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NAATP 2012: Aftercare can’t be an afterthought

May 21, 2012
by Nick Zubko, Associate Editor
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Best practices in continuing care discussed by leaders from CRC Health, Hazelden, Caron and Sierra Tucson

More treatment centers are recognizing that primary treatment is just one facet of patient care. The next step starts the minute patient walks out the door. While most facilities understand why, many are still challenged by how to keep track of clients and keep them engaged.

At the 2012 NAATP Conference in Phoenix, leaders from four treatment centers discussed strategies for keeping in touch with alumni and increasing the use of technologies such as text messaging and social media portals to facilitate continuing care.

A few thoughts from the panel members include: 

Phil Herschman, Chief Clinical Officer, CRC Health Group: I’ve been in this business for 30 years, and virtually the entire time we've been talking about chemical dependency as a chronic disorder. But we don’t treat it as such on a regular, consistent basis. We talk about it, we give it lip service, but we don’t do it. The next evolution of treatment will be an increased focus on what happens post discharge.

In my conversations payers are willing to pay for it, though it’s not clear what the best form is yet. So if we start talking about recovery and actually start practicing disease management concepts in a continuing care environment, we’ll be able to dramatically increase the likelihood of recovery. Then, we don’t have to talk about our stories; we can talk about recovery.

Janelle Wesloh, Executive Director, Recovery Management, Hazelden: We need to keep doing what we’re doing, but do it better in regard to the things we do with people after treatment. In many cases, it’s horribly difficult for a person leaving treatment to return to their home environment. Things that were messy and awful when they left are still there. If they don’t have the support that they need, any continuing care plan goes in a drawer because life hits them full in the face.

If someone’s not calling them to connect, check if they’ve made appointments, and ask if they’re meeting up with alumnae, all the things we did in treatment were a waste of time. I know that’s a provocative thing to say, but you spend all this time doing all this great work in treatment, then basically throw them to the wolves.

We need to set them up in a supportive way and not leave them to figure it out for themselves. We don’t want to set up barriers for our clients, we want to remove them. That’s where we’ll see our outcome rates change because these things do make a difference. But we need to figure out ways to make it work, ways to get reimbursed for it—especially for treatment centers that don’t have as many resources.

Mike Early, Executive Vice President/Chief Clinical Officer, Caron: We’ve done a great job of selling treatment over the last number of years, but we haven’t done a great job of selling recovery. It’s a chronic disease and people are beginning to talk more and more about that. And that’s what I believe this next generation needs to focus on; you need to be talking about the recovery process, not just treatment. I have a lot of hope based on what I’ve seen that we will see a return to addiction being treated as a chronic disease.

Tim McLeod, Senior Alumni Coordinator, Sierra Tucson: People talk about budgets to go toward alumni relations, and it’s frustrating. It can be an uphill battle. What I’d like to see in 10 years, or hopefully sooner, is that as much money that’s spent on the front end is spent on the back end. We talk about how hard it is for that individual when they come out of treatment and how we can support them. But doesn't have to be a fight to offer that support.

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We have a (relatively) small program for people recovering from co-occurring disorders (substance abuse and severe mental illness) and we have been tracking outcomes from everyone who ever began the program --not just those who graduate. We start with requesting open ended permission to speak with their Moms under the simple theory that if Mom doesn't know where you are, you've relapsed for sure.

We call people every six months and they are always glad to hear from us --even the ones who have relapsed, interestingly enough. Though it's self-report, we get their sobriety status and the results are stunning: we've always seen between 35%-50% clean, sober, and stable for at least a year. The last two reviews show that 48.6% & 48.5% have between one and three years sobriety.

We're fascinated by the possibility of setting up a social networking site and using it for maintaining contact --have to learn more about that.

Inquiries welcome: Richard Bearman, Peer Connection, c/o 410.546.7754