Case Management W2 Flashcards
1
Q
What is a model
A
- Simple direction of a system
- Help us to process something in a certain way
2
Q
Criteria of evaluating a model
A
- Consistent with SW professional values and ethics
- Make sense to consumers
- Facilitate assessment decision making processes
- Provide guidance through CM process
- Based on sound theoretical understandings
3
Q
Contemporary models of CM can be classified according to
A
- Target group
- Employing body and its philosophy and goals
- Purpose (why CM is being used and what it’s meant to achieve)
- Professional orientation (clinical or general focus)
- Setting (organisation, funding, who makes decisions)
4
Q
Categorising models of CM
A
- Client focused
- Service focused
- Goal focused
- Role focused
These models significantly influence how CM functions are performed and where the scope of authority lies
5
Q
CM Model types
A
- Clinical model
- Brokerage model
- Strengths - based model
- Recovery model
6
Q
Clinical model
A
- Used with clients diagnosed with more severe mental health issues
- Includes specialist expert and practice
- Long-term as opposed to short term and assistance
- Effects of de-institutionalisation has promoted the need for this model
7
Q
Clinical CM important resources
A
- May require decision making with, on behalf of client because they are unable to do so for themselves
- Links individual into formal and informal networks of support
- Provides advice and counselling
8
Q
Core of Clinical model
A
- Develop genuine and trusting relationship
- Relationship is further developed into a therapeutic alliance
- Targeted to specific client group
9
Q
Clinical model central principles
A
- Continuity of care
- Development of collaborative relationships
- Flexibility - changing nature of need
- Facilitation of client resourcefulness
- Formal/informal resources
10
Q
Clinical CM Model
A
- Focus on changes, options and pacing of relationships to obtain successful
- Remains aware of clinical mental health understandings throughout case management process
11
Q
Clinical Model strengths
A
- Improve administration efficiency
- Improve case coordination and continuity of care
- Team case review can lead to increased clinical accountability
- Reduction of costs due to reduction of readmissions
- Can involve low case loads to offer a more intensive service
- Clinical documentation to improve service provision
12
Q
Clinical Model limitations
A
- Can involve untimely bureaucratic process
- Requires specialist knowledge and skills
- It may not consider the person holistically
- May not be client-directed
- Influences by medical model
- Can involve high case loads
- Lack of transparency of clinical records
13
Q
Brokerage Model 2 essential factors
A
- Appropriate responses by service providers
2. Frequent advocacy by CM
14
Q
Brokerage Key principles
A
- Identifying and matching needs of clients to resources in the community
- Development of services and packages from community services and resources
- CM has little control over services, needs strong knowledge of services and appropriateness to client
- Effective CM must be appropriate responses/services and CM constantly advocate
15
Q
Brokerage Model considers
A
- Estimated/expected costs of delivering specific services
- Desired client outcomes within specified time frames
16
Q
Brokerage model is “fiscal” model of CM
A
- Dictate the way services are organised and delivered (determined by cost)
- Goals of org may take precedence over individualistic goals (i.e. budget constraints)
- CM management roles may be determined by administrative responsibilities more than professional imperatives
17
Q
Brokerage model limitations
A
- CM experience can limit approach
- CM has little control over the services they refer to
- Useful if required services are not available within one service provider/systems (changing nature of HS)
- Places lots of responsibility on te client to evaluated usefulness of the service
- Relationship is not as a major focus
18
Q
Strengths of Brokerage model
A
- Services are prioritised
- Providers are more careful as they must justify each component of the plan
- Efficiency improves, service provision reduced to the shortest time frame
- Single point of contact
- Scarce resources are saved
- Resources are allocated according to predetermined priorities
19
Q
Traditional approaches create dynamics where
A
- Problem is defines as a lack or deficiency in the client of client system
- Problem is defined by the ‘expert’ based on expert knowledge
- CM is directed at overcoming the deficiency at the heart of the problem
- Results in a bias towards weakness and pathology
20
Q
Strength based model
A
Purpose: assist individuals identify, secure and sustain the range of resources needed to live in an interdependent way in the community.
- Developed by Rapp and Wintersteen late 1980s
- Initially for individuals experiencing mental health issues
- Enhance individualisation of person
- Founded on environmental conception of human behaviour
Rationale - look past the individuals pathology, weakness, problems and/or deficits and maintain focus on their unique strengths
21
Q
Strength based model assumptions
A
- All people possess wide range of talent, ability, skills resources and aspirations
- Focus on “strength an potential”
- Emphasis on positive aspects of life (with exceptions)
- People have the capacity to determine what’s best for them. (client expert)
- Empowers people to make choices (control and responsibility)
22
Q
Strengths perspective
A
- Looks at how people have already shown resilience in difficult times
- Looks for resources that nourish resilient spirits in people
- Emphasis on positive attributes and qualities, creating qualitatively different context for CM practice
Research highlights when a clinician intentionally engages in change talk, clients are 4 times likely to discuss change
23
Q
6 Strength model principles
A
- Focus on individual strengths
- CM and client relationship is primary and essential
- Intervention strategies based on clients self determination
- Intervention incorporate relevant and accessible community services (formal/informal)and aggressive outreach
- Community viewed as a resource and not obstacle
- Clients with long-term issues, are assisted to make gains with their lives (celebrate gains) People learn to grown and change.
