The Role Of Aftercare In Dual Diagnosis Recovery

When a person has a dual diagnosis, it means that they have both a substance use disorder (SUD), e.g., drug or alcohol addiction, and a co-occurring mental health disorder, like depression, an anxiety disorder, PTSD, bipolar disorder, or ADHD. Dual diagnoses are very common. In fact, around 50% of people who experience a substance use disorder are believed to also experience some form of mental illness, and vice versa, according to Cleveland Clinic.

Fortunately, dual diagnosis treatment programs are available to provide evidence-based care for both SUDs and other mental health disorders that may occur alongside them. But, as important and meaningful as dual diagnosis treatment can be, it is only one step in the recovery process. 

Aftercare can help bridge the divide between inpatient treatment and the return to everyday life, helping clients transition from a rehab environment back home or to a sober living residence while they continue to receive care and support. This reduces the risk of relapse and otherwise supports lasting recovery and a positive recovery experience.

What Is Dual Diagnosis Treatment?

In a dual diagnosis treatment program, the client will be carefully evaluated and a personalized treatment plan will be developed to help meet their individual needs, which can often be complex. This plan will include a variety of evidence-based individual and group treatment services designed to address not only the client’s mental health issues or their SUD, but both together. 

This integrated approach is valuable, as poor mental health and addiction tend to be very closely linked, with one often exacerbating the other. 

Common treatment approaches for a dual diagnosis include:

• behavioral therapy, especially cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT)
• medications, often including antidepressants, antipsychotics, prescription stimulants, buprenorphine, methadone, naltrexone, or others
• peer support groups, including 12-step groups
• nutrition education and other healthy lifestyle support
• alternative treatment options, often including meditation, mindfulness, exercise, and yoga

Evidence has consistently demonstrated that, when a co-occurring mental health disorder is present, dual diagnosis treatment is far more effective than treatment for one disorder alone and can help clients achieve a greater degree of stability more quickly, and continue with a much lower overall risk of relapse. 

What Is Aftercare?

An aftercare program, also known as therapeutic aftercare, continuing care, or post-care recovery, is any form of structured ongoing treatment that takes place after a person’s initial rehab program. Thus, aftercare can take a wide range of different forms, including both professionally facilitated and peer-led activities, all of which share the same basic goals.

Goals of aftercare support include:

• to help a person maintain his or her recovery from substance use or an acute mental health condition
• to help prevent and minimize relapses
• to support clients in other ways as they build stable, healthier, and happier lives

Examples of services commonly featured in dual diagnosis aftercare plans are explored below. 

Aftercare Coordination In Dual Diagnosis Treatment Programs

Because relapse is a common risk for people in recovery, aftercare services should be carefully coordinated and laid out by addiction treatment professionals before clients leave their treatment program. Here at Ohio Recovery Center, for example, our aftercare coordinator works closely with each client and their case manager, primary clinician, and other care team members to develop a personalized plan that meets the client’s needs and helps them achieve their long-term goals for recovery. 

This service matters, as people who follow through with their aftercare treatment generally experience more successful recoveries overall, with many reporting a lower risk of relapse, better outcomes when relapse does occur, and even a greater sense of direction and purpose in life as a whole.

Common Aftercare Options

There are many possible programs, services, and activities that can be considered aftercare, and each person may be best served by a different combination of these, depending on their own unique preferences, location, goals, and motivation. 

Case Management

Case managers help people in recovery by actively monitoring and, as their name suggests, managing a participant’s recovery in various ways. While case managers do not provide treatment directly, they will work to connect clients with appropriate healthcare providers, employment resources, financial assistance opportunities, legal services, housing, family resources, and even self-help groups as needed. They can also help to advocate for their clients, working to make sure that those under their supervision get the unique personal support and attention they need. 

Outpatient Treatment 

When most people think of outpatient treatment for substance use issues, they think of programs that are a good fit for less-severe forms of SUD, not full-blown drug or alcohol addiction. However, outpatient programs come in a variety of different levels of intensity, and even regular outpatient care can be an ideal fit for people who are still recovering from severe SUD and who have recently completed an intensive inpatient/residential dual diagnosis treatment program. 

In this situation, outpatient care can provide many of the same forms of support that clients receive in rehab, including individual and group counseling/therapy, medication support, contingency management services, and more. And many people are able to return to work and resume living at home while they participate in their scheduled outpatient sessions. 

