CLINICAL HANDBOOK OF SCHIZOPHRENIA

322 V. SYSTEMS OF CAREculties in generalizing newly learned skills, increases retention of consumers in service,and provides opportunities for identifying community resources.6. The case manager–consumer relationship is primary and essential. Without thisrelationship a person’s strengths, talents, skills, desires, and aspirations often lie dormantand may not be mobilized for the person’s recovery journey. It takes a strong and trustingrelationship to discover the rich and detailed tapestry of someone’s life and to create an environmentin which a person is willing to share what is most meaningful and important—his or her passion for life.EngagementPRACTICE GUIDELINESThe purpose of engagement is to create a trusting reciprocal relationship between thecase manager and the consumer as a basis for working together. To facilitate each consumer’srecovery journey, the relationship should be a hope-inducing rather than spiritbreakingprocess. Examples of spirit breaking include restricting people’s choices, imposingour own standard of living on people, making their decisions for them, and tellingpeople that they are not yet ready for work, a car, or an apartment. In contrast,hope-inducing relationships are built through caring interactions, focusing on people’sstrengths, celebrating their accomplishments, promoting choice, helping them achievegoals that are important, and promoting a future beyond the mental health system. Engagementand the entire case management process occurs in the community, not in themental health agency.Strengths AssessmentThe purpose of a strengths assessment is to amplify the well part of an individual by collectinginformation on personal and environmental strengths. The strengths assessment isorganized by eight life domains: daily living situation; finances; vocation/education;social supports; health, leisure, and recreational activity; and spiritual/cultural activity.Information is organized in each life domain by the current situation, the future (desiresand aspirations), and past situations. A strengths assessment, unlike many assessments, isan ongoing, continuous process. The information is gathered in a conversational manneras the case manager and consumer spend time together. It is critical that case managerscollect specific information, avoiding the tendency to rely on pleasant adjectives (e.g., diligent,humorous, kind). The inquiry should focus on specific achievements, talents (playingthe 12-string guitar, skill as a foreign car mechanic), and environmental resources(church choirmaster, playing gin with one’s brother).Personal PlanningThe purpose of personal planning is to create a mutual work agenda between the casemanager and consumer that focuses on achieving goals that the client has set. Goalsare inherent to hope and indispensable precursors to achievement. The personal planlays out the decisions that the consumer and case manager must discuss and uponwhich they must agree. Their decisions include the long-term goal or passion statement,specific tasks needed to pursue the goal, deciding who is responsible, and datesfor task completion. The personal plan is in part a “to-do list” for both the consumerand the case manager.