24
Q
Fundamental concepts of Strengths model
A
- Professional relationship with respect
- Use client strengths, assets and abilities rather than limitations and deficits
- Goals (big/small) to be reinforced when accomplished
- CM is advocate for client
- Client defines the goals and targets through interactive process
- CM seeks appropriate community resources and meet client needs
25
Recovery Model key points 1
- Each person's recovery is different (individual journey)
- Recovery requires others to believe in and stand by client
- Underlying principles of hope, empowerment, social inclusion and personal growth
- Recovery does not mean cure
- Recovery can occur without professional help
- Recovery is ongoing process
- Recovery from mental illness (i.e. stigma, unemployment, loss of rights) sometimes more difficult that recovery of mental illness itself
26
Exam Q. what is CM function. (Kanter, 2011)
- Main activity or part of array of interventions?
- Scope of CM practice focused on clients holistic or narrowly focussed on single domain such as illness?
- Relationships between CM and client interpersonal or administrative?
27
People are more than their diagnosis
- Mental health diagnosis
| - Employers, friends, family, members of the public
28
Recovery model - key points. 2
- Currently popular in mental health policy and service delivery guidelines
- Risen from the intellectual product and lived in experience of consumers, survivors and ex-patients
- Contested definitions - is it a process or an outcome?
- Based on the premise that people with mental illness do recover (often without treatment)
29
Consumer definition of recovery (Mary Ellen Copeland)
Elusive and means different things to different people. But most people agree that a person "in recovery" works on taking back control of his/her life, achieving his/her own goals/dreams
30
Consumer definition of recovery (Pat Deegan)
Recovery is a process, a way of life, a way of approaching the days challenges and not a perfect linear process. Consider falters, slide back, regrouping and starting again. Need to meet the challenge of disability and re-establish a new valued sense of integrity and purpose within and beyond limits of disability, the aspiration to live, work and love in a community where one makes a significant contribution
31
Personal vs Clinical Recovery
Personal:
- Focus on unique personal journey of consumer
- Values lived experiences and expertise of consumer
- Supported by informal support network of connection
- Achievable without service provision
Clinical:
- Approach used by policy and services
- Focus on relationships (Mental health clinician, consumer and family member)
- Identifies how mental health clinician facilitates a process that supports recovery, in partnership with the consumer
32
Process
- Harder to ground in theory and collect evidence
- Personal journey
- Not reliant on interventions
What might recovery look like?
33
What is Recovery?
- Renew a sense or possibility of hope
- Regain competencies
- Reconnect and finding a place in society
- Rebuilding self confidence, sense of self often lost through illness and engagement with service systems
- Understanding the impact of disadvantage
34
How to work in Recovery Orientation
- Openness (willing to listen and learn)
- Collaborate as equals (who is the expert)
- Focus on persons inner resources
- Reciprocity
- Go the extra mile
(Borg and Kristiansen, 2004)
35
Star of Recovery Framework, 2 areas of focus
1. Individual effort of recovery (cannot be manufactured by others)
2. Effort of others (formal/informal)
36
Life domains: (Exam)
Connection to networked life (how people connect)
37
Factors influencing our CM roles (Exam)
Political context:
- Privatisation
- Neo-liberalism
- Administration
38
Benefits Family/Carer perspective (Exam)
Potential for greater involvement
39
Why does definition/language matter?
- Who should do the defining? (Exam)
- Depend on cultural and social context
- Change over time
- Guide treatment
- Assist in research
- Shape policy, funding, service provision, insurance
- Language, power, stigma, discrimination
40
Strength of Recovery model
- Focus on clients strengths not deficits
- Links people with others who are further along recovery
- Highlights importance of building supportive relationships and assist in recovery path
- Develop unique coping skills in client
- Accepts "set backs" as part of process (not failure)
- Encourage client to make meaning out of recovery experience
- Understanding that recovery may be a lifelong process
41
Limitation of Recovery model
- Evidence base is not firmly based as other models
- May devalue the role of professional intervention
- May marginalise those who don't fit well with this model
- Requires CMs with specialist knowledge of and support the model
42
Factors influencing choice of CM models
- Aims and objectives of organisation
- Philosophical framework of the organisation
- Target population characteristics
- Socio-demographic factors
- CM level of experience
- Service delivery systems
43
Different models with different strengths:
- Whose interests are being served?
- Which voice is being heard?
- How is efficiency to be judged?
- Will people involved take a short/long term view?
- Does the model ensure clients receive care and services in an equitable way?
