Section 1
AN INTRODUCTION TO CASE MANAGEMENT
What is case management?
1.1The roles and responsibilities of a case manager can be many and varied, however, they are typically understood as falling into three broad essential functions: a counselling function, a coordinating function, and an advocacy function. In the appropriate space below, provide a brief description of the type of services a case manager may provide in each of these functions. Hint: see page 13 of the Study Guide. (Your total response should be no more than 50 words)
The process of case management
The process of case management involves three key components: assessment, planning, and implementation. Complete the table below by briefly outlining the roles that the client and case manager play in each of these components of case management. (Your total response should be no more than 100 words
Select true or false in relation to the following statements:
a)The process of assessment should continue throughout the entire case management process so that the suitability of services can be continually monitored, evaluated, and the case plan re-assessed if necessary.
b)During the planning stage of the case management process it is notnecessary to consult with the client because you will have all the information you require from the assessment
Once a case plan has been implemented changes cannot be made to the case plan.
Key considerations in case management
When engaging with a client and developing a case management plan, it is important to consider the client’s family structure and its dynamics, style of communication, and decision-making processes. Why is this important? (Your response should be no more than 100 words)
When developing a case management plan it is also important to explore the client’s issues holistically by considering the impact and interaction that exists within and between all areas of the client’s life (including the client’s social, cultural,psychological, physiological, and economic circumstances). Explain how this helps facilitate client goal-setting and participation in the case management process. (Your response should be no more than 100 words)
Case managers must be well-versed in all laws and regulations relevant to their location, the type of work conducted, and the types of clients they serve. Provide three examples of laws or regulations that are relevant to the work of case managers. (Your response should be no more than 20 words)
Case managers must have a good understanding of the resources available in their local area. This includes both the services availablewithin their own agency/organisation as well as those offered by other service providers. List two potential strategies that a case manager might use to identify services available in their area. (Your response should be no more than 30 words)
Facilitating client participation in the case management process
1.8 One of the core themes of case management is that the client is central to the goal-setting process. Therefore, case managers must promote client engagement, empowerment, and self-determination. List three strategies that a case manager may use to help facilitate client engagement in the case management process. (Your response should be no more than 30 words)
1.9 Understanding and applying behaviour change models such as the stages of change model can assist case managers to make the necessary adjustments to their approach in order to better engage reluctant clients.a)Complete the table below by providing, in your own words, a brief description of each of the stages of change and at least one approach you might take as a case manager when working with a client in that stage. The first stage has been completed for you to give you an idea about the level of depth required in your response. Hint: see pages 17-18 of the Study Guide.
b)For each of the following statements you must identify which stage of change you believe the client to be in and provide a brief response that you could give as their case manager to help encourage each client’s participation in the case management process. You must ensure that your response is appropriate to the client’s stage of change. (Each response should be no more than 30 words)
i. From a client who has been court mandated to attend your drug and alcohol service after being caught high-range drink driving on three separate occasions: “I’m not sure why I’m even here, I don’t have a drinking problem.”
ii. From aclient who has come into your familyviolence support organisation:“I don’t want to be with him anymore –I don’t want to keep being hit. I’ve tried to leave my boyfriend before, but it was really hard. He kept threatening to commit suicide, and I felt so guilty I went back to him. I think I can leave this time; I really want to. I just need to make sure I’m better prepared. I need to plan out exactly what I will do so that I can stick to it this time.”
iii. From a long-term unemployed client referred to your employment support service:“I’ve been thinking about quitting drinking for a while now but I’m just not sure how I’ll cope being sober.”
A note on the importance of cultural considerations
1.10 Why is it important to consider the client’s cultural background and other diversity factors during the case management process? (Your response should be no more than 100 words)
1.11As a case manager, you will likely come into contact with clients from a wide range of backgrounds, including people of different ages, sexual orientations and cultural/linguistic backgrounds, as well as people with disabilities and people who may be facing homelessness. When working with clients, it is important for you to remember not to make assumptions, and to always treat your clients as individuals, taking into account their unique history, circumstances,and needs.
