotions, form healthier behaviors, and reintegrate into everyday life while remaining sober. It is one of the ways those who struggle with substance abuse can bring part of treatment with them out into the outside world, making the transition a bit easier.
Two forms of mental health counseling that are commonly used in both inpatient and aftercare treatment include cognitive-behavioral therapy (CBT) and dialectical behavioral therapy (DBT).
Cognitive-behavioral therapy is widely used to teach those in recovery about how to find connections between their thoughts, feelings and actions, and their impact on recovery. Often used to heal anxiety and depression (which are also disorders commonly seen in alcoholics,) CBT aims to find the “why” behind an individual's thoughts and behaviors and gives them the tools to move through them.
CBT has three main goals: recognize, avoid, and cope. For those with substance abuse struggles, that translates to recognizing what triggers you to drink, learning to avoid and remove yourself from those triggers, then utilizing the skills you’ve learned with your therapist to cope with those same triggers to help you avoid a relapse.
Dialectical behavioral therapy has several core principles that can be especially helpful in addiction recovery. These include improving communication skills, coping skills and self-image through mindfulness, distress tolerance, and emotional regulation. “A big part of the treatment and the recovery process is teaching clients how to respond in a more effective, appropriate way and recognize that sometimes, we need to have tough conversations. It’s coming from a place of genuine caring and concern,” Sarah Espenshade of Espenshade Counseling shares.
DBT has three main methods when treating those with addiction: assist an addict with finding a new community and environments that support a sober lifestyle, motivate an individual to remove any relationships that do not support their new lifestyle as well as any substances in their environment, and to inspire an individual to remain confident and self-assured during stressful or triggering periods in their lives.
While many alcoholics’ attend therapy alone to repair relationships that may have been tested and damaged due to alcohol, many counseling services and sobriety programs offer family therapy or counseling to help both clients and their family members engage in positive communication methods to create a robust support system for clients.
Depending on an individual's circumstance, they may benefit from including both personal and family therapy in their aftercare plan to help them work through the “why” behind their drinking while simultaneously healing the relationships that may help them stay accountable to their sobriety.
Recovery Coaches
Recovery coaches are “trained professionals who partner with an individual in recovery to meet them exactly where they’re at in their recovery journey,” says Cini Shaw, Executive Director of The Lighthouse Recovery 365. Many recovery coaches have experienced AUD themselves and can therefore connect with clients on an even deeper, more personal level. Having experience in both treatment and aftercare, Recovery Coaches can ease an individual into their own aftercare plan.
There is a difference between therapy and Recovery Coaches. While some therapists may focus on addiction recovery, it is usually not their only area of expertise, whereas Recovery Coaches are trained specifically to work with those going through addiction treatment.
In order to help clients progress in their sobriety journey and assist in avoiding relapse, coaches can help clients create a plan to achieve their long-term recovery goals post-addiction treatment. Afterward, they help ensure that clients not only stay on the path to sobriety but that they heal and develop wellness skills to sustain it. “I really do believe that this is how we save lives,” Shaw says, “by being with people and supporting them during this challenging transition back to home, community, family, and work.”
Methods that recovery coaches may use to help those suffering from addiction sustain sobriety include face-to-face meetings, daily check-ins via phone or text, and remote alcohol monitoring. Whether coaches and clients can meet in person or whether they’re miles away, the important thing is for them to remain connected throughout their aftercare period.
While conversations will help the recovery coach gauge how clients are feeling, Soberlink’s real-time reminders, testing, and alerts allow clients to build structure and accountability into their day and consistently document their sobriety. Knowing that they will be tested can help clients remain more conscious of their choices and more deliberate with their actions minimizing a client’s possibility of relapse. Shaw explains, “All the little roadblocks, all of those firsts: a family dinner and everyone’s drinking, a business trip, or they’re alone on a plane, and the flight attendant asks them if they want something to drink. The thing that is nice about Soberlink is that it helps people get in front of these kinds of things … It helps to keep people accountable and honest.”
Alcoholics Anonymous
Alcoholics Anonymous (AA) is one of the most widely known tools to help manage addiction and can be a necessary resource to include in your aftercare plan. AA, which is a 12-step program that has been around since 1935, is a free resource that is extremely accessible, as it has meetings all around the world at all times of the day, both in person and online.
Those newly out of treatment may find AA especially welcoming and comfortable, as many rehabs and organized treatment centers require group therapy sessions for their occupants. AA can give an individual a community of like-minded people with the same goals as their previous group therapy community did. This also may help those who are in need of a new community of sober friends and supporters in this new season of life.
Added Support for Aftercare
There are multiple methods to utilize in an aftercare plan to help keep clients further connected to their sobriety journey and their support systems. This can include videoconferencing, telephone check-ins, and online assessments. Each of these options provides clients with additional support post-treatment as they navigate through the unfamiliar terrain of recovery.
Videoconferencing and Telephone Check-Ins
When face-to-face communication between a recovery coach or someone in the client’s support circle is not possible, videoconferencing often serves as the next best thing and has been shown to produce effective results for those who are actively managing their addiction.
One study, published by The Journal of Substance Abuse Treatment, evaluated the effectiveness of weekly web-based videoconferencing and in-person counseling for AUD and other Substance Use Disorders (SUD) over three months. The results supported video conferencing as a sufficient method of counseling based on attendance, urinalysis results, and patient satisfaction ratings.
Another clinical trial, cited by the Surgeon General, compared weekly phone calls and brief counseling with two other treatments: standard continuing care and individualized relapse prevention. Telephone monitoring produced the highest rates of abstinence from alcohol during follow-up twelve months later.
Video conferencing and telephone check-ins also are ways to stay connected to those you met in addiction treatment. Not only will this help you feel less jarred by the abruptness of leaving the “treatment bubble,” it also will help you stay in a community with others who are also trying to manage their addiction. This is an excellent way to practice accountability during your aftercare period and find a community of like-minded individuals.
Online Assessments
If you are struggling with finding resources to add to your aftercare plan, utilizing online assessments may be beneficial. In this digital era, there are a variety of exceptional websites and apps that clients can utilize to aid in their sobriety journey. These can include daily check-ins from Soberbuddy, a recovery-focused website that delivers daily “bite-sized recovery challenges” to clients’ inboxes, as well as words and stories of encouragement to aid in managing addiction.
CHESS Health is another addiction management platform that can be a helpful tool to provide clients with ongoing support in their addiction recovery journey. The app offers both static components, like guided meditation, as well as dynamic features, which are triggered by GPS. Dynamic features include alerts when clients are near high-risk areas, such as bars or liquor stores, asking if they really want to be there and gently reminding them of their sobriety.
Though utilizing online assessments is not necessary or vital to managing your addiction during aftercare, individuals may find this boosts their self-esteem and self-worth as they continue to see success with these resources, ultimately helping them maintain sobriety.
Stay Committed, Stay Sober
We know that managing addiction through any period is hard, but coming out of your treatment bubble may make it feel impossible.
We are here to tell you that, yes, it will be difficult at times; however, with a plan in place, slipping up or experiencing a relapse will become less likely. By finding treatment tools that work for your specific circumstances and a community of people who support you, practicing accountability and achieving lifelong sobriety can be a possibility for you.