Magazine article Addiction Professional

Effective Continuing-Care Planning: An Addiction Counselor's View

Magazine article Addiction Professional

Effective Continuing-Care Planning: An Addiction Counselor's View

Article excerpt

Addiction professionals understand that continuing care is an essential piece of the addiction treatment continuum. Continuing-care plans with varying levels of accountability exist throughout the United States. For the addiction treatment professional, however, the difficulty often comes when it is time to put the next "right step" in place for a patient moving to the next level of care.


Traditional 30-day inpatient treatment and corresponding outpatient treatment have become highly refined over the years. Today there are hundreds of excellent treatment centers throughout the United States that offer variations on these basic models. Most do a great job of detoxing their clients and beginning the process of getting them grounded in an understanding of their addiction and their responsibility to manage their ongoing care once they leave treatment. As is well-known among treatment professionals, managing one's addiction is easier while still in treatment with all of its available support. It is the transition out of treatment and either "back to life" or on to a lower level of care that presents the greatest challenges to the newly recovering individual.

Too often this crucial piece of continuing-care planning does not get the attention it requires from counseling professionals. It is not enough to keep individuals addiction-free during the time they are under a professional's care and then idly release them to the world with a basic plan for attendance at 12-Step meetings and words of encouragement.

More care must be given to working with the patient on successful implementation of an in-depth, thoughtful and structured continuing-care plan. If counselors and case managers gave each client's continuing-care plan more individualized attention, it would greatly increase the rate of recovery and would provide a more seamless transition.

Often the focus of counselors and case managers is on keeping the client in the here and now, present and focused on the work at hand. This goal becomes a dilemma as an equal effort to engage the patient in a continuing-care plan is begun. The unfortunate outcome is that aftercare planning often receives only passing attention as a final treatment planning item.

Our challenge is to raise awareness of both the importance of continuing care and the responsibility of the treatment program to look outside its own borders and build a more seamless continuity of care.

Here are some solutions that address five of the issues facing continuing-care planning and implementation today.

Concern: Aftercare plans are often homogenized and lack specificity.

Solution: Individualize your client care plans. All addiction professionals say that they customize the plan, but the reality is that too often clients in recovery receive a standardized plan--and patients are made 100 percent responsible for its implementation.

If your patient is simply leaving primary treatment to return home, rather than going on to another level of care such as a halfway house with a built-in treatment agenda, truly individualized follow-up is vital. Once out of treatment, many patients simply are handed a piece of paper suggesting they attend AA meetings three times a week. That's not enough--a truly individualized care plan will give the address and phone number of a convenient AA group near their home or office, explaining the dates/times of the appropriate meetings, what to expect, and more.

Information that is simple for an addiction professional to research can be impossible for a patient to handle--many patients don't know what an AA meeting is or how to find one--and it's the responsibility of the continuing-care coordinator to remove every obstacle in the way.

Individualized continuing-care plans recognize the factor of age. If a patient is a teenager, the plan might involve high school guidance counselors and parents, whereas a plan for a senior in recovery might take into account medical issues, and expectations of wife/husband and children. …

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