You officially completed treatment…congratulations!

Now what? Like other areas of life where one completes a task, there are steps necessary to maintain positive results.

In substance use recovery, this is often referred to as aftercare planning.
In outpatient therapy, we also call this maintenance.

Think “stages of change” model. For many people, the first step to seeking help is the most difficult. Individuals may be pre-contemplating change as there is increasing awareness of concern and then moving along to contemplation, working through ambivalence. Then there is the commitment to change–taking action steps to achieve the end goal. This process can take a while and relapse is common. The Journal of the American Medical Association reports that “among individuals with substance abuse disorders who get treatment, 40% to 60% will relapse within 1 year”.

It is important to keep in mind that relapse does not not equal failure. Understanding the relationship between alcohol and drug addiction on the brain can help put things into perspective. Understanding the diagnostic features and developmental course of various mental health conditions is also beneficial. Each one has different risk and protective factors. Consider family history; also consider environmental factors.

Depending on your unique situation, different levels of care may be recommended to address the presenting concerns. Additional supports such as specialized treatment modalities, psychiatry, or a support group, may be recommended. It is common to step down from a higher level of support such as residential treatment or intensive outpatient to a weekly outpatient level clinic such as CARE Counseling. It is also common to step down from weekly outpatient treatment to every other week or less as progress is achieved and progress maintained. Having a maintenance plan in place can help.

Here are Five Questions to Ask Yourself

1. What are my Triggers?
Are there any particular places, people, or activities that are triggers for relapse? Are there any thoughts I may be experiencing that are triggers?

2. What are my Warning Signs?
What thoughts, feelings, or behaviors may indicate a risk for relapse?

3. What is my Self-Care?
What are you doing to take care of yourself that is beneficial for your mental health and/ or sobriety?

4. What are my Coping Strategies?
What coping skills am I using to help maintain the gains I’ve made in managing my mental health and/or sobriety?

5. What is my Sign to Return to Therapy/ Treatment?
Difficulties being consistent with self-care, falling out of routine, increased/ new stressors, experiencing a crisis, and difficulties using coping strategies are all signs that it may be time to reach out for help.

Our therapists at CARE Counseling will work with you to help understand your triggers and warning signs. They can assist with safety planning, if needed, as well as strategies for self-care and coping. We understand that life is stressful and maintaining gains takes intentional effort and ongoing support. We encourage clients to return to CARE Counseling in the future, or to call to get referrals to other providers even after services end.

Written by Charlotte Johnson MA, LPCC