Consider the following client scenarios. For each scenario, briefly outline one diversity factor you would have to take into consideration as their case manager, and explain how you would adapt the case management, planning and/or referral process to meet the client’s specific needs (Each response should be no more than 80 words).
a)You have just started working with a new client, Akio, who comes from a Japanese background. Akio’s intake form indicates that his primary language is Japanese, but that he does have some limited understanding of English. During your first session with Akio, you notice that he often looks confused and struggles to respond to your questions, and will frequently resort to saying “yes” or nodding, even when the question requires a more detailed response (such as “what would you like to focus on in our work together?”). You are finding it very difficult to communicate with Akio, and are concerned that he does not understand what you are saying.
b)You have started working with a new client, Keira. Keira comes from a multiracial background, with her family on her father’s side coming from an Aboriginal background, and her family on her mother’s side coming from an Irish background. Keira is proud of her Aboriginal and Irish heritage. However, you are unsure of how strongly Keira identifies with her Aboriginal background, and whether or not she would prefer to receive services from an Aboriginal Community Controlled Organisation (ACCO).
c)You are working with a client, Mike. Mike suffered a spinal cord injury a year ago that resulted in loss of function in his legs. Mike now requires a wheelchair to get around, but retains full functioning of his other limbs and extremities. Mike has been out of the workforce since his accident, and is now seeking support from your organisation to help him find employment and get his life “back on track”. Mike is also seeking support from yourorganisation to link him with some community sports and recreation groups so that he can make friends and get involved with the community again.
d)You are working with a client, Todd, who is seeking support for his drug and alcohol addiction. Todd is a gay man and discloses to you that he has had bad experiences in the past with fundamentalist religious organisations. He tells you that his parents were extremely religious, and sent Todd to several religious camps during his adolescence to “cure” him of his sexual orientation. Todd also tells you how he once tried to attend an alcohol support group run by the local church, but was shunned for being gay. Consequently, Todd is now extremely wary and uncomfortable being around fundamentalist religious groups.
e)You are working with a client, Kim (22), who has recently separated from her abusive boyfriend after a year of emotional and physical abuse. Kim is pregnant and has been cut off financially from her ex-boyfriend. She has been staying with a friend while she looks for a job and a place of her own. However, this has taken longer than she expected, and this friend has now told her that she will have to leave within the next few days. Kim has nowhere else to go, and tells you that she is worried she will have to sleep on the street. She also tells you she doesn’t know how she will get to any appointments you arrange for her, as she does not have any means of transport.
f)You have been referred a new client, Russell (75), who recently suffered a stroke. Although Russell’s cognitive functioning remains intact, he is now experiencing difficulty with movement and balance, and requires assistance with performing everyday tasks. Russell has been referred to your organisation for help with co-ordinating the services which will support his recovery and enable him to continue living independently in his own home. Although Russell is still of sound mind, he has granted his daughter, Elizabeth, power-of-attorney in his affairs so that she will be able to help himwith managing decisions about his care.
g)You have been providing support to young person, Jodie (14), for issues of low self-esteem and anxiety. Jodie’s family moved to the area several months ago. During this time, Jodie has been struggling in school, and tells you how she has no friends because the other kids think she is “weird”. She tells you that she knows about some fun youth groups that operate in the town she used to live in, 1 hour away from where she currently lives. She asks you if you could arrange a referral to one of these groups so that she can meet new people and make some friends. When you ask Jodie what her parents think about this idea, she tells you that she hasn’t told them, as they would “probably think it was a stupid idea”. You are aware that Jodie is still a minor, has no personal income, and has no means of transporting herself.
1.12Select true or false in relation to the following statements:
a)A female Muslim client has been assigned to a male case manager. During the first meeting the client requests to be assigned to a female case manager, stating that she does not feel comfortable working with a male. The case manager should reject this request because the client is discriminating against him on the basis of his gender.
b)A case manager should always refer a client of Aboriginal or Torres Strait Islander descent to an organisation that specialises in working with Aboriginal and Torres Strait Islander peoples, even if the client would prefer a referral to a mainstream service.
c)Effective case management involves respecting the cultural protocols, systems, and beliefs of the client and incorporating the client’s individual needs into the case management plan.
Client rights and responsibilities
1.13One of the underlying responsibilities of the case manager is to protect the rights of the client. List three specific client rights that a case manager must always keep in mind. (Your response should be no more than 30 words)
1.14Clients have the right to make a complaint if they are dissatisfied with any area of service delivery. It is the case manager’s responsibility to ensure that they clearly explain the potential avenues for making a complaint according to the procedures of their organisation. Imagine that the Information Sheet your organisation distributes to clients (which reflects your organisation’s policies and procedures) states:
We respect your right to a professional service. If you are unhappy with the service you receive, we have the following procedures in place to receive your complaint:
▪Discuss the situation with your case manager so the matter can be dealt with promptly. If you want support in making a complaint, ask someone you trust to accompany you. This may be a family member, carer or advocate.
▪If the situation is not settled at this level, you can put your complaint in writing and send it to the Centre Manager. We can provide you with some assistance with this if you need it.
