Key takeaway
Discharge week can put a sheet in front of you titled an aftercare contract. SAMHSA's intensive outpatient protocol uses continuing care for the support that follows formal treatment. The paper may be your plan, an agreement between programs, or consent to send records. Tonight, ask which one you are holding, and ask the date of the next appointment.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
They put a sheet in front of you and called it an aftercare contract. You do not know whether signing means you are finished, or whether your chart is about to leave with a program you did not choose.
If there is an overdose, very slow breathing, a seizure, or someone who will not wake, call 911. For a mental health crisis, call or text 988.
Ask which paper this is
TIP 47 avoids the word aftercare and talks about continuing care: the mutual-help groups and other community support available once formal treatment is over. A form that says aftercare may mean that, or it may mean something else. Before you sign, ask whether you are holding your discharge plan, a house rule, or consent to send records. Ask the date of the next appointment, and who you call if they do not answer.
The plan is yours to help build, from resources that actually exist. Confirm the next clinical help, the medicine, and a response if use returns, using the aftercare checklist. The agreement between programs is separate. If one program refers you to another, it is supposed to have a referral agreement so the next program takes part in the planning. You may never see that agreement. Ask whether it exists.
Consent is the third sheet. Written consent comes before clinical information moves. A promise to attend groups is not, by itself, permission to send your chart. Privacy rules are the records question. If the consent names a program you did not choose, stop and ask.
What the signature does
People who remain in ongoing care matched to their needs are more likely to maintain gains. After residential care, follow-up in outpatient treatment or an aftercare program helps lower relapse risk. The signature does not purchase that follow-up. The next appointment does.
If a line names one mutual-help group, ask what happens when that group is a poor fit. You still help build the plan. A couples-counseling recovery contract is homework inside that therapy, explained in rebuilding trust. Alumni contact stays voluntary. A newsletter signup is not the next clinical hour. When the intensity changes, look at step-down care.
Search FindTreatment.gov for the next program. Call or text (800) 653-9376 if you want help asking what a program puts in writing at discharge.
Additional Resources
Sources cited on this page:
- NCBI Bookshelf: SAMHSA TIP 47, Chapter 3, intensive outpatient treatment and the continuum of care
- SAMHSA TIP 47 full document (terminology: aftercare and continuing care)
- NIDA: Principles of Drug Addiction Treatment, third edition (revised January 2018)
- SAMHSA FindTreatment.gov
- 988 Suicide & Crisis Lifeline
Common Questions
Why does SAMHSA avoid the word aftercare?
TIP 47 avoids aftercare and uses continuing care. Research sometimes uses aftercare for ordinary outpatient care after residential or intensive treatment, and sometimes for mutual-help groups after formal treatment ends. In that volume, continuing care means the mutual-help and other community support available once formal treatment is over. A form with the older word on it still needs a plain explanation.
Is a referral agreement the same as a contract I sign?
Not automatically. If a program sends you to a separate step-down program, it is supposed to have referral agreements so the next program takes part in continuing-care planning. That agreement is between providers. You may never see it. Your own paper may be a discharge plan you help write. Ask who the other party is, and what happens if you disagree with a line.
What has to happen before my records follow me?
Written consent. The clinician should get your written consent and then arrange a timely transfer of clinical information to the next program. Responsibility for your care should transfer clearly before the first provider lets go. A signature on a house rule is not that consent. Read the consent line. If it names a program you did not choose, stop and ask.
Does signing mean I am done, or that I joined an alumni group?
No. People who remain in ongoing care matched to their needs are more likely to maintain gains. That is a research summary, not a personal guarantee you can buy with a signature. Alumni contact is voluntary connection after a stay. A newsletter signup is not the next clinical appointment.
Is this the recovery contract from couples counseling?
No. Inside behavioral couples counseling, a written recovery contract is homework a counselor assigns, along with shared activities. An aftercare form at discharge is a handoff between levels of care. They are two signatures. Neither one is a vow that use cannot return.