RDAP

Residential Drug Abuse Treatment Program

CLINICAL DISCHARGE SUMMARY

Client Name: Client Number:

Date of Birth: Facility Name:
Admit Date: Discharge Date:
Discharge Status:

Demographics:

Summary of Treatment Progress: (add additional pages as needed)

Low Medium High

1 Acute Intoxication and/or Withdrawal Potential

Low Medium High

2 Biomedical Conditions and Complications

Low Medium High

3 Emotional Behavioral & Cognitive Conditions / Complications
As evidenced by:

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TCU Criminal Thinking Scales measurements throughout treatment follow:

Admission Mid-Point Discharge
SCALE Date:
Entitlement
Justification
Power Orientation
Cold Heartedness
Criminal Rationalization
Personal Irresponsibility

TCU CEST Psychological Functioning Scale measurements throughout treatment:

Admission Mid-Point Discharge
SCALE Date:
Social Function
Psychological Function
Motivation
Engagement

Low Medium High

4 Readiness to Change
As evidenced by:

Low Medium High

5 Relapse / Continued Use / Continued Problem Potential
As evidenced by:

Low Medium High

6 Recovery & Living Environment
As evidenced by:

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Continued Level of Service Recommendations:

None Recommended Level III.1 Clinically Managed, Low Intensity, Residential
Level I Outpatient Services Level III.5 Clinically Managed, High Intensity, Residential
Level II.1 Intensive Outpatient Services Level III.7 Medically Monitored Intensive Inpatient
Level II.5 Partial Hospitalization Level IV Medically Managed Intensive Treatment

Diagnosis (DSM-IV-R)

Axis I:

Axis II:

Axis III:

Axis IV:

Axis V:

Continued Care Recommendations:

Signature Primary Counselor: Date:

Supervisor's Signature: Date

There are _________ additional pages attached to this report.

C O N F I D E N T I A L