Social Work Case Management

Case Studies From the Frontlines

Michael Holosko

• Publisher: SAGE Publications, Inc
• Year: 2017
• ISBN:
  9781483374499
• Edition: 1
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

Written by a social worker for social workers!

This innovative book equips readers with the knowledge and skills they need to be effective case management practitioners in a variety of health and human service organizations. A must-read for students and professionals in social work, this important work introduces a unique Task-Centered Case Management Model built around the unifying principles of the profession—person-in-environment, strengths-based work, and ecological perspective. Over twenty case studies by case managers and professionals offer innovative practice insights, illustrating the practice roles and responsibilities of today?s case managers and the realities of conducting case management in today's growing, exciting, and challenging field.

PART I Trends, History, Social Work Case Management Model, and Practice Competencies

1 Current Trends Shaping Social Work Case Management

“Everything should be made as simple as possible, but no simpler.”

—Albert Einstein

Trends Influencing Social Work Case Management (SWCMG)

The North American health and human services organizations (HSOs) in which professionals are employed are usually stressful settings in which to work (Holosko, 2006). They are generally characterized by ongoing annual funding and budget cuts, more stringent eligibility criteria for service provision, shortened time frames for interventions, increased caseload numbers, numerous regulatory policies and procedures that are constantly being amended, less time for supervisors to consult with their front-line workers, and increased organizational settings in which to work and collaborate (Preston, 2010; Savaya, Gardner, & Stange, 2011). When changes in policies, budgets, or service provision happen, front-line workers, supervisors, and managers are forced to respond rapidly and adapt to them. Many human service workers feel that such changes seem to occur almost on a daily basis.

HSOs are profoundly influenced and shaped by a variety of trends that impact the where, when, and how SWCMG is practiced in this era of changing health care reform (Cesta, 2012). Almost a decade ago, Hoge, Huey, and O’Connell (2004) advocated that behavioral health workforce personnel require an understanding of the diverse paradigms of various economic forces and trends that influence health care delivery, in order to be competent working in this area. Understanding such trends seem even more important today, given their frequency and occurrence. Sometimes such trends are clearly presented to HSO employees, and/or are time framed; for example, the agency will go paperless by July 15th. Other times, they and their implications are unclear to both the HSOs themselves and their employees; for example, next year’s state budget will have severe cuts to all state-funded mental health agencies. In such cases, these decisions are often made well beyond the agency walls—from “places above.” Thus, like many other employees, social work case managers (SWCMs) work in settings rife with overt organizational change and uncertainty, for example, fiscally, politically, administratively, and policy-wise.

This chapter first identifies these various external trends and shows how they flow downward and eventually influence SWCMG practice. Second, it identifies selected practice transitions that SWCMs have to embrace to accommodate these trends. Finally, it concludes with a rationale for better SWCMG education and training across all social work curricula to meet the demands for employment in this burgeoning growth area. The trends described herein influence different health and human service professionals in various ways; however, this chapter emphasizes how they impact social worker practitioners in general, and SWCMs in particular. We preface this discussion by stating that the trends presented are certainly not the only ones impacting social workers and SWCMs, but ones that have been well cited in the extant literature in this field.

International Trends: Neoliberalism and Globalization

Neoliberalism

Somewhere, in the conceptual stratosphere above, social workers have often heard how the two topical buzz words neoliberalism and globalization have impacted social welfare policies and practices. Just how they have done this is less clear. Schriver (2013) noted that the worldwide trends of these rather nebulous concepts appear much better known outside of the United States than they are in America. However, given their prominence in shaping national social welfare policy in many developing and underdeveloped countries of the world, they merit attention in any discussion of macro trends influencing social work and SWCMG practice. It is important to first note (and distinguish) that the term liberalism is a political doctrine, and neoliberalism is an economic doctrine. Further, these very different concepts are often blurred because they both have the word liberal within them. Another point of conceptual fuzziness here is when liberalism gets applied to the field of economics, it refers to policies meant to encourage entrepreneurship by removing government controls and interference, which positions the term to more of a right-wing conservative notion than its truer liberal left-of-center political meaning. The concept of liberalism clearly embodies a political philosophy favoring individual freedom and liberty, equality, and capitalism (Hartz, 1955, as cited in Nilep, 2012), which has a long and deep effect in American history.

Turning to the concept of neoliberalism, neo means “new,” so this “new liberalism” was an economic shift from the previously described political concept above. Neoliberalism is about the freer movement of goods, resources, and enterprises in an effort to find cheaper labor and resources and, therefore, ultimately maximize profits and efficiencies (Holosko, 2015). The key assumptions or elements of neoliberalism described by Martinez and Garcia (1997) from the Corporate Watch include the following:

1. The rule of the market: The freedom for capital, goods, and services, where the market is “self-regulating.” It also includes the de-unionizing of labor forces, removal of financial regulations, and more freedom from state or government.
2. Cutting public expenditures for social services: This means reducing the so-called social safety net for the poor including health, human services, and education.
3. Deregulation: It involves the reduction of government regulation of anything that could diminish profits, including the protection of the environment and safety on the job.
4. Privatization: It includes selling state-owned enterprises, goods, and services to private investors including banks, key industries, railroads, toll highways, electricity, schools, and hospitals.
5. Eliminating the concept of “public good” or “community”: In short, these should be replaced with “individual responsibility,” at any cost.

As the concept relates to our post welfare states of its current citizen regimes, neoliberalism is also used to describe social welfare, welfare policy, ideology, or governmentality (Holosko & Barner, 2014; Larner, 2005; SUNY Levin Institute, 2013).

Globalization

A consensual definition of globalization is, “a process of interaction and integration among the people, companies, and governments of different nations, a process driven by international trade and investment, and aided by information technology” (Holosko & Barner, 2014). This process has had profound effects on the environment, culture, economic development, prosperity, and human physical well-being in societies around the world (SUNY Levin Institute, 2013). Although neoliberalism and globalization were presented separately above, given their similar economic growth and trade imperative, in the past 15–20 years, these concepts have been inextricably braided (Holosko & Barner, 2014). In short, globalization is the reigning socio-historical re-configuration of social space, and neoliberalism is the policy approach to it. The term now used to promote their interrelationship is neoliberal globalization (Scholte, 2005).

When examining the literature about the so-called pluses or minuses of ...