Program Goals/Target Population
Transitional Case Management (TCM) was a strengths-based case management intervention that provided expanded case management services during an inmate’s transition from incarceration to the community. The goal of TCM was to increase participation in community-based substance abuse treatment, enhance access to other needed social services, and improve drug use, crime, and HIV outcomes for substance-abusing individuals on parole.
Case managers received comprehensive training based on a detailed manual that covered the rationale for TCM; a description of the two study conditions; detailed procedures for implementing TCM; study monitoring procedures; descriptions of forms and data collection procedures; session objectives, agendas, and sample scripts; a job description for the case manager; and general information on research procedures and human subjects issues.
While TCM delivered the standard services associated with traditional case management (e.g., assessment, planning, referral, advocacy, monitoring), the model was based on strengths-based principles that differentiated Transitional Case Management from traditional case management. These included:
- An emphasis on the client’s strengths and previous accomplishments, not his or her pathology or deficits
- Establishing a relationship between the client and case manager as an essential component of the case management
- The fundamental role of the client in directing the selection of goals, interventions, and services based on his or her needs and desires
- The use of both formal and informal community resources (e.g., faith-based organizations, families, self-help groups) to support the client’s transition
- Aggressive outreach on the part of the case manager, who served as a bridge to available formal and informal resources
- A belief that each client is able to learn, grow, and change and that the role of the case manager is to support that process
Because TCM concentrated on solutions rather than problems, the intervention included breaking goals down into specific activities and identifying individuals responsible for those activities. The intervention occurred in three stages:
- Strengths assessment. This assessment was conducted at the first meeting, about 2 months before the inmate’s release from prison. The assessment concentrated on identifying strengths and accomplishments, as well as on goals and resources, and on developing plans to address the inmate’s immediate needs after release.
- Conference call. This call occurred approximately 1 month before release and included the treatment counselor, the parole officer, and family members. The call concentrated on discharge plans and generated support and encouragement for the client.
- Community sessions. Case managers met with clients weekly for 3 months postrelease, and then monthly for an additional 3 months.
Clients were drawn from inmates receiving substance abuse treatment in prison and had been referred to publicly funded community treatment after release. Inmates were shown a video meant to increase their motivation to pursue treatment once they had transitioned back into the community.
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Substance Abuse Treatment and Other Needed Services
Prendergast and colleagues (2011) failed to find statistically significant differences between the groups at 3 or 9 months with regard to participation in services. Compared with those in the standard referral (SR) group, those in the Transitional Case Management (TCM) group did report significantly more nights in residential substance abuse treatment at 3 months; however, the difference was not significant at 9 months. There were no other differences in treatment or other services received by both groups.
Drug and Alcohol Use, Arrests, and HIV Risk Behaviors
Researchers failed to find statistically significant differences between the SR and TCM groups at 3 or 9 months with regard to behavioral outcomes, including any drug use, any arrests, and HIV risk behaviors (sex without a condom).