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Continuing Care

Continuing Care. Recovery Oriented Systems of Care. Principle. Health care professionals should remain involved and available to those they serve until long term recovery can be self-managed by the patient, family, and extended support network

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Continuing Care

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  1. Continuing Care Recovery Oriented Systems of Care

  2. Principle • Health care professionals should remain involved and available to those they serve until long term recovery can be self-managed by the patient, family, and extended support network • Community is the ultimate healing agent, not treatment

  3. Recovery Stability • Stability of recovery not reached until 4-5 years of sustained remission • Post-treatment monitoring and support can significantly elevate long-term recovery outcomes

  4. Recovery Stability • Extended period of check-ups and support rather than longer periods in primary treatment • Emotional support and mental health service needs that were not present during initial treatment may present during post-treatment monitoring

  5. Critical Elements of Continuing Care • For a five year period: • post stabilization monitoring, • stage-appropriate recovery education, • active recovery coaching, and • re-intervention when needed

  6. RM Continuing Care • Provided to all clients, not just those who “graduate” 2. Responsibility for contact shifts from client to the treatment agency

  7. RM Continuing Care • Timing: Capitalizes on critical windows of vulnerability (first 30-90 days following treatment) and power of sustained monitoring (Recovery Checkups)

  8. RM Continuing Care • Intensity: Ability to individualize frequency and intensity of contact based on clinical data • Duration: Continuity of contact over time with a primary recovery support specialist

  9. RM Continuing Care • Location: Community-based vs. clinic-based • Staffing: May be provided in a professional or peer-based delivery format • Technology: Increased use of phone & Internet-based support services

  10. Evidence Based Practice • The Effectiveness of Telephone-Based Continuing Care for Alcohol and Cocaine Dependence. • James R. McKay, PhD; Kevin G. Lynch, PhD; Donald S. Shepard, PhD; Helen M. Pettinati, PhD

  11. Telephone Based Continuing Care Research • Intensive Outpatient completion • 12-week continuing care protocol • weekly telephone-based monitoring and brief counseling contacts combined with weekly supportive group sessions in the first 4 weeks

  12. Telephone Based Continuing Care Research • Telephone-based continuing care appears to be an effective form of step-down treatment for most patients with alcohol and cocaine dependence who complete an initial stabilization treatment, compared with more intensive face-to-face interventions • However, high risk patients may have better outcomes if they first receive group counseling continuing care after completing intensive outpatient programs

  13. Phone Contact • Initial face to face session to orient client • One 15 minute phone call per week • Began with brief review of progress toward one to two goals identified in prior session • Plans for achieving goals over next week were then discussed, along with any other pressing issues

  14. References • Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices.White, 2008.

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