Saturday, April 2, 2011

I'd like a New Case Manager

I had been at Empoder for 6 months when a client responded to my department's decision to deny her financial assistance by asking to get a new case manager. It was the first time I heard that request (request, demand) from a client. Though all financial decisions are made by the department's team they're delivered by the primary case manager. I had worked with the client for a month and met a few times which didn't help develop a strong rapport between us. I tried to suggest other options but my client was adamant. She wanted a new case manager. The truth was I wasn't really interested in continuing to work with her. I was annoyed by what I felt was her sense of entitlement and brash attitude with me. I responded that my supervisor would call her to follow up. Later, after speaking with Feona, my supervisor, I realized it would've been better that I referred my client to talk to Feona directly since she initiated that request.

Typically once clients work with a case manager at Empoder they'll continue to work with that person. Rarely do transfers to other case managers occur. When they do usually it's with newer clients or on a case by case basis where both case manager and client find it difficult to work together but there's still reason for the client to continue and receive services. It's also not unusual for case managers to collaborate on particularly intensive clients.

If I could talk to myself at that moment, six months into the job, I would tell myself that just because someone requests a new case manager it doesn't mean by itself that I'm not doing a good job.* I'd also tell myself (after I calmed down) to remember where clients are coming from in terms of their own difficulties, challenges, and lives before they walked in my office. Not to mention the need to not personalize other clients' anger or negative emotions when directed at me, something that would take me a while to fully learn and hey, something I still need to remind myself.

It's not necessarily unusual for case manager/client relationships to have ups and downs but ultimately they succeed for similar reasons. Rapport is essential for a good professional relationship. This is based on mutual trust, respect and something intangible. I add the intangibility factor because sometimes a case manager and client don't click and it's not necessarily something that may be anticipated.

A general request that my department honors is a potential client's initial request to work with a man or a woman. Matching client and a case manager based on this preference may set better grounds for a comfortable and trusting relationship. To a degree it helps that case managers' expertise be taken into account when matched with new clients. For example, case managers with more experience with people with severe mental illnesses may work more effectively with a person with schizophrenia as opposed to a CM without this experience. On the other hand, a case manager's work at my department is superficial compared to therapy work. We're not clinicians or therapists. Our job is often to refer and mediate, connecting clients with services they need, navigating health or benefits systems with them. It helps to have experience with a certain segment of the population but if that's not there, it's possible to work to connect with another person through respectful, empathetic, and patient approach. More so than possible -- it's necessary. Taking part in mental health (and crisis, motivational interviewing, and so on) trainings, which we all should do as case managers, should complement this approach.

* Regardless of an incident like this it's important to continue and reassess how you work, your skills and effectiveness as a case manager. For the sake of this post I didn't delve into this.

1 comment:

Btrflygl said...

Great post. I can certainly identify with many of the things you wrote about :)