Case Study

Case Scenario/ Task

Question 1 A

Case 1

Key Issue	Needs	Priority
Tom is a disruptive who is aged at 13 and has to be disciplined	Alice needs financial support along with help to discipline Tom and help her through depression	The remove Alice from depression and ensure that Tom gets the required help

Case 2

Key Issue	Needs	Priority
John is being physically abused by someone from home and he is hearing impaired	John needs help to stop being abused and ensure that he is shifted to a safe environment where he feels protected	The priority is to deal with the current wounds of John and ensure that he is shifted to a safe place and help him with his hearing Provide him with a case manger on an immediate basis

Case 3

Key Issue	Needs	Priority
Ben is an abandoned child who has no place to stay and his hungry along with agitation and aggression issues	He needs to take care of and be provided with shelter and food. He also need someone who can listen to him in patient manner and calm him down by addressing his anxiety issues	The priority is to calm him down and provide him with food such that he does not get anxious.   Attend to him in the most immediate manner possible

Question 1 b

Case 1

Key potential referral agencies	Other support which might be needed	Relevant information and resources
Beyond blue Access to Allied Psychological Services (ATAPS)	Help in communication with the service providers	Website of service providers

Case 2

Key potential referral agencies	Other support which might be needed	Relevant information and resources
Older Persons Abuse Prevention Referral and Information Line (APRIL) NSW Elder Abuse Helpline Seniors Rights Victoria Advocare Inc.	Help the client deal with the existing bruises till the case is completely referred to someone else	Website of service providers

Case 3

Key potential referral agencies	Other support which might be needed	Relevant information and resources
Beyond blue Head space Youth services Australia		Website of service providers

Question 1 c

The potential referral group Access to Allied Psychological Services (ATAPS) ha the following Referral protocol and requirements are given as below All ATAPS services are given in a manner where the population that requires it the most or has major difficulty to access the heath treatment related to mental disorders are given on priority. It is an important referral group with respect to combating and the encouragement of the following type of requirement from the people

• Client who is not in a position to obtain the mental health services where it is completely funded
• Client who are not able to pay the complete fees or pay lesser fees
• Carers with a diagnosis of mental illness;
• Culturally and linguistically varied groups
• Aboriginal and Torres Strait Islander client who are unable to secure help in an easy manner
• Client who are at the risk of getting homeless or are already homeless
• Children who are at the risk of development of mental disorder if goes unattended
• Client in locations which are remote in nature
• Clients that have attempted suicide in the past or experienced harm to oneself in the past or are at the risk of committing suicide
• Women with depression (Australia, 2005)

• Question 1 d

  Relevant information Things that one can do in order to combat depression or anxiety
  • Let the person know in case they exhibit symptoms of change in their behaviour.
  • One should take time and spend time talking to the person about their involvements and tell them that they are there to listen without judging them on any parameter
  • Suggest the friend that they might need to see a doctor or a support service which may help them and probably make an appointment for them
  • Probably accompany the person when they go to the doctor
  • Offer to provide your services to find information about topics like depression and anxiety by checking online material.
  • Try to encourage the person to get enough exercise, eat in healthy manner and try to rest enough at night.
  • Tell the person not to indulge in drugs and other intoxication substance as it will prove to be non – beneficial for the person
  • Encourage the persons close and near ones like friends and family to take them out and make them a part of various activities like watching a movie, dinners and lunch and ensure that they keep in touch with the person.
  • Inspire the person to deal with their doubts with the help of their doctor or the consulting psychologist (Productivity Commission. (2008).

  • Question 1 e

    	Suicidal Ideation	Homicidal Ideation	Physical Aggression	Suspected Child Abuse/Neglect	Domestic Violence	Elder Abuse	Substance Abuse	Psychotic Thought Processes
    Past Issues: onset, duration, severity	Onset	Not applicable	Present since one year	Present	Na	NA	Onset	severe
    Current Risk Rating	Low 1	Na 0	High 3	High 3	Na 0	Na 0	Moderate 2	High 3
    Method of Assessment	Talking to the client	Na	Medical testing	Talking to the children	Na	Na	Drug testing and medical evaluation	Testing and talking to client

  • Actions Taken

    Referral to a depression help diagnosis centre

    Suggesting exercise and meditation techniques which will help the client to calm down

