Case Management

The 5 stages of Change

The 5 stages of Change

1) Precontemplation

2) Contemplation

3) Developing a plan

4) Implementing the plan

5) Maintenace

Response to client relapse

Look at clients attempts to change rather than their failure and acknowledge them.

Practice reflective listening

Discuss what was learned and what can be done differently.

Identify relapse triggers and warning signs to create a prevention plan.

Response to Precontemplation

Reflect client unreadiness to change back to them.

Look together at their behaviour.

Use “I” statements of how it negatively impacts them.

Invite feedback from the client.

Listen and explore obstacles.

Accept where they are at.

Response to Contemplation

Reflect clients unreadiness back to them.

Do not pressure them to change, reassure them it is their choice when and if they change.

Discuss the risks and benefits of change.

Identify potential solutions.

Collaborate with client (listen and learn to the client and give information.)

Response to developing a plan

Review any past lessons learned.

Brainstorm ideas together.

Support client and take baby steps if needed.

Use tentative “I” messages to express concerns if you think something will not be effective.

Response to Implementing a Plan

Use reflective listening skills

encourage and support their efforts

Response to Maintenace

Identify obstacles of long term success (triggers, environment)

Follow up with them and encourage

Acknowledge their success

Work through any obstacles

Strengths-based Theory

A social work practice theory that emphasizes people's self-determination and strengths. It is a philosophy and a way of viewing clients as resourceful and resilient in the face of adversity.

Life Course Theory

- person-centred, strengths based
            - a multidisciplinary theory model or framework for understanding the person in their environment (PIE) and the influences of time in shaping people’s lives.
            - Time, in various ways, is an influence on the life course: sociology, anthropology, history, psychology, economics, demography, medical/biological, etc. all contribute to our understanding of the life course.
            - is a good framework for social work assessments – it considers biological, psychological, and social transitions along with the impact of historical and social changes over time

- easily allows for information from other theory bases and disciplines to be incorporated or used to understand the life and circumstances of a person, allowing for an eclectic and thorough assessment.

- Key Points:
1. Individual and family development must be understood in the context of time (historical context that the people lived in).

2. All aspects/dimensions/domains of a person’s aging need to be considered - biological , psychological, social, spiritual, etc. What is the clinical term used to describe the above?
BIO-PSYCHO-SOCIAL.

3. Roles and behaviours are affected by our age groups.

4. The choices and actions individuals’ take, and their life path are shaped by the opportunities and constraints of history and social circumstances.

5. Diversity factors such as cohort, gender, race, culture, social class, and individual capacities affect our life course.

6. Experiences with one life transition have an impact on other transitions (+ or -) as well.

4 Phases of Process

1. Assessment

2. Planning

3. Linking

4. Monitoring

Assessment

Diagnostic study of the client and the client’s environment.

            A) involves initial contact with applicant

            B) the initial contact is the starting point

            C) includes gathering the assessing information

Planning

Process of determining future service delivery in an organized way.

            A) individual has met eligibility criteria and is now a client

            B) counsellor and client develop service plan and arrange for service delivery

            C) the plan lists each objective, services needed to reach that objective, and methods of checking progress

D) involves working with other professionals

Linking

Referring the client to the services needed to help them reach their goals.

            A) Nature of agency often determines who provides services and what services are available

            B) Case manager should monitor services

            C) Work closely with other professionals

            D) Evaluate

Monitoring

Keeping track of how well the plan is working for the client and being available when problems arise.

Components of Case Management

          - Case Review

            - Documentation - written record of the work with client

            - Client participation means client takes an active part in the care process

Principles and Goals of Case Management

            - Integration of services

            - Recognize the whole person

            - Clients with multiple problems are best served when services are integrated

            - Continuity of care

            - Equal Access to services

            - Quality Care

            - Client empowerment

            - Evaluation

3 Aspects of Ethical Behaviour

- Moral: moral choices have to do with culture and socialization. We choose what we believe is moral behavior based on what we feel is right, what we have been socialized to view as morally correct, and what the culture in which we grew up would view as morally right. Often, morality is tied to the religion we practice. We internalize certain moral principles and choose to apply these principles as we believe they should be applied. Usually, when we violate what we feel is moral behavior we wrestle with our own guilt, but we usually do not face public condemnation or punitive action unless the behavior is also illegal or violates an ethical code.

- Ethical: ethical behaviour is usually represented in ethical codes. These codes are generally developed as guidelines stipulating the behavior of members in particular groups or professions. They are not applied at the discretion of the individual but are required of the professional to maintain professional status. Violations of these codes will often result in sanctions applied by the group or profession against the individual. Suspension and loss of privileges often follow violations of ethical codes, including the right to continue working in your field.

- Legal: when we refer to what is legal, we are referring to what is the law. Laws will often embody moral and ethical principles, but not always. Governments and the courts determine what is legal and illegal behavior, what behavior is a criminal offense. The courts make decisions about the consequences of illegal behavior.

Boundaries

Limits of the case management role to prevent the relationship from becoming a friendship.
            - defined boundaries in the human services as “invisible barriers that separate various roles and limit the type of interaction expected and considered ethically appropriate for each role.”
            - avoid all dual relationships.
            - avoid accepting gifts to keep the relationship professional.
            - it is a violation of all ethical codes, and in most states against the law, to engage in a sexual or romantic relationship with a person receiving services from you