▪The Centre Manager will endeavor to resolve the complaint. If you are unhappy with this responseyou have the right to present an Appeal to the Centre Director. Again, we can provide you with some assistance with this if you need it.
▪The Centre Director will make a final decision. If you are still unhappy with the response you have the right to referthe matter to the Community Service Ombudsman.
Your organisation requires you to not only provide your clients with an Information Sheet but to also provide a brief verbal explanation of the complaints process during your first meeting with the client. In the space below, write what you would say to a client during your initial meeting to explain their avenues of complaint and rights of appeal. (Your response should be no more than 150 words)
A note on the risks and responsibilities relating to duty of care
1.15Case managers are compelled by law to engage in professional behaviour that does no harm. There are certain situations where, according to Duty of Care requirements, client rights such as confidentiality may need to be breached. Duty of Care requirements pertain to child protection, domestic violence, suicide, elder abuse, and persons with disabilities. In your own words, complete the table below by providing a brief description of a case manager’s Duty of Care requirements in the following areas. The firstrow, Child Protection, has been completed for you to give you an idea about the level of depth required in your response. Hint: see pages 23-24of the Study Guide.
Key approaches to case management
1.16There are four evidence-based best practice approaches to case management that case managers should be familiar with: strengths-based, rights-based, person-centred, and needs-based. In your own words, complete the table below by providing a brief description of each of the four approaches. The first row, Strengths-Based Approach, has been completed for you to give you an idea about the level of depth required in your response. Hint: see pages 24-28 of the Study Guide.
Strengths-based approach
Working from a strengths-based perspective means that case managers focus and work to build on people’s unique assets, culture, skills, interests, abilities and competencies to enhance protective factors, move clients toward goal achievement, and build resilience. A strengths-based approach offers case managers a mechanism for addressing and valuing the experience, skills, values and development of clients. Within the strengths-based perspective, case management is seen as a collaborative process between the case manager, the client, and other key stakeholders. The strength-based approach to case management is strengths-focused, client-driven, relationship-centred, and solution-focused.
1.17In each of the following scenarios, identify how you would implement the suggested approach. (Each response should be no more than 75 words)
a)Imagine that you are a case manager working with Mary. Mary is a 25-year-old woman who has come to your organisation for support with mental health concerns (social anxiety). Mary tells you that she has a lot of trouble making friends. She discloses that she has tried to engage in social gatherings, however she gets panic attacks and becomes too embarrassed to return.You have discussed all of the approaches with Mary, and together you have decided that a strengths-based approach would be most appropriate. Using a strengths-basedapproach, what are two strategies you would use to support Mary within the case managementprocess?
b)Imagine that you are a case manager in a local employment agency. There have been several complaints made by clients in the last few months raising some concerns within the agency that client rights may be being violated as they are accessing services. You have been assigned to a team to ensure that your agency is promoting rights-based practice. What are four organisational policies and/or procedures your team should consider to ensure that the rights of clients are being upheld in all aspects of service delivery?
c)Imagine that you are working for a community organisation that supports people with intellectual disabilities. Your client, Bernard, is 19 years old and has to make the transition from his parent’s home into an adult care centre. His family has requested your support in making this transition. Discuss twoprinciples that you would need to uphold to ensure you are practicing from a person-centred approach in your work with Bernard and his family.
d)Imagine that you are a case manager within an organisation that supports clients at-risk of homelessness. Jamila, a 20-year-old woman has just come to see you for an initial appointment. During your assessment, she discloses that she has been sleeping rough for the last six months. She also discloses that she has been huffing gasoline, and, despite wanting to quit, she says that huffing helps her forget about her pain. She tells you that she has been both physically and sexually assaulted while sleeping rough, but that these incidents were never reported to the authorities. Based on information you obtained through the assessment, what are two of Jamila’s needs that would need to be addressed using the needs-basedapproach?
Integrating your knowledge
The following questions require you to draw upon all of the knowledge and skills you have learned throughout this section of the Study Guide.
1.18Beth is a newly graduated case manager working for a busy community services organisation. Beth’s organisation employs an intake officer who collects some basic client information to pass onto the case manager prior to the initial appointment. The intake officer collected the following information about Beth’s new client, Joy:
Joy is a 32 year-old single mother with three sons aged 8, 6, and 4. -Joy works part-time as a cashier in a supermarket but her work hours were cut back six months ago and she has been having significant financial problems since.-Joy is behind in her rent and is growing concerned that she may soon get evicted. -Joy contacted the organisation for assistance in finding an affordable rental home.-Joy also reported that her eldest son has been behaving “badly” and that she needs some help to manage his behaviour. Joy mentioned that sometimes his behavior gets so bad that she has to “thump him back into line”.
