Nantaporn Ieumwananonthachai
Thammasat University
August 23, 2011
Case Management is …

a collaborative process of assessment, planning,
facilitation and advocacy for options and services to
meet an individual’s holistic needs through
communication and available resources to promote
quality cost-effective outcomes. (Case Management
Society of Australia 2009)

a process for assessing the client’s total situation
and addressing the needs and problems found in
the assessment. (Summers, 2009)
History

Case management emerged as a separate and
professional service in the 1970s, where it was
seen as a way to connect clients with multiple
needs to an increasingly complex social service
delivery system (Turner & TenHoor, 1978).

Throughout its history, case management has
focused on the holistic needs of clients, addressing
basic needs such as safety, food, and shelter, as
well as emotional, medical, and other needs
including employment, education, and connection
with others in the community (Rapp, 1998)
Advancement of
Sciences,
Technologies, and
Medicine
“Holistic
Interdisciplinary”
concept
“Individualized
Human Right”
concept
Cross border
issues
Complex social
situation and
problems
Organization mandate is
not consistent with
responses required
Limitation on quality
and access of services
CM
Limitation of
resources and
services
Globalization and Gap
in Economic
Development
Require intensive coordination
Questions?
Do you know any two person who have the
same exact background?
 Would it possible for two person to have the
same exact problem (with exact same details)?
 Would it possible for two person to have the
same preference?
 Would it appropriate to solve problem of two
people with different background, different
strengths, different preference, using the same
solution?

Principles of Case Management

The service delivery is individualized based on comprehensive
assessment that is used to develop a case or service plan
Questions?
Who own the problem?
 Who should work on the problem?

 Let client work on the problem with your
support
 CM is an expert on available services and system
 But client is an expert on his/her own life.
Principles of Case Management




The service delivery is individualized based on comprehensive
assessment that is used to develop a case or service plan
The plan is developed in collaboration with the client and
reflects their choices and preferences for the service
arrangements being developed
The goal is to empower the client and ensure that they are
involved in all aspects of the planning and service
arrangement in a dynamic way. (Case Management Society of Australia 2009)
Multiple services are provided to individual in a holistic
approach with case manager as main coordination mechanism
through multidisciplinary team and case conference
Human Trafficking

The United Nations definition of Human
Trafficking is “The recruitment, transportation,
transfer, harbouring or receipt of persons, by
means of the threat or use of force or other
forms of coercion, of abduction, of fraud, of
deception, of the abuse of power or of a position
of vulnerability or of the giving or receiving of
payments or benefits to achieve the consent of a
person having control over another person, for
the purpose of exploitation”
Advancement of
Sciences,
Technologies, and
Medicine
“Holistic
Interdisciplinary”
concept
“Individualized
Human Right”
concept
Cross border
issues
Complex social
situation and
problems
Organization mandate is
not consistent with
responses required
Limitation on quality
and access of services
CM
Limitation of
resources and
services
Globalization and Gap
in Economic
Development
Require intensive coordination
CRISIS INTERVENTION
 Medical treatment
physical examination and treatment
 psycho and emotional support


Legal assistance - law enforcement
Legal advice
 Legal support
 Investigation and proceedings

 Social services
Crisis measures - inc. temporary care
 Complete assessment (incl. risk)
 Planning

Rehabilitation: Prevention of
further harm

Restriction/protection orders

Permanency planning and monitoring

Family support services (economic, mediation,
social skills, housing, employment, social services…)

psychological and emotional support

support during and after legal proceedings

advocacy and referral to existing services
Coordination/ Linkages
Health
Personnel
Therapist
Community
workers
Psychologist
CM
Families
Social Worker
Police
Other
Professionals
Case Management definition in
work with victims of trafficking

"a collaborative means of helping people who
are disadvantaged or devalued in society, to
discover their strengths and personal power,
pursue their own objectives, and begin to
confront the systems that oppress them, in
order to redistribute power and thereby
improve their life chances and quality of life"
(Spindel, 2008, p.15).
Coordination/ Linkages
Health
Personnel
Therapist
Community
workers
Psychologist
CM
Families
Social Worker
Police
Other
Professionals
Case Management is one of the services
delivery approach
The Case Management approach assumes that clients
with complex and multiple needs will access services
from a range of service providers and the goal is to
achieve seamless service delivery. This assumption
highlights that the concept of Case Management is
based in service provision arrangements that require
different responses from within organisations and
across organisational boundaries. Case management is
described as a boundary spanning strategy to ensure
service provision is client rather than organisationally
driven. (Case Management Society of Australia 2009)
Components of Case Management Process
Identification
/ Selection
Termination
Evaluation
Assessment
Client
Implementati
on/
Coordination
Planning
Standards of Practice for Case Management, revised 2010 (USA)
1. Client Identification and Selection

