CASE MANAGEMENT

 
 

Pupose

The purpose of our therapeutic process is to assist individuals within the target population of our initiatives.

Goals

Assist in navigating life circumstances through case management services. Decrease homelessness and depressive symptoms, increase sense of purpose, and connect to services.

Our Approach

Five Fold Life deploys an agency based practice (ABP) through an eclectic approach; integrating multiple evidence based practices (EBPs) into one competency based framework. We believe this forms the strongest advocacy approach as it focuses on the total person as an inidividual living in an environment; while at the same time individualizing care by applying interlocking frameworks to address as many features of the human experience as possible.

Step 1

The first steps to care are through establishing a connection with a person in the target population and conducting a competency based assessment. This type of assessment is driven by theories that incorporate biological, psychological, social, and spiritual aspects of human experience. The Diagnostic and Statistical Manual may also be used to guide the assessment process. The advocate can use the information gathered from the individual in the target population to form ideas about how to recommend theoretical approaches to assist the person in developing a desired outcome.

Step 2

After meeting with the individual and assessing for needs the advocate presents the case to a group of advocates with the consent of the individual. This allows the team to come together and provide collective insight that may not be available to any one advocate. This team collaboaration strengthens the framework of the entire approach.

Step 3

After meeting with the advocacy team, the primary advocate meets with the individual over several sessions to provide results of the team based assessment. The sessions going forward include applying this competency based framework; while including aspects such as psychoeducation, goal development, and working towards an outcome that is generated by the needs and goals as described by the individual. An important part of empowerment for the individuals of the target population is for them to know they have the best insight into their personal experience, and this ultimately drives the entire helping approach.

Theoretical Framework

Our “theoretical framework” (Ref. 1) combines the bio-psycho-social-spiritual framework with an ecological systems approach, and other theoretical approaches, this creates a comprehensive and holistic competency-based assessment model. Each of these perspectives brings unique insights and considerations to the assessment process, enhancing the understanding of the individual within their broader context.

Here's how they might complement each other:

  1. Bio-Psycho-Social-Spiritual Framework:

    • Biological: Examining the client's physical health, genetics, and any medical conditions.

    • Psychological: Assessing mental health, cognitive functioning, and emotional well-being.

    • Social: Considering the impact of family, social networks, and community on the client.

    • Spiritual: Exploring the client's beliefs, values, and sources of meaning.

  2. Ecological Approach:

    • Recognizing the influence of the client's environment on their well-being.

    • Assessing the various systems (micro, meso, exo, macro) that impact the client's life.

    • Understanding how environmental factors contribute to or mitigate challenges.

  3. Strengths Perspective:

    • Identifying and building upon the client's strengths, resources, and resilience.

    • Shifting the focus from deficits to capabilities and assets.

    • Collaboratively setting goals that leverage the client's strengths.

  4. Trauma-Informed Care:

    • Sensitively addressing the impact of past trauma on the client's well-being.

    • Creating a safe and supportive environment to minimize re-traumatization.

    • Integrating trauma-sensitive approaches into assessment and intervention.

  5. Systems Theory:

    • Examining the interconnectedness of the client with their family, community, and broader society.

    • Understanding how changes in one part of the system can affect the whole.

    • Collaborating with different systems to promote positive outcomes for the client.

By integrating these perspectives, advocates can conduct assessments that are not only thorough but also culturally sensitive, client-centered, and geared towards promoting holistic well-being. This approach recognizes the complexity of individuals and their environments, fostering a more nuanced understanding of the factors influencing their lives. It also aligns with the values of empowerment, collaboration, and cultural competence in social work practice.

These theoretical Aspects provide the foundations that Inform Our overall Approach:

Eclectic Approach:

  • Focusing on general aspects of the human experience: body, mind, soul, spirit

Spiritual Cogntive Theory (core cognition):

  • Foundational human experience driven by spiritual influence

Psychodynamic Approach (thoughts):

  • How experiences over lifetime affect perception

Cognitive Behavioral Approach (behaviors):

  • How thoughts affect behavior and outcomes

Eclectic Approach

An “Eclectic Approach” (Ref. 1) that incorporates elements related to the body, mind, soul, and spirit suggests a holistic perspective that considers various aspects of a person's well-being. This approach draws from different therapeutic modalities and philosophical frameworks to address the physical, psychological, emotional, and spiritual dimensions of an individual. The goal is to offer a comprehensive and individualized approach to support overall well-being.

