Transcript Critical analysis

  • Assignment date : 7th Febuary 4.00pm
  • Weight: 40% 
  • Criteria & Marking:

1. The student uses literature (minimum of 10 separate sources) to identify and describe the case management process and case management skills demonstrated by the Case Manager in the video.

2. The student describes and critically analyses the Case Manager’s strengths and weaknesses, the effects of these on the interaction, and makes specific suggestions for how the approach taken by the case manager could impact on other parties communicating with them.

3. The student also discusses evidence-based strategies that they would have used to manage this situation.

4 The student displays quality and professionalism in their writing through thorough proofreading, use of the transcript template, use of professional first person tense and consistent referencing using APA7 style.

  • Description:

 For this task you need to write a 1200 word assignment in which you analyse and reflect on a case management assessment (a video that is provided in the course L@G site).With reference to a minimum of 10 peer reviewed,   current (within the last 10 years) and scholarly pieces of literature , in your essay you need to:

  • Critically analyse the Case Management process and Case Management skills demonstrated in the video.
  • Analyse the Case Manager’s strengths and weaknesses.
  • Explain how these strengths and weaknesses may impact other parties communicating with them.
  • Discuss evidence based strategies that you would have used to manage this situation.
  • More Information:
  • Submission: Online Turnitin submission via L@G. Please use DRAFT SUBMISSION to generate a report then submit using the FINAL SUBMISSION point
    This assessment item:

Resubmit: N

Criteria 15 Mark

  1. Critically analyse the Case Management process and Case Management skills demonstrated in the video to facilitate the case management process.
  2. 2, Analyse the Case Manager’s strengths and weaknesses. Explain how these strengths and weaknesses may impact other parties communicating with them.
  3. 3. Discuss evidence based strategies that you would have used to manage this situation
  4. . Scholarship

Some references to use

What would your future self say? Using motivational interviewing to affect behaviour change

First Published April 29, 2015 Other Find in PubMed
Article information 
Article has an altmetric score of 6


Based on a workshop delivered to RSPH members in February 2015 by Neal Gething, Registered Psychologist at Empowerment Training Consultancy, this article explores the technique of motivational interviewing and how it can be used to change behaviour.

We cannot change anything until we accept it. Condemnation does not liberate, it oppresses. Carl Jung

Before you start reading, think of a behaviour that you would like tochange. If you can, write it down and describe it, so you can easily comeback to it as you are reading throughthis article. An important part of motivational interviewing is to be able to first apply the technique to yourself: once you’ve found the trick to changing your own behaviours, you can then use this knowledge to help transform others.

Motivation, in simple terms, is the desire to change something. Motivational interviewing is a person-centred counselling approach that focuses on collaboratively eliciting, and subsequently strengthening, an individual’s motivation to change.1 Rather than focusing on the negative battle, the technique encourages the individual to focus on what they are good at, who they are now – their needs, desires and goals – and the person they will turn into – their future self. Ultimately, motivational interviewing is about change, and the threeprinciples that underlie all change: everything is a state of mind; state of mind is habit; and habits can change. We all learn things by habit, for example, how we sign our name and which arm our watch is on. Motivational interviewing focuses on finding these habits and discovering what it is that blocks you from getting up and doing what you know is right, that is, from changing your behaviour.

The Essence of Motivational Interviewing

Pause here and think about how compassionate you are towards yourself – what do you say to yourself when you think about the behaviour you are going to change? What motivates you?

‘It’s not your fault, but it is your problem.’

Change is the responsibility of the individual, and it is important to remember that you cannot force behaviour change in others: in order to change a behaviour, you need to own your own problem. The role of the motivational interviewer is to be a supportive companion who focuses on bringing the conversation back to change, and on listening to the person rather than the problem.

The key here is developing a discrepancy with who/where an individual is now compared to who/where they want to be

The first step is discovering who the client is (the present self) and facilitating them in looking at who they are when their problem owns them, beginning to engage the habit mind. The key here is developing a discrepancy with who/where an individual is now compared to who/where they want to be, which brings you to the second step – discovering who the client wants to be (desired future self). Here, it is important to focus on keeping statements positive: on ‘be this’ rather than ‘don’t be that’. This is an important stage in giving the mind the right information for change to happen and recognising the barriers that might get in the way of your future self:

‘How dare you ask me to change, you don’t know what I’ve been through.’

