Guidelines for Client Discharge

Dawn Farm takes the issue of terminating services to clients very seriously. We recognize that for many of our clients’ termination of treatment means returning to homelessness and/or environments that encourage and support their addiction. Termination also often creates a crisis in which the client is unsure of how their most basic needs will be met (food, shelter, personal safety, etc); they also often have no transportation and may be estranged from their family due to an unsuccessful discharge. We will attempt to provide referrals and crisis intervention to address this crisis. We will avoid discharging clients in inclement weather or at night and we will provide advance notice when the group will not be harmed.

• Dawn Farm believes that it is almost never in the interest of a client to be discharged.
• Dawn Farm discharges clients for the welfare of the group.
  • When the effect on the group is in question staff should consider consulting the group.
• Dawn Farm believes addiction is a chronic disease and makes every effort to avoid refusing services to addicts being symptomatic. If we must discharge a client for symptomatic behavior we will see if Dawn Farm can offer other services or a referral to meet their needs.
• Dawn Farm has a policy of zero tolerance for violence and animal abuse.
• Dawn Farm may discharge a client for failing to progress in treatment. We have an obligation to discharge a client when they are clearly not benefiting for three reasons:
  • Ethical standards dictate termination of services when those services are not meeting the client’s interests.
  • We generally have a waiting list and keeping a client that is not benefiting means postponing admission of another client who may benefit.
  • We have an obligation to funding sources to be responsible stewards of their funds. It is unethical to retain a client and accept funding when we know they are not benefiting from our services.
• Dawn Farm encourages its clients to be honest and open about mistakes they’ve made so that they can learn from them. Dawn Farm will not discharge a client who admits to a rule violation unless:
  • There is clear reason to believe the client admitted to the rule violation for self-serving motives. (Ex. - They knew that someone else was about to tell or the client is seeking to take advantage of our willingness to retain a client who discloses rule violations – “I’ll just own it and then I won’t get kicked out.”)
  • There is clear reason to believe that keeping the individual will harm the group. (Ex. - The group would feel unsafe or the person’s behavior or attitude would have a clearly negative impact on the group culture.)
  • The client is not motivated to address the behavior in question.
  • The rule violation is part of a larger pattern of behavior that staff has attempted intervention and the client is not responding.
• All clients being discharged will receive an aftercare plan to address some of the concerns mentioned above.

When a client is discharged for aggressive/assaultive behavior or self-harm the case manager must attempt to contact the client within 72 hours of discharge to ensure linkage to appropriate care, if possible. Dawn Farm tries to administratively discharge clients as little as possible.

See also: Procedures for Discharge and Referral