The transition from alcohol or substance abuse treatment back to home life can be an emotionally charged time for everyone involved. For parents, it’s often a mirror image of the days and weeks immediately preceding treatment. Before you placed your teenager in a residential program, you probably felt a disconcerting and uncomfortable jumble of sadness, anger, fear, uncertainty, and that special parenting emotion – guilt. Now, as your teenager’s return-home date approaches, it’s likely you feel a mix of positive emotions: excitement, hope, relief, anticipation, and another special parenting emotion – pride. Those feelings are certainly appropriate to the moment and a welcome change from the darker moods you experienced on the front end.
But it’s not as simple as that.
You and your family took a big, scary step when you sought out and committed to residential treatment for your child. The decision to place a loved one in an alcohol or substance abuse program is never easy, and you should be commended for making the hard choice. No one will blame you for being on pins and needles the entire time your teenager was away, nor will anyone blame you for being thrilled about their imminent return. The successful completion of a residential treatment program is a legitimate reason for hope. There’s an unexpected catch, though: positive emotions aren’t the only ones you’re feeling – or at least we bet they aren’t. Alongside excitement, pride, and joy, you probably feel some of the same negative emotions you felt before treatment: anxiety, fear, and uncertainty.
Don’t worry – and don’t let the conflicting emotions confuse you.
They’re a perfectly natural reaction to what your family and your teenager face now: the unknown. Before your teen entered treatment, you also faced unknowns, but you did your best to minimize their size and scope. You researched different locations, talked to various admissions and clinical staff members, then made a wise and responsible choice based on the information you had. During treatment, you knew exactly what your child was doing almost every moment of every day. You reassured yourself with the knowledge your teen was in the hands of skilled professionals, receiving the best combination of therapy, counseling, and complementary supports available. Now that they’re returning home, you wonder what’s going to happen when all that goes away.
Here’s something to keep in mind as you enter this next phase of the recovery journey:
All that is not going away.
You chose a treatment center that offers evidence-based therapy and has a proven track record of delivering effective, solution-focused treatment, which means the entire goal of the program was to empower your teen with the tools they need to achieve sustainable, life-long sobriety. You chose a treatment center with a clinical staff who worked with you and your teen to create an aftercare plan designed to address the challenges presented by this very moment.
In other words, this is the moment you’ve all been waiting for – and your family and your teen have everything you need to meet this critical moment head-on.
Beginnings Are Delicate: That’s Why You Have an Aftercare Plan
The end of treatment is the beginning of true recovery. And true recovery means you and your teenager get to test – in the real world – everything you’ve learned about sobriety over the past few weeks or months. Should you be concerned about peer pressure, environmental triggers, unsupervised down-time, and the looming specter of relapse?
After all, relapse rates after treatment for alcohol and substance use disorders are high: the latest data indicate eighty-five percent of individuals relapse within a year of entering treatment, and around sixty percent relapse within one month of entering treatment. A widely quoted study published in 2000 by the scholarly journal Alcoholism Treatment Quarterly and referenced by this popular article in The Atlantic presents another set of alarming statistics: an average of eighty-one percent of individuals stop attending Alcoholics Anonymous within one month of leaving treatment, and roughly ninety-percent stop attending meetings within three months of leaving treatment.
Those numbers sound grim – but should they give you license to freak out?
Here are two reasons why:
- Many people who relapse early either don’t have a solid aftercare plan or they don’t stick to it.
- Relapse is not failure.
But here’s the most important reason why you shouldn’t freak out: you have a robust aftercare plan that’s designed specifically to help your teenager navigate life after treatment. You have a plan that includes the following essential elements:
- Family Engagement. The fact you’re reading this article is proof you’re engaged in your child’s treatment. If you participated in family therapy during their stay, you’re familiar with the vocabulary of recovery, your role in this phase of recovery, and the best ways you can support your child as they resume life at home. This is the time to make sure everyone else in the family is on the same page and know their role in your teen’s recovery, too.
- Therapeutic Support. Successful recovery involves the ongoing input of addiction counselors, behavioral therapists, and in some cases, psychiatrists. If the treatment team uncovered co-occurring mental health disorders while your teen was in treatment, then continuing therapy to manage those issues is essential. This cannot be emphasized enough: your teen may have developed a substance use disorder to self-medicate the symptoms of a co-occurring condition such as depression or bipolar disorder. If you drop that element of therapy after treatment, you increase the chances of relapse. Before your teen leaves treatment, you should already have a therapist or psychiatrist lined up and initial appointments booked.