    Child care centres

    Rehabilitation centre

    Rehabilitation centre

  • Question 1 f

    1. Children and young client
    Risks Responsibilities ‘
    • Protection of children’s rights
    • Provide them with a safe background
    • Ensure they feel they are treated with respect
    • Make them feel secure
    • Listen to their problems
    Risks
    • Children may not listen
    • Children tend to keep things to themselves hence not listen to the care provider
    • May show aggression
    • Self-harm
    2. Domestic violence
    Responsibilities
    • Ensure that the victim is kept at a place separated from the aggressor
    • Give first aid
    • Medical evaluation to see symptoms of nay internal injury
    • Make them feel safe
    Risk
    • Victim may want to go back to the oppressor
    • Does not give full details to the acre provider
    • Does not co operate
    3. Suicide
    Responsibilities
    • First ensure that there is no destructive thing near the victim
    • Report the incident to the relevant service provider
    • Make them feel protected
    • Talk to them in a clam manner
    Risk
    • Victim may try to commit suicide again
    • Victim may escape when no one is noticing
     
    4. Elder abuse
    Responsibilities
    • The elderly person should be protected from the abuser
    • Any wounds or injury should be taken care of
    • The elderly person should be spoken to and details should be taken about the oppressor
    Risks
    • Due to old age , the damage may already be done
    • The elderly person may not be able to communicate due to shock
    • Unwilling to communicate since there is no understanding (Anderson et al., 2006)

    • Question 1 g

      Case 1

      Potential barriers	How might such barriers be addressed
      Alice may not be willing to seek help since she may not understand the gravity of the situation with respect to her depression May not understand the kind of help required hence may be apprehensive to receive it	Explain the client about the ways that they will be able to help Alice in and give her a comforting environment Explain to her as to why the help will be beneficial and ensure that she understand the way the provision will help her to lead a better life

    • Case 2

      Potential barriers	How might such barriers be addressed
      Unwilling to reveal all the details to the case manager since it may include revelation of the family member   May not easily understand what the person in charge has to say since client suffers from hearing disability	By speaking to the family members in a way that they don’t come to know that someone has come from the services agency Speaking to Mara in order to get more details abbot Johns family Speaking slowly to John such that he understands all the details and feel that he is an environment where is understood

    • Case 3

      Potential barriers	How might such barriers be addressed
      Unwilling to listen to the person in charge Continuous agitated Behaviour May bring more harm to himself since he is already picking his arm	Have someone else continuously speak to Ben till the other client is done Request the other client if Ben can be attended to first such that he does not create more ruckus Be stern and explain that if he is going to continue picking his arm it will only cause further distress and will make his case weaker Offer him a glass of water and maybe some cookies to cool him down

    • • Case management is not a line of work but it is a cross-disciplinary and interconnected specialty practice.
      • It is meant for the advancement of a client’s health and the promotion of their wellness and autonomy through advocacy, correspondence, education, identification of service resources, and facilitation of service. They are overseen by the principles of autonomy, benefaction and justice.
      • The case management work force come from a diverse background with respct to health and human services professions
      • The main job of a case manager is to ensure tha the clients get the required support through the achievement of quality outcomes.
      • Case managers’ first duty is to their clients – coordinating care that is safe, timely, effective, efficient, equitable, and client-cantered.
      • The services should be in conformity to the benefits of the client as mentioned in their health insurance plans.
      • Case managers enhance the case management services and their associated outcomes by maintaining clients’ privacy, confidentiality, health, and safety through advocacy and compliance to ethical, legal, authorisation, certification, and regulatory standards and guidelines, as appropriate to the practice setting.
      • The managers should have the required qualifications knowledge, experience and competency in order to ensure that the client gets the fitting quality and care under the given support systems (Gursansky, Kennedy & Camilleri, 2012).
        • Resources such as human, physical, financial or wasted and the service delivery gap is widened
        • Potential competition for resources between providers
        • Negative impact since many resources are wasted in duplication (Bronstein et al., 2015)
          • Interest of the public and client above their own personal interest
          • Respect of the dignity and the rights of the client
          • Maintain a neutral nature while dealing with clients
          • Work with integrity and respect the various constraints of one’s designation
          • Obey all the required laws and rules (Tahan, Huber & Downey, 2006).
            • Assessment of the client
            • Asking the questions
            • Acquiring the evidence by conduction research
            • Appraisal of the evidence doe its validity and applicability
            • Apply it to practice by integrating the evidence with clinical expertise
            • Evaluation of the performance (Powell & Tahan, 2008).

