Case management is one of the principal services provided to individuals and families confronting numerous challenges, including severe psychological disorders, addiction, and homelessness. It’s the process of developing a plan to coordinate and implement services that a patient needs to address these issues.
While case management is commonplace today, that wasn’t always the case. Prior to the 1950s, mental health care was provided primarily in public mental hospitals and comprised mental health services and everyday support. Significant changes in mental health service distribution led to the deinstitutionalization movement of the 1950s and 60s, resulting in a radical surge in discharges from mental hospitals and an amplified need for services in the community.
The solution became what is known as case management today. Medicaid and Medicare demonstration projects in the early 1970s showed how to work with a client directly to incorporate and receive necessary services for their health. This brought about the creation of case managers, whose chief role of case managers is to champion clients and support systems.
Case managers come from diverse backgrounds within health and human services vocations, including nursing, medicine, social work, rehabilitation counseling, workers’ rewards, and psychological and social health.
While the four levels of case management don’t change, there are different approaches to case management in general, called a case management model. Today, we’re going to discuss some of the most popular types of models for case management and the best circumstances that each one is suitable for.
What Are the 4 Models of Case Management?
While there are many models of case management, the four most prevalent ones are:
- The Brokerage Model Case Management
- The Clinical Case Management Model
- The Strengths-Based Clinical Case Management Model
- The Intensive Case Management (ICM) Model
1. The Brokerage Model Case Management
This is the first — and perhaps the briefest — case management model that focuses on evaluating needs, referring to services, and synchronizing and supervising an ongoing treatment. In the brokerage model, services are primarily office-based with the case manager coordinating services offered by a number of companies and professionals.
The case management model of social work indicates that the client may be given responsibility in terms of the approach and time of employing the resources available to them once they have been briefed about the services.
In the Brokerage Model of Case Management, case managers do not get as involved with the client as they would in other models, with most of their time getting spent on organizing care for the patient and ensuring a smooth flow of services.
Like all models of case management, the Brokerage Model does have its merits and demerits. While the model gives the clients higher levels of freedom, it also allows the case managers to serve more clients as there’s less one-on-one interaction. It’s an excellent choice for initial treatment participation and linking first-time clients to services needed.
However, the Brokerage Model is not considered ideal for some complex cases where the case managers must spend more time with the clients. And as they don’t get to have a closer relationship with the case managers, many clients do not opt for this model.
Although the brokerage model lays little emphasis on monitoring and evaluation results, the manager may be able to manage data collection and evaluation across service providers. To this end, the best approach is to encourage the use of an integrated management system.
Using integrated case management systems for evaluating needs, tracking services, assessing results, and more, service providers and case managers can easily get hold of key information about their synchronized efforts.
2. The Clinical Case Management Model
This model arose from a need for case managers to provide some therapeutic services. While in many ways — such as engagement assessment, evaluation and planning, and community linking — the clinical model bears similarities to the brokerage model, the former has the additional component of therapeutic and environmental interventions including psychotherapy, psychoeducation, and crisis intervention.
The case management of the nursing model is typically office-based, with case managers being clinicians who offer counseling and consultancy services to a client. Since the case manager is well aware of the client’s needs, their increased level of understanding improves their capacity to identify requires services and link the client with formal resources in the form of community service providers.
More importantly, clinical care providers are well-positioned to encourage the client to connect with their family, friends, and peers, while helping them address social, emotional, and mental blockades to services. That association can boost the client’s inclination and ability to follow through with services.
Being clinicians, the case managers in the Clinical Case Management Model have a higher degree of responsibility than the Brokerage model, providing a wider variety of services to the clients. They are more focused on the execution of the whole care plan for the patient, rather than just referring the clients to other professionals as in the Brokerage model.
As the case managers of the Clinical Case Management Model are more involved with the clients, they are able to assess the gaps and identify areas of improvement in their care plans. Plus, with more face time with the case manager, clients feel more motivated and supported which makes the cure more efficient.
While it has many benefits, the Clinical Case Management Model may become demanding, sometimes even exhausting, for the case managers who are more hands-on in this role and are required to utilize multiple skills at a time. Plus, with increased one-on-one client interaction and involvement, there are fewer clients on the case managers’ caseloads.
The use of integrated case management systems also helps clinicians/case managers in the Clinical Case Management Model to create better care plans, identify gaps, improve coordination with clients as well as other professionals, and make the overall case management experience smooth and error-free.
3. The Strengths-Based Clinical Case Management Model
The model, as the name suggests, is built on a client’s strengths. The case manager in the Strength-Based model has the responsibility and skills to identify and analyze the particular strengths of a client. The analysis of these strengths then provides the groundwork for a tailored care plan for the client.
