It is important to prepare clients ahead of time for the cessation of treatment. This is known as the process of discharge planning and is focused on equipping the client with the skills and contacts to continue the positive progress of treatment and avoid relapse. Clients being discharged from residential AOD services in particular can struggle to find housing, employment, and engage with outpatient services [650]. It is important to involve clients in their discharge planning and make them fully aware of their options [234]. While it may be useful to arrange or plan follow-up consultations to monitor how well the client is maintaining the progress made during therapy, a client has the right to refuse further follow-up; if this situation occurs, note the refusal in the client’s record and avoid judgemental reactions [234].
Attempt to link the client with further treatment or support and provide emergency assistance numbers. Communicate with relevant service providers where necessary as outlined above. As with all other steps in the treatment process, the discharge plan should be documented in the client’s record. Research has indicated that the increasing number of health workers involved in managing complex clients creates challenges for maintaining effective communication between all involved [651]. The likelihood of an adverse event is increased when clients are frequently handed over, transferred or discharged, making the importance of effective communication and accurate case notes even more vital [652, 653]. Challenges for busy health care staff include [654, 655]:
- Multitasking.
- Shift changes.
- Gaps in information transfer.
- Interruptions.
- Previous handover lacks detail or is inconsistent.
It is also important to consider such aspects as stability of accommodation and social support when planning for discharge and, with the client’s consent, to involve family and carers as they will play an important role in maintaining treatment outcomes [389, 656, 657]. It is useful to discuss relapse prevention and other strategies (e.g., problem solving, goal setting, and relaxation) with the client during discharge planning and provide the client with skills to manage high-risk situations, lapses and symptoms of mental health conditions that may occur. Chapter B6 provides useful information regarding relapse prevention, support and self-help groups, and other management techniques that clients may benefit from. Appendix BB and Appendix CC provide useful CBT and anxiety management strategies.