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Fundamentals of Case Management Practice: Skills for the Human Services 5th Edition Solution Manual

Fundamentals of Case Management Practice: Skills for the Human Services 5th Edition Solution Manual makes textbook problem-solving simple, with detailed answers that make learning fun.

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    Exercises for Chapter 1 Exercises These exercises can also be filled out online at CengageBrain.com. Exercises I: Case Management Instructions: In each of the following situations, develop a tentative plan for the client. List the various services you believe each person needs initially. Include in your plan for each client both formal and generic services, and where appropriate, use social suppo rts and support groups. Suggest other services the person might use later once the case is stabilized. Think about how you can involve others close to the person and how you will involve the client in planning. 1. You are called by the daughter of an elderly woman who lives alone. The daughter lives in another city and is concerned because her mother does not drive and has seemed unhappy and listless on the phone. The daughter expresses concern that her mother seems lonely and is perhaps depressed. The daughter does not know her mother’s neighbors and calls you instead at the Office of Aging. She has told her mother she is going to call your agency for help, and the mother had no objection to that. 2. A man with an intellectual disability lives alone with his widowed mother. She has fallen and broken her hip and will be at the rehabilitation hospital for about 6 weeks. He cannot stay alone. He has a job at Goodwill Industries. County transportation take s him there every morning at 8:30 A . M . and brings him home at 5:00 P . M . 3. A woman and her two children are waiting to receive their welfare check. They came to your state from another to escape an abusive husband and father. The woman is frail and

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    appears sick. They have no place to go and have not eaten in several days. The children smell as if they need a bath and are listless. 4. A mother of two preteens has brought her son in for services. The woman is a widow. She confides that she has been having trouble controlling the boy, who is the oldest, and that the girl is disgusted with her brother’s behavior and does not want to be inv olved in helping him. Lately the boy has become involved with teens his age and older. They have been drinking and coming home when they feel like it. The mother allowed them to smoke pot in the garage in hopes that she could keep the boy at home, but now she feels that backfired. The boy makes it clear that he thinks coming for help is ridiculous and says the one thing he will not do is give up his friends. 5. A man has been referred by his family physician for help. The man seems extremely inebriated. His wife brings him in and says she is worried that he may go into delirium tremens if he withdraws from alcohol too quickly. His family physician did not see him but sent the couple straight to your office. 6. A father brings in his 14 - year - old daughter who is running the streets, refusing to listen, and failing in school. He is at his wits’ end, saying he must work and cannot be home when the girl returns from school. Her mother died 4 years ago, and the troubl e started when the daughter was about 12. The father feels that he and his daughter have a difficult time communicating with one another. 7. A police officer asks you to come to the home of an older man he has been concerned about for several weeks now. The man is delighted to see you and tells you that he is having pains in his legs and is unable to walk. During your visit, he asks you to get things for him that are nearby, but obviously it is too painful for him to get up. He says he does

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    not go to the kitchen often to prepare meals, but the police officer has stopped by several times with sandwiches, and Mrs. Jones from up the street, an old friend of the man’s late wife, has brought a casserole on occasion. He is adamant that he wants to stay in his home as long as he can. 8. A woman comes in complaining of depression. She says it started when her husband left with a younger woman and she has not been “right since.” She reports having difficulty falling asleep and complains of no appetite. She says she has missed more than 3 we eks of work since he left last month. There are no children, but she tells you she has neglected the dog and cannot remember if she fed him last night or not. She appears listless and very sad, weeping off and on during the interview. 9. A man in his 60s comes in on the recommendation of his doctor. He had a back injury some years ago and was placed on codeine at the time. After the back injury, other things went wrong. The plant where he worked closed down and his mother died. He found hi mself feeling very alone and uncertain about finances. “It was then that I started to drink too,” he tells you. When you ask what he means by “too,” he says his doctor believes he has become addicted to codeine. “I don’t know,” he says. “I’ve gotten to the point that I can’t get through a day without a lot of help.” 10. A single mother brings her 12 - year - old son in because they are “not getting along.” She reports that he does not listen and comes and goes as he pleases. His homework has fallen off and his grades have slipped, but he is still doing well in math and likes his math teacher. The boy’s father was killed in a railroad accident 2 years ago. The mother tells you that the boy and his father enjoyed a close and warm relationship, and that she has felt her influence on him slipping away since the accident.

