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What is Case Management?

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  1. Paul Turnbull Amy Kirby DOMICE Conference 2011 What is Case Management?

  2. What I’m going to do • Definitions and aims of case management • Models of case management • How case management can be applied to probation • Concerns about case management • Suggested improvements to case management

  3. Origins of Case Management • Case management originated in the US in the latter half of the twentieth century • First developed in the mental health field • Case management developed further 1980s (See Marshall, 1996; Holt 2000 and Keetley and Weaver, 2005)

  4. Definitions • Case management is difficult to define • Need for flexibility • Definition depends on the goals of CM and the setting • CM is a ‘family of related approaches’ (see Murphy Healy, 1999; Keetley and Weaver, 2005; McNeill, 2009 )

  5. Aims of Case Management • To sustain contact with a client • To improve health and social functioning (Keetley and Weaver, 2005) 3) To reduce and prevent re-offending

  6. Process of Case Management

  7. Process of Case Management • Referral • Assessment and engagement • Implementation of care plan/service delivery

  8. Process of Case Management • Monitoring • Review

  9. Application of Case Management to Probation Holt (2000) What needs to happen in order to transfer CM to a probation setting? • clarify the relationship between goals of the service and the part that the case manager plays in meeting them • clarify the theoretical model used • identify the main users • create an appropriate tool for measuring effectiveness (which focuses on the link between ‘process’ and ‘outcome’)

  10. Models of Case Management In Probation Holt (2000) 4 elements of case management (‘4 C’s’): • Consistency • Continuity • Consolidation • Commitment

  11. Models of case management in probation 3 models of case management: • Specialist • Generic • Hybrid Shared principles: • ‘Continuity of contact’ • Teamwork • Face to face meetings • Consideration of contextual factors

  12. Core Correctional Practice (Dowden and Andrews, 2004) 5 elements: • ‘Firm but fair’ approach • Modelling and reinforcement to improve pro-social behaviour and cognitive skills • Teaching problem solving skills • Effective use of community sanctions • Relationship factors- need for ‘open, warm and enthusiastic communication’

  13. Concerns • Fragmentation: due to the separation of case management and interventions and the separation of roles. Concerns about effects this could have on relationships (see Raynor and Maguire, 2006; Robinson, 2005; Faulkner, 2008). • Theoretical basis for case management: Discrepancies between case management theory and practice. Concerns over extent to which theory and practice fits in with what works principles (Stanley, 2009)

  14. Concerns • Commodification: introduction of a profit motive into probation by contracting private organisations. Possible effects this could have on voluntary organisations and supervisory relationships (see McCulloch and McNeill, 2007; Allen and Hough, 2006; McSweeney and Hough, 2006; Hough, 2006) • Staff morale: Holt’s ‘4 C’s’ have not been applied to probation staff (see Robinson and Burnett, 2007; Robinson, 2007)

  15. Suggested improvements • Reintroduction of ‘forgotten’ good practice e.g. negotiated consent (Robinson and Raynor, 2006) • Craft Model (Hough, 2010) Training: • ‘Open, consultative and participatory’ (Gibbs, 1999). • Needs to be collaborative and involved team working events (PA Consultancy, MORI, 2005). • Importance of thorough training for all members of the probation team (Knight and Stout, 2009) Contestability: • Creation of ‘shared enterprise’ (McSweeney & Hough, 2006)

  16. Good Practices for Case Managers Focus on one criminogenic need per session and only brief discussion of conditions (Bonta et al, 2008) Role probation officers could have in helping offenders to rebuild family links.

  17. Barriers to effective case management • High workload • Difficult client group with a range of complex needs • Lack of political will (see Mills and Codd, 2008; Maguire and Raynor, 2006)

  18. Summary • Case management has a range of meanings within different settings • But the aim should be to sustain contact with client and improve their position • And can be achieved through a process of assessment, engagement, planning, implementation, monitoring and review