A step above sober living, The Canyon’s Extended Care program provides a transition to more freedom within the structure of an ongoing program. Men live in the Cliff House while women reside in the A-Frame, both on The Canyon’s grounds but a little further removed from the main houses.
Extended Care includes 15 hours of weekly therapy programs as well as individual counseling. Individuals in EC are permitted to have a car and can leave the property, but there are curfews. Lunch and dinner are eaten in the main house, prepared by our talented executive chef.
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A Resource on Extended Care Options
In the past, an addiction issue was treated much like a medical crisis. A person was swept into a facility, given needed care, pronounced “cured” and then sent back home again. While some people may have achieved long-term sobriety under this model, many did not. When they returned home, their old habits were waiting for them as though they’d never left. Friends tempted them with drugs and invitations to parties. Families continued to drink or use drugs in their presence. The corner bar right by the office seemed to call out each time the person walked past. A relapse seemed almost inevitable.
To close this gap, and help the person deal with the chronic nature of addiction, experts now use a variety of methods to extend addiction care. Instead of releasing a person from care and simply hoping that person will stay free of a relapse, therapists are taking an active role in helping people manage their disease over a long period of time. Through this method, the person strengthens their sobriety skills and stays well for a longer period of time.
This article will outline the variety of extended care options available, progressing from low levels of engagement to the highest level of engagement possible. One program we provide at The Canyon is described at the end of this article. This intensive program may provide just the sort of help some people need in order to make long-lasting changes and beat back their addictions. If you agree, and you’d like to know more, please call us for more information.
Option 1: Telephone Outreach
When some patients emerge from recovery programs, they’d like to head back to work and move back in with their families as quickly as possible. These patients may be able to handle many of the stresses of everyday life, but they still need to stay connected with their therapists on a regular basis, so they can deal with issues as they emerge and handle them before they grow into enormous problems that are hard to solve. In order to tackle these goals, some therapists use a telephone outreach program.
In a typical telephone outreach program, patients attend multiple counseling sessions both with a therapist and with a support group; however, they also talk with their therapists periodically in a telephone touch-up session. The calls may be either formal or informal, but the patient is expected to participate in each and every call, just as the person is expected to keep every appointment made with a therapist. Over time, the person transitions out of intensive counseling sessions and only works via telephone counseling sessions.
A study in the Archives of General Psychiatry compared the outcomes of people who received this form of therapy with those who received counseling alone, with no telephone outreach component. Researchers found that people who did receive telephone counseling performed as well as people who only received face-to-face counseling, although researchers found that the outreach was most effective when the patients had completed intensive counseling sessions as outpatients. In other words, it can be an effective method of care when a patient is through residential care and living at home, but it shouldn’t be provided as a substitute for face-to-face counseling sessions that take place when a person’s program is complete. Moving from intensive residential care to telephone care only may be too difficult for people to handle.
Option 2: Sober Living
For people who aren’t quite ready to live at home, but who may not want to participate in intensive daily counseling sessions, sober living communities can provide an ideal setting. These facilities provide no medical staff and no therapy. Instead, they’re made up of communities of people who are all in recovery from addiction. Sober living communities often ask members to:
- Abstain from drugs and alcohol
- Complete household chores
- Participate in sobriety meetings
- Keep therapy appointments
- Abide by a curfew
- Demonstrate respect for others
These rules aren’t optional, and people who habitually break the rules are often asked to leave. By enforcing these rules, sober living communities teach residents how to live a sober lifestyle that is based on work, responsibility and routine. These are the cornerstones of a sober life, and an addict can strengthen those skills by living in a sober living community.
According to an article written for the journal Substance Abuse and Misuse, sober living communities like this have been used to help a wide variety of recovering addicts, including people who have been released from prison, and those who are going through outpatient care for addiction. This could highlight one of the drawbacks of a sober living community. In an ideal situation, a sober living community would contain people who are all in the same stage of recovery from addiction. However, if the facility allows people who are new to recovery, the community might be less helpful. It might be harder for people to relate to one another, when they’re all in different stages of recovery.
