Management in Community Corrections - Case Study Example

Running Head: Case Management Care Plan Name Lecturer Date Case management care plan is a collaborative and client centered process that helps clients to access multiple services and supports for people suffering from complex health needs. The aim is to achieve social participation as well as optimal well being towards leading an independent life. The case in this paper involves a young male called Zane who is suffering from schizophrenia. He is also addicted to both alcohol and cigarettes which have had detrimental effects to his physical, social and emotional life aspects. This paper addresses several issues concerning the client and how a Community Corrections officer engages with the patient towards developing positive living. As outlines by Ballew & Mink (1996), a community corrections officer case worker has responsibilities that need to be enhanced for effectiveness in the community service work. First, as a community worker it is important to assess the situation which involves the client’s behavior. This may involve understanding different circumstances affecting the client as well as those associated with environment and family background. In this scenario, from the assessment, Zane is aged 19 years old and in the stage of growth he is an adolescent. It would be of help noting that at this stage, different body changes takes place (Ballew & Mink 1996). As a result, Zane may be influenced to attempt and adopt strange behaviors depending on the situation he is in. Some of these strange behaviors involve assault and theft and could be greatly contributed by drugs and alcohol. There is need to develop a strategic plan. From scenario, it is worth noting that Zane’s parents kicked him out at a very tender stage of growth. Adolescence stage needs lot of guidance though a higher percentage is contributed by parents. It is important to create a more habitable environment for Zane involving preparation my first approach to Zane. There is also need for enough educative talks, counseling sessions that should be done frequently. Therefore, having the following in mind will act as a guideline of the necessary method of approach. A network between the client and his parents is vital. The Corrections officer in this case acts as an intermediary between Zane and his parents with the aim of reconciling them together again. As a result of this, there is coordination between the responsible people in the recognition process. There is need for advocating for good communication between Zane and his parents. This enables both parties solve bureaucracies effectively with minimal disagreements. Monitoring and evaluation of Zane’s condition is also an important factor. This ensures that there is improvement from the past condition to the current condition. If the condition fails to improve, there is need to draw up alternative measures. Counseling is grounded in ethics, organizational and statutory principles for it to be professional and authentic. Every counselor is required to be trustworthy, committed and confidentiality by respecting client’s autonomy. For this case, the counselor should understand Zane situation by be concerned in order to win trust from Zane. The counselor also should seek for objective good and externally agreed codes about an appropriate intention and action to help Zane come out drug abuse. It will be good for the counselor to avoid any action which may make Zane feel rejected considering his current situation. While helping him to stop drinking all together the counselor should take neutral ground avoid subjectivity or self imposing values to Zane (Bond, 2010). This is achieved by considering the objective good or right action based on the good and interest of the client. Zane confidentiality will be safeguarded for counselor not exposing or requiring Zane to do so. For instance, the counselor should not require Zane to face his parents. In case the counselor what to consult on Zane information, is advisable to seek fellow practitioner’s assistance to find the way forward. The counselor also should follow the regulations in order to offer the best solutions. As a result, the counselor will maintain relationship boundaries for better results. The counselor should not get lost especially when feels Zane should act otherwise or when their roles involved overlap. The counselor to avoid this should be trained to have sufficient self-awareness. The counselor should not be blinded by his position in the organization to impose personal values to Zane. Counselor should take any complain from Zane as a constructive complement to better the exercise (Rizq, 2011). In the scenario of Zane, it is worth noting that all the parties involved are very important. This include s Zane, his girlfriend and parents in the process of counseling. As an officer, there should be an environment that is comfortable to accommodate the person involved (Roessler & Rubin 2006). First, there should be efficient and quality care. In the case of Zane, beyond counseling, the right medication for schizophrenia should be administered to in the right way. By giving the right medication to Zane will reduce the chances of abnormal behaviors that could affect communication or cause danger. As a result, if there is a good communication, Zane may be able to contribute well in the talk engagements. Appreciating the patient’s feelings is very essential when in engagement and collaborative process. This helps in making the real conclusion about the patient. Despite Zane suffering from a mental disorder, he will feel that he is cared for and people empathize with the situation he is facing. Zane being an adolescent needs a lot of love and parental care. In this scenario, behavior of the character of a “parent” would be necessary in attribution for attention during engagements. There is need to provide equitable services for the purpose of reducing the encountered conditions. One example is Zane’s involvement in crime as a result of drugs and excessive alcohol. There are Services like day to day or specific periods counseling and follow ups that should be availed to the patient. It may also include availing medication for mental disorder condition as has been prescribed and consistent follow ups to ensure that the condition is