Spending time on feelings of ambivalence is necessary here as it is common for uncertainty to cause fluctuation through a range of emotions, including fear, anger, grief, guilt, shame and helplessness, leading to internal power struggles. Avoid letting this power become the focus of the discussion as it can cause individuals to fight back – this can lead to arguments, which should be avoided. It is important to remain focused on discovering and understanding the desired future self: through maximising the desire for change, the perceived ability to change and the actual ability to change will increase.

What would your Future Self Say?

Every time the problem is mentioned, ask the individual this question: establishing and focusing on the future self and driving towards it are the key to motivational interviewing. Collaborative and change-focused empathy is important here: displaying compassion and affirming an individual’s struggle. Any behaviour that relates to the future self should be focused on and expanded: for example, if the future self is judging the current self, this needs to remain the focus until the relationship becomes a positive one:

‘How do I accommodate the behaviour into my future self?’

The final step is goal setting: securing a commitment to change. Goal setting within motivational interviewing is slightly different – it is about cultivating change based on the values that have been drawn out from investigating your present self and your desired future self – rather than setting goals just to tick boxes. Goal setting to secure change includes the following: the changes I plan to make are, the reasons I want to make these changes are, future actions are, I will know I am changing when and I will know when I’m regressing when.


Motivational interviewing is a key behaviour change technique used by psychotherapists, occupational health doctors and general practitioners (GPs) in their day-to-day work with clients. As this article has explored, the technique makes use of short-term, solution-focused strategies to help individuals overcome behaviours and actions that may be impeding their health and wellbeing. This is achieved through the key principles: understanding what motivates you by focusing on the self and your values rather than on the problem, identifying the barriers to change and identifying how these barriers can be overcome by setting up a dialogue between the present self and the future self.

Thinking back to the behaviour that you identified at the start, what would your future self say?

Alison Firth
RSPH Editorial Officer


1.Miller, WR, Rollnick, S. Motivational Interviewing: Helping People Change, 3rd edn. New York: The Guildford Press, 2012.
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View Abstract

Article available in:

Vol 135, Issue 3, 2015

Some more references

  1. Andrews, H., Griffiths, S. and Loney, A.M. 1995. “Confidentiality in the country”. In The Bulletin of the Australian Psychologist, August 17–19.  [Google Scholar]
  2. Berkman, C.S., Turner, S.G., Cooper, M., Polnerow, D. and Swartz, M. 2000. Sexual contact with clients: Assessment of social workers’ attitudes and educational preparation. Social Work, 45(3): 223 [Crossref][PubMed][Web of Science ®][Google Scholar]
  3. Boland‐Prom, K. and Anderson, S.C. 2005. Teaching ethical decision‐making using dual relationship principles as a case example. Journal of Social Work Education. Special Issue: Innovations in Gerontological Social Work Education, 41(3): 495–510.  [Web of Science ®][Google Scholar]
  4. Brodie, L., Nagy, S., English, M. and Gillies, D. 2002. Protectiveness without possessiveness: Caring for children who require long‐term hospitalisation. Neonatal Paediatric and Child Health Nursing, 5(2): 11–17.  [Google Scholar]
  5. Caffarella, R.S. 1994. Planning programs for adult learner, San Francisco: Jossey‐Bass.  [Google Scholar]
  6. Carr, P. 2004. Riding the tiger of culture change. T + D. Alexandria, 58(8): 32 [Google Scholar]
  7. Fronek, P., Kendall, M., Ungerer, G., Malt, J., Eugarde, E. and Geraghty, T. 2009. Towards healthy professional‐client relationships: The value of an interprofessional training course. Journal of Interprofessional Care, 23(1): 16–29.  [Taylor & Francis Online][Web of Science ®][Google Scholar]

