Case Management to Enhance AIDS Risk Reduction for Injection Drug Users and Crack Cocaine Users: Practical and Philosophical Considerations

Seventy years ago when Mary Richmond (1922), a pioneer in the field of social work, said that social casework consisted of those processes designed to affect adjustments between an individual and the social environment, she could well have been describing case management. Thirty-five years ago Helen Perlman’s (1957) problemsolving model of social casework consisted, in part, of letting people identify their problems and then helping them to mobilize “inner and outer forces” to deal with the problems (Skidmore and Thackeray 1982, p. 69). Case management as a conceptually distinct modality evolved out of social casework in the early 1970s when people who had been released from State mental hospitals returned to their communities and struggled to function successfully. Case management provided a mechanism through which recently released patients, with the assistance of case managers, could navigate the often fragmented social service system to access the resources that would enable them to live and function adequately in their communities (Stein and Test 1980; Test 1981)