Download - Case management
![Page 1: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/1.jpg)
Case Management18th Annual NADCP Training Conference
Nashville, TNJune 1 2012
Chief Mack Jenkins, M.S.San Diego County Probation
![Page 2: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/2.jpg)
ObjectivesDefine Case Management
Discuss the Core Functions of Case Management
Review Evidenced Practices of Case Management
Review Strategies of Case Management
![Page 3: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/3.jpg)
Definition Of Case Management• a collaborative process which assesses, plans,
implements, coordinates, monitors and evaluates the options and services required to meet an individual’s health needs, using communications and available resources to promote quality, cost-effective outcomes.”
Case Management Society of America
![Page 4: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/4.jpg)
More DefinitionsThe provision of, or referral to a
comprehensive set of services designed to increase the probationer’s overall success.
A system of support, monitoring and advocacy to assist the probationer through change.
“helping people whose lives are unsatisfying or unproductive due to the presence of many problems which require assistance from several helpers at once” (Ballew and Mink, 1996, p. 3)
![Page 5: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/5.jpg)
Case Management In Drug CourtMore than one case managerNon-case managers providing some servicesCoordinated case management a mustSharing of information from all team
membersEveryone’s on the same page
![Page 6: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/6.jpg)
Core Functions Of Case Management
![Page 7: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/7.jpg)
Core Functions Of Case Management
AssessmentPlanningLinkageMonitoringAdvocacy
![Page 8: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/8.jpg)
It begins with EngagementDetermine motivation to change behavior Identify degree of support from family and
friends. Discuss realistic criminal justice system (or
other) consequences. Establish a positive, professional, therapeutic
relationship with the participant. Be consistent
![Page 9: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/9.jpg)
Try to identify the problem…Is it addiction?Is it criminal thinkingIs it co-occurring disorders (MH, DD,
Physical)Is it all of that…and more?
![Page 10: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/10.jpg)
AssessmentMake sure it’s ongoing.Avoid duplication when possible.Consider and discuss varied responses.Consider formal and informal assessment.Coordinate!
![Page 11: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/11.jpg)
Assess Your AssessmentsWhat assessments are being conducted?Who’s conducting them?Are they 3rd or 4th generation?What are the assessments assessing?How is the information being shared?
![Page 12: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/12.jpg)
Case PlanningDon’t overwhelm the participant—make it
doable.Include the participant in developing the case
plan.Make the tasks and objectives measurable.Prioritize the tasks.SMART: specific, measurable, attainable,
rewarding, timelyIndividualize! Individualize! Individualize
![Page 13: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/13.jpg)
Case Planning QuestionsIs there more than one case plan?If there are, can they be combined?If they can’t, how can your team be sure they
don’t contradict each other?Do all team members know what’s on all case
plans?Does the participant know what’s on all case
plans?!
![Page 14: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/14.jpg)
LinkageKnow what services are available in your
community.Know the services participants are eligible
for .Know the participants.Help the participants make the initial
contact.Follow up after a referral is made
![Page 15: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/15.jpg)
Linkage QuestionsWhat services do your drug court
participants need?What services does THIS participants need?What changes do you see in your target
population? In your community?What partnerships do you need to make to
increase services available to participants?
![Page 16: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/16.jpg)
MonitoringDetect non-compliance including new AOD
use.Catch the participants doing something right!Assess the recovery environment (i.e. home)Track attendance and participationShare information timelyLook for small changes
![Page 17: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/17.jpg)
Monitoring QuestionsDoes your drug court team have a community
supervision component?How often are participants seen in their
homes?Are searches allowed? Conducted?How often are participants drug tested?How is information shared and how timely is
it shared?
![Page 18: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/18.jpg)
MonitoringMultifaceted:
Quality assurance of service provisionprobationer performance: attendance,
participationCoordination of assessments with providers
SupervisionOffice visitsHome visitsOther field contacts
Drug Testing
![Page 19: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/19.jpg)
Field VisitsIdentify goals of visitUse visit to assess the recovery environmentCommunicate the good and the bad back to
the team—timely!Safety First!
![Page 20: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/20.jpg)
AdvocacyKnow what participants can do and what
they need help with.Help the participant assert him/herself and
learn to advocate for him/herself.Identify program areas that need some
advocacy for the benefit of all participants.
![Page 21: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/21.jpg)
Advocacy QuestionsWhat’s the difference between helping and
enabling?What skill development is occurring to help
participants learn how to advocate for themselves?
![Page 22: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/22.jpg)
Eight Evidence-Based Principles for Effective Interventions
![Page 23: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/23.jpg)
Eight Evidence-Based Principles for Effective Interventions
1. Assess Actuarial Risk/Needs.2. Enhance Intrinsic Motivation.3. Target Interventions.4. Skill Train with Directed Practice 5. Increase Positive Reinforcement.6. Engage Ongoing Support in Natural
Communities.7. Measure Relevant Processes/Practices.8. Provide Measurement Feedback
NIC, 2004
![Page 24: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/24.jpg)
1. Assess Actuarial Risk/Needs
Know the assessments usedReview assessments with offenderIncorporate into case planRe-assess and measure change
![Page 25: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/25.jpg)
2. Enhance Intrinsic MotivationUse verbal and non-verbal communication
skills: Attending, reflections, summarizations, open-ended
questions, etc.Explore offender’s attitude toward changeAvoid non-productive arguing and blaming Encourage praise, be optimistic
![Page 26: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/26.jpg)
3. Target Interventionsa. Risk Principle: Prioritize supervision and treatment resources for higher risk offenders.b. Need Principle: Target interventions to criminogenic needs.c. Responsivity Principle: Be responsive to temperament, learning style, motivation, culture, and gender when assigning programs.
