Skip to main content

Maryann Roebuck’s linkedin.com/in/maryannroebuck research A Qualitative Study of the Working Alliance in the Strengths Model of Case Management with People with Severe Mental Illness written with Tim Aubry and Stephanie Manoni-Millar examines client perceptions of the working alliance to advance client recovery in the unique context of community based care settings.

This paper is a useful resource to reflect, have a relook on practice, and think about how we are doing with the push and pull, the dance of sorts with individuals we serve in our helpers role in community based “case management.”

strengths imagehqdefault

(image of components of Strengths based approach is from https://www.scie.org.uk/streng...-approaches/guidance)

Working Alliance that supports change in community setting

….Some proposed underlying mechanisms of change within the working alliance include having clear goals, having small caseloads, affirming a person, mutual respect, adopting structured interventions, and being a responsive case manager …

… Research also shows that the working alliance in mental health case management may be different than the therapeutic alliance in psychotherapy. The community-based setting of mental health case management makes the practice more task-focused, and involves providing access to services and helping people to remain in the community (McCabe & Priebe, 2004)

Components of implementing the Strengths Model

….Strengths model case managers base their practice around six principles:

(1) There is an overall focus on individual strengths rather than pathology or deficits;

(2) The community is viewed as an oasis of resources;

(3) Interventions are based on client self-determination;

(4) The case manager-client relationship is primary and essential;

(5) The primary setting for the work is in the community, not in an office;

(6) People can recover, reclaim and transform their lives (Rapp & Goscha, 2012).

strengths model ecology 10597_2021_903_Fig1_HTML

(image: conceptual diagram of study findings – key elements of study concepts, including base foundation of: Community Mental Health Field and Organizational Context and headings of: Strengths model influence, influencing factors, Key elements of working alliance and reported life changes.  All of this described in article text body)

See the article (free access) article here: https://link.springer.com/arti...7/s10597-021-00903-9


While post here is about encouraging use of this article to reflect on our individual practice, below are links to  background webinars about how this article fits into  a broader research initiative on the strengths model and more details on implementation within organizations and broader care systems.  

Webinar: Implementing strength-based case management: The value of fidelity monitoring https://vimeo.com/654657660

Eric Latimer, Tim Aubry, Janet Durbin, Maryann Roebuck “Evaluating the strengths model of case management for people with severe mental illness: Results of a multi-province study

https://www.youtube.com/watch?v=QyMZKExVlLE

Attachments

Images (2)
  • strengths model ecology 10597_2021_903_Fig1_HTML
  • strengths imagehqdefault
Last edited by Registered Member
Original Post

Replies sorted oldest to newest

For me, as a front line worker, who works long term with people tryinig to support recovery practices and strengthening community and professional networks potentially surrounding people, I wondered about:

-         How were outside providers perceived?  What is the quality of the bridging and moving people to expand their networks?

-         How are workers and clients managing system goals of program flow, when and how are people moving out of programs, yea old “transition of care” or continuity of care maintained?

-         Would be great to flush out more, the steps or meaning of autonomy

On the quality of the relationship, rapport etc. I wondered:

-         How are power differences between client and worker discussed? – Are they acknowledged, where does the mental health ACT and duty of care by the worker fit?

-         Are clients and workers clear about competing goals, that come into play?  Or are does the strengths model dismiss this as relevant?

-         “hope” seemed to be defined as indicated by “actions taken” in the past, some kind of motivational intervention.  Is hope a precursor to the recovery model?   (Sorry, I’m in early interest in this concept, and flubbing about on it.)

Add Reply

Post
CAMH Logo

This website has been funded by a grant from the Government of Ontario.
The views expressed do not necessarily reflect those of the Government of Ontario.
×
×
×
×
Link copied to your clipboard.
×