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    11. A woman comes to your agency on a referral by the courts after she was arrested for selling various prescription medications on the street. She tells you she currently has some amphetamines, Xanax, and a popular addictive pain medication in her bag. The co urt is ordering her to show within the next week that she has enrolled in a program that will get her help with her own addiction to some of the medications she sells. “I have regular customers,” she tells you. “And they are going to crap when I stop comin g around.” Asked where she gets her medications, she smiles mysteriously and says, “The police are looking into that — you don’t need to.” She denies she is addicted to anything, but court records, including an evaluation by a psychologist, which she has bro ught with her, indicate that she is addicted to several different medications. 12. A woman who was recently placed in the community after 3 years in a state mental hospital is having trouble adjusting to the living arrangement made for her by the hospital. She is not going out and does not participate in any activities. She is friendly w hen you talk to her and seems glad to have your company, but she does not seem to know how to take care of the details of everyday living. She has a roommate who is more competent and independent. The two get along well. 13. A woman with two small children is referred to you because she recently lost her apartment. She has a meager income from a part - time job as a clerk in a convenience store and was unable to pay the rent and take care of other bills. She seems unaware that s he might be eligible for financial assistance. She is not sure where her children’s father is at the moment. All her belongings are packed in five bulging garbage bags. She and her children seem malnourished and thin.

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    14. A man comes in who was referred by his job for possible crack use. The man admits he uses crack, but rarely and certainly not to the extent that it would interfere with his work. He will be given 4 weeks off if he enrolls in a legitimate program for detoxi fication. He seems reluctant and torn. Eventually, he agrees to work with you on a plan. 15. An older woman comes to you for help after a particularly abusive incident with her husband. She admits that she is becoming increasingly afraid of him. She has no friends and no job, “because he wouldn’t let me out of the house — or out of his sight.” She h as a number of old bruises and lost two teeth in this last incident. She is asking for help and says, “I don’t know. I really fear for my life. It’s just gotten out of hand and I don’t know where it will end.”

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    Exercises II: Decide on the Best Course of Action Instructions: Sit with a small group of other students and decide how you will handle each situation. There are many areas both ethically and legally that are not clear, so the discussion you have with your colleagues about these cases is much like a discussion you mig ht have in a real agency. There are no “correct answers.” 1. You are the case manager for a man who has only recently had a first manic episode. He had submitted to treatment, responded well, and returned to work. However, he is currently experiencing another episode, and this one seems more severe. He is not sleeping or eating, is sending cryptic messages on the Internet, and believes everything he reads there is directed at him. He believes the government is “monitoring” him, and that he has an important job lined up with a record company in New York. You have determined that he is not leaving his house, and that he is preoccupied with what is happening on message boards and chat rooms on the Internet. You have checked in with him several times by phone. Each time he assures you that he is fine and does not need help. What is the best course of action? Do you risk seeking an involuntary commitment, knowing that he seems just well enough to convince the emergency room physician he is not in need of hospitalization? Will this alienate him and make it impossible for you to work with him? Do you wait for things to get worse? If so, is there a chance he may leave the house and get into trouble? What might happen if you wait it out? 2. A 72 - year - old woman on your caseload has been in mental health services for a number of years, ever since the year after she graduated from college. She has had severe episodes of schizophrenia over the years with countless hospitalizations and prescriptio ns

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    for numerous antipsychotics and antidepressants. All her life she has been a client of social services and hotlines, reaching out frequently for any support she could get. She has always been very dependent on her case managers, calling them often for supp ort. When support was withdrawn, as it often was when workers tried to get her to be more independent, the woman would deteriorate. Sometime after she turned 60, these severe, acute episodes diminished, and she has been living in comfortable subsidized living arrangements for senior citizens. As she has grown older she has developed breathing problems that will eventually take her life . In an effort to be helpful and without your knowledge, her family doctor referred her to hospice for support. In his view she was facing the end of her life. Hospice entered the picture with considerable support, seeing her often, providing meals and com panionship. This level of attention met the woman’s needs for support and she became extremely dependent on the hospice workers. She seemed happier and began to participate more in the group activities at the apartment building where she lived. This level of support is more than you could give and you have been relieved that she is doing so well with the hospice workers. However, hospice has decided to withdraw their services. The woman’s death does not appear to be imminent. In fact she appears to be impro ving slightly. The woman has called you, her case manager, in a complete panic at the prospect of losing this support. She is not eating and is distraught. What are the ramifications here? What does continued hospice support mean for hospice, which relies on public and charitable funding? What are the consequences if the services are withdrawn for this woman and for you? Are there solutions to this problem? A re there ethical considerations here?

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    Exercises for Chapter 2 Exercises These exercises can also be filled out online at CengageBrain.com. Exercises I: Ethics Instructions: The hypothetical practice situations that follow are designed to stimulate thinking and discussion on the issue of confidentiality. Each situation is followed by a multiple - choice list of possible responses you might make. Choose the responses that you co nsider the best. In some cases you might want to use more than one of the responses listed. Others may choose a different answer. Discuss with your fellow students the different possibilities and what might present the best outcome for the client. 1. Paula is a 17 - year - old client in the daytime partial hospitalization program. Her mother phoned and requested to know Paula’s psychiatric diagnosis so that she could inform the family’s physician who is treating Paula for diabetes. You should: a. Advise the mother of the diagnosis and the name of the psychiatrist who made the diagnosis. b. Call the family physician directly and advise him of the diagnosis. c. Ask Paula to sign a release of information form giving consent for the physician and the mother to be advised of her diagnosis. d. Refuse to release the information at all. 2. Kelly requests a copy of his current treatment plan. You should: a. Have Kelly put the request in writing and discuss the issue with the treatment team. b. Make a copy of the current treatment plan and give it to Kelly.

