What Is Case Management?
Case management can be generally described as an integrated approach to the impartment of health, substance abuse, mental health, and social services. Clients are linked with the appropriate services to address their specific needs or stated goals.
It is particularly useful in the treatment of substance abuse when the client has other disorders and conditions and requires multiple services over an extended period of time, and who have problems getting access to those programs.
What’s the Difference Between Treatment Planning and Case Management?
Substance use treatment and case management functions are different. Treatment involves activities that help the client recognize their problems, acquire motivational abilities, and tools to stay abstinent. Case management supports the client as he goes through the recovery process.
Case Management Throughout the Treatment Continuum
The continuum of substance use disorder (SUD) treatment ranges from case finding and pretreatment to primary treatment to aftercare. Although there are goals and treatment actions at all points on the continuum, clients’ needs usually don’t fit into any one area at a given time. Case management will bridge the client’s needs and the structure of the program.
Case management focuses on the whole individual and emphasizes thorough assessment, service planning, and coordination to address all facets of a client’s life.
The functions that make up case management are:
- Assessment
- Planning
- Linkage to services
- Monitoring
- Advocacy
What Do Case Managers (CM) Do?
When implemented effectively, case management enhances the scope of addiction treatment and supports long-term recovery. Throughout treatment, a case manager provides support in the form of:
- Comprehensive care
- Client-centered approach
- Treatment knowledge
- Stabilization
- Collaboration
- Advocacy
- Familiarity
- Anticipatory action
- Flexibility
- Community-based connections
Comprehensive Care
Case managers provide a single point of contact for the client when accessing multiple health and social service systems. In doing so, case management replaces a disorganized process of referrals with a single, well-structured service. By providing comprehensive care, case management gives the client a sense of continuity. By being the single point of contact, case managers are obligated to the members in the systems they contact, as well as their clients.
Client-Centered Approach
Case managers adopt a client-centered approach to support your treatment needs. Using their expertise, they identify a range of options tailored to you while emphasizing your right to make your own decisions. Once you select the best option, the case manager leverages their knowledge to help you access the services you’ve chosen, ensuring a seamless and empowering process.
Treatment Knowledge
It is vital for case managers to have a strong understanding of treatment options and resources. This includes knowledge of evidence-based therapies, medications, support groups, and other interventions that can be utilized to address specific needs.
Similarly, this knowledge helps case managers prepare inpatient clients for a smooth transition into outpatient care. Case managers also ensure that treatment release dates are carefully coordinated to prevent any gaps in service, providing consistent and reliable support.
Stabilization
Case management starts by addressing the client’s immediate needs. By prioritizing essentials like food, shelter, clothing, transportation, or childcare, case managers can help clients feel stable enough to focus on treatment. A key aspect of case management is to help clients find stability in early recovery. That way, they can learn the necessary life skills that will support them in building happy, independent, substance-free lives.
Collaboration
Effective case management requires collaboration between the case manager and various treatment professionals involved in the client’s care. This may include psychologists, psychiatrists, social workers, substance abuse counselors, and others. By working together and sharing information, these professionals can create a comprehensive treatment plan that considers all aspects of the client’s well-being.
Advocacy
Case managers also play an important role in advocating for their clients’ rights and needs within the healthcare system. They can serve as a liaison between the client and healthcare providers, ensuring that their clients receive the best care possible. This can include advocating for proper treatment, connecting clients with resources, and negotiating on their behalf.
Anticipatory Action
Case managers must have a deep understanding of the typical journey of addiction and recovery. This knowledge enables them to anticipate potential issues, evaluate available options, and take the appropriate action—whether by intervening directly or involving another member of the treatment team.
Flexibility
Case managers working with individuals struggling with substance use must navigate a variety of factors, including co-occurring physical and mental health disorders. Flexibility is key to addressing these complexities effectively. However, the flexibility of a case manager’s approach is limited by the program’s structure, resource availability, and the authority granted to treatment professionals by the client and HIPPA.
Familiarity
When case managers take a hands-on approach to meeting their clients’ needs, they can validate their clients’ experiences in ways other methods simply cannot. Building this level of familiarity allows professionals to better understand the realities of their clients’ lives and set more effective, tailored treatment goals.
Community-based Connections
Many aspects of case management rely on community-based connections. This is because case managers often assist clients in navigating and collaborating with community organizations. In some instances, case managers take a more active role by initiating community outreach programs. They may even accompany clients to register for benefits, waiting in lines or taking public transportation alongside them. However, the level of direct community involvement by a case manager varies based on the treatment provider’s approach and the engagement of local community organizations.
Why Is Case Management Effective?
