Case Management

Overview How to deal with a case with multiple problems? What is the case management in social work? How to develop social work knowledge? How to know which way is better for our clients? The necessity of social work research What does “evidence-based practice” mean?

A Case Example Younghui is a 18-year old girl. She just stopped attending high school because she is pregnant. She will give a birth in two months. She ran away from her home and found on the street at one night. She was referred to a social worker from the police officer who first found her on the street. How can you help Younghui if you are her social worker who takes this case?

Case Management (사례관리) A method of providing services whereby a professional social worker assesses the needs of the client and the client's family, and arranges, coordinates, monitors, evaluates, and advocates for a package of multiple services to meet the specific client's complex needs.

Case Management To coordinate clients’ diverse services in a systematic way To addresses both the individual client's biopsychosocial status as well as the state of the social system To plan, seek and monitor services from different social agencies on behalf of a client. One agency takes primary responsibility for the client and assigns a case manager to coordinates services, advocates for the client.

Client-Level Intervention To conduct a face-to-face comprehensive assessment with each client: client's strengths and limitations in terms of the social, financial, and institutional resources available. To develop an individualized service plan with the client that identifies priorities, desired outcomes, and the strategies and resources to be used in attaining the outcomes. The direct contact between social worker and client is essential to effectively accomplish the assessment and service plan development. To include implementing the service plan To engage in all stages of client intervention The social work case manager should be granted sufficient authority to access, allocate, monitor, and evaluate service and fiscal resources. To be more readily achieved in delivery systems structured with a single point of entry and integrated funding.

System-Level Intervention analyzes the strengths and limitations of environmental systems such as programs, services, and policies delineates desired outcomes selects strategies to improve systems assesses the effectiveness of strategies continues to revise better for desired outcomes and strategies.

Overview What is “Evidence-based Practice (EBP)? What can be beneficial from the EBP? Why is the EBP important to social work?

How to know which way is better for your client? As a professional social worker, you completed a face to face interview to assess Mrs. Choi’s needs. Mrs. Choi is a female elder aged 65 years. Of her diverse needs, you appraised her mental condition as the most serious. Because she did not seem to have any energy and interest in her daily life for a long time, you further assessed her depression with the GDS scale. And then you found that her score was quite high, indicating severe level of depression. Now, you are planning to intervene her depression. How can you proceed to next steps of intervention process for her case?

Evidence-base practice (증거 기반 실천) Evidence-based practice (EBP) is a process in which the practitioners (social workers) combine well-researched interventions with clinical experience and ethics, and client preferences and culture to guide and inform the delivery of treatments and services.

What can be benefits from the EBP? To serve our clients better :individuals, families, communities and policies To confirm the effectiveness of our interventions as professional social workers Development of knowledge that we can have confidence will help our clients Find the best (better) practice methods Demonstrate our effectiveness (accountability) To respond to increasing demands from the field: Social Workers with practice knowledge and research capacity

But why is it difficult to apply into social work practice? One of the major challenges to incorporating research evidence into organizational life is the absence of an evidence-based organizational culture within human service agencies.

EBP for All Practice Levels from Populations to Individuals Evidence-based Policy is concerned with problems about how best to achieve a large group or population goals. Evidence-based (Direct) Practice is concerned with problems about how to make diverse practice choices for specific clients

Evidence-based Practice Questions For children with mental health problems is it best to: provide remedial treatment services in residential treatment facilities Or in community-based programs that allow children to remain at home? Is it best to provide adults with severe and persistent mental disorders: sheltered work programs supportive services aimed at securing employment in the community? The evidence-based approach is now being applied to policy, management, and direct practice problems. Because policy, management, and direct practice problems differ one from the other, the evidence-based approach looks a bit different in each of these practice areas. This difference is due to, primarily, the character of the problems and questions addressed. There are common elements as well, derived from the evidence-based approach. Evidence-based policy deals with problems about how best to achieve group or population goals. For example: For children with mental health problems is it best to provide remedial treatment services in residential treatment facilities or in community-based programs that allow children to remain at home? Is it best to provide adults with severe and persistent mental disorders sheltered work programs or supportive services aimed at securing employment in the community?

Evidence-based Practice Questions Among adolescents at risk for pregnancy Will a sex education program that stresses abstinence Or One that provides birth control information Result in the lowest pregnancy rates? My second COPES question came from my concern for teen pregnancy. One of my clients, a 17 year-old African-American female, is three months pregnant. I feel I could have prevented this, but it is too late now to prevent her from being a mother at an early age, so my focus should be on how I can help the other adolescents in my caseload from falling into the same trap. Thus, my COPES question is the following: Among adolescents at risk for pregnancy will a sex education program that stresses abstinence or one that provides birth control information result in the lowest pregnancy rates?

Definition of EBP EBP is integration of Best research evidence Practitioner expertise Client values

Research evidence Expertise Client values Practice relevant research from: Basic sciences Client-centered practice research about: Accuracy & precision of assessment tests Efficacy & safety of therapeutic, rehabilitative, & preventive treatments. Expertise Ability to use skills & experience to rapidly identify: Client’s unique psychosocial state & problems or needs Individual risks & benefits of potential interventions to the client Client’s personal values & expectations Client values Unique preferences, concerns, & expectations of client that must be integrated into intervention decisions to serve client

How to execute the EBP in Social Work Placing client’s benefits FIRST Practitioners adopt LIFELONG learning CONTINUALLY ASKING specific questions of direct practical importance to clients SEARCHING objectively & efficiently for current best evidence Taking appropriate action GUIDED by evidence In social work Leonard Gibbs has defined evidence-based practice as: Placing the client’s benefits first, evidence-based practitioners adopt a process of lifelong learning that involves continually posing specific questions of direct practical importance to clients, searching objectively and efficiently for the current best evidence relative to each question, and taking appropriate action guided by evidence (Gibbs, et al., 2003).

Newest View of EBP Best available research evidence Decision-Making Client/population characteristics, needs, values, & preferences Resources including practitioner expertise Evidence-based Behavioral Practice Council, EBBP.ORG

Steps in Evidence-Based Practice Question Formulation Search for evidence Critically appraise the relevant studies you find Determine which evidence-based intervention is most appropriate for your particular client(s) Apply the evidence-based intervention Evaluation and feedback Re-test Because the evidence-based process informs future questions & practice, it is useful to think it as a cycle.