Curriculum for Addiction Professionals > Competency 5: Continuing Care of Families Affected by FASD > 4. Clinical and Environmental Stabilization for Clients with an FASD or Possible FASD

Please Select One 1. Competency Description 2. Pretest 3. Learning Objectives 4. Clinical and Environmental Stabilization for Clients with an FASD or Possible FASD 4a. Multidisciplinary Approach to Continuing Care 5. Continuing Care for Clients with an FASD or Possible FASD 5a. One-on-One Counseling and Structured Group Involvement 5b. Treatment Plan Development 6. Relapse Prevention 6a. Community Referrals 6b. Employment 7. Continuing Care Services for Clients with Children with an FASD or Possible FASD 7a. Multidisciplinary Approach to Continuing Care 7b. Counseling and Structured Group Involvement 7c. Potential Risks for Child Abuse in Families 7d. Treatment Plan Development 7e. Value of a Mentor and Support Group Network 7f. Ongoing Case Management 8. Continuing Care Issues for Families with an Individual with an FASD 8a. Role of Family in Preventing Alcohol-Exposed Pregnancies 8b. Access to Services 8c. Access to Services-What Families Need 9. Issues Related to Professional Values and Ethics 10. Matching Activity 11. Posttest 12. References

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Competence 5: Continuing Care of Families Affected by FASD

Clinical and Environmental Stabilization for Clients with an FASD or Possible FASD

Studies show that addiction affects multiple facets of women’s lives. Best practices in addiction treatment have long reflected the need for a holistic, comprehensive approach to clinical and environmental stabilization. It is important to address the diverse needs of women, their children, and their families over an extended period of time.

Services are often fragmented and emanate from different funding streams with different requirements. Therefore, efforts are needed to address problems of access, efficiency, accountability, and continuity of care. The challenge is to coordinate and integrate services provided by multiple agencies or systems.

Case management is a process used to create an integrated plan to promote recovery. It enables women and their children to receive and appropriately use a variety of services for their improved functioning. Services should be provided for as long as a woman and her family need and can benefit from them.

Despite the challenges of service integration, collaborative efforts (e.g., service linkages) are essential ingredients in meeting the multifaceted needs of women with an FASD, children with an FASD, and families of clients with an FASD. The table describes the characteristics of effective case management models.

Characteristics of Case Management

Characteristic	Model A	Model B	Model C
Duration	Indefinite (defined by client needs)	Time-limited	Begins at intake, continues throughout treatment, and trails client through followup
Intensity	Frequent contact (daily) High staff ratio (1:10)	Infrequent contact (quarterly) Low staff ratio (1:75)	Frequent contact High staff ratio (1:10)
Focus of services	Broad, inclusive	Narrow, exclusive	Comprehensive, including identification and outreach, assessment, planning, linkage, monitoring, evaluation, direct service, crisis intervention, system advocacy, and resource development
Availability	24 hours	Office hours	24 hours
Site of service	In vivo	Office only	Wherever appropriate
Consumer direction	Consumer directed	Consumer directed	Consumer directed
Advocacy	Advocates for client to gain access to services	Gatekeeper for system (finds alternatives to requested services)	Advocates for the client to gain access to services, advocates for system changes
Case management training	Advanced professional degrees	On-the-job training	Advanced professional degrees
Case management authority	Broad authority, administrative control	No authority, persuasion only	Authorization of services and utilization review; decisionmaking authority
Team structure	Full team model: All case managers share all clients	Primary counselor with individual caseload	Primary case manager with individual caseload

Source:  Siegal, H.A. 1998. Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol Series 27. DHHS Publication No. (SMA) 98-3222. Rockville, MD: Substance Abuse and Mental Health Services Administration.

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