              Question 2

              The steps involved in case management process is given below
              1. Assessment
              These steps consist of the collection and analysis of the information from the client. The client is asked about all the information regarding their back ground, family structure etc. this also involves the determination of their needs and the determination of their appropriateness for service and the making of referral.
              2. Planning
              The planning steps involve the identification of the services and the various strategies that are involved in the intervention. This also include the consultation with the relevant parties and the the setting of goals for the client. This process involves the formal writing of the case management plan
              3. Implementation
              In this phase the execution of the case management plan is done which mainly involves the sourcing and engagement of the service in line with the plan. The source as well as the provision of resources is done in the implementation step.
              4. Coordination and Monitoring
              The on-going formal or informal process is monitored to ensure that here is no lapse in the implementation of effectiveness. It also consists of the constant evaluation of the strategies that are used in case management and ensure they are progressing in the correct manner. Also makes the necessary adjustments in this phase in case any issue have been encountered while monitoring the process (Austin, 2013)
              5. Advocacy
              The client’s family or the client are given access to the appropriate services and ensured that they get all relevant help and advocacy help, also the identification in gaps in provision of services and arrangement of termination is done.
              6. Termination
              It is the need of the provision of services to the client and it includes a part of the case management plan. The clients may terminate the provision service in an early manner if they feel that the provision of services are nota according to their needs or are inadequate or inappropriate (Swayne, Duncan & Ginter, 2012).

              Question 3

              There are several models which can be used that are relevant and appropriate in case management. The first type of model is the broker and generalist model. In this type of model it mainly encompasses the usually accepted purposes of a case manager. The case manager mainly recognizes the needs of the person and then links them to suitable service providers by their own referrals. The generalist model is based on the assumption that the function of the case management and will do referrals but also there is a close interaction with the client. Both the models whether it is brokerage and generalist model there are no outreach done by the case worker or the multi-disciplinary team allocated to the client. These types of model is very relevant to the Alice since she has a gambit of problems and by using the various referral service she can get herself out of depression, get financial aid and help in the evolvement of her children which id her prime need of the hour. The second type of model is intensive case management model where the support is provided to the client for a long period of time and the provision of services is done under the roof of one association as opposed to the brokerage model which is completely based on referrals. This model is useful for tacking the case of John since housing for a longer period will help the case manager to find an appropriate solution and he does not have to go back to the place where he is physically abused (Naleppa & Reid, 2003). The third type of model is the Strengths-based case management model and this mainly consists of the ways the case management has evolved. The main focus is on the strengths of the client instead of the focus on their weakness and the barriers they encounter to take the relevant steps. The main drive is to build on the client’s informal health networks as contrasting to the reliance on structured programs within a support centre. The success factor of this model is mainly dependent on follow-up process with the client in order to safeguard their interest with respect to obtaining the services they need. This type of model plays a role to address any denial and resistance, and its philosophy promotes positive effects. This type of model is apt and relevant while dealing with Ben since he needs to be reminded of his positive growth (Fisher, 2005).

              Question 4

              Evidence-Based Practice (EBP) is defined as the conscientious, judicious and the explicit usage of its most useful evidence which is currently present and make decisions which is for the best interest of the individual client. The integration of the individual clinical expertise of the client with the available clinical evidence in an external manner based on systematic research forms a part of this model. It is mainly the amalgamation of clinical know-how, patient values, along with the finest research evidence into a decision making process for client care. (Campbell et al, 2007). The EBP has the following steps

            Question 5

            1. Cooperation & expectations which involves the case management and requires assistance and clear expectations.
            2. Leadership is the crux for the presence of an effective administration role in case management
            3. Culture: Effective case management creates a system of culture of obligation, awareness, and appropriate collaboration for whoever comes to seek help
            4. Management information: effective case management requires managerial information
            5. The drive that the case management service providers should have is intense and the key benefits of multi agencies is that the cases do not get ‘lost’ in the system and ensure that the follow up of leads happen.
            6. the first duty of the manager is to ensure that the clients are given care in a safe, timely, effective, competent, on equal basis and which is client-centered.
            A list of case managers principles are also given below

