Case management has been variously classified as a skill group, a core function, service coordination, or a network of "friendly neighbors." Although it defies precise definition, case management generally can be described as a coordinated approach to the delivery of health, substance abuse, mental health, and social services, linking clients with appropriate services to address specific needs and achieve stated goals. The Consensus Panel that developed this TIP believes that case management lends itself to the treatment of substance abuse, particularly for clients with other disorders and conditions who require multiple services over extended periods of time and who face difficulty in gaining access to those services. This document details the factors that programs should consider as they decide to implement case management or modify their current case management activities. This summary is excerpted from the main text, in which references to the research appear.

Case management has been variously classified as a skill group, a core function, service coordination, or a network of "friendly neighbors." Although it defies precise definition, case management generally can be described as a coordinated approach to the delivery of health, substance abuse, mental health, and social services, linking clients with appropriate services to address specific needs and achieve stated goals. The Consensus Panel that developed this TIP believes that case management lends itself to the treatment of substance abuse, particularly for clients with other disorders and conditions who require multiple services over extended periods of time and who face difficulty in gaining access to those services. This document details the factors that programs should consider as they decide to implement case management or modify their current case management activities. This summary is excerpted from the main text, in which references to the research appear.

American Indians and Alaska Natives have consistently experienced disparities in access to healthcare services, funding, and resources; quality and quantity of services; treatment outcomes; and health education and prevention services. Availability, accessibility, and acceptability of behavioral health services are major barriers to recovery for American Indians and Alaska Natives. Common factors that infuence engagement and participation in services include availability of transportation and child care, treatment infrastructure, level of social support, perceived provider effectiveness, cultural responsiveness of services, treatment settings, geographic locations, and tribal affliations.

A Treatment Improvement Protocol on case management, which can be described as a coordinated approach to the delivery of health, substance abuse, mental health, & social services, linking clients with appropriate services to address specific needs & achieve stated goals. Case management lends itself to the treatment of substance abuse, particularly for clients with other disorders & conditions who require multiple services over extended periods of time & who face difficulty in gaining access to those services. This report details the factors that programs should consider as they decide to implement case management or modify their current case management activities.

Major research advances have substantially improved our understanding of the biology of HIV and the pathogenesis (i.e., origin and development) of AIDS. The pathogenesis of AIDS is now known to result from the ability of HIV to replicate at the rate of a billion new virions (viral particles) per day and nearly 10 trillion new virions over the course of HIV infection. This, countered by the ability of the body to produce CD4+ T cell lymphocytes (a primary target cell for HIV), sets the stage for the struggle between HIV and the immune system-a struggle that lasts from the first day of HIV infection to end-stage disease and death.

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

This TIP provides counselors with clinical guidelines to assist with problems that routinely occur with clients in the criminal justice system who are dealing with substance abuse and dependency disorders. It describes the unique needs of offenders. It addresses the challenges counselors and criminal justice personnel are likely to face at every stage of the criminal justice continuum.

The primary audience for this TIP is administrators of outpatient substance abuse treatment programs. A few words about this audience are in order. Whereas TIP 8 addressed intensive outpatient treatment, the current TIP drops the word "intensive" from its title because the consensus panel hopes that this TIP will find an audience beyond administrators of IOT programs. Most of the concepts and guidelines included in this TIP apply to the administration of all substance abuse outpatient treatment (OT) programs. On those rare occasions when information applies only to IOT programs, the authors have been sure to make this clear. Although the term "administrator" is used most often to describe the audience for this book, the terms "executive" and "director" appear as well and are used interchangeably with administrator. These overlapping terms emphasize the varied roles and responsibilities that administrators assume.

Clinical supervision (CS) is emerging as the crucible in which counselors acquire knowledge and skills for the substance abuse (SA) treatment profession, providing a bridge between the classroom and the clinic. Supervision is necessary in the SA treatment field to improve client care, develop the professionalism of clinical personnel, and maintain ethical standards. Contents of this report: (1) CS and Prof¿l. Develop. of the SA Counselor: Basic info. about CS in the SA treatment field; Presents the ¿how to¿ of CS.; (2) An Implementation Guide for Admin.; Will help admin. understand the benefits and rationale behind providing CS for their program¿s SA counselors. Provides tools for making the tasks assoc. with implementing a CS system easier. Illustrations.