1. Case Management Models
ReadingsCourse Text: Frankel, A. J. & Gelman, S. R. (2012). Case management: An
introduction to concepts and skills (3rd ed.). Chicago, IL: Lyceum Books.Chapter 1, “ The
Evolution of Case Management Practice” Chapter 2, “ Overview of Case Management
Practice” Chapter 3, “ The Roles of a Case Manager” Article: Arnold, E. M., Walsh, A. K.,
Oldham, M. S., & Rapp, C. A. (2007). Strengths-based case management: Implementation
with high-risk youth. Families in Society, 88(1), 86– 94.Retrieved from the Walden Library
using the ProQuest Central database.Article: Cait, C.– A. (2006). A relational psychoanalytic
model for case management: A literature review. Psychoanalytic Social Work, 13(1),
67– 83.Retrieved from the Walden Library using the SocINDEX with Full Text
database.Article: Greene, G. J., et al. (2006). A solution-focused approach to case
management and recovery with consumers who have a severe mental disability. Families in
Society, 87(3), 339– 350.Retrieved from the Walden Library using the ProQuest Central
database.MediaCourse Media: Laureate Education, Inc. (Executive Producer). (2012). Case
management for persons in need. Baltimore, MD: Author.“ Virtual Client Case Files.” Click
the following link to access the Course Media transcript: Virtual Client Case Files
transcriptTRANSCRIPT:Application Assignment Case StudiesCase Study 1: Group CaseYour
Clients:? Robert—
Youngest of the family, 12 years old. Very smart but withdrawn. Tends to
be anti-social and likes to hide in spots where he can remain unseen. He becomes angry
when others show him kindness and is very resistant when adults try to talk to him.?
Adam—
Oldest of the family, 17 years old. Sweet and timid. He is aware of the dangers
presented by his family dynamics. Has been hospitalized multiple times after attempting to
commit suicide.? Abigail—
Grandmother, 62 years old. Kind-hearted and hard working. She
received custody of the boys about a year ago. She is trying to do the best she can despite
multiple family hardships. She lives alone and has been divorced from her husband for
more than 10 years with no contact since. She is open to outside help and is currently
receiving financial assistance and counseling from the department of social services
(DSS).Background:Robert and Adam were living in a car with their mother, Victoria, before
DSS took the boys from her care. Victoria, a young mother with a severe addiction to drugs,
has since disappeared and has not tried to obtain any visitation rights to see the boys.
Robert and Adam were unable to live with their father, Jacob, due to Jacob?s diagnosed
schizophrenia. Jacob currently lives in an assisted facility, with little to no contact with the
family. Jacob and Victoria had a very volatile relationship while together, much of which the
boys saw first-hand.Abigail, their grandmother and closest relative, took custody of the boys
2. and admits that she is finding it hard to care for them. Abigail welcomes the therapy
provided by DSS and hopes that it will help them discuss issues that have plagued their
family for years. Abigail always attends the mandatory family counseling sessions, as well as
a single-parent group offered for DSS custody cases.During one emotional group session,
Abigail revealed that she blames herself for the cause of her family?s problems. Her
husband beat Adam and Robert?s father, when he was a little boy. Doctors believed that
these frequent acts of violence were what caused Jacob?s schizophrenia. Abigail also
suspected that her only daughter, Jenny, was sexually abused by her husband. Abigail, also a
product of family incest from her own grandfather, admitted that the warning signs were all
there, but she was too afraid to follow through with her suspicion. Abigail disclosed that
though Jenny had worked hard to make a good life for herself, she spiraled into a severe
depression after her husband divorced her for a transgendered lifestyle. Jenny now has
trouble living outside the fantasies that she finds in her soap operas. Abigail believes that
both Jenny and Jacob could have lived a better life if she could have stopped her husband
from the physical, verbal, and sexual abuse.Meeting Your Clients:When Abigail, Robert, and
Adam meet you at the park, you notice that Adam stays close by Abigail, while Robert runs
through the parking lot on his own. As you introduce yourself, Robert decides to ignore you
by walking the opposite way toward the playground. Adam shakes your hand
apprehensively and then begins to draw at a nearby table.As you talk with Abigail, you see
her emotions bubbling to the surface as you explain the ways in which you can help her as
