Muir Wood therapist, David Laing


Aftercare: Ongoing Support When Rehab is Complete

When symptoms reappear, it indicates that some small aspect of the original treatment plan didn’t take hold and that additional treatments are needed in order to bring the person full relief. By participating in aftercare, people are providing themselves with the opportunity to jump on a recurrence and stop it, before it’s allowed to spiral out of control.

Mental health programs that treat teens sometimes hold graduation ceremonies in which those who have completed their formal inpatient treatment programs are asked to take a bow and bask in public adoration for the huge gains they’ve made. These ceremonies can be incredibly rewarding, and people who do complete inpatient mental health treatment programs have a right to be acknowledged for the hard work they’ve done, but these festive events can also be a little deceptive, as treatment for a mental health issue might continue long after the formal program has ended. In fact, aftercare might be vital for long-term success for people with mental health issues.

The Underlying Concept

Mental health issues aren’t similar to colds or viral infections in that they sweep over the body and then leave no traces behind. Many mental health issues cause changes within the brain, or they stem from abnormalities in the brain, and while people can learn to live with these issues, they might not ever be truly resolved. For example, according to the U.S. National Library of Medicine, people with bipolar disorder are likely to feel either intense mania or overwhelming depression at least once, even when they receive treatment for their disorder. People with depression, anxiety and more might also see their symptoms return from time to time as well. Organic changes in the mind can persist, and it might take a lifetime of work to keep symptoms of the disorder from taking over.

Those who abuse substances and develop addictions might also be at risk for relapse. According to the Substance Abuse and Mental Health Services Administration, about one-third of people achieve permanent abstinence the first time they go through treatment, but the rest of people will need more than one round of care in order to make permanent changes. They may find that their urge to use overwhelms them, and they slide back into addiction as a result. People who have histories of both addiction and mental illness face additional dangers as they attempt to recover.

Those who slide back into substance abuse might trigger a mental illness symptom outbreak, and the reverse might happen as well. It’s not considered a failure if the recurrence of mental illness symptoms takes place, and those who relapse to substance abuse aren’t condemned to be addicts for the rest of life. Aftercare strives to help people understand that a relapse is simply an opportunity. When symptoms reappear, it indicates that some small aspect of the original treatment plan didn’t take hold and that additional treatments are needed in order to bring the person full relief. By participating in aftercare, people are providing themselves with the opportunity to jump on a recurrence and stop it, before it’s allowed to spiral out of control.

Touchup Therapy

There are times when life provides transitions that could lead to a recurrence of a mental health issue.

For teens, these triggers might include:

  • A physical illness
  • Divorcing parents
  • Loss of a boyfriend or girlfriend
  • Death in the family
  • Moving to a new community
  • Changing schools

These transition points can make a teen feel vulnerable and upset, and it’s possible that disordered thinking might take place. The teen might begin to lean on old habits and poor coping skills, and a mental illness or addiction could blossom in these times of uncertainty. A few sessions with a counselor might help teens to brush up on the lessons they learned in their treatment programs, and this could help them to deal with their changes without sliding backward.

Teens often have a long time to react before they make a terrible choice. For example, a study in the journal Addictive Behaviors found that relapses to drug use tended to take place in teens who had experienced a desire to use drugs in the two weeks prior to the relapse.
If these teens had contacted therapists as part of an aftercare program as they were contemplating a return to drug use, it’s possible that they might never have used drugs at all. The therapy could have shown them a better way.

Ongoing Therapy

Some mental health conditions need more than simple touchups from time to time. Serious mental health conditions such as schizophrenia, bipolar disorder and obsessive-compulsive disorder might require ongoing medical care, including medications. Teens with conditions like this might need to work with counselors on a regular basis, ensuring that the medications they’re taking are provided at the proper dosages and that their disordered thinking isn’t returning. These teens might begin their journey to healing in an inpatient addiction or mental health facility, but as part of their mental health aftercare program, they might be transitioned to counselors in the community. It can be difficult for teens to switch from one counselor to another in this way, but in time, teens can build up trust with their new counselors and continue to work on their mental health issue.

There are times when teens aren’t able to catch their addiction relapse cues in time, and they may begin to abuse their substances of choice on a compulsive basis. These teens might need to reenter their formal treatment programs once more for another round of detoxification and therapy. Again, this isn’t considered a failure, but it is vital for teens to get the proper kind of help if they relapse to addiction. With that help, they might be able to move forward.

Support Groups

Therapy can be a vital part of the aftercare plan, but support groups can also play a key role. In a support group, such as Alcoholics Anonymous or Narcotics Anonymous, a teen has the opportunity to meet others who are also working toward sobriety, and a teen might also have the chance to learn how real people keep their mental illnesses and their addictions under control. These meetings also provide teens with a sponsor, or a member who is a bit stronger in sobriety, and this person can help to escort the person to a meeting. According to an article written by the Partnership at, teens are often terrified to go to a 12-step meeting, but going along with a sponsor can help to ameliorate those fears and help a teen to feel connected and in control. Sponsors can also remain available 24/7 for teens, functioning as a shoulder to lean on when times are tough. Teens might find that this kind of ongoing support could help them to feel safe and strong in sobriety.

Meetings are often held at different times during the week, and some meetings are specialized to meet the needs of a specific type of person in recovery. A study in the Journal of Child and Adolescent Substance Abuse suggests that teens attend meetings more often when the meetings are filled with people who are in the same age group. They feel a sense of affiliation when they’re surrounded by their peers, and this could make them more likely to keep going back to their meetings and participating in recovery. Addiction facilities might seek out these types of meetings, and provide clients with robust lists of meeting dates and times. This can help to ensure that teens go to the meetings, and get the most out of their attendance.

In addition to the opportunity to listen and learn, support groups provide teens with the opportunity to:

  • Volunteer in the community
  • Participate in recreational activities with other sober people
  • Make sober friends
  • Mentor new members
  • Find sober role models

All of these benefits could help teens to maintain their sobriety. They’re continuing to learn and grow, and this could be a habit they maintain well into adulthood. Some people attend support group meetings for the rest of their lives, as the fellowship they find in these meetings seems to make such a positive difference in their lives.

At Muir Wood, we work hard to link our clients with support group meetings in the community. There’s a particularly strong youth recovery community in Sonoma and Marin Counties, for example, and we provide a list of all meetings to our clients when they leave us. We also provide support through counseling and follow-up calls, just to make sure our clients are doing as well at home as they did in our care. If you’d like to know more about any of these steps, please contact us. We specialize in helping adolescent boys who have addictions, mental illnesses or both. We’re happy to talk with you about our work.

Muir Wood Adolescent and Family Services is a Joint Commission-accredited mental health and substance use disorder treatment provider located in Petaluma, California. We provide integrated evidence-based care including psychiatry, psychotherapy, experiential therapy, wellness services, and milieu therapy for adolescents and teens, and their family members.