Many clients who access counselling have multiple services assisting them with their ongoing living, health, and social needs. In some cases, clients are supported by a case manager (or a case management service) who coordinates these services to make sure that clients’ needs and goals are met in an efficient and effective manner (Summers, 2016). The concept of case management traditionally emerged from mental health sector as a way to meet the complex needs of clients accessing mental health services, which often involves engaging with multiple services (Woodside & McClam, 2018). Since then, the field of case management has evolved, moving away from “managing” client cases to “supporting” and “coordinating” care and services, which better reflects the role of case managers today. Case management practices are now widely implemented in human services contexts as a promising way to support effective and quality service delivery.

Collaborative case management has now become a common element within most community services organisations. The social and economic pressures of modern society resulted in increasing demands for services as well as competition for funding. To cope with this demand, many organisations and practitioners are opting to provide more specialised care and work in partnerships and/or referral networks to provide the multiple layers of support clients require – this is where case management becomes vitally important (Blundo & Simon, 2016). Consequently, some community services organisations will have staff and practitioners acquiring generic case management duties instead of having designated case managers. With the increasing recognition of multicultural and diversity in modern societies, case management principles and practices also support service delivery to become more streamlined, culturally appropriate, and personalised to suit clients’ needs.  Essentially, case management involves facilitating the coordination of, and communication between clients, service providers and other key stakeholders, as well as monitoring progress.

In comparison to a counselling process, the case management process is typically more solution-focused and structured with concrete steps. As it is heavily guided by the organisation’s service delivery framework and relevant legislation, case management can come across as more directive than a counselling process. Nevertheless, both counselling and case management processes operate from a client-centred perspective and aim to work collaboratively with clients to achieve positive life goals or outcomes.

There are three key components of case management: assessment, planning, and implementation. The following diagram depicts tasks relevant to these components (adapted from Woodside & McClam, 2013, p. 9):

Essentially, assessment is a process in which the client provides the case manager with information about their needs and desires and the case manager analyses this (along with other information) in order to fully understand the client’s needs and the goals for case management. This is similar in nature to the assessment and exploration of client needs in the counselling process; however, case managers tend to have a broader focus hence the assessment may cover multiple layers of client needs (e.g., emotional, mental, physical, occupations, relational). Assessment often involves engaging not only the client, but also their family members, carers, and other significant people in the client’s life. It is important to remember that the process of assessment continues throughout the case management process so that the suitability of services can be continually monitored, evaluated, and the case plan re-assessed if necessary (Woodside & McClam, 2013).

The planning stage involves the case manager consulting with the client and their family/significant people to determine which services would best suit the client’s needs. The case manager then uses this information to develop a written case management plan (or case plan) that facilitates coordination of services at the implementation stage.

Implementation involves ensuring that the case management plan is put into action and that the client begins taking steps to achieve their goals within the plan. This involves the case manager liaising with the client, their family, and relevant services in order to encourage the client’s progress, monitor the case plan, and make adjustments if required (Summers, 2016).

It is important that the client is always the central focus of the entire process. The case manager takes the time to develop rapport with the client, then uses effective communication skills in order to help the client identify their needs/goals, their strengths, their resources, and their supports, and develops an appropriate case management plan for the individual client. Moreover, the case management process should not be regarded as a linear process; instead, you are likely to revisit previous stages or steps with clients whenever their needs or circumstances change.

As Summers (2016) outlines, case management is a multi-faceted approach that involves critical consideration of five key factors:

  1. The relationship dynamics of clients and their families. Case management often involves engaging and supporting not only the client, but also other people who are significant in the client’s life, such as family members, friends and carers (Guzys et al., 2021). Indeed, case plans will usually include one or more significant people in the client’s life. In such cases, it is important to consider the dynamics, particularly the power dynamics, of these relationships and how they might be impacting on a client’s life and their capacity for self-determination. The complexity of these dynamics is perhaps no more obvious than within the structure of the family unit. The client’s involvement in (or separation from) their family, the family’s current situation, and their expected level of involvement are important considerations when assessing, planning and implementing a case management plan (Mullahy, 2014). As Mullahy (2014) argues, when developing a case plan where family is involved in the case management process, consideration must be given to family structure and functioning; communication styles; and dynamics and decision-making processes.
  2. The relationship between the client’s social, psychological, physiological, and economic circumstances. All aspects of the client’s life are interconnected. Therefore, it is important to consider each client holistically when developing a case management plan. This is an important consideration because if both you as a case manager and the client understand these links, you can help them clarify their needs and then they can set more effective goals. If the client is engaged in goal setting, they are more inclined to participate in the case management process. 