          Question 6

          The issues faced by clients, their family and carers accessing multiple services is give below
          • Multiple services means the accommodation of various services in the given time hence the services may overlap and it may not be possible for the client to be present for various services in the given amount of time
          • Becomes difficult to coordinate with the various activities so the different services
          • Multiple service may give different diagnosis which is conflicting in nature and it may be difficult to choose which is the right one or the more relevant one
          • Also multiple services may give the same treatment which may resulting service duplication
          • Multiple service may mean multiple barriers which needs to be resolved by the client or the family and finds (Powell & Tahan, 2008).
            Impact of service duplication

        Question 7

        The case management principles and practice is given below The guiding principles are given below
        • Approach should be client centered and have a synergetic partnership
        • Shared decision making and should advocate client through self care and self determination
        • Approach should be holistic and comprehensive
        • Should be culturally aware about the various aspects
        • Ensure safety of client
        • Link the resources with requirements (Brun & Rapp, 2001).
        The practice of case management includes the following

      Question 8

      It is important to consider the various ethics or principles and practices when one is working across multiple services that will have a range of different funding arrangements. They are given below
      • Identification of a head who will establish a flawless direction and vision for the service and at the same time listen and provide support and management to the members of the team
      • Incorporation of a set of values that promised direction to the multiple services and they should be consistent portrayed and should be visible
      • Demonstration of a team culture and an atmosphere of interdisciplinary trust where consent within the multiple services is sought with respect to the funding arrangement
      • Ensures the appropriate process and infrastructure that is required for the upkeep of the goal of the service
      • efficient organized documentation throughout the services and the funding details which is easy for retrieval with respect to different services
      • Ensure that only truthful and honest appeals are processed by doing a thorough background check on all the client who have come to avail the services
      • No discrimination should be made against the various clientele with respect to gender, caste, creed , ethnicity , religion or colour
      • Ensure that no person is given preference due to personal relationship with the client
      • Absolutely no amount of bribery should be entertained in order to expedite the process of getting funding
      • safeguard the welfare and rights of both those with whom the management will interact professionally and other affected persons
      • Upkeep of professional standards of conduct, clarification of professional roles and obligations, acceptance of appropriate responsibility for their behaviour, and seek to manage conflicts of interest that could lead to exploitation or harm (National Association of Social Workers (NASW), 2013).

      Question 9

      In case a client requires help, it is done in formal manner by setting a meeting between the organizational and the client. The steps and several roles involved in formal meeting processes
      • The firs step is to define the purpose of the meting
      • Access the background information on the participants of the meeting. This includes a preliminary research such as the clients, carers, guardians, parents, advocates and others service providers among others
      • Setting out an agenda which reflects the objectives of the client
      • Introduce the participants and their roles in the case of the client
      • The objectives should be presented next
      • Facilitation of the discussion about the processes t to ensure that the client participates and hence setting of the goals
      • Identification, negotiation and keeping records of the outcomes
      • Identification and the agreement on the outlines and developments within which the delivery of services will be done that includes
        • Rights, characteristics, responsibilities, making judgements. accountability and the results
        • Ways to address the experience, services, values and the development of the client
        • The outcome of the statutory mandates on involvements between the client and other people who form a significant part of the meeting
      • Definition and the exploration of the individual needs of the family and the needs and the rights of the community and the responsibilities of the organization to ensure that all the rights are protected with respect to all the client who are involved
      • Facilities the sharing of information on all matters
      • Conflict resolution if any arise and the discussion should be focused such that the objective of the meeting is achieved
      • Providing of information with respect to the rights of appeal and the avenues of the complaint (Wacker & Roberto, 2014).

