Intensive Case Management Improves
Abstinence and Employment among Substance Dependent Women Receiving
Temporary Assistance for Needy Families

Research Summary and Comments

Women with substance use disorders (SUDs) receiving
Temporary Assistance for Needy Families (TANF) have high rates of
co-occurring mental health and social problems and experience severe
and persistent barriers to employment. Researchers examined 2-year
differences in abstinence and employment outcomes among 302 women with
substance dependence receiving TANF. Participants were randomized into
2 groups: usual care (screening and referral to treatment with limited
outreach if patients failed to attend the first treatment session), and
intensive case management (ICM) (a manual-guided intervention involving
identification of barriers to treatment, assistance getting into and
during treatment, coordination of needed services, weekly meetings with
a case manager, and incentive vouchers for attending treatment).

  • Although the usual care group had higher rates of employment than
    the ICM group during the first year, this relationship reversed in year
    2, with the rate of improvement significantly higher over time in the
    ICM group.
  • The mean abstinence rate across 24 months was also significantly
    higher in the ICM group (47%) than in the usual care group (24%).
  • At 24 months, abstinence was higher among ICM participants who were
    working (3 of 5) compared with participants in the usual care group (1
    of 3).

Comments by Norma Finkelstein, PhD, LICSW
study provides support for those who advocate that ongoing treatment is
critical to successful employment outcomes for women with SUDs. In
addition, ICM appears to yield significantly better outcomes in both
abstinence and employment for this population. Most government agencies
providing financial assistance offer limited screening and treatment
referral for clients with SUDs, usually with limited success. These
results demonstrate that more intensive interventions can significantly
improve employment outcomes in this group.

Morgenstern J, Neighbors C, Kuerbis A,
et al. Improving 24-month abstinence and employment outcomes for
substance-dependent women receiving temporary assistance for needy
families with intensive case management. Am J Public Health. 2009;99(2):328–333.

Article courtesy of Join Together