minimized appropriately. In consideration to the scenario, Zane had suffered because of been subscribed to the wrong medication. Similarly, it is important to ensure that the administered drugs are appropriate and effective to the condition. In cases of failure, further investigations could be necessary. Fifth, care provided should be comprehensive hence should cover all aspects of the patient’s condition from the state of medication to rehabilitation process. This will enhance the growth of stability in the patient’s health. Therefore, enabling normality in the way the patient attends to normal life including sports and work (Roessler & Rubin 2006). The client has several critical issues as identified below: He is suffering from a serious mental disorder- Schizophrenia. According to Lieberman et al (2005) schizophrenia a mental disorder that appears in late adolescence or early adulthood. The client lies within the mentioned age bracket of 19 years. Though the client sought for medication, it has been ineffective which has caused a sense of misjudgment in his life. This is evident through his indulgence in bad behaviors such as armed robbery. Zane is a drug addict. He consumes about six bottles of alcohol. He also smokes 25 cigarettes in a day. There is need for him to come out of this situation in order to enhance his recovery. Zane is living in isolation. This is evident on the account that he doesn’t live with his parents. He was kicked out of home on account of his alcoholic behaviour. He had to seek for shelter at his friend’s place. The condition in the friend’s house is not the best since Zane has to spend the nights on a couch. The client has poor eating and sleeping habits. These two factors are dangerous for his condition because they influence his mental condition. Lack of sleep can facilitate an increase in impaired judgment. In addition, poor eating habits will increase the effect of the drugs that he is using leading to more illnesses. The client does not have a permanent source of income which also a stressful condition in his life. The critical issues above make the client a high risk patient. A patient is considered to be high risk when they have a complex or catastrophic illness (Caldwell & Gottesman, 1992).Such patients require extensive medical interventions or treatment plans. Zane is identified as one of such patients especially because of his mental disorder as well as drug addiction. There are several strategies used by the Community Corrections Officer while working with such clients. Conduct assessment is one of the strategies: There is need for the Corrections Officer to assess what the patient feels about their condition. Ask questions such as, “What do you think about your drinking?” “Have you ever done something you regret while you were drunk?” Have you experienced problems with your friends or at school in relation to your alcohol and cigarettes use?” Answers to these questions help the officer to identify the level at which the client is surviving in the condition and the relevant treatment approaches to be applied. There is need to provide direct and clear feedback. The Corrections Officer gives information to the client in relation to the answers given in order to help the client understand the results of their behavior for example, “as your corrections officer, I am concerned about the number of bottles of alcohol that you consume in a day and how that has affected you.” “The armed robbery that you were involved in was probably as a result of substance abuse. Developing negotiation and goal setting towards a treatment contract is important. The Corrections Officer engages the client in coming up with new rules of conduct of behaviour towards developing a positive and health living. For example, the officer may tell the client, “You need to reduce your level of smoking and drinking. What do you think about reducing to three drinks and ten cigarettes per day?” This will be of significant help to you especially in reducing your risk of getting into trouble such as theft. The officer should offer the client diary cards that will help in keeping track of the drinking and smoking behavior within a specified period of time. Development of application of behavioral modification techniques is another vital strategy. The Corrections officer should provide the patient with examples of persons who have indulged in substance abuse resulting to uncontrolled behaviors. Talk openly about ways that the client can use to avoid such situations. The Officer is required to set up a continuing care plan. It involves creating schedules for follow-up appointment that will help in reviewing of diary cards. In addition, assure the client that you are ready to answer their questions in case there are any. Psychological interventions for schizophrenia and substance abuse involve include; individual therapy and cognitive behavioral therapy. Individual psychotherapy was developed by Sigmund Freud as psychoanalysis. It considers symptoms of mental illness as external expressions of problems that are unconscious (Marlatt & Donovan, 2005). The patient and the analyst meet severally with the aim of revealing and exploring the unconscious conflicts. In this study there is need for the Corrections officer and the client to explore the unresolved conflicts that have facilitated substance abuse as well as the mental disorder, for example, the lack of a permanent job by the client. In addition, there is need for the Corrections Officer to conduct one-on-one therapy with the client in order to help him develop coping skills even in the current condition. According to Bellack and DiClemente(1999), majority of schizophrenic patients have experiences of delusions as well as false beliefs in which they normally resist to change. Alcoholism and cigarette smoking also offer false confidence to the user. Therefore, cognitive behavioral therapy aims at changing these thoughts and behaviours which are maladaptive in nature. As a result, the patient is helped in decreasing the impact of symptoms as well as improvement in their social life. This intervention can help Zane to get back to his social life like in the instance of playing football with his social team. Psychosocial interventions involve services as well as strategies that aim at changing the behavior