Does clinical case management improve outpatient addiction treatment

• Published in: Drug and alcohol dependence Vol. 55; no. 1; pp. 91 - 103
• Main Authors: McLellan, A.Thomas, Hagan, Teresa A, Levine, Marvin, Meyers, Kathleen, Gould, Frank, Bencivengo, Mark, Durell, Jack, Jaffe, Jerome
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-06-1999; Elsevier Science
• Subjects: Addiction; Adult; Ambulatory Care - standards; Behavior, Addictive - psychology; Biological and medical sciences; Case Management; Clinical case management; Counseling; Demography; Desintoxication. Drug withdrawal; Drug addiction; Female; Follow-Up Studies; Health Services - supply & distribution; Humans; Male; Medical sciences; Outpatient; Outpatient treatment; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity of Illness Index; Substance Abuse Treatment Centers; Substance-Related Disorders - diagnosis; Substance-Related Disorders - rehabilitation; Time Factors; Treatment Outcome; Treatments; United States; North America; America; Addiction; Clinical case management; Outpatient; Human; Health system; Drug addiction; Treatment; Accessibility; Public health organization; Use; Mental health; Detoxification; Health service; Ambulatory; Public health
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/S0376-8716(98)00183-5

This project evaluated whether clinical case managers (CCMs) could increase access and utilization of social services in the community; and thereby improve outcomes of addiction treatment. No case management (NoCM)—patients received standard, group-based, abstinence-oriented, outpatient drug abuse counseling, approximately twice weekly. Clinical case management (CCM)—patients were treated in the same programs but also were assigned a CCM who provided access to pre-contracted, support services such as drug free housing, medical care, legal referral, and parenting classes from community agencies. CCM patients received more alcohol, medical, employment, and legal services than NoCM patients during treatment. At 6 month follow-up CCM patients showed significantly more improvement in alcohol use, medical status, employment, family relations, and legal status than NoCM patients. We conclude that CCM was an effective method of improving outcomes for substance abuse patients in community treatment programs. Essential elements for successful implementation included extensive training to foster collaboration; and pre-contracting of services to assure availability.