Joy said that she is originally from Papua New Guinea and, while she has livedin Australia for 10 years, she has no other family here and is struggling to manage her son’s behaviour as he grows up. After reviewing the intake information, Beth concludes that Joy simply needs a second job. Beth reasons that if Joy earns more money she will be able to pay the rent, which will relieve the stress and tension in the household, which should, in turn, also resolve the eldest child’s behavioural problems. As such, when Joy arrives for her appointment Beth immediately tells Joy that she will refer her to her local employment support agency and that they will help her find a second job. Beth then advises that she will also make Joy an appointment with one of the financial counsellors employed with the organisation who will be able to help Joy“better manage her finances”
16CHCCSM005Assessment Book Section 1Assessor’s CommentsTo be completed by the Australian Institute of Professional Counsellors to provide constructive feedback on your responses to questions in Section 1 of this Assessment Book.Competent / Not Yet CompetentAssessor’s Name:Date:
17Section 2DEVELOPING AN APPROPRIATE CASE MANAGEMENT PLANCollaborative assessment2.1The goal of assessment is to understand the client’s current situation. List four aspects of the client’s situation that case managers are interested in exploring in order to develop an initial understanding of the client’s needs. (Your response should be no more than 50 words) 2.2Select true or false in relation to the following statements:a)Assessment can involve gathering information not only from the client but from other sources (e.g., family, friends, and other service providers). TrueFalseb)It is sometimes necessary to address the needs/goals of other relevant parties (e.g., family members) as part of the client’s case plan.TrueFalsec)Even if a client is in a crisis state the case manager must complete a full assessment during the initial meeting. TrueFalsed)When engaging in assessment processes, case managers should be mindful of their statutory requirements and may need to make notifications to relevant authorities if situations of risk (e.g., self-harm or child abuse) are identified. TrueFalseCollaborative planning2.3Once an initial assessment is complete, the first step of the planning process is to help the client prioritise their concerns and to develop immediate, short-term, and long-term goals that work toward addressing these concerns. Which of the following statements about establishing goals is incorrect?a)Goals should be stated in positive termsb)Goals should be overly optimistic because you want your client to aim highc)Goals should be measureabled)Goals should be explicit Your response:Select answer2.4Seven core principles of case planning are outlined on pages 37-38 of the Study Guide. Select twoof these principles and, in your own words, explain their importance in
18developing effective case management plans. (Your response should be no more than 100 words)2.5Why is it important for case managers to assist clients to set realistic targets for change and, wherever possible,to take personal responsibility for case management processes? (Your response should be no more than 100 words) Implementation2.6What should you do if you are ever uncertain about the type or degree of support you should be providing for your client as part of their case management plan? (Your response should be no more than 10 words)2.7Select true or false in relation to the following statements:a)When engaging in direct service provision case managers must still allow the client to ‘be in the driver’s seat’ in order to help the client work towards achieving their goals. TrueFalseb)If a case manager is engaging in direct service provision they no longer need to follow any organisational policies or procedures because they are now working one-on-one with the client.TrueFalsec)When engaging in referral and service coordination it is important to seek agreement from the client about what information can be shared with other service providers. TrueFalsed)While acting as a service coordinator, it is important for case managers to establish clear arrangements with both the client and other service providers regarding how each service will be involved in the case plan and who will be doing what as part of the plan.TrueFalsee)The process of advocacy involves taking over the decision-making process for clients. TrueFalseMonitoring and review2.8It is important that the case manager establishes specific processes for the monitoring of the case management plan. In your own words, briefly explain why it is important for a
19case manager to establish processes to monitor and review the case management plan. (Your response should be no more than 50 words)A note on working with clients in complex or high risk situations2.9Case managers will sometimes work with clients in complex or high risk situations (such as when the client has a combination of significant factors impacting on their well-being). These situations require sensitive and experienced case management. What strategies would you employ as a case manager to work effectively with clients in complex or high risk situations? (Your response should be no more than 100 words)Integrating your knowledgeThe following questions require you to draw upon all of the knowledge and skills you have learned throughout this section of the Study Guide. 