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Transferring Clients from Intensive Case Management: Impact on Client Functioning
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Evaluated the effects of transferring clients from assertive community treatment (ACT) to a less intensive (Step-Down) case management program. This study examined (1) which clients were transferred to Step-Down, (2) whether Step-Down was truly less intensive in terms of amount of service provision, and (3) whether Step-Down leads to deterioration in functioning or increase in hospital use. A retrospective review of the records of 107 Step-Down clients and 128 ACT clients was conducted. The current mean age for the sample was 42.0 yrs. Functioning was measured using the Community Living Adaptation Scale and psychiatric hospitalizations had been recorded by case managers as they occurred. Service use decreased significantly after transfer to the Step-Down program, and no negative effects of transfer on hospital use or client functioning were evident. Critical elements for successful step-down are suggested and discussed and ideas for future research direction are given. (Authors)
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A program of the U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration, Center for Mental Health Services