1. Body: Physical well-being can be addressed through practices such as exercise, nutrition, and relaxation techniques. Physical health is often connected to mental and emotional well-being, and holistic approaches may include elements of somatic therapies or body-oriented practices.

2. Mind: Cognitive approaches, such as cognitive-behavioral therapy (CBT), can be used to address thought patterns, automatic cognitions, and beliefs that impact emotions and behaviors. Mindfulness and meditation techniques may also be incorporated to enhance awareness and focus.

3. Soul: The term "soul" is often associated with the inner essence or core self. In an eclectic approach, the soul might be explored through the psychodynamic approach, looking at questions of purpose, meaning, and personal identity. Practices like journaling, art, or narrative could be utilized.

4. Spirit: The spiritual dimension often involves a connection to something beyond the self, whether it's a higher power, nature, or a sense of interconnectedness. Spiritual practices, meditation, prayer, or discussions of existential themes can be incorporated to address this aspect.

5. Integration: An eclectic approach seeks to integrate these various elements rather than treating them in isolation. For example, recognizing that physical health can impact mental health, and spiritual well-being may influence emotional resilience.

6. Mind-Body Connection: The mind-body connection is a key aspect of this approach. Practices like meditation, stretching, and tai chi, integrate physical movement with mindfulness, and can be utilized to enhance the connection between the body and mind.

7. Holistic Healing: Holistic healing practices may be incorporated, considering the individual as a whole and addressing imbalances in physical, mental, and spiritual dimensions. This could involve alternative therapies such as acupuncture, massage, or energy work.

8. Personalized Approach: An eclectic approach recognizes that individuals are unique, and there is no one-size-fits-all solution. Advocates might tailor interventions based on the specific needs, preferences, and belief systems of the individual.

9. Psychoeducation: Providing psychoeducation about the interconnectedness of body, mind, soul, and spirit can empower individuals to take an active role in their well-being and make informed choices about their health.

Spiritual Cogntive Theory

"Spiritual Cognitive Theory" (Ref. 1) typically refers to an approach that integrates elements of spiritual or religious beliefs with cognitive theoretical techniques. The cognitive approach is a psychological approach that aims to address and modify patterns of thought and behavior that contribute to psychological distress. In the context of spiritual cognitive theory, the integration of spiritual or religious beliefs involves considering and incorporating these beliefs into the helping process.

Spiritual Cogntive Therapy Practical methods related to this approach:

1. Incorporating Spirituality: Advocates may work with individuals to explore and integrate their spiritual or religious beliefs into the therapeutic process. This may involve discussions about the individual's worldview, values, and beliefs.

2. Addressing Cognitive Distortions: Like traditional cognitive approaches, the spiritual cognitive approach addresses cognitive distortions—patterns of negative or unhelpful thinking. This could involve examining how spiritual or religious beliefs influence thoughts and emotions.

3. Meaning-Making: Exploring the meaning of life events, suffering, and challenges from a spiritual perspective can be a central component. Individuals may be encouraged to find purpose and meaning through their spiritual beliefs.

4. Mindfulness and Meditation: Practices associated with spirituality, such as mindfulness and meditation, may be incorporated into the helping process to help individuals become more aware of their thoughts and emotions.

5. Values-Based Living: Identifying and aligning one's life with spiritual or religious values can be emphasized. This may involve setting goals and making decisions in line with these values.

6. Integration with Traditional Theory: Spiritual cognitive theory doesn't necessarily replace traditional helping approaches. Instead, it integrates spiritual components into evidence-based cognitive techniques.

Psychodynamic Approach

The “psychodynamic approach” (Ref. 1) is a broad psychological perspective that emphasizes the role of the unconscious mind and early childhood experiences in shaping an individual's personality, behavior, and mental health. It encompasses various theories and therapeutic techniques developed by pioneers such as Sigmund Freud, Carl Jung, and others.

It's important to note that while the psychodynamic approach has contributed significantly to the field of psychology, it has also evolved over time. Modern psychodynamic approaches may incorporate a more collaborative and relational approach, focusing on current interpersonal dynamics and the helping relationship.

