Abstract
Social workers perform a range of services that touch on many disciplines within the greater health and human services field. Case management, which is closely identified with social work, features a skill set that can be applied to many areas within the discipline of social work, ranging from child protection to substance abuse. These skills include problem assessment, treatment formulation, coordination and counseling. There are considerable career development opportunities, and new skill development paradigms provide important resources for professional growth.
Keywords: Social workers, health and human services, case management, child protection, substance abuse
A Career in Health and Human Services
Social workers are, practically speaking, the “chameleons” of the health and human services industry. Their work requires them to cross over into many disciplines, including community service, education, criminal justice and health care (Burger, 2010, p. 262). As such, being a social worker requires remarkable adaptability, patience and the willingness to learn new skill sets “on the go.” Today, social workers draw on a wide range of professional skills and community resources in the performance of their jobs, which they employ in working with groups to effect change and serving as “change agents” within their communities (Burger, 2010, p. 223). Case workers typically focus on individuals and families, serving their clients’ needs and interests guided by a thorough and unique understanding of their life situations and backgrounds (Burger, 2010, p. 226). Case management is a widely recognized component of the profession and is, perhaps, the one aspect most readily associated with the field of social work.
This paper will examine not only the day-to-day responsibilities of the case manager, but also the attributes, interests and educational needs and preferences of individuals who choose a career in case work. As with most career path choices, social work attracts a certain personality type, and case work can be one of the most demanding branches of the profession. It is interesting and worthwhile to note that other health professionals, such as psychologists, nurses, counselors, may also have case management responsibilities (Burger, 2010, p. 226). But while these individuals may bear responsibility for certain aspects of a client’s (or patient’s) life, the case manager takes responsibility for the “whole person” in working with individuals who require help managing their own lives (Burger, 2010, p. 226).
Career characteristics and functions
While there are many recurring processes that typify a case management career, the case manager can usually count on a client list that reflects considerable ethnic and social diversity. This may include single-family homes; two-parent homes; foster child or adoptive situations; families with gay or lesbian parents; children whose primary caregivers are grandparents or some other family members; and immigrant families; among others (Ritter, Ritter, Vakalahi, Vakalahi and Kiernan-Stern, 2008, p. 31). And there is little uniformity in the nature of case work itself: managers generally fall into one of many categories, which include child protection; intake work; family preservation; foster care/adoption; and substitute care (Ritter, Ritter, Vakalahi, Vakalahi,
Kiernan-Stern, 2008, pp. 32-35). Strong decision-making, incisive interviewing, task prioritization and the ability to work in a conflict-oriented environment are just a few of the core competencies required of a case manager (Ritter, Ritter, Vakalahi, Vakalahi, Kiernan-Stern, 2008, p. 38).
Education/training requirements
In most cases (within the United States), social workers possess a BSW (Bachelor’s in Social Work), or an MSW (Master’s in Social Work). Due to the high demand for social workers throughout the U.S., many social work educational programs receive federal funding designed to help match graduates with field placement opportunities in child protective services (Ritter, Ritter, Vakalahi, Vakalahi, Kiernan-Stern, 2008, p. 38). However, some have criticized social work educational practice in the U.S. for focusing too heavily on churning out as many bachelor’s degrees as possible and doing too little to foster an environment in which students go on to seek a higher level of expertise and proficiency (Gursansky, Harvey and Kennedy, 2003, p. 158). Others contend that educational requirements should be gauged based on the particular needs of the various case management sub-disciplines: for instance, a bachelor’s degree may be appropriate for “discrete” case management fields, such as intake and referral, while more advanced degree work may be necessary for “psychosocial enhancement case management” work (Raiff and Shore, 1993, p. 88).
There are a number of national associations that offer credentialing and certification in case management. The American Case Management Association, for example, offers an Accredited Case Manager (ACM) credential to social workers and nurses with the requisite licensure, education and experience (Education-Portal.com, 2012). The Commission for Case Management Certification confers an accredited Certified Case Manager (CCM) certification, which requires, among other things, post-secondary education and state licensure (2012). The National Association of Social Workers requires all members to obtain education and training in core concepts of case management (Gursansky, Harvey and Kennedy, 2003, p. 158).
Typical work settings can expect to spend a great deal of time on the phone (or some other communications device)
coordinating services, following up with clients and making arrangements with other service professionals. In terms of venues, case managers may find themselves working in community health centers, hospitals, schools, substance abuse centers, nursing homes, schools and government-run facilities. The average salary for a case manager is about $55,000 yearly.
