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What to expect when your child completes treatment is something to begin preparing for at the start of treatment. It can help bring clarity to their goals and next steps. Regardless of what level of care they are stepping down from, effective planning can help you and your child better navigate the ups and downs of recovery.
What is discharge planning?
Your child may currently be in a hospital setting, residential program, or individual therapy, amongt other levels of care. Discharge planning, also known as aftercare or continuing care, refers to the transition from one level of care to another. The plan outlines the likely next steps for your child and what role the family will play.
With input from your child (and you if your child has signed a release or is not of age), their treatment team will identify the specific services your child needs going forward. They will share medical records for the referral and make all necessary appointments for follow-on care. The plan should be in place before your child is discharged so that you and your child know where they are going and who they are going to see. Alameda County Behavioral Health provides a good example of a discharge plan jointly created by a patient and their counselor, which includes the patient’s goals and their plans in case of relapse.
What happens when my child is discharged?
Each level of care has its own step down. For example, residential treatment usually leads to partial hospitalization or an intensive outpatient program. Partial hospitalization moves on to an intensive outpatient program and intensive outpatient typically moves down to individual therapy.
That being said, discharge planning, much like treatment itself, is not a one-size-fits-all plan. Providers may offer different recommendations based on what is medically necessary, whether there are co-occurring disorders involved and many other factors.
What should a discharge plan include?
Depending on your child’s treatment plan, you can consider many different aspects of continued, formal treatment.
Next level of care
The treatment program will recommend an appropriate level of care for your child once they have completed their current treatment program. There may be differences in what your child, the family and treatment team want to do. For example, your child may want to skip additional treatment and instead go to support group meetings, or they may want to return home instead of recovery housing. In case of such differences, the treatment team will work with your child to develop an acceptable plan, understanding that it may not be ideal from everyone’s perspective.
Medication
Your child, like many others struggling with substance use disorders, may have a co-occurring disorder, which can require additional mental health counseling and the use of medications. A shorter-term prescription will be provided to bridge the time between discharge and upcoming appointments. The cost of medications and continued prescriber visits should be considered in the planning process.
Logistical considerations
Your plan should take into consideration the transportation needs of your child. Some programs will arrange for transportation while others may provide public transportation schedules. The more widespread use of telehealth may make it easier for those with transportation challenges to access continuing care.
Other considerations
Beyond the specifics of treatment, there are other continuing care considerations. For example, having access to a gym or other recreational activities, using a recovery coach, going to support group meetings, and moving to sober living (or moving to a substance-free dormitory if they are in college) may be part of a plan. Connecting your child with alumni support networks and encouraging engagement in other sober, positive activities can be helpful.
If your child is still in school, you may need to consider impacts to their education, if specific accommodations need to be made, or if there are any school counseling resources they can use.[1] Similarly, if your child will miss work due to treatment, providers can help advocate for different working conditions or medical leave forms.
If your child is involved in the judicial system, treatment providers can provide documentation to show that your child has been in treatment. This can be especially helpful if your child has missed court dates or appointments with probation officers.
Family support
Building family support into continuing care should be an essential part of your child’s discharge plan. This can include a family meeting prior to discharge where you can share expectations and review the plan. Family therapy, support groups, self-care and other forms of ongoing family-specific help may be recommended.
It is important to work together with treatment providers regardless of the level of care in order to do what is best for your child. Recovery is a long process, but with the help of a solid, strengths-based discharge plan and your support, your child can have a successful outcome.