Case Management Meeting people where they are, with what they have, to get to where they are going…
Philosophy of Case Management Case Management focuses on strengthening an individual’s ability to maintain wellness at an optimum level. The aim is to encourage, exemplify, and equip. Case Management involves a collaborative effort of both the case manager and the consumer. This effort includes: - Assessing - Advocating - Linking - Monitoring - Referring Each of these components, along with counseling services, are used to provide a support and a foundation in the recovery process.
Substance Abuse Services of ODMHSAS believes that Case Management: • Enhances a path towards recovery • Activates a hidden resource within an individual striving for change • Reforms an individual’s state of mind • Navigates individuals towards success
In providing Case Management… ODMHSAS believes in the Strengths- Based Model approach in offering services.
Strengths-Based Model “This model suggests that individuals and communities have strengths that can be called forth, expanded, and matched to help people reach their potential. These same processes can help all of us lead successful and satisfying lives.” W. Patrick Sullivan, Ph.D. Professor Indiana University School of Social Work
What do mean by “strengths?” Strengths include: • Qualities/Personal Characteristics (Friendly, kind, dependable, sensitive, etc.) • Skills/Talents (good cook, good guitar player, great memory, etc.) • Environmental Strengths (my dog Rex, bicycle, SSI check, church group, etc.) • Interests/Aspirations (start a business, have my own place, become a chef) Chapter 5: Strengths Assessment: Amplifying the Well Part of the Individual. Rapp & Goscha, The Strengths Model; 2nd Edition.
So…. What are the core values and beliefs that drives all the techniques and skills in this model?
Six Strengths Principles “The following six principles are the transition between the theory which seeks to explain people succeeding in life and the specific methods for assisting people toward that end. The principles are the governing laws, or values, or tenants upon which the methods are based.” (p. 122) Rapp, C. (1998) The Strengths Model of Case Management. New York: Oxford University Press.
The Six Strengths Principles 1. People have the capacity to recover, reclaim and transform their lives. 6. The community is an oasis ofThe Six Strengths Principlesresources. 5. Preferred setting for our work is the community. 2. The focus is on the individual strengths rather than deficits. 4. The relationship is primary and essential. 3. The client is seen as the directorof the helping relationship.
Strengths-Based Practice • Philosophy of Practice • Way of viewing the people we serve • Way of being in relationship to people • Set of Tools • Strength Assessment • Personal Plan (Service Plan) • Group Supervision University of Kansas, School of Social Welfare
THE SEVEN CORE HELPING FUNCTIONS OF THE STRENGTHS MODEL
FUNCTION 1 • ENGAGEMENT: Activities and responses specifically designed to promote the development of a collaborative, reciprocal helping partnership.
FUNCTION 2 • GRADUATED DISENGAGEMENT: Activities and responses specifically designed to incorporate naturally occurring helpers/resources into the individualized community living plan.
FUNCTION 3 • ASSESSMENT: Data focused on what people currently have going for them in essential life areas; what their personal desires are relative to each of these areas; and how they have experienced outcomes in these areas in the past. The data gathering is focused on each person’s unique desires, aspirations, and WANTS (motivation).
FUNCTION 4 • PLANNING: Actively identifying with person the NEEDS related to personal goals that have been identified in the assessment. It is in the planning stage that activities related to personal deficits, problems, and symptoms are identified and mutually negotiated.
FUNCTION 5 • IMPLEMENTATION: Collectively activating the plan, primarily through the sub-functions of ADVOCACY AND LINKAGE. The case management helping process has, at its core, the goal of increasing access to resources and promoting supportive connections in the community.
FUNCTION 6 • MONITORING: Meeting with service participants and resource providers at regular intervals to identify progress, modify, adjust and build on the plan, and to honor the learning that occurs in the recovery process.
FUNCTION 7 • SUPPORTIVE COUNSELING: Providing information, ideas, affirmation, validation, gently challenging, providing caring encouragement, instilling hope, honoring one’s cultural world view, and embracing spontaneous celebration, joy and humor.
An area of importance in the Strength-Based Model is the helping relationship between case manager and consumer.
What is the of definition of “help” within the Strengths-Based Model? To assist individuals, families, and communities within the context of a mutually enriching, collaborative partnership, to identify, secure, and sustain the range of resources, both external and internal, needed to live in a normally interdependent manner in the community.
Critical Elements of the Helping Relationship An effective helping relationship should be: • Purposeful(goal-directed towards helping the consumer) • Reciprocal(learning from each other/be a support not a dictator) • Genuine(show a sense of sincere commitment to his/her journey) • Trusting(mutual trust & respect/demonstrate consistency) • Empowering(assist the consumer in making their own decisions) University of Kansas, School of Social Welfare
Hope Inducing Behaviors • Giving positive encouraging comments • Following through on appointments • Communicating a “Can Do” attitude • Celebrating accomplishments/successes • Going with a person to a doctor appointment or court hearing for support and to reduce fear University of Kansas, School of Social Welfare
Hope Inducing Behaviors (cont.) • Helping a person establish goals • Generating many options for what the person wants • Providing education to people about their recovery • Communicating with people that they may not need services forever University of Kansas, School of Social Welfare
Scenario 1 Due to experiencing several toothaches within the past month David wants to set up an appointment with a dentist. You have assisted him in this process several times but he always failed to follow through with his appointment. Today, he comes to you again and tells you that he needs to set up an appointment…. How would you engage David?