      Question 10

      The following things are very important to understand from the perspective of case management A Family systems and dynamics When a case is being approached by an organization it is extremely important to understand the family system and the dynamics that the person belongs to. A person cannot be understood in isolation to their family since their family has a deep influence in the way they work and carry out their tasks. there are many rituals which are unspoken due to the influence that the family rituals have on them and each family member is expected toad her to these rules. The way family members interact with each other is analysed when it is viewed as change. The preparation stage for case management consists of the changes that an individual makes in their life and the way these changes will impact there family interactions and members and the consequences of these changes will be examined during the preparation phase B Cultural considerations, history, protocols and systems of culturally and linguistically diverse clients and Aboriginal and/or Torres Strait Islander client The Aboriginal and/or Torres Strait Islander client are culturally different from the common Australian due to the diversity in culture that they face. Culture determines how comfortable a person is with respect to asking for help and the accepting the help. It helps the mangers to determine how these client may collaborate with them on the basis of a different gender, communicate participate and trust. This client may feel that since they are culturally so different, case managers may find it difficult to understand them and their needs. The understanding of the dynamics of their culture, it will help the case managers to build rapport with their client and make them feel at ease which will generate a greater commitment from the client side. Also knowing there history may help the managers understand the way their clients functional and what is acceptable to them and what is nota acceptable to them. It’s very important for these mangers to gain the trust of these culturally diverse clients in order to help them in the correct manner (Naleppa & George, 2013).

      Question 11

      There is a list of protocols, policies, standards, legislations and statuary mandates which apply to case management. It is important that the organizations follow these guidelines since it will help them to service the client in a better manner and ensure that the case is managed in an in-depth manner, these are given below Statuary place requirements are
      • Code of practice
      • Health records legislation
      • Child protection and guardianship legislation
      • Access to all and equity
      • Public health services
      • Freedom of information to everyone
      • Privacy legislation
      • Health and safety at workplace
      Organizational polices, protocols and procedure are given as follows
      • The consultation with relevant parties like clients , guardians, careers, advocates, parents and other service providers
      • The participation in case management and agendas
      • Protection of the client rights
      • Upholding of the duty of the care requirements
      • Work within the outlined positions with specifications and role responsibilities
      • Referral of the appropriate advocacy services to the client or their family and friends whichever is appropriate
      • Support the client in order to identify and express their concerns and helps them in case they need advocacy
      • Follow the appropriate policies and procedures while managing a complaints by the client
      Relevant legislation include the following
      • Health and safety
      • Child protection
      • Privacy of individuals
      • Freedom of information
      • Disability
      Document protocols are given below
      • Record information in a careful and accurate manner
      • Ensure recorder information is free from biased comments and negative labels
      • Maintain confidentiality and privacy of the client and the documents
      • Secure all records in an appropriate manner
       

      Question 12

      There are various ways in which it can be determined whether a client requires an interpreter or not. They are outlined as given below
      • Client who cannot communicate in the written manner or spoken communication with the organisation
      • When required to make significant decisions about their lives and they cannot understand English hence require interpretation services
      By providing such client with interpreter the organization ensures that no part of the details is left out and everything can be recorded in a complete manner. The steps involved in arranging an interpreter should be followed in a meticulous manner. The first step is to speak to the client and find out the language in which the interpreter is required. It is essential that the interpreter that the organization provides is accredited and paid interpreters should not be family members or friends. The option of telephone interpretation should be given and the client should be asked a bunch of questions. If telephonic interpreters not suitable in the particular circumstances that the organization should arrange for location convenient to the organization and client. The interpreter should be accredited by the National accreditation Authority for Translator’s and Interpreters for them to be hired by the agency and can interact effectively with each other, particularly when accessing medical, government and other services (Austin, 2013).

1. For 3 THREE case studies of your choice which may include John Green developed by David in earlier classes,or from following four case studies answer the following questions

a. Summarise the key issues, needs and priorities for this particular client? Case 1

Key issues	Needs	Priority

  Case 2

Key issues	Needs	Priority

  Case 3

Key issues	Needs	Priority

b. Determine in each case potential / likely referral agencies; other support the person may need and relevant information and resources which may be of use Case 1

Key potential referral agencies	Other support which might be needed	Relevant information and resources

  Case 2

Key potential referral agencies	Other support which might be needed	Relevant information and resources

  Case 3

Key potential referral agencies	Other support which might be needed	Relevant information and resources

c. Contact one of these potential service referral agencies and attach or describe their referral protocol and requirements d. Download, or collect potentially relevant information and resources to be submitted as attachment here and also provided to the client if appropriate e. Using the provided risk assessment worksheet determine by observation and discussion with the client you feel is most at risk what are their indicators of imminence of self-harm or harm to other RISK ASSESSMENT WORKSHEET  

