When discussing our program with potential clients, some of our services require a bit of explaining. For instance, Amethyst clients at all three levels of care—detox, residential and day/night treatment—meet with a supervisor once every week to discuss case management services. And when we mention this to clients who have never been through treatment before, most of them ask the same question:
“What exactly are case management services?”
It isn’t surprising that many need to ask this question. Case management services don’t often enter the equation when clients and their families first start researching prospective treatment centers. Most usually concern themselves primarily with components of care more directly related to the recovery process. They want to know if they can find a good dual diagnosis facility, or one that offers cognitive behavioral therapy. Others may desire access to 12-step meetings, or a faith-based program that respects their religious beliefs. Some just want to know about the food.
Amethyst offers all of these things and more. And like many treatment centers, we tend to emphasize these aspects of our program when providing potential clients with information. But while we may not discuss case management services that often, their role in the treatment process cannot be overstated. Because while the client will do great work in treatment to develop a plan for the future of their recovery, case management provides a range of practical services that help make that future possible.
Our case management supervisor, Lexi Cunningham, was gracious enough to take time out of her incredibly busy schedule to talk with us about her work. Her answers to some of our questions should provide clients with a much greater understanding of what case management can offer, and why it’s such an important part of the overall treatment process.
Services Provided by Case Management
Case management can be hard to define, due to the very wide range of services they offer. Naturally, our first question for Ms. Cunningham was how she might describe her work to those who know nothing about it.
“I would definitely discuss about helping the clients with all legal issues, any aftercare options that they could have. Something to help set them up with a continuum of care so they have somewhere to go after treatment. Where they aren’t just left to their own defenses, they have more. So basically client care, to make sure that they’re ready for the future. Anything that they think they want or need when they complete 24-hour surveillance treatment, that’s what I help them with.”
She mentions two branches of service explicitly here: legal and aftercare. We will cover each of these separately, but first we should note the subtle modesty in her answer.
As previously noted, case management offers a diverse range of services. Some of these services do not fit neatly into a category. For instance, case management services may include help applying for SNAP or other benefits. While not strictly related to recovery, these types of services help clients with their recovery more than you might think. Right after treatment, while clients are first looking for jobs, many will find themselves down on their luck. Even at its very best, the approval process for government benefits is not immediate. By allowing case management to help them with their applications while still in treatment, clients cut down on the amount of time it takes to get back on their feet after leaving.
So when Ms. Cunningham says that she helps clients prepare for the future, she means it. Thanks to case management, clients will leave treatment having already arranged something of a life for themselves. This allows them to spend more time focusing on their sobriety, rather than stressing over paperwork.
Helping Clients Resolve Legal Issues
Many clients enter treatment with unresolved legal issues. Some enter treatment specifically at the behest of the courts, while others face pending cases for which they must still negotiate the outcome. In either circumstance, case management services often prove beneficial.
Your case manager can help you in a few different ways. For unresolved cases, Ms. Cunningham often acts as a court liaison, calling the courts and updating them on the client’s treatment progress. She may also call probation officers or other authorities, should the situation demand it. And when the client graduates treatment, she makes sure they have any character letters they might need.
The specifics of each case will naturally vary. Clients may face anything from a simple DUI charge to felony assault. Depending on the nature of the charge, some clients may require more from case management than others.
“If the client needs more help with the legal stuff—because somebody can come in with a lot of legal stuff—they can be dealt with more than once a week.”
This extends to those who leave treatment as well. Should a member of our alumni need access to their treatment records, such as a character letter they misplaced or perhaps the lab results from their urinary analysis screens, case management can provide. We naturally cannot make your legal issues disappear, but we will do anything we can to help alleviate them.
Legal issues may also play a role in deciding the client’s aftercare plan. Fortunately, aftercare is another area in which Ms. Cunningham excels.
Developing a Personalized Aftercare Plan
Clients will generally make one of two choices regarding their post-treatment living arrangements. They will either seek out a sober living home, or return to their previous place of residence. However, this plan sometimes changes during the treatment process. A client who initially intends to return home may decide they want to extent their care by seeking an intensive outpatient program. Sometimes the family makes this decision for them. This puts the client in the position of needing to find a sober living home while having performed absolutely zero research on their options prior to entering treatment.