she begins to care for Robert and Adam. Abigail emphatically tells you that she wants to
break the cycle and protect Robert and Adam from further harm. She admits, however, that
she is seeing very troubling signs from both the boys. Robert has a habit of hiding under the
stage to craft small weapons at his after- school program. He refuses to talk to her and often
throws things when she tries to offer him love and support. Adam has black circles under
his eyes and she believes that he has had trouble sleeping. Though he is open to Abigail?s
hugs and warm conversations when in private, she notices him refrain and even verbally
reject these actions when Robert is around.Moving Forward:The next day, you pull out
documentation recently given to you by teachers who work with the boys at school and at
the after-school program. Though these teachers do not know the details of the family, their
comments reflect similar concerns to Abigail?s. You have met with the boys only briefly, but
it is obvious that the pattern of their behavior is very troubling. You must now begin to
figure out which resources will help Abigail, Robert, and Adam as they move forward as one
family unit.Case Study 2: Individual CaseYour Client:? Charlene—
Oldest of two and only
daughter in the family, 16 years old. Intelligent and caring. Her recent patterns of cutting
class to hang out with students known as ?the bad kids? has caused her once-high GPA to
plunge into the failing range. Teachers have noted that Charlene appears to be very
distracted and socially disconnected when in class, traits that they had not previously seen
with her before this year.Background:Charlene?s new and at-risk behavior prompted Kate,
the high school guidance counselor, to talk with Charlene. As Charlene walked into Kate?s
office, Kate was surprised to see that it wasn?t just Charlene?s school behavior that had
changed. Charlene, once known for pulling her long, beautiful hair neatly back into a bun,
now let it lay limp in front of her face. Her color-coordinated slacks and blouse were also
3. exchanged for a big jacket and Windbreaker pants. Kate also noted how Charlene seemed to
wrap herself inside the jacket—
an odd behavior considering how warm the weather was
outside.In talking with Charlene, Kate learned that she felt unsafe at home. Her father, a
local handy-man with a high school education, had a history of coming home from work
drunk and belligerent. Over the past year, these actions had transformed into physical and
verbal abuse toward Charlene specifically. Charlene had never been on a date with a boy,
yet her father constantly accused her of ?sleeping around? and dressing like a tramp.
Charlene said that she felt her mother was too terrified of her father to protect her from his
vitriolic language, rage, and drunken rants that centered on her worthlessness. Charlene
confided to Kate that she wanted to safely separate from her father and her current home
life. Charlene had not attempted to run away because she did not want to abandon her 11-
year-old brother Matthew . Though Matthew did not receive any physical or verbal abuse,
Charlene was afraid that her father?s temper would be transferred to him if she were to
leave.Kate called the department of social services , which found bruises on Charlene?s
arms and back. Charlene and her brother Matthew were immediately placed into a foster
home until further evaluation and home visits have been conducted with her mother and
father.Meeting Our Client:Your first encounter with Charlene is at her new foster home. As
you greet her in the kitchen, she seems frightened, yet confident at the same time. Knowing
that teens love the occasional junk food, you offer her one of the meals that you picked up
from the local fast-food restaurant. As the two of you eat, you casually begin to make small
talk about today?s popular music artists. She doesn?t talk much but giggles when you make
a bewildered comment about the recent antics of one outlandish pop star. As you continue
to engage her in conversation, you turn the topic toward popular comedies that have
recently come to theaters. Charlene smiles as you mention one movie that she wants to see.
She even excitedly talks about the cast of characters and movie plot. You make her a deal
that if she can earn a C or higher on her next test grade, you will take her to see the movie.
She agrees and with a sip of your chocolate shakes, this connection with her is your
breakthrough for today.Moving Forward:Right now, Charlene is very vulnerable. She has
been hurt by the two adults who were supposed to put her well-being above their own.
