Substance Abuse Case Management Best Practices

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.

We must recognize that substance abuse and relapse from treatment are the product of complex forces and factors in an individual’s life. 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. It is important for Case Managers to ensure that those seeking and receiving treatment for substance abuse and addiction have lasting positive outcomes by using these three strategies.

1. Identify Patients with Complex Needs

An integrated approach to treatment and support services is most beneficial.

·         Young adults, due to their chronological age and limited life experience, may require additional assistance in the area of life skills development.

  • Clients who are only able to function well within the confines of a residential setting may have particular difficulty meshing their recovery 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.

2. Engage Clients by Meeting Immediate Needs and Building Trust

Engage clients to reduce internal and external barriers to treatment. With many substance abuse patients, that might begin with providing for simple, immediate needs and building trust.  While most engagement includes a structured interview to collect information about an individual’s history and needs, the goal of building trust through these early stages cannot be overstated. A good initial relationship can be critical as the individual experiences difficulties and challenges later in the treatment process.

3. Assess the Ability to Access Services Independently

Identify the needs of the individual for a range of those services, from medical interventions to family support and employment services and help clients learn how to obtain those services and function more independently. Assessment should consider service procurement skills and employment skills. Service procurement skills includes:

·         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