While residential treatment provides a natural “safe zone” where people seeking sobriety can focus on their immediate situation — addiction — those of us working as treatment providers know that the real work of recovery begins when residential or formal treatment ends. The combination of medical detox, followed by rigorous counseling and family work while in treatment, are only the first steps to a life free from a substance use disorder. So, what should families expect when their loved one prepares to leave treatment and head back home?
What is discharge planning?
Discharge planning is a critical component of a treatment program that helps patients and their families prepare to navigate the ups and downs of a life in recovery. A detailed and organized discharge plan can provide both stability for the person entering recovery and peace of mind for their families. Below, take a look at the key components of a discharge plan as well as what questions to ask as your loved one engages in treatment.
When should the process start?
Discharge planning should begin at the onset of treatment. Parents and loved ones sending their family members to residential care should ask what role discharge planning will play in their treatment stay. Reputable centers will ensure that discharge planning remains a focus during the entire treatment experience.
Who should be involved in the planning?
While discharge planning begins with the patient, many other people will likely be involved in the process. Most people in treatment sign consents that allow providers to touch base with auxiliary points of contact, including family members. Those contacts will naturally be included in the discharge planning process. Though parents and loved ones cannot ultimately dictate a patient’s discharge plan, they may provide valuable insight into aftercare needs.
Along with family members, clinicians may interact with those in the recovery community, as well as with medical and other mental health professionals, such as physicians and therapists. On-site clinical staff should facilitate communication between the patient and these external points of contact. Together, the treatment team will build a discharge plan that reflects these relationships and support services.
Key components of a discharge plan
Counseling is a critical component of most patients’ aftercare plans. Recommendations may include work with a therapist or various levels of clinical support such as Intensive Outpatient or Outpatient services. These clinical services provide support for the challenges presented by life after treatment and may include group work or individual therapy.
Co-occurring disorders are common with addiction, and many people exiting treatment will need to adhere to the medical plan laid out by their treatment team. This includes being compliant with prescribed medications. It is critical that discharged patients understand how and when to take their medications. They will also need to be connected with doctors and mental health professionals in their area who can monitor their progress over time. Affordability may also be a consideration and should be addressed as part of the plan.
Substance use disorders can impact the entire family. Many treatment providers will recommend ongoing support for the family as a component of the treatment plan. This type of support may involve individual or family counseling or family-oriented support groups (such as Al-Anon or Families Anonymous). Studies have consistently shown that recovery outcomes improve when families engage in their own recovery. This allows the entire family to heal from unhealthy family dynamics that may be present.
Support groups, such as 12-Step fellowships, allow people to learn practices to improve their recovery while they develop a network of support. These types of groups often provide the much-needed guidance and motivation necessary to maintain long-term recovery. Many treatment programs also have valuable alumni groups. A discharge plan may include referrals to alumni meetings along with mutual aid and support groups that can serve as vital support along the recovery journey.
Structure and Accountability
Residential treatment is a rigorous process during which nearly every minute of the day is planned. Leaving a structured environment of this nature without an idea of how to spend one’s time after treatment can be difficult for a client. Together with their counselor, patients in treatment should develop a working schedule which includes discharge recommendations such as participating in an Intensive Outpatient Program, as well as other sober, positive activities (e.g., going to the gym, volunteering, attending support group meetings, work/school). All of these aspects provide much-needed structure and accountability.
A Plan to Address Relapse
Relapse does not have to be a part of recovery, but having a plan in place if it happens can be extremely beneficial for the patient and their loved ones. A relapse plan outlines exactly what steps to take if relapse occurs. It is imperative that this step-by-step plan be developed before leaving treatment.
Safe Living Accommodations
For some patients, returning to an unhealthy environment can be very difficult. It is important that patients discharge to living environments that support recovery. As families approach discharge plans, they should work to ensure that safe living accommodations are available immediately after treatment.
The goal of treatment & aftercare
Developing a comprehensive discharge plan may seem like a daunting task, but it doesn’t have to be. While the goal of any treatment stay is recovery, the most successful outcomes occur when the patient learns to develop healthy relationships and interests that do not end at “graduation” from residential care. Ultimately, recovery is about breaking old ways of thinking and learning how to practically apply recovery principles to everyday life. Through open communication with a treatment team as well as the family system, it is possible to develop a plan that supports recovery from addiction — not only for today, but for a lifetime.