Chemical Dependency Case Management Dana WalkerInstructor Timi Fair 1/17/15Paper #1

An Effective and Efficient Chemical Dependency Case Manager

The sign of a good case manager starts with building a genuine, client-focused professional

relationship with the individual who has come to an agency for help. Managers must also be well-

educated in all aspects of case management. This includes knowing ethics, codes of conduct,

confidentiality laws, following agency missions and goals for treatment, and writing accurate,

concise chart notes. The case manager must also build a strong rapport with his or her peers and

members of referral sources (when used), and communicate with them regularly in order to provide

comprehensive, supportive, wrap-around care for the individual.

The start of care rests solely on the case manager’s shoulders, at the first session, in making

the individual feel welcome at the treatment center. They must also employ empathy and genuine

interest, and ask pertinent questions about why the individual is seeking help, listening attentively

and without judgment. Something that must be addressed at the time (if possible), is whether the

individual’s basic needs have been met, such as food, shelter, and clothing. If immediate need is

apparent, ascertaining these basics first will provide stability and facilitate future success if the

individual enters and proceeds through treatment.

There are times though, when the individual may be reluctant to open up to a stranger,

especially when they are seeking treatment for substance addiction and/or mental illness that they

may have never divulged before, or who have been court-mandated to do so, which can breed

resentment, anger, and resistance. If the individual becomes disruptive, the manager must know

how to deescalate the situation in a positive, win-win manner, while maintaining his or her

composure and professionalism. Above all, the manager must be flexible during every stage of

treatment, since managing people who are struggling will certainly include ups and downs.

In subsequent sessions a good case manager continues to build rapport and trust, further

encouraging disclosure of the individual’s problems and needs. The strengths-based approach is a

excellent tool to use, which helps the individual to realize inherent strengths, adding to the

foundation for gaining mastery over their problems. Using the Brief Risk Intervention (BRI) tool is

also helpful. This tool is used to assess the extent and severity of the individual’s use and habits,

and helps one to visualize the impact and risks that substance use and/or mental illness has had on

their lives, as well as the risks or rewards for continuing or discontinuing current patterns of use and

behavior.

Another tool that helps to reinforce a supportive, working relationship with the individual is

by offering a business card with the managers’ contact number, a crisis number, and appropriate

links to outside resources, especially if the current agency does not address a given problem. In this

way, the individual has access to resources when they are not in treatment, or if they have dropped

from treatment but need help.

An important measure the manager must employ on behalf of the individual is to have good

follow-through. Not being reachable, not returning calls, being late for appointments, or having

unstructured, inconsistent care conveys to the individual that they do not matter and are not worth

helping. Those actions may trigger past experiences of people not being there for them, and can

ruin the foundation of trust and the individual/case manager relationship. It may also discourage the

individual from following through in treatment if they feel there support system has fallen apart.

Another aspect of being an effective case manager has to do with being well-informed. The

Washington Administrative Codes (WAC) arms managers with by-laws for social and human

service provisions regarding administrative, outpatient, and chemical dependency services, with

protocols in agency conduct and licensure, patient treatment and consent, and manner of services

provided to an individual. Akin to the WAC is the Revised Code of Washington, laws that define

and dictate the parameters of Treatment for Alcoholism, Intoxication, and Drug Addiction (RCW

70.96A). Failure to comply can result in suspension or revocation of licensure, and/or termination

from an agency. Along with the aforementioned, the Health Insurance Portability and

Accountability Act (HIPAA) addresses an individual’s consent for disclosure of records, the right to

privacy and its exceptions. It is imperative that a case manager be thoroughly versed in all three

components, keeping them on hand for reference when needed. A final component is knowing the

agency mission and goals for treatment, and codes of conduct. All of these serve to protect the

interests of the individual, employees, the agency, and its stakeholders.

Finally, in a nutshell, a good case manager should possess the following: A desire to help

others; prompt attendance; be willing to admit to mistakes and correct them; ask questions when

something is not understood; refer individuals to coworkers when needs are outside of one’s

expertise; take care of one’s self in order to be of better service to others; write accurate, concise

chart notes (especially if subpoenaed to court and/or audited); seek continuing education and

knowledge; be culturally sensitive to other cultures and customs; and have an overall strong work

ethic. These and the aforementioned all contribute to making an effective and efficient social and

human services case manager.