Case Management. A brief overview

Term Paper , 2008 , 36 Pages , Grade: 1,3

Social Work

Case work with individuals and families is once again increasingly in the focus of specialist discussions in social work. The performance and quality requirements for case work are becoming ever greater, since people's living conditions have changed, their problem situations have changed and often become complex, multi-burdened problem situations. Added to this is the increase in the legal right to professional assistance.
For some time, attention has therefore been focused on the concept of case management, which could represent a qualified continuation of social individual case assistance.

structure

1. Prologue

2. Definition of case management

3. Historical development of case management

4. Axiology of Case Management

5. Theoretical background of case management
5.1. Central functions of case management
5.2 Systems Theory

6. Praxiology of Case Management
6.1 Fields of action and areas of application
6.2 Overview of different phase models
6.3 The phase model according to Manfred Neuffer
6.4 Key qualifications of the Case Manager

7. Possibilities and Limitations of Case Management in Social Work

8. Epilogue

Bibliography:

1. Prologue

The focus of the expert discussions of social work is again increasingly on case work with individuals and families. The performance and quality requirements for case work are taking on ever greater proportions, as people's life situations have changed, their problem situations have changed and often become complex, more burdened problem situations. In addition, there is the increase in the legal entitlement to professional assistance.¹

"The difficulties and hardships of people are now so involved in everyday life that (!) they hardly disappear if money is given from time to time or good advice or if one tries to cope with the social burdens with psychotherapy or medication. In a complex situation, perhaps everything is required together, coordinated with each other, or even just a better organization in coping with everyday life."²

These multidimensional life situations of the clientele, but also new action-theoretical insights of the systemic model of thought require new holistic concepts to be designed and applied. Social and health care reforms are also playing their part. "The direction of redesign is in all care services for people... the same: it must (!) be rationalized, with a view to ensuring quality and limiting costs."³

To make matters worse, most of those in need do not know the appropriate assistance for them or are not accessible to them. Therefore, it is "Increasingly... [required,/ the verf.] Coordination and cooperation between the services, the service providers, the specialists and those...who are to receive the support." ⁴

For some time now, attention has therefore been focused on the concept of case management, which could represent a qualified continuation of individual social assistance.⁵

2. Definition of case management

In order to achieve a first approximation of the term "case management", it makes sense in my opinion to translate it into German. "Case" means "case" and "to manage" refers to activities such as leading, managing and managing operations.

With regard to social work, it is therefore roughly outlined to take up a case with all its facets, to pass it on to other bodies and institutions, but to keep the overall overview and thus to manage and manage the case.

According to Wendt, case management begins with two facts. The first is the observation that clients in social work usually have a whole pool of problems. The second fact relates to the large number of aids and support services that would be suitable for a problem situation. From this, Wendt concludes that "... a coordinating and arranging service required..."⁶ seems to deal successfully with this situation.⁷

Stimmer explains that case management in individual case assistance combines this uncoordinated juxtaposition of different assistance services into an overall process.⁸ This is coordinated and invested by the case manager in order to deal with the various aspects of people's complex life situation as effectively as possible. The client is "seen as an active partner and independent user of the service offer..."⁹. Therefore, case management is probably understood by its proponents as a further development of the classic individual case help, which makes an accent shift.¹⁰

According to Ballew and Mink, case management has two accents that underscore Stimmer's opinion:

1. The development/improvement of a resource network
2. Strengthening the client's personal empowerments.

The former arises from the desire of various people and institutes to help a client and the coordination of this help by a case manager. The latter includes "the client's knowledge, skills and attitudes."¹¹.¹²

"Careful assessment of neediness, comprehensive care planning, coordination of services and follow-up examination – all this makes a big (!) and whole (!) Case Management. (...) Its specific objectives and functions may vary considerably.'¹³

According to Easterling, case management can be divided into five categories according to its professional location. He speaks here of private, primary, nursing and case management in insurance. In addition, there is social case management that the "... Supporting a person or family with a plurality of services to be deployed in a planned and coordinated manner." ¹⁴ distinguishes.¹⁵

Case management hides behind many terms. In English, a further adjective is added to case management depending on the subject area (see point 6.1.). Wendt has proposed the term "support management" as a German term, which has now become commonplace. Furthermore, there are the terms case management or clinical case management, which are used for case management in the medical field. ¹⁶

"Case Management... thus offers the opportunity to holistically combine a case-by-case approach with personal networking and social space orientation. The cross-border approach gives those affected more certainty to find differentiated assistance in their complex problems, burdens and disadvantages, in the form tailored to them and at the right time, while at the same time reducing the number of adaptation efforts to be made." ¹⁷

3. Historical development of case management

In the USA, unlike in Europe, free engagement dominates. Therefore, "... regulates the provision of social benefits less by offices with broad competence, such as those held by the youth, social and health offices [, /the verf.]." ¹⁸

According to Galuske, case management was developed from the end of the 70s in the USA as a method of social work for two reasons:

The fragmentation of social services led to orientation problems on the part of the clients, on the part of the providers this fragmentation led to less effective overlaps and coordination problems.¹⁹ In addition, "... the system of social services was increasingly put under pressure by the conservative, neoliberal policies of the Reagan administration to organize social services more cost-effectively and efficiently."²⁰.

