Fiduciary Case Management
and the Sober Coach
Here's why clients appreciate our multi-facted approach toward treating their addiction: they need it.
What do you do with a client who has multiple bank accounts, a cell phone, enabling "friends", and connections for drugs far better than most people ever get?
Part of the answer is a straightforward but somewhat involved process called Fiduciary Case Management (FCM).
FCM involves a series of protocols wherein the client holds no funds of his or her own and has no access to revolving credit. The client might (depending on circumstance) be allowed to hold a pre-filled debit card; might be allowed a few dollars in pocket change; and will be required to maintain receipts for all expenditures. The client is placed on a budget. Weekly, upon presentation of receipts, proof of meeting attendance (if required), proof of sessions with health care professionals and others, the Sober Coach evaluates how closely the client has held to the terms of the weekly contract.
The Sober Coach is required to track these expenditures so the client can see his/her their money goes -- so we can see where their money goes -- and so the concerned family member can see where the money goes.
Money, cell phones and emails are the order of the day for a chronic relapser. When we remove the client's access to these triggers, we see either a move toward compliance or true defiance. From that point, the rest of the treatment plan will be determined.
FCM does not work for everyone; in our experience, these clients have experienced the greatest success with FCM:
- Adolescent addicts (male & female);
- Addicts and alcoholics with an acute history of post-residential treatment relapse;
- Prescription medication addicts;
- Clients with a strong, healthy family involvement.
Whether the client is initially compliant or resistant, FCM provides a very clear pathway for success. It allows the Sober Coach to avoid the power shifting and triangulation used by most chronic substance abusers. It is black & white, all on paper, and either compliance exists or it does not. The client does not have the ability to opt out; they don't have any funding with which to do so.
We use FCM most often in cooperation with trusts and with existing treatment professionals. The Sober Companion does not use this method too often; in that relationship, the client is never allowed to carry his or her own money or phone. For more about how a Sober Companion will deal with a clients money, click here.
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