Gardening can be more than a relaxing pastime. It also has clear mental health benefits—and it even supports addiction recovery. Rehabs with horticultural therapy help patients get grounded, literally. This treatment can inspire an appreciation for nature, give you a new hobby, and help you get to know yourself again.
Horticultural therapy looks different for everyone. In some programs, you’ll tend to a small window box of herbs. Others, like Mountainside Treatment Center, have more outdoor space for clients to explore.
What to Expect in HT, Whether Your Garden’s Big or Small
Specially trained therapists facilitate HT2 in rehab. You might see them one on one, or meet with a group of your peers. Treatment takes place in a natural setting, like a greenhouse, outdoor garden, or vegetable patch. In any of these places, you’ll learn about gardening and what different plants need to survive. Then, you’ll put it into practice.
Like most complementary therapies, HT also invites you to process your feelings. You might talk while you’re watering, or check in after you finish weeding for the day. Specifically, gardening teaches patients to be mindful.3 This skill is hugely important during addiction recovery.
How Can Gardening Help With Addiction?
Plants don’t judge you.4 They don’t know if you have an addiction or any other diagnosis. The way you treat them is the only thing that matters. And what’s more, they depend on you for care. You’ll learn how to show up for them every day, doing your best even if you feel your worst. And that skill can help you commit to every phase of addiction recovery.
“This lesson that all things must grow, live, perish, and in turn be put back into the land is a part of our holistic outlook on recovery and living.”
In their program, gardening becomes a metaphor for your personal growth. The act of starting rehab can be a challenge, even before you begin treatment. HT reminds patients that letting go of the past is empowering. And what comes next can be beautiful.
Enlightened Solutions in Egg Harbor City, New Jersey shows clients how gardening echoes the cycles of recovery.
The Benefits of HT in Rehab
Rehabs around the world use horticultural therapy to treat mental health issues, including addiction. And even after treatment, the benefits of gardening can support your ongoing recovery.
“Everything you do in the garden is an act of love.”
Gardening lets patients connect to nature. Every day you can see, feel, and even taste your own impact on the world around you. At rehabs like Mountainside Treatment Center, that perspective is crucial. Sheree Surdam, overseer of their horticultural therapy program,10 explains why.
Gardening gives “people a sense of purpose and stewardship over the natural world,” she says. “Everything you do in the garden is an act of love.”
Root Yourself in Recovery
A healthy plant is tangible. When you smell a rose you grew, you’re breathing in joy of your own hard work. And by learning to nurture your garden, you can learn to nurture yourself.
Substance misuse can be extremely isolating. For some clients, rehab is a good time to break out of old patterns and start rebuilding interpersonal relationships. And, as valuable as talk therapies are, there are some skills you can only learn by engaging in mutual support. If your goal is to focus on those skills, you might benefit from joining a therapeutic community.
While many of these programs take place within rehab facilities, they take a unique approach to the healing process. Residents receive some level of professional care, which may include talk therapy, medical supervision, and various other programs. In addition to this, clients actively cultivate a community of mutual emotional support.
In some of these earlier programs, members were prohibited from using medications of any kind, even to help with detox. Over time, and as public opinion has shifted, many facilities have adopted a more modern approach. Today, it’s quite common for TCs to be connected with more traditional rehab facilities. This allows clients to benefit from recent medical advances, while still connecting deeply with one other. If you attend one of these programs, you will also be asked to take on greater responsibilities than you would be in a more traditional rehab program.
Collective Responsibility
In a therapeutic community, clients are often expected to participate in group activities, engage directly with one another, and even perform daily chores. These activities are intended to help you cultivate life skills and build healthy relationships. By behaving as an important part of a larger collective, you may become more confident in your own personal strengths.
As psychiatrist Penelope Campling explains, this philosophy is founded on the ideas of self-empowerment and collective responsibility. She writes, “therapeutic communities3 are deliberately structured in a way that encourages personal responsibility and avoids unhelpful dependency on professionals. Patients are seen as bringing strengths and creative energy into the therapeutic setting, and the peer group is seen as all-important in establishing a strong therapeutic alliance.”
TCs conceive of the “community as [the] method“4 or mechanism of healing. In this model, clients are not only accountable for their own recovery; they also assume a certain level of responsibility for each others’ healing processes. There is “an emphasis on social learning5 and mutual self-help…This aid to others is seen as an important part of changing oneself.”
Length of Stay in a Therapeutic Community
These programs often last longer than other forms of treatment, and your length of stay will likely be determined by your unique needs. At Start2Stop, a facility in London, offers a Secondary Care Programme for those who have completed 28-day inpatient treatment. “Everyone is different and the length of stay will depend upon individual circumstances,” says the provider. However, most clients stay on-site for approximately three months.
Research suggests that it is especially important for clients to prioritize aftercare following their stay in a TC. According to one study on therapeutic communities’ effectiveness,6 both “length of stay in treatment and participation in subsequent aftercare were consistent predictors of recovery status.” This may be related to the well-documented importance of community for mental health.7 After you learn to engage with fellow residents in a TC, it may be difficult to return to a less communal setting.
Group Activities
While therapeutic communities share a particular approach, various TCs have slightly different philosophies regarding recovery. For instance, some of these programs are founded in the 12 Steps of A.A. or N.A. Others may host only teens, or offer gender-specific treatment. No matter who is part of your cohort, you can expect to participate in focused group activities.
It’s quite common for clients to engage in group therapy or support groups during their stay. You may also join in group outings or even shared meals. These experiences help residents cultivate a sense of community by both offering and receiving emotional support from peers. When this exchange occurs outside of traditional talk therapy, clients can practice interpersonal skills in a variety of contexts. This may help you prepare for life after rehab, when you’ll start interacting with people who aren’t necessarily in recovery.
A growing body of evidence suggests mutual support between clients with substance use disorders8 is hugely beneficial. Experts have found that these relationships “fill a gap that often exists in both formal and informal treatment for individuals with SUD by focusing on recovery first and by helping to rebuild and redefine the individual’s community and life.”
You are more than your illness. Simply watching a movie with a friend, going on a hike, or talking about a good book can help you remember that. And during your time in residence at a TC, you may have more and more opportunities to engage in these activities.
Stages of Recovery
Many therapeutic communities employ a “hierarchical model of care”.9 In this dynamic, clients gain more privileges as they work through predefined stages of recovery. These privileges often include access to the outside world, such as receiving an allowance, using a laptop, or going off-site. For example, you might be allowed to spend a night away from the facility after being in the program for a certain period of time.
Because of this philosophy, TCs may be a good fit for people with responsibilities they can’t set down for months at a time. In particular, students and employed professionals may be able to keep up with school and work during treatment. Some clients might need to do this remotely, while others may be allowed to leave the facility during the day.
Unlike other rehab models, therapeutic communities actively encourage clients to reintegrate with the outside world10 before completing treatment. According to the National Institutes of Health, “as program participants progress through the stages of recovery, they assume greater personal and social responsibilities in the community. The goal is for a TC participant to leave the program not only drug-free but also employed or in school or training. It is not uncommon for program participants to progress in their recovery to take on leadership and staff roles within the TC.”
