Providing treatment and support for individuals battling substance abuse is challenging. Despite the wide range of programs available, 40-50% of individuals who receive treatment for chemical dependency will relapse at some point, and most within the first year.
Because substance abuse comes with a complex set of circumstances and treatment needs, clinical practitioners recognize the need for continued and complex treatment and support. This makes case management a valuable tool in ensuring that those seeking and receiving treatment for substance abuse and addiction have lasting positive outcomes.
There has been a fair amount of research identifying best practices and successful strategies for substance abuse case management. I want to highlight three important strategies that ensure that substance abuse case management starts off on the right foot.
Most chemically dependent individuals can benefit from case management services, but certain groups benefit most from this more complex, integrated approach to treatment and support services. The Journal of Global Drug Policy and Practice explains,
- Young adults, due to their chronological age and limited life experience, may require additional assistance in the area of life skills development. They also tend to benefit from the additional supervision a case manager can provide.
- Individuals with long histories of treatment and recovery attempts will also profit from the supplemental assistance of a case manager.
- Clients who are only able to function well within the confines of a residential setting may have particular difficulty meshing their recovery needs and non-clinical needs on an outpatient basis.
- Individuals with co-occurring diagnoses (e.g., depression, anxiety, bipolar disorder, eating disorders, ADD/ADHD) have multiple areas that need ongoing consideration and management.
- Chemically dependent individuals with medical and legal difficulties associated with their previous abuse of substances will likely need additional support in problem solving these areas.
- Older adults benefit from having a case manager to effectively coordinate their overall medical and psychological care. The need for a primary point of contact when working with older adults is critical as many providers may be part of the treatment team and ongoing communication among them is necessary.
The goal of the engagement stage of substance abuse case management is to reduce internal and external barriers to treatment. For many substance abuse patients, that might begin with providing for simple, immediate needs and building trust with the case manager.
Providing a pair of shoes or a ride to the doctor not only reduces the stress of an individual’s immediate concerns, but opens the door for a case manager to begin building trust. Since many resources have waiting lists or drawn-out intake procedures, these simple services can help ensure early, frequent opportunities for case managers to interact with clients in a positive, supportive way.
While most engagement also includes a structured interview to collect information about an individual’s history and needs, the goal of building trust through these early stages of case management cannot be overstated. A good initial relationship between client and case manager can be critical as the individual experiences difficulties and challenges later in the treatment process.
The focus of substance abuse case management is to help individuals to access social services. Most case management assessments will identify the needs of the individual for a range of those services, from medical interventions to family support and employment services. But ultimately, the goal of a substance abuse case management approach is to help clients learn how to obtain those services and function more independently.
An assessment should consider two types of skills, 1) service procurement skills and 2) employment or vocational skills. Service procurement skills includes the following:
- Ability to obtain and follow through on medical service
- Ability to apply for benefits
- Ability to obtain and maintain safe housing
- Skill in using social services agencies
- Skill in accessing mental health and substance abuse treatment services
Employment and vocational skills focus on an individual’s potential for independence. Case managers should evaluate the following skills and abilities as part of their assessments:
- Basic reading and writing skills
- Skills in following instructions
- Transportation skills
- Manner of dealing with supervisors
- Timeliness, punctuality
- Telephone skills
In developing a substance abuse case management strategy, case managers can use the process of connecting a client with needed services as an opportunity for teaching individuals how to obtain similar services in the future. They can also integrate ongoing and long-term employment training and services where needed.
Successful substance abuse case management recognizes that substance abuse and relapse from treatment are the product of complex forces and factors in an individual’s life. Starting off strong builds a foundation for addressing those forces and factors throughout treatment and services. For more information about substance abuse and mental health services and case management, visit our Health and Human Services page.