Focus on identifying clients who would
benefit from case management services.
Standards of Practice for Case Management, revised 2010 (USA)
2. Assessment and problem/
opportunity identification:
 Begin after the completion of the case
selection and intake into case management
and occurs intermittently, as needed,
throughout the case. (Standards of Practice for Case
Management, revised 2010 (USA))
What do we need to know
from assessment?
Exploring and evaluating initial problem and
the background,
 person’s current situation,
 person’s background,
 what the person needs to make life more
stable and to resolve current problem, and
 strengths of person and environment

(Summers, 2009)
3. Development of the
Case Management Plan

Establish goals of the intervention and prioritizes
the client’s needs, as well as determines the type
of services and resources that are available in
order to address the established goals or desired
outcomes.
Standards of Practice for Case Management, revised 2010 (USA)
4. Implementation and coordination
of care activities
Put the case management plan into action
through the coordination with service
providers, and client and family.
 If the client has to be referred,
communicate with new provider (CM) and
client, and ensure smooth transition.

Standards of Practice for Case Management, revised 2010 (USA)
Coordination
Divide into 3 phases
1. Beginning
2. Network maintenance
3. Termination (Onopas, 2011)
Referral
1.
2.
3.
4.
5.
6.
Identify objective of the referral, and jointly work with client
to select appropriate agency for referral
Communicate with destination agency and new CM, to
ensure smooth transition
Prepare necessary document for referral
Prepare client for the transition
If the client has to be transferred to another geographical
area, ensure that there is someone to accompany the client
if s/he is not capable of travelling by him/herself.
Follow up on the transition, and evaluate client’s
satisfaction.
5. Evaluation of the case
management plan and follow-up

Involve the evaluation of the client’s status
and goals and the associated outcomes.
Standards of Practice for Case Management, revised 2010 (USA)
6. Termination of the case
management process

Bring closure to the care. The process
focuses on discontinuing case management
when the client transitions to the highest
level of function, the best possible outcome
has been attained, or the needs/desires of
the client change.
Standards of Practice for Case Management, revised 2010 (USA)
Case Management goals





enhancing developmental, problem-solving,
and coping capacities of clients
linking people with systems that provide
them with resources, services, and
opportunities
creating and promoting the effective and
humane operation of systems that provide
resources and services to people
improving the scope and capacity of the
delivery system
contributing to the development and
improvement of social policy (NASW, 1992)
Micro
Meso
Macro
Case Manager is working with
 Client/ Services User (Micro)
 Personal context (Meso)
 Social context: Environment (Macro)
Client/service user
 Individual: with problems that are
complex, chronic, severe, repeated, etc.
 Target group: elderly/ child and youth/ female (with
all forms of violence), substance abuser, HIV/AIDS or
chronic patients, disable (physical/ mental/ intellectual),
perpetrator after being released, those at risk of facing
repeated problems, etc.
Personal context:

Family, work group, social groups, family
culture, family values, family structure,
religious group, social class, role status –
conflict – strain. (Summers 2009)
Social context: Environment
 services system
 economic and politic
 culture and belief
Assignment
Talk to human service professional in your
community about what that person sees as an
unmet need in the community.
 What one service relating to human trafficking
would the professional like to see developed?
 What specific need would that service met?
 What client population would that project
address?
 How could the clients who need this service be
mobilized to work in their own behalf?
Roles of Case Manager
 Facilitator (within service system)
 Advocator (rights holder)
 Educator
 Negotiator
 Coordinator
 Manager (monitor and follow up on outcomes/ and transition)
Attitudes of an effective CM
Warmth
 Genuineness
 Empathy
Profound effect on client’s ability to move
forward and heal


Self-Assessment exercise (5 minutes)
Skills required to be an effective CM






Work effectively with people to promote their
growth
Work with people of various professions,
paraprofessionals, the public, and clients and
their families
Identify what your client needs
Keep accurate and well-organized records
Allow the client to take leadership in planning
services
Develop creative resources within your
community to meet client needs.
Knowledge base for Case Management
Individual and family dynamic
 The relationship between and among social,
psychological, physiological, and economic
factors
 The focus and policies of your agency
 Government regulations that affect your
agency’s delivery of service
 The vast array of community services and
resources where you practice.