This flexibility should not be confused with a lack of structure. On the contrary, clients enjoy certain freedoms precisely because they remain accountable to themselves, each other, and their healthcare providers. At every stage of recovery, you’ll be expected to follow certain house rules.
Common Regulations in Therapeutic Communities
Life in a TC strikes a delicate balance. On the one hand, you’ll slowly gain privileges that aren’t available in other rehab programs. And on the other hand, you’ll be expected to take on responsibilities that are rarely associated with inpatient treatment. These two components work in concert to empower clients. The daily practice of caring for yourself and others, while watching the impact of your behavior in real time, can have a huge impact on the recovery process.
Sobriety
Most therapeutic communities have a zero-tolerance policy for substance use. You may undergo regular tests to confirm your sobriety. This practice is especially important for clients who spend significant time off-site. By gathering data about your health, your clinicians can monitor your progress and make adjustments as needed.
If you do test positive for substances during your stay, you may have to leave the program permanently. While this may sound extreme, it’s in line with the philosophy of community accountability. In a TC, even more than in some other programs, your behavior has a drastic impact on the health of other residents. This strategy not only discourages substance misuse; it also protects clients from engaging in enabling behavior.
Household Chores
Living in a community means being partially responsible for the well-being of the whole group. With this in mind, most TCs require residents to take care of their own living spaces. These activities aren’t simply utilitarian; they’re also an exercise in interpersonal dynamics. A task as simple as sweeping the floor can become an act of caring for your cohort.
Each program has its own unique expectations of clients. At MARR, a TC in Georgia, clients “complete chores, buy groceries together, have dinner at the dining room table every night, and navigate day-to-day activities. This sense of community has proven to be a huge factor in the recovery process. It lets clients know they’re not alone while challenging their old habits at the same time.”
This practice teaches valuable life skills, helps clients develop healthier habits, and fosters strong relationships. It may also have a long-lasting positive effect on the psychological aspect of healing. Data suggests that life skills training11 and related activities may be an important preventive measure for those in recovery from substance use disorders.
Curfew
TCs have a strong focus on building healthy habits into your daily routine. Because of this, you can expect to follow a clearly defined schedule during your time there. Although it will likely include much more free time than a traditional rehab, you’ll still have to abide by a curfew. This curfew may change over time, as you progress through the stages of recovery. And even if you’re able to spend the occasional night off-site, you’ll still likely need to return at a predetermined time. Much like regular drug testing, this practice helps clinicians gather data about your recovery process—specifically your ability to keep your commitments and respect healthy boundaries.
Does Scientific Data Support Healing in a Therapeutic Community?
Significant research supports the idea that clients benefit from building community during recovery. Connecting with your peers not only gives you access to support; it also positions you to help the people around you. By empathizing with the people in your cohort, you may gain new insights into your own recovery process. As you develop mutual compassion and respect, you may also gain new confidence in your own role in the group.
However, much research is needed into the efficacy of TCs.12 Despite their lengthy history, there is little scientific data regarding their clients’ long-term recovery. One commonly cited study from the 1980s found that “nearly 30% of addicts treated in TCs maintain maximally favorable outcomes, while another 30% show significant improvement over their pretreatment status.” Because our clinical understanding of substance use has progressed so much since then, those findings may or may not reflect present-day outcomes.
More recently, a 2016 study found that “peer-led recovery support services13 may be a helpful addition to traditional professional services. More research is needed to make definitive recommendations.” However, it’s important to note that this is an analysis of specific peer-led services which may or may not be available in every therapeutic community. Based on related information, it’s very likely that TCs continue to have a positive long-term effect on recovery. But—just like any healing modality—treatment in a therapeutic community may be best when combined with traditional modalities, such as talk therapy and medical care.
Is a Therapeutic Community Right for You?
There’s no doubt that therapeutic communities offer a unique approach to recovery. This type of environment might be a good fit for clients who want to focus on improving their interpersonal relationships and developing life skills. And because residents may gain off-site privileges during their stay, this model may be especially appealing to people with certain commitments, such as work, school, or family responsibilities.
However, some clients may find that the lifestyle of a TC is incompatible with their own needs. For example, highly visible people—especially high-level executives and those with celebrity status—may require greater discretion. Others may need specialized medical care that isn’t available in this environment. And if you feel that you would benefit from more structure, or a greater level of protection from the outside world, you might consider attending a more traditional rehab program.
It’s also possible to take a combined approach, and attend a TC after completing detox or another inpatient treatment program. And, at any rehab, you can find ways to participate in a community both during and after the program. Even individual treatment programs may allow you to connect with loved ones during your stay. Whatever modality feels right for you, remember that healing your relationships is an important part of recovery.
Frequently Asked Questions About Therapeutic Communities in Addiction Treatment
What is a therapeutic community in addiction treatment?
A therapeutic community in addiction treatment is a supportive environment where individuals in recovery live together, fostering personal growth through peer support, self-help, and shared responsibility.
What are the benefits of a therapeutic community in addiction treatment?
Therapeutic communities in addiction treatment provide a sense of belonging, support, and accountability, helping people develop life skills, coping strategies, and form healthy relationships.
How does a therapeutic community in addiction treatment promote recovery?
Therapeutic communities promote recovery by offering a structured environment for building healthy relationships, encouraging self-reflection, personal growth, and the development of healthier behaviors and coping mechanisms.
Substance use disorders can be extremely isolating. These conditions are often related to difficult relationships with family, friends, or colleagues. In some cases, challenging relationships encourage unhealthy behavior. On the other hand, even the healthiest of dynamics can be undermined by untreated mental health concerns. In both cases, many people find that building community is an important part of recovery. This process can begin during residential rehab.
When you first enter inpatient treatment, you may be struggling with the idea of community. During your time there, you can work on your interpersonal skills and begin to define or redefine what social support means to you. Different facilities take various approaches to this aspect of healing. You may be getting to know a cohort of your peers, staying in touch with far-away loved ones, attending groups, or all of the above. Whatever therapeutic modalities you use, you’ll likely learn how to relate to the people around you in a healthier way.
The Impact of Substance Use Disorders on Relationships
Your illness is not your fault. It’s all too easy to blame yourself for factors outside of your control, including genetic predispositions and traumatic life experiences. No matter what, you are not to blame for simply having a substance use disorder. That being said, you can choose to change your behavior in ways that will make your relationships more sustainable. It can be very challenging to make those changes. But, with appropriate support, it is possible.
There is a complex association between social support and substance use disorders. For some clients, substance misuse feels like a solution to social isolation.1 On the other hand, previously healthy relationships may deteriorate when a person develops a substance use disorder. This often results in unsustainable social dynamics and interpersonal strife. Depending on how your community is structured, these difficulties may play out in a number of ways.
Family Dynamics
All Points North Lodge in Vail Valley, Colorado, offers different forms of family therapy including virtual options.
Research has established that substance use disorders strongly impact immediate family members.2 Spouses and children, in particular, may experience psychological effects. This can result in codependent relationships, in which one partner tries to support a person with a substance use disorder, but unintentionally enables them instead.
