Case Management Core Concepts

Person-Centered Ecological Approach to Case Management

• Core Attitudes:

  • Acceptance: Meet clients where they are, validating their experiences.

  • Self-Determination: Respect clients' choices, supporting autonomy.

  • Nonjudgmental Attitude: Listen without judgment to foster trust.

  • Motivation & Encouragement: Instill hope, highlight strengths.

  • Collaboration: Partner with clients, valuing their contributions.

  • Individualized Planning: Recognize unique strengths and needs.

  • Seeing Clients as Separate: Maintain boundaries, avoid emotional intrusion.

• Key Skills:

  • Reflective Listening: Show acceptance, encourage progress.

  • Open Questions: Invite clients to share what matters to them.

  • I-Messages: Share concerns tentatively.

  • Disarming Anger: Accept criticism, stay non-defensive.

  • Informed Consent: Provide clear information to empower decisions.

Handling Initial Inquiries

• Collect essential information from the person seeking services.

• Referral Source:

  • If not the client, gather info about the problem, demographics, and contact details.

  • If the client, gather the same info but also assess/address distress and schedule intake.

• Both Cases:

  • Obtain demographic information.

  • Document the chief complaint briefly.

Steps for "New Referral or Inquiry" Form

1. Record name, sex, DOB, address.

2. Note home/work phone numbers.

3. Indicate parent/spouse (or N/A).

4. List employer (or N/A).

5. Specify school (or N/A).

6. Note referral source (self, doctor, etc.).

7. Document "Chief Complaint".

8. Summarize previous treatment briefly.

9. Note disposition of client with brief language.

10. Confirm and verify appointment for intake.

11. Sign and date the intake.

• Chief Complaint Tips:

  • Be specific, brief; avoid generalities.

  • Note distress/motivation.

• Be formal, use black ink, no pencil or correction liquid, sign/date, use N/A not blanks

• Show clients unconditional positive regard and authentic presence!

The First Interview/Intake Assessment

• Goal: Build a holistic understanding of the client’s situation and needs.

• Gather information about:

  1. Presenting problem and related needs.

  2. Relevant history related to the chief complaint.

  3. Client-identified needs and priorities.

  4. Client’s support system.

  5. Client’s current services/providers.

  6. Client’s strengths.

  7. Potential areas of risk and challenges.

  8. Client’s identity (values, beliefs, self-concept, etc.).

  9. Client’s readiness for change.

  10. Client’s disposition/affect.

Preparing for the Interview

• Review Intake Materials:

  • Consult the intake report, check past records.

  • Approach records critically.

• Prepare Questions:

  • Prepare questions about overall health and well-being.

  • Prepare questions about presenting problem/chief complaint.

  • Prepare questions about inconsistencies in records.

  • Prepare questions about client’s interests, strengths, and past successes.

  • Have a question prepared about risks and safety that is standard and includes specific language.

Meeting and Greeting the Client

• Make a Good Professional First Impression to Foster Rapport.

• Greet the client warmly, whether on the phone, computer, or in person.

• Make your initial greeting formal (may become less formal later) and use ‘Hello Mr.., Ms.".

• Formally introduce yourself and let the client know your role/position is at the agency and what to call you.

• Make initial observations about the client’s affect, presentation, social skills.

• Demonstrate your deep curiosity about the client (client-focus).

• Redirect personal inquiries and set boundaries early.

Accurately Collecting Information

• Collect enough information and accurate information.

• Use open questions, conversational style; the use of closed ended questions for verification and clarification.

• Allow space for the client to tell their story.

• Reflect content and feelings and show empathy.

• Keep a posture of curiosity.

• Avoid any verbal or non-verbal expressions that show disapproval or judgement.

• Explore the Presenting Problem/Chief Complaint.

• Explore deeper by asking ”why now?”.

• Explore how the issue is impacting their functioning or well-being.

• Explore known supports and protective factors as they relate to the presenting problem.

• Explore readiness for change as it pertains to the presenting problem.

Asking Questions and Avoiding Intrusions

• Balance between keeping things organic, collecting info, and being tactful.

• Open Questions: Encourage elaboration

• Closed Questions: Use sparingly

• Why Questions: Generally be avoided due to tendency to be viewed as judgment

• Tread carefully; avoid pushing clients too hard.

• Understand what is important to them (needs) and enough details to make goals/plan

Client Expectations and Responsibilities

• Clarify needs, expectations, and responsibilities.

• Understand expectations:

  • "In what ways do you envision me being able to help you with those needs?”

  • “What services are you hoping to be linked up with?”

  • “If you had to pick the top 5 needs in your life right now, what would they be?”

• Client Responsibilities:

  1. Fill out and sign necessary paperwork

  2. Provide necessary documents/consents/etc.

  3. Keep appointments

  4. Be on time and respectful

  5. Be honest and open with CM during the process

• Be clear about things like call-back windows availability, and any other policies or procedures that are important to understand (no-show policy, etc.)

Wrapping Up the First Interview/Assessment

• Summarize the problem/needs with the client.

• Summarize client expectations.

• Discuss client responsibilities and CM responsibilities.

• Discuss next steps to develop (or complete) the treatment plan.

• Remind about communication methods and policies.

• Make concrete plan for next appointment and give reminder card, email, text.

• Ask if client has any other questions.

• Offer any immediate resources (especially related to safety and health).

• End session with authentic statement about desire to help and offer optimism about process.