Document Sample
Requirement Powered By Docstoc
					                    Child Protective Services: Case Management

2105.15 Relapse Issues in Substance Abuse Cases
Evaluate each occurrence of relapse individually, on a case-by-case basis by requesting an
assessment from a drug treatment provider with a recommendation of services needed. File a
deprivation complaint if safety of a child cannot be ensured in the home or through other
controlling safety interventions. If a child is not at imminent risk and/or safety is controlled
through other means, evaluate the existing evidence of substantiated maltreatment with the
supervisor to determine whether court-ordered intervention is necessary for compliance with
services. If the court is already involved, notify the court of the relapse of any significant changes
to the case plan resulting from the relapse.

Procedures/Practice Issues

Relapse is defined as a falling back or sliding into a former state. Within the context of substance
abuse, relapse is marked by a subsequent occurrence of drug use following a period of
abstinence/sobriety. Relapse occurs in varying degrees, ranging from a single instance of drug
use to an extended episode of binging that lasts for several days. Relapse is most often triggered
by physical, emotional and/or psychological cues in the environment (e.g., the smell and/or sight
of the drug, a former hangout where the person used drugs, interaction with people with whom
the person commonly used drugs, etc.).

Signs of relapse:

 increasing lack of cooperation/avoiding behavior;

 deterioration in daily living activities;

   Unexplained financial hardship;

   mood swings;

 depression; anger, anxiety, or paranoia;

 setting expectations that are too numerous or unrealistic;

 distancing from friends who are clean and sober; and,

 re-establishing old relationships with drug-using acquaintances

Relapse planning involves the identification and development of a plan of action that the family
agrees to follow in the event that relapse occurs. This may include outlining who will contact the
DFCS case manager, participation in AA or NA, weekly telephone contact with an identified family
member or friend, a temporary care giving resource for the children, etc. Discuss these plans
with family members so that roles and responsibilities are clearly defined.

Social Services Manual                                        Child Protection Services Chapter 2100, Section V
August 2006                                                                                             Page 1
                    Child Protective Services: Case Management

The best predictor of whether a person will recover from an instance of relapse is the correct
treatment intervention matched to the person’s stage of change. When there is no progress in
other life areas (e.g., improved parenting competency, financial stability, positive relationships,
etc.), there is also a lack of necessary motivation to regain control over the addiction. To prevent
the risk of relapse, address all of these factors in case management.

Case managers will not share the results of drug tests, drug assessment or the relapse of a client
without the expressed written consent of the client, unless there is a court order to do so.
Providers/vendors are bound by confidentiality agreement in the contract. Providers/vendors are
prohibited from revealing results of drug tests with anyone without a signed consent agreement.

Social Services Manual                                       Child Protection Services Chapter 2100, Section V
August 2006                                                                                            Page 2

Shared By: