Financial Capacity Building in SUD Treatment: A Co-Creation and Engagement Approach to Intervention Development

Background/Objectives: Low-income individuals with substance use disorders (SUDs) face significant barriers in managing personal finances. While fewer than half have access to traditional financial services, all pay monthly bills. Reestablishing financial functioning is essential to fully recover from addiction. We utilized an intervention mapping (IntMap) approach to assess barriers to developing a financial capacity building intervention among low-income persons receiving public sector SUD treatment. The goal was to strengthen SUD client financial recovery capital, using a co-creation and engagement approach.

Research Questions:

1. Barriers to assessing financial capacity of clients with SUDs?
2. Recommendations from clients and case managers for incorporating money management skills into treatment?
3. Community resources available for potential interventions?

Methods: The team used an IntMap framework, focusing on the first steps: (1) problem logic model, (2) program outcomes and objectives (logic model of change), and (3) program design. The iterative and mixed methods approach utilized surveys and qualitative data. Financial capacity questions were included during intake for all clients over a 24-month period to inform a needs assessment. Program notes, minutes from staff meetings, and administrative records were reviewed for financial capacity building themes and barriers. Initial findings were shared with staff who then initiated financial capacity building conversations with clients. A potential creative partnership with a community bank was explored.

Results: The problem logic model developed through the needs assessment indicates the majority (51%) of clients with SUDs do not have access to financial services through insured financial institutions. Over 70% of clients without a bank account use cash, pre-paid debit cards, or money orders for essentials.

One barrier to the IntMap process was client and staff engagement. Almost 30% of clients asked about financial capacity at intake did not respond. However, over 90% of clients responded to the follow-up study conducted after several months of treatment. Delaying data collection until trust with the clinical staff had been developed facilitated data collection.

We partnered with a local bank to offer financial management classes to a group of 10-12 clients with SUDs. The classes were an initial exploration to assess the community institution’s willingness to partner, and client interest in the subject matter. Classes were used to develop a logic model of change moving clients from their existing financial situation toward additional financial capacity. Feedback from participating clients was overwhelmingly positive, with high reports of usefulness (4.4) and likelihood of recommending the workshop to others (4.5) (scale: 1(low) to 5). Participants noted a particular interest in credit recovery information.

Conclusions and Implications: Financial capacity is a key part of recovery for individuals with SUDs. Using an IntMap strategy and working iteratively with staff, clients, and community members, we completed the initial steps of developing an intervention to build financial capacity among clients in treatment for SUDs. Strategic data collection is necessary, and clients with SUDs need targeted training in credit recovery, financial literacy, and money management skills, which may be possible in partnership with community banks.