Work with offenders

What is your understanding of case management? Show how a case management approach has shaped your work with offenders (either and individual or group) through discussion of one or more pieces of work you have been involved in. This essay will discuss my understanding of case management as a result of theoretical literature available at this time and personal experience. I will discuss definitions of case management and the differing models they can assume.

How a case management approach has shaped my work with offenders by comparing and contrasting interventions available and identifying the structure of case management from referral to evaluation. In doing this I will discuss the developments within the context of What Works and Evidence Based Practice. By using local developments within the geographical area in which I work, I will critically analyse this approach and its effectiveness. From the literature I have read it is clearly apparent that there are several models of case management and a general agreement that various models have similar components Huxley [1993].

Moxley [1989] defines case management as: ' a client-level strategy for promoting the coordination of human services, opportunities and benefits. The major outcomes of case management are… the integration of services… and achieving continuity of care [p. 11]'. Whilst there exist a wide miscellany of models within the context of human service agencies, the term 'case management' is used to describe a variety of models, each with there own emphasis and focus dependant upon their service goals. Therefore within the framework of case management, there is a need for clear expression of purpose Holt [2002]

The case management model was developed and originated in North America and is still instrumental in the delivery of health and social care. Research from the USA, UK and Australia identifies case management as an effective way of delivering services to long-term care groups. Case management and care management developed in the UK in the 1980's, and was an effective in implementing major policy change such as, the mental health reforms and the onset of the notion of care in the community Huxley [1993].

Holt [2000] identifies the fact that a variety of models exist which reflect the diversity of agencies and the complexity of individual need. He does however point out that regardless of what the need is the central function remains the same. These being assessment, planning, linking, monitoring and evaluation. Holt refers to Rubin [1992] who discusses the often-present further component of advocacy. Holt [2000] sees this element as something, which empowers service users within the context of anti-discrimination.

Case management has evolved therefore as a response to fragmented service provision, the often complex multiple needs of clients and the need for integration and coordination Moxley [1989] The literature that exists distinguishes between the role of the case manager and the system of the case management i. e. the core functions combined into a process designed to be integrating and facilitative. Holt [2000, 2002] identifies this issue and places emphasis on the fact that both the system and the process are combined as a result of the skills of the case manager.

ooking at the above interventions an individual who has few needs may be provided with brokerage, its unlikely they will have any individual casework from a case manager rather the case manager may coordinate services provided by colleagues or partner agencies. The objective of which may be to prevent further intervention in a time efficient and cost effective manner. Huxley [1993] identifies this feature of the model as coming under criticism in so much brokerage functions are not enough on there own. He examples the need for case managers to possess and exercise 'human relation skills'.

When dealing with individuals with mental health problems, an assertive model is often used to help individuals who will not care for themselves, or are a danger to others, or who may not recognise that they are in fact ill. As such if the individual is to remain within the community and not become institutionalised, any services provided must reach out and provide regular and consistent contact plus an immediate response to any issue or problem as it arises. Case management in this forum often involves mandatory, intense casework, medication review, outreach provision and 24 -hour support Huxley [1993].

Many individuals are resistant to such interventions, as such it can be very difficult for the case manager to respond, particularly in terms of engagement with an individual who is resisting or refusing to communicate. This problem or issue is frequently encountered by probation staff when working with individuals, as such both interpersonal and motivational skills, as well as an ability to communicate at the level of the individual are necessary to provide a basis for trust and understanding in building a good relationship with individuals who have mental health issues.

A task-centred problem solving approach is a model often used in social work settings with both voluntary and involuntary clients Trotter [1999]. In this model individuals work through there problem or issue with the help of a case manager or other key worker. As a result of the individual identifying the issue or problem, defining and re-defining it, setting goals and producing a time limited action plan in conjunction with the case manager; this process emphasises the need for empowerment of the individual and places responsibility for carrying out these tasks with the individual allowing them to make informed choices and decisions.

It would appear this model was one of the main features of probation practice pre-what works, in a time when the Biesteck model of advise, assist and befriend was favoured. However the Home Office agenda of enforcement and public protection is perhaps leaning more towards an assertive model in a time of confront, control and monitoring offending behaviour Warral [1997]

Though task centred work still features in probation practice, as is evident in the production of supervision plan objectives, the use of effective practice and a move towards cognitive behavioural approaches, would appear to have influenced case management within the probation setting. As such an effective model of case management must target resources, directing them in line with the service aims and the needs of the individual under supervision. Ross [1980] identified three models, which are set apart by the range of tasks used; minimal, co-ordinating, comprehensive.

Though the central functions remain fluent, the extent of the tasks taken can become more intense if the needs are assessed as greater. During the 1990's the Home Office undertook detailed research of probation interventions and services in order to evaluate work done with offenders. Andrew Underdown coordinated a piece of research and in 1998 his report of the HMIP What Works Project – Strategies for Effective Offender Supervision was published. This period also coincided with the Crime Reduction Strategy launched by the Government Home Office [2000].

21 million was designated to What Works over the three-year period 1999-2002. Whilst the major focus seemed to be the development of successful cognitive behavioural programmes, it was highlighted that case management as a model needed a holistic approach for effective practice to happen. Underdown [1998] showed inconsistencies of work with offenders in all probation services. He identified the need to develop structured assessments, plus a variety of supervision options, improved reviews and evaluations of supervision quality.