What is Case Management?

Case Management: Using a Strengths-Based Approach

Sarah Cooper, Farida Miri, and Vesna Mirosavljevic

What is Case Management?

• Being the link between all Government Assisted Refugee clients to all aspects of service provision

• Utilizing both the client’s internal and external resources and supports, with the emphasis on self sufficiency and integration (Sutherland, 2006, p 128)

• For GARs - coordinated by three Settlement Counsellors

• For independent clients - by the Intake and Settlement Counsellor

Case management at ISIS

• Develops an understanding of the client’s needs

• Develops short and long term goals in collaboration with the client

• Develops an individualized plan with each client according to his or her strengths and needs

http://www.scotland.gov.uk/Publications/2007/09/03145057/6

Role of the Settlement Counsellor

• Orchestrating the case management plan• Enlisting the support of other organizations,

resources within ISIS, and external service providers.

• At the centre of this approach is a culturally sensitive and friendly environment.

Role of the Settlement Counsellor

Models of service delivery

Previous method:

• GAR clients seen by staff in the settlement unit:

– RAP Worker 1, RAP Worker 2

– Settlement Worker (ISAP)

– Health Coordinator

– Others as needed

• “Assembly-line” structure

Challenges with the old model

• Not enough time to get to know client

• Client was not able to develop trust with worker before moving on to the next person

• RAP process is too short (6 weeks) to address strengths, needs, and goals- focus is only on getting things done

• Confusion for client over who was doing what in their lives- client not knowing who to see at MISA

What does that look like at ISIS?

• RAP worker responsible for first 2 weeks with clients (airport greeting, temporary accommodation, housing- in conjunction with settlement counsellor, shopping, banking, entitlement, moving)

• Settlement Counsellors meet clients in hotel to introduce themselves and explain what will happen in next few weeks- short assessment of strengths and needs (medical, crisis, other)

• Settlement Counsellors apply for provincial health insurance, PR address notification

What does that look like at ISIS?

• Settlement Counsellors meet clients in their permanent accommodation. Provide orientation to apartment living, emergencies, etc. Provide first week assessment (may include assessment for Life Skills Link Program)

• Neighbourhood and public transportation orientation

• Health orientation

• School registration and education system orientation for those eligible.

• Link to federal and provincial programs (CCTB, GST)

What does that look like at ISIS?

• Budgeting, more banking orientation if necessary

• Life in Canada orientation

• Information and advocacy on CIC loans

• Recreation/ community resources

• On-going problem solving, emotional support, and advocacy

• Internal referrals: Employment Specialist, Health Coordinator (if needed), Life Skills Link (if needed), Family Counsellor, HOST program, tutor program, Crisis Worker (if needed), Business Unit (if required), pro-bono legal students

What does that look like at ISIS?

• External referrals: Family resource centres, YMCA, libraries, places of worship, food banks, recreation centres

• CCTB clawback information

• End of RAP exit interview, short-term goals revisited, usually at 3 months

What does that look like at ISIS?

• 6 months: check-in and discussion re long-term goals and public housing application

• 8 months: preparation for coming off RAP- Review long-term goals

• 12 months: application for income assistance if needed

• Settlement Counsellors continue to work with many GAR clients past one year. Many need support as they navigate the income assistance system for the first couple of months.

Advocacy +Strengths-Based Approach

• Includes the following:– the importance of genuine dialogue; – forming positive expectations of clients; – helping clients participate more fully in their world

of people, institutions, and communities, – identifying natural resources in the clients’ world; – learning from clients (Saleeby, 2006, p 78).

• Extra-therapeutic factors:

– clients have their own resources in themselves, families, friends, communities that contribute to their settlement just as much or more than we do as service providers

Advocacy + Strengths-Based Approach

The strengths-based perspective is used in all aspects of settlement service delivery at ISIS. We try to help clients identify: •ways in which they learned new things in their own countries •how they solved problems at home •what resources they used when they needed assistance

Encourage clients to relate past experiences to their settlement process

Advocacy + Strengths-Based Approach

• Advocacy is a very important aspect of the Settlement Counsellor’s job. Settlement Counsellors encourage clients to advocate on their own behalf whenever possible.

• This might mean more work sometimes for the Settlement Counsellor because the preparation time for the client to do this on his or her own is often longer. But it is an important element of case management!

Advocacy + Strengths-Based Approach

http://www.scotland.gov.uk/Publications/2007/09/03145057/4

Advantages of the Case-Management Approach

• More time for getting to know the client as a whole: helping him or her identify strengths, needs and goals, assisting client with the self-advocacy process

• Client is able to identify who is working with him/her- knows who to go to for questions

• Settlement Counsellor is central referral point for client

• Settlement Counsellors have been able to develop a trusting and collaborative relationship with clients- work together towards the client’s identified goals

Challenges of the Case Management Approach

It was not always easy!

• How to divide the clients equally among Settlement Counsellors

• When to refer clients to internal resources and when the issue is something the Settlement Counsellor should deal with herself

• Balancing time between new arrivals and those who have been here for a few months- especially when arrival times have been erratic

• Coming up with creative ways to accommodate group processing

• REPORTING!!!!!

Recommendations

• Make allowances for group processing- be flexible

• Plan as much as you can who will do what before you start the case management process- but be prepared to change it too!

• Remember that every client is unique- some are resistant to strengths-based approach

• Schedule a person who can be on ‘drop-in’ duty for clients who arrive with unscheduled appointments

• Take care of yourself!

References

Saleeby, Dennis ed. (2006). The Strengths Perspective in Social Work Practice. Boston: Pearson.

Scottish Government (2007). The New Mental Health Act: An Easy Read Guide. http://www.scotland.gov.uk/Publications/2007/09/03145057/0

Sutherland, Edna (2008). Refugee Children and Families: A Model for Successful Integration. Calgary: Edna Sutherland & Associates.