Another full article

There’s More Than Meets the Eye: The Nuances of Case Management

W. Patrick Sullivan 


Destinee F. Floyd

Pages 184-196 | Published online: 17 Aug 2012


This work reflects one facet of a qualitative study that focused chiefly on the attitudes of case managers about recipients of service. To this end, 50 interviews were conducted with case managers who work primarily with adults challenged by serious and persistent mental illness. These interviews were conducted between June and September 2009 and those included in this analysis were nearly evenly divided between two Midwestern states. Nine interviews were dropped from the analysis when it was recognized that these case managers worked with children, and one interview was discarded due to technical difficulties with the audiotape, leaving 40 interviews available for analysis. The final sample was predominantly female (28 female, 12 male), overwhelmingly white, in their mid-30 s (M age = 35), and were an experienced group who averaged more than 7 years in the field. Thirty-one respondents reported holding a bachelor’s degree, 7 had earned an advanced degree, and data were missing on 1 informant. Social work and psychology were clearly the most popular fields of study. Caseload size was a more difficult item to measure given that some worked within a team where responsibilities were shared. However, based on estimates provided by the interviewees, most were assigned between 20 and 30 clients (M = 30.7, median = 22.5). The mix of clients served by these case managers matched the profile one would find in case management programs in community mental health centers across the nation. Accordingly, the primary diagnoses represented on these caseloads are schizophrenia, major depression, and bipolar disorder.

Informants were drawn from nine urban and suburban community mental health centers. Executive directors and program managers from multiple sites were contacted directly and asked to disseminate information about the study, and as a result the total universe of possible candidates for inclusion is not known. In this exploratory project, participation was voluntary, and in general interested parties contacted one of the authors directly to establish an interview time. The study was reviewed and approved by the host university institutional review board and all participants signed an informed consent form and were given a $25 gift card for their participation. Due to the convenience sampling method used, and restricting the informants to two Midwest states, the results must be interpreted with caution.

The interviews averaged between 30 minutes and 1 hour in duration and were recorded and transcribed verbatim. All participants were asked to describe the characteristics of clients they served, aspects of the job they liked and disliked, and their beliefs about the concept, process, and possibility of recovery from mental illness. From this basic template, additional questions or probes were used to clarify responses or gain additional insights based on the responses offered.

Interview data were analyzed using elements of Spradley’s (1979) ethnographic interviewing method. Here interview transcripts are reviewed and coded, often line by line, with a goal of identifying common and overarching themes at play in the area of interest. In this method data collection and data analysis are contemporaneous; therefore, when interesting themes surfaced, as was the case in this study, these items are explored in greater depth in subsequent interviews.

Consistent with the description of the research method just offered, each interview in this study was independently coded by two reviewers with an initial goal of determining overarching themes present in the data set. Because the interviewers used a semistructured format as described previously, a basic framework was in place to begin organizing the data. The next step in the research process involved taking a deeper look at the data within each of these categories.

When reviewing the transcripts it was noted that case managers routinely shared what might be deemed practice wisdom or specific practice methods they used to help consumers. Therefore, as is common in studies of this nature, this new area of inquiry emerged naturally from the data. Accordingly, the focus here is on the process of helping, specifically the use of the professional relationship and other key elements of direct practice case managers identified as germane to working with this clientele. References to direct practice and the professional relationship were identified in 33 of the 40 transcripts, and these statements were subsequently analyzed and coded separately. Each respondent is different. Some case managers share detailed descriptions of their practice experiences, whereas others offer more parsimonious responses. The task at this stage was to develop a set of common themes that faithfully captured the observations of these case managers. Although the themes are conceptual, each was constructed from the comments of between one half and two thirds of informants. The results of this effort are presented next and illustrated by direct quotes from the respondents. In essence, this work represents an attempt to tell the story of the practice of case management from the perspective of this set of case managers.


Like most roles in mental health practice, the ability of the case manager to convey care is an indispensable ingredient for success (Mancini, Hardiman, & Lawson, 2005). Yet, as these respondents suggest, overall effectiveness is buttressed by a deep tool kit and the ability to navigate a plethora of thorny dilemmas that are sure to arise in the course of their work. As the data analysis process unfolded, it became clear that key themes could be loosely organized around traditional temporal phases of the helping process and the use of the professional relationship. Case managers, particularly those engaged in outreach, work directly with consumers during all phases of the helping process—a process that is generally seen as time unlimited given the daunting nature, and often lifelong problems, these individuals face. What is particularly noteworthy is how these case managers address the unique challenges that arise when working with this population.