If your family is struggling with issues like these, it’s important to focus on how you can heal, both individually and as a group. Family therapy may be especially beneficial here. Reconnecting with your loved ones may have a direct impact on the outcome of treatment. Research has found that “family support in the intervention process3…contributes to a higher rate of recovery success among addicts.”
When you first begin healing—and especially if you start by attending inpatient rehab—you’ll probably take a break from certain relationships. And if there are people in your life who actively interfere with your recovery, your break from them might be permanent. One expert writes that even “thinking about people, places, and things associated with past [substance] use” may be associated with relapse.
As beneficial as it can be to let go of toxic dynamics, it can also be painful. Residential rehab can provide a buffer during this process. If you attend an inpatient program, you’ll be surrounded by trained professionals who have experience helping clients navigate this type of grief. In some programs, you’ll also be able to build relationships with the other people in your cohort.
At most residential rehab facilities, you’ll be in recovery alongside a group of your peers. Some rehabs have an especially strong focus on these relationships. The Hope House Scottsdale, for example, hosts no more than ten clients at a time. Brenna Gonzales, Clinical Director, describes this environment as “a tight-knit community.” These settings give you more time with your providers and may foster stronger relationships between clients themselves. And there are numerous ways to build relationships during inpatient treatment.
Group Therapy
In a group therapy setting, you’ll have the opportunity to talk about your emotional experience in a protected environment. Some modalities encourage clients to speak directly to each other, offering insight and support during the session. And even if you’re instructed not to discuss much of your personal history during therapy—as is true in dialectical behavior therapy—you may still develop an emotional connection to the people around you.
Support Groups
Although more research is needed, “peer support groups included in addiction treatment5 show much promise in potentially reducing substance use.” Some programs include 12-Step groups, such as A.A. or N.A. Others offer non-12-Step support groups that serve a similar purpose, with a slightly different philosophy. Most of these groups are designed to help you connect with those who have similar life experiences. You may find that the people in your group can offer insights you simply wouldn’t reach in more traditional talk therapy.
Experiential Therapy
Sierra by the Sea in Newport Beach, California offers experiential therapies unique to their beachside location.
In experiential therapy, clients engage in a wide variety of activities, from skiing to visiting museums. Along with other therapeutic benefits, these experiences allow you to practice interpersonal skills in a new setting. For example, if you and your cohort go through a ropes course together, you may learn valuable lessons about communication, trust, and how to take risks in a healthy way.
Healing Past Relationships
Not every rehab will connect you with a cohort. Some facilities offer individual treatment, serving only one person at a time. This can be very important for well-known clients, who may require high levels of discretion in order to effectively begin healing. However, healing in private does not mean healing in isolation. These programs are extremely personalized, with treatment plans tailored to meet the unique needs of each individual client. Sometimes, that means staying in touch with your family, loved ones, and even your colleagues during treatment.
Family Therapy
Many rehab centers offer family therapy. “Family” may be defined in many ways, including people such as parents, children, partners, dear friends, and chosen family members. If this modality is right for you, you may participate in regular sessions, either in person or online. Some facilities also offer support groups that are only for family members, helping them heal from adverse experiences related to a loved one’s substance use disorder.
Family therapy isn’t right for everyone. Some clients may even decide to cut ties with family members to focus on recovery. There is no right or wrong way to approach this; only the way that works best for you. It’s important to remember that you get to decide who is part of your community. And if your family is included in that, they may be a valuable source of support both during and after rehab.
Forming a Sober Support Network
Recovery doesn’t end when you leave rehab. At this stage, you’ll find yourself in a new environment, and therefore, within a new community. This community may be made up of your family and old friends, or it may be something you haven’t experienced before.
For example, before returning home, you may choose to spend time in a therapeutic (or sober living) community. These programs provide less structure than inpatient rehab, while still supporting a healthy lifestyle for people with substance use disorders. These environments can be helpful for people who do not have strong support networks to return to. As one expert writes about the value of community in recovery,6 “Individuals with substance abuse problems who are living in a collaborative housing setting will have their addiction treated more effectively than [those] not residing in a community-based facility.”
If and when you do return home, community will continue to be important. You may find support from 12-Step or similar support groups, which will allow you to connect with peers in your area. Many rehab programs also have strong alumni programs, through which you can stay connected with your cohort.
And as important as these programs are, they aren’t everything. After rehab, you’ll also start to create a life that feels rich and meaningful, without relying on substance use. You may engage in new hobbies, meet people with similar interests, and find healthy ways to have fun. This may sound frivolous, but in fact, it is an absolutely essential part of recovery. Research has shown that “increasing recovery-supportive social connections can have a profound benefit for achieving and maintaining abstinence.”7
The Effect of Community Support on Long-Term Recovery
When considering the importance of community for people recovering from substance use disorders, many researchers refer to a study conducted in the early 1980s, commonly known as “Rat Park.”8
In his study, researcher Brian Alexander began by giving rats free access to water laced with opiates. He found that when given a choice between plain water and drugged water, solitary rats would continue drinking the opiate solution until they overdosed. Another group of rats was placed in an enclosure he called Rat Park. As it was later described by journalist Johann Hari, this environment was “basically heaven for rats. They’ve got loads of cheese, they’ve got loads of colored balls, they’ve got loads of tunnels. Crucially, they’ve got loads of friends.” Faced with the same choice between drugged and pure water, none of the subjects in Rat Park overdosed.
The Rat Park experiment is not without flaws.10 Some experts critique it as an oversimplification. And indeed, this theory of substance misuse focuses only on the idea of a subject’s current environment. It ignores genetics, life history, and the effects of long-term stress, all of which can contribute to a person’s mental health. However, more robust research continues to support one of its findings: that strong communities can help guard against substance misuse.
One study, conducted in 2021, analyzed several social factors as potential risk and protective factors for substance misuse.11 Researchers found that “those with a greater number of close friends had more strengths and fewer barriers” to addiction recovery. This suggests that one’s relationships, and not just one’s environment, support the process of healing.
Recovering Your Relationship With the World Around You
Much like the process of recovery, building community takes time. Many clients enter rehab with much to learn about how to engage in healthy relationships. You may need to practice setting boundaries, expressing your needs, or navigating group dynamics. And as much progress as you might make during rehab, you’ll find yourself learning a whole new set of skills after treatment.
Remember that a strong community is more than a checkbox. It is a complex, living, breathing, changing group of people, all of whom relate to each other in unique ways. And as you reconsider your relationship with substances, you may also redefine what you need in your relationships with other people. Your support network might look very different after rehab than it did earlier in your life. And for some people, that can be extremely healthy.
Frequently Asked Questions About Building Community in Rehab
Why is building community important in the rehab process?
Building community in rehab fosters support, connection, and a sense of belonging. It creates a safe environment for patients to share experiences, offer encouragement, and learn from each other. Strong interpersonal relationships help support the healing process.
What are the benefits of peer support in rehab?