Case management services prove vital in this instance. And while most will be happy just to find an open bed, Ms. Cunningham will help them out a little further. Most sober living homes offer similar arrangements, but to the extent that she can find something to fit the client’s specific needs, she will go out of her way to do so. The initial conversation generally proceeds as follows:
“I would talk to them about what the rules are where they want to be located, whether it be down south, back home, Port St. Lucie, up north…that’s where I start off. Usually all house rules are pretty much the same, the rent’s pretty much the same, curfew—everything’s pretty much the same. So basically I ask them where they want to go, and then we go from there. If the client only has $300 to move in, then it’s me calling places to find out who would take $300 to move in to a private sober living.”
Ms. Cunningham can help narrow down the choices further if the client intends to stay in the area. Due to her experience, she knows many of the owners and managers of the local sober living homes. She knows their personalities, their integrity, and their approach to recovery. Naturally, this only helps insofar as the best match for the client is able to house them. But if she can find a house with an open bed that suits the client’s personal and financial needs, she’ll do what she can to get them in.
Not everybody needs help with their aftercare plan. Even in these cases, Ms. Cunningham will discuss their plan with them. Whether pursuing a plan devised by the client alone or working with the client to arrive at the best option, she follows this up with the rest of the treatment team.
“If the aftercare plan’s set, I let the therapists know, make sure that they’re okay with that aftercare plan. Any legal stuff, like if they have to return home after PHP, I let the therapists know. It’s pretty hands-on with the clinical team.”
Once the client is happy with their aftercare plan and the clinical team has agreed, Ms. Cunningham can put things in motion. Reserving a bed, writing a character letter if the client needs it for court, making sure that clients in dire financial straits will have their food stamps when they get out. Those who take medication for co-occurring disorders will also receive information on local medical practitioners so they can continue to seek help and renew their prescriptions.
Not only do these services help the client, but Ms. Cunningham believes they provide the client’s family with some solace as well.
“It’ll give them more relief that they have somewhere to go after treatment. It does help them, relieve them, that the client’s going somewhere and that they are being cared for after they complete with us. That they’re not just going nowhere. We’ve set them up with everything.”
Of course, case management services can only help the client fulfill the needs which they choose to address. This gives clients a bit of control over the help they receive, but also limits our staff’s ability to help those who do not want it. Even in these cases, however, we do our best to provide.
Getting the Most Out of Case Management
Because case management works hands-on with the clients, Ms. Cunningham often works directly with the clinical team. Not just to determine aftercare plans, but sometimes to address other issues as well. For instance, some clients begin to feel the weight of the pressure while making decisions about the future of their legal issues or aftercare plan. When this happens, case management services can work with the clinical team to help them.
“It’s usually pretty hands-on with the therapists. I usually talk to the therapists about everything because sometimes the clients report to me that they’re overwhelmed, or this isn’t working for them. Whatever the case may be, I just let the therapists know. Unless, you know, it’s not relevant and doesn’t need to be told to the therapist.”
Other cases that may necessitate discussion with the rest of the treatment team include those cases in which clients refuse help. We asked Ms. Cunningham specifically how she goes about managing these cases.
“I usually refer it to the therapist. I do document that they’re declining my help. I’ll refer it to the therapist and the clinical team and usually then either the clinical director speaks with them or the therapist. And if nothing can change then nothing can change. But, you know, I still meet with them once a week. I won’t neglect them because they’re telling me they don’t need my help. They’ll still be met with once a week. Usually they will change their mind by the end.
What I usually do if they do decline and will not take my help on anything, I will still give them a list of IOPs in the area that they are going—therapists, and psychiatrists, and sober livings. I still provide them with information, just in case they change their mind, and I document it that way.”
This sends an important message to clients. Even those who resist our services will still receive access to them in the event they undergo a change of heart. This extends beyond case management. Our therapists, group facilitators, medical professionals—no one here will ever leave clients in the dust. And since many sober living homes do not advertise online, the information Ms. Cunningham provides to clients who think they can do without it may still prove quite useful.
In the end, however, clients who make use of case management services from the beginning will benefit far more from Ms. Cunningham’s knowledge, experience, and sheer access to information and resources. They will be able to make more progress each week toward securing a future for themselves. And once they leave treatment, they will feel far less burdened for having allowed our team to help lift some of the weight off of their shoulders.
That is why we say that the value of case management services cannot be overstated. It would be like trying to quantify the value of your future. All you really need to know in the end is that, with the help of Ms. Cunningham and her team, you’ll be guaranteed to have one.
Should you have any questions about case management services, or about any other aspects of our program here at Amethyst, do not hesitate to contact us. We are here to offer any support you might need.