Charlene is 16 and able to make her own decisions about attending school and counseling
sessions. These two factors are equally important and make your case management plan
two-fold . First, you must gain her trust and show her that you are there for her during this
traumatic period in her life. Second, you must find the best way to coordinate her care in
hopes that your interventions will prove to be successful.Case Study 3: Individual CaseYour
Client:? Jason—
Oldest of three children, 27 years old. Likable yet self-destructive. Jason
graduated from high school with a C average and has held down consistent yet marginal
jobs since. Jason has lived in a small town just outside the city his whole life. Many in town
attribute Jason?s inconsistent patterns of behavior to the dissolution of his family during his
late teens. Jason is the only one who chose to stay in town and has come to have a
reputation for severe drug abuse around the holidays.Background:Jason was picked up by
the police for stealing and riding a horse into the middle of town. The police documented
Jason as being disoriented and panicked. He had been passionate about his need to go
across the river where his troops were waiting. When asked his name, Jason had replied
4. ?George Washington.? The police brought Jason to the local hospital, where he was
diagnosed as having a schizophrenic break. A urine sample also revealed traces of drugs in
Jason?s system.Meeting Your Client:You meet Jason at a recovery center eight months after
this first known schizophrenic break. The center is ready to discharge him into a group
home with three others who have previously left the center and are attempting to integrate
back into the community. As you review the discharge reports, you see that Jason has been
taking his medication regularly, as well as attending all counseling sessions with his
therapist.You are scheduled to drive Jason to the group home tomorrow but have arranged
for the two of you to meet one another while walking the grounds of the center today. As
you introduce yourself and the ways in which you can be a resource for him, you notice that
he constantly fidgets with his clothes. As Jason attempts to introduce himself, he seems
embarrassed when reflecting on the actions that brought him to the hospital. As a result, he
is unable to hold eye contact with you for more than a few seconds.As the conversation
turns to his newly diagnosed illness, he makes a sudden and angry outburst that implies he
knew this day was coming. He explains that both of his younger sisters had been in and out
of the hospital, one for an eating disorder and the other for alcohol abuse. He figured that
his ?time? was coming. He adamantly blames his parents for the fate of his family. Jason
confides that he can never remember a time when his mother showed anyone in his family
love or affection. She worked long hours as a nurse and seemed detached from the family
when at home. When Jason was in his early teens, he found out that his grandfather had
verbally abused his mother after a chronic illness had confined him to a wheel chair .
Jason?s father was quiet and incapable of holding down a steady job. Jason admits that he
admired his mother for her hard work, but he hated both his parents for the lonely nights
and little opportunities for social interaction outside of school.As you and Jason casually
shoot hoops at the center?s basketball court, his mood lightens and you can see why people
in town believe him to be a likable guy. Jason even jokingly comments that he hopes you will
be able to help him control any other past presidents who try to take over his body during
his next schizophrenic break.Moving Forward:As you leave the recovery center and begin
preparations for tomorrow?s events, you reflect on the complex case that you have ahead of
you. You will need to develop an action plan that you and Jason will use as he learns to live
with a troubled past and a chronic mental illness.ASSIGNMENT:Application: Case
Management ModelsWhen case management first evolved as an occupation, there existed
no models or theories from which to learn. Case managers simply observed their clients and
provided services based upon their perceptions of the clients’ needs. As time went by,
researchers began to organize case managers’ practices into prominent models that are
used today. Some of these models include the task-centered model, assertive model,
relational psychoanalytic model, empowerment model, and strengths-based model. Each
case management model presents a unique approach to the case management process for a
variety of clients. For example, the strengths-based model is the cornerstone on which most
case management models are built. This model seeks to empower clients through attention
to relationships between case managers and clients and the establishment of client
autonomy. Each model can be effective with certain clients, and it is up to case managers to
determine which model is most appropriate for their clients.This week’ s Course Media
5. introduces you to three case studies that you use throughout the course. Each week, you
apply new concepts to address the needs illustrated in each case.To Prepare for this
Assignment:Review Chapter 2, “ Overview of a Case Management Practice.” Pay particular
attention to the descriptions of the case management models.Review “ Strength-Based Case
Management: Implementation with High-Risk Youth.” Focus on the description of
strengths-based case management and how the model was adapted for use with
adolescents.Review “ A Relational Psychoanalytic Model for Case Management: A Literature
Review.” Consider the relational psychoanalytic model, with its emphasis on the
importance of relationships with clients.Review “ A Solution-Focused Approach to Case
Management and Recovery with Consumers Who Have a Severe Mental Disability.” Focus
on the description of the new perspective on goals for those with severe mental
disabilities.Select two case management models and consider their strengths and
weaknesses.Review the media titled Virtual Client Case Files in this week’ s Learning
Resources. Consider how each model might be applied to the case studies.The Assignment
(1– 2 pages)Briefly describe the two case management models you selected.Explain two
strengths and two weaknesses in the two case management models.Explain how each case
management model might be applied to the case studies.
