Quality chemical dependency treatment in an era of cost containment: clinical guidelines for practitioners

The increased demand for effective chemical dependency treatment combined with the escalating cost of mental health and chemical dependency care creates a challenge to balance the quality and cost of care. Social workers can successfully meet this challenge through individualizing client care by matching the client's needs to the appropriate level of care. Three clinical guidelines designed to deliver quality care that is cost-effective are offered: (1) Use the least-restrictive level of care most likely to initiate abstinence. (2) Assess the likelihood of treatment failure at the level of care chosen and the risks to the client if treatment fails. (3) Identify treatment failure quickly and move the client to a more-intensive level of care if significant risks are present. Combining these guidelines with an integrated treatment delivery system and appropriately trained practitioners can benefit clients, providers, and payers of chemical dependency care.