of persons who are affected by alcohol and drug abuse as well as mental disorders. These interventions are non-medical. Family psycho-education is an important aspect of psychosocial treatment. It involves emphasis on positive effects of family participation in the treatment of a patient. In this case, the Corrections Officer needs to offer information to the patient’s parents about ways of reducing substance abuse for their son. The parents should feel that they are part of the treatment process by learning constructive ways of communication as well as problem solving with their son. Social skills training are another form of psychosocial intervention. It involves teaching affected individuals specific skills that are important for achieving instrumental goals. It involves complex interpersonal skills that for smooth combination of simple behaviors. They include focused instruction, modeling, role playing as well as provision of feedback about the learning that patients have undergone. All these factors lead to help in development of a healthy physical, emotional and social life which the client in this study has lacked. When individuals are equipped with skills that help them in dealing with stressful conditions in their life, they are able to solve problems as well as challenges in their lives. As a result, triggers of schizophrenia are reduced. Protective effects of social skills training help in maintaining stability for the illness as well as promote progress towards recovery in relation to substance abuse. Case management is a process that plans, monitors and evaluates services which are necessary for meeting a client’s health needs. It involves advocacy, resource management as well as promotion of quality and cost effective interventions (Simon et al, 2006). A case plan is individualized in order to address all aspects of well being of the client. While developing a case management plan, a Community Corrections Officer should have information concerning the client’s needs, problems as well as desires. These are determined from findings that are obtained during client’s assessment. In this case, the client’s desire is to quit smoking as well alcoholism and develop a positive living. There is need to have information about the strategies that will be applied in helping the client out of their condition. Carey, K. B. (1996) posits that treatments and interventions are key elements towards improvement of the client’s condition by solving his or her problems. Zane’s state of substance abuse will be addressed using interventions such as individual therapy, social skills training and family psycho-education. The Correction Officer together with the Care team need to have enough information on the use and administration of the different care giving methods and interventions that will help in restoring the condition of the client. Information on the goals and objectives of the care process should be available. Knowledge of specific outcomes helps in guiding care giving processes. Time is an important factor in a care management. Each care process should be allocated enough time thus facilitating recovery of the patient towards stable conditions. In Zane’s case, it is important for the Corrections Officer to have proper time frame for the client’s gradual reduction in intake of alcohol as well as cigarette smoking (Bottlender & Soyka, 2004). The roles and responsibilities of stakeholders should be documented in order to enhance smooth flow of activities. Information concerning the intended outcomes should also be available. There is need to develop goals upon which treatment will be based as indicated below: 1. To reduce the number of alcohol intake by three per day This is not an easy venture to be explored by an alcoholic. Therefore, there is need for the Corrections Officer to identify with the feelings of the client through expression of empathy. Empathy is based on respect as well as acknowledgement of the client’s perspective. The Officer is required to understand the client without blaming or criticizing him for the many bottles of alcohol that he consumes as well as the number of cigarettes that he smokes. This way, the client develops a sense of acceptance and the willingness to take up the challenge towards fighting the temptation to take more than the agreed amount of alcohol. 2. To encourage and support abstinence from alcoholism and smoking Self efficacy is an element that can help in achieving an alcohol resistant state of the client. The client need to develop a positive believe that they can change and successfully reduce alcohol intake. This is developed in the face of faith and hope that the behaviour should completely stop. A client should also develop personal responsibility for change through assessing their current behaviour on the account of their newly adapted way of living without alcohol. 3. To ensure resolution of alcohol-related social problems This objective is achieved through developing discrepancy. Many young people are aware of the effects of their alcoholic behavior. They understand the risks that they are exposed to such as armed robbery in which the client was involved. However, the client still continues with the behavior. Discrepancy is a task that seeks to amplify and intensify the negative thoughts of substance use. This approach triggers the client to set personal goals such as health and academic success above their desire for alcohol use. A continued emphasis on this element helps the client to develop a negative feeling towards drinking and smoking leading to complete abstinence from the behavior. McCorry et al (2000) observes that it is important for the Corrections Officer to monitor the progress of the patient in treatment orientation. Treatment orientation involves can be conceptualised as the immediate goals that have been emphasized in treatment. In addition, it involves the specific techniques that are considered in the achievement of the goals. Coding tapes is one common approach. It involves audio-videotape treatment sessions and then coding them. This way, the Corrections officer is able to follow up on the progress of the client in treatment which helps in establishment of change if necessary. For example, coding weekly sessions will help to access the workability of the social skills learned by