The strength-based clinical case management models have a promising success rate because it is built around the clients’ goals and personal needs, valuable information that is carefully incorporated in every step of the rehabilitation process. Through such personalized care, the model dispels the notion of ‘one-size-fits-all’ and instead creates care plans that are perfectly tailored to each client’s needs.
Strength-based practice in social work has a strong theoretical foundation as an effective building strategy that builds on an individual’s success. The strength-based case management model identifies that the decisive objective of a case manager goes beyond just accessing services, while caseworkers focus on empowering clients and their families.
Case management and clinical services hone in on producing client opportunities for growth, education, and skill development. The strengths-based case management model identifies the value of community services and family collaborations; it also encourages the client to build and foster casual support networks along with recognizing and accessing formal community services and established resources.
As the care plan is built around the client’s strengths and needs, they feel more enthusiastic about it, increasing its efficacy manifold. But on the case manager’s part, the Strengths-Based model can be demanding as it requires in-depth analysis of the client. Plus, some critiques highlight that as the model focuses on a client’s strengths, their weaknesses tend to be overlooked.
Nevertheless, this management model does not believe in the fact that the clinician is the expert on the client’s needs. Executing a program based on this model requires that organizations support caseworkers with a dynamic case management system that can track highly customized services and seize intricate data and metrics.
Besides, these models involve outreach, medical services, support, and strong organization between caseworkers and customers. Implementing a program based on this model requires that organizations and agencies support case managers with a robust case management system that can track highly individualized services and capture complex data and metrics.
4. The Intensive Case Management (ICM) Model
Critical mental diseases are defined by a diagnosis, degree of debility, and the existence of some abnormal behavior that can cause significant distress over a long period of time to both the individual affected and their family and friends.
Until a few decades ago, it was common for those afflicted with these illnesses to remain in an institution for most of their lives, but in many countries of the world, they are now managed in the community with one of the numerous different types of intervention. Intensive Case Management (ICM) is one such intervention.
It comprises the management of the mental health problem and the rehabilitation and social support requirements of an affected individual over an unspecified period of time. ICM, which offers clients 24-hour support, is designed to meet the needs of high-service users and focuses on low staff-to-client ratios, outreach, services brought to the client, and hands-on help in a number of fields.
The goal of this model is to deliver high-quality services in a short amount of time. One of the ways in which the Intensive Case Management Model is different from the Brokerage model is that the clients get a lot more individual attention from the case managers as the target is to do more in less time.
In this model, the case manager may meet regularly with the client and track their progress, accompany the clients to sessions and appointments, determine the duration of rehabilitation on the client’s needs, and share caseloads with other case managers to ensure complete individual care that the clients may require.
With a higher degree of the case manager’s involvement with the client, recovery is reached sooner than in other case management models. In certain cases, ICM has proven to double the attendance of substance-treatment rates. Plus, the relationship between the client and case manager is stronger than any other model, promising better and faster results.
On the downside, some clients may find the ICM care plan too intense. This may result in the client feeling stressed out about their progress in the rehabilitation process.
Also Read: Why is Mental Health Important
Additional Case Management Models
While the four listed above are the most prevalent models of case management, they aren’t the only options to address the care needs of suffering individuals. Additional case management models include:
- Collaborative Care Model: Combines behavioral health and physical health services under one umbrella with a patient-centered care team that uses shared care plans to incorporate goals.
- Community-Based Case Management Model: Focused on adults with mental or substance abuse issues to become independent and readjust into their community.
- Evidence-Based Case Management Models: Using previous evidence at a social worker’s disposal, such as surveillance data and research studies, to make decisions for clients about appropriate treatment and services.
- Complex Care Management Models: Prevents excessive emergency room visits by connecting clients to necessary in-home care and services.
- Triad Model Case Management: Instead of a sole case worker, the Triad Model allows three professionals to work on a case together, each focusing on their area of expertise.
- Comprehensive Case Management Model: The overall idea of thoroughly selecting the correct case management model for each client. Doesn’t have to stick to one specific set of guidelines.
Technology Support for Organizations Using Different Case Management Models
These components alone show how tough case management can be in the absence of an integrated system that keeps the functions in a cohesive order. Organizations seeking to provide quality case management must prioritize effective service design and delivery.
When choosing a case management model, it’s important to be proactive and calculated, make professional development precedence, and recognize approaches for recording and assessing your case management services.
Technology support for organizations using different case management models is also extremely important in this fast-paced business environment. The strategies delineated in this article are aimed at providing case managers and their companies with guidelines to design an all-inclusive approach to case management.
Using a well-developed and clearly designed case management model, organizations can better serve people and families, thereby playing a cardinal role in their growth and well-being.