Research points to two reasons why case management is effective as a complement to substance abuse treatment.
- Staying in treatment longer is associated with better results. One of the main goals of case management is to keep clients engaged in treatment and progressing toward recovery.
- Treatment may be more likely to succeed when a client’s other issues and substance use are focused on simultaneously.
Why Is Case Management Important?
Because addiction has an effect on so many parts of a person’s life, an all-inclusive continuity of services promotes recovery and encourages the substance abuse client to integrate into society as a healthy, substance-free person. The continuum of care needs to provide engagement and motivation, treatment services at the appropriate level, and support services that will allow the individual to maintain long-term abstinence while leading a healthy life in the community.
In most jurisdictions, services are splintered and insufficient to meet the needs of the population of substance abusers. Treatment needs to be regulated to ensure smooth transitions to the next level of care, avoid gaps in service, and react quickly to the threat of relapse. Case management can help achieve all of that.
Who Benefits from Case Management?
Most substance-dependent people can benefit from case management services, but some groups benefit the most from the more integrated manner of treatment and support services. The Journal of Global Drug Policy and Practice includes these groups:
- Young adults—due to their age and brief life experience, they may need additional assistance in life skills development. They also benefit from the additional supervision a case manager provides.
- Residential clients--Clients who have only been able to function well within the setting of a residential treatment center may have a particularly difficult time blending their recovery needs and non-clinical needs on an outpatient basis.
- Co-occurring diagnoses—People with co-occurring disorders, also known as a dual diagnosis, have several areas that need continual consideration and management.
- Clients with medical and legal issues—Chemically dependent clients with legal and medical problems related to their previous SUD will need support in solving problems in these areas.
- Older adults—A case manager is a benefit to older clients to effectively integrate their medical and psychological care. It is essential to have a primary point of contact when working with older adults because ongoing communication among the treatment team members is a necessity.
The Cost Factor
One of the main results from the drive to reduce the costs of treating addiction and mental illness has been the curtailment of hospital and residential care and the increased use of outpatient programs. This is especially true of patients supported by Medicaid and other public funds.
A similar effort aimed at cost containment has been the decreasing of social support services, aka “wraparound” services, deemed “not medically necessary” such as housing referral, employment counseling, and legal assistance that had traditionally been provided in addiction programs.
There have been efforts to address the problems correlated with the shift to the outpatient treatment setting and reductions in the availability of the wraparound services. In response to this, was the emergence of the intensive outpatient program (IOP). IOP is designed to provide more frequent and intensive treatment sessions without the expense of residential or hospital stays. Sessions are usually 2-4 hours, 3-4 times weekly
A recent study compared the quality of services provided within an intensive outpatient program with those from a traditional outpatient program (typically 1-2 hour sessions twice weekly). The intensive programs provided about twice the frequency of drug and alcohol-based counseling sessions each week, but not more employment, medical, psychiatric, housing, or family services than the traditional outpatient programs.
A six-month follow-up showed that patients treated in the intensive programs had improvements in their addiction problems but little change in their health and social problems. They did not have substantially better results than those treated in the traditional programs.
Case Management and Relapse Prevention
Due to the chronic and relapsing nature of substance use disorders, a broad and continuous method such as case management is required. During aftercare, also called continuing care, the patient no longer needs services at the intense level provided during primary treatment. Counseling is more of a monitoring function as clients get accustomed to a pro-social, sober lifestyle.
Whether they completed treatment in a residential or outpatient program, they have some of the skills to maintain sobriety and begin working on repairing various areas of their lives. Areas that relate to environmental issues such as vocational rehabilitation, finding employment, and safe housing are within the scope of case management.
The period after discharge from a treatment program typically has a high risk of relapse. There is also a substantial risk of overdose death following a long period of abstinence due to the patient’s lower tolerance.
The case manager’s in-depth knowledge of the client’s real-world needs helps the client who is no longer using. People in aftercare have a variety of needs, including housing, a source of income, marketable skills, and a support system. Many will seek medical or dental care for the first time in years.
These patients have multiple psychological, emotional, and social problems that are often not addressed in outpatient programs. Providing help in legal advice, basic needs, and family services may improve patients’ psychosocial performance. Treatment continuity is related to higher abstinence rates and fewer readmissions to hospitals.
Case Management at Footprints to Recovery
We know that everybody’s situation is different. Footprints to Recovery has medical professionals and counselors who will work with you to develop your treatment plan. Your case manager will help you transition from phase to phase and on to recovery and reintegrating into your community. You will never be completely on your own without support.
Contact us today. Consultations are free and confidential, day and night, seven days a week.
Our admissions team is available 24/7 to listen to your story and help you get started with the next steps.
