Process improvement for behavioral health

Offer Telephone Support


Clients do not have someone to facilitate the journey through addiction treatment and provide support during transitions from one level of care to the next.


Stay in touch with clients during their transition from another level of care to outpatient treatment by using the telephone.

Featured Stories

NRI Community Services in Woonsocket, Rhode Island offers a continuing care/recovery support management program to clients using a telephone support system. The clinician calls the client, rather than depending on the client to call the clinician. The routine phone contact makes it possible to assess relapse and other risk factors and arrange for case management services and face-to-face contacts as needed. Once the client attends the first intensive outpatient appointment, the telephone contacts end. For more information, see the NRI Clinician Manual and Participant Workbook.

Jim Taliaferro Community Mental Health Center in Lawton, Oklahoma uses telemedicine for staffings and consultations between clients and satellite clinics.

Fayette Companies in Peoria, Illinois has their recovery coaches use the telephone to stay in contact with clients. They find it helpful for clients who have declined other types of services (or don’t feel the need for these services) or for clients who have recently disengaged from treatment and are not ready to return.

Women’s Recovery Association in Burlingame, California found that having clients stay in contact with Recovery Coaches weekly increased continuation. Also, after a relapse, clients who had Recovery Coaches returned to using recovery support services sooner than clients who did not have a Recovery Coach. They bought cell phones for clients to help stay in contact wherever they were. Email also helped them stay in contact with transient clients. See the Recovery Management Continuing Care Protocol and Pilot Program Weekly Risk Assessment & Progress Notes for the method they used to assess a client risk.

Lessons Learned

  • Have the clinician initiate the phone call, not the client.
  • Use telephone support to stay connected with clients who decline other forms of treatment.
  • Use cell phones and email to maintain contact with transient clients.

Tracking Measures

Cycle Measure

Percentage of referred clients who were admitted

Data Collection Forms



  • 1. Select one referral source.
  • 2. Identify who will provide telephone support to transitioning clients and how the transition process will be communicated.
  • 3. Collect baseline data for the percentage of referred clients who were admitted for two weeks.


  • 4. Offer telephone support to a selected number of clients for the next two weeks.
  • 5. Track the percentage of referred clients who experienced the telephone support who were admitted.


  • 6. Check the fidelity of the change. Was the change implemented as planned?
  • 7. Evaluate the change:
    • To what extent was the telephone support used?
    • Did the percentage of referred clients who were admitted increase?


  • 8. If this change was an improvement:
    • Adopt this change or adapt it for more improvement and re-test it with the same referral source.
    • Make this process available to all of the clients from the same referral source.
    • Expand the use of this process to other referral sources.
    • Document the processes that resulted in an improvement so that you can continue to use them efficiently.
    • Test other, related promising practices that apply to your setting.

If this change was not an improvement and you can’t make it work, abandon this practice and test other promising practices that might be more successful in your setting.