Case management, like other helping roles in mental health, naturally begins with engagement. Consider the complicated dynamics here. The nature of some mental illnesses makes trust a complicated proposition, and this can be magnified by personal experience. For example, trauma is a significant factor in the expression and course of mental illness, and sometimes is experienced within mental health settings (Frueh et al., 2005; Robbins, Sauvageot, Cusak, Suffoletta-Maierle, & Frueh, 2005). Furthermore, over time the roll-call of professionals who have been assigned to an individual can be a lengthy one, particularly given the high turnover in case management (Selden, 2010). Placed in this context, distrust and skepticism are healthy responses. How do these case managers surmount this early obstacle to relationship building? Where this particular case manager begins reflects one commonsense approach to dealing with potential apprehension and apathy:

I do a pretty good job at listening. I think people … often aren’t heard. And if you don’t start there you really can’t connect. I mean there are people I know, even on my team, that are so much better than I am at the nuts and the bolts. My supervisor calls it getting people. You know, getting people food, getting people housing … I can do that stuff, but where I really see results is just by listening to how people feel about their lives.

Going perhaps one step further, a case manager with a dozen years in the field noted, “To tell you the truth, rarely do I know people’s diagnosis when I go into the interview because I don’t want to see a diagnosis; I just want to see a person.”

Because case management is often focused on resource acquisition and goal attainment, there is often an inherent bias for immediate action. This impulse is even more acute in an era where terms like medical necessity have become embedded in the lexicon. It is a dilemma faced by this respondent:

When they are not feeling so great it is harder to have them focus on the positive. But you just kind of got to pull it out of them in a way. Then maybe sometimes just wait for them … Sometimes it is just a matter of working with the client for a while before you get to that point because they are just at such a bad stage and just need to get through the day.

It is the steps between engagement and establishing goals that might be the hardest for both parties. Client-centered planning and self-determination are important principles in case management (see Rapp & Goscha, 2006), and whereas some struggle with these standards, others wholeheartedly subscribe to them. For example:

There are some things that I really, really believe. That philosophically about being there for other people is to not put people in a help or helped position, because that makes one person in power and one person helpless. And I don’t think the person is helpless.…If I can kind of join with them in a relationship and just kind of be on the same plane as them (then) you can kind of introduce some different ideas and kind of discuss these things that are happening instead of saying, “This is what we are going to do today, and this is what you have to do.”

As another case manager put it succinctly, “I really do feel like I am somebody who is a guide that just kind of walks with them side by side. I don’t know how else to describe it.”

All people are unique, and one important skill of the case manager, particularly those versed in the strengths model, is to affirm and build on that uniqueness (Rapp & Goscha, 2006). In the best of situations, case managers assist people with clear goals, a plan to reach those goals, and the skills and confidence to do so. Rarely is it so simple. Some case managers in this study reported that they nudged consumers forward by offering a different vision of the future—a technique described here:

You have to be able to bring your clients along with you … and have them as invested as much in their recovery as you are. So that is the skill. The most important thing is knowing how to do that, and then holding that vision for them when they can’t … sometimes they can’t envision their recovery. So that I can help with, I can teach that and model that. If it’s just because they like where they are at and want to be where they are at with their symptoms and don’t want to be treated, that is a choice, too.

Many noted the importance of consistently communicating the belief that things can improve, particularly for those in the most dire straits. As one case manager describes it, “I hope that the things that I do can help them to see that they have power and the ability and that it’s not just in my head. Because I have told some folks before that I am going to have hope whether you do or not—and you can borrow my hope until you get your own.”