Peer support in rehab offers several benefits:
• Fosters mutual understanding and empathy • Enhances motivation and accountability • Creates a sense of shared journey • Provides inspiration • Reduces feelings of isolation • Increases the likelihood of long-term recovery
How is community built in rehab?
Community is built in rehab through various activities including group therapy, support groups, experiential therapy, outings, and shared responsibilities. These activities promote social interaction, communication, and collaboration. They foster a supportive environment for people to share and learn from one another.
The process of recovery is different for every person. For some, it includes the use of CBD. However, this is a controversial topic. Many believe that the use of any psychoactive substance, including prescribed medication, interferes with sobriety. And if you’re deciding whether or not CBD will play a role in your recovery journey, it’s important to remember that recovery isn’t about following universal rules. It’s a way to build a life that feels healthy for you.
CBD, or cannabidiol, is one of hundreds of active ingredients in cannabis. It’s readily—and legally—available in many areas. As more and more U.S. states legalize marijuana use,1 for medical and/or recreational purposes, CBD will likely become even more accessible.
Some areas have also decriminalized marijuana,2 with or without officially making it legal. According to the National Conference of State Legislatures, “This generally means certain small, personal-consumption amounts are a civil or local infraction, not a state crime (or are the lowest misdemeanor with no possibility of jail time).” This speaks to a cultural shift in perspective.
CBD is a cannabinoid.5 That is, it’s a chemical substance that interacts with the human body’s cannabinoid receptors. Cannabis plants are believed to produce between 80-100 different cannabinoids. You may be more familiar with THC, which is the most prevalent cannabinoid we know of, and which produces a “high.” CBD is “the second most prevalent active ingredient in cannabis.”6
The Chemistry of CBD
There is much research to be done on all cannabinoids, including THC and CBD. However, these two chemicals are the best-known, and most-researched, cannabinoids to date.
Many experts describe a simple difference between these two compounds: THC is psychoactive, and CBD is not.7 However, this may be an oversimplification. According to one source, “A chemical is considered psychoactive when it acts primarily on the central nervous system and alters brain function, resulting in temporary changes in perception, mood, consciousness or behavior.” Despite this distinction, it remains true that CBD, unlike THC, is not intoxicating.
There is a clear reason for this: CBD and THC have different neurochemical effects.8 Both CBD and THC act on the brain’s cannabinoid type 1 (CB1) receptors. Even without the feeling of intoxication, CBD has a noticeable impact on brain chemistry and may be able to treat both physical and emotional symptoms.
The Experience of CBD
Research suggests that CBD may help treat anxiety,9 insomnia, chronic pain, inflammatory conditions, and symptoms associated with substance use disorders. Some people use it to help with acute symptoms, such as panic attacks and pain flare-ups. Others take it daily, to manage chronic conditions.
CBD is available in several forms. Tinctures can be added to food or taken sublingually, delivering the cannabinoid directly to the bloodstream. Vape oils and high-CBD plant strains can be inhaled, taking effect more quickly but lasting for a shorter time. Lotions and salves are used topically, for a greater impact on localized physical pain.
Because it’s a relatively new subject of study, experts still have much to learn about the benefits and risks of CBD. To date, it’s believed to have a variety of medical applications.
There is some controversy about cannabis as a treatment for mental health conditions. However, preliminary research suggests that CBD may have antidepressant and antipsychotic qualities. And experts agree that CBD for addiction treatment is a promising area of study.13
CBD and Substance Use Disorders
A steadily growing body of research suggests that CBD may alleviate many of the symptoms associated with substance use disorders. According to one study, “the fact that patients with substance use disorders often present with various psychiatric and medical symptoms that are reduced by CBD—symptoms such as anxiety, mood symptoms, insomnia, and pain”14 suggests that this cannabinoid may help people in various stages of detox and recovery.
CBD is an especially promising option for people healing from opiate use. This is because certain cannabinoid receptors are co-localized with opioid receptors in the brain. As a result, CBD can have a direct impact on these receptors, which may help during withdrawal and detox.
Also, many people who overuse opiates do so because they experience physical pain. Because pain relief is one effect of CBD, the cannabinoid may decrease the underlying symptoms that lead to substance use.
Beyond its application for recovery from these specific substances, CBD may help to alleviate cravings and other withdrawal symptoms. According to one study, CBD can even help people quit smoking.16
While there are other medical treatments to aid in this process, CBD may be an even safer option, because it has a low risk of chemical dependency. “According to a report from the World Health Organization, ‘In humans, CBD exhibits no effects indicative of any abuse or dependence potential17…To date, there is no evidence of public health-related problems associated with the use of pure CBD.’”
Am I Still Sober if I Use CBD?
Although CBD is not believed to be habit-forming, it is still a substance. And people in recovery need to be mindful of how they use all medications. Because of this, it may or may not be appropriate for a person in recovery to use CBD.
One important part of recovery is learning to define what health means specifically for you. And your definitions of health and sobriety may change over time. As you approach these issues, it’s extremely important to stay true to yourself, and be honest with your mental healthcare team. You might also connect with a community that defines sobriety in a particular way, which may impact how you view your own recovery process.
Total Abstinence
For some people, sobriety means total abstinence from all psychoactive substances,18 including prescribed psychiatric medication. This strict boundary may even impact the way you approach your physical health. For example, some people in recovery from opiate use refuse narcotic medications at all costs, even when they have surgery.
There is nothing inherently right or wrong about this perspective. It has become common enough that most doctors can accommodate their patients’ needs without the use of these medications. It’s not an easy path, but for many people, it’s the right one.
Harm Reduction
Not everyone commits to total abstinence. And not everyone should. Some serious mental health conditions make prescription medications an absolute necessity. For example, people with bipolar disorder may experience debilitating depression if they abstain from mood stabilizers. At the end of the day, sobriety is meant to be a path toward health, not away from it.
Even Alcoholics Anonymous takes a nuanced approach to the idea of abstinence.19 They recommend that members who require medication continue to take it, but only if they can stay accountable to themselves, their communities, and their medical teams. It’s possible to use substances safely if you’re doing so under appropriate supervision.
As cannabis use becomes more and more culturally acceptable, we are likely to learn more about the medical applications of CBD, especially as relates to recovery from substance use disorders. Because of this, it may become more widely used by people who still consider themselves to be sober.
The Risks of CBD
Despite promising research, there are still some risks associated with CBD use. Although it’s not believed to be habit-forming, it is still a cannabinoid. And many CBD products include trace amounts of THC, which can sometimes be addictive. Studies suggest that 9% of people who smoke cannabis develop a dependence on it.20 For those without substance use disorders, that may be an acceptable risk. For some people in recovery, it may be too dangerous.
If you plan to use CBD in response to a substance use disorder, proceed carefully. Make sure to talk to your treatment providers about its potential risks and benefits, and find out if it can interact with any of your other medications.
Whether or not CBD is right for you, it’s important to be fully honest with yourself, your support network, and your healthcare providers about your experience. For example, if you decide to use cannabis in response to acute panic attacks, and then find yourself using it daily, this may be a warning sign. As with any other substance, it’s best to be mindful of the emotions you associate with its use. Like many other substances, it’s possible to use CBD appropriately. It’s also possible to misuse it, or to overuse it.
