Why we stopped using the term ‘aftercare’

Abstract

The words we choose to describe alcohol and other drug (AOD) treatments and interventions reveal assumptions about how we understand AOD use. Moreover, they have important implications for how the treatment is imagined, implemented and funded. Service provision which follows engagement in an intensive (usually residential) program is often called 'aftercare' in the international AOD field. In this commentary, we argue that the term 'aftercare' fails to articulate the nature of ongoing care required by people who are managing AOD use. We maintain that 'aftercare' positions post-residential care as being less important than other treatment modalities, rather than as integral to a continuum of care. It is a term that implies that care should be acute, like much treatment delivered through a medical model, and assumes that people follow linear pathways in managing their AOD use. Assumptions embedded in the term 'aftercare' such as these may disincline governments from funding ongoing services for people exiting intensive programs. Alternative terms including 'continuing coordinated care' more aptly signal the integrated and ongoing service provision that should be available to support people in sustaining changes initiated through other AOD interventions.

‘I just wanted a change, a positive change’: Locating hope for young people engaged with residential alcohol and drug services in Victoria, Australia

“…drug and alcohol services, hope, qualitative, resources, young people issues in their day-to-day lives, meaning young people often need ongoing and holistic care (MacLean et al, 2022).…”

“…Young people reporting problematic AOD use are likely to experience multiple disadvantage, including poverty, homelessness, educational disengagement, family breakdown and mental illness (Almqvist & Lassinantti, 2018; Moustafa et al., 2021; Sandu, 2021). It can be difficult to address AOD use while young people still face myriad social issues in their day‐to‐day lives, meaning young people often need ongoing and holistic care (MacLean et al., 2022).…”

“…Hope is also central to narratives of recovery and social models of health, where the possibility of recovery is proposed as a potential solution to the range of social problems people face (Webber & Joubert, 2015)—including problematic AOD use. These narratives tend to focus on hope as a cultural resource, but false hope and unrealistic expectations of recovery can likewise be a source of frustration and disengagement (Amati et al., 2019; de Graaf, 2016), particularly when people experiencing problematic AOD use face the very real prospect of ‘relapse’ (Bryant et al., 2021; MacLean et al., 2022). Petersen (2015) is also critical of the broader socio‐politics of hope in health and medicine.…”