Extended Care is a relatively new concept in the addiction treatment field and is largely a result of the growing evidence that more is needed to obtain long-term success and avoid relapse. It’s careful to note that some organizations refer to sober living or outpatient programs as extended care. While these programs do offer long-term sobriety support, extended care treatment is a specific type of program. Make sure you ask the right questions when researching addiction treatment options to be sure the program you are considering is a true extended care program.
An extended care program bridges the gap between the highly controlled environment of inpatient drug treatment and the more liberal setting of a sober living program. Extended care treatment programs take place within a residential setting. Patients may stay for 90 days or longer. Extended care is considerably less expensive than inpatient treatment and may be a good option for someone who has experience a short relapse.
What should a good Extended Care Program provide?
- A program curriculum. Unlike sober living programs, an extended care program should have a curriculum in place that includes programming throughout the day.
- Clear objectives. There are clear objectives and goals for each client to achieve.
- 24/7 supervision and staffing. Unlike sober living programs, extended care should program staff-supervised activities and staff engagement with the client throughout the day.
- Life skills training. One key differentiator of extended care services, as compared to sober living, is life skills training and clinical services to ensure the patient will be ready for an independent life.
- Employment assistance and coaching. Some clients better manage this process with added support.
- 12-step recovery augmentation or support.
- A strong clinical component. Extended care programs should include clinical services like group therapy and individual therapy to supplement the structure in the house. Make sure that the clinical team and housing team are with the same company to facilitate good communication with each other.
Signs that an Extended Care Program is needed
Clients, their loved ones, and clinicians often ask how they can know whether or not an extended care program is a right choice. Here are common factors that merit consideration of an extended care addiction program:
- Previous failures at the sober living level of care
- Dual diagnosis clients who may benefit from added mental health support
- No structure of career or family to return to
- Lack of life skills for independent living
- 18-25 age group often requires a more structured transition
- Moving to a new location where client has no community support established
- Repeated relapses after treatment episodes
- Low motivation for recovery
- Inability to demonstrate a clear plan with purpose
- An inpatient or residential treatment stay of fewer than 90 days
A stair-stepped transition to independence
Extended care is a step-by-step approach to helping the client transition from the highly structured and safe environment of an inpatient or residential program, so they are prepared for success in a lower structure, independent setting such as sober living. The best example of how extended care greatly increases outcomes is by comparing day one at sober living and extended care.
A client arrives at the house with a cell phone, possibly computer in possession. He or she is given money to go grocery shopping.
Most, if not all of the housemates are busy with their business either going to 12-step meetings or work.
The client receives an orientation of house rules and requirements. He/she must get compliant as soon as possible.
At this point, they face the pressure of finding meetings to attend, get employment in short order, possibly fill service work requirements and make new friends.
You have a person newly in recovery, now faced with mainstream society stressors for the first time since getting sober.
They have money in their hands and find other occupants already engaged in their daily routines.
If the individual is to succeed, they must be unafraid and motivated to ask for help when needed.
A client arrives, is greeted by staff members who check in client’s belongings and introduce them to the rest of the community and other staff.
After the admissions process, the client joins the rest of the community at their regularly scheduled activity.
The client receives a plan of objectives to complete over the course of the program.
They receive instruction as to how and when to find recovery meetings and a sponsor, as well as service commitments. Counseling appointments are set up.
Policies are in place for the use of cellphones, the internet and when other privileges become available.
You have a person newly in recovery that receives a step-by-step approach on how to regain their independence.
Much of the needed support is there for the client instead of them having to worry about getting it all set up on their own.
The accountability is real, and they are welcomed into a new community without having to pursue it on their own.
Structure and accountability
There is significantly more structure and accountability within an extended care program. In addition to a daily curriculum of activities, extended care includes significant hours of clinical services, led by trained professionals. This includes both group and individual therapy, to help the individual learn new coping skills and develop new habits needed for long term success. It offers participants a longer period of time to deal with the underlying psychological and mental health issues that often accompany a substance addiction.
Programming is designed to further life skills so the newly sober person is ready to tackle employment, school, family and the community. Life skills include eating healthy, fitness, meditation, and other healthy habits that improve the mind, body, and spirit. They will participate in 12-step groups and develop new social peers.
In summary, extended care treatment programs offer a managed approach, clinical support, and accountability for the newly sober individual as they continue their path to lifelong sobriety. They will continue to develop the life and coping skills required for success. All of which improve their chances of staying sober and regaining their place in their families and society.
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