This points to the importance of the therapeutic alliance between the case manager and client. The power of persuasion on the part of the case manager often helps the client understand the dangers of using substances in the context of their vulnerability to relapse of psychotic episodes. The client must feel sufficient trust and acceptance to confide personal information about drug and alcohol use. A critical and punitive attitude on the part of the case manager is very likely to push the client away. The case manager creates an environment of acceptance and at the same time educate the client about the dangers of drugs and alcohol.
Clients often discuss drug and alcohol use when in the company of their own peers.
In the group intervention, they have the opportunity to role play situations as a means of acquiring skills to say 'No'. The case manager remains mindful of the confidential nature of the personal disclosure and is careful not to breach the trust that has developed. Referrals to Drug and Alcohol Programs are generally avoided except for liaison and assistance with assessment when necessary. Each client is prepared for discharge from PEPP through each stage of treatment and recovery. Discharge is presented as a long-term goal and viewed as an accomplishment.