Hangover anxiety, or hangxiety, isn’t a diagnosis, but rather how you feel after a night of drinking alcohol. A hangover has physical symptoms like nausea and a headache, but you can have mental effects as well.
Drinking responsibly likely won’t lead to these negative feelings; however, if you’re consistently drinking a lot and feeling hangover anxiety, then it may be time to look for help. Getting treatment for alcohol addiction can help you get a handle on your drinking, so you don’t have to wake up with worry the next morning.
When you start drinking, alcohol drives a surge of endorphins in the brain2, which feels good at first. Then, after this rush, there’s a decrease in blood alcohol concentration (BAC) which leads to a form of withdrawal. This is what we commonly refer to as a hangover.
This withdrawal affects you physically and mentally, including provoking anxiety and depression symptoms. Hangover anxiety can look different for everyone, but these are some common symptoms:
Restlessness
Anxiousness
Ruminating on yesterday’s events
Heart racing
Feeling guilt
Difficulty concentrating
What Causes Hangover Anxiety?
After your endorphins drop, your brain can quite literally feel exhausted the next day. Your body uses a lot of energy trying to maintain homeostasis after being affected by the alcohol. And cortisol, the stress hormone, releases after drinking3, making you feel even more anxious.
These factors can also exacerbate hangnxiety symptoms:
1. Social Anxiety
You might use alcohol as a “social lubricant” if you experience social anxiety. This can cause you to drink more than you should. Though for those few intoxicated hours you may feel less anxious, these feelings return as the alcohol wears off. And if you have a hangover from excessive alcohol consumption, your anxiety can skyrocket. Alcohol will enhance whatever emotional state you’re in, so if you’re anxious, it’s going to come back in full swing.
Alcohol causes poor sleep quality5 because it messes with your rapid eye movement (REM) cycle. This, in turn, negatively affects your mood because getting proper sleep is vital for good mood and functioning.
Repetitive negative thinking (RNT) is negative thought patterns that are recurring, unproductive, and common in disorders like anxiety and depression. It’s also a part of emotional dysregulation. These patterns of thinking are associated with prolonged negative emotional states6, so this can exacerbate symptoms when you experience hangover anxiety.
How to Cope with Hangxiety
The best way to avoid hangxiety is to avoid drinking, especially in excess. Doctors recommend drinking a minimal amount of alcohol because excessive alcohol consumption can lead to various health problems such as liver damage, heart disease, and certain types of cancer.
However, if you do decide to drink, there are a number of ways you can cope with your hangover anxiety and make this experience manageable:
However, drinking responsibly, or being abstinent, can help you avoid these feelings all together.
How to Have Fun Without Alcohol
Life can be just as fun, if not better, without alcohol. You’ll feel healthier and more energized, which can help you do more outdoor activities like hiking or kayaking. You’ll also save a lot of money from not buying drinks, which you can spend on new experiences like travel or exploring the area you live in.
You can also talk with your therapist and dig into the real reasons why you’re drinking alcohol. Why are you having this drink? And why do you feel like you need to drink so much? This can reveal deeper issues that you can work through together.
When to Seek Professional Help for Your Drinking and Anxiety
Taking a step back and assessing the role that alcohol plays in your life, especially if you have pre-existing anxiety or depression, is crucial. If you’re using alcohol as a crutch, and as a coping mechanism to suppress difficult feelings, then it may be time to reach out for help.
Mental Health Treatment Options
Alcohol is a depressant, so it can aggravate your existing conditions. If you drink to escape your anxiety or depression, treating the root cause of your disorder can help mediate this issue.
Attending an outpatient program can teach you skills to help you replace your drinking with healthy coping techniques. You’ll explore how drinking has been a way to hide from uncomfortable feelings, and then you’ll learn how to face those hard emotions. You’ll likely practice different talk therapies like cognitive behavioral therapy (CBT) to learn new positive ways of thinking.
Virtual treatment for anxiety and depression can be a great way to learn these tools with more flexibility. You can prioritize healing and see how it fits into your life.
Alcohol Addiction Treatment Options
Detox with a licensed professional may be the first step in your sobriety journey. Safely ridding your body of alcohol can help you feel clear minded and ready to tackle treatment. Different levels of residential or outpatient care can help you replace your unhealthy coping mechanism, drinking, with positive habits.
A great option post-treatment is sober living homes. These programs are less structured than residential rehab, and provide a comfortable place for you to focus on your recovery. While living here, you’ll likely attend an outpatient program, go to work or school, and grow with other companions in recovery.
Life Without Worry in the Morning
Drinking socially and safely is perfectly acceptable, but if heavy drinking and hangxiety is a normal thing that you’re getting addicted to as a coping mechanism, then it’s time to get help. Life can feel so much more fulfilling without hiding behind alcohol. Embrace your true self and find freedom through rehabs for alcohol addiction.
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.
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.