In the mid-70s, there was also a campaign of deinstitutionalization in the USA and other countries, which led to a reduction in stationary services. There were

"... chronically mentally ill, mentally handicapped and people in need of care in large numbers from inpatient accommodation [dismissed/ the ed.]. From the point of view of the rights of the citizens, it was no longer considered justifiable to keep them in homes and institutions, and had also recognized that (!) the care there makes the inmates unfit for life, costs a lot and does more harm than good."²¹

Due to deinstitutionalization, it was now necessary "... to organise adequate outpatient care by social and medical services."²²

Case management should serve as an instrument for dealing with this specific constellation of problems. The aim was primarily to create an organised coordination of supply and demand for social services.²³

In 1988, the British government presented its concept within a white paper "and defined it in it community care as a local provision of the services and support that people with problems of old age, mental illness, mental or physical disability or sensory disability need in order to be able to live as independently as possible in their own home or in comparable forms of local housing) Management in individual cases serves this purpose and is therefore expressly recommended." ²⁴

Since the end of the 80s, case management has also been increasingly used in Germany.²⁵

4. Axiology of Case Management

According to Wendt, case management assumes "that (!) People who can cope alone in their way of life and have some success, are or can be busy in those areas where there is a deficit in the event of a need for support."²⁶

Accordingly, the social worker is aware that the desired result of case management is not available. Only the client himself and the resulting resource network can achieve this goal. Therefore, the client is responsible for his possible learning process.²⁷

All help and support is linked to the client's resources. "That (!) such strengths are present, the client (!) does not have to prove; it is already part of the task of social work to determine the competencies in a joint assessment and to become productive with them, not because of the defects."²⁸

Moxley describes six guiding principles of the practice of case management in the context of social work. Although not all of these principles can be projected onto the human image of case management, I would still like to name them all for the sake of completeness.

First of all, the case manager should adhere to the principle of picking up the client where he is at the moment. In addition, a holistic view of the client and his problem situation should take place, instead of reducing the client to the specific, current problem. Since case management has to do with administrative processes, case managers must demonstrate competence in the administrative area. Clinical procedures and skills enable a profound study of the client's behavior and background. Unlike Wendt, Moxley writes in his fifth principle: "The case manager concentrates accountability with his knowledge of clients and their situation."²⁹

Moxley's final tenet is that case managers try to achieve a unity of social services so that they are complementary to clients' coping options." ³⁰

Ballew and Mink assume that there are certain obstacles that prevent a person from making use of sources of help. They have divided these obstacles into three categories; 1. external disability, 2. own inability and 3. internal inhibitions. External disabilities include "... Deficiencies in the client's environment..."³¹, the required resource does not exist or is not able to meet the demand or a general availability of a resource that is not available for a particular client.³² Another external disability is when, "The source of aid... exists [is/the verf.]; but you need a second resource to tap into it, and it is not available. Secondary resources include information, transportation and childcare."³³

One's own inability as an obstacle to accessing resources implies intellectual disabilities, severe mental illness, physical infirmities and alcohol and drug abuse. ³⁴

Internal inhibitions are defined by Ballew and Mink as follows: "... Beliefs, attitudes, or values of the client that lead to patterns of behavior that stand in the way of the person seeking or accepting help."³⁵. These include, according to her remarks, pessimism, criticalism, fatalism and cynicism.³⁶

In summary, I would like to quote Obrecht, who has written down the image of man for social work within the framework of his action-theoretical framework:

"In the view of social science systemism, human individuals are curious, active, membership- and relationship-oriented, adaptive and self-knowledgeable biosystems."³⁷

5. Theoretical background of case management

5.1. Central functions of case management

The aim of case management is the independent lifestyle of the clientele. In order to achieve this, help should be offered that interferes as little as possible with the familiar living environment. Furthermore, case management is resource-oriented. The resources of the client and the surrounding social network should be the basis of the help.[xxxviii]

"Involving resources in a help process means identifying strengths and positive forces that motivate all those involved, especially the clients, to tackle change. Especially in complex and multiply loaded situations, a driving force is needed that brings movement into systems and their environment. Today, this approach is associated with the concept of empowerment, among other things." [xxxix]

In accordance with Neuffer's remarks, the resource-oriented case work is carried out on five levels.

1. Personal Resources

These identify strengths and competencies that lie in the client himself. They can refer to the body or cognitive area. The ability to build and maintain social and emotional relationships also falls within the realm of Personal Resources.

