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The concept of case management is quite broad as it covers many areas. While accepting that it is difficult to concisely define case management, Moore (1990) suggested that the definition of the term case management was social science that was individually adapted to meet the specific needs of a patient. The method is quite instrumental for the purposes of intervention.
Case management is normally in two broad categories. These categories are the post treatment and the post intervention category. The proponents of case management methods have supported it saying that it is inclusive and comprehensive as it covers external aspects affecting the addict.
This stems from the fact that psychoactive substance abusers are also faced with other challenges that are quite significant in their lives apart from the abuse of psychoactive substances. For example, the use of too much alcohol and any other drugs normally results to other problems.
Such problems may include housing problems, employment issues, relationship issues among others (Oppenheimer et al., 1998). Westermeiyer (1989) suggests that addiction does not exist in isolation. It is elevated by other factors such feeling neglected, stress etc. He suggests that it is difficult to treat such addiction if the other factors are still existent.
How case management is used
Case management normally occurs under differently under different situations. Case management usually depends on five differerent functions. These functions are assessment, planning, linkage, monitoring and finally there is advocacy.
These functions can work independently or together depending on the specific circumstances that is surrounding the addict or patient. Advocacy is one of the most important functions of case management. It emphasizes more on flexibility. Whereas the professional counsellor may speak on behalf of the client, it is required that the services being offered by the professional fit the client and not for vice-versa.
The first way in which cased management works is through acting as a tool of social service that seeks to address the social problems that the addict maybe facing. This normally seeks to address the root of the addiction. It also aims at giving people what they lack socially in order to make them free from the situations that drove them to drug abuse in the first place.
For instance, where a person became an addict from the reason of feeling neglected, the counsellor may call upon his family members and explain the problem. The counsellor does this under the assumption that the addict’s family shall develop a caring attitude towards him and make him stop his addiction.
Case management is important as it is fragmented in terms of functions. The functions are specifically suited for specific cases. It is not a blanket treatment method.
It gives considerations as to what is actually behind the patient’s addiction. The case management normally takes four main models. These models are generalist model, the community based treatment model, the assertive model and the last one is the clinical based model (Sullivan, 1991).
The generalist model deals with problems generally. These are normally in generalised categories. For instance problems caused by mood swings. The community based model seeks to understand and rectify the injustices in the community that may have been the trigger factor for the addiction. Such factors may include unemployment.
The strength assertive model is the one that dwells on the strengths that the addict needs to overcome the addiction. The clinical method is based on the clinical activities such as therapy. It is important to note that these methods may be combined in order to achieve the maximum results.
Ways in which patients may be screen for discharge
Screening is always important before discharging a patient in order to make sure that they are healthy and are not to be lured in the addiction again. The process of screening extends to checking whether the addict has developed means of fighting influence to slip back to the addiction.
There are different ways in which screening may be done. One way of checking whether the addict is clean from the psychoactive substances that he had been using is through urine test. Urine test normally disclose whether the person has been or has not been talking any drugs. Some sophisticated urine tests normally reveal the approximate withdrawal period if the addict had actually stopped taking the substances.
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Another method of screening is through monitoring and observing. In this method the patient is kept under probation. He is observed how he is behaving towards the substances that he should be quitting.
This method normally tests the social resistance to pressure to fall back to the substance abuse. It is more of a social tool rather than a scientific one. The best thing about this method is that as a social tool it can tell whether the patient shall slip back to the addiction.
Treating addiction as required under case management should be very flexible. It should be specific according to the addict. This is because the needs of different addicts vary. The variation is due to the fact that each case of addict is normally coated with different environment factors and face different influences.
Such factors may include the level of assistance from the family, the environmental setting of their upbringing. Thus case management seeks to deal with the situation on a case by case basis analyzing the external factors influencing the addict’s behaviour.
Moore, S.T. (1990). A social work practice model of case management: The case management grid. Social Work Journal. ; 35(5):444–448
Oppenheimer, E.; Sheehan, M.; and Taylor, C. (1988). Letting the client speak: Drug misusers and the process of help seeking. British Journal of Addiction. 1988; 83:635-647
Sullivan, W.P. (1991). Case Management in Alcohol and Drug Treatment: Conceptual Issues and Practical Applications. Springfield, MO: Center for Social Research, Southwest Missouri State University.
Westmeiyer, J. (1989). Cross-cultural studies on alcoholism; In: Goedde, H.W., and
Agarwal, D.P., eds. Alcoholism: Biomedical and Genetic Aspects. Elmsford, NY: Pergamon Press; pp. pp. 305–311.