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Section 1 Foundations for Best Practice in Case Management Chapter 1 Ethics and Other Professional Responsibilities for Human Service Workers 1 Introduction 1 Dual Relationships 2 Value Conflicts 5 Clients' Rights 9 Privileged Communication 18 Diagnostic Labeling 21 Involuntary Commitment 22 Ethical Responsibility 23 Stealing from Clients 26 Competence 27 Responsibility to Your Colleagues and the Profession 28 Professional Responsibility 30 Summary 31 Exercises: Ethics 31 Exercises: Ethically, What Went Wrong? 34 Exercise: Decide on the Best Course of Action 38 Chapter 2 Case Management: Definition and Responsibilities 39 Introduction 39 A History of Case Management 40 Why Case Management? 40 What Is an Individualized Plan? 41 Assessment 42 Planning 44 Linking 48 Monitoring 49 Service Coordination 49 Levels of Case Management 52 Separating Case Management from Therapy 55 Case Management in Provider Agencies 56 Managed Care and Case Management 57 Underlying Principles: Hope and Self-Determination 58 Generic Case Management 62 Summary 63 Exercises: Case Management 63 Exercises: Decide on the Best Course of Action 67 Chapter 3 Applying the Ecological Model: A Theoretical Foundation for Human Services 69 Introduction 69 Seeking a Balanced View of the Client 70 The Three Levels 72 Looking at What the Person Brings 72 Looking at What the Context Brings 73 Developmental Transitions 74 Developing the Interventions 75 Working with the Generalist Approach 76 Larger Interventions 77 Summary 77 Exercise: Looking at Florence's Problem on Three Levels 77 Exercises: Designing Three Levels of Intervention 79 Section 2 Useful Clarifications and Attitudes Chapter 4 Cultural Competence 83 Introduction 83 Where Are the Differences? 84 Strangers 86 Anxiety and Uncertainty 87 Thoughtless Versus Thoughtful Communication 89 Dimensions of Culture 92 Obstacles to Understanding 98 Competence 100 Summary 102 Exercises: Testing Your Cultural Competence 102 Chapter 5 Attitudes and Boundaries 105 Introduction 105 Understanding Attitudes 105 Basic Helping Attitudes 106 Reality 109 How Clients Are Discouraged 109 Understanding Boundaries 112 Seeing Yourself and the Client as Completely Separate Individuals 112 Erecting Detrimental Boundaries 113 Transference and Countertransference 114 Summary 115 Exercises: Demonstrating Warmth, Genuineness, and Empathy 116 Exercises: Recognizing the Difference-Encouragement or Discouragement 120 Exercises: Blurred Boundaries 120 Chapter 6 Clarifying Who Owns the Problem 123 Introduction 123 If the Client Owns the Problem 124 If You Own the Problem 127 If You Both Own the Problem 127 Summary 128 Exercises: Who Owns the Problem? 129 Exercises: Making the Strategic Decision 131 Section 3 Effective Communication Chapter 7 Identifying Good Responses and Poor Responses 135 Introduction 135 Twelve Roadblocks to Communication 136 Useful Responses 140 Summary 148 Exercises: Identifying Roadblocks 148 Chapter 8 Listening and Responding 151 Introduction 151 Defining Reflective Listening 152 Responding to Feelings 152 Responding to Content 156 Positive Reasons for Reflective Listening 158 Points to Remember 158 Summary 160 Exercise: How Many Feelings Can You Name? 160 Exercises: Finding the Right Feeling 160 Exercises: Reflective Listening 161 Chapter 9 Asking Questions 167 Introduction 167 When Questions Are Important 168 Closed Questions 168 Open Questions 168 Questions that Make the Client Feel Uncomfortable 170 A Formula for Asking Open Questions 171 Summary 173 Exercises: What Is Wrong with These Questions? 174 Exercises: Which Question Is Better? 