Recovery is a journey, not a destination. For clients with Alcohol Use Disorder (AUD), rehabilitation plays a significant role in recovery as individuals attain sobriety and begin to find inner peace. The journey doesn’t stop there, however. Aftercare is the next critical step as clients exit the “treatment bubble” of rehabilitation and reorient themselves into another chapter of their life.
The “Treatment Bubble”
From the moment they wake up to the moment they fall asleep, clients in rehabilitation are entirely immersed in the recovery journey, as explained by Certified Interventionist and Recovery Coach John Roesch. The safety, security, and connection that clients experience in the “treatment bubble,” may appear to be slipping away as their discharge date approaches. For some, it can be overwhelming to abruptly transition from treatment back to everyday life. Often, the positive changes that clients have made may be placed in jeopardy if they’re returning to the same environment that they were in before detox or residential treatment.
To ease these anxieties and help maintain sobriety established in 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.”
What is Aftercare?
Aftercare, or treatment that takes place 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. Methods of comprehensive continued care include 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. 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. Here are some examples of each.
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.
Cassie’s Cottage, a women’s sober living home in Connecticut, emphasizes two critical aspects of the recovery journey: connection and accountability. To support both, residents are encouraged to use the Soberlink System upon 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.
Therapy and counseling
During inpatient treatment, therapy and counseling sessions are regularly held at least once daily. 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. 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. 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.
To repair relationships that may have been tested and damaged due to alcohol, many counseling services and sobriety programs, help both clients and their family members engage in positive communication methods to create a robust support system for clients.
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. In order to help clients progress in their sobriety journey, coaches can help clients create a plan to achieve their long-term recovery goals. 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 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. 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. “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,” Shaw says.
Continued care options, like those mentioned above, help ensure individuals feel supported in their recovery journey, instead of overwhelmed. As the first year of sobriety can often be the most challenging, aftercare for AUD is essential to hold individuals accountable and set up success for long-term recovery. 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 commonly viewed 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.”
Aftercare and Alcohol Use Disorder
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 supports, 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. After leaving the security and familiarity of treatment, they 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
Providing motivation in newfound territory, recovery-oriented systems of care help emphasize the reality and hope of long-term recovery. With this system of 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 turn back to what’s familiar.
Added Support for Aftercare
There are multiple methods to help keep clients further connected to their sobriety journey and their support systems, such as videoconferencing, telephone check-ins, and online assessments. Each of these options provides clients with additional support 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. 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.
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. CHESS Health is another addiction management platform that can be a helpful tool to provide clients with ongoing support in their 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.
Remote Alcohol Monitoring for Accountability
‘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. To strengthen clients’ support systems, clients can send tests to their recovery coaches, recovery professionals, or family members. 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. A study by the Journal of Political Sciences and Public affairs provides evidence that alcohol supply and relevancy has 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.
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, discover how 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.
About the Author
Soberlink supports accountability for sobriety through a comprehensive alcohol monitoring system. Combining a breathalyzer with wireless connectivity, the portable design and technology includes facial recognition, tamper detection and real-time reporting. Soberlink proves sobriety with reliability to foster trust and peace of mind.