Finding Balance, With or Without CBD
As cannabis use becomes less stigmatized, people are starting to question whether or not it interferes with sobriety. There’s no clear answer to this. However, the same is true for most substances. If you’re recovering from cocaine use, can you still safely drink? If you’re recovering from opiate use, should you take Prozac? These questions are complicated, and the answers may vary from person to person. During rehab and recovery, you’ll likely start to define where the line is for you.
As you think about your personal history of substance use, you’ll start to distinguish between healthy and problematic behaviors. Are there ways you’ve used substances in the past that felt sustainable? In the process of recovery, are you still capable of approaching medication in that way? If you can incorporate CBD into a genuinely healthy lifestyle, it has many benefits. However, if you’re concerned about using it unsustainably, it may not be worth the risk.
Frequently Asked Questions About Using CBD in Recovery
Is it possible to use CBD while maintaining sobriety?
The definition of sobriety varies according to different recovery philosophies. Some people choose total abstinence from all psychoactive substances, including CBD. Others may take a harm reduction approach, considering the potential benefits of CBD for managing symptoms. It’s important to communicate openly with your healthcare team and determine what aligns with your recovery goals and personal definition of sobriety. Remember, recovery is a journey of self-discovery and finding the balance that works for you.
Are there risks associated with using CBD in recovery?
While CBD is not believed to be habit-forming, it’s still a cannabinoid and may contain trace amounts of THC. It’s essential to discuss CBD use with your treatment providers, as it may interact with other medications. Honesty with yourself, your support network, and healthcare providers is crucial in monitoring your CBD use and recognizing any warning signs of misuse or overuse.
Can CBD help with cravings and withdrawal symptoms during recovery?
CBD shows promise for alleviating addiction-related symptoms, including cravings and withdrawal, due to its impact on cannabinoid receptors in the brain. It’s shown positive effects in helping people recover from opioid, cocaine, and methamphetamine use. While CBD isn’t a standalone solution, it may be worth exploring as part of a comprehensive treatment plan. Consult with your healthcare provider to determine if CBD is a suitable option for you.
While rehab is a place to begin recovery, it’s only the first step in a long journey. During your program, you’ll start learning how to build a better life. This carefully curated environment may include individual and group therapy, recreational activities, and medical treatment. Most rehab programs are designed to temporarily protect you from external stressors, including work and family obligations. Without those concerns, you can dig deep into healing, developing sustainable tools to use in the future.
Think of your time in rehab as an intensive retreat. This is a crash course. It isn’t meant to be temporary. The goal is not to stay in rehab forever, but instead to learn new skills that you can put to use after leaving the program. And, best of all, you don’t have to do it alone. There are many resources available to people transitioning out of residential rehab.
Post-Treatment Challenges
It’s natural to be concerned about your transition out of rehab and back into the wider world. Without the structure of the program, you can expect to encounter both new and established triggers on a more frequent basis. You may also be returning to difficult circumstances. For example, you and your therapist might discover that work stress prior to rehab was interfering with your mental health. If that’s true, you may be planning to change jobs soon after you return home. Situations like this one can be stressful even in the best of times.
Every person’s experience of rehab is different, but recent graduates tend to have a few common concerns. Before you finish the program, it can be helpful to plan around how you’ll navigate the following:
Relationships and Community
Many people go to rehab when they realize they need more care than they’re getting from their loved ones. Because of this, it’s common for alumni to return home to difficult dynamics. You have to let go of unhealthy relationships in order to prioritize your own healing process. Without the structure of your program and the in-person support of your recovery peers, it can be hard to maintain those boundaries.
Healing takes time. That’s true for the body, the mind, and also for relationships. Many programs offer family therapy, so your loved ones can begin healing even before you return home. This work not only affects your familial dynamic; it can also have a positive impact on your and your loved ones’ other relationships. Ryan Soave, the Director of Program Development at All Points North Lodge, says “…often when we do family work, the families get better. We also find that they get better in their lives outside of the family.
However, family therapy is just one part of rehab. They may have attended weekly sessions, but you’ll have gone through a much more intensive program. You may find that you have more tools for emotion regulation than the people around you. Be patient with them, and with yourself, as you learn how to relate to each other during this new stage of your process.
Relapse
From the moment you arrive at rehab, you’ll begin preparing for the possibility of relapse. Healing isn’t always a linear process, and this is an area of concern for many people in recovery. As such, your team of providers can help you plan ahead. Jan Gerber, CEO of Paracelsus Recovery, offers a clear description of this issue. “There’s a term called ‘post-treatment crash,’” Gerber says, “which is a quite familiar term to everybody working in addiction treatment. No matter how successful and intensive the treatment has been, without the proper care and company after leaving treatment, there are risks for relapse.”
Leaving rehab is stressful. And if substance use has been your primary way of coping with stress up to this point, you may have the urge to fall back into old patterns during this transition. Instead of engaging in unhealthy behavior, it’s important to stay focused on yourself and your goals. Having a clear and specific plan for aftercare can make that much easier. Even before you return home, you can start researching aftercare options to support you in life after rehab.
AspenRidge Recovery in Lakewood, Colorado provides a comfortable sober living environment for clients attending their intensive outpatient program (IOP).
Individual Therapy
Individual therapy is an essential component of recovery. In most rehab facilities, this is a major focus of the program; clients often have daily one-on-one sessions, in addition to group sessions and other activities. Individual therapy is one of the most effective ways to heal from any mental health issue, including substance use. It’s highly recommended for people in recovery to continue individual therapy even after transitioning out of inpatient care.
Therapy offers a private, confidential space where you can explore your emotional experience. Because your emotional life changes over time, this isn’t a quick process. It takes time to process your past, learn to navigate the present, and plan for the future. Many people attend therapy for years, or throughout their lives. Like rehab, therapy is a tool to kickstart the healing process. However, therapy is also important for the maintenance of your mental health regardless of where you are in your recovery journey.
You may or may not be able to continue seeing the same therapist you saw during rehab after you leave the program. Most therapists are only licensed to practice in certain locations. Because of this, people who travel to attend rehab will almost certainly need to find a new therapist once they leave. Some therapists are able to offer telehealth services, or sessions on a remote basis. If you’d like to continue seeing the same provider after you return home, make sure to check with them before you leave to find out if that’s possible.
Finding the right therapist for you can be a long and even arduous process. The therapist-client dynamic works best when your provider has an intuitive sense of your needs, goals, and values. What’s more, not every therapist has experience in treating addiction. If you have additional concerns, you may need a provider who has other competencies as well. For example, a therapist who specializes in working with teenagers might not be a good fit for someone in their 40’s. Remember that you’re allowed to shop around. You can research a provider’s credentials before reaching out, and you can ask to have an initial trial session before committing to a longer process. It’s ideal to begin looking for a therapist before you leave rehab.