Pushing, Pulling, and Letting Go

Serious mental illness is often associated with the presence of negative symptoms that result in dramatic decreases in energy and motivation. Although these symptoms might not be as dramatic and as obvious as others, in the long run they present the most formidable barriers to the recovery process. Naturally, these same issues, as well as consumer ambivalence and disinterest, can thwart the process of case management. So one sensitive issue faced by these case managers is how much (if at all) to push and pull recipients who express a desire to reach valued goals yet seem reluctant or fearful to take the next step. These issues are salient as case management and other assertive treatment models have been criticized as unduly coercive (see Sullivan & Carpenter, 2010). Whereas some case managers remain incognizant of the dilemma present here, others clearly understand what is at stake:

Case managers who are always in control and don’t let them have control or input hinders them too.…It makes them feel like they don’t have a voice and don’t have control. Here they are being told what to do and how to do it … for me that really can hinder recovery because they are not getting a chance to get out and recover. They are kind of being held down.

A frequently expressed theme was the importance of refraining from doing too much for those who can take greater control of their lives. Likewise, as many consumers can attest, there are case managers who feel empowered to exert a level of control over decisions that is unwelcome and unwarranted (Mancini et al., 2005). So at hand is a difficult balancing act. Consistent with the first theme is an observation made by a 3-year veteran in the field; “If you are working faster and harder than them, and they are consistently behind you or not even working at all, then it just becomes normal for them.…They have that expectation that you will do everything for them.”

So how does a case manager decide how much to do or not do for a given consumer?

Here is one response:

When it seems like you are working harder than the client, or it seems that you are more interested in the client’s issues then they are, that’s a frustrating thing, you know, because you see that they need these things in their life, but they don’t see that. So you have to let them lose those benefits or just let them do what they’re going to do and be there to pick them up and deal with the natural consequences.

Sometimes it is a matter of timing, as many case managers acknowledge that in the early stages of the relationship there is a necessity to be more involved to move the process along. One 20-year veteran of the field offers this advice: “Your steps are going to be pretty minimal until they can get that investment. Sometimes I think that if a person is not there yet you kind of have to do that a little for them until they get there, or until they can hear some hope.”

When case managers speak about their work, a common theme is planting seeds. The idea is easy to grasp. The general notion is to override inertia by gently suggesting action steps that are consistent with the goals the consumer has selected. Here is how another long-tenured case manager described the process: “Well, I will kind of push a little bit like saying, ‘Hey, I was kind of thinking this would be a good idea, what were you thinking?’” The trick, according to this informant, is never push too hard because “it’s not going to work.” A fellow employee argues that everything still comes down to the relationship:

You focus more on what they want out of life and what is getting in the way, and if that happens to be symptoms then you plant that seed every so often about that. You take that opportunity, but you don’t keep pushing because you are usually met with a lot of resistance. The more you push the more they resist.

There is little question that when professionals fail to attend to the wishes and needs of individuals, and worse, use various forms of leverage to shape client choice, claims of undue coercion are justified. Consider this observation:

Where I am really proud of myself is that I refuse to take no for an answer. If you tell me on day one that you want to accomplish this then we are going to accomplish it. And even if you tell me, “I don’t think I want to do this anymore,” then you have to have a reason why.

Here the line between good practice and coercion is at least blurred. The lingering question is this: How many times must a person say no? It is for that reason alone that the appraisal of the appropriateness of interactions rests primarily with the consumer (Sullivan & Carpenter, 2010). Understanding where to draw the line might come with experience, so one can appreciate the candor of this relative newcomer to the discipline:

I don’t always know, and there have been times when I worried that I have pushed too hard.…So with pushing I trust my gut a lot, and then if I am getting the impression that I pushed too hard then I will say … “Well it’s an idea and this is your choice, not my choice.” So I do a lot of pushing and then back off.

Moving Forward

Anthony (1993) offered recovery as a guiding vision for mental health services nearly two decades ago, and as time has passed the notion has been widely embraced. The concept suggests that people facing serious mental illnesses can enjoy a productive and satisfying life in spite of the obstacles they might face. Recovery is generally seen as a nonlinear process that is driven by the unique desires and goals of consumers (Ochocka, Nelson, & Janzen, 2005; Sullivan, 1994). Professionals can play an important role in this endeavor, and several case managers in this study described the hard work required to find any thread that could serve as a useful platform for a productive working relationship. One veteran case manager offers this assessment:

That is one of our big roles … with some clients it is a little harder to find that light or that interest than others. But sometimes you have to grab on to a little interest that they talk about, or kind of worm it in and see if it grows if you feed it a little bit. Because a lot of our clients are either numbed by their medication, or beaten down just with the pure magnitude of the intensity of their symptoms or life circumstances.

