It can sometimes come as a bit of a shock to both clients and their families once the time of rehab comes to an end that there is mention of ongoing treatment – most commonly referred to as aftercare.
Ongoing treatment is what aftercare really is, however, and this might even seem a bit excessive after a period of rehab that may have lasted several weeks, even months.
It is not an overstatement to say that recovering from a substance misuse disorder can be one of the most challenging things anyone can ever experience.
The kind of work that has to be done in order to help someone break out of addictive behaviours would be hard to imagine for some people who have not experienced it themselves.
Because recovery is so demanding for the person struggling with addiction it can cause a huge emotional strain.
Some of the things that can come up for a person when they are faced with the issues underlying their addictive behaviours can be very distressing or, at least challenging.
Dealing with these challenging issues is one of the principal ways rehab helps people who have become trapped in substance misuse.
Rehab provides a place where professional support is readily available so that anything that might come up can be worked through safely.
When substances are no longer available as a way of coping with emotional struggles, new and healthier ways have to be found.
Rehab teaches new ways but it would be unrealistic to expect anyone to suddenly be able to deal with everything life brings easily, when they might have been relying on substances to do this for many years.
Once the time in rehab comes to an end, aftercare continues to provide the vital emotional support that everyone needs when they go back into the “normal” world and start living their lives without substances.
Everyone needs support in life, and aftercare ensures that support is there when starting out in recovery.
Whilst someone is in rehab, one of the areas they will look at is relapse prevention.
This is the very practical area of looking at ways to avoid situations (of all sorts) that are more likely to cause someone to relapse back to their addictive behaviour.
Rehab will help someone reflect on, prepare and plan for occasions, whether that involves particularly places, people or emotional triggers, that might threaten their recovery.
However, looking at these things whilst in rehab can seem very different to when they are faced in reality.
This is why it is important to have support in place where these difficult situations can be talked over once again, and fresh plans and supports put in place so that the challenges can be conquered.
Aftercare is an opportunity to learn or revise relapse prevention mechanisms to keep someone’s recovery safe.
Substance misuse disorders can be extremely confusing conditions. Why people misuse substances, why they struggle to stop, why they make the decisions they do, can seem incomprehensible questions.
In rehab, clients learn what we know about the science and psychology behind addictive behaviours and how this knowledge can help us learn how to bring about change.
Due to the complexity of these disorders, there is a lot that can be learned.
The time in rehab, however, does not have as its main aim, the making of lots of substance misuse experts.
There is a lot to be done during rehab, and not enough time to go into too much detail about what science has discovered about addictive behaviours.
Aftercare will often provide opportunities to learn a little bit more about substance misuse.
Indeed, once a person returns to life outside of rehab, some of the things we can learn about the way addiction happens in the brain will probably make a lot more sense.
When someone begins to live life without substances, things can seem very, very new. For someone suffering from a substance misuse disorder, their brain considers that substance as important as food and water.
Life in recovery is a life where the brain has to re-learn how to do life without that substance.
This can be difficult to imagine, but for many people recovering from addiction, they just will not have learnt (or will have forgotten) how to do some things without their substance of choice in their system.
There will be many occasions when they will feel like they simply do not know what they are supposed to be doing.
Aftercare is one of the ways of providing a support structure for people who are trying to rebuild their lives in recovery.
Having an agreed aftercare meeting in their timetable provides a concrete event to build other things around, as well as an opportunity to talk with a professional about precisely those times when they are feeling lost.
Because life in recovery is so new, and addictive behaviours so challenging to undo, it is enormously beneficial for people newly in recovery to have people to whom they are accountable.
Being accountable does not mean having people who tell you off when you do something wrong. It means having people there to talk to openly about how recovery is going: what is going well and what is going not so well.
The reason for accountability is entirely positive: it is so that the other person can try and help find ways to improve the things that are proving challenging and give much deserved positive feedback about the things that are going well.
When we are used to living our lives in a particular way for so long, it can be really difficult to know how to make decisions in a new way. Expecting to be able to do this all alone at the start of recovery is making an unreasonable demand.
Accountability provides someone to help bounce ideas off in order to make healthy decisions.
The difficult truth is that many people who are struggling with substance misuse, spend their time with other people who are in the same situation.
This is to be expected when you are in a situation that can feel very isolating and lonely.
When starting in recovery, it is important to have positive and supportive relationships in our life that will truly help us to keep making the right decisions.
Unfortunately, the reality is that if someone’s support network is made up of people still making unhealthy decisions, then when difficult times come it is likely that their advice will not be the best.
Even if rehab doesn’t provide a set of new best friends, aftercare will definitely provide a set of people who are in exactly the same boat as each other.
Creating a network of people who have been through similar struggles and are familiar with the battles that can come along, provides healthy support and removes any chance of feeling isolated.
When rehab comes to an end, it can be a temptation to think it can all be put behind us and a totally new life can begin. Actually, this is true.
But we need to continually learn from our experiences and continue to do the things necessary to keep our minds and bodies healthy. Aftercare is an important part of that.
Never try to do recovery alone; use the support that is offered; after all, you deserve to give yourself the best chance.