Comprehensive Case Management For Substance Abuse Treatment

A Treatment Improvement Protocol on case management, which can be described as a coordinated approach to the delivery of health, substance abuse, mental health, & social services, linking clients with appropriate services to address specific needs & achieve stated goals. Case management lends itself to the treatment of substance abuse, particularly for clients with other disorders & conditions who require multiple services over extended periods of time & who face difficulty in gaining access to those services. This report details the factors that programs should consider as they decide to implement case management or modify their current case management activities.

Case management has been variously classified as a skill group, a core function, service coordination, or a network of "friendly neighbors." Although it defies precise definition, case management generally can be described as a coordinated approach to the delivery of health, substance abuse, mental health, and social services, linking clients with appropriate services to address specific needs and achieve stated goals. The Consensus Panel that developed this TIP believes that case management lends itself to the treatment of substance abuse, particularly for clients with other disorders and conditions who require multiple services over extended periods of time and who face difficulty in gaining access to those services. This document details the factors that programs should consider as they decide to implement case management or modify their current case management activities. This summary is excerpted from the main text, in which references to the research appear.

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

Treatment Alternatives to Street Crime (TASC) provides an objective bridge between two separate institutions: the criminal justice system and the drug treatment community. Under TASC, community-based supervision is made available to drug-involved individuals who would otherwise burden the justice system with their persistent drug-associated criminality. TASC operates in more than 100 jurisdictions. Covers: empirical and theoretical foundations of TASC; early years of TASC; early TASC evaluations; the current structure of TASC; and the future of TASC. References.

Substance use disorders typically take years to develop and to become entrenched. Thus, for users, creating a new and sustainable drug-free life takes time, intensive effort, and extensive ongoing support. This book is a clinician-friendly manual for implementing Reinforcement-Based Treatment (RBT), an intensive, evidence-based model for treating substance use disorders in community settings. RBT integrates the most effective behavioral techniques with motivational interviewing, highly individualized treatment plans, and case management. The goal is to help clients avoid substance use triggers and develop recreational outlets and support systems that are incompatible with substance use. Additionally, the model emphasizes customer service-a concept underemphasized in most programs-to ensure that clients receive positive reinforcement for attending treatment. Using a step-by-step approach that takes the reader through each treatment component, the authors provide clear, detailed, and practical case illustrations and a variety of useful forms and therapist scripts. RBT is a comprehensive approach that can be used with various populations to help clients initiate abstinence, prevent relapses early in the recovery process, and maintain sobriety on an ongoing basis. It is therefore an ideal model for clinicians, administrators, case management professionals, and others who work with substance abusers.