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Continuing Care Model

This model addresses the chronic nature of substance use disorders by emphasizing long-term outcomes of treatment and focusing on recovery. Similar to other chronic diseases, substance use disorders require continuing care and follow-up. Continuing care is the support plan following treatment for substance use disorders. The goal of a continuing care model is to focus on the successes made during the initial phase of care — for example, through inpatient and residential care programs — by providing follow-up care throughout recovery. The continuing care model focuses on active and ongoing care management.

While there is not a standard type of treatment, frequency of treatment, or length of treatment, continuing care may involve outpatient services provided on a weekly basis for a few months up to one or two years.

A publication in the Journal of Substance Abuse Treatment identified four components of effective continuing care interventions:

  • Extended monitoring: The “gold standard” is in effective extended monitoring is drug testing via the collection of biological data, particularly urine samples.
  • Performance-based incentives: Incentives for drug-free biological samples have been show to produce better results for abstinence among individuals with substance use disorder.
  • Alternative forms of service delivery: Interventions that require frequent, in-person check-ins can be burdensome for some patients. Programs may consider home visits, telephone-based care, and web-based interventions as alternatives.
  • Community support: People in recovery need support from friends, family members, and peers.

Examples of Continuing Care Programs

  • Discovery Place in Burns, Tennessee offers a long-term continuing care program to patients who have completed a 30 day residential treatment program. The long-term program consists of 12-step recovery meetings, workshops, and instruction on cultivating a healthy lifestyle.
  • The Hazelden MORE (My Ongoing Recovery Experience) program is an online, computerized recovery program developed for patients who have recently completed the residential treatment program for substance use disorders. In addition to the computerized modules, patients have access to a recovery coach as well as a licensed counselor.

Considerations for Implementation

There is not a standard definition for continuing care, how frequently it should be provided, or for how long. However, a common goal of continuing care programs is to support people who have a substance use disorder during recovery. Continuing care models constitute a shift in the field of substance use disorder treatment, as many treatment programs traditionally focus on providing time-limited, specialized behavioral therapy and/or medication-assisted treatment. One study that reviewed the literature on continuing care models identified characteristics of continuing care models that are likely to be most effective, including interventions with a longer duration and interventions that make “active and direct attempts to bring the treatment to the patient.” The study also suggested that additional research is needed to identify continuing care interventions that are cost-effective, encourage participation, and are appropriate for people with different types of substance use disorders.

Resources to Learn More

Continuing Care Research: What We've Learned and Where We're Going
Literature review of continuing care interventions implemented in the past two decades.
Author(s): McKay, J.
Citation: Journal of Substance Abuse Treatment, 36(2), 131-145
Date: 3/2009

A Path Forward to Measuring Continuing Care Management for Substance Use Disorders: Patient-Focused Episodes of Care
Discusses goals of continuing care and identifies challenges to providing continuing care.
Author(s): Rosen, A. and McKay, J.
Date: 11/2009

Recovery and Recovery Support
Information about recovery-oriented care and grants related to recovery and recovery support.
Organization: Substance Abuse and Mental Health Services Administration