Continuing care is a general term for the care that follows completion of a partial hospitalization (PHP) treatment program.
People who successfully complete a primary treatment program for substance abuse or addiction should be proud of their accomplishments. However, despite their positive results, they still have many challenges to face on the road to long-term recovery. One of the keys to meeting those challenges and maintaining sobriety is enrollment in some sort of continuing care program[i] designed to reinforce the benefits of primary treatment.
Anyone who successfully completes a treatment program must return to daily life and its many routines and unexpected events. In many cases, this also means returning to environments and situations where drug or alcohol abuse occurred in the past. People leaving treatment centers have almost certainly learned new skills for coping with exposure to these substance use triggers. However, even with new coping skills in place, anyone in recovery can succumb to a triggering event or setting and return to active drug or alcohol intake.
In fact, over 50 percent of all people who complete a substance use treatment program will relapse at some point within the next 365 days[ii]. Relapse is dangerous for two reasons. First, it can lead to the long-term re-establishment of a dysfunctional pattern of drug and/or alcohol consumption.
In addition, a relapse can lead to the onset of a fatal or non-fatal substance overdose. As a rule, the longer people remain in treatment (30 – 60 – 90 days), the less chance they have of relapsing after returning to their daily lives.
Continuing care is a general term for the care that follows completion of a partial hospitalization (PHP) treatment program. However, this term does not necessarily apply to all post-treatment care options. For example, some people follow participation in a drug or alcohol program with brief check-ins designed to provide an update on their condition. In addition, some people follow up their program participation by joining a 12-step or self-help group.
Both of these options can provide a real-world benefit. However, continuing care usually refers to a longer, more structured type of follow-up administered by the same types of addiction specialists who conduct primary substance treatment.
The nature of a structured continuing care program depends largely on the type of setting used for primary substance treatment. This is true because continuing care efforts take a less concentrated form than primary treatment. For example, a person who undergoes primary treatment in a residential program might start receiving follow-up care in an intensive outpatient program, or IOP. On the other hand, a person who undergoes primary treatment in an IOP might start receiving follow-up care in a less intensive outpatient program.
Intensive outpatient programs[iii] are designed to provide many of the same core benefits as participating in an inpatient substance use treatment program. In fact, people unable to participate in inpatient programs sometimes enroll in IOPs instead. The heart of the typical IOP is multiple weekly sessions of group therapy. Specific benefits of this form of therapy for continuing care participants include:
Intensive outpatient therapy also tends to include some form of one-on-one counseling for participants. This counseling is generally secondary to group therapy. Nevertheless, it plays an important role in making sure that continuing care meets the needs of each enrolled person. IOPs also usually feature continuing medical and psychological/psychiatric assistance.
People enrolled in less intensive outpatient programs attend fewer treatment sessions than people enrolled in IOPs. However, they still gain many of the benefits provided by IOP enrollment. The focus in outpatient continuing care is group therapy, which often takes only an hour or so per week. Like intensive programs, outpatient programs usually feature continuing medical and psychological/psychiatric assistance for all participants.
Studies show that participation in continuing care has, at a minimum, a moderate positive effect on the chances that graduates of an addiction treatment program will maintain their sobriety over time. For example, when people enroll in an IOP after receiving treatment for alcohol abuse/addiction, they consume alcohol much less often than people who don’t enroll in continuing care. In addition, they have a lower level of exposure to alcohol-related harm.
The benefits of continuing care are largely linked to the amount of time participants stay enrolled. Positive results occur most often in longer-term programs, and less often in shorter programs. The very best outcomes are found among people who participate in some form of continuing care for six months to a full year. People who start by participating in an IOP can stay involved by eventually switching over to a less intensive outpatient program. Continuing care also works best when it provides enough time to focus on the needs of the individual and make adaptations in treatment when needed.
At Transformations Treatment Center our outpatient phase of treatment includes both intensive outpatient and outpatient continuing care options. Laura Lawrence, MA, CAP, Director of Outpatient and Family Services at Transformations Treatment Center says, “It is my personal belief, backed by statistics, that the longer you remain in treatment the greater the possibility of sustained recovery.”
Our continuing care programs are designed to deliver the counseling and skills training needed to increase the long-term odds of maintaining sobriety. Small groups, 12 step meetings, weekly alumni meetings and morning, afternoon and evening sessions are just a few options available. Our intensive outpatient program is also suited for people who can’t set aside the time required for a full course of inpatient substance use treatment.
