Continuing Care Offered to Graduates of Crossroads for Women

Posted on Feb 3, 2012 in Care Issues

by Continuing Care Case Manager, Sheila Ciminera

Aftercare is an important component in the continuum of care that Crossroads for Women provides. It is vital to the long term success of substance abuse and mental health treatment. Aftercare, or continuing care, is a lower intensity continuation of the support and resources offered during the higher intensity programming of The Crossroads or Maya’s Place. Graduation can be an exciting, yet anxiety-provoking time for clients as they embark on a new independent chapter in their lives.

Aftercare ensures that there is no break in services for our clients; rather, there is a seamless transition to the next step in the continuum of care. This lack of hiatus is crucial, and in response to research showing an increased risk of relapse after discharge from treatment. The risk is particularly high in the first 3-6 months, but can extend to up to 2 years after leaving a program (Gossop et al., 2008). In the years after graduation, major events such as job loss, medical issues, or family problems can destabilize a client’s life. Without support, these issues could lead to reincarceration or homelessness. By accessing aftercare services during difficult times, clients are able to weather crises and maintain the lives they have worked so hard to build.

A 2008 study showed clients in treatment were more likely to be successful after discharge when they were able to access continuing care before discharge, and work with staff to create an aftercare plan that involved weekly contact (Schaefer et al.) All of our graduating clients are contacted by the after care coordinator to educate them about services provided, and assist them in developing a plan for continued services. Additionally, research indicates that use of the same provider for both treatment and continuing care has also resulted in longer engagement in continuing care (Schaefer et al., 2005).

Aftercare services have demonstrated higher rates of abstinence in individuals with substance use disorders (Moos and Moos, 2003). Aftercare is associated with positive outcomes for individuals with mental health disorders (Grella et al., 2010). Aftercare has also been shown to have a significant impact on recidivism. A 3 year study reflected that only 27% of offenders participating in aftercare recidivated, in comparison to 75% of offenders that had not received aftercare services (Wexler et al., 1999).

We have 20-25 women accessing aftercare services at any given time. They are able to attend our weekly groups and holiday events. They also can utilize case management services. Some of the issues which aftercare clients have received services for include utilities assistance, medical insurance, vocational skills, mental health management, legal, eviction prevention, housing, domestic violence, relapse prevention, discharge planning for release from jail, and coordination of services for children.

The after care coordinator also gives referrals to clients who did not successfully complete our programs, but are nonetheless reaching out for support. The clients of Crossroads for Women have trust in our agency and staff. This makes them comfortable to reach out to us days or years after their discharge from the program. The aftercare program reflects our long term commitment to our clients and their continued well-being.

Further Reading:

Gossop, M., Stewart, D., & Marsden, J. (2008). Attendance at Narcotic Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: A 5-year follow-up study. Addiction, 103, 119-125.

Grella, C. E., Stein, J. A., Weisner, C., Chi, F., & Moos, R. (2010). Predictors of longitudinal substance use and mental health outcomes for patients in two integrated service delivery systems. Drug & Alcohol Dependence, 110(1/2), 92-100.

Moos, R.H. & Moos, B.S. (2003). Long-term influence of duration and intensity of treatment on previously untreated individuals with alcohol use disorders. Addiction 98(3), 325-337.

Schaeffer, J. A., Harris, A. S., Cronkite, R. C., & Turrubiartes, P. (2008). Treatment staff’s continuity of care practices, patients’ engagement in continuing care, and abstinence following outpatient substance- use disorder treatment. Journal Of Studies On Alcohol & Drugs, 69(5), 747-756.

Schaeffer, J.A., Ingudomnukul, E.. Harris, A.H.S., Cronkite, R.C. (2005). Continuity of care practices and substance use disorder patients’ engagement in continuing care. Med Care 43, 1234-1241.

Wexler, H. K., & Melnick, G. (1999). Three-year reincarceration outcomes for Amity in-prison therapeutic community and aftercare in California. Prison Journal, 79(3), 321.