Preparing for a Service Planning Conference or Disposition Planning Meeting Introduction After you have completed your assessment on each new client and done a tentative plan with the person, your agency might hold a meeting in which more specific plans are made for the individual’s care or services. In some agencies this is done informally. In small agencies, particularly, individual case managers may make those decisions by themselves, referring people to other services in systems that will have more formal case management. In some places, children who come into the system are presented by their case manager to a “children’s panel” consisting of child psychologists, child psychiatrists, social workers, pediatricians, and others who serve children. Many other places use panels of professionals for creating plans for clients from different populations; in this situation, the case manager presents the case to representatives of any number of agencies serving or specializing in that population. Together the group decides what combination of services would best suit people in their current situation and gives a diagnosis, if appropriate. If a person has both a substance abuse (SA) problem and a mental health problem and the agencies that address these two problems are not combined, representatives from each of the agencies working with the client should meet together to decide what should be done. In the past a client could be turned down for mental health services because he was drinking and turned down for SA services because he was suicidal. That kind of “turf” exclusion at the expense of the client is no longer tolerated by funding sources that expect people to be served. In these meetings, decisions regarding the service an individual will receive are made with others who have experience and come, perhaps, from different disciplines. When the meeting is over, a formal plan will be drawn up. What You Will Need to Bring to the Meeting You should consider bringing three items to these planning meetings. 1. Tentative service plan:You have already developed a tentative service plan with the individual. Bring this tentative plan to the service planning conference. 2. Human service directory:As you work within the same social service system, you will come to know, without consulting a directory, which agencies are reliable and which services are used most often by your agency when referring people. As you begin your career, you need to know what human service organizations are available in your community. If there is a directory, bring that to the meeting so that you can work with your peers to find the best placement for your client. A good place to look is the local phone book, where social services are usually listed together. You might copy these pages and bring them to the meeting. 3. DSM Handbook:The DSM is a large volume containing considerable information. If you are working in an area that is likely to use the DSM to give diagnoses, you m.

1. Preparing for a Service Planning Conference or Disposition
Planning Meeting
Introduction
After you have completed your assessment on each new client
and done a tentative plan with the person, your agency might
hold a meeting in which more specific plans are made for the
individual’s care or services. In some agencies this is done
informally. In small agencies, particularly, individual case
managers may make those decisions by themselves, referring
people to other services in systems that will have more formal
case management.
In some places, children who come into the system are
presented by their case manager to a “children’s panel”
consisting of child psychologists, child psychiatrists, social
workers, pediatricians, and others who serve children. Many
other places use panels of professionals for creating plans for
clients from different populations; in this situation, the case
manager presents the case to representatives of any number of
agencies serving or specializing in that population. Together the
group decides what combination of services would best suit
people in their current situation and gives a diagnosis, if
appropriate.
If a person has both a substance abuse (SA) problem and a
mental health problem and the agencies that address these two
problems are not combined, representatives from each of the
agencies working with the client should meet together to decide
what should be done. In the past a client could be turned down
for mental health services because he was drinking and turned
down for SA services because he was suicidal. That kind of
“turf” exclusion at the expense of the client is no longer
tolerated by funding sources that expect people to be served.
In these meetings, decisions regarding the service an individual
will receive are made with others who have experience and
come, perhaps, from different disciplines. When the meeting is

2. over, a formal plan will be drawn up.
What You Will Need to Bring to the Meeting
You should consider bringing three items to these planning
meetings.
1. Tentative service plan:You have already developed a
tentative service plan with the individual. Bring this tentative
plan to the service planning conference.
2. Human service directory:As you work within the same social
service system, you will come to know, without consulting a
directory, which agencies are reliable and which services are
used most often by your agency when referring people. As you
begin your career, you need to know what human service
organizations are available in your community. If there is a
directory, bring that to the meeting so that you can work with
your peers to find the best placement for your client. A good
place to look is the local phone book, where social services are
usually listed together. You might copy these pages and bring
them to the meeting.
3. DSM Handbook:The DSM is a large volume containing
considerable information. If you are working in an area that is
likely to use the DSM to give diagnoses, you might consider
purchasing the DSM Handbook, which contains only the most
basic information and is easier to carry with you when you go to
meetings of this sort. Bring your DSM Handbook to assist in
making the provisional diagnosis.
Goals for the Meeting
Goal One: Diagnosis
If the person being discussed is seeking mental health/mental
retardation or substance abuse services, you will need to give a
provisional diagnosis at this meeting. Older people who appear
to have some type of dementia also receive diagnoses. Children
with mental retardation, clinical disorders, or learning disorders
also require diagnoses from the DSM, as would someone
suffering a significant emotional response after an assault.
Diagnoses in these service delivery systems are usually required
for payment purposes and can be changed after the individual is

