All Treatment had the opportunity to discuss aftercare treatment with the Executive Director at Sierra Tucson, Dr. Patricia Ryding.
AT: What is the definition of aftercare?
Dr. Patricia Ryding: It depends on what the individual's needs are because all aftercare plans are individualized. Meaning there is no cookie cutter formula for what people need - it depends on what their issues are in treatment. There may be 12-step meetings, connecting with a sponsor, counseling for particular traumas, psychiatric care, and/or intensive outpatient care. The objective of aftercare is to provide a bridge from the protective environment of primary or residential care to the "real world", giving the patient manageable steps towards independence while maintaining a life of sobriety.
there is no cookie cutter formula for what people need
AT: Does every patient who leaves residential treatment have some sort of aftercare plan?
Dr. Patricia Ryding: Yes. That's actually a requirement. The Joint Commission, which regulates hospitals, requires that every discharged patient have a discharge or aftercare plan. We are no different than a medical hospital which gives every patient a discharge plan, outlining the steps they should follow upon leaving the hospital; to be sure the recovery plan is followed.
AT: Is aftercare is something covered by one's insurance?
Dr. Patricia Ryding: Generally yes. If one has insurance benefits it is generally covered under the outpatient pocket of the mental health section.
AT: Does that also include Medicare or Medicaid?
Dr. Patricia Ryding: Medicaid no. Medicare yes, or sometimes yes. It depends on the policy, whether it's disability or retirement.
AT: Are there specific things that family and friends can do during aftercare that is most helpful to the patient?
Dr. Patricia Ryding: Certainly. Make sure the patient is following through on their aftercare plan. Support that plan. If it's keeping doctor's appointments, group therapy, 12-step meetings, etc. Without being co-dependent they can encourage and help their loved one to follow the plan. Sometimes people in post-treatment feel good and think "I don't really need all that", which can get them into tough situations.
AT: So does that mean aftercare plans are reviewed with the patient and their family?
Dr. Patricia Ryding: Ideally yes. When the family is here during the Family Week, there will be a meeting with the continuing care counselor. This requires the approval by the patient to include their family in the aftercare plan. Patients need the support and encouragement of this community to give them the best chance for continued sobriety. Discharge planning or aftercare planning starts the day of admission. So as a patient is coming in the door we are asking ourselves "What does this patient need to be successful, post-discharge?"
AT: What is the biggest hurdle for recovering addicts when they re-enter society after residential treatment?
Dr. Patricia Ryding: To stop from moving so fast. After leaving treatment the patient feels invincible. They need to stay grounded. Take one step at a time. Follow their aftercare plan.
AT: If a relapse occurs, what should be done?
Dr. Patricia Ryding: Relapse is a part of the process. As a clinician, my biggest concern is that when people relapse they feel like a failure. Sometimes that testing of the water, while it's not good, is not all that unusual. This disease is about recidivism. It's about getting back on the horse, attending meetings, calling your sponsor, and possibly going back into detox. It may be about another piece of emotional or psychological work that needs to be done. Or they've ignored triggers and thought they were fearless and put themselves in danger by thinking they could handle a situation that turned out to be toxic.
AT: What are two or three factors that have the strongest impact on post-treatment long term sobriety?
Dr. Patricia Ryding: Support. The patient's support system is critical. Having a sober community of friends and family who aren't going to try and convince you to consume the drug of choice. Also, attending 12-step meetings and on-going therapy support in critical to long term sobriety.
AT: So if you're a family member of an alcoholic, should you practice abstinence?
Dr. Patricia Ryding: Not necessarily. They need to get to Al-Anon. Not everyone in an addict's life will also be an addict. But the patient in recovery needs to be surrounded by people who are safe. The main thing is to have clear communication between friends, family members and the addict. Questions like: "Does the presence of alcohol in our cupboard bother you? If so, I'm happy to hide it or get rid of it." People should not feel responsible for keeping the patient sober, but they can support that person, love them, and engage in conversation to be sure that home is a safe environment for everyone.
AT: What are most important questions a family should ask of a treatment facility when they are investigating where to place their loved one?
Therapy has a bias towards people who can verbalize but the reality is that for some people talking is not the best way for them
Dr. Patricia Ryding: Can this facility treat the issues that my loved one has? Because most people are not "just" an alcoholic or drug addict. There could be pain issues, trauma issues, or sexual compulsivity issues.
Can my loved one operate in this environment? Is it too big? Too small? Is it co-ed and my loved one needs a single gender environment?
Also, how do they address the issues? Is the staff prepared and able to address the individual's issues?
What other types of therapy are offered? Music, art, acupuncture, etc. Therapy has a bias towards people who can verbalize but the reality is that for some people talking is not the best way for them to emote or deal with their feelings. For that reason we have other forms of therapy that help those for whom sitting and talking about their feelings is not effective.
If treatment is so painful for the patient that they can't function or get out of bed the next day, then they're moving too fast. That's not the treatment for them. They need to slow down and take a different approach.
So families need to be sure the treatment facility has approaches that can be tailored to the needs of the individual patient - to assure the most effective and lasting recovery.
All Treatment does not provide medical advice, diagnosis or treatment. See additional information.