CLINICAL HANDBOOK OF SCHIZOPHRENIA

31. Clinical Case Management 317recommendations, additional incentives, such as assistance with graduate education, maybe required to retain skilled case managers in the mental health system. Mental healthagencies and state universities might consider forming consortiums to encourage skilledcase managers to advance professionally and remain in community support programs inmanagerial and supervisory roles, so that they may train and supervise the next generationof clinical case managers. In conclusion, despite the challenges of incorporating clinicalskills into the traditional case management role and retaining experienced workers,clinical case management interventions, when used judiciously and assertively, can powerfullyenhance treatment protocols for clients with schizophrenia. Clinical case managementhas the potential to be not only the key integrating element in a complex system ofcare but also the main catalyst for improving clients’ psychosocial well-being and longtermrecovery.KEY POINTS• Case managers play a vital role in coordinating multiple services and improving access tothe social, material, and environmental resources deemed necessary for clients withschizophrenia to achieve independent living in the community.• Continuity of care should be a guiding principle in case management approaches for treatmentof schizophrenia to avoid fragmentation of services that can undermine even the mostefficacious therapeutic interventions.• Optimal case management services should be delivered by a multidisciplinary team thatcan provide assertive outreach, 24-hour coverage, and long-term, open-ended treatment inclients’ natural environments.• Core functions of case management include promoting client engagement and followthrough in treatment; acting as the primary client contact; brokering of services; advocacyand liaison functions; and providing a wide array of psychotherapeutic interventions.• Case managers should be well-versed in the range of evidence-based practices for peoplewith schizophrenia; clinical interventions and services should be flexible and tailored to suiteach client’s particular needs and goals for recovery.• Administrators and supervisory staff members should ensure that case managers receiveongoing training, support, and clinical supervision to foster effective therapeutic skills, tomaintain professional treatment boundaries, to reduce job burnout, and to curb high staffturnover.REFERENCES AND RECOMMENDED READINGSCarey, K. B. (1998). Treatment boundaries in the case management relationship: A behavioral perspective.Community Mental Health Journal, 34(3), 313–317.Grech, E. (2002). Case management: A critical analysis of the literature. International Journal ofPsychosocial Rehabilitation, 6, 89–98.Harris, M., & Bergman, H.C. (1987). Case management with the chronically mentally ill: A clinicalperspective. American Journal of Orthopsychiatry, 57, 296–302.Hromco, J. G., Lyons, J. S., & Nikkel, R. E. (1997). Styles of case management: The philosophy andpractice of case managers. Community Mental Health Journal, 33(5), 415–428.Kanter, J. (1989). Clinical case management: Definitions, principles, components. Hospital and CommunityPsychiatry, 40, 361–368.Morse, G. A., Calsyn, R. J., Klinkenberg, W. D., Trusty, M. L., Gerber, F., Smith, R., et al. (1997). Anexperimental comparison of three types of case management for homeless mentally ill persons.Psychiatric Services, 48, 497–503.Mueser, K. T., Bond, G. R., Drake, R. E., & Resnick, S. G. (1998). Models of community care for se-