3. in the system and has been thoroughly observed. Not everyone,
however, will have a diagnosis.
Goal Two: Level of Case Management
In addition to the provisional diagnosis, you may assign the
level of case management if your agency uses different levels.
For our purposes, we use the four levels discussed in Chapter 2.
1. Administrative case management:People receiving services
are placed in a pool with other clients who require little service
or follow-up beyond the original referral. The client tends to
function independently.
2. Resource coordination:Clients are often in need of services
and assistance on issues such as housing, medication, or
therapy, but they generally do well with the services offered and
do not pose a risk to themselves or others.
3. Intensive case management:Clients are at high risk for
rehospitalization or for behavior that poses a danger to
themselves or other people.
4. Targeted case management:Clients of varying needs are given
to a case manager who carries a smaller caseload as a result; the
client has the same case manager through stable times and times
of crisis, giving the person continuity of care.
Goal Three: Services
In every case management situation, the most important part of
the intake process is to make decisions about the service the
individual will receive. Your assessment prepares you to make
those decisions wisely. Remember that you do not give the
service. Your task is to look at the material in your assessment
interview, such as:
· The strengths and weaknesses of the person
· What the person said she wants or expects
· What services this person could use well or fit into well
· What the major problems or presenting problems were
(presenting problems are those that brought the person into the
agency in the first place)
· Goals you have for the person and the person’s own stated
goals

4. · Any other pertinent circumstance or information about the
person that you feel is relevant
Using the material you have assembled, you (and presumably a
team) will develop in this meeting a plan for services, and for
treatment if needed, that matches the client’s problems and
expectations.
Preparing to Present Your Case
In the planning meeting, you will give the pertinent details that
will help the group make decisions about where the client will
be referred and the type of treatment the individual will need.
Your presentation is a short, oral summary of your case to the
group. It should be given in an orderly manner.
Before the meeting, review the details of the case. Bring the
intake and assessment material with you, and refer to it if you
do not know the answer to a question. In general, however, you
should be able to answer most questions without reference to
the material.
The elements of your presentation will include the following
information:
1. Why the person came to the agency. What were the
presenting problems?
2. How the person presented in the assessment interview.
3. What the person indicated are his goals and expectations.
4. Additional relevant information that would have bearing on
the disposition of this case.
5. Your impressions and recommendations.
These five elements are described in more detail in the
following text.
1. Why the client came to the agency. What were the presenting
problems?Discuss why the client came to the agency. What were
the outstanding problems she talked about during the phone
intake and at the assessment interview? Mention any other
outstanding problems that you feel should be addressed.
2. How the client presented in the assessment interview:Talk
about any unusual or bizarre behavior. Describe any
hallucinations or delusions the client might have had. Most

5. clients will not have any of these. Simply describe how the
person seemed during the interview.
3. What the individual indicated are his goals and
expectations:What did the person say he wants to have happen
as a result of seeking services? Tell why the person sought help,
and what the he expects the outcome will be. Even though you
will formulate the final specific goal plan for this person, be
sure to indicate the client’s input here. What did the individual
want? What were his stated goals? What was his priority? Have
a tentative goal plan ready that addresses these, but expect
others to see and suggest additional goals or to suggest changes.
4. Additional relevant information that would have bearing on
the disposition of this case:If there is other information that the
team should have in order to make a decision, be sure to discuss
that. In addition, describe any unusual characteristics that might
give a clearer picture of the person. Perhaps it is something the
person said; provide her wording if possible. Perhaps she has
worked for several years at the Humane Society and has four
dogs she rescued. During the interview, she talks about her dogs
and shows you pictures of them. This fact may not directly
influence the treatment plan created to deal with her depression,
but it will give the team a clearer picture of who this woman is
and her interests and the goals she might have talked about,
either short term or long term.
5. Your impressions and recommendations:What is your
impression of this person, and what do you recommend that
might address the problems the person felt were most pressing?
This would be the information you put together for the
impressions and recommendations after you took the social
history.
Making the Presentation
By following the format discussed here, you will make a good
presentation. Be prepared to talk about the case to the team for
about 3 to 5 minutes. You should not have to read through notes
or shuffle papers. Simply describe your client. After you are
finished, the team will ask you questions about the person. You

