Back to tools
Scope & communication
Scope & Escalation Tool
Helps an outpatient therapist organize substance-use concerns and draft an editable consult-request message.
Reflection + communication aid, not a clinical screener — educational only.
Runs entirely in your browser. Nothing is saved or sent. Use initials only — no PHI.
Step 1 of 4Boundary
First, the boundary
If any of the following are present right now, this isn't a scope question — it's a crisis question. The tool won't generate an outreach draft until you confirm none apply.
- Active suicidal ideation with plan or intent, recent attempt, or access to means
- Severe withdrawal already happening (recurrent vomiting, hallucinations, prior seizure or DTs, severe autonomic instability)
- Acute psychiatric crisis (psychosis, mania, severe agitation, danger to others)
- Acute medical emergency (chest pain, possible stroke, head injury with loss of consciousness, suspected overdose, severe GI bleed)
- Pregnancy with active heavy alcohol or opioid use and no prenatal care
Move through one section at a time
This is a communication aid for licensed clinicians. It is general information, not medical, clinical, ethical, or legal advice. It does not screen, diagnose, score, or recommend a provider, program, or level of care. Scope-of-practice, referral, and coordination decisions are governed by your state licensure board, your professional code of ethics, your malpractice coverage, applicable federal and state law (including 42 CFR Part 2 for substance use disorder treatment records), and your own clinical judgment in conversation with a real consultant, supervisor, or attorney. Use this tool to organize the outreach you are about to make, not to replace the judgment behind it. Runs entirely in your browser. Nothing is saved or sent.