Comprehensive case management for substance abuse clients who have mood or anxiety disorders

Abstract

Background: The Iowa Case Management Project (ICMP) was developed to evaluate the effectiveness of a comprehensive, solution-focused model of case management with rural clients in substance use disorder treatment.

Aims: To evaluate the effectiveness of a strengths-based case management model to help clients with and without co-occurring psychiatric disorders reduce substance use and improve psychiatric functioning.

Method: Clients admitted to residential or intensive outpatient substance use disorder treatment who volunteered (N = 518), were randomly assigned to one of four research conditions. In three conditions, participants received Iowa Case Management (ICM), while in the fourth condition participants received standard substance use disorder treatment services. Participants completed assessments at intake, three, six and 12 months.

Results: A diagnosis of a psychiatric disorder did not impact the effect of case management on substance use, and client substance use decreased significantly in all four conditions, but was not different between groups. Participants without a co-occurring diagnosis had significantly better outcomes at follow-up points compared to those with a co-occurring diagnosis.

Conclusion: The findings suggest that strengths-based case management is effective in improving psychiatric functioning among participants without a co-occurring disorder, but not among participants with a co-occurring disorder.

Keywords:

• anxiety disorder
• case management
• co-occurring
• mental health
• mood disorder
• substance use disorder

Acknowledgements

Acknowledgement is given to Drs. Tyrone Borders and Jerry Ingram for assistance with early drafts.