By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
How does aftercare relate to treatment?
Aftercare is continuing or follow-up care that is received after the initial intense round of treatment. This is common in counseling those with a substance use disorder. It should be more common for those with most types of mental illness also. Aftercare is intended to prevent a return to active symptoms of the disorder. In the case of substance use disorders, this means aftercare should reduce the risk of relapse.
This term probably originated back in the days when the 28-day rehab was common practice. You got your initial drug or alcohol treatment in a residential treatment center and then after that initial period, you went home. Remember that while medical treatment for physical health problems has been around for centuries, treatment for substance use disorders and mental illness are relatively new procedures.
It is easier staying clean and especially sober when you are in a residential program. It is possible to get drugs and alcohol into a rehab facility but many of the people who are there are really trying to quit and they will report that kind of thing. Programs try their hardest to keep drugs out, kind of like jails do.
What often happened when people left the program was that they ended up back in the same environment as before. Everywhere you go there are people using drugs, drinking, and so on. The temptation to revert to the old ways of behavior is tremendous. Think of the alcoholic in early recovery. Everywhere they go there is alcohol. Why even the grocery store is out to get them. You have to walk past the wine to get produce and the beer is in front of the meat case.
To help people who had done a residential drug treatment program stay sober aftercare of some kind is a big help. This may be as little as one time a week or it could be more. Some aftercare’s are even a meeting every night.
Having this ongoing connection to other clean and sober people helps keep the person focused on their recovery and reduced the temptation to do what others were doing and get high or drunk. If you hang out with sober people you are less likely to drink.
Recently we have seen this same aftercare advantage with those with a mental illness. You can go see a therapist, get and take meds but if at the end of a few weeks you go back to your old way of living and nothing changes then you can end up feeling the way you used to feel. The depression has returned.
Staying connected to meds and therapy longer reduces the risk of relapse. One study I read reported that those who stayed on antidepressant meds for two years had fewer relapses even after discontinuing the medications.
Whatever you do to change your life. Keep doing it after that initial change effort starts working. That is aftercare in practice. Maintaining your changes is the primary purpose of attending an aftercare program.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
You might also want to check out these other posts Drug Use, Abuse, and Addiction
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