176 Exercises: Opening Closed Questions 176 Exercises: Try Asking Questions 179 Chapter 10 Bringing Up Difficult Issues 181 Introduction 181 When to Use Confrontation 182 The I-Message in Confrontation 183 The Rules for Confrontation 184 Asking Permission to Share Ideas 188 Confronting Collaterals 189 On Not Becoming Overbearing 189 Summary 191 Exercises: What Is Wrong Here? 191 Exercises: Expressing Your Concern 193 Exercises: Expressing a Stronger Message 195 Chapter 11 Addressing and Disarming Anger 197 Introduction 197 Common Reasons for Anger 197 Why Disarming Anger Is Important 198 Avoiding the Number-One Mistake 199 Erroneous Expectations for Perfect Communication 200 The Four-Step Process 201 What You Do Not Want to Do 203 Look for Useful Information 205 Managing an Angry Outburst 205 Summary 206 Exercises: Initial Responses to Anger 206 Exercises: Practicing Disarming 207 Chapter 12 The Effective Combination of Skills 209 Introduction 209 Combining Skills and Attitudes 210 Communication Skills That Facilitate Change 211 Trapping the Client 216 From Adversarial to Collaborative 217 Case Manager Traps 219 Summary 222 Chapter 13 Putting It All Together 223 Introduction 223 Exercises: Putting It All Together 223 Section 4 Meeting Clients and Assessing Their Strengths and Needs Chapter 14 Documenting Initial Inquiries 231 Introduction 231 Guidelines for Filling Out Forms 232 Steps for Filling Out the New Referral or Inquiry Form 232 Steps for Preparing the Verification of Appointment Form 236 Summary 237 Exercise: Intake of a Middle-Aged Adult 238 Exercise: Intake of a Child 238 Exercise: Intake of an Infirm, Older Person 238 Chapter 15 The First Interview 241 Introduction 241 Your Role 241 The Client's Understanding 242 Preparing for the First Interview 242 Your Office 243 Meeting the Client 244 Taking Notes 245 Collecting the Information 245 Asking for More Clarification 245 What Information to Collect 246 Client Expectations 246 Social Histories and Forms 247 Wrapping Up 247 The Client Leaves 248 Summary 248 Chapter 16 Social Histories and Assessment Forms 249 Introduction 249 What Is a Social History? 250 Layout of the Social History 250 How to Ask What You Need to Know 251 Capturing the Details 257 Who Took the Social History 258 Social Histories in Other Settings 258 Writing Brief Social Histories 262 Using an Assessment Form 266 Taking Social Histories on a Computer 267 The Next Step 267 Summary 268 Exercises: Practice with Social Histories 268 Exercises: Assessment of a Middle-Aged Adult 269 Exercises: Assessment of a Child 269 Exercises: Assessment of an Infirm, Older Person 270 Exercise: Creating a File 271 Chapter 17 Using the DSM 273 Introduction 273 Background Information 275 Using the DSM 278 Making the Code 284 Summary 286 Exercises: Using the DSM 287 Chapter 18 The Mental Status Examination 291 Introduction 291 What to Observe 292 How to Observe 292 Documenting Your Observations 292 Mental Status Examination Outline 293 Summary 309 Exercises: Using the MSE Vocabulary 310 Chapter 19 Receiving and Releasing Information 313 Introduction 313 Sending for Information 313 If You Release Information 313 Directions for Using Release Forms 314 Examples of the Release Forms 316 When the Client Wants You to Release Information 317 When the Material Is Received 318 Summary 319 Exercise: Send for Information Related to a Middle-Aged Adult 319 Exercise: Send for Information Related to a Child 319 Exercise: Send for Information Related to a Frail, Older Person 319 Exercise: Maintaining Your Charts 319 Chapter 20 Facilitating a Meaningful Change and Recovery 321 Introduction 321 How People Do Not Change or Recover 322 What Is Change? 322 What Is Recovery? 