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| It's Time To Stop Kicking People Out of Addiction Treatment |
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Interventions by professional helpers that are later recognized as ineffective or even harmful have a long and colorful history. Some of the most widely practiced of such interventions have left later generations pondering, "What on earth were they thinking?" Lectures on the history of addiction treatment stir feelings of enlightened condescension amidst tales of treating morphine addiction with cocaine and other such
idiocies, but occasionally a conference attendee asks the tough question:"How will the current era of addiction treatment be judged in the future?" And, of course, that is the rub, because it is so difficult to clearly see our own professional miscues and mistakes without the benefit of historical hindsight. This essay explores one practice - administratively discharging clients from addiction treatment - which we suspect will be judged harshly by historians of the not so distant future.
Administrative discharge: Definition and criteria
Administrative discharge (AD) - also referred to as "disciplinary discharge," "discharge for cause," or "discharge upon staff request" - is the adversarial termination of services due to a client's failure to comply with program rules and expectations. The reasons for AD vary by modality but generally include:
Failing to participate in service activities, e.g., missing counseling sessions.
Threatening, or appearing to threaten, the physical or psychological safety of others.
Breaking rules regarding relationship boundaries, e.g., having phone or face-to-face contact with family members or friends during a "blackout" period, verbal abuse (profanity, racial slurs), or "fraternization" (sexual or other inappropriate activity with another client).
MORE...
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