PS450 Unit 7 Treatment Team Paper Example

The Recovery House That Banned Her Medication: A PS450 Unit 7 Treatment Team Paper

[Student Name]

Purdue University Global

PS450: Case Management in Clinical Settings

Unit 7 Treatment Team Paper

[Instructor Name]

[Date]

The client, the team members and the housing are composite; the reviews cited are real.

The Team

Four months into the court program, Brandi had a team of eight people around her. The judge chairs staffing meetings and decides on sanctions and incentives. The court coordinator manages schedules and data. A child protective services caseworker is responsible for her two children's safety. Her counselor provides individual and group treatment. A nurse practitioner prescribes her buprenorphine. A peer recovery coach meets her weekly. Her defense attorney protects her legal interests. I am her case manager, responsible for linking her to services and coordinating among the others.

Each member has a different mandate. The caseworker's legal duty is to the children. The counselor's and nurse practitioner's duties are to Brandi's health. The judge balances accountability with support. Those mandates usually point in the same direction, toward a healthy parent and a safe reunion. In June they did not.

The Conflict

Brandi needed housing. The caseworker had made clear that the friend's apartment where Brandi was staying was not suitable for her children, and federal timelines in child welfare cases press for permanent plans for children within months. The caseworker found an opening at a residential recovery house for women with children, a two-bedroom unit with on-site support, available immediately.

The house had a rule: no residents on medications for opioid use disorder. Brandi had been taking buprenorphine for six months and had not used opioids since starting it.

At the staffing meeting, the caseworker argued that the house offered exactly what the children needed: stability, supervision and a sober environment. The nurse practitioner objected that stopping buprenorphine would put Brandi in danger, and that the house's rule reflected stigma rather than evidence. She cited a meta-analysis of cohort studies showing that death rates among people with opioid dependence were far lower while they stayed on methadone or buprenorphine than after they stopped, with the weeks just after stopping especially dangerous (Sordo et al., 2017). For a mother whose children were about to move in with her, that risk was not abstract. The counselor agreed and added that Brandi's trauma symptoms made a sudden change in treatment particularly risky. The peer coach, who is in recovery on methadone, said quietly that she had lost a friend who stopped medication to get into a house like this one. The judge asked whether there was another option.

Both sides of the dispute were protecting someone; the team's task was to find a path that did not require choosing between Brandi's medication and her children's home.

What Effective Teams Share

Woltmann et al. (2012) pooled randomized trials of collaborative chronic care, testing it in primary care clinics, specialty mental health and behavioral health programs alike. These models organize care around teams with defined roles, care management, shared information systems and decision support. The review found that they improved mental health outcomes, including symptoms and quality of life, across a range of conditions and settings, without large increases in cost.

When Cochrane reviewers looked at efforts to help professions work together better, through tools like structured team meetings and shared goals, they judged the overall evidence thin and uncertain, but suggested that practice-based activities like regular team rounds and checklists may improve some aspects of care (Reeves et al., 2017). The authors called for better research rather than concluding that collaboration does not matter.

Together, these reviews point to features that make teams work: clear roles, structured communication, shared goals and someone responsible for following through. In Brandi's team, the roles were clear, and the staffing meeting provided structure. What was missing at first was a shared goal broad enough to include both the children's housing and Brandi's medication.

Resolving the Dispute

My role was to change the question from which mandate wins to what option satisfies both. Three steps followed. First, I asked the team to agree on the shared goal: stable housing for Brandi and her children, with her treatment unchanged. Everyone, including the caseworker, agreed with that framing.

Second, I took responsibility for finding alternatives. Within a week I identified a recovery residence an hour away that accepts residents on medication, and a transitional housing program in town that has no medication restriction and offers family units, with a two-week wait. I also learned from the state's recovery housing association that houses receiving certain state funds are expected not to exclude residents on medication, and shared that information with the caseworker.

Third, I brought Brandi into the decision, which the team had been discussing without her. She chose the transitional program in town, to stay near her children's school and her job, and asked whether she could bring her daughter for weekend overnight visits while she waited. The judge approved the plan at the next hearing.

Afterward

The decision had effects beyond housing. The caseworker, who had not known the medication rule existed when she proposed the house, asked me to share the list of recovery residences that accept medication with her whole unit. The peer coach told me that it was the first staffing meeting where she felt her experience had changed the outcome. And Brandi, who had not been told about the house until after the meeting, asked to attend future staffings for any decision about where she would live. The judge agreed that she could attend the portion of each staffing that concerned her plan.

What the Conflict Showed

The conflict revealed both a strength and a weakness of Brandi's team. The strength was that members spoke openly about their mandates and trusted the process enough to disagree. The weakness was that the team had begun to decide for Brandi rather than with her, and that no one had been assigned to look for alternatives until the case manager took it on. Both lessons fit the research: effective teams combine clear roles with someone responsible for coordinating and following through, and they keep the client at the center.

Conclusion

Brandi's team faced a conflict between child safety and medical treatment that neither side could resolve alone. Research on collaborative care shows that teams with defined roles and coordination improve outcomes, and the evidence on interprofessional collaboration suggests structured practices help. In this case, a shared goal, a search for alternatives and Brandi's own choice turned an impasse into a plan.

References

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 2017(6), Article CD000072. https://doi.org/10.1002/14651858.CD000072.pub3

Sordo, L., Barrio, G., Bravo, M. J., Indave, B. I., Degenhardt, L., Wiessing, L., Ferri, M., & Pastor-Barriuso, R. (2017). Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ, 357, Article j1550. https://doi.org/10.1136/bmj.j1550

Woltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. S. (2012). Comparative effectiveness of collaborative chronic care models for mental health conditions across primary, specialty, and behavioral health care settings: Systematic review and meta-analysis. American Journal of Psychiatry, 169(8), 790-804. https://doi.org/10.1176/appi.ajp.2012.11111616