Cultural competence
As previously mentioned, case managers may be required to work in any number of environments, including diverse ethnic and cultural settings. Cultural sensitivity, which is essential in such a situation, is a core value emphasized by most professional organizations, including the Council on Social Work Education and the National Association of Social Workers Code of Ethics (Keys, 1994, p. 30). In recent years, there has been greater stress placed on diversity awareness in social work curricula at the university level. The Council on Social Work Education requires that schools must incorporate ‘clearly articulated objectives, outlines, and content incorporating diverse racial, ethnic, and cultural perspectives’” (Keys, 1994, p. 30). In the United States, where ethnic diversity continues to grow at a steady rate, the ability to move seamlessly in and out of different sub-cultures is absolutely vital if the case manager is to succeed as an agent for individual and social change.
In The Encyclopedia of Social Work, the case manager is defined as someone who “must develop cultural competency, understanding the traditions, rituals, teachings, language values, and beliefs of the particular organization or community” (Mizrahhi, 2008, p. 286). Just as field anthropologists must adopt the norms and practices of the cultures they study, so the social worker must understand the client’s cultural background from the inside out. Cultural competence in social work has also evolved to include organizations, where it is defined as “a set of congruent policies, structures, procedures and practices that together enable social work service providers to work effectively in cross-cultural situations” (Mizrahi, 2008, p. 487).
Career development
One of the benefits of working in case management is the transferability of skill sets between career areas. In most cases, the ability to assess, plan, coordinate, document and adapt treatment plans, once learned, can be applied in a variety of roles. In the area of child protective services, case workers can move among a wide range of services, including supervising visits between parents and children, examining children for abuse and neglect, driving clients to service appointments and attending court hearings (Ritter, Ritter, Vakalahi, Vakalahi, Kiernan-Stern, 2008, p. 35). Achieving a level of professional expertise in these and other functions is a matter of technical proficiency, but some theorists have developed more comprehensive and inclusive methods of continuing professional development.
One such conceptual framework, called reflective practice, establishes a means of continually assessing effectiveness whereby the practitioner “is able to constantly learn to re-appraise their activity on the basis of the impact that it is having” (Matthews, McCormick and Morgan, 2010, p. 187). This approach encourages social workers to continually question and realign their practices. Other approaches to continuing career development stress cutting-edge training programs that incorporate the latest developments in theory and best practices within the
Alternative career
Increasing specialization in the field of social work has given rise to greater specialization in social work curricula among American universities. One such “niche” is in the area of substance abuse counseling, in which many higher institutions now offer both bachelor’s and master’s degrees (Burger, 2010, p. 259). As previously mentioned, the day-to-day work of a case manager offers exposure to many different areas of specialization, and “all social workers can provide counseling and psychosocial support to clients, and in any number of settings, social workers may encounter clients with substance abuse” (Ritter, Ritter, Vakalahi, Vakalahi, Kiernan-Stern, 2008, p. 105). Substance abuse presents the social worker with the opportunity to apply and adapt experience gained as a case manager, including assessment, the formulation of a treatment plan and the need to gauge the success of the program initiated on behalf of the client.
Research has shown that substance abuse clients benefit materially from a case management approach. More specifically, it has been proven that substance abuse subjects experience more positive results when their problems are dealt with together, and as a whole (Center for Substance Abuse Treatment, 1998). Case management skills can be applied to the specific needs of those suffering from HIV/AIDS, mental illness, homelessness and other problems ancillary to substance abuse (1998). Interagency case management can be highly effective in coordinating the full range of services needed to provide substance abusers with comprehensive treatment initiatives (1998). As well, case management holds great promise for substance abuse care given the fact that substance abuse treatment programs, to a large degree, now operate under the provisions of managed care.
Conclusion
Clearly, a career in case management can lead to opportunities in multiple social work disciplines. For a decisive, confident and organized individual, the ability to accurately assess a client’s needs, develop a treatment regimen accordingly, coordinate among services needed and determine the success of the approach adopted, presents opportunities in both functional and psychosocial service areas. The growing complexity of American society has engendered a need for greater specialization in the field of social work and placed a premium on the ability of case managers to coordinate multiple services for their clients. Though a physically and emotionally demanding field, case management can be highly rewarding. A social worker/case manager is not only a care giver but a teacher as well, someone who endeavors to show clients how to manage their own affairs and make good decisions in their lives.
Thus, professional development is a viable and important part of a career in case management. New approaches to career improvement and advancement offer additional resources for the social worker who can learn to think reflectively and implement practical changes where needed. It should be remembered that social workers are increasingly valuable components of the health and human services industry, particularly given that people in need of aid are confronted by an overwhelmingly arcane and intricate social services and health care edifice. Case managers can play an indispensable role in helping the uninitiated navigate the daunting twists and turns of this bureaucratic machinery.
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