- Medical Support. Chronic alcohol and substance use have significant short- and long-term health consequences. Before your teen leaves treatment, you should have a general wellness checkup scheduled with your primary care physician, and your teen’s discharge packet should include all medical records related to their time in treatment, from the moment they entered detox – if applicable – to the moment they leave the facility. If their treatment plan included medication for co-occurring disorders, the aftercare plan and discharge packet provided by the treatment center should include prescription information, contact information for prescribing psychiatrists, and any information related to relapse prevention drugs such as Narcan or Naltrexone, if applicable.
- Community Support. Positive social support outside the family is an essential element of sustainable recovery. While your teen was in treatment, they probably attended Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings. If the 12-Step approach was part of your teen’s treatment plan and it worked for them, then it’s important to start going to meetings right away. Your teen’s aftercare plan should include times and locations for meetings in your area. Help your teen find the right meeting for them, and make sure they start the process of finding a sponsor and working their steps as soon as possible. If 12-Step meetingts aren’t part of their aftercare plan, social support is still extremely important. A study on social support for recovering alcoholics published in 2009 showed that the addition of only one abstinent member to a recovering addict’s social network can increase their chances of maintaining sobriety by twenty-seven percent. Non-12-Step social support options include groups such as Refuge Recovery and SMART Recovery for Teens.
- Healthy Lifestyle and Complementary Supports. During treatment it’s likely your teenager learned about the importance of exercise, nutrition, and stress management in the recovery process. They may have been exposed to yoga, meditation, and basic mindfulness exercises such as deep breathing or progressive muscular relaxation. It’s important to keep the momentum and enthusiasm for these activities going when they come home. Don’t wait, and don’t drop the ball – if your teen liked yoga, find a yoga class and get them to it right away. If they discovered (or rediscovered) a love of exercise, find a way for them to get exercise on a regular basis, if not daily. They may also be ready to return to sports teams or other extracurricular activities that were interrupted by their substance use. If they show an interest, find a way to help them get back to the activities they used to love. And if you learn they love something new, find a way to help them to pursue it.
Think of your teenager’s aftercare plan as the blueprint for sustained sobriety. When things get tough, and they have hard days filled with stress and triggers, the best thing you can do for them is insist they follow the plan. It may change over time, because your child will change over time – but don’t let it go. Two years after treatment, the plan may look completely different than it looked upon discharge. That’s okay. It’s even good: that means your teenager is working their sobriety and recovery, adapting it to new circumstances, and making sure it’s relevant to who they are in the moment, not who they were when they left treatment.
So…What Happens Now?
We’ll answer by circling back to a point we made above, without explanation: relapse is not failure. Here’s the missing explanation: the path to recovery and sustainable sobriety is rarely linear and almost never easy. What happens now is you follow the aftercare plan. Keep your kid filled with healthy food. Make sure they get regular exercise and plenty of sleep. Make sure they get to their meetings and appointments with their psychiatrist or therapist. While you’re covering the basics, expect your teen to hit bumps in the road. Expect them to experience setbacks. Expect them to have bad days, and yes – accept the fact that they may relapse. In most cases, relapse won’t mean they have to return to square one. Relapse means it’s time to recommit to recovery. Relapse means it’s time to have a look at what caused it, re-evaluate the aftercare plan, and make adjustments if necessary. Relapse means there’s more work to do. Relapse is a reminder that recovery is a lifelong process and sobriety can be hard.
In AA meetings, they have a word for a minor relapse: it’s called a slip. When you slip, you tend to fall, and as all of us learn early in life, falling is not the end of the world. We all fall. Often. What matters is not that you fall – what matters is that you get back up, dust yourself off, and get back the work at hand. For your teenager, the work at hand is sobriety. While we have, admittedly, spent the last section of this article preparing you for the ups and downs of life after treatment – okay, mostly the downs – we want you to know there’s also a very good chance you’ll experience something amazing: the return of your child, whole and thriving, living life on their own terms and making positive, life-affirming choices that don’t include alcohol or drugs. There are no guarantees in recovery, but if your teen has completed a stay in residential treatment and the clinical staff has determined they’re ready to return home, then you most certainly have ample reason to be cautiously optimistic. And if you want to jump for joy, we most certainly won’t stop you – because, even though we’re playing it close to the vest, return home day is a very, very good day indeed.
Angus is a writer from Atlanta, GA who writes about behavioral health, adolescent development, education, and mindfulness practices like yoga, tai chi, and meditation.