Intervention in Case Planning

Counsellors are often directly involved in the intervention phase of case planning. A counsellor may in fact be a service provider that a case manager utilises as part of their case plan. This article, however, is not focused on direct, personal interventions (although that is generally the core work of the counsellor), it is focused instead on the intervention processes counsellors can utilise when positioned in the role of service coordinator or case manager.

In this role, counsellors must have knowledge in the following key areas:

  1. Service delivery systems in their local community
  2. Appropriate process for referral
  3. Appropriate use of broker and advocate roles
  4. Mechanisms for empowering and enabling clients

Let’s consider each of these areas separately.

1. Knowledge of service delivery systems in the local area

To provide the most effective and relevant service network for a client, comprehensive knowledge of what’s available in the client’s local community is a must. Selecting resources for clients that will meet their needs is both a science and an art.

Selection of resources will be made increasingly proficient, as counsellor knowledge in relation to available resources increases. Additionally, counsellors must develop a solid understanding of client preferences, strengths and values in order to ascertain which services may best fit client need.

Armed with extensive knowledge of community resources and an understanding of client needs and preferences, a counsellor can maximise the likelihood of effective referral selection and thus optimise client outcomes.

2. Knowledge of the appropriate process for referral 

Referral is the process of linking clients with selected services in the community. Referrals are made only with the permission of the client (or client guardian) and may involve the counsellor making the initial contact with the identified service on behalf of the client and/or accompanying the client for the first meeting.

Additionally, effective referral procedures ensure that the client has adequate resources to attend the service (i.e. they have transport, financial resources and/or childcare etc.).

Follow-up is an additional part of a well-executed referral. Follow-up allows the counsellor to determine if there was an appropriate ‘fit’ between client and service. Additionally, follow-up enables counsellors to gain a greater understanding of the service on offer, thus increasing the likelihood of making appropriate referrals to that service in the future.

3. Knowledge of the appropriate use of broker and advocate roles

In the same way a mortgage broker acts as an intermediary between client and lender, the broker in case management acts as the intermediary between client and community service. The broker role provides clients with information, awareness and knowledge of the services available to them. Additionally, the broker acts to assist clients in accessing those services, as required.

Advocacy, on the other hand, sees the counsellor speak and/or act on direct behalf of the client. The following paragraph offers an apt warning about the frequency at which advocacy should be undertaken.

“It is often unclear how much and to what degree case managers should be involved in client advocacy. Whenever case managers act on behalf of their clients, even just to make a referral, they are acting as client substitutes. Every time this happens, and often it must, clients are losing the opportunity to practice advocating for themselves. By definition, practicing any new behaviour, including assertive skills, community assessment, and self-advocacy, is a learning process that includes making mistakes (Wehmeyer and Metzler, 1995).

At times the wisdom of Solomon may be required in order to decide when to back off and support clients in their attempts to act for themselves, when to advocate for them, and when to find some kind of middle ground. We must constantly remember that the more clients learn to act for themselves and their families, the more independent and self-sufficient they will become.

An additional value of self-advocacy is that people become more involved in their community and with people who share their life problems. Thus case managers should not take on the advocacy role as a habit without careful consideration.” (Frankel & Gelman, 2004)

Broker and advocacy roles are crucial to the success of case management processes. Linking clients to resources that will serve as a strong community support system is the ultimate aim of case management. Counsellors must, however, be mindful and cautious of the fine line that distinguishes effective client advocacy from the unintentional fostering of client dependency.

4. Knowledge of the mechanisms for empowering and enabling clients

Simply stated, empowered individuals are aware of, and act on, the right to make their own choices and decisions. To empower a client is to raise their awareness about personal rights and entitlement. Strategies to empower aim to transform client feelings of helplessness and powerlessness into greater self-assuredness and confidence. Minor shifts in the way a counsellor conducts casework can serve as a great starting point for empowering clients.

This can be achieved by consistently and directly involving clients in the process of case planning; keeping clients clearly informed throughout the process; advocating only when necessary and maintaining a focus on client strengths and resources.

Enabling is the process of assisting a client (or client system) to carry out an activity that would otherwise not be possible.  An important part of enabling involves encouraging the client to develop positive thinking in relation to the achievement of goals.

To do this, the counsellor must listen for indications of how a client is thinking about and perceiving their established objectives and goals. By doing this, the counsellor is able to identify potential barriers to achievement and highlight areas requiring attention or intervention.

Monitoring

Refinement and adjustment over time are important and valuable parts of case planning. Case plans are developed on the basis of assessment information and inevitably require modification as new information is introduced. For this reason, it is essential that both counsellor and client maintain flexibility in relation to goals, objectives and timeframes. Monitoring needs to occur over the full course of intervention.

When progress is monitored, both counsellor and client are afforded the opportunity to share what they feel is working or not working in the case plan; what needs refinement or modification; what goals or objectives need to be removed, added or altered and/or what time-frames need adjustment.

Collaboratively discussing potential changes in a case plan not only contributes to a client’s sense of accountability but also serves to empower and enable.

Source: www.mentalhealthacademy.com.au