	Suicidal Ideation	Homicidal Ideation	Physical Aggression	Suspected Child Abuse/Neglect	Domestic Violence	Elder Abuse	Substance Abuse	Psychotic Thought Processes
Past Issues: onset, duration, severity
Current Risk Rating
Method of Assessment
Actions Taken

Ratings: 0 Not applicable 1 Minimal risk 2 Low risk 3 Medium risk

• High risk: requires immediate intervention

1. Discuss, (with reference to the other 2 cases), your risks and responsibilities as a worker relating to your duty of care in regards to:
2. children and young people
3. domestic violence
4. suicide
5. elder abuse

g. Name any potential barriers which may impact on the progress of this client to a case plan, and how might such barriers be addressed? Case 1

Potential barriers	How might such barriers be addressed

  Case 2

Potential barriers	How might such barriers be addressed

  Case 3

Potential barriers	How might such barriers be addressed

1. List the steps involved in the case management process.
2. Describe several models of case management which you think may be relevant and appropriate in these cases. Discuss why you chose them in relation to the clients and models specifically.
3. What is evidence based practice requirements?
4. List case management practice requirements generally.
5. What might be issues faced by clients, their family and carers accessing multiple services and what could the impact on them of service duplication?
6. What are case management principles and practice?
7. What is important to consider in terms of ethics or principles and practices when you are working across multiple services who will have a range of different funding arrangements?
8. List the steps and several roles involved in formal meeting processes.
9. Why is it important to understand the following in case management?
10. Family systems and dynamics
11. Cultural considerations, history, protocols and systems of culturally and linguistically diverse clients and Aboriginal and/or Torres Strait Islander people
12. List the protocols, (including documentation protocols), policies, procedures, standards, legislation and statutory mandates that apply to case management.
13. How would you know if your client required an interpreter and what would be the steps involved in arranging this?

CASE STUDIES:

1. You work as a caseworker in a Family Support Service.

Alice is a single parent, with four children: Ellie aged 15, Tom aged 13, Laura aged 10 and Beccy aged 3. Alice contacts your agency for help with parenting Tom who has been disruptive at school. Alice (mother) has been diagnosed with depression 12 months ago by her GP. She also said on referral that she is struggling financially, separated from her husband 4 months ago, is in the family home for now but also needs help with figuring out court – children’s access and custody arrangements and property settlement. In passing she mentioned that she is also worried about Beccy because she didn’t seem to be at the same stages as other children in the playgroup she attends and another parent had commented recently to her about this.

2. You are an outreach support worker at a general community organisation within a section that offers support to people from culturally and linguistically diverse people.

John, 80 years old, who is hearing impaired, has been attending a Men’s Shed group which recently had an outing to the coast. Although John said he couldn’t swim, because of the heat he did expose more of his leg and arm than he normally would and the worker noticed that he had several bruises and what looked like cigarette burns exposed. The worker approached him and tentatively asked him about the burns and John immediately covered up and withdrew. You are aware (service case notes) that John is a long term relationship with Barry and that John has a grown son Ted aged 60, and grandchildren Mara aged 29, and Alice 32. John turned up the week after the coast trip with his face cut and a black eye with Mara asking for help and he was referred to you.

3. You are a Youth Housing Outreach Worker attached to a generalist Youth Centre.

Ben, 16 years old, drops in to see you, slurring his words and swaying, saying he has “no where to live, no money, he’s starving” and when you ask if he can take a seat, you are already talking to another client, almost immediately he begins swearing at you demanding that you fix everything for him immediately. Eventually you manage to calm him down but notice he is still agitated (tapping his foot) and is picking at his arm making it bleed.

4. You are a generalist caseworker with an emergency relief program in a church based national organisation

Asmara has contacted your program needing help to feed her two children, Sara, 11 and Naseef, 6. Asmara’s husband, Syed, died from lung cancer last month, and she has been left with the care of two children, Sarah 11 and Geoffrey, 9. Asmara’s English is not the best, but it soon becomes clear that food is not the only issue she has. From what you have understood you have concerns also about her mental health, (very agitated and manic behaviour); and her housing (her husband worked and their savings are depleted. They were renting and the landlord has been visiting a lot and Sarah says ‘threatening’ them. Some of Syed’s family (a brother and his wife) are in Perth and encouraging her to come to them.