The single most important decision a service member at JBSA makes when considering treatment is whether to self-refer or wait for a command-directed process. These two paths are not equivalent. They lead to different outcomes, carry different career implications, and involve different levels of confidentiality.
Self-referral means you go to your branch’s substance abuse office on your own, before anything happens. Command notification means your command identified a problem and sent you. Self-referral is treated more favorably in every branch policy. The window to self-refer closes the moment a misconduct incident occurs.
Side-by-side comparison
| Factor | Self-referral | Command referral |
|---|---|---|
| Who initiates | You, voluntarily | Your command, after an incident |
| Confidentiality | Clinical details protected. Command notified of treatment only | Full incident documentation in service record |
| Career impact | Generally limited to period in treatment. No punitive separation for self-referral (Army, Air Force) | Significantly higher. Potential for administrative action |
| Security clearance | Voluntary treatment is a mitigating factor per DCSA guidelines | Incident prompting referral may itself trigger clearance review |
| Timing | Available now, before any incident | After an incident. Options have already narrowed |
How self-referral works at each JBSA installation
Contact the Army Substance Abuse Program directly. AR 600-85 explicitly protects soldiers who self-refer from punitive separation solely for seeking treatment. The ASAP counselor initiates a clinical assessment to determine the appropriate level of care.
Contact the ADAPT office through the 59th Medical Wing behavioral health clinic. AFI 44-121 governs the process. Air Force policy provides confidentiality protections for the clinical content of treatment. Your commander receives notification that you are in the program, not the clinical details.
Contact the ADAPT office through the 902nd Medical Group. Same AFI 44-121 framework as Lackland. For aviation personnel at Randolph, there are additional flight medicine considerations that ADAPT staff are experienced with.
Call TRICARE at 1-888-874-9378 and ask about covered substance use treatment at civilian facilities. This option keeps the initial contact outside the command chain. Prior authorization is required for residential treatment.
What your command is told
What your command is told when you self-refer
Your commander receives administrative notification that you are participating in substance abuse evaluation or treatment. This tells them you are in the program. It does not tell them which substance is involved, what happened in your sessions, your diagnosis, or your treatment plan. This information is protected under the Privacy Act and military health privacy policy.
What your command is told when they refer you
Command-directed referrals are initiated because an incident already occurred. Your command already has information about the incident. The clinical content of treatment is still protected, but the incident that prompted the referral is documented in your record and known to your command.
The self-referral process step by step
Contact your installation substance abuse office directly
ASAP, ADAPT, or SARP. You do not need to go through your chain of command. Call directly.
Complete the initial assessment
A counselor conducts a clinical assessment using standardized screening tools. This determines the appropriate level of care. The assessment is confidential.
Administrative notification goes to your command
Once treatment is initiated, your command is notified administratively. Clinical details remain protected.
Treatment begins
Outpatient counseling, military residential program, or TRICARE-covered civilian treatment, depending on clinical assessment.
Aftercare and return to duty
Aftercare planning begins before treatment ends. Return to full duty depends on clinical progress and, for some specialties, additional evaluations.