Guidelines for Case Management
Plan ahead (prevent crisis)
 Be accountable
 Be optimistic
 Involve your clients
 Go where your clients are
 Promote independence
 Develop a large number of resources

Assignment

Put together a resource book listing
agencies and what they do, support groups,
and places where educational seminars and
workshops are held for the general public.
Collect them from the community where
you expect to practice, and keep the latest
copy of social services agencies found in
most telephone books.
Sample Tools for CM
 Bio Psycho Social Assessment
 Strength Based Assessment
 Life Plan
 Contract Plan (Task Plan)
 Case Conference/ Multidisciplinary
meeting
Team
A team or group consisting of representatives from
several different professional backgrounds who all
have different areas of expertise.
(http://society.guardian.co.uk/glossary/p)
A group of professionals from diverse disciplines
who come together to provide comprehensive
assessment and consultation in abuse cases
(http://wiki.answers.com/Q/What_is_the_meaning_of_the_term_multidis
ciplinary_team#ixzz1UzV0oQFy)
Coordination/ Linkages
Health
Personnel
Therapist
Community
workers
Psychologist
CM
Families
Social Worker
Police
Other
Professionals
Why a multidisciplinary approach?
Deal with complicated problems
 Provide diverse and overall aspect on particular
issue
 Provide opportunity to see from different angles/
professional perspectives
 Allocate work among agencies
 Reduce duplication of work

Multidisciplinary team meeting
A meeting consist of many professionals
vs.
Case Conference
A meeting for a particular case
Multi Disciplinary Case Conference (MDCC)
For Child Protection (Abuse) case,
 MDCC is a forum by which professionals having a major role in
the handling and investigation of a suspected child protection
case can share their professional knowledge, information and
concern on the child health, development, functioning and
his/her parents’/carers’ ability to ensure safety of the child.
 Focus on protection and welfare of the child and not
prosecution of the abuser.
 Analyzes risks and recommends actions to be taken in relation
to the welfare planning of the child and his/her family,
respecting the statutory obligations of individual members for
the case. (from: www.swd.gov.hk/doc/fcw/proc_guidelines/childabuse/Chapter11.pdf)
Objectives of case conference





Discussion of the clients history
Identification of the clients multi-disciplinary needs
Identification of outcomes to be achieved by
members of the team providing services to client
Identification of tasks to be undertaken to achieve
outcomes and allocation of tasks to team members
Assessment of success or otherwise of previously
identified outcomes (adapted from http://www.gpageelong.
com.au/Our-Services/Medicare/case-conferencing.html)
Samples of roles of CM for
Trafficking victim (US)


In addition to serving as a single point of contact, a central case manager
can assess a client's need for services and support; identify, obtain, and
coordinate those services for the client; coordinate and manage
communications across systems; and serve as a liaison for the client.
Other functions of the case manager include: translating for the victim or
obtaining translation services; accompanying clients to appointments;
assisting/teaching clients to access public transportation; and in some
cases, teaching clients basic life skills. Sometimes this includes teaching
clients how to use kitchen appliances or how to make a phone call.
Offering reassurance and comfort to clients often occupies much of a
case manager's time, but it is essential in building trust and rapport with
the client. In fact, many providers and law enforcement representatives
note that the case mangers are often the first and sometimes the only
person a victim trusts.
From: Case Management and the Victim of Human Trafficking: A Critical Service for Client
Success By: Heather J. Clawson and Nicole Dutch , June 2008
Ingredients for Effective CM in Human
Trafficking

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
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Establishing a hopeful relationship with the client;
Assessing client strengths and needs;
Developing, in partnership with the client, a service plan to
achieve desired outcomes;
Locating, linking, and following up with needed services and
support;
Monitoring, coordinating, and adjusting services and supports to
achieve desired outcomes;
Providing crisis prevention and intervention services and
support; and
Advocating for the client.
Extracted from the NACM Web site, http://www.yournacm.com/definition.html
The effectiveness of any case management
program depends upon the availability of highquality treatment and support services in a
given community, the structure and
coordination of the service system, and on the
ability of an individual or family to pay for care
either through private insurance or (more
often) through public benefit and entitlement
programs.
From: Case Management and the Victim of Human Trafficking: A Critical Service
for Client Success By: Heather J. Clawson and Nicole Dutch , June 2008