Case Management
Sarah Himmelheber, LCSW
In today’s discussion...
Defining case management
Reviewing models of case management
Process of rapport building
Developing case plans
Working the case
Successfully partnering with clients
Discharge process
Confidentiality issues
Supervision
Self-care strategies
Case examples
What is Case Management?
Type of service to clients
coordinating and therapeutic
function for clients receiving
services
Defining the case
Goals of the working relationship
Objectives and interventions
Timeline/ boundaries of the
relationship
Models of Case Management
The Broker
The primary function is to link the client to
needed, usually external, resources. This model
limits the role of the case manager/ client
relationship. The main task is to identify what
the client needs and then to facilitate the referral
so the client is connected to the service provider.
The Rehabilitationist
The Rehabilitation model identifies strengths
and deficits of the client and attempts to remedy
a wide array of problems and barriers that may
include medical, mental health, vocational and
housing issues. The case manager’s role is to
assist the client in overcoming barriers that
prevent independent functioning in the
community. When barriers have been addressed,
the relationship between the case manager and
the client is reduced or terminated.
Models of Case Management
The Full Support
By using an integrated team of providers including case
managers, outreach workers, rehabilitation specialists,
and medical professionals, this model relies less on
outside referrals and provides the client with in-house
service delivery. In this model the case manager not
only coordinates care but also provides clinical support
and life skills training.
“Full Support” models have been effective in reducing
inpatient psychiatric hospitalizations and are generally
used with clients who have long-term care needs. The
relationship between client and the treatment team is
open-ended and ongoing rather than limited to specific
goals (Draine, 1997). Determining when to terminate
services can be challenging when using this model.
Models of Case Management
The Strengths Model
As implied in the name, the Strengths model
avoids assessing client needs in terms of
pathology or deficits. The focus is exclusively
on strengths. Self-determination of the client
and assisting with client-specific goals are
the task of the case manager. This model
places strong emphasis on case manager-
client relationships. The efficacy of this
model relies on intensive outreach and
follow up (Standard, 1999, Rapp, 1998).
Fliesher, P. and Henrickson, M. (2002). Towards a Typology of Case
Management.
Retrieved from:
http://www.hawaii.edu/hivandaids/Towards%20a%20Typology%20o
f%20Case%20Management.pdf
Building the Trust Relationship
• Living social work values
• Using active listening skills
• Task-centered trust
development
Social Work Values
Service
Social justice
Dignity and worth of the
person
Importance of human
relationships
Integrity
Competence
Active Listening Skills
Reflecting
Paraphrasing
Clarifying
Summarizing
Active Listening Exercise
Partner up, with each person
playing the client once
Refer to active listening
scenario handout
Comments?
Limitations to active listening
Serves as a starting point
Task-Centered
Trust Development
Method for building relationships
with apprehensive clients
Cleaning
Food inventory/ meal planning/
grocery shopping
Public transportation assistance
Side-by-side linking
Community-based or office-based
Moving towards...
Developing a Case Plan
Example cases?
Realism
In goal formulation
The role of you/ your agency
Resources
Developing the Case Plan
Intake process
Review example form
Goal and objective
formulation
Keeping a time frame
Schedule towards the goal
Interventions: what you can
do
Dealing with challenges
Working the Plan….
Knowing your local resources
Coalitions
Staff time to attend meetings
Organizational strategies
Post-meeting notes
Scheduled office time
Jointly monitoring and
reviewing goals
Celebrating progress
Whose Case Is This?
Idea of progressive client control
May be related to length of case plan
Boundaries
What type are appropriate?
Strategies for handling challenges
Avoiding us/them
Modeling
Responsibility
Acceptance
Understanding
Expectations for the working relationship
Dealing with Challenges
Strategies for improving
the relationship
Back to assessment
Highlighting changes
The importance of
documentation
The Discharge Process
May vary by service provider
Connected to goals
Start from the first session
What ought to be included
Medicare defines discharge
planning this way: “A process used
to decide what a patient needs for
a smooth move from one level of
care to another.”
Review example form
Confidentiality Issues
Within agencies
Employees & volunteers
Review example volunteer form
With other agencies
Review example Release of
Information form
Supervision
Formal versus informal
What to cover
Stress and Self-Care
• Being mindful of stress
- Signs of stress?
• Strategies for stress reduction ...
• How to ask for a break...
"We learned that it was not the clients themselves who
were causing the major portion of the stress, but the
work environment itself," said Tracy Whitaker,
director of the Center. "The primary stress social
workers face is that they don't have enough time to
do their jobs, and related to that, have too heavy a
workload. This was true across practice areas.”
http://www.naswdc.org/pubs/news/2008/11/self-care.asp
Wrapping Up…
Case Examples?
Questions & Ideas?
Thank you!
Contact information:
Sarah Himmelheber, LCSW
sarah.himmelheber@gmail.com