Date of Award

2016

Document Type

Open Access Dissertation

Department

Psychology

Sub-Department

College of Arts and Sciences

First Advisor

Bret Kloos

Abstract

The recovery movement in the field of community mental health has brought attention to more holistic outcomes of services for adults with psychiatric disabilities, including community integration. However, there is a lack of empirical investigations of the roles that service providers, and case managers (CMs) in particular, can play in promoting such outcomes for their clients. The present study took an exploratory, hypothesis-building approach to describing the ways in which CMs supported the community integration of their clients with serious mental illness. A cross-sectional design was used with qualitative and quantitative data collected from 6 CMs and a sampling of 20 clients.

Findings documented that clients’ community issues were often viewed as relevant to CM services, though to varying degrees. CMs were primarily described as promoting community integration by connecting clients to resources, providing encouragement, and serving other supportive functions (e.g., goal planning, accountability, regular check-ins). CM practices varied in the extent to which they aligned with recovery principles, including CM’s primary goals in case management, CMs viewing themselves as central vs. supplemental to clients’ community lives, how they related to clients (parental vs. coach roles) , and methods they used to connect clients to community resources. Mixed method analyses revealed that CMs whose practices aligned more closely with the principles of recovery and client-centered care (e.g., holistic, collaborative approaches) tended to have clients with higher community integration scores. Higher functioning clients generally reported more peripheral, supplemental support from CMs whereas lower functioning clients described support from their CMs as involving stronger guidance and direction.

The present study was intended to be exploratory and hypothesis-building; as such, limitations included having a small sample size and a cross-sectional design. Nevertheless, a key benefit of this study was its ability to identify recommendations for future research and considerations for practice which are more likely to be implementable in real-world settings. One key recommendation generated from this study to be tested in future research is that bolstering CMs’ use of client-centered approaches to case management (holistic perspective, collaborative approach) might allow them to more effectively promote clients’ community integration.

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