Program Profile: Transitional Case Management

This is a strengths-based, case management intervention that provided expanded case management services to incarcerated persons during their transition from incarceration to the community. The program is rated Ineffective. There were no statistically significant differences between the transitional case management treatment group and the standard referral control group in nights spent in residential substance abuse treatment or in past 30-day drug or alcohol use, at the 9-month follow up.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

Transitional Case Management (TCM) was a strengths-based case management intervention that provided expanded case management services during an individual’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.

Key Personnel

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.

Program Components

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 TCM 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 person’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 person’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 incarcerated persons receiving substance abuse treatment in prison and had been referred to publicly funded community treatment after release. They were shown a video meant to increase their motivation to pursue treatment once they had transitioned back into the community.

Study

Prendergast and colleagues (2011) conducted a multisite study in four States with male and female inmates (n = 812). Subjects were recruited from secure correctional facilities that offered substance abuse treatment services. To be eligible, inmates needed to be 18 or older, be enrolled in a drug treatment program, have a referral to a community-based substance abuse treatment program, be about 3 months away from release, and be scheduled for release to a metropolitan area where TCM managers were located. Inmates were excluded if they received a referral to community-based case management services, were registered sex offenders, had parole requirements that prevented their participation, or could not provide informed consent. Eligible inmates were assigned to a transitional case management (TCM) group (n = 412) or to a standard referral (SR) group (n = 400) using urn randomization. Participants did not differ significantly on any variables, except ethnicity (the TCM group had a larger percentage of whites than did the SR group: 50 percent versus 44 percent). Women were oversampled relative to their percentage in the prison population.

Both groups received in-prison substance abuse treatment, referrals to publicly funded treatment, and in-prison exposure to a video developed to encourage engagement in treatment post-release. The SR group received the usual planning and referral services available in prison and while on parole, including referrals to community-based treatment in the community to which the parolee was being released. Parolees in this group were supervised and received standard services through their parole officers. The TCM group received standard services as well as services specified in the TCM protocol. These activities included a strengths assessment; a conference call with family members, a treatment provider, and a parole officer; and community sessions with the case manager (see above). Attendance at TCM sessions was voluntary.

Data was collected through individual interviews at baseline, 3 months post-release (91 percent follow-up participation), and 9 months post-release (90 percent follow-up participation). Baseline data was collected from clients at time of consent or within a week following consent. Researchers used the CJ–DATS Core Intake to collect information on sociodemographic background, family and peer relations, health and psychological status, criminal history and criminal justice involvement, drug use history, and HIV/AIDS risk behaviors. The TCU Drug Screen was used to collect data on substance abuse or dependence. The Client Evaluation of Self at Intake was used to collect information on treatment motivation. The Services Needed and Received collected self-report data on services needed and received since release or last interview.

Twelve case managers were recruited for this project across the four sites. They received comprehensive standardized training, based on a detailed manual developed for the project, over 3.5 days. Managers received supervision during the project through biweekly calls early in the project, then monthly calls, as well as site-specific supervision. Managers participated in a 3-hour refresher course halfway through the study. At the beginning of the project, there were seven women case managers and five men; their average age was 39.6 years; six were African American and six white; seven had achieved a bachelor’s degree and five a master’s. Seven had previous experience as a case manager.

Researchers used chi-square tests and t-tests to assess substance abuse and other services received. Two-way interactions for each outcome variable were examined using a mixed-effects model. Fifty-three individuals were excluded from analysis. The study authors did not conduct subgroup analyses.

These sources were used in the development of the program profile: