CLINICAL HANDBOOK OF SCHIZOPHRENIA

TABLE 31.1. Clinical Case Management Activities31. Clinical Case Management 311Promoting client engagement and involvement in treatment• Creating a working alliance.• Assisting in assessment and treatment planning across all client domains.• Setting and maintaining appropriate treatment boundaries.• Assertive outreach—reaching out to clients in their natural environments to maintain regularcontact.• Assisting client in identifying personal goals, individual strengths, and perceived obstacles thatshould be considered in treatment planning.Acting as primary client contact within the community mental health agency• Initiating and/or facilitating case discussions regarding client care at treatment team meetings.• Maintaining regular communication on individual client progress with the team leader and treatingpsychiatrist.• Ensuring that the client’s medical record is kept current with all required documentation, includingtreatment plans, clinical updates, and progress notes.Brokering of services• Benefits assistance (Social Security Disability, food stamps, and other entitlements).• Coordinating medical care (regular medical and dental care; referral for other medical specialists asneeded, including encouragement to follow through on medical testing and treatment whenindicated).• Assisting clients in obtaining legal representation when needed.• Promoting follow through with all outside referrals for benefits and services.Advocacy and liaison functions• Working with landlords to help clients maintain housing when problems arise.• Supporting and assisting clients in navigating the criminal justice system.• Helping to safeguard client rights.• Acting as a liaison in psychiatric or medical facilities when a client is in need of hospitalization.Psychotherapeutic work• Comprehensive assessment and treatment planning.• Medication and symptom monitoring.• Crisis planning and emergency response.• Teaching life skills to promote client independence (budgeting, money management, cooking,shopping, housekeeping, parenting, use of public transportation).• Psychoeducation (e.g., signs and symptoms of schizophrenia, negative effects of co-occurringsubstance abuse, influence of stress on course and severity of mental illness).• Coping and social skills training.• Illness management and recovery.• Supportive counseling.• Family education and support.• Coordinating and/or providing specialized services for clients with co-occurring substance usedisorders.• Social integration (helping to fortify and expand natural social supports/community involvement).• Vocational assistance (frequently coordinated with supported employment specialist).is kept current, including all required documentation, such as treatment plans, clinicalupdates, and progress notes.Brokering of ServicesThe impact of social and environmental pressures (e.g., homelessness, poverty, discrimination)on the psychological well-being of individuals with schizophrenia is compelling.Beyond the provision of mental health treatment, case management involves brokering of