![Page 27: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/27.jpg)
3. Target Interventionsd. Dosage: Structure 40-70% of high-risk offenders’ time for 3-9 months.
e. Treatment: Integrate treatment into the full sentence/sanction requirements.
![Page 28: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/28.jpg)
4. Skill Train with Directed PracticeUse Cognitive Behavioral treatment methods
Support treatment efforts in field workUnderstand anti-social thinking and
appropriate communication techniquesPositively reinforce pro-social attitudes and
behaviorsMake appropriate referrals using evidence-
based information
![Page 29: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/29.jpg)
5. Increase Positive Reinforcement
Identify short-term goals for participants
Acknowledge achievement of short-term goals
Convey optimism that the participants can change
Encourage and praise any evidence of pro-social behavior.
Reinforce participant change talk and self-efficacy
![Page 30: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/30.jpg)
6. Engage Ongoing Support in Natural CommunitiesAssist participants in identifying who is
supportive and who is not
Conduct frequent home visitsCase Managers need to learn and apply
relapse prevention techniques. Identify and establish relationships with
participant’s positive support systems in the community.
Recognize triggers for relapse and make timely intervention
![Page 31: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/31.jpg)
7. Measure Relevant Processes/Practices
Documentation! Documentation! Documentation!
Identify strategies
“You can’t manage what you don’t measure”
![Page 32: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/32.jpg)
8. Provide Measurement FeedbackFeedback to the participants
Feedback to your supervisor
Feedback to service providers
![Page 33: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/33.jpg)
Case Management Strategies
![Page 34: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/34.jpg)
Drug Court Populations
Re-entry
Juveniles and Young Adults
Participants with a Mental Health Diagnosis
![Page 35: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/35.jpg)
Re- Entry Population“an estimated 80% of the state prison
population report histories of substance abuse, 90% fail to obtain those services while incarcerated. It is estimated that only 10% of offenders receive appropriate community linkage and follow-up services upon release.”
Scott SylakPresident, National TASCHouse Subcommittee HearingFeb. 8, 2006
![Page 36: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/36.jpg)
Strategies for Reentry Process starts at the time of the presentence
report.Services accessed while in custody.Upon release, re-assessment and linkage to
community services.Coordination and information flow
throughout the process is key.
![Page 37: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/37.jpg)
Juvenile and Young Adults:Significant brain distinctions
Memory deficitsIncreased impulsivenessVisual learningDisturbed sleep cycles“Hormone Hell”
![Page 38: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/38.jpg)
Brain ChemistryFor different reasons, brain chemistry is an
issue for juveniles, young adults and methamphetamine users.
A longitudinal study on adolescent brain development shows that brains are still developing until age 24 or so.
Methamphetamine causes physical changes in the brain.
![Page 39: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/39.jpg)
JuvenilesConsider brain development issuesProvide sequential directionProvide shorter time span between hearingsFocus on short-term goals and outcomesDifferentiate between willful non-compliance
and inability to complyEncourage “dream talk” to begin goal
discussion
![Page 40: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/40.jpg)
![Page 41: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/41.jpg)
Young AdultsConsider brain development issuesProvide sequential direction18-24 year olds are still going through some
of the same changes as their younger counterparts
![Page 42: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/42.jpg)
Methamphetamine UsersConsider brain development issues-reduced
memory, lack of motivation, lack of feelingsProvide sequential directionAttend to the physical maladies caused by
useAttend to the life skills deficits left by useConstantly keep the message hopeful,
simple, clear, and consistent.
![Page 43: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/43.jpg)
With many participants, but especially meth users and youthPatience
Redundancy
Instilling hope
Maximizing engagement strategies
Accountability
![Page 44: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/44.jpg)
Tools:Encourage & supportRepeat everythingReaffirmRemind of next contact, reaffirm message of
other treatment team membersRepeat consistent message of “show up”.Require repeat backsWrite it down (them), reaffirm.
![Page 45: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/45.jpg)
Clients with a Mental Health DiagnosisParticipants with co-occurring disorders
often experience more severe and chronic medical, social and emotional problems.
They are more vulnerable to both AOD relapse and a worsening of the psychiatric disorder.
Participants with co-occurring disorders often require longer treatment, have more crises, and progress more gradually in treatment. They often have reduced skill retention.
![Page 46: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/46.jpg)
Clients with a Mental Health Diagnosis
Team must be familiar with psychotropic medications and their side effects
Do not dismiss participants as a resourceProvide enhanced community supportsUnderstand what role drug use has played in
the participants ’s lifeExpect setbacks, but don’t assume failure
![Page 47: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/47.jpg)
SummaryDefining Case Management
As an individual case managerAs part of a team
Employ the key functionsAssess and reassessDevelop a case plan to target identified needsActively work to link participants to servicesClosely monitor the participant’s progress,
provide feedback and supportSupport but don’t enable
![Page 48: Case management](https://reader034.vdocument.in/reader034/viewer/2022052619/55628d99d8b42a950c8b4956/html5/thumbnails/48.jpg)
SummaryKnow the Evidence Based Practices
Develop Strategies that recognize the deficits of the targeted population and use strengthen based approaches to the address them.