Intensive Outpatient Programs and Partial Hospitalization Programs
Intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) are one step down from residential treatment. These programs allow you to live off-site—usually either at home or in a sober living environment—while undergoing intensive therapy at a hospital or rehab center. An IOP or PHP might be right for you if you need significant support during the transition out of rehab.
Intensive Outpatient Programs (IOPs)
If you participate in an IOP, you will live at home, on your own, or in a sober living environment, but you will attend the clinical program several days a week. Each of these programs is unique, but most of them include 10 or more hours of group and individual therapy per week. The Substance Abuse and Mental Health Services Administration (SAMHSA) lays out specific guidelines for IOPs,1 stating that “IOP services may incorporate other in-house treatment and peer services, encourage clients’ attendance at mutual-support groups, and collaborate with local community providers to secure needed services (e.g., medication-assisted treatment, psychological assessments, vocational rehabilitation services, and trauma-specific treatment).”
IOPs offer a gentle transition out of rehab. AspenRidge Recovery, a facility in Colorado, describes this type of program as “a safe and accountable way [for clients] to test their skills in real-world situations while still having a supportive team to rely upon.” You’ll continue to have a team of healthcare providers at your fingertips, as well as access to a cohort of people who are also in recovery. Your time on-site is intended to help you process the experiences you have outside of rehab and in between therapy sessions.
Partial Hospitalization Programs (PHPs)
PHPs are similar to IOPs, but clients spend more time in the program. If you attend a PHP, you’ll spend the majority of each day in treatment, and only go home at night. This is a good option for people who need to be closely monitored by healthcare providers, but have some responsibilities they can’t simply put on pause, like family or schoolwork. You can attend a PHP after rehab, or choose this type of program instead of 24/7 treatment.
Pillars Recovery, a rehab in California, recommends PHPs to clients who can’t afford inpatient rehab. They also offer clients the option of staying in a sober living environment during the program. Depending on your insurance, one of these options may be more accessible than a more traditional stay at a rehab facility.
Sober Living Environments
A sober living environment hosts residents who are adjusting to the rhythm of life without substance use. They are safe environments with clear rules and regulations, but far less structured than inpatient rehab programs. While you may choose to attend therapy during your time there, those sessions would likely take place off-site and through a different program. The goal of your stay in a sober living environment is to transition out of intensive treatment into a more flexible schedule.
Many sober living environments will only admit clients who have already completed a residential treatment program. Some, however, are available to people recovering from a number of concerns, and not only from substance use.
Unlike inpatient rehab, sober living offers you the opportunity to socialize and set your own schedule. You may have access to planned outings, a library of relevant materials, and other activities, such as yoga and meditation. You’ll likely be required to attend regular meetings, such as 12-step meetings, that support your new lifestyle.
Some kinds of healing can only be accomplished alone or in therapy. Other kinds of healing can only be achieved in a community. As you transition out of inpatient treatment, it’s important to take the skills you developed in rehab and put them into practice in your daily life.
Pillars Recovery in Newport Beach, California offers an intensive outpatient program (IOP) and day treatment (PHP) for clients wanting to step down to transitional living for a structured, healthy lifestyle post-rehab.
Support Groups
Support groups are a valuable resource for people in recovery, both during and after therapy. These settings allow you to learn from other people with similar life experiences, and gain insights you might not have access to in individual therapy. Catherine Ulrich Milliken, Program Director of McLean Borden Cottage, explains that attending groups is “an important part of recovery, and the evidence shows that it’s a good, helpful component. It’s another way to be connected to a community. It’s another place of accountability. It’s another place for support. It’s the roof on the house of sobriety – making sure people engage in a spiritual component.”
Various support groups are available in most areas. Most aftercare programs—such as IOPs and PHPs—will provide facilitated sessions on-site. However, most of these groups are easily accessible to anyone.
If you’re living independently, don’t be afraid to try out a few groups before you decide which one(s) you’d like to attend regularly. The specific people in your group have a huge impact on the experience. You may find that you really connect with the people who attend a certain meeting on Wednesday nights, but you don’t have much in common with the people who go to the same group on Fridays. Rehab alumni often find it helpful to attend more than one group; some people even go to at least one session every day after leaving inpatient treatment. These groups are offered in a wide variety of styles, giving you the freedom to choose which philosophy works best for you.
12-Step Groups
In 12-Step support groups, participants follow 12 clearly defined steps toward recovery. These steps were originally defined by Alcoholics Anonymous, and over time, numerous similar groups have branched off. All over the world, it’s now possible to find local chapters of Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, Pills Anonymous, Codependents Anonymous, Sex Addicts Anonymous, Workaholics Anonymous, and more. While these different groups use slight variations on the original 12 Steps, they all share a similar philosophy.
Most 12-Step meetings open with a reading or a prayer. After that, members may be invited to share their stories, or to engage in a group conversation. Every group’s format is a little different, based on the specific needs and goals of the participants and facilitators.
Sponsorship is an important component of the 12-Step program. A sponsor is someone who has been attending the group for some time, who feels ready to volunteer to work closely with newer members. When you form a relationship with a sponsor, you’ll connect with them outside of group meetings, possibly through regular conversations or other activities. This allows you to learn from their experience, strategize ways to achieve your own goals, and stay on track as you continue to heal. Depending on your specific sponsor, you may even be able to call them at a moment’s notice when you’re having a hard time.
12-Step groups have a strong focus on faith. While all are welcome, much of the literature references a higher power, and sometimes even a Christian God. These groups are a good fit for people who want to develop a spiritual practice, and they may be less effective for those who don’t. Alcoholics Anonymous, Narcotics Anonymous, and other 12-Step groups are some of the best-known support groups for people in recovery, but they’re far from the only options.
Other Support Groups
If the 12 Steps aren’t right for you, there are many other established support groups you can join. For example, SMART Recovery groups focus on self-empowerment and behavioral health. Their 4-Point Program2 encourages members to prioritize the following goals:
Building and maintaining the motivation to change
Coping with urges to use
<anaging thoughts, feelings, and behaviors in an effective way
Living a balanced, positive, and healthy life
Groups are led by trained facilitators, who may or may not have personal histories of substance use. This abstinence-oriented program is founded in science rather than faith.
LifeRing Secular Recovery is another secular group, with a similar focus on personal growth. They espouse the 3S philosophy, “Sobriety, Secularity, and Self-Help.” Members give and receive support from each other in each meeting, but unlike 12-Step programs, do not engage in sponsorship. Instead, this organization teaches that “you know what’s needed in your life3 and what has to be abandoned. You know what triggers cravings and what provides healthy and strengthening pleasure. You know the path you want to be on and you are the only person who can figure out how best to get there.” Participants are encouraged to make their own choices, and to creatively build a life that makes them happy.
Social Interest Groups
As important as it is to see a therapist and connect with your peers, there’s more to healing than processing complex emotions. Recovery is also an opportunity for joy. As you begin to live a more sustainable life, you’ll naturally find healthier ways of relating to the world.
After completing inpatient treatment, many people find joy in taking up new hobbies and learning new skills. Joining a special interest group can support that process. You may even want to continue working on something you started during rehab. For example, if you loved your time in art therapy, you might enroll in a painting class. Pursuing these activities can keep you grounded as you go forward, and may even remind you of positive experiences you had during treatment.
