| DISCHARGE SUMMARY |
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Name | SID # | TDCJ # |
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Date of Entry | Scheduled Release Date |
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County of Conviction | County of Residence |
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Primary Counselor |
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Transitional Coordinator/Case Manager |
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Circumstances of Discharge |
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Identified needs and problems (from Master Treatment Plan):
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Progress and Prognosis:
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Resident | Date |
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Primary Counselor | Date |
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Transitional Coordinator/Case Manager | Date |
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Senior Counselor | Date |
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What are you going to do if a relapse occurs? |
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What type of support group(s) will you attend and where? |
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Will you have a sponsor? Who? Why that person? |
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Are you going to work the 12 steps? |
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How are you going to use your leisure time? |
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PERSONAL AFTERCARE GOALS AND OBJECTIVES |
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ABSTINENCE GOALS: What do I need to maintain my sobriety? (Basic Needs) |
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What do I need in order to continue to grow and strengthen my sobriety? |
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SOCIAL GOALS: What type of relationships with others do I need in order to feel I have a healthy social life that will enhance positive feelings about myself and my sobriety? |
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PHYSICAL GOALS: What are my specific plans for increasing my physical health? |
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What type of maintenance schedule will I need in order to continue the changes initiated during my treatment? |
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RECREATIONAL GOALS: What do I plan to do to meet my needs for fun and frolic that will not endanger my sobriety? |
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CREATIVE AND OTHER PERSONAL GOALS: In what areas am I creatively talented? |
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What are some specific projects I want to begin and complete after discharge (e.g., music, art, carpentry, auto mechanics, writing, and electronics)? |
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What are the steps I need to take in order to successfully initiate and complete a creative project? |
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NOTES/COMMENTS: |
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