Case management and behavioral contracting. Components of rural substance abuse treatment

This article presents a model of case management with rural clients entering drug and alcohol treatment. As part of a larger treatment protocol called Structured Behavioral Outpatient Rural Therapy, behavioral contracting is combined with strengths perspective case management to help rural clients motivate themselves to engage and complete drug and alcohol treatment. This combined approach is designed to continually communicate and teach an "A-B-C" cognitive-behavioral approach to problem-solving and change. While not a panacea for addressing the myriad problems facing clients with drug use problems, such an approach promises to improve "treatment as usual" formats, which often ignore the formidable obstacles to human change experienced by rural clients and clinicians.