2. Family resources

The center of interest here is the interrelationships between the family members. These are reflected in the communication process, in the individual subsystems and the established values and standards.

3. Socio-ecological resources

These are often found in the neighborhood, in relatives, in the circle of friends, in self-help groups and in citizens' initiatives. They help a person or a family to expand relationships and participation in the social space or in the milieu.

4. Socio-economic resources

This refers to resources that the education sector, a job and basic material services provide and thus offer legal security. They therefore play an important role and should start with the individual cognitive abilities of the clientele.

5. Cultural resources

These characterize resources that result from a person's cultural background. According to Neuffer, "Belonging and the orientation, recognition and encounter to be found in it can... represent decisive fields of strength."[xl]

Neuffer complains that this form of resources are given too little attention and must be much more strongly included in the help process of social work.[xli]

If we look at case management from the point of view of resource-oriented case work, there are clear work orders for the case-leading specialist. The buried and existing resources of the client must be scouted, tapped and demanded. Furthermore, new resources must be developed and created.[xlii]

Through the resource-activating case work, it is possible for the client to solve later problems independently. At this point, the concept of self-employment refers to two forms: First of all, that the client helps himself, but also that the client is able to look for help that can help him solve the problem. The aim of resource-oriented case work is therefore by no means that a client masters all subsequent problematic situations as an individual.

5.2 Systems Theory

Systems theory offers a structure from which specific action concepts can be developed and justified, which are aligned with a common framework for action theory.[xliii] You "...offers a frame of reference for the discipline and profession of social work, which ranges from metatheory to everyday practice and develops the action concepts necessary for social work such as case management, consulting, mediation, social networking in a profession-specific manner. With its basic understanding, systems theory offers the ground for a reflexive help process in which future changes are in the foreground, be it in the actual client system, be it in the surrounding environment or in the helper system itself."[xliv]

The position of critical constructivism on systems theory is most significant for social work. "The subject (system) creates its understanding and its material basis in an exchange and in confrontation with the environment, together with others. A material world is taken for granted in this approach, without the claim to really be able to depict it."[xlv]

Behind the concept of systems theory are various theoretical approaches.[xlvi] According to Neuffer, the action-theoretical approach based on Obrecht's critical constructivism is the furthest and most up-to-date.

"In this theory, a system shows characteristics through the relationships of its parts that its parts alone lack (emergence). Concrete systems are created through internal connections, as well as through their external connections with the environment."[xlvii]

[...]

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¹ cf. Neuffer, 2007: 18

² Wendt, 1995a: 7:

³ Wendt, 2001: 7

⁴ Wendt, 1995b: 11

⁵ cf. Neuffer, 2007: 18

⁶ Wendt, 1988:19

⁷ cf. Wendt, 1988:19

⁸ cf. Stimmer, 2006: 61

⁹ Stimmer, 2006: 61

¹⁰ cf. Galuske, 1998: 184

¹¹ Ballew/ Mink, 1995: 56

¹² cf. Ballew/ Mink, 1995: 56

¹³ Renshaw/ Hampson/ Thomason et al. (1995). 124

¹⁴ Easterling et al. 1995: 3 f; quoted in Wendt, 2001: 55 f

¹⁵ see Easterling et al. 1995: 3 f ; quoted in Wendt, 2001: 55 f

¹⁶ cf. Wendt, 2001: 49

¹⁷ Neuffer, 2007: 19

¹⁸ Wendt 1995b: 16

¹⁹ cf. Galuske, 1998: 183

²⁰ Galuske, 1998: 183

²¹ Wendt, 2001: 14 f

²² Wendt, 2001: 15

²³ Galuske, 1998: 183

²⁴ Caring for People, 1989: 3, cit. In: Wendt,2001:17

²⁵ Galuske, 1998: 183

²⁶ Wendt, 1988: 20

²⁷ cf. Wendt, 1988: 20

²⁸ Wendt 1990: 69 f. zit. In: Wendt, 1995b: 53

²⁹ Moxley, 1989: 142ff cit. In: Wendt, 2001: 54 f

³⁰ cf. Moxley, 1989: 142ff cit. In: Wendt, 2001: 54 f

³¹ Ballew/ Mink, 1995: 69

³² cf. Ballew/ Mink, 1995: 69

³³ Ballew/ Mink, 1995: 69

³⁴ cf. Ballew/ Mink, 1995: 69

³⁵ Ballew/ Mink, 1995: 69

³⁶ cf. Ballew/ Mink, 1995: 70

³⁷ Obrecht, 1999: 20

• College: Leuphana Universität Lüneburg
• Grade: 1,3
• Author: Sarah Giehring (Author)
• Publication Year: 2008
• Pages: 36
• Catalog Number: V1170804
• ISBN (PDF): 9783346579775
• Language: English
• Tags: case, management