the client’s family and how they apply them in helping their alcoholic son to recover. When several video copes are taken over a period of time, the corrections officer is able to compare the progress leading to better handling of the client. Use of questionnaires is another approach that assists in monitoring the progress of clients towards recovery. The Corrections officer offers the client with a range of written questions every time they meet for a treatment session. The questions should be formulated in a way that the client answers them in relation to how he is fairing on with treatment as well as daily orientations of life. As a result, the officer is able to assess the progress of the client and establish whether the treatment orientation will ultimately provide positive results to the patient or not. Several drug addicts recognize the extent to which their problems are as a result of drug abuse. However, these clients are unable to realize that the drugs are responsible for the problems prevailing in their life. According to Roche and Richard (1991), living in denial by the clients poses a challenge to the Corrections officer in relation to monitoring of treatment progress. Instead of adhering to treatment models, clients end up shifting the blame to other people which hinders developments in positive change. As a result, there is need to for the corrections officer to develop intervention models which are non-judgmental. The Johnson model works by contrasting the client’s positive personality traits with negative traits that result from the addiction (Harrell et al, 2000).The Officer needs to organize for a group in which the emphasis is based on consistent, collective expression of support for the client. Availing information to the addicted person on alternative treatment models helps in increasing the likelihood of successful future treatment. Working towards a therapeutic alliance with a substance abuser is not an easy task due to their unsettling as well as threatening condition. As a Community Corrections officer, it is therefore important to avoid patterns which invite which invite such feelings Roche and Richard (1991). There is need to have proper training, experience and mentoring in order to have vast knowledge in handling substance abuse clients. This way, the clinician will not feel intimidated. In case of persistent difficulty in forming an alliance with the client, the officer need should consider factors such as gender, race, or level of education. This challenge can also be addressed through consultation with peer officers in the quest for offering help to clients. Individuals who suffer from both schizophrenia and substance use are challenging to help. McLellan et al (2005) observes that this is because the clients normally want to distance themselves from the activities involved interventions and methods of treatment. As a result, the corrections officer is unable to monitor some of the aspects that are highlighted in the care management plan such as goals and objectives. In conclusion, Case management care plan is an important aspect of developing positive leaving clients who have mental disorders as well as substance addiction. Community care givers need to have the correct information on how to apply different treatment strategies in order to help affected persons. However, there are several challenges that are encountered during the process which calls for intervention models that will enhance continuity of treatment. References Harrell, A., Cavanagh, S., & Roman, J. (2000). Evaluation of the DC Superior Court drug intervention programs. US Department of Justice, Office of Justice Programs, National Institute Ballew, J., & Mink, G., (1986). Case management in the human services. Springfield, IL: Charles C. Thomas, Publisher. Bellack, A. S., & DiClemente, C. C. (1999). Treating substance abuse among patients with schizophrenia. Treatment of Mental Illness and Substance Abuse: A Compendium of Articles from Psychiatric Services, 28, 24. Bond, T., (2010). Standards and ethics for counseling in action, Los Angeles: SAGE. Bottlender, M., & Soyka, M. (2004). Impact of craving on alcohol relapse during, and 12 months following, outpatient treatment. Alcohol and Alcoholism, 39(4), 357-361. Caldwell, C. B., & Gottesman, I. I. (1992). Schizophrenia—A High‐Risk Factor for Suicide: Clues to Risk Reduction. Suicide and Life-Threatening Behavior, 22(4), 479-493. Carey, K. B. (1996). Substance use reduction in the context of outpatient psychiatric treatment: a collaborative, motivational, harm reduction approach. Community Mental Health Journal, 32(3), 291-306. Carmen, B., Angeles, M., Ana, M., & María, A. J. (2004). Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction, 99(7), 811-828. Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., ... & Hsiao, J. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1209-1223. Marlatt, G. A., & Donovan, D. D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford Press. McCorry, F., Garnick, D. W., Bartlett, J., Cotter, F., & Chalk, M. (2000). Developing performance measures for alcohol and other drug services in managed care plans. Joint Commission Journal on Quality and Patient Safety, 26(11), 633-643. McLellan, A. T., Lewis, D. C., O'Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness. JAMA: the journal of the American Medical Association, 284(13), 1689-1695. McLellan, A. T., McKay, J. R., Forman, R., Cacciola, J., & Kemp, J. (2005). Reconsidering the evaluation of addiction treatment: from retrospective follow‐up to concurrent recovery monitoring. Addiction, 100(4), 447-458. Rizq, R., (2011). IAPT, anxiety and envy: A psychoanalytic view of NHS primary care mental health services today. British Journal of Psychotherapy, Vol 27, Iss 1, p. 37-55. Roche, A. M., & Richard, G. P. (1991). Doctors' willingness to intervene in patients' drug and alcohol problems. Social Science & Medicine, 33(9), 1053-1061. Roessler, T., & Rubin, E., (2006). Case management and rehabilitation counseling: Procedures and techniques. PRO-ED, Inc. 8700 Shoal Creek Blvd, Austin, TX 78757. Simon, G. E., Ludman, E. J., Bauer, M. S., Unutzer, J., & Operskalski, B. (2006). Long-term effectiveness and cost of a systematic care program for bipolar disorder. Archives of General Psychiatry, 63(5), 500. Read More

