After an intensive period of treatment, particularly inpatient treatment, any further intervention that helps maintain sobriety is known as aftercare. For some, returning to normal circumstances with a relapse prevention program in place is appropriate, while others prefer to spend a period of time in a sober living community before returning home. Some benefit from engaging a recovery coach or peer recovery support to help maintain their sobriety.

    A relapse prevention program (also called a long-term treatment plan) usually consists of a combination of methods, often including participation in a mutual help group alongside stress reduction techniques, continued counseling, and lifestyle changes.  This plan is usually made by a doctor or other recovery professional in concert with the client. A strong relapse prevention program will consider the client’s needs and circumstances and include elements of support for physical, emotional, behavioral, spiritual, and social aspects of the client’s life.

    The goal of engaging in aftercare is to provide stability and allow the client to transition into long term recovery.

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    There are multiple definitions of what recovery coaching is, but the common denominator is that coaches work to help people in varying stages of recovery achieve their personally-defined goals. Unlike therapists and psychologists, coaches do not do insight-oriented therapeutic work. Their job is to promote change as their clients see fit by acting as a recovery and empowerment catalyst.

    Coaches go by many titles: sober coach, sobriety coach, recovery coach, sober companion. There are differences in nomenclature, and sometimes job duties, but all serve the same purpose: to remove barriers and facilitate recovery for people who are in, seeking, or considering, recovery from addiction. Coaches are commonly in recovery themselves and can offer insight based on their lived experience.

    While a counselor is a licensed professional who must be certified to conduct therapy, a recovery coach requires no license or certification. There are a number of certification programs for recovery coaching, but no central regulating body.

    The relationship between client and recovery coach, while professional, is usually informal and personal, and non-clinical in nature. Coaches help clients stay focused and aware of their choices, actions and responsibilities. Coaches can physically accompany clients through new services or environments while helping them to avoid triggers. They can help bridge the gaps in treatment and keep momentum going, providing support in finding a job, housing, or education. Recovery coaches do NOT diagnose, treat, or offer therapy or medical advice.

    When seeking a coach, one of the best ways to find a good and reliable coach is to ask for a referral from someone with whom you have an established relationship, like a therapist or psychologist. Topics to discuss with the prospective coach include: the effectiveness of their methods, their boundaries, confidentiality and how fees/costs are handled. Fees for recovery coaches vary but their services are typically paid out-of-pocket and may be sizable.

    International Association of Coaching code of ethics>

    The Center for Addiction Recovery Training (CART) has established a Recovery Coach Professional (RCP) designation to elevate the standard for recovery coaches worldwide>

     

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    Peer recovery support specialists (PRSS) are similar to recovery coaches, but typically work for non-profit organizations such as community-based centers, hospitals, clinics, or governmental organizations. They may be volunteers or employed by an agency, and they do not typically command the high fees sometimes seen with recovery coaches in private practice. Most peer recovery support specialists are in recovery themselves, although not every organization requires this. Peer support specialists who work in publicly funded services are required to meet government and state certification requirements, which are not required for private recovery coaches. The Council on Accreditation of Peer Recovery Support Services (CAPRSS) is the sole accrediting body in the United States for recovery community organizations and other programs offering addiction peer recovery support services.

    Peer recovery coaching, unlike therapy, draws from the coach’s personal experiences. A PRSS can use their own story to build trust, encourage the client, and to act as a role model for the client. They assist in developing and monitoring recovery plans, helping to navigate the substance use disorder/ mental health systems, holding the client accountable for their actions, promoting self-determination and personal responsibility, modeling effective coping strategies, developing community support, teaching and practicing new skills, teaching, supporting and coaching the client on effective communication with doctors and therapists, among other things. A PRSS promotes self-efficacy and helps their peers in recovery to take control of their lives and find meaning, purpose and connections. They provide informational, emotional and intentional support to help clients achieve their personal recovery goals.

    “Research has shown that peer support facilitates recovery and reduces health care costs. Peers also provide assistance that promotes a sense of belonging within the community. The ability to contribute to and enjoy one’s community is key to recovery and well-being.” [1]

    SAMHSA: Peer Support and Social Inclusion>

    SAMHSA: What Are Peer Recovery Support Services?>

    The Council on Accreditation of Peer Recovery Support Services (CAPRSS)>

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    For some, it is helpful to spend time in a community of peers in a sober living community after intensive treatment. This transitional period of supportive care can help reinforce new habits developed during treatment, and deepen the commitment to sobriety as a new way of life.

    Sober living communities offer:

    • An environment free from drugs or alcohol
    • Peer support from other members of the community, often including house meetings or other group support activities
    • An affordable place to live for those who are seeking employment after treatment
    • House curfews, chores, house meetings, and contribution of rent or jobs in the community to create a sense of participation and responsibility

     
    Sober communities are intended as a bridge between residential treatment and regular life; they are less structured than inpatient care but provide a sense of safety to those who still feel new to sobriety and need support before facing the pressures of normal life.

    “Some of the best resources for finding a sober living home are treatment facilities, 12-Step groups, or medical and mental health professionals. Some tips on how to find and choose a sober living home include:

    • Find a home that is centrally located to meeting, counseling, or therapy session locations.
    • Be sure that all rules are understood and attainable.
    • Try to find a home that has a range of people in recovery, such as a selection of people who have been abstinent for longer than 30 days, 60 days, or 90 days.
    • Listen to or seek out personal referrals from people who have lived, or are living, in the sober living home to decide if it is the right fit for you.

     
    Sober living homes may or may not be accredited or licensed through a state, local, or national agency. The National Alliance for Recovery Residences (NARR) sets national standards that affiliate agencies can use to certify sober living homes and that individuals can use to find a sober living home with a high standard of care.” [1]

    Oxford House offers self-run sober communities nationwide>

    National Alliance for Recovery Residences>

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