Chapter 10 Case Management/Counseling Reading this excerpt from a human service student’s journal is a very appropriate way to begin a discussion of case management/counseling: I was having a real hard time studying and I was sure I was going to flunk my courses. I couldn’t concentrate because my family was going through a divorce. I felt like I was being pulled apart by my parents. Who was I supposed to be loyal to? I knew I was getting to depend on cocaine too much. I was stoned most of the time. I figured I better talk to someone soon before I blew my stack. I started asking my friends and my dorm supervisor for the name of a good therapist. People would ask me if I wanted to see a psychiatrist, a psychologist, a social worker, a family therapist, a drug and alcohol counselor, or what. I’d ask what the difference was but no one gave me a clear answer. So they didn’t know and I didn’t know! I felt more confused than when I began looking for help. Thus far in this book you have met many human service workers. The majority of them were delivering direct services and spending most of their day working one-on-one with clients. Although doing similar work, they were likely to be referred to variously as: · Case workers · Social workers · Counselors · Advocates · Therapists · Case managers · Clinicians · Therapists All this semantic fuzziness can be confusing to a client who must figure out whom to go to with a problem. And a worker searching the job listings in the newspaper or a web site can never tell from the title of the position exactly what tasks or problem areas it will include. The general public, accustomed to name brands, finds it difficult to understand how a middle-aged woman with a doctorate in psychology and a young man with an associate’s degree in human services can both assert that they do “counseling.” In an effort to make job titles uniform, some professionals in the human service field have suggested that a distinction in title should be made according to how much a human service worker deals with highly charged emotional material rather than with the ordinary problems of daily life. They might say A social worker or therapist who has an advanced degree helps clients deal with deep-seated intrapsychic problems. A case manager or counselor (a less academically trained person) helps clients make decisions and then use social resources to implement them. But we don’t think that is a sensible distinction! All human service workers, regardless of their backgrounds, job titles, or their clients’ problems, must inevitably deal with inner emotions as well as external pressures. Of course, with more study, experience, and training, a clinician can work more effectively with the deep emotions that surround problems. Human service problems stem from the interaction of biological, emotional, and environmental stresses. If we ignore one set of forces, we get a lopsided view of a problem. And lopsided views lead to ...