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    c. Discuss the treatment plan with Kelly and then see that he has a copy. d. Refer Kelly to the attending psychiatric physician. 3. A 13 - year - old boy requests that his school counselor be sent a copy of his initial interview and discharge summary. He signs a release of information form, documenting his written consent for the information to be transmitted. You should: a. Forward the material to the school counselor. b. Give the information to the boy who can deliver it to the school counselor. c. Have the medical records department forward the information to the school counselor. d. Refuse to release the information until a parent cosigns the release of information form. 4. In the case above you would a. Release the complete chart b. Release just the discharge summary c. Release only those portions of the discharge summary that the school needs for their work with the boy and not release the initial intake summary as it contains information that is no longer relevant but taken out of context could be damaging to the boy’s family d. Meet with the parents to go over what you have decided to release as outlined in C before anything is released to the school. 5. Mary Smith is a depressed elderly woman who was admitted to Polyclinic Hospital due to severe back pain. She was advised she might need surgery to correct the problem. You are her case manager at the Office of Aging, and she calls to say she is considering suicide. The constant back pain has made her feel like “just giving up.” Mary is currently at home, awaiting a surgery date. You know Mary has a supply of pain pills, and she says

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    she wants to take all the pills. You feel there is a substantial risk that Mary might follow through on her threat. You should: a. Contact the Polyclinic orthopedic staff who are currently seeing Mary in the outpatient clinic. b. Maintain frequent contact with Mary, but respect her wishes to keep her suicide plans confidential. c. After discussing with Mary what you are about to do, contact crisis intervention. d. Advise the city police department of Mary’s suicide plans. 6. Bill Jones is a client who has been in alcohol treatment programs at your facility. He is currently depressed about his pending divorce and present marital separation. He has signed a release of information form for you to share information with his priest, who is counseling Bill about his religious conflicts regarding the divorce. A man calls you claiming to be Bill’s priest and requesting information on Bill’s current state of mind. You have never actually spoken with Bill’s priest, and you think this mig ht actually be Bill’s wife’s attorney calling. You should: a. Give no information on the phone until you have verified the identity of the caller. b. Refer the caller to Bill, but send the information to the person at the address on the release form Bill signed. c. Insist upon meeting with the priest in person. d. Share no information with the caller and contact Bill e. Get the person’s number and call him back. 7. Patty is completing a student internship for her associate’s degree in the therapeutic activities program. She asks to review the medical records of the people who were just in her projects group. You are supervising Patty. You should:

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    a. Advise Patty that the records are confidential and may not be inspected by students. b. Make certain that Patty is well trained in the policies and procedures relating to confidential information, and only then allow her access to the medical records. c. Permit Patty free access to the records because she is like part of the staff. d. Obtain written consent from each client for Patty to review the records. 8. Jerry was a client who improved and was discharged 2 years ago. You receive a call from the National Can Company. The caller explains that Jerry has applied for a job and that the company would like to hire him. Jerry told them he was in treatment 2 years ago and was discharged after showing considerable improvement. The company wishes to confirm the fact that Jerry did indeed complete the program as he claims. You say to the caller: a. “I don’t know if Jerry was ever a client of our agency. If you send me a release - of - information form I can look into that and get back to you.” b. “Jerry was a patient here but I am not at liberty to say any more than that without a release - of - information form.” c. “I can tell you that Jerry was a client here around 2012 and he successfully completed the program with us. I will need a signed release - of - information form from Jerry to put in his file.” d. “I don’t know what you are talking about. Good - bye.” 9. Clark is currently enrolled in treatment, and you are his case manager. He asks you if he may read his medical record. You should: a. Ask Clark to put the request in writing, and assist Clark in completing the written request if he seems to have limited skills in reading and writing. b. Present Clark’s request to Clark’s treatment team.

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    c. If the treatment team concludes that it will not harm Clark to review his record, allow Clark to read it in the presence of a therapist (after deleting information from sources that asked to remain anonymous). d. Decide with the treatment team who will assist Clark in reading and understanding his record. Then follow through by allowing Clark to review his record with that person.

