The Importance of Aftercare

April 1st, 2024

By P. Casey Arrillaga, LCSW, LCDC

Tens of millions of Americans need treatment every year for
mental health disorders including addiction to alcohol and/or other drugs. Of
these, only a small percentage get help, and many continue to struggle after
treatment has ended. What can be done to improve their odds of living good
lives? One factor that can make all the difference is aftercare. We’ll look at
the ins and outs of this vital piece of the treatment experience and how to
determine if you or your loved one is getting what they need.

What We Know So Far

In 2020, the Substance Abuse and Mental Health Services
Administration [SAMHSA], surveyed Americans about mental health, including
addiction to alcohol and other drugs (also known as SUD for “Substance Use
Disorder”). They found that over 52 million American adults had issues with
mental health. The survey separated this from SUD, which was problematic for another
40 million people aged 12 or older. This means that about 15% of Americans aged
12 and older needed SUD treatment. Unfortunately, many of these never got the
treatment they needed or didn’t get enough of it. Of the people who showed both
SUD and other serious mental health disorders, about half got treatment for one
or the other, but less than 10% were treated for both. This might be a good
time to note that at Windmill, we always treat our clients for any addiction
and other mental health conditions holistically, because we know it is hard to
recover from one condition when another goes completely unaddressed. Unfortunately,
many treatment facilities do not do this, or don’t take the time required to do
it effectively.

To make matters worse, many who get treatment still struggle
after they get out. Relapse is a danger for SUD and any other mental health
disorder. While estimates differ, most researchers find relapse rates after
treatment to be in the 40-60% range. Many factors play a role in this. For
instance, younger people have a higher risk of relapse. Having multiple mental
health issues also increases relapse risk. How long the treatment program lasts
is significant, with longer programs leading to lower relapse risk even if the
client doesn’t finish them. Of course, whether the client completed the program
makes a big difference. Unsurprisingly, program completion is associated with
lower relapse risk.

Research shows that the first 90 days after leaving
treatment are the most treacherous. While the risk is lower for those who can
get through this vital time period, support is still needed. The longer someone
stays connected to support systems, the better their odds of avoiding relapse
or minimizing how bad it gets if it happens. Higher levels of support and
staying connected to recovery fellows and the treatment center community
increase the chances of staying healthy. If relapse occurs, the connected client
is more likely to return to treatment and turn things back around.

This is where aftercare programs come in. Aftercare is a
general name for any follow-up care that happens after residential or intensive
outpatient treatment has been completed. This may include alumni events and
gatherings, meetings held at the treatment center, follow-up phone calls,
social media groups, or anything else that keeps the alumni client connected to
their treatment experience after they are done.

Aftercare can make the difference between staying healthy or
relapse after treatment has ended. While it is not the only factor, engagement
in aftercare has been shown to improve not only the chances of preventing a
return to the previous problems, but it also increases satisfaction with
recovery and quality of life. Some researchers have found aftercare so
important to recovery after treatment that they don’t like using the term
“aftercare,” because they feel it doesn’t put enough emphasis on how much of a
difference it makes. They would prefer that it be given a name that makes it
clear that it is a part of the treatment experience that every client should
experience rather than something optional that is done “after.”

All of this makes clear that an important question to ask
before choosing a treatment center is whether they offer aftercare and how
robust that aftercare program is. Many places that might otherwise seem like
good options fall short in this area, which means that no matter how good their
treatment is, they are sending their clients out into the world without the
tools and support they need at this most vital stage.

What Should You Look For?

When looking at treatment options, you want to find a place
that puts strong emphasis on aftercare. It should include multiple ways for
clients to stay connected and involved after they leave treatment.

As you may have guessed, at Windmill, we take aftercare very
seriously, which may be one more reason we have been rated as having the best
success rates in the nation. Here are some of the ways in which we have
aftercare covered:

• Multiple alumni meetings weekly – We have five
  recovery/support meetings that include alumni and current clients every week.
  Three are open to both alumni and their family members, including our DAA
  meeting, our SMART Recovery Family & Friends meeting, and our weekly family
  workshop. All three are hybrid (in-person and online), so our alumni and their
  families can join from wherever they are. We have two other specialized
  meetings weekly that alumni and current clients can attend together to share
  experience, strength, and hope, including our weekly Guardians Anonymous
  meeting for veterans and first responders.
• Special events – Alumni and their families come
  from all over for our annual alumni roundup, Halloween party, and other events
  throughout the year.
• Alumni calls – Our staff makes follow-up calls
  to alumni to see how they are doing. We also get regular updates from many of
  our alumni who check in to let us know how their lives are going.
• Featured speakers – Many of our alumni have come
  back to speak to the community at Windmill, often talking to current clients
  about how their lives have changed during and after treatment. It is a great
  joy to see them bring their families to celebrate getting one or more years of
  recovery and talk about how they did it.
• Social media – Windmill has several private
  social media groups where alumni share victories and milestones, as well as
  being able to ask for support when they need it. We also have a private group
  for alumni family members, many of whom have gotten to know each other through
  our family workshop and SMART Family & Friends meetings.

The Bottom Line

Relapse risk is real for anyone who struggles with any
mental health disorder, including addiction of any kind. Aftercare can make a
vital difference, sometimes being the support that makes it all work after
treatment. When considering treatment for yourself or a loved one, find a
program that has the strongest aftercare you can.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.