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The Functions of Case Management - correct answer Assessment Planning Linking Advocacy Monitoring Assessment (Functions of CM) - correct answer Identify clients' strengths, weaknesses, and needs. Planning (Functions of CM) - correct answer Linking (Functions of CM) - correct answer Help clients obtain required services by referring or transferring clients to services in the formal and informal care-giving systems. Advocacy (Functions of CM) - correct answer Intercede on behalf of the client to obtain needed resources. Monitoring (Functions of CM) - correct answer Evaluate progress continuously and take action if needed. Models of Case Management - correct answer Brokerage/Generalist Model Assertive Community Treatment Model Strengths-Based Model
Clinical/Rehabilitation Model Brokerage/Generalist (Models of Case Management) - correct answer In this model, the case manager identifies clients' needs and helps them access the necessary resources. Ongoing monitoring is not emphasized, nor is advocacy. The brokerage/generalist model is most useful when there is a problem with access, not availability, of resources. (Models of Case Management) - correct answer Assertive Community Treatment (Models of Case Management) - correct answer the case manager has frequent, long-term contact with clients in their natural settings (e.g., home), focusing on the practical problems of daily living. Advocacy is emphasized Strength-Based (Models of Case Management) - correct answer In this model, the case manager supports clients in their search for resources. It encourages the use of informal helping networks as opposed to institutional ones. It involves aggressive outreach to clients, helps clients develop their own goals, and emphasizes the role of advocacy. Some of the principles of the strengths perspective are encouraging client control over the search for those resources they perceive as needed and viewing the community as a resource and not a barrier (Siegal, Rapp, Kelliher, Fisher, Wagner & Cole, 1995). Part of the value of traditional substance abuse treatment based on the disease concept is that it gives straightforward structure to a life that may have lacked adequate rules and structure. The strengths-based approach is an alternative to the disease concept approach, which some assert may actually intensify problems for some clients (Siegal, et al., 1995).
being unable to attend treatment during certain hours might be a barrier to participating in some treatment programs. It is sometimes important that barriers to entering treatment be removed quickly, since clients may lose their motivation to enter treatment if there is a delay in getting started. In this phase, the case manager assesses the client in order to identify problems that would be amenable to treatment. Primary Treatment (The Treatment Continuum) - correct answer At this phase, the case manager orients the client to the program and may help the client resolve immediate problems that would keep him/her from focusing on treatment. The case manager makes a plan for resource acquisition to meet the client's short-term needs. The case manager also organizes the timing and application of services, provides support during transitions, promotes client independence, intervenes to avoid or respond to crises, and develops external support structures to facilitate community integration, advocates for the client in all areas of life, coordinates the timing of various interventions to ensure that the client can achieve goals, and plans for discharge and re-entry into the community. Clients benefit from case management services while participating in any category or level of primary treatment. The American Society of Addiction Medicine's (2001) levels are early intervention (level .05), outpatient services (level I), intensive outpatient or partial hospitalization (level II), residential or inpatient services (level III), and medically managed intensive inpatient services (level IV). Aftercare (The Treatment Continuum) - correct answer Aftercare, sometimes called continuing care, follows discharge. At this phase, case managers help clients transition out of treatment and take responsibility for their lives. The client may need housing, a source of income, or
a social support system. Disengagement (The Treatment Continuum) - correct answer Ideally, disengagement can take place over time. The case manager and client can discuss what the client learned from interacting with different service providers and be encouraged to continue accessing the resources the client needs in life. Case Management Improves Outcomes - correct answer Clients are more likely to get appropriate services when attention is paid to case management, and this increases the likelihood of positive outcomes. For example, McLellan, Hagan, Levine, Meyers, Gould, Bencivengo & Jaffe (1999) found that clients who had received clinical case management had better outcomes in terms of alcohol use, medical status, employment, family relations, and legal status at 6 months following treatment than those who did not. They noted that case management worked best when staff was trained to collaborate with each other rather than engage in rivalry and when pre-contracting for services to ensure availability was arranged. Community Resources - correct answer Case management may involve coordination with a variety of resources in the community including child protection systems, criminal justice institutions, primary health care providers, psychological testing services, social service systems, family therapy services, housing programs, vocational rehabilitation programs, health insurance companies, and self help groups. Counselors need to be personally familiar with the resources in the local community. This includes knowing something about the resources' treatment philosophies, personnel, and logistics, such as costs and hours of operation. Advocacy and Coordination in Case Management - correct answer Advocacy is part of case management, and may involve coordinating with families, community agencies, legal systems, and legislative bodies (CSAT, 2000, p. 3) in order to
family involvement; providing support; tracking substance abuse relapse episodes following treatment; connecting the youth with school, work, and community resources; and helping youth fulfill legal obligations (Godley, Godley, Pratt, & Wallace, 1994). Documentation of Case Management Activities - correct answer All case management activities should be documented as part of the client's record. Notes regarding case management activities will appear throughout the client's record, since they occur at all phases of treatment. A guiding question for deciding what to include in the client's record is "What do others need to know to respond therapeutically?" (Kinney, 2003, p. 288). Examples of entries related to case management activities are properly completed release forms to share information with other treatment providers and notes of counselors' efforts to advocate for clients, such as "met with school guidance counselor to ensure support for client's treatment" (Graham et al., 1995, p. 441). Entries should indicate what the counselor coordinated, with whom, when, and why. Note also that counselor records, including electronic files, are legal documents. Evaluating Case Management Effectiveness - correct answer Counselors are expected to monitor the effectiveness of case management activities for individual clients. Treatment programs should track effectiveness for groups of clients. Information about effectiveness can be gathered through interviews with clients, collateral interviews, and interviews with professionals who worked with the client. Examples of information that can be collected include frequency of client relapses based on self reports and collateral reports, urine screen results, and case manager observations of the client's behavior. Some programs (e.g., Godley, et al., 1994) report quarterly the percent of clients who relapsed, were arrested, who linked with the recommended support systems, or who made progress toward their educational or vocational goals.
