Article

Improving linkage with substance abuse treatment using brief case management and motivational interviewing

Center for Interventions, Treatment, and Addictions Research, Wright State University, Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45435, USA.
Drug and Alcohol Dependence (Impact Factor: 3.28). 04/2008; 94(1-3):172-82. DOI: 10.1016/j.drugalcdep.2007.11.012
Source: PubMed

ABSTRACT Poor linkage with substance abuse treatment remains a problem, negating the benefits that can accrue to both substance abusers and the larger society. Numerous behavioral interventions have been tested to determine their potential role in improving linkage.
A randomized clinical trial of 678 substance abusers compared the linkage effect of two brief interventions with the referral standard of care (SOC) at a centralized intake unit (CIU). Interventions included five sessions of strengths-based case management (SBCM) or one session of motivational interviewing (MI). A priori hypotheses predicted that both interventions would be better than the standard of care in predicting linkage and that SBCM would be more effective than MI. We analyzed the effect of the two interventions on overall treatment linkage rates and by treatment modality. Logistic regression analysis examined predictors of treatment linkage for the sample and each group.
Two hypotheses were confirmed in that SBCM (n=222) was effective in improving linkage compared to the SOC (n=230), 55.0% vs. 38.7% (p<.01). SBCM improved linkage more than MI (55.0% vs. 44.7%, p<.05). Motivational interviewing (n=226) was not significantly more effective in improving linkage than the standard of care (44.7% vs. 38.7%; p>.05). The three trial groups differed only slightly on the client characteristics that predicted linkage with treatment.
The results of this study confirm a body of literature that supports the effectiveness of case management in improving linkage with treatment. The role of motivational interviewing in improving linkage was not supported. Results are discussed in the context of other case management and motivational interviewing linkage studies.

0 Followers
 · 
91 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: In this paper we describe a multiprocessor architecture used in a real-time interactive system based on the recognition of sentences composed of sequences of isolated utterances. Anyway, the same general criteria could as well be used in the continuous speech framework. Particular attention is devoted to the control machanisms which supervise the system and, finally, detailed examples are given.
    Acoustics, Speech, and Signal Processing, IEEE International Conference on ICASSP '82.; 06/1982
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Since the 1990s, case management has been implemented in the USA and Canada – and recently also in various European countries – to support substance abusers with multiple and complex needs. Although this intervention is often presented as a set of standardised functions, its application is often a subjective task involving various dilemmas, which may influence case management outcomes significantly. Based on a comparison of case managers’ experiences in Denmark and Belgium, we focus on several core dilemmas in case management for substance abusers with complex problems. Case management practices vary from one project to the next and even within the same project. Such differences are apparently related to the way in which case managers approach dilemmas such as those existing between control versus self-determination, or between systematic versus ad-hoc planning. The conclusion is that it is vital to discuss these dilemmas during training courses and supervision meetings in order to ensure that the intended form of intervention is actually delivered on the ground.
    International Journal of Social Welfare 09/2009; 18(3):270 - 280. DOI:10.1111/j.1468-2397.2008.00608.x · 0.54 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to identify the psychosocial factors which influence transitioning HIV positive clients without primary medical care to a case management agency within 6 weeks by a city brokerage agency. People living with HIV who reported being in a social support group and those who requested assistance with meeting their basic needs were significantly more likely to attend their first case management appointment within 6 weeks (adjusted OR 1.91 95% CI 1.22-2.97 and OR 1.24 95% CI 1.01-1.54, respectively). Individuals requesting medical care or substance abuse treatment were less likely to accomplish transitioning (adjusted OR 0.75 95% CI 0.59-0.95 and adjusted OR 0.70 95% CI 0.53-0.91, respectively). The implications of this study for improving the effectiveness of brokering case management for those with HIV are discussed.
    AIDS and Behavior 11/2009; 14(2):459-68. DOI:10.1007/s10461-009-9628-9 · 3.49 Impact Factor
Show more