Spirit Breaking Behaviors • Telling people they aren’t ready to work • Imposing our own standard of living on people • Not listening to what a person is saying • Accepting charity (e.g. going to food banks, second hand stores) University of Kansas, School of Social Welfare
Spirit Breaking (cont.) • Refusing to do something because “it’s not my job” • Family members controlling decisions for client • Employers/employees treating the person poorly • Lack of support by family University of Kansas, School of Social Welfare
Scenario 2 You are assigned to Michelle to become her case manager. Upon meeting her for the first time, she appeared disheveled and distressed. She expresses how grateful she is for you to be her case manager and begins to tell you that she cannot pay her rent, her car does not work, she lost her job, cannot find a daycare for her 3 yr old child, and needs to get her prescription refilled. How do you engage Michelle?
Core Behaviors for Engagement in the Strengths Model • Schedule meetings with the person at a time and place (provides community choices) mutually agreed upon. (In most situations, minimum contact is one time per week.) • Case manager and consumer are involved in an informal activity as a backdrop of getting to know each other (e.g. cup of coffee, exploring interests, walking, etc.) • Case manager engages person in a conversational manner, exploring interests and experiences that they have in common. University of Kansas, School of Social Welfare
Core Behaviors for Engagement (cont.) • Case manager uses empathy, reinforcing comments, both verbally and non-verbally • Case manager discusses purpose of case management and mutual expectations (Looks toward replacement of self, focusing on graduated disengagement) • Case manager uses every opportunity to identify personal and environmental strength University of Kansas, School of Social Welfare
Core Behaviors for Engagement (cont.) • Case manager uses every opportunity to identify personal and environmental strength • If having difficulty engaging with a person, case manager reviews with team in group supervision by presenting clearly and concisely the situation to generate new ideas. University of Kansas, School of Social Welfare
Another area of importance in the Strength-Based is obtaining the information needed to assist the consumer on their recovery journey.
Completing a strength assessment helps the consumer and case manager be aware of the resources the person currently has and have accumulated, as well as, obtaining information needed to help them in their journey of transition and maintenance.
A strength assessment should include areas that are essential to consumers. According to The Strengths Model these areas include: - - Daily living situation - Health - Financial/Insurance - Leisure/ Recreational - Vocational/Educational - Spirituality - Social Supports Each area is divided into three temporal categories: • Current status - (includes personal competencies and the person’s present life circumstances) “What are my current strengths?” • Desires and aspirations - (refer to the future) “What do I want?” • History - (learn what kinds of resources the person used in the past) “What strengths have I used in the past?”
According to The Strengths Model, a strength assessment should be: • thorough, detailed, and specific • part of an ongoing process in which information is updated on a regular basis; • conducted in a conversational manner; • from the client’s perspective and be written in a person’s own words; • evolve at a client’s pace
The third area of importance in the Strengths-Based Model is the development of a consumer’s plan towards recovery.
What factors affect goal achievement? * Interests/Desires * Skills * Confidence * Environmental Resources and Supports University of Kansas, School of Social Welfare
Common Challenges to Setting Goals: • The person’s goal seems unrealistic, grandiose or delusional. • The person’s goal is vague • The person has no goals.
The last area of importance in the Strengths-Based Model is Group Supervision.
Group Supervision Group supervision is the fuel that keeps strengths model practice alive and strong on a team level. The structure is design to keep the team focused on generating creative strategies, rather than digressing into venting or rehashing of problems. University of Kansas, School of Social Welfare
For each client discussed, the process consists of six steps: • Hand out strengths assessments • What is the client goal(s) and what help do I specifically need from the group? • What is the current situation and what has been already tried? • What does the team need clarified from the strengths assessment? • Brainstorming • What will be my plan based upon the suggestions made? University of Kansas, School of Social Welfare
Always remember, Case Management. . . . - identifies the needs of individuals- helps individuals to see hope on the horizon- provides a way for individuals to go forward in life.
Acknowledgements • The Kansas Department of Social and Rehabilitation Services • University of Kansas School of Social Welfare (Lawrence, Kansas) • The Strengths Model: Case Management with People with Psychiatric Disabilities. Rapp, Charles A. & Goscha, Richard J. (2006)
Contacts Coordinator of Case Management and PACT Services Dawn Talton Phone: (405) 522-3856 Email: firstname.lastname@example.org Field Service Coordinator/ Case Management (SA Recovery Division) Kodi Pollard Phone: (405) 522-2347 Email: email@example.com OHCA Contact (Case Management): Erin Meyer Phone: (405) 522-7772 Email: Erin.Meyer@okhca.org