6. should be able to answer these without reference to your notes,
but that may not always be so. If you do not have the
information, turn to your notes when you need to.
Sample Presentation
Following is the presentation on Larry McCune by a case
manager in the planning conference:
Mr. McCune is a 34-year-old male, an engineer. He came
seeking help for symptoms resulting from a severe traffic
accident about 4 years ago. He said he was driving and was in
the intersection when the light turned red. He was hit and his 4-
year-old daughter died in the accident. His marriage broke up
about a year ago, and the remaining child, a 9-year-old boy, is
currently with the wife.
Mr. McCune complained of severe headaches, and says he has
nightmares that involve the accident. He also said he thought he
had a phobia (his word) about riding in cars and, more recently,
in other forms of transportation. He said he doesn’t feel able to
work consistently and talked about being irritable, especially at
work.
During the interview, Mr. McCune had a flat affect and
sometimes he was tearful when he discussed the loss of his
daughter and later when he was describing the divorce. He
seemed to me to have some slowed motor responses. He sat
quietly during the interview. He looked sad, and there was no
animation in his speech. There were times he appeared not to be
focused on the interview.
He is asking for help that will allow him to return to work. He
says the two biggest obstacles to that are his problems with
transportation and also his irritability with coworkers. I talked
to him about the need to find out the origin of the headaches
and he agreed with that.
Right now he lives alone. He has stopped attending church, and
he said he has few friends. He accepted all my suggestions
without much discussion. He seemed pretty passive.
I see this man as depressed and anxious in the sense that he
seems to have developed a strong fear about using a car or other

7. transportation. The other impression I had was that he is dealing
with a lot of guilt, which he agrees needs to be addressed too. I
am recommending that he be evaluated for any residual
neurological problems resulting from the accident, just to check
on the headaches, and I would like to have him evaluated for
depression and possible antidepressant medication. He asked
specifically for counseling, and I recommend that. I think he
could benefit from that. Mr. McCune might actually benefit
from a grief support group in time. His goal for coming, he told
me, is to get back to feeling better and being able to work
consistently. Does anyone have any questions?
In this presentation, the case manager has briefly addressed all
five parts of the presentation. Others at the meeting might want
additional information. For example, someone might ask this
case manager about the client’s relationship with the wife and
son. Here is how the case manager might answer that question:
We really only talked about that a little bit. He pays support but
not consistently. He said his ex-wife is working. He did say he
sees his son, but I understood that this is not like a regular
visitation schedule or anything. He doesn’t describe the
relationship with his ex-wife as extremely hostile. My
understanding was that she left because she couldn’t take his
irritability and not going to work regularly.
In the Appendix at the back of this book is a form titled
“Planning Conference Notes.” You may use this form to make
sure you have notes on the five points you want to cover in a
planning conference on your client. You would not give this
form to anyone, but it helps you to make sure that all the points
are covered and gives you a place for the notes.
Collaboration
Treatment or service planning, when it is done with a team, is a
collaborative activity. While you come with background and
some firsthand information about the person being presented
and ideas for a plan, everyone contributes to the discussion in
order to be sure the best plan is ultimately created.
Some case managers become defensive as others suggest

