Transcript Strengths-Based Case Management Fidelity

The Gary Bond Festschrift
Strengths-Based Case
Management Fidelity
Charles A. Rapp, PH.D.
Rick Goscha, MSW
Indianapolis, IN
September 23, 2009
GARY
by Scott Adams
Strengths Model Practice
• Philosophy of Practice
– Way of viewing the people we serve
– Way of being in relationship to people
• Set of Tools/Methods
– Strengths Assessment
– Recovery Goal Worksheet
– Group Supervision
N=4
Impetus to Develop Fidelity Scale
1. Method for monitoring intervention in future
research
2. Separate strengths model programs from
charlatans
3. Policy decision by the Kansas SMHA
Source of Items
1. Text book on the strengths model (Rapp,
1998; Rapp & Goscha, 2006)
2. Survey of experts study (Marty, Rapp &
Carlson, 2001)
3. “Principles of effective case management of
mental health services” (Rapp & Goscha,
2004)
4. Collective experiences (wisdom?) of the
developers, CATS, service providers
Fidelity Measure
I. Structure
II. Supervision
III. Clinical Practice
I. Structure
• case managers job responsibilities are fully
devoted to case management
• case managers have low caseload ratios
• employment services are integrated into the
case management team
• strengths-based group supervision is used
II. Supervision
• field mentoring
• ratio of case managers to supervisors
• review of strengths tools (strengths
assessment, recovery goal worksheets,
integration into practice)
• feedback to case managers on the skills in
using the tools
III. Practice
• strengths assessment
• integration of strengths assessment into
practice (e.g. setting goals, use of resources)
• recovery goal worksheet
• community contact
• use of naturally occurring resources
• hope-inducing behavior
Multiple Sources of Data
• case records
• interviews with consumers, case managers,
supervisors
• direct observation
Reliability
Inter-rater reliability coefficient
Cronboch’s alpha
.97 p>.001
.98
Only one of 36 items were raters not in
complete agreement
• Percent of goals reflecting a trend to formal
service