2.10Imagine that you are a case manager working for an organisation that provides social supports and activities for elderly clients. During your shift, an elderly woman presents to your service with a younger woman, who appears to be her daughter. You introduce yourself and briefly discuss the types of services your organisation offers. Through these introductions, you learn that the elderly woman’s name is Mary and her daughter’s name is Andrea. You have established that the two women are seeking help from the organisation, so you take them into an interview room. a)What should you do next? Hint: Consider what the first step of the case management process should be. (Your response should be no more than 30 words)Now imagine that you have finished conducting an initial assessment interview with Mary and Andrea. In this interview, you learned that Mary (80) has been brought to the organisation by her daughter, Andrea, who is concerned for her. Mary currently lives alone, but Andrea visits her every day, takes her shopping for food every week, helps her with daily cooking and cleaning, and transports her to and from medical check-ups every few months. Andrea also helps to administer her mother’s medications for her existing medical conditions. However, Andrea has recently received a promotion at work that will require her to relocate interstate within the next four weeks. Consequently, she will no longer be available to assist her mother with her day-to-day needs. Andrea would like Mary to move into a retirement community but Mary is vehemently opposed to the idea and states that she will not leave her home. Mary is very upset by her daughter’s decision to move. There is no other family in the local area, and Mary has no friends to keep her company. Mary says that she feels abandoned and does not know how she will cope without her daughter around. Andrea reports that Mary has become very withdrawn and depressed over the last couple of weeks, and that she has been frequently crying and is struggling to get out of bed most mornings. She has also lost much of her appetite and will often refuse to eat or take her medication when
20Andrea offers it to her, saying “Why does it matter if I live or die? You won’t be here anyway.” Andrea is very concerned for her mother’s welfare and wants your organisation to help with organising services to ensure that all of her mother’s needs will be taken care of when she relocates. In collaboration with Mary and Andrea, you have identified the following issues that need to be addressed in Mary’s case plan: -Mental health and wellbeing-Social connectedness -Weekly transportation for grocery shopping-Monthly transportation for medical check-ups-Daily help with cooking and cleaning-Help with administration of medicationYour organisation specialises in providing social supports and activities for elderly clients. Although your organisation does not provide transport services, it does work closely with “Community Transport Services” who offer transportation services to elderly clients. Your organisation also has connections with Community Care, which provides counselling and psychological services in the local community, as well as “Home Helpers”, an in-home support service which provides help with everyday tasks such as cooking, cleaning and administration of medication. b)Which of Mary’s needs would need to be addressed immediately (within the next few days), and what steps would you need to take to help ensure these needs are met? (Your response should be no more than 30 words) c)Which of Mary’s needs would need to be addressed over the next few weeks (prior to her daughter moving away), and what steps would you need to take to help ensure these needs are met? (Your response should be no more than 50 words) d)Which of Mary’s needs would need to be addressed over the next few months, and what steps would you need to take to help ensure these needs are met? (Your response should be no more than 50 words) e)Consider Andrea’s needs. What needs might Andrea have that should be integrated into the case management plan? (Your response should be no more than 30 words) f)Consider the information provided about your organisation and its referral network. Which organisations would you anticipate using to help meet each of Mary’s identified needs? Imagine that Mary agreed with your ideas. In the space below, outline an initial action plan that outlines which services you would involve to help meet each of Mary’s needs. (Your response should be no more than 50 words)
21g)When developing Mary’s full case management plan, why would it be important to consider practical factors such as the experience, workload, and geographical location of potential service providers? (Your response should be no more than 50 words)2.11Imagine that you are working for the local community centre providing case management support for disadvantaged people in the local community. You have just started working with Amir, a young single man originally from Iran. During your first meeting with Amir he provided the following information: -Amir came to Australia as a refugee approximately 3 years ago but has lived in an immigration detention centre for 2.5 years. Amir was released from detention six months ago when he was granted his permanent residency, meaning that he is free to live, work, and study in Australia. -Since his arrival in Australia, Amir has been trying to learn more advanced English skills, but reports that he is struggling to do so without taking any classes. You provided Amir with information about the weekly English language class at a local neighbourhood centre and he has agreed to contact them to enrol in the next class starting next week. -Amir explained that he is currently unemployed and searching for work. Amir is currently on a Newstart allowance but is not aware of any job support providers. You agreed to contact the local job support provider to schedule a coordinated case meeting. In the meantime, Amir said that he will continue looking for work using job search websites. -Amir reported that he feels isolated in Australia and has a very limited support network. Amir told you that he wanted to connect with the local Persian community but was unsure how to go about doing this. You provided Amir with the contact details for the local Persian society group. Amir explained that he would feel comfortable contacting them directly. Amir also expressed excitement about attending English classes as a way of meeting new friends. -Amir reported that he is currently living with a friend but will not be able to stay there for much longer. When you explained the housing and homelessness services available to him, Amir