STRENGTH-BASED

CASE MANAGEMENT
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BY:
VERNELL JENKINS

Background
According to the American Medical Association the addiction to alcohol
and other drugs is considered a disease.
Alcoholism is a primary chronic disease with genetic, psychosocial, and
environmental factors influencing its development and manifestations. The
disease is often progressive, fatal and characterized by impaired control of
over drinking, preoccupation with the drug alcohol, use of alcohol despite
adverse consequences (National Council of Alcoholism and Drug
Dependence, 1992).

Problem Statement
Scenario: 35 year old, Jane Doe, mother of two children (9 and 6 years old) entered the agency to
inquire about alcohol and drug abuse treatment. During the assessment , the client openly explained
that she abuses drugs (crack-cocaine) and alcohol for many years. She recalled her first use of
drugs(marijuana) begin at age 16. The client has been in the agency prior, and is also a recipient of
government benefits (TANF and MAF). A situation with DSS has cause her to enter the agency to

seek help. Due to a history of child neglect, both her children has been removed from the home and
temporarily placed with relatives . The client stated that DSS is working with her to restore her
family and she has been advised to seek drug treatment. She believes she has been falsely accused of
leaving her children alone. Jane Doe shows willingness and a desire to obtain treatment, however
she avoids entering an inpatient residential treatment. Serenity Healthcare is an outpatient treatment
center designed to assist clients who do not require stabilization and have mild to moderate
withdrawal needs.

Strength Based-Clinical
Assessment

Assess/Evaluate the client (Jane Doe) to identify the needs

(Clinical Assessment 12 pgs.)

Analyze to determine if the outpatient treatment is best service for the client.
(Substance abuse screening instrument-DAST; Michigan Alcoholism Screening Test & Scoring Instrument (MAST)

Setting Goals

Focus on the clients strengths; drive/willingness

Goal is that clients use community resources

Establish services and follow the progress through service interactions (for
example: individual or group sessions are required)

Advocate to ensure that the client is receiving the treatment that they need
in order to sustain a healthy lifestyle. (Consent to release information DSS-6969)

Interventions
Screening, Brief Intervention, Referral, and Treatment

Step Study & Meetings - Twelve steps with emphasis on the AA twelve steps
Stress management

Behavioral therapy to improve problem solving and give positive reinforcement

In some cases medication (like methadone) is used in treatment -with physicians

care (however, not yet considered for Jane Doe)

24 hr Hotline: 910-678-8733

What are some biases you had going into the interview?
I began to develop opinions/bias about the client as she explained the history of child neglect.
She justified the incident and implied that she had been falsely accused. I believe children are
one of societies most vulnerable people and I feel parents should prioritize and protective
them. When she didnt take ownership of the neglect it bothered me, however later the bias
went away.

What were some value differences between you and the client?
Now that the first impression/bias is gone , I dont believe our values differ. I understand the
client has an illness that influence her behaviors.

What events or life experiences have shaped them into the person they are?
After a series of questions, the client stated that she has live among two generations of alcohol
and drug abuse. Now she has found herself raising her children in the same atmosphere.

What is the staff recommendation about diagnosis, Interventions or treatment?

The staff was willing to provide services to the client. Having the client to request for service showed
her strength about her situation although other influences. Knowing the long history concern the
staff, therefore residential services was explained (but rejected constantly by the client).

What does research say on their diagnosis/problem/treatment?

According to the overview of the Adult Placement Criteria (ASAM PPC-2R) mild to moderate
severity, with potential to distract from recovery; need stabilization.
They also explained that the intensification of addiction or mental health symptoms, despite active
participation in a Level1 (outpatient treatment) or Level II(intensive outpatient treatment) indicates a
high likelihood of relapse or continued use or continued problems without near-daily monitoring and
support.

What changes do recommend for the agency or service (Needs of agency, changes, and rights
issues)?
The agency seem to function well on early intervention and outpatient treatment. Many of the clients
reveal multiple issues of mental issues along with substance abuse , therefore I feel additional
clinical therapy is needed to help evaluate and coordinate service in order to provide better treatment.

Practice Behaviors

Generalist Practice Behaviors

1.1, 1.3, 1.4, 1.6, 2.1, 2.2, 2.4, 3.2, 3.3,
4.1, 4.2, 4.3, 5.1, 5.2, 5.3, 6.1, 7.1, 8.1,
8.2, 9.1, 9.2, 10.2, 10.3, 10.4, 10.5,10.6,
10.7, 10.8, 10.9, 10.10, 10.11, 10.13