School During Eating Disorder and Substance Use Treatment: A Guide for Districts and Programs
Students in treatment for an eating disorder or a substance use disorder can keep up with school when the home district, the treatment program and the family plan instruction around care. The amount of school time depends on the level of care, and a few legal and privacy rules work differently for these students. This guide walks districts and programs through both.
This article is general information, not legal or medical advice. Rules vary by state and district.
How much time each level of care leaves for school
Residential treatment: students live at the program. Many programs build daily school time into the schedule; one eating disorder program, for example, reports 20+ hours of academics a week in residential care.
Partial hospitalization (PHP or day treatment): students go home each evening, but treatment usually runs Monday to Friday for 5 to 6 hours a day during school hours. Some programs set aside one to three hours of classroom time each weekday, so instruction has to be planned with the program.
Intensive outpatient (IOP): typically 2 to 4 days a week for 2 to 3 hours, often after the school day, which lets many students return to their regular schedule.
Students often move between these levels over a few weeks or months. For scheduling ideas, see our guide to PHP and IOP students.
What the district still owes
A student in treatment is still the district's student. Depending on state rules and how long they'll be out, they may qualify for home or hospital instruction; see our homebound instruction rules by state. If the student has an IEP or 504 plan, services continue during treatment, and the team may need to meet to adjust how they're delivered.
Eating disorders
Eating disorders are mental health conditions that can qualify a student for a 504 plan or an IEP, depending on how they affect learning and daily life. Eligibility is decided student by student, so a referral or a team meeting during or after treatment is often worth considering.
Substance use disorders
Section 504 has a specific rule here. A student who is currently using illegal drugs isn't protected when the district acts on that use. But students in a supervised rehabilitation program who aren't currently using, or who have completed one, are protected. Students with IEPs keep their IDEA protections.
Privacy: what can be shared
Treatment details are sensitive, and substance use treatment records have extra protection. Federally assisted programs fall under 42 CFR Part 2, which generally requires the patient's written consent before records are shared, a stricter standard than HIPAA. Expect the program to ask for a specific consent form before it talks with the school.
For instruction, the school rarely needs clinical details. Ask for what teaching requires: the student's schedule, current coursework, accommodations and any topics to avoid.
Planning instruction around treatment
Name one contact at the district and one at the program, and agree on how they'll communicate.
Get the treatment schedule, including groups and meal times, and set lesson times that fit around it.
Prioritize essential coursework and reduce the load where you can, so school adds structure without adding stress.
Keep sessions short and steady rather than long and occasional.
Record instructional hours so the student gets attendance and course credit.
Check with the treatment team before assigning work that may touch on treatment topics, such as nutrition or calorie units for a student with an eating disorder.
Plan the step-down and the return to school early, including any changes to the IEP or 504 plan.
How Einstein Tutoring helps
Einstein Tutoring partners with school districts and treatment programs, including psychiatric units, partial hospitalization and residential programs, and eating disorder and substance use programs, to provide certified teachers in person or virtually. Teachers follow the student's home school curriculum, work around the treatment schedule and keep records the district can use.
To refer a student or set up instruction for your program, contact us or call (617) 600-5944.
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