There are meet-up and affinity groups for almost any interest you might have. You can join a knitting circle, take a philosophy class, or start playing softball. It can be especially helpful to connect with people in person, instead of only engaging through social media. Forming relationships with people who share your interests but not necessarily your struggles can also be a helpful reminder that you are a complex, multi-faceted person. There’s far more to you than just your challenges.
Just as there are lessons you can learn in group therapy that would never come up in a one-on-one session, there are also valuable experiences you can only have outside of therapy. In an affinity group, you can learn about social dynamics and problem solving in entirely new contexts. You can also create new memories, develop a sense of accomplishment, and find ways to have fun without substances! These are the experiences that make life in recovery meaningful.
Charting a Course After Treatment
Recovery is the process of creating a life you don’t need to escape. Rehab can give you the tools to begin that process, but it’s up to you to follow through after you leave treatment. Maintaining your health isn’t just about giving up destructive habits; it’s about replacing them with positive ones.
The map is not the territory. During rehab, you’ll start to define what kind of life you want. After primary treatment, you can begin actively moving toward that life. This process can sometimes be messy and surprising, but it can also be highly rewarding.
No matter what, you don’t have to do it alone. All of these strategies—individual and group therapy, support groups, and social groups—invite you to connect with people who want to see you succeed. Making those connections is the first step toward a better life after rehab.
Frequently Asked Questions About Rehab Continuing Care
What can I expect after leaving rehab?
After leaving rehab, you can expect to face new and existing triggers in the wider world. It’s important to plan around navigating relationships, maintaining boundaries, and addressing post-treatment challenges. This is especially true if you’re returning to difficult circumstances. Remember to get sufficient support in place before leaving treatment, and be patient with yourself and others as you adapt to this new stage of your recovery journey.
Should I continue individual therapy after leaving rehab?
Yes, individual therapy is highly recommended even after transitioning out of inpatient care. It provides a private space to explore your emotional experience and continue your healing journey. Therapy helps with emotional processing, navigating the present, and planning for the future. Finding the right therapist may take time, so it’s ideal to start looking for one before you leave rehab.
What continuing options are available after completing residential rehab?
After completing residential rehab, most patients use some combination of stepped-down care options. These include intensive outpatient treatment programs (IOPs), sober living, support groups, and virtual therapy. These provide ongoing support, structure, and community as you transition from residential rehab to daily life.
Rehab is just the first step in making long-term changes to your lifestyle. Because many people choose to go to rehab in response to a crisis, it’s easy to approach this process with a sense of urgency. In the moment, that urgency is warranted. However, when you’re so focused on the short term, it can be difficult to imagine a better future. People tend to catastrophize, picturing themselves going through crisis after crisis, and this emotional spiral can lead to poor decision-making.
Preparing for hard times is helpful, but catastrophizing is not. You are a dynamic, learning, growing person. And the more time you spend focused on healing, the more tools you will develop to navigate any hardship that comes your way.
After rehab, it’s natural to be concerned about relapsing. And that’s understandable, because relapses do happen. But they’re not the end of the world. By the time you leave rehab, you’ll be prepared to work through these setbacks. Nearly 75% of people who experience addiction ultimately recover.1 This includes people who experience relapses.
The process of preventing a relapse begins the moment you enter rehab. Addiction treatment providers understand that your goal isn’t just to complete the program, it’s to successfully reenter the world and live a sustainably healthy life. Your experience of rehab will prepare you for what comes next.
Relapse is a valid concern for many clients. That’s why so many good-quality rehabs focus on giving you the tools you need to work through it.
Delamere in England offers relapse prevention support, 12 months of aftercare, and a 24/7 helpline for those who complete their residential program.
What Causes Relapse?
Stress
Stress is a natural part of life, and research shows that people with a history of addiction may be more sensitive to stress. Even positive events can be stressful,2 like getting a promotion or planning a wedding. The goal isn’t to eliminate these triggers, but to manage them in a healthy way.
Following rehab, stress can make you vulnerable to relapse.3 That’s because there’s a well-understood link between stress and addiction4—and this is especially true of chronic stress. Many people first turn to substances in response to difficult life situations. And without strong coping mechanisms, it’s easy to fall back into those unhealthy patterns. During rehab, you’ll learn how to manage your responses to stressful situations.
Although mindfulness is something of a buzzword these days, it’s also an effective tactic for coping with stress. This and other emotion regulation techniques taught in rehab can help you focus on the issue at hand, instead of getting lost in a series of overwhelming reactions.
Unexamined Trauma
Don Lavender, Program Director of Camino Recovery in southern Spain, explains the impact of unresolved trauma on relapse:
“The biggest contributor to relapse is stress, and the biggest contributor to stress is unaddressed or unresolved trauma.”
Trauma can result from any number of things, and no two people have the same experience. One person might develop PTSD from a car accident, while another walks away with no lasting psychological effects. Ongoing trauma, such as an abusive relationship or a toxic living situation, can result in complex PTSD (CPTSD), which has slightly different symptoms than PTSD.
With either of these conditions, it’s quite common to develop triggers. A trigger is an experience that evokes feelings of the original trauma, which are often disproportionate to the present moment. For example, open flames might trigger a person with PTSD from a house fire. When they see a burning candle, they may feel a sense of fear and urgency or even rush to put out the flame. In life, this isn’t always an appropriate response. That’s why, in healing from PTSD and CPTSD, clients are encouraged to pinpoint their triggers and develop more effective coping mechanisms.
Substance abuse is a common response to triggers5 like these. When you feel frightened or hurt, substances can short-circuit your emotional state. However, mind-altering substances are just tools, and each one of them has a specific effect. And when substances are the only tool you have available, it makes sense that you would try to use them to fix emotional problems. That’s why rehab is designed to give you more tools, so you can always use the right one for the task at hand.
Patients at Michael’s House in Palm Springs, California discuss relapse prevention strategies in group therapy.
How to Plan Ahead
Rehab is designed to give you the resources you need to not only guard against relapse, but to deal with it when it happens. Many people have concerns about transitioning out of rehab and back into their regular lives. It’s important to remember that rehab is not a vacation; it’s more like a class. You won’t be expected to go back to your old routine when you finish the program. In fact, your experience in rehab will help you decide how to change that routine in order to prioritize your long-term health.
By the time you decide to go to rehab, you probably already know that your habits need to change. Your team of healthcare providers understands this, and they want to help. The process of planning for your reentry into the wider world begins the moment you enter the program, says Rowland Tweedie, the Health and Fitness manager at Paracelsus Recovery:
“Often I tell clients their job, in that initial period after the treatment, is them: it’s their health, it’s their wellbeing. We should plan that…It’s important to have local support in place.”
