What is Continuing Care?
Continuing Care DefinitionContinuing care is defined as a lower-intensity treatment following intensive residential or outpatient interventions. Often synonymous with aftercare, continuing care offers support for individuals after intensive treatments with a focus on abstinence management.1
What is the Difference Between Assisted Living and Continuing Care?
Assisted living is often confused with continuing care. While continuing care retirement communities exist for older adults who need help, these differ from continuing care for addiction recovery. Assisted living retirement communities tend to be long-term assisted living situations.
Continuing care for addiction does not always have a residential component; rather, individuals participate in check-ins and regular counseling. Check-ins may be in person or through telehealth visits. Psychoeducational groups, 12-Step programs, and recovery groups are another part of continuing care for individuals with addiction.
Why Is Continuing Care Important?
Treatment for substance abuse usually takes place in a time-limited setting. Upon completion of a treatment program, many individuals relapse due to a lack of perceived support. Continuing care is important in relapse prevention and mental health management as it provides extended recovery monitoring.2
As individuals move through recovery, their needs for treatment may shift. Continuing care allows for adjustments to be made as necessary to an individual’s treatment plan. Additionally, continuing care puts individuals in touch with resources for relapse prevention and support. Continuing care is not linear, and individuals may move between different levels of intensity in care.
Important Services on the Continuum of Care
Residential TreatmentResidential treatment programs and detox centers are where the continuum of care begins. Residential treatment facilities allow individuals to receive round-the-clock care and monitoring for the initial part of recovery. This is especially beneficial for individuals who are at high risk for relapse or do not have support at home. Residential care can take place at a continuing care facility, or in continuing care communities such as sober living programs.3
Outpatient treatment tends to be less intensive than residential treatment but still requires a time commitment. The recommended minimum duration for intensive outpatient treatment is considered to be about ninety days, with a recommended minimum of nine hours of structured treatment per week.4
Non-intensive outpatient treatment is shorter in duration, lasting anywhere from forty-five to sixty days. Outpatient treatment options vary; as individuals meet goals related to their sobriety, the intensity of treatment decreases.
Aftercare ProgramsOnce individuals complete their chosen primary treatment program, they can be transitioned into community continuing care programs or aftercare programs. Individuals who already have a period of sustained sobriety, are beginning to see improvements in relationships, have developed coping skills, and are living in drug-free environments are the best candidates for continuing care programs. Support groups, 12-Step programs, and peer recovery support services are all a part of the continuum of care.
Effective Continuing Care Components
Extended MonitoringExtended monitoring is key in continuing care programs. Individuals receive check-ins regularly and are encouraged to attend therapy. Extended monitoring allows for effective relapse prevention as individuals can easily get in touch with the help they need. Additionally, extended monitoring allows for adjustments to be made in any medications prescribed to manage addiction or withdrawal symptoms.
Performance-Based IncentivesTo ensure its effectiveness, the use of performance-based incentives is important along the continuum of care. Individuals receive incentives to maintain sobriety as they graduate to less intensive levels of care. In programs like 12-Step, individuals receive a physical token for sobriety milestones, which can be beneficial in the maintenance of sobriety. Contingency management plays a major role in continuing health care, and providing performance-based incentives can be extremely helpful in sustained abstinence.
Alternative Forms of Service Delivery
Continuing health care is customizable and often offers multiple forms of delivery. Continuing care support can take place in person, in a group setting, or through virtual avenues. Therapies such as cognitive behavioral therapy are often used along the continuum of care. Many therapists offer telehealth visits as a way to reduce barriers to care. Phone check-ins can also be a part of continuing care.
Another form of continuing healthcare is the use of recovery management checkups. These check ups consist of a clinical assessment, which includes testing the urine for substance use, and are provided every three months. This allows for easier re-entry into more intensive treatment programs.
Community SupportCommunity support is key in continuing care. Individuals are encouraged to participate in 12-Step integration programs or other peer recovery support services. These services are beneficial, as not only do they provide a sense of community, but they also allow individuals to see others move through stages of recovery and sobriety. Additionally, programs like these increase personal engagement in care and help individuals smoothly transition through the continuum of care to full recovery.5
Continuing Care Success Predictors
Who is Eligible for Continuing Care Programs?Individuals who have recently completed a residential or intensive outpatient program are most eligible for continuing care programs. Continuing care is not for individuals who are in the early stages of treatment or who have not undergone detox. This is because continuing care programs are designed to reinforce and maintain changes made during treatment.
Some Tips to Maintain Your Continuous Care
Continuing healthcare requires personal responsibility, and many individuals relapse once initial treatment ends. Maintaining a relationship with a primary care provider or therapist who can provide support throughout recovery is important to maintain continuous care. A primary care provider can also supply continuing medical education that can be helpful to recovery.
Additionally, knowing your triggers for relapse and knowing when to get in touch with a healthcare provider for help is important in continuing care. A helpful step to take in maintaining sobriety is getting involved in a continuing care community and joining a peer-based support group. Both having support and supporting others is healing and can provide you with the accountability to maintain your own personal care.