8. changes or additions to the tentative plan. One case manager
was “upset” when the tentative diagnosis she had in mind was
questioned by the psychiatrist. Feeling that a change in the
diagnosis would reflect on her and imply incompetence, she
resisted any change and became angry.
Another case manager was sure that the man whose situation he
was presenting was not experiencing medical problems as a
result of his drinking. This case manager became sarcastic in
the planning meeting when others asked that a medical
examination be part of the plan. “I think I’ve seen enough
alcoholics to know when someone needs medical care and when
they don’t,” he sneered at the others on the team.
In a third situation, a woman presented a case of a client
suffering from severe anxiety. The case manager thought the
problem was a generalized anxiety disorder. Another case
manager questioned the diagnosis, stating that it seemed more
like posttraumatic stress disorder. The client’s symptoms and
complaints needed further evaluation by the team, and a
discussion ensued. The case manager was asked questions as the
team attempted to assemble more details in order to make the
diagnosis. The case manager answered these questions, but she
did so in a petulant manner and later reported that her “feelings
were hurt” because “people I thought were my friends just
ganged up on me in there.”
It is important to ask questions of your colleagues in a
collaborative and respectful manner. Do not grill the people
presenting cases. Do not be dismissive of their interpretations
of the situations or demean the conclusions the presenters have
made. After all, the presenter is the person who actually saw the
person, and her observations are extremely relevant to the
decisions made on the person’s behalf. Good collaboration is
critical to quality exploration of the person’s case and for
positive outcomes.
You can see part of an actual service planning conference on the
DVD that comes with your textbook.
sidenote:

9. Service Planning Conference
Follow-Up to Meeting
After the treatment planning conference or disposition meeting,
you will write up a formal service plan for your client using the
“Treatment or Goal Plan” form we looked at in Chapter 21.
When your goal plan is completed, you will:
1. Meet with the individual and discuss the plan:Your first
contact note, for our purposes in the classroom, should be
written on your first meeting with the person after developing
the goals and referral options and having those confirmed in the
treatment planning conference or disposition meeting. At this
meeting, you will go over the plan with the client, or the
client’s parents in the case of a child, and note their response
and any changes you make to the plan as a result. When you and
the individual feel comfortable with what is planned, you can
move on to referring the person to the place where he will
receive the treatment or service. In Mr. McCune’s case, he will
probably be seen by a neurologist for evaluation of his
headaches, by a psychiatrist for evaluation of his depression and
possible medication, and by a counselor at a counseling service
to work on issues of guilt and loss.
2. Make referrals for your client to the agencies that will
actually carry out the services.
Summary
After you have met with a client and heard the person’s
concerns and issues, and after you and the person have
developed a plan that appears to meet those needs and seems
satisfactory to both of you, often you will be asked to sit down
with others to go over the individual’s situation and the plan for
that person. This meeting is meant to offer support in the belief
that several people looking at a person’s case together can
refine the plan somewhat. For that reason, keep in mind that the
meeting is a collaborative one. You can expect to answer
questions and hear ideas about your client, and you will be
expected to ask questions and offer suggestions to others.
Once you have completed this meeting you will:

10. · Write a formal service plan and have your supervisor (in this
text, your instructor) sign it
· Meet with the client to review the final plan
· Write a contact note about the meeting with the client for the
person’s file
· Refer your client to the people and agencies indicated in the
plan
Exercises Planning
Exercise I Developing a Service Directory
Instructions: Before you go to a planning meeting, you need to
know what services are available in your community. Gather
information on various social service agencies. Some regional
phone books contain special pages of social services. Some
counties publish a directory you may be able to purchase. The
library may have lists of agencies you can copy, or a local
agency may have compiled a directory.
Be sure the directory you compile or obtain is relevant to the
area in which you intend to work following completion of your
courses. In this way, you will begin now to become familiar
with the services that are available.
Exercise II A Simulated Planning Meeting
Instructions: To simulate a planning meeting, form groups of no
more than five students (otherwise it will take too long for
everyone to present a case). Present one of the cases you have
developed to the group, following the instructions for
presentation provided in this chapter. Be sure to bring the
information on the client and the material you will need to plan
services and give a diagnosis.
You can have your instructor act as the senior specialist who
can confirm with you the proper diagnosis, or you and the team
can arrive at your own decision.
Sign the revised planning form, and have your instructor also
sign it, as your supervisor.