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    Exercises II: Ethically, What Went Wrong? Instructions: The following hypothetical practice situations are designed to help you apply what you have learned in this chapter. For each situation, decide what was done in the situation that was unethical. 1. Jennifer had a long day and was trying to get out of the office before 5:00 P . M . She had one more person to see. Dr. Adams had asked Jennifer to give Abdul, a young man recently diagnosed with schizophrenia, a prescription for a new medication. Jennifer had her coat on when she handed the prescription to Abdul in the waiting room. Ab dul wanted to know what the medication was and why his prescription was being changed. “Will there be any side effects?” he asked Jennifer. She replied hurriedly, “Oh, no. Dr. Adams says just take this until he sees you next time.” 2. Carl is uncomfortable around gay men. Bert, his client, is gay and has just broken up with his lover. Bert, who is 42 years old, had been in a long - term relationship and is devastated and in tears in Carl’s office. Because Bert has suffered from severe dep ression in the past, Carl attempts to have him evaluated by the therapist this afternoon. In the meantime, Bert is still weeping and now threatening to take his life. Carl is particularly uncomfortable with this man’s tears and believes this is drama. Carl says, “Oh, c’mon now. Let’s get a grip. You can’t sit in here all afternoon carrying on. Here, take some tissue and go out in the waiting room until Dr. Paul can see you.” 3. Elizabeth visited the home of an elderly man and got him to sign a release of information form so she could process an application to the county nursing home. In the man’s records were references to the fact that many years ago as a teenager he was convict ed of shooting a man in a bar fight, a crime for which he served 2 years in prison. She knows the people at the home will be titillated over this little tidbit of information, especially her

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    friend Rhoda, who does the intakes. Even though she knows this is not part of the home’s evaluation, that the client has led an exemplary life since that time, and that the nursing home staff might take it out of context, she releases the information anywa y, based on her client’s signature on the release form. She and Rhoda have a good laugh about it the next day. 4. Jim is doing an intake with a man who claims he is depressed. He tells Jim that ever since his wife left he has had trouble concentrating and waking up in the morning. He talks about how lonely it is at home, how much he misses his children, how he is temp ted to drink in the evenings, and how little he has to look forward to. Jim nods. He understands. “Yes, my wife left last month too,” Jim tells the man. “I know just what you mean. I get to feeling like, well, like there isn’t as much meaning. I never knew the kids were so important to me, but I guess they were. On Saturdays, I used to do things with my son and I still get him every other weekend, but it’s not quite the same thing, is it?” “No,” the man responds, “I was thinking . . .” Jim interrupts the ma n to say, “Well, I do a lot of thinking too. I think about what I could have done differently and if it was my fault. Don’t you think these women would see that it’s hard, too hard I think, to raise kids alone?” The conversation continues in this vein unti l the end of the interview. 5. Carmen is supposed to see her small caseload of persistently mentally ill individuals at least twice a week. Lately, with school and her mother’s death, she has not really seen her clients that often. She has checked in with them on the phone, but she also has used time when she was out seeing clients to do errands at the library and to empty her mother’s home. Now one of her clients is in court after committing a crime. The client and the lawyer agree that the client might be able to use his mental health status as a reason for committing the crime, and they ask to introduce the case record as evidence in the court proceedings. Fearing that it will be discovered how little supervision and attention she has

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    given her client, and knowing that ultimately she could be blamed for the fact that her client committed the crime while under her somewhat irresponsible care, Carmen invokes the concept of privileged communication to avoid having to give the file to the c ourt. 6. Ted is in a clinic with his elderly client, Gretchen, for a routine blood workup, which they do every other month. He notices Gretchen is bruised on the face and arms. For a while he makes small talk with her, and then he asks her about the bruises. She is somewhat evasive but indicates, “They weren’t the result of no fall!” Without explicitly blaming her daughter and son - in - law, with whom she lives, Gretchen makes it quite clear that the bruises are not the result of an accident. After the blood test, duri ng which neither the doctor, who sees her briefly, nor the technician make any mention of the bruises, Ted takes Gretchen home. He toys with the idea of reporting the bruises to protective services at the county Office of Aging but decides not to. He bases his decision on the fact that the law does not specifically require him to do so, that it would be hard and take a lot of time to have to place Gretchen in another living arrangement, and that the daughter seems like a very nice person whom Ted does not f eel like stirring up over an uncomfortable situation. 7. Kitty has a whole list of things to do today and doubts she can get it all done. She hates the way there are always things left to do at the end of the day. It just seems that no matter how hard she works, something new comes up that she cannot complete. O ne of her clients, Isabel, has told her on the phone that she wants to sign a release of information form for her lawyer. Kitty has the form ready for the time when Isabel will be coming in at the end of the week. Today a man calls and says he is Isabel’s lawyer and he needs just two dates to help him file a brief with the court on the Isabel’s behalf. Kitty gives him the two dates and hurries to the next thing on her list.

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