Many practitioners can point to breakthroughs that emerged from the smallest step. As one case manager suggested, “Even talking about someone’s positive attributes gets the conversation going.” Sometimes success is primed merely by offering an alternative perspective:

Well I think for one I try to instill hope in people or I try to let people know that I think they can make a change and I believe that they can get better. (I) also help people to make educated choices with different treatment options … (and) try to get things that they enjoy, try to find things that they find satisfaction with outside of the center, outside of their medication, just in the community at large.

Many of the case managers in this study were trained in approaches that place heavy emphasis on the goal-setting process. As one case manager noted, when goals are broken down into manageable steps, that makes it possible “to be able to check it off the list.” This method can reinforce the drive to forge ahead (Sullivan & Floyd, in press). One professional who works primarily with younger adults observed, “If you get them going and they have a little bit of success it seems to really feed their self-esteem and their motivation, and they just want to keep going.” When people stumble or lose faith, one case manager reminds consumers, “Hey, we had a goal here, you didn’t think it was a huge goal, but you had it, and continued down this path and you are going to build on it … and before you know it you are going to be amazed at where it has gotten you.”

Because the nature of the challenges recipients face can be cyclic, case managers here report that they repeatedly reminded consumers that recovery is not easy. There are tangible methods case managers use to deal with the flagging emotions of consumers. For example, one informant routinely offers proof that accomplishments have been made:

I always photocopy last year’s goals and then I take it to them, because you talk about it during the year. But it is a good thing to see it laid out in front of you, so I always take it with me and say “Do you remember this? This was your goal and you are so far down the road now.”

At times, activities that can have a positive impact on a consumer’s life might appear on the surface to be relatively insignificant as one case manager notes:

I really like working with people and helping them with some of the challenges they have in life. A lot of times things that should seem like something everyone should know how to do, like something as simple as mopping a floor or something … teaching a client how to do that, and seeing them do that, and then in the future doing it on their own and seeing improvement … that is kind of rewarding.

Building on the Relationship

The nature of the professional relationship in mental health has been explored from many angles. Clinicians have been groomed for generations to pay heed to the interpersonal dynamics of helping. That noted, few case managers in this sample took a detached approach to the individuals in their caseload, and it seemed that those who were still passionate about their job were equally passionate about the individuals who had become a part of their lives. As one case professional noted, “I don’t know how you really do this job without really being invested in it. Even when you try to hold your clients at an arm’s length, when you are in their life and they are in yours for as long as some of these folks are, it is really hard not to be.”

There are limits, however, and most case managers can discuss the importance of leaving work at the office and not crossing the line in their involvement with others. One informant who had been at the same post for a decade offered this caution:

They want to make us their best friend, but you can’t really … if you are a good case manager, you can’t be their best friend. You know you are going to move to another job or something eventually. And you don’t want to be too enmeshed. Because I have seen that—where people are giving clients money and going to do stuff with them on the weekend, and that is not good because you will end up disappointing them eventually.

Nonetheless, much of the work of the case manager, according to some respondents, involves being a stable presence in a consumer’s life. After 11 years at her post, one case manager remarked, “I think that makes a huge difference for people, just having that stability or any type of stability in their life.” Likewise, another veteran concurs: “I encourage them and be the person in their life that is hopeful and is supportive and is consistently available. Because … they are just not consistent, and things in their life are not consistent.”

Also as noted in the growing body of literature about recovery, sometimes consumers need to simply take a break from mental health care (see Davidson, Shahar, Lawless, Sells, & Tondora, 2006). This case manager concurs:

Sometimes you have to have a fun meeting rather than filling out job applications. We have to go get ice cream or go to the park or something fun …. It is fun. It seems like a lot of our clients don’t have a lot of other people in their lives so I have some people that I am kind of their companion. So doing things like that helps a lot.


