HHS 201 Introduction to Human Services Wk4-D1
Chapter 10 Case Management/Counseling
Reading this excerpt from a human service student’s journal is a very appropriate way to begin a discussion of case management/counseling:
I was having a real hard time studying and I was sure I was going to flunk my courses. I couldn’t concentrate because my family was going through a divorce. I felt like I was being pulled apart by my parents. Who was I supposed to be loyal to? I knew I was getting to depend on cocaine too much. I was stoned most of the time. I figured I better talk to someone soon before I blew my stack. I started asking my friends and my dorm supervisor for the name of a good therapist. People would ask me if I wanted to see a psychiatrist, a psychologist, a social worker, a family therapist, a drug and alcohol counselor, or what. I’d ask what the difference was but no one gave me a clear answer. So they didn’t know and I didn’t know! I felt more confused than when I began looking for help.
Thus far in this book you have met many human service workers. The majority of them were delivering direct services and spending most of their day working one-on-one with clients. Although doing similar work, they were likely to be referred to variously as:
Case workers
Social workers
Counselors
Advocates
Therapists
Case managers
Clinicians
Therapists
All this semantic fuzziness can be confusing to a client who must figure out whom to go to with a problem. And a worker searching the job listings in the newspaper or a web site can never tell from the title of the position exactly what tasks or problem areas it will include. The general public, accustomed to name brands, finds it difficult to understand how a middle-aged woman with a doctorate in psychology and a young man with an associate’s degree in human services can both assert that they do “counseling.”
In an effort to make job titles uniform, some professionals in the human service field have suggested that a distinction in title should be made according to how much a human service worker deals with highly charged emotional material rather than with the ordinary problems of daily life. They might say
A social worker or therapist who has an advanced degree helps clients deal with deep-seated intrapsychic problems. A case manager or counselor (a less academically trained person) helps clients make decisions and then use social resources to implement them.
But we don’t think that is a sensible distinction! All human service workers, regardless of their backgrounds, job titles, or their clients’ problems, must inevitably deal with inner emotions as well as external pressures. Of course, with more study, experience, and training, a clinician can work more effectively with the deep emotions that surround problems.
Human service problems stem from the interaction of biological, emotional, and environmental stresses. If we ignore one set of forces, we get a lopsided view of a problem. And lopsided views lead to inadequate interventions.
For example, Timothy, a counselor in a residential prison-diversion program, has been asked by Barry, one of the residents, for a change of roommates. Before Timothy began to juggle rooms to accommodate Barry’s request, he encouraged Barry to clarify the problem he was having with his present roommate. Timothy asked Barry about:
Barry’s expectations of his present roommate and what he thought his roommate’s expectations were of him
The similarities and differences in their habits, routines, and lifestyles
The extent to which they both tolerated differences in styles
The methods of conflict resolution they had already tried when they had a disagreement
The stresses of study, family, work, or social life that may have been aggravating their problem
After several conversations with the two men, some separately and some together, Timothy suggested that the tension between them might lessen if they set up a more workable system for cleanup. He offered to help them design a chore chart. They also agreed to make some mutually acceptable rules about playing the radio and going to bed. Through their sessions, one of the young men realized that some of his anger at his roommate probably stemmed from his past irritations with his brother and that, in fact, there were many parts of living together that he enjoyed. They agreed to try to use the chore chart and a few rules they both could agree on for two weeks. They also agreed to check in with Timothy for ten minutes each day. Thus, both young men found possible solutions to a relationship problem that at first seemed insurmountable.
There might have been other root causes for the tension. Perhaps Barry brought home a great deal of anger from his job and that was the primary source of tension between the roommates. If that had been the case, Timothy could have referred him to a vocational counselor and a youth employment agency to help him change jobs or cope better with the one he had.
Although the counseling assignment of beginning human service workers might involve helping clients find and use resources, they should never lose sight of the fact that a client’s unexplored feelings can subtly sabotage even the simplest solution.
