Treatment Planning, Collaboration, and Referral
What a defensible plan contains
A treatment plan names the problem in behavioral terms, sets a broad goal, then breaks it into measurable objectives with timeframes, specific interventions, the person responsible, and review dates. Goals are directional ("achieve stable recovery"). Objectives are SMART ("attend 8 of 8 scheduled group sessions within 30 days"). The plan is developed with the client, not for the client, and it is revised when assessment or ASAM criteria indicate a change.
Know the ASAM levels of care in order: Level 1 outpatient; 2.1 intensive outpatient; 2.5 partial hospitalization; 3.1 clinically managed low-intensity residential; 3.5 clinically managed high-intensity residential; 3.7 medically monitored intensive inpatient; 4 medically managed inpatient. Referral questions usually hinge on matching the six dimensions to the least restrictive level that is safe.
Collaboration, releases, and referral
Collaboration means multidisciplinary teamwork, case management, family and court or child-welfare coordination, and warm handoffs rather than faxed names. For substance use records, 42 CFR Part 2 governs, and it is stricter than HIPAA. Written consent must identify the client, the disclosing program, the recipient, the purpose, what information and how much, a statement of the right to revoke, an expiration date or event, the signature and date, and notice that re-disclosure is prohibited. Verbal consent is insufficient, and revocation must be honored.
Traps and a rule of thumb
Watch for vague objectives, plans written without client input, and the belief that a general consent form covers any future request. Part 2 disclosures in legal proceedings generally require a court order meeting Part 2 requirements, not a subpoena alone. Also remember continuing care planning begins at admission, not discharge.
Rule of thumb: if you cannot measure it and no one is named to deliver it, it is not an objective.