The counselor should not get lost especially when feels Zane should act otherwise or when their roles involved overlap. The counselor to avoid this should be trained to have sufficient self-awareness. The counselor should not be blinded by his position in the organization to impose personal values to Zane. Counselor should take any complain from Zane as a constructive complement to better the exercise (Rizq, 2011). In the scenario of Zane, it is worth noting that all the parties involved are very important.

This include s Zane, his girlfriend and parents in the process of counseling. As an officer, there should be an environment that is comfortable to accommodate the person involved (Roessler & Rubin 2006). First, there should be efficient and quality care. In the case of Zane, beyond counseling, the right medication for schizophrenia should be administered to in the right way. By giving the right medication to Zane will reduce the chances of abnormal behaviors that could affect communication or cause danger.

As a result, if there is a good communication, Zane may be able to contribute well in the talk engagements. Appreciating the patient’s feelings is very essential when in engagement and collaborative process. This helps in making the real conclusion about the patient. Despite Zane suffering from a mental disorder, he will feel that he is cared for and people empathize with the situation he is facing. Zane being an adolescent needs a lot of love and parental care. In this scenario, behavior of the character of a “parent” would be necessary in attribution for attention during engagements.

There is need to provide equitable services for the purpose of reducing the encountered conditions. One example is Zane’s involvement in crime as a result of drugs and excessive alcohol. There are Services like day to day or specific periods counseling and follow ups that should be availed to the patient. It may also include availing medication for mental disorder condition as has been prescribed and consistent follow ups to ensure that the condition is minimized appropriately. In consideration to the scenario, Zane had suffered because of been subscribed to the wrong medication.

Similarly, it is important to ensure that the administered drugs are appropriate and effective to the condition. In cases of failure, further investigations could be necessary. Fifth, care provided should be comprehensive hence should cover all aspects of the patient’s condition from the state of medication to rehabilitation process. This will enhance the growth of stability in the patient’s health. Therefore, enabling normality in the way the patient attends to normal life including sports and work (Roessler & Rubin 2006).

The client has several critical issues as identified below: He is suffering from a serious mental disorder- Schizophrenia. According to Lieberman et al (2005) schizophrenia a mental disorder that appears in late adolescence or early adulthood. The client lies within the mentioned age bracket of 19 years. Though the client sought for medication, it has been ineffective which has caused a sense of misjudgment in his life. This is evident through his indulgence in bad behaviors such as armed robbery.

Zane is a drug addict. He consumes about six bottles of alcohol. He also smokes 25 cigarettes in a day. There is need for him to come out of this situation in order to enhance his recovery. Zane is living in isolation. This is evident on the account that he doesn’t live with his parents. He was kicked out of home on account of his alcoholic behaviour. He had to seek for shelter at his friend’s place. The condition in the friend’s house is not the best since Zane has to spend the nights on a couch.

The client has poor eating and sleeping habits. These two factors are dangerous for his condition because they influence his mental condition. Lack of sleep can facilitate an increase in impaired judgment. In addition, poor eating habits will increase the effect of the drugs that he is using leading to more illnesses.

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