StrengthsBased Case Management For Adolescent Drug Abuse

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Strengths-Based Case Management For Adolescent
Drug Abuse

• Julie K. Williams, LMSW
• Pamela E. Noel, Ph.D.
• James A. Hall, Ph.D., LISW
• University of Iowa

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Goals for Todays Presentation

• Describe basic principles and procedures of
  strengths-based case management (SBCM)
• Describe special considerations when using SBCM
  with adolescents
• Describe basic techniques for measuring CM
• Describe two examples of CM with adolescents in
  substance abuse treatment

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Principles of Strengths-BasedCase Management
(SBCM)

• Preliminary questions

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• Why do people seek help?
• What are the basic approaches to helping?
• Who/what are the targets of these approaches?

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Person-in-Environment

• Person
• Affect
• Behavior
• Cognition

• Environment
• Family environment
• Neighborhoods, etc.
• Social climate
• Political climate

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What is Strengths-Based Case Management?
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SBCM is a collaborative process of

• Assessing
• Planning
• Implementing

• Coordinating and Monitoring
• Advocacy
• Termination

from a strengths perspective.
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A focus on strengths

• Environment
• Personal supports
• Environmental supports
• Professional supports

• Person
• Internal strengths
• Talents
• Knowledge

Case managers help bring these strengths and
resources together to reduce problems and improve
quality of life
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Special considerations with adolescents

• Developmental issues
• Ethical issues
• Legal issues

• Cultural Sensitivities
• SES
• Rural/Urban
• Gender/gender identification
• Race/ethnicity

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Case Management with Adolescents
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Case Management with AdolescentsReview of the
literature

• CM perceived as beneficial by adolescents
  (Rosenfeld, Keenan, Fox, Chase, Mechiono,
  Woods, 2000)
• CM built into some treatment models (Diamond,
  Godley, Liddle, Sampl, Webb, Tims, Meyers, 2002)

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Case Management with AdolescentsReview of the
literature

• CM is pivotal in outreach, should remain a
  consistent presence (re HIV youth Johnson et
  al., 2003)
• CM increases continuing care services
  utilization, decreases alcohol and marijuana use
  (Godley, Godley, Funk, Passetti, 2002)

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Basic Techniques for Measuring Case Management

• Dosage

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SBCM Program Dosage

• Amount
• Quantity of the target activity
• of minutes of contact with a CM
• Frequency
• The rate of occurrence or repetition
• total of sessions with the client

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SBCM Program Dosage (continued)

• Duration
• How long CM occurred over time
• Breadth
• total different SBCM-related activities that
  occurred

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SBCM Client Dosage

• Client Availability
• Time proportion of client availability for SBCM
  activities
• hours spent on SBCM activity/day
• Collaboratively predetermined
• Regularly monitored

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Additional Evaluation Procedures

• Pre-session Change evaluation
• similar to Bergs idea (1994)
• Post-session checklist
• Client and worker
• Worker fidelity to SBCM
• Taped sessions
• supervisory meetings

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Project PALSICMP with Adolescents
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Project PALSPurpose

• To evaluate the effectiveness of PALS training
  (social and network skills training) with
  pregnant or parenting adolescents aged 14-19
  years who are using or at-risk of using
  substances.

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Project PALSMethod

• Sixteen weekly sessions of CM with follow-up at
  3- and 12-months
• CM n 141 No CM n 158
• CM components included
• Cognitive Behavioral Therapy
• Crisis Intervention
• Transportation

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Project PALSResults

• Teens assigned to the CM condition
• improvements in depression
• self-esteem
• aggressive behavior/delinquency
• compared to teens not assigned to case
  management.

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ICMP with AdolescentsPurpose

• To evaluate the effectiveness of Iowa
  Comprehensive Case Management (CCM) with
  adolescents receiving outpatient treatment.

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ICMP AdolescentsMethod

• CCM provided for length of outpatient treatment
• Follow-up at 3-months and 6-months
• n42 (32 males, 9 females)
• No baseline differences between CCM and control

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ICMP AdolescentsResults

• No significant between group findings
• Client availability issues
• Need to control for utilization of other services
• Small sample (low power)

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Recommendations

• Strengths-Based Case Management with adolescents
• person-in-environment approach
• strengths perspective

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• Special Considerations Adolescents
• Developmental issues
• Ethical issues
• Legal issues
• Cultural sensitivities
• Problem severity

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Measurement and Evaluation

• Dosage
• Amount
• Frequency
• Duration
• Breadth
• Client availability

• Pre-Session Change
• Post-Session Checklist
• Worker Fidelity

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Dimensional Characteristics of Case Management

• Ridgely Willenbring (1992) Revised