Key components and concepts associated with the psychodynamic approach:

1. Unconscious Mind: According to psychodynamic theory, a significant portion of our thoughts, feelings, and memories exists in the unconscious mind. These unconscious elements influence our behavior and emotions without our conscious awareness.

2. Role of Early Childhood: Psychodynamic theorists, particularly Sigmund Freud, believed that experiences in early childhood play a crucial role in shaping personality and influencing later life. Early relationships with caregivers, known as attachment figures, are considered particularly important.

3. Psychoanalysis: Developed by Sigmund Freud, psychoanalysis is a helping approach within the psychodynamic framework. It involves exploring the unconscious mind through techniques such as free association, dream analysis, and transference. The goal is to bring repressed thoughts and emotions into conscious awareness.

4. Defense Mechanisms: Psychodynamic theory proposes that individuals use defense mechanisms to cope with anxiety and protect the ego from distressing thoughts and emotions. Examples include repression, denial, projection, and sublimation.

5. Tripartite Model of the Mind: Freud proposed a tripartite model of the mind, consisting of the id, ego, and superego. The id represents primal instincts and desires, the ego is the conscious mind that mediates between the id and reality, and the superego is the moral component, internalizing societal norms.

6. Transference and Countertransference: In the helping relationship, transference occurs when the client projects feelings from past relationships onto the helper. Countertransference refers to the therapist's emotional reactions to the client. Both phenomena are explored to gain insights into the client's unconscious processes.

7. Symbolism and Dreams: Psychodynamic theorists place significance on symbolism and the interpretation of dreams. Dreams are seen as a window into the unconscious, revealing repressed desires and conflicts.

8. Holistic Perspective: The psychodynamic approach often takes a holistic view of the individual, considering the interplay of biological, psychological, and social factors in shaping mental health.

Cognitive Behavioral Approach

The “Cognitive-Behavioral Approach (CBA)” (Ref. 1) is a widely used framework that addresses the relationship between thoughts, feelings, and behaviors. It is based on the premise that our thoughts and interpretations of events significantly influence our emotional responses and behaviors.

The Cognitive-behavioral approach is adaptable and has been applied to various mental health conditions. It is considered a short-term, structured, and goal-oriented approach that emphasizes the development of practical skills to manage and overcome psychological difficulties.

Here are key concepts and principles of the cognitive-behavioral approach:

1. Cognitive Restructuring: This focuses on identifying and challenging distorted or negative thought patterns. This process, known as cognitive restructuring or cognitive reframing, helps individuals replace irrational thoughts with more realistic and balanced ones.

2. Behavioral Activation: Behavioral activation involves identifying and modifying behaviors that contribute to psychological distress. It emphasizes engaging in positive and reinforcing activities to improve mood and overall well-being.

3. ABC Model: The ABC model is a fundamental concept in CBT. It stands for Activating event, Beliefs, and Consequences. It illustrates how events trigger thoughts (beliefs), which then lead to emotional and behavioral consequences.

4. Automatic Thoughts: Automatic thoughts are spontaneous and often unconscious cognitions that arise in response to situations. This helps individuals become aware of these automatic thoughts and evaluate their validity and impact on emotions.

5. Mindfulness and Awareness: Mindfulness techniques are often integrated into CBT to help individuals become more aware of their thoughts and feelings without judgment. Mindfulness can enhance emotional regulation and promote a non-reactive awareness of the present moment.

6. Homework Assignments: CBA often involves between-session assignments to practice and reinforce therapeutic skills. These assignments may include keeping thought records, conducting behavioral experiments, or practicing relaxation techniques.

7. Goal-Oriented and Time-Limited: CBA is typically goal-oriented and time-limited. The therapist and client collaborate to set specific, achievable goals for therapy, and the focus is on practical strategies and solutions.

8. Empirical Basis: CBA is known for its empirical support and evidence-based practices. Numerous research studies have demonstrated its effectiveness in treating a variety of mental health issues, including anxiety disorders, depression, and more.

9. Collaborative Helping Relationship: The helping relationship in CBA is collaborative and active. The therapist and client work together to identify and change patterns of thinking and behavior.

10. Relapse Prevention: CBA often includes strategies for preventing relapse. This may involve developing coping skills, recognizing early warning signs, and having a plan to manage challenges that may arise after therapy.

REFERENCE

(Ref. 1) ChatGPT, a language model developed by OpenAI.