Planning for life after rehab is different for everyone, and your providers will help you come up with strategies that fit your needs. Some clients find it helpful to create an emotional first aid kit, in which they write down strategies to employ in the future. It can be difficult to think clearly during times of extreme stress, and this is one way to remind your future self of the tools you have available. For example, an emotional first aid kit might include the following:
The phone number of your therapist or sponsor
A list of activities you enjoy, like cooking or exercising
A list of distress tolerance skills you learned in therapy, such as listening to a song you love, lighting a scented candle, or holding an ice cube in your hand
A comfort object, like a soft pillow or a worry stone, that you can pick up and hold in the moment
A mantra you can repeat to yourself during meditation
Rehab is a valuable opportunity to learn from experts, and many programs include educational components. You might learn about the root causes of addiction, including biological predispositions, risk factors in your upbringing, and co-morbid diagnoses. Many rehab centers offer skills coaching, equipping you with healthy habits intended to improve your quality of life. You might learn how to exercise properly, how to cook, or even how to paint. Craving management classes provide strategies for working through any urges you experience in the future.
This type of learning is extremely important, and you’ll ideally come away from it with many useful coping strategies. However, finishing rehab doesn’t mean you’re simply “fixed.” When you exit the program, you’ll begin a whole new learning process. The environment of a rehab facility is very different from the wider world, and it will take you time to reacclimate. There will be times when you’re overwhelmed and unsure of how to react to a new situation. Each of these moments is an opportunity to put your new skills into practice.
Immersion Recovery Center in Florida helps patients prevent relapse via stepped-down treatment like sober living and outpatient care.
Life After Rehab
By the time you leave rehab, you’ll have a very specific plan in place for aftercare. Although the transition may be jarring, your team will work with you to make it as seamless as possible. Most clients make plans for continuing care, which may be ongoing or may just see them through the transitional period. These services may be offered by your original treatment facility, or you may work with a different provider after you complete the program. Certain types of care may be covered by insurance, but that’s not universally true.
If you traveled to a destination rehab center, you can still find providers that will be locally available when you return home. This may take a little more effort on your part, but it’s important to at least begin the process before you finish the program. You’ll want to have ground support as soon as you arrive, so that your new team can help you process the move to a new place. At this point, you’ll also be navigating brand new big changes. You may need to restructure your relationships, move to a new home, or change careers. It’s far easier to do this with a team standing by to support you in person.
Continuing care refers to any type of support that sustains your ongoing recovery. Components of continuing care may include the following:
Individual therapy
Psychiatry
Group therapy
Support groups (12-Step programs, harm reduction meet-ups, etc.)
Work with a nutritionist
Personal training and exercise
Massage therapy or acupuncture
Family support (family of origin or chosen family)
Community support (friends and loved ones)
Recreational groups (hiking groups, sports teams, fan clubs, knitting circles, etc.)
Any or all of these types of care may be appropriate for you. And remember that healing can be fun! Joy and passion are essential components of recovery. Taking pride in your accomplishments—whether a big presentation at work or a doodle of your cat’s face—allows you to find meaning in your daily life. It’s also important that you find healthy and sustainable ways to unwind. As you transition out of your old lifestyle, it can be difficult to imagine having fun without using substances. But don’t be afraid to try new things. There are countless ways to enjoy yourself, and you may be surprised to find you have much more fun when your head is clear.
Responding to Relapse
Relapses happen. Even when you have new skills, a strong support network, and the very best of intentions, this is a risk that you’ll face during recovery. Remember that relapse is not a sign of weakness, and it doesn’t have to be a failure. As Dr. Christine Merzeder, Senior Clinical Coordinator at Paracelsus Recovery, explains:
“When [you] relapse, there’s no moral issue with that. We say, ‘Okay, back to square one.’ If you relapse, phone us, come back to us. We give you advice on what to do. Don’t panic.”
If you do relapse, start by reaching out to a trusted healthcare provider. This could be someone you see regularly, like a local therapist or psychiatrist, or you can call the facility where you started treatment. Don’t isolate yourself or get lost in feelings of shame. There is a strong link between shame and addiction,6 and hiding your struggles often amplifies them.
Remember that this is a relapse. That means you’ve been here before, and you’ve gotten help before. You already have the tools you need to start or restart the healing process. You are living proof that change is possible. Some rehabs offer programs specifically for people who have relapsed after treatment. Depending on where you go, you may be able to return to the same place for a shorter stay. If that’s not available to you, you might also consider an Intensive Outpatient Program (IOP) in your area. In an IOP, you would continue to live at home, attending regular therapy sessions and workshops at a local treatment center.
Healing is a holistic process. If you’re considering rehab as an option, you probably already understand that substance abuse can have an impact on every area of your life. This might include your job, your family, your social life, and even your physical health. The goal of rehab is not just to heal your mind; it also aims to empower you to make big changes to the structures around you. You’ll have to reexamine the way you relate to the world, and take steps to make your life more sustainable. Don’t be daunted by this process. With every positive change, you’ll build momentum. This is true even during setbacks. If you relapse, remind yourself how far you’ve already come.
Lasting change is a long, slow process. The Stages of Change model7 lays out the many steps that go into this process, from precontemplation to ongoing maintenance. Most notably, this model includes relapse as a distinct possibility. Alex Lickerman, M.D., writes:
“Never let a few days, or even weeks, of falling back into bad habits discourage you from fighting to reestablish the good habits you want. Always remember: No one was born with habits. They were all learned, and can all, therefore, be unlearned.”
Relapse is just one step in a lifelong journey. It may feel like a step backward, but it’s also an opportunity to learn more about yourself. Pain of any kind—be it emotional, physical, or spiritual—is just information. When you touch a hot stove, you learn not to do it again. The lessons of relapse are more complex. You may learn that a particular relationship is causing you harm, or that you need to pay more attention to your sleep schedule. Any information about yourself is valuable. This learning process empowers you to build a life aligned with your values.
Remember: the path to healing isn’t linear. Whether you’re recovering from a broken ankle or emotional trauma, setbacks are to be expected. If you can, let these experiences motivate you. Listen to yourself, understand your needs, and focus on doing the next right thing.
If you’re in need of support, many rehabs offer programs that can help. Search for a facility based on your criteria and speak directly with an admissions advisor about the best course of action for you.
Frequently Asked Questions About Relapse
What are the causes of relapse?
Many factors can contribute to relapse, including stress, boredom, negative emotions, and peer pressure. Be aware of your own triggers and to have a plan in place for coping with them.
What can I do to prevent relapse?
There are a number of things you can do to prevent relapse. These include attending regular therapy and support groups, learning healthy coping strategies, avoiding triggers, taking prescribed medication (if necessary), and leaning into your support network.
What should I do if I relapse?
If you relapse, talk to your therapist or sponsor. They can help you understand what happened and develop a plan to prevent relapse in the future. Remember: relapse is a common part of recovery and it does not mean you’ve failed. An addiction treatment center, addiction-specialized therapist, or supportive loved one can help you recommit to your recovery and get back on track to your goals.
While visiting McLean Borden Cottage as part of our Destinations series, Catherine Milliken, the Program Director gave us an excellent explanation of the “relapse process.” Watch this 3-minute video to get a better understanding of what causes relapse and how it can be prevented each step of the way.
