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4 Case Management Models

January 5, 2017

Female case manager wearing glasses and business wear smiling at her client over a clipboard.

A case manager helps individuals and families meet their comprehensive health needs by advocating for them and coordinating appropriate care. This job title can be found in social services, health care and other fields such as social work.

Achieving client wellness and autonomy is a collaborative task, and case managers can rely on a number of case management models to provide high-quality services. The following models represent common approaches in the profession.

1.    Intensive Case Management

Intensive case management (ICM) provides assertive outreach and counseling services, including skills-building, family consultations and crisis intervention, according to the Journal of Psychoactive Drugs. It is similar to and sometimes grouped with assertive community treatment, a case management model that utilizes a team approach and larger caseloads.

“It is designed for clients with lower acuity, but who are identified as needing intensive support for a shorter and time-delineated period,” says the Homeless Hub, an academic research compendium operated by the Canadian Observatory on Homelessness at York University. In this service area, ICM helps “clients maintain their housing and achieve an optimum quality of life through developing plans, enhancing life skills, addressing health and mental health needs, engaging in meaningful activities and building social and community relations.”

Research on ICM shows that the case management model is effective.

  • ICM has a “moderately strong evidence base” for homeless populations, the Homeless Hub reports.
  • ICM has been tested for assisting diverse substance-abusing populations, especially homeless and alcohol dependent persons, according to the Journal of Psychoactive Drugs. It is cost-effective and beneficial in these populations and for persons with severe mental illness and co-occurring substance use disorders. Limited research is available for other substance-abusing populations.
  • ICM “was found effective in ameliorating many outcomes relevant to people with severe mental illnesses,” a study published in the Cochrane Database of Systematic Reviews says.

2.    Strengths-Based Case Management

Strengths-based case management is a perspective originally developed to help a population of persons with persistent mental illness make the transition from institutionalized care to independent living, according to Comprehensive Case Management for Substance Abuse Treatment from the Substance Abuse and Mental Health Services Administration (SAMHSA). The model focuses on two principles: providing support for asserting direct control over clients’ search for resources such as housing and employment; and examining clients’ strengths and assets as the vehicle for resource management.

“Strengths-based approaches concentrate on the inherent strengths of individuals, families, groups and organisations, deploying personal strengths to aid recovery and empowerment,” according to Iriss, a charitable company serving people who use Scotland’s social services. “In essence, to focus on health and well-being is to embrace an asset-based approach where the goal is to promote the positive.”

There is some evidence that suggests strengths-based approaches can improve social connections, have a positive psychological impact and enhance well-being, help children and families, and improve retention in treatment programs for those who misuse substances. The Journal of Psychoactive Drugs and SAMHSA say that strengths-based case management improves client outcomes in substance abuse.

3.    Brokerage/Generalist Case Management

Case managers in brokerage/generalist models help clients identify their needs and broker resources. Rather than an intensive long-term relationship, the case manager may limit planning to the client’s early contacts. Ongoing monitoring is not provided or is relatively brief.

The models have received criticism because of limited contact between case managers and clients. “Nonetheless, this approach shares the basic foundations of case management and has proved useful in selected situations,” SAMHSA says. “The relatively limited nature of the relationship in this model allows the case manager to provide services to more clients. This approach is also appropriate in instances where treatment and social services in a particular area are relatively integrated and the need for monitoring and advocacy is minimal.”

A potential advantage of the approach is how it allows case managers to deliver immediate results to clients. One example of this is how case managers in a large metropolitan area were able to link HIV-infected clients with at least two referrals during the initial session to agencies or services that would provide ongoing services. Case managers working with substance-abusing clients in a large metropolitan area had access to funds and were able to purchase treatment services, drastically reducing waiting periods.

The model is particularly effective for clients who are “not economically deprived, who have significant intent and sufficient resources,” according to SAMHSA.

4.    Clinical Case Management

Clinical approaches to case management combine resource acquisition (case management) and clinical (therapy) activities. Clinical and rehabilitation approaches are often combined, as some case managers provide activities like psychotherapy and teaching specific skills so that one treatment professional provides, or at least coordinates, therapy and case management activities.

The approaches are common in substance abuse treatment programs. Driven by staffing considerations, having one treatment professional provide all services to clients is more economical than separating clinical and case management services, SAMHSA says. A program for women who have substance abuse problems used the clinical case management approach due to the belief that women have special needs in the treatment setting. The program holds that these needs are most appropriately addressed through a therapeutic relationship with one caregiver.

Starting a Career in Case Management

Case managers play a pivotal role for their clients, helping them receive the care and resources they need. They do this in a variety of environments, including hospitals, mental health clinics, crisis centers, legal advocacy organizations, welfare agencies and schools.

Those interested in becoming a case manager can complete a bachelor’s degree in a field that relates to the intended area of specialty. Although a limited number of case managers enter the field with an associate degree and some have a master’s degree, most case managers have a bachelor’s degree. They also often complete an internship at a clinic or agency before obtaining full-time employment.

Grace College’s online Bachelor of Science in Human Services prepares students to advocate for those in need of assistance and support. Graduates gain the knowledge and skills to enter fields like case management.

This GOAL (Grace Opportunities for Adult Learners) program is designed for adults who are currently balancing work and personal commitments. It can be completed in as little as 16 months, is priced substantially below most degree completion programs and is taught by outstanding and understanding faculty who are geared toward teaching adults.