Intensive Case Management Improves Welfare Clients Rates of Entry and Retention in Substance Abuse Treatment. Discussion


CC and ICM appear to be useful strategies to integrate substance abuse treatment into welfare programming. For example, 65% of clients in CC entered treatment after receiving an evaluation and referral. At the same time, intensive case management was significantly more effective than a triage and referral system in engaging clients in substance abuse treatment. Significant differences occurred in outpatient treatment. Rates of entry and engagement in outpatient treatment appeared low in CC. About half of CC participants (47%) did not attend a single outpatient session and only 38% attended more than 2 sessions of outpatient treatment. These low rates occurred even though about half of CC clients were assigned to an episode of inpatient care before being referred to an outpatient program. ICM was more effective in getting participants to attend a first session and remain in outpatient treatment once they began.

Findings strongly support the literature indicating that standard substance abuse treatment may be poorly matched to the needs of disadvantaged parenting women, but that augmenting services through case management can substantially increase treatment engagement. Results are preliminary and future reports will present more sophisticated methods of analysis and other outcomes such reduction in substance abuse and increases in employment.