CLINICAL HANDBOOK OF SCHIZOPHRENIA

Resource Acquisition32. Strengths-Based Case Management 323The purpose of resource acquisition is to acquire environmental resources desired by theconsumer to achieve goals, to ensure his or her rights, and to increase his or her assets.Primacy is placed on normal or natural resources, not mental health services, becausetrue community integration can only occur apart from mental health and segregated services.Therefore, work is done with employers, landlords, coaches, colleges, teachers, artists,ministers, and so forth. The identification and use of community strengths, assets,and resources are as critical as the identification and use of individual strengths.Often, the case manager helps community resource personnel adjust to accommodatethe desires or needs of a particular person. There are times, however, when adjustmentsare not needed in the setting or in the client, or if needed, the adjustments are veryminor. This occurs when the case manager finds the “perfect niche,” where the requirementsand needs of the setting perfectly match the desires, talents, and at times, idiosyncrasiesof the consumer.Harry, a 30-year old man, grew up in rural Kansas, living his whole life on a largefarm. He was diagnosed with schizophrenia and entered the state psychiatric hospital.Upon discharge, Harry was placed in a group home, with services provided bythe local mental health center. Although not disruptive, Harry failed to meet thegroup home’s hygiene and cleaning requirements, did not use mental health centerservices, and resisted taking his medication. It was reported that Harry would packhis bags every night, stand on the porch, and announce that he was leaving, althoughhe never left. Over the next 2 years, Harry’s stay at the group home was punctuatedwith three readmissions to the state hospital.Although Harry was largely uncommunicative, the case manager slowly beganto appreciate Harry’s knowledge and skill in farming, and took seriously Harry’s expressionof interest in farming. The case manager and Harry began working to find aplace where Harry could use his skills.They located a ranch on the edge of town, where the owner was happy to acceptHarry as a volunteer. Harry and the owner became friends, and Harry soon establishedhimself as a dependable and reliable worker. After a few months, Harry recoveredhis truck, which was being held by his conservator, renewed his driver’s license,and began to drive to the farm daily. To the delight of the community support staff,Harry began to communicate, and there was a marked improvement in his personalhygiene. At the time of case termination, the owner of the ranch and Harry were discussingthe possibility of paid employment.CONTRASTING THE STRENGTHS ASSESSMENTAND THE PSYCHOSOCIAL ASSESSMENTDavid was required to attend the day treatment program 5 days per week as a conditionfor residing at the program’s transitional living facility. Over the past 2 weeks hehad become increasingly more aggressive with staff members and other clients. Hewas suspended for 1 day the previous week for yelling at clerical staff members whorefused to give him bus tickets. David stated that he did not want to be at day treatment,that he wanted to go to work. Staff members said that he was not “ready to goto work,” but that he could demonstrate his “work readiness” by his behaviors atthe day treatment program. A staff meeting was called to decide what to do with David.The prevailing thought was that he would probably need to be rehospitalizedand have his medications adjusted.