323 Physical Health Is Part of Wellness 324 Self-Determination 324 Relationships that Support Recovery 324 Encouragement as Part of Recovery 326 Stages of Change 330 A Case History 331 Ambivalence and Reluctance 333 Rolling with Resistance 333 Summary 334 Exercises: Helping People Change 335 Section 5 Developing a Plan with the Client Chapter 21 Developing a Service Plan at the Case Management Unit 337 Introduction 337 Involving the Client and the Family 338 Using the Assessment 339 Creating the Treatment or Service Plan 340 How to Identify the Client's Strengths 341 Individualized Planning 342 Sample Goal Plan 343 Summary 346 Exercises: Broad Goal Planning 346 Chapter 22 Preparing for a Service Planning Conference or Disposition Planning Meeting 349 Introduction 349 What You Will Need to Bring to the Meeting 350 Goals for the Meeting 350 Preparing to Present Your Case 351 Making the Presentation 352 Collaboration 354 Follow-Up to Meeting 354 Summary 355 Exercises: Planning 355 Chapter 23 Making the Referral and Assembling the Record 357 Introduction 357 Determining Dates 358 Sample Referral Notification Form 359 The Face Sheet 359 Summary 362 Exercises: Assembling the Record 363 Chapter 24 Documentation and Recording 365 Introduction 365 Writing Contact Notes 366 Labeling the Contact 367 Documenting Service Monitoring 367 Documentation: The Finishing Touches 368 Government Requirements 371 Do Not Be Judgmental 372 Distinguish Between Facts and Impressions 372 Give a Balanced Picture of Your Client 373 Provide Evidence of Agreement 373 Making Changes to the Plan 373 Summary 374 Exercises: Recording Your Meeting with the Client 374 Exercises: Recording Client Contacts 375 Exercises: Using Government Guidelines to Correct Errors 380 Exercises: Spotting Recording Errors 381 Section 6 Monitoring Services and Following the Client Chapter 25 Monitoring the Services or Treatment 383 Introduction 383 What Is Monitoring? 384 Purpose of Monitoring 384 Collaboration 386 Leave the Office 386 Responding to a Crisis 387 Follow-Up 388 Summary 388 Chapter 26 Developing Goals and Objectives at the Provider Agency 391 Introduction 391 Client Participation/Collaboration 392 Expect Positive Outcomes 392 Writing the Goals 393 Objectives 394 Combining Goals and Treatment Objectives 394 Finishing Touches 396 Summary 398 Exercises: Developing Goals and Objectives 400 Chapter 27 Terminating the Case 407 Introduction 407 A Successful Termination 408 The Discharge Summary 410 Summary 413 Exercises: Termination of a Middle-Aged Adult 413 Exercises: Termination of a Child 414 Exercises: Termination of a Frail, Older Person 414 Chapter 28 Taking Care of Yourself 415 Introduction 415 See Yourself as an Effective Tool 415 While Attempting to Understand Others, Don't Fail to Understand Yourself 416 Consistently Underestimating Clients Wears Workers Out 417 Develop Healthy Relationships Away from the Agency 420 Develop Other Stimulating and Rewarding Interests 421 Summary 421 Appendix A Wildwood Case Management Unit Forms 423 Arrangement of the Client's Chart 423 Face Sheet 424 New Referral or Inquiry 425 Verification of Appointment 426 Request/Release of Information 427 Release of HIV/AIDS-Related Information 428 Intake Assessment Form 429 Peer Support Services Referral Form 436 Peer Support Mutual Agreements Plan/Outcome Report and Renewal 437 Planning Conference Notes 441 Treatment or Goal Plan 442 Referral Notification Form 444 Contact Notes 445 Contact Notes: Children's Case Management Services 446 Discharge Summary 447 Appendix B Work Samples 449 Examples of Progress Notes or Contact Notes 449 Dating Your Forms 451 Sample Cases with Service Plans 453 Appendix C Grading the Final Files 455 References 458 Index 460