Intensive case management (ICM) can help substance-abusing women who receive welfare benefits stay off drugs and make strides in employment, report Dr. Jon Morgenstern and colleagues at Columbia University. In a study of 302 applicants for Temporary Assistance for Needy Families in New Jersey, the researchers assigned roughly half to an ICM intervention that included weekly visits from a case manager, help in overcoming treatment barriers, assistance in identifying and meeting other patient service needs, and voucher incentives for remaining in treatment. The rest of the trial participants received the care welfare agencies typically provide to substance-abusing clients, which consists of screening and referral for treatment.
When interviewed after 24 months, 47 percent of the women receiving ICM had been abstinent from drugs for the past 30 days, compared with 24 percent of those in the usual care group. At that same time, 22 percent of the women in the ICM group—but only 9 percent of those in the usual care group—were employed full-time. For comparison, the full-time employment rate was 34 percent among 150 female welfare recipients who did not abuse drugs.
The researchers are now conducting a cost-benefit analysis of ICM. If their promising results are replicated in future evaluations, welfare agencies may have an effective tool to help some of their most vulnerable clients.
American Journal of Public Health 28(53):14372–14378, 2008. [Abstract]