It is probably fair to suggest that case management is not a job for everyone. The actual work is often done in the consumer’s home and community, and rarely is there a set schedule. Interestingly enough, these are the very elements of the job that case managers in this study seemed to value most of all. The perspective offered here was pervasive in this sample:

I like being out in the community, I’m not stuck behind a desk doing computer work all day like some of my friends I graduated from college with … I get to talk to people. I get to deal with people on real issues and help fix them.

There are also frustrations that come from regularly confronting the realities of serious mental illnesses. As one case manager shared, “You watch somebody work really hard, and you walk with them down this road and they get there just to see a dead end. That overwhelming feeling of, oh man—that is rough.” What seems to sustain these informants through the dark times is the belief that things will get better. One experienced case manager describes an internal process that many of his peers must feel:

You know I have been here 9 years, and there have been some really, really tough days and I am only human. I have some days where I have to take a step back for a minute—get to the core of what I do, and why I am here, and why I went into social work in the first place. It seems that folks grow and change beyond this mental illness thing, (and) that is worth it. And those are the moments that you keep filed away on the toughest of days … I have a belief in why I am here.

Although some case managers interviewed here will likely have short tenures, it was noteworthy that many remained upbeat years into their career, and report that they truly enjoy the people they work with. Indeed, where case managers seemed to thrive emotionally were in those situations where the relationship was not viewed as a one-way street, for as one experienced professional noted, “They’ve taught me just as much, if not more, than what I taught them.”

It is contended that case management, perhaps because it is viewed as an entry-level position, is routinely misunderstood and underappreciated as a professional discipline. As one respondent noted, “As a therapist you have your session in a room, it is confidential, and then you send them home.…The therapist gets really just a peek in the window through talk therapy, but the case manager gets to see it all.”

The intention here has been to tell a slice of the case management story from the words of those who are on the streets daily. It is a tale that flows naturally as these informants discuss the nature of their work and the people with whom they interact. The interviews also highlighted what those in the field have known for years: To be successful, a case manager must possess many direct practice skills. Nonetheless, because they share ice cream, help clean apartments, and spend time on the telephone helping secure needed benefits, it is easy for some to misinterpret the complexity of the job. Yet, as one case manager noted, “I think I am in a way kind of doing therapy.” Indeed, there are many ways to assist others, for as this respondent reminds us:

I thought it was very therapeutic to spend time with people and to look them in the eye and give them attention. That in itself was therapeutic and I would try to do things beyond that. But if it was literally going to Burger King with them and drinking coffee for an hour and a half, that was helpful. It gave me an opportunity to really get to know people and for them to learn how to befriend people.

What these case managers underscored is that there is more to this job than meets the eye. Because so much emphasis is placed on the practicalities of this role, in particular those activities that focus on the daily needs of consumers, other key aspects of case management can be overlooked by others. Newcomers to the field might fail to see this as a viable professional role; the valuable insights that case managers can offer might go fallow in multidisciplinary team meetings; and supervisors might fail to address the interpersonal aspects of the role. Indeed, when discussing the exhaustive list of tasks she and other case managers in her organization performed on a regular basis, one respondent finally paused and said, “There is quite a bit we do.” Because of what they do, and because turnover is a consistent issue (see Selden, 2010), even greater care should be taken in the recruitment and supervision of case managers, and every effort should be extended to retain those who are truly exceptional.

Another Reference to use

Using the ‘Seven A’s’ assessment tool for developing competency in case management.


Gallagher LPTruglio-Londrigan M

Please describe how the Case Manager in the video used the Seven As

Please research  and use references from AUSTRALIA for

  • The process of identifying and establishing goals 
  • How goals are described and prioritised
  • Ways to engage clients in goal setting
  • Developing interventions
  • The process of developing individualised case management plans
  • Implemention
  • Monitoring
  • Evaluation
  • Ethical principles that underpin case management practice
  • Ethical dilemmas that arise in practice
  • Ethical decision making
  • Managing your caseload
  • Effective case documentation
  • Healthy practice

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