The following principles will guide all team members in the process of integrated case management:
Client-centred Service – The Ministry for Children and Families is committed to putting clients at the centre of all service planning and practice. That means supporting clients to use their strengths to identify and achieve their goals, and direct their own lives to the greatest extent possible. This approach challenges all integrated case management team members to adapt services to fit client needs, rather than to expect clients to adapt to administrative or service structures.
Building on Strengths – Far too frequently, in our efforts to improve the circumstances of our clients, we focus immediately on their problems and work to develop solutions. While well-intended, this approach fails at the outset to identify the strengths and successes of the clients, which may often be the foundations for far more lasting changes in their lives. In addition, a positive approach makes it far easier for the client to stay committed and the team to be collaborative.
Advocacy – Integrated case management provides clients with the opportunity to participate in decisions that affect their lives. They may find it difficult, however, to attend meetings on their own and to speak for themselves. In these circumstances, clients should be encouraged to bring a friend, advocate or support person with them.
Recognizing Diversity – Our clients have diverse needs, background and abilities. The integrated case management team needs to respect and respond to the social, cultural and economic factors that shape clients’ lives.
Collaboration – Integrated case management brings together the varied disciplines, talents, perspectives, knowledge and experience of many team members and challenges them to share their individual skills, knowledge and expertise with each other. This process not only
supports the best possible outcomes for clients, but it also offers opportunities for increased growth and understanding for all team members.
Mutual Respect – It is essential that all team members show respect for one another’s knowledge, skills, experience and perspective, regardless of age, level of training, position, job classification, particular discipline, or the ministry or agency represented. It is particularly important that team members foster a climate of respect for clients.
Participation – Team members must be willing to participate fully in the activities of the team. At the beginning of the process, full participation may involve a significant investment of time – in the long run, this initial investment is likely to save time for all team members and improve outcomes for clients.
1 Ministry for Children and Families. Integrated Case Management: ICM User’s Guide. Author, 1999 .
Accountability – The Ministry for Children and Families is committed to creating a system that is accountable to the people who use it. Clients must be informed to the greatest extent possible of all activities that might affect them. In addition, integrated case management activities must be recorded. The review of this documentation will allow us to enhance our practice and to better understand what approaches work best with which clients.
A Holistic Approach – Integrated case management should provide for a complete
understanding of the various aspects of a client’s circumstances and needs, including family considerations, and the development of a case plan broad enough to address them.
Continuity – Clients need a sense of continuity in the services they are receiving – not only in how the services relate to each other, but also in how the services develop over time. To preserve a sense of continuity, every effort should be made to ensure that over the course of a client’s involvement with the ministry, at least one member of the integrated case
management team is present from the beginning to the end of the process.
Planning for Transitions – Integrated case management teams should take special care to plan for transitions in the lives of clients – for example, changing schools, moving from childhood to adolescence, and changes in family structure.
Least Intrusive and Intensive Intervention – Integrated case management is an important support to the ministry’s promotion, prevention and early supports strategy, which is aimed at providing support to youth and families as early as possible, before difficulties develop into crises. While it is clear that appropriate supports are necessary when clients encounter difficulties, it is important to minimize the number, intensity, duration and restrictiveness of the interventions in order to acknowledge and build on the strength and independence of the families.
“Integrated Case Management" and "Collaborative Practice": Some Definitions and Key Elements
2To stimulate discussion on integrated case management within MCF, we have provided below several definitions and core characteristics of integrated case management and collaborative practice . These have been excerpted from a recent report submitted to MCF on multi-disciplinary child welfare education and an options paper on common intake response and ICM.
Collaborative practice can be described as an interactive process by which individuals with diverse training meet together to plan, generate and execute solutions to mutually identified problems related to the welfare of children and families (Knapp et al, 1993, as cited in Tate & Hubberstey, 1997). It is increasingly "seen as an approach to maximize the delivery of coordinated, effective and efficient services to health care consumers" (Fulton, 1996, p. 4, as cited in Tate & Hubberstey, 1997).
Some specific characteristics of collaborative practice include:
• active participation of the client
• sharing or transferring of information and skills across traditional boundaries
• participants view themselves as part of a team and contribute to a common goal
• relationship between participants is non-hierarchical and power is shared
• leadership is shared and participants are inter-dependent
• participants work together in planning and decision making
• participants offer their expertise, share in the responsibility and are
acknowledged by other members of the group for their contribution to the goal
• clear definition and understanding by team members of participants' roles/responsibilities
• respect for autonomous professional judgement and autonomous choice and
• decision making of the client/family
• effective communication skills and group dynamics
• supported by organizational structures and vision
2 Hubberstey, C. and B. Tate. Multi-disciplinary Child Welfare Education Project Report.
Ministry for Children and Families, 1997.
More Definitions3
Integrated case management refers to a team approach taken to coordinate various services for a specific child and/or families through a cohesive and sensible plan. All members of the team work together to provide assessment, planning, monitoring and evaluation. The team should include all service providers who have a role in
implementing the plan, and whenever possible, the child or youth's family.
Co-operation or collaboration: working or acting together; collaborating or co-operating means that services remain separate, but that separate service providers have contact, share information and approach a client as a common concern.
Integration: combine parts into a whole; this suggests more than co-operation or more co-ordination of various disciplines working together. Integrating disparate services means combining services and service providers with the result that something new is created. Full service integration means that an interdisciplinary team of service providers offers service under a single, unifying mandate.
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3 Capital Region, Response/Screening, Integrated Case Management Committee, Ministry for Children and Families. Common Options Paper: Common Intake Response/Screening, and Integrated Case Management Model, 1997.