Fiduciary Case Management (FCM)

Sober Champion Articles

Fiduciary Case Management (FCM)

Fiduciary Case Management is a finely calibrated plan to encourage positive behaviors, and to discourage harmful ones. When a substance dependent person has substantial resources at his disposal – whether or not there exists an organic desire to become abstinent – his resources must be managed by someone other than himself.  This is the role of a Fiduciary Case Manager (FCM). Clients appreciate a multi-faceted approach toward treating their addiction for one basic reason: they need it.  There is much more involved than just keeping someone away from booze and dope; any professional provider must plan for financial contingencies when contending with high-net worth clients.

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Fiduciary Case Management (FCM)

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 (FCM).

 

FCM involves a series of protocols wherein the subject holds no funds of his or her own and has no access to revolving credit. The subject 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 subject 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 subject has held to the terms of the weekly contract.

 

The Sober Coach/FCM is required to track these expenditures so the client can see where his/her their money goes — so we can see where their money goes — and so concerned family members, attorneys, trust administrators and (often) courts also can see where the money goes.

 

Money, cell phones and emails are the order of the day for a substance dependent person who suffers from regular relapse. When a professional removes the subject’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 is not required for every Sober Champion subject, and it does not work for everyone; in the experiences of most addiction treatment professionals, 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 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. Clients have no ability to opt out, because they have no funding with which to do so.

 

 

Part of the answer is a straightforward process called Fiduciary Case Management (FCM).

 

FCM protocols we use during a Sober Companion service are a little different than those we use during Sober Coaching. Unless there is a deviation from our standard contract, our staff will not allow the client to hold his/her own cell phone, wallet, credit/debit cards or cash. We tailor the protocol to the client – often, there will be no internet access without direct supervision.

 

Though a client might have a deep desire to stay clean, there are times when his ability to make the right move just seems to disappear – without warning. That’s where we come in, and it’s why FCM is a crucial tool for people in early recovery from addiction.

 

The Sober Coach’s job goes way beyond hanging out and shopping with our clients. Our goal is to help you stay away from drugs & alcohol, but not at the expense of your sanity. We encourage our clients to accept and engage personal responsibility without throwing caution to the wind.

 

We use varying levels of FCM with our 24-hour clients because it really works. FCM protocols are laid into the contract and are clearly defined for clarity and ease of use. With this foundation, the client understands where his/her power and access to funding lie.

 

FCM is not a panacea for people intent on relapse; if you are hell-bent on getting loaded, you will do it eventually. If you are at the in-between stage (which is where most recovering people find themselves immediately after treatment or intervention), the presence of a Sober Companion and a Fiduciary Case Management contract provide structure and balance required to make the right decision – especially when the wrong decision looks really tasty.