A case manager is an advocate who takes on clients with complex issues and finds integrated treatment options beyond just detox and rehabilitation. Although case management has roots in social work, the position does not involve training to become a social worker and instead involves working across multiple disciplines to help clients get services they need to maintain a healthy lifestyle. The job has become increasingly popular since the 1980s, especially for those overcoming addiction or substance abuse.
Types of Treatment Case Managers
- Strengths-based perspective
- Assertive community treatment
What Case Managers Do
- Screening and assessment
- Brokering for resources
- Developing case plans
- Determining eligibility for benefits
- Evaluating Progress
Case managers are involved in multiple therapeutic and medical disciplines, including helping ex-convicts, people with chronic or mental illnesses, homeless and formerly homeless individuals, and those overcoming addiction. The position requires advocating for all kinds of assistance, including help with prescription medications, routine doctors’ appointments, housing, job retraining, and more. Case managers typically work with multiple clients at once through an organization like a hospital or charity; however, case managers tend to focus on one discipline, such as substance abuse.
It is important for case managers to have some core competencies
. These include:
- Understanding models of addiction and substance abuse, especially as these relate to finding treatment and other resources
- Describe these philosophies and scientific approaches to their client to help focus treatment
- Recognize the importance of family, social networks, and community on the treatment and recovery plan
- Maintain working knowledge of treatment options, including government, insurance, and more
- Understand diverse cultures to incorporate cultural differences as a way of supporting treatment rather than working against it
- Appreciate and promote an interdisciplinary approach to addiction treatment
There are a few types of case managers, and each has basic expectations for how their job will be performed.
Case Management Models
There are four basic types of case managers. These are:
Broker/generalist:This type of case manager links their clients with appropriate services as rapidly as possible. The case manager provides few direct services beyond initial assessment; however, once the level of need has been determined, this type of case manager can get referrals to a variety of agencies, including drug testing services, work training, and housing. This type of case management is often found in settings involving a high volume of clients, such as probation court or hospitals.
Strengths-based perspective:This form of case management develops a longer-term relationship between the client and the case manager. The two work together to develop a treatment plan based on what the individual believes are their strengths and focuses on getting treatment that involves building on those strengths. That could include non-institutional treatments, such as complementary medicine or spiritual direction.
Assertive community treatment:This style involves case managers meeting clients in their “natural settings,” often at home or nearby. The management system focuses on daily living needs, like prescription medications, housing, income, and help for children. Individuals meet with their case managers on a frequent, regular basis, and the relationship is developed with the aim of the two maintaining a long-term commitment to managing the individual’s substance use disorder and any co-occurring mental health issues.
Clinical/rehabilitation:In this type of case management, the individual works with a case manager who provides integrated clinical treatments in addition to managing resources; these treatments can include therapy, counseling, skills development, intervention, and more. This is another long-term type of case management since the relationship between therapist/case manager and client is integral to the healing process.
What Case Managers Can Do
Regardless of the model used to manage their clients, a case manager is expected to provide six primary types of assistance, especially in a substance abuse rehabilitation setting. These are:
Screening and assessment: This is the initial assessment of a new client. It involves determining their condition, strengths, treatment needs, and ultimate goals.
Brokering for resources: The case manager will take information gathered during their assessment and begin contacting services through the Department of Health, Social Security Administration, insurance, community partners, child welfare organizations, and vocational rehabilitation as needed.
Developing case plans: The primary goal of case management, whether the relationship is short-term or long-term, is to help the client find the resources they need to become and remain healthy and self-sufficient. The case plan is essentially a roadmap, created by the case manager with extensive input from the client. In most case management models, the client must agree with the plan. Each step of the plan shows how the individual will use resources to overcome addiction, find work and housing, and maintain sobriety.
Determining eligibility for benefits: Once the plan has been agreed to, the case manager helps the client fill out paperwork to apply for benefits. These could be social security or disability benefits, Medicare or Medicaid, insurance coverage, food stamps, or charity help. In some cases, this could also be contacting support groups, churches, or nonmedical treatment services.
Evaluating progress: The case manager either maintains contact with the client to receive updates on progress, gathers progress reports from outside services like rehabilitation and therapists, or both. By using milestones to track the client’s progress, the case manager can determine how effective the treatment plan is and whether it should be re-evaluated.
Recording case progress:Leaving a paper trail helps to track an individual’s progress on a long-term basis. If the person leaves the case manager’s care but then returns for support later, their original plan, level of completion, and overall effectiveness will remain on record for future reference. This can help with the development of a new plan, or it may involve a return to the original plan.
When Is a Case Manager Needed?
When a person overcoming substance abuse works with a case manager, they are better able to coordinate several outpatient services. This may include detox and outpatient rehabilitation, but it can also include a continuation of care after hospitalization and inpatient rehabilitation. Finding a place in a sober living home, maintaining prescription medications, getting transportation to therapy appointments, and finding support groups are all things a case manager can help with.
While anyone overcoming addiction can benefit from the help a case manager provides, demographics that particularly benefit include adolescents and young adults; older adults and the elderly; those who have relapsed in the past; those diagnosed with co-occurring mental health and substance abuse disorders; and those who have struggled with polydrug abuse.