Case Management
Practice
Skills for the Human ServicesContents

Human Service Workers 1
Introduction 1
Language and Ethics 2
Dual Relationships 2
Value Confl icts 6
The Rights of Individuals Receiving Services 10
Confi dentiality 13
Privacy 17
Health Insurance Portability and Accountability Act 17
Social Networking 20
Privileged Communication 21
When You Can Give Information 21
Diagnostic Labeling 24
Involuntary Commitment 25
Ethical Responsibilities 26
Protecting a Person’s Self-Esteem 27
Stealing from Clients 29
Competence 30
Responsibility to Your Colleagues and the Profession 31
Professional Responsibility 33
Summary 34
Talk it Over 34
Exercises I: Ethics 34
Exercises II: Ethically, What Went Wrong? 37
Exercises III: Decide on the Best Course of Action 41
Exercises IV: What is Wrong Here? 42
Chapter 2 Case Management: Definition and Responsibilities 43
Introduction 43
A History of Case Management 44
Why We Use Case Management 44
Assessment 45
Planning 46
Creating an Individualized Plan 49
Linking 52
Contents v
Monitoring 53
Advocacy 53
Service Coordination 55
Levels of Case Management 57
Separating Case Management from Therapy 59
Case Management in Provider Agencies 60
Managed Care and Case Management 61
Underlying Principles: Hope and Self-Determination 63
Generic Case Management 65
Summary 65
Exercises I: Case Management 66
Exercises II: Decide on the Best Course of Action 69
Chapter 3 Applying the Ecological Model: A Theoretical Foundation
for Human Services 71
Introduction 71
Seeking a Balanced View of the Client 72
The Three Levels 74
Looking at What the Person Brings 74
Looking at What the Context Brings 75
Developmental Transitions 76
Developing the Interventions 77
Working with the Generalist Approach 78
Macro Level Interventions are Advocacy 79
Summary 79
Exercises I: Looking at Florence’s Problem on Three Levels 80
Exercises II: Designing Three Levels of Intervention 81
Section 2 Useful Clarifications and Attitudes
Chapter 4 Cultural Competence 85
Introduction 85
Culture and Communication 85
Your Ethical Responsibility 86
Where Are the Differences? 86
Strangers 88
Anxiety and Uncertainty 89
Thoughtless versus Thoughtful Communication 90
Dimensions of Culture 94
Obstacles to Understanding 99
Competence 101
Summary 102
Exercises I: Testing Your Cultural Competence 103
Chapter 5 Attitudes and Boundaries 107
Introduction 107
Understanding Attitudes 107
Basic Helping Attitudes 108
Reality Check 111
How Clients Are Discouraged 111
Understanding Boundaries 114
vi Contents
Seeing Yourself and the Client as Completely Separate
Individuals 114
Erecting Detrimental Boundaries 116
Transference and Countertransference 116
Summary 117
Exercises I: Demonstrating Warmth, Genuineness, and
Empathy 118
Exercises II: Recognizing the Difference—Encouragement or
Discouragement 123
Exercises III: Blurred Boundaries 124
Chapter 6 Clarifying Who Owns the Problem 127
Introduction 127
If the Client Owns the Problem 128
If You Own the Problem 131
If You Both Own the Problem 131
Summary 132
Exercises I: Who Owns the Problem? 133
Exercises II: Making the Strategic Decision 135
Section 3 Effective Communication
Chapter 7 Identifying Good Responses and Poor Responses 137
Introduction 137
Twelve Roadblocks to Communication 138
Useful Responses 142
Summary 150
Exercises: Identifying Roadblocks 150
Chapter 8 Listening and Responding 153
Introduction 153
Defi ning Refl ective Listening 154
Responding to Feelings 154
Responding to Content 158
Positive Reasons for Refl ective Listening 160
Points to Remember 160
Summary 162
Exercises I: How Many Feelings Can You Name? 162
Exercises II: Finding the Right Feeling 162
Exercises III: Refl ective Listening 163