Ecological systems theory highlights the importance of a ‘person in environment perspective’, stressing how critical interactions occur between individuals and their environment. The importance of this ‘person in environment approach’ becomes apparent when a concern or challenge in one area of a client’s life has a strong impact on another area. For example, if a client becomes seriously ill, they may as a consequence lose their job, become depressed, and withdraw from their support network. While consideration must be given to all areas of the person’s life and while intervention may still target all areas, the illness can be seen as the primary issue, because treatment of the illness is likely to have a positive flow-on effect to other areas of the client’s life. In this way, it is also important for the case manager to develop a holistic understanding of the client’s circumstances so that a realistic case plan can be developed. This understanding can help the case manager provide or co-ordinate interventions that not only address client need, but are fully accessible and realistic for the client based on their individual circumstances. For example, there is little point referring a client to a high-cost service provider if the client has no means of paying for the service.

  • Organisational services, policies, procedures, and documentation requirements. It is vital for case managers (as well as counsellors and other helping professionals) to work within their organisation’s policies and procedures. This involves managing their role and responsibilities as well as maintaining adequate documentation. The requirements not only serve to make sure best practices are applied for each client, but also to protect both the case manager and their agency/organisation.
  • Relevant state and federal laws and regulations. Case managers must also be well-versed in all laws and regulations relevant to their location, type of work, and the types of clients they work with. In some cases, participation in case management process is statutory (i.e., legally required); hence, the nature and approach to case management will be influenced by respective requirements. Some areas of laws and regulations relevant to case managers (or counsellors working in a case management capacity) include mandatory reporting laws; guardianship, trustee and administration acts; mental health legislation; child protection laws; home and community care standards; and clients with statutory limitations imposed upon them.

It is the case manager’s responsibility to ensure that they work within all statutory requirements and specific practice standards that relate to their area of work. On top of the list above, there are more common legal considerations relating to information sharing (e.g., privacy legislation), the client’s right to confidentiality, informed consent, and work health and safety legislation. Case managers must also comply with relevant practice standards and professional codes that regulate their profession and/or area of work. Examples include the National Standards of Practice for Case Management and Australian Community Workers Code of Ethics.

  • Local community services and support resources. Finally, case managers must be familiar with the resources available in their local area – this includes both the services available within their own organisation as well as those offered by other service providers. This will allow the case manager to develop the most effective case management plan with their client. Directories such as infoXchange service seeker, Lifeline service finder, and local service directories can be used as a starting point in building a referral directory. In doing so, case managers should not only gather information about services provided, but how to make a referral as well as eligibility and funding requirements. With this information, case managers can prepare case plans (in collaboration with clients) with the inclusion of the most appropriate service providers for each individual client. Therefore, the ongoing development of strong and positive relationships with other service providers can be seen as a major part of being a case manager. Interagency network meetings are excellent opportunities to develop these relationships.

Editor’s Note: This is an excerpt from the unit Develop, Facilitate and Review All Aspects of Case Management, which is available in AIPC’s Diploma of Counselling, Diploma of Community Services (Case Management), Diploma of Financial Counselling and the Diploma of Youth Work.  Graduates of the Diploma of Counselling can also opt to enrol in the Case Management Skill Set via their my.AIPC student portal.

 

References

Blundo, R. G., & Simon, J. (2016). Solution-focused case management. Springer.

Guzys, D., Brown, R., Halcomb, E., & Whitehead, D. (2021). An introduction to community and primary health care. Cambridge University Press.

Mullahy, C. M. (2014). The case manager’s handbook (5th ed.). Jones & Bartlett Learning.

Summers, N. (2016). Fundamentals of case management practice: Skills for the human services. (5th ed.). Cengage Learning.

Woodside, M. & McClam, T. (2013). Generalist case management: A method of human service delivery (4th ed.). Brooks/Cole, Cengage Learning.

Woodside, M. & McClam, T. (2018). Generalist case management: A method of human service delivery (5th ed.). Cengage Learning.