As a new case manager, how are you going to develop a network of services available in your community? What strategies do you think would be most effective when networking? In response to y

Revisiting the Assessment Phase

· List the two areas of concern that are addressed when reviewing the problem.

· Describe the ways in which the continued assessment can change over time.

Developing a Plan for Services

· Identify the parts of a plan.

· Write a plan.

· See first-hand how a plan can change during the case management process.

· See how a client (Sharon Bello) and a case manager (Alma Grady) work together to develop a plan for services.

· Learn how goals and objectives are formulated.

Identifying Services

· Locate available services.

· Create an information and referral system.

Gathering Additional Information

· Compare interviewing and testing as data collection methods.

· Identify the types of interviews.

· Show how sources of error can influence an interview.

· Illustrate the role of testing in case management.

· Define test.

· Categorize a test.

· Identify sources of information about tests and the information that each provides.

· Learn about how to prepare clients for testing.

· Analyze the factors to be considered when selecting, administering, and interpreting a test.

· 8-1Introduction

· Although some agencies call the individuals they work with “clients,” we use the term “consumers.” We changed our language when we began to evaluate our services. These individuals actually come here for the services we provide. In other words, they actually “buy” our services. They could go elsewhere. Consumers choose agencies for a variety of reasons; we hope they see this agency as a welcoming and friendly place.

· —Case manager, family services, New York, New York

· We use the Millon Adolescent Clinical Inventory for each of our new clients who come to live with us. We call our clients “residents.” This inventory has 160 items. It is a questionnaire that addresses a range of issues, including personality patterns, expressed concerns, and clinical syndromes. First, we score the questionnaire, and then we identify issues of concern from the question and from the resident. Finally, the resident and the case manager together make a treatment plan that addresses the areas of concern.

· —Case and intake worker, emergency shelter, St. Louis, Missouri

· When I first meet clients during the interview, I help them understand what will happen if they join our program. We have some basic criteria, such as having a 9.5 in math and a 10.0 in reading on the TABE test. Plus, they have to be able to type 30 words per minute and have a minimum understanding of computers. If they join the program, they must attend classes on a regular basis. They may only miss 8 days within a 6-month period. That is difficult for some of them.

· —Case manager, welfare-to-work and case management services, Knoxville, Tennessee

· A caseworker at a school for the deaf also notes the importance of gathering information to see the big picture.

· One skill that I need in this job is to be able to talk with the different professionals, family, and friends of the children I work with. So many people have to be involved to address such complex problems. I search and search for all of the little pieces. But the job is still not done. I need to step back and see the big picture. This is the key to case management. Without a case manager or someone taking the case management approach, no one has the big picture.

· This chapter explores the planning phase of case management, when the helper and the client together determine the steps necessary to reach the desired goal. The activities involved in this phase include reviewing and continuing to assess the problem, developing a plan, using an information system, and gathering additional information. Running through our discussion in this chapter are two critical components of the case management process—client participation and documentation.

8-1aRevisiting the Assessment Phase

The next phase of case management begins with a review of the problems and strengths identified during the assessment phase. Before moving ahead with the process, the case manager will need to know if the problem has changed, if the same client resources are available, and if any shift in agency priorities has occurred. To complete the review quickly before moving into a planning mode, the case manager and the client examine two aspects of a case.

The first area of concern involves a review of the relevant facts regarding the problem. At this point, the case manager and the client revisit the identification of the problem. The initial question that the helper asks can help determine whether the problem still exists. Working with people requires an element of flexibility; clients’ lives change, just as ours do. Thus, the problem may have changed in some way: the client may have a different perspective on it; the participants may be different; or assistance may no longer be needed, appropriate, or wanted. Once the case manager has confirmed that the problem still exists and has documented any changes that have occurred, the problem itself is revisited. Is the problem an unmet need, such as housing or financial assistance, or is it stress that limits the client’s coping abilities or causes interpersonal difficulties? Is the problem a combination of several factors? This activity is best accomplished by talking with the client and reviewing his or her file. The client is still considered the primary source of information and a critical partner in the case management process. We return to Sharon Bello to illustrate reviewing the previous assessment.

My Story

Sharon Bello, Entry 8.1

Alma Grady

When I first started working with Sharon, I read through her file several times. Then, when she and I met for the first time, I asked her to tell me about herself. As the conversation continued, I asked her to help me think about my situation. I thought this would be a good way for us to get to know one another and begin our work together. When I read Sharon’s file, I could see her situation when she first came for services. But looking at the later entries, I could also see how her situation changed. When she first applied for services, we needed to verify her financial situation, confirm her physical disabilities, assess her vocational skills and interests, and assess her mental health needs. Everything to date has changed except her physical disabilities. Once she and I outlined a list of her first issues and then considered her status now, we agreed we needed to update her plan.

Joint Summary

I wanted Sharon to describe her current issues (and then we will work on strengths). We constructed this description with Sharon taking the lead:

“I am doing well in school and making progress toward my employment training. I want to stay in school and attend a 4-year college to become a human services professional. My financial situation has improved, although it is still difficult for me to care for my children. I don’t have much extra support and lots of times my children need things for school and athletics. Although I am not so distraught about the death of Sean, I am still depressed. I go to see the psychiatrist to manage my meds for depression. Alma thinks that counseling on a regular basis might help. I also feel lots of stress with school and childcare demands.”

Sharon and I agree that we will:

· a)

Revise her educational goals

· b)

Re-assess her mental health status

· c)

Explore a part-time job at the college

· d)

Explore a paid internship at the college

Other techniques that are helpful in reviewing the problem are observations and documentation. In the course of receiving the application, conducting the intake interview, making a home visit, or all three, the case manager has opportunities to observe the client beyond the office setting. For example, these observations may be richer if they occur in the home or if the client is accompanied to the office by family members or a significant other. Information available from such observations includes the client’s thoughts, feelings, behaviors, and relationships. In the case of Sharon, Sharon and Alma agreed that they would work together to gain new information and reformulate her plan as needed.

Documentation in the case file also provides facts and insights about the client. Case notes, reports from other professionals, and intake forms help the case manager pin down past occurrences and pertinent facts about the present situation. Case managers who have a long history in service delivery may call on knowledge and experience from the past to understand a current case. Sometimes, knowledge comes from a case manager’s own perception, instinct, experience, or street know-how. Many case managers mention rapid insight they sometimes have about a client, the client’s environment, possible difficulties, and creative approaches to the case management process. This insight is treated as just one piece of information and must undergo the same scrutiny as the other information collected.

8-1cDeveloping a Plan for Services