How to Increase Participation in Substance Abuse Aftercare Treatment

Long-term substance abuse treatment is associated with better outcomes. One way to prolong support for alcoholics and addicts is to provide aftercare following completion of inpatient treatment. "Aftercare, more appropriately termed continued care, can help prevent relapse and chronic disease," Professor Yifrah Kaminer said after he led a University of Connecticut study on chemically dependent adolescents. Participation in aftercare groups depends upon motivation and overcoming barriers to attendance.

Instructions

Encourage and Ensure Access

• 1

  Provide an orientation session. A study conducted by Virginia researchers compared a 20-minute session with an aftercare therapist who encouraged participation, explained why it was helpful and had the participant sign an agreement to attend, to a 40-minute motivational video. Those who received the 20-minute orientation session were 70% more likely to attend aftercare than those who watched the video.

• 2

  Arrange aftercare groups near where participants live. A study at the Center for Health and Veterans Affairs in Palo Alto, California found that participants who lived within 10 miles of aftercare services were more than twice as likely to attend groups than those who had to travel more than 50 miles. Only 40% of those who lived 25 miles away had any participation. Distance and transportation are barriers to accessibility. Having a choice of times as well as places also allows needed flexibility for those whose jobs may take precedence.

• 3

  Provide childcare. For parents who complete substance abuse treatment and who reunite with families, the care of young children can be isolating. Difficulty going to self-help meetings and aftercare lead to high rates of relapse and are linked to a lack of safe babysitting options. With encouragement from therapists, aftercare participants may be willing to organize and take turns providing childcare so that parents can attend groups.

• 4

  Reduce the stigma of relapse in aftercare. Although a no-tolerance policy may be appropriate during inpatient treatment, life outside a recovery home is more intense. Participants have learned that they have a disease that is susceptible to relapse. Relapse prevention is the focus of aftercare but the loss of support networks after relapse can make recovery difficult. Aftercare groups can help a member who has relapsed and others can learn objectively about the consequences of relapse. One appropriate strategy is to give the decision to exclude a relapser from aftercare to the other members of the group.