Some people find that living with others in different stages, or with those who have difficult temperaments, is actually a helpful part of the process, however. As an article from the National Housing Institute puts it, conflicts in the house are sometimes resolved through confrontation and role-play. People learn about themselves in these sessions, and they learn to handle arguments and disagreements without resorting to drugs. This can be an incredibly helpful lesson for recovering addicts to learn. Many of the people interviewed in this article refer to their housemates as “family,” and it’s likely that the lessons they learned in their transitional home will be applied in their relationships with their family at home.
Option 3: Hospital Setting
Some people begin the addiction recovery process in a hospital setting. They go through medical treatments to help them remove drugs and alcohol from their systems, and they go through intensive counseling programs while they live in a separate wing of the hospital. Before they’re released from the hospital altogether, they move to another part of the hospital and they go through less intensive counseling programs. They may also be allowed to leave during the day, as long as they’ve met their addiction-related responsibilities for that day.
The International Journal of Psychosocial Behavior published an article in which researchers compared two forms of hospital care for people recovering from addiction and mental illness. The programs differed in approach, with one facility providing a strict environment that was nearly military in nature, while the other provided a more normalizing approach that was similar to a sober living community. Both were found helpful in treating people with both addiction and mental illness.
Option 4: Residential Setting
Some facilities that provide residential care for addiction also provide their own versions of sober living communities. These facilities also ask residents to live in groups and enforce the rules on their own when possible, but the residents are all still connected to the resources provided in the residential program. Counselors are still involved, drug testing is still provided and meals are still served on a regular basis. This option is a bit of a blend between options 2 and 3 described above, allowing people to learn how to interact in a community, while still allowing the addict to maintain contact with the therapeutic community that was formed during the early stages of the treatment process.
In an article published in the Journal of Substance Abuse Treatment, researchers suggested that models of care for addiction that were well integrated tended to be most successful. In other words, programs in which addicts work with the same therapist, in surroundings that seem familiar, encourage addicts to stay engaged and involved in the process of recovery. It’s easy to see how a residential setting would fit into this model. The addict has made a connection with the site, and the therapist at the site, and the work continues in that vein.
This is the sort of support we provide at The Canyon in our Extended Care program. People live on the grounds, but in separate structures that are removed from the main treatment facility. People participate in weekly counseling sessions, and individual counseling sessions, and they access meals on a regular schedule in the main facility. It’s a way we help our patients transition to a successful life at home.
Making a Choice
Some people will need to live in an extended care program. The issues they face at home are just too strong to deal with alone. Other people might be able to heal with the help of counseling sessions and telephone contact, as long as they can rely on their family members and friends to help support their recovery. Choosing between these options can seem overwhelming, but the person’s addiction counselor or case manager might be able to provide vital help. This person has supported the addict in the recovery process, and this person likely knows just the sort of help the addict will need to maintain a sober lifestyle for many years to come. Good issues to think about during the decision-making process include:
- Cost. Some programs are more expensive than others, and some plans aren’t covered by insurance or by welfare programs.
- Setting. Most programs are voluntary, meaning that the addict can walk out at any time. Settings that make the addict uncomfortable might encourage the addict to walk right out.
- Rules. The addict will need to comply with the rules provided in these settings or face consequences. In sober living communities, for example, addicts might be asked to move out if they break the rules. It’s best to ensure that the addict will be able to comply before move-in day arrives.
- Neighbors. Some communities are targeted for a specific type of person, and it’s best to ensure that the setting chosen will be the best setting to treat the issue that addict is dealing with.
- Length of stay. Some settings place a cap on how long an addict can stay, while others do not. It’s best to clarify this issue so families can plan their next steps.
No matter the setting, remember that participating in an extended care program is the best thing an addict can do to achieve long-term sobriety. As an article in the journal Addiction puts it, interventions that last for six months or more are more likely to be effective than interventions that last for a short time and simply end. By accessing care for a longer period of time, the addict has the opportunity to strengthen sobriety skills and learn how to live a completely new life.
If you’d like more information on extended care and the program we offer here at The Canyon, contact us today. We are here to help.