Peer Support Groups

Support groups like SMART Recovery, Narcotics Anonymous (NA), Alcoholics Anonymous (AA), and others are an ideal resource for people in recovery from addiction. Many participants in these programs have their own histories with mental health disorders, too, like bipolar disorder, anxiety disorders, depression, and others, with valuable insights to share.  

However, many people also find it rewarding to participate in support groups specific to their own mental health diagnosis. These groups can come in many forms, including some in-person meetings and many groups that are organized in online spaces, like NAMI Connection Recovery Support Group. 

These mental health-focused groups allow participants to share information, to talk through their struggles, and to receive much-needed encouragement and reassurance from those who know, intimately, what they are going through. 

Medication-Assisted Treatment (MAT)

MAT options like those using naltrexone, methadone, buprenorphine, and disulfiram have been shown to dramatically improve recovery outcomes when also used in combination with counseling and/or behavioral therapy. These medications work in different ways and are FDA-approved to treat different disorders, specifically alcohol use disorder (AUD) and/or opioid use disorder (OUD), but they can make a tremendous difference when used in the right setting. 

Many people who begin MAT will continue to take their medications long-term, often for years at a time, without any real issues. This can help take some of the pressure off, allowing people to focus on their mental health without also battling with withdrawal symptoms, cravings, or other symptoms that MAT may alleviate. 

Medication Management

As with MAT, different medications may be prescribed to people in recovery to treat co-occurring mental health disorders when appropriate. This may include antidepressants, antipsychotics, anxiolytics, stimulants, and more. 

As people adapt to these medications and experience changes over time, it may be necessary to adjust the dosage or change the medication in order to continue achieving the desired results. This is best accomplished through regular visits with qualified care providers.  

Family Psychoeducation (FPE)

Addiction and mental health issues can be disruptive within families, breaking down relationships and generating deep hurt, resentment, poor patterns of communication, and other negative dynamics. While family therapy attempts to heal this damage, addressing the family unit as the object of treatment, FPE instead targets the family member’s mental illness for treatment directly. 

In FPE sessions, families come together and work with a trained clinician to learn about their loved one’s mental illness, including its signs and symptoms, its treatment, and how they can join together to work toward recovery as a team. This process usually takes just a few weeks and has been shown to strengthen families, improve participant stress and mental health, improve family communication and coping skills, and reduce the risk of relapse. 

Sober Living Housing

Depending on the person’s situation, going back to the living environment they were in before they went to rehab may not be a healthy or positive option, or they may simply not be ready to return to independent living. Sober living housing, also called recovery housing, may be a better option in these and similar situations. 

Recovery housing programs can vary, with some being privately operated and others publicly supported, some offering short-term residence vs. long-term residence, etc.

Whatever the case, sober living housing can give people a safe, comfortable, substance-free place to land after rehab as they continue building their recovery, in the company of others who have faced the same challenges. This can lead to relationship-building, accountability, and a reduced sense of isolation and loneliness, including for people with dual diagnoses. 

Life Skills Training

It’s hard to overstate just how damaging addiction and mental health disorders can be before seeking treatment. People who experience these health issues may, naturally, need extra care and support in order to get their lives back on track once they are in recovery. 

As part of this process, many community-based services may be recommended as needed, including:

• academic support
• career coaching 
• job skills training
• financial coaching and budgeting
• legal support
• social skills training
• anger or stress management

Case managers or other rehab center staff will connect clients with these resources, monitoring their progress over time.

Aftercare Coordination At Ohio Recovery Center 

Recovery is a process, an up-and-down journey that takes courage and can last a lifetime. However, the sooner people seek treatment, the better off they tend to be. 

At Ohio Recovery Center, in Van Wert, OH, we are proud to include professional aftercare coordination in all of our residential addiction treatment and dual diagnosis treatment programs. 

Other evidence-based and holistic treatment services we offer include:

• medical detox and stabilization services
• behavioral health and mental health evaluations
• diagnostic services
• personalized treatment planning
• individual and group behavioral therapy
• support groups
• medication management
• MAT options 
• wellness activities including yoga, meditation, fitness classes, hiking, etc.
• community activities including karaoke, game nights, movie viewings, etc.

Our treatment services are focused on you as a whole person, taking into account the big picture of your recovery journey, not just your short-term needs. To learn more about what this means and how ORC can meet your needs (or those of a loved one), please reach out today!