by Charles A. Rapp and Richard J. Goscha; New York, Oxford University Press, 2006, 320 pages, $55
Dr. Adams is assistant professor of psychiatry at the University of Maryland, Baltimore.
The helpful and practical book The Strengths Model guides willing case managers toward a recovery-oriented approach for the people they serve. Its brevity increases the likelihood that this important text will be read, and it will not leave the reader feeling shortchanged on content.
The authors encourage improving the language and behaviors of case managers, but they do not rid us of the term "case manager." They reintroduce the term "traveling companion," which was used by Dietchman (1), but recognize that it has yet to replace the term "case manager." Their stated intent is not to change terms but to change behaviors. The authors and the rest of us remain stuck with the dehumanizing terms "case manager" and "case management" for now.
The opening chapter entitled "History Critique and Useful Conceptions: Toward a Strengths Paradigm" could be renamed "The Weakness Model: How We Misunderstood and Mistreated the Mentally Ill and Continue to Do So." We are reminded of how we have labeled people with our terms, dictated the duration and type of treatment they are to receive, and required that they come to our turf and play by our rules. If not, they are labeled as "noncompliant" and are described as "lacking insight." We set goals such as "structure" and "socialization," as if someone prefers those over a job, friends, a home, and a life.
It is our good fortune that the remaining chapters direct us from the weakness model to the strengths model. Rapp and Goscha chide some of us for claiming to carry out the strengths model when what we are doing actually falls a bit short of the mark. They teach us how to do strengths assessment and how it can replace the typical problem-based assessment. We also learn how to create a personal plan with real goals instead of the typical, one-size-fits-all individual treatment plan that is loaded with our terms and goals.
Later in the book the authors direct us to see the community as full of helpful people and useful services in the chapter titled "Resource Acquisition." We learn how to find strengths in the community and not solely in the client, and we are encouraged to look outside the mental health services sector to help people enhance their lives. Another chapter demonstrates how to create an organization that is top-down but has the clients at the top, not the chief executive officer. We are taught how to structure teams, how to optimize their size, how to support them, and how to supervise them using strengths-based methods.
Case managers and those who supervise them will greatly benefit from this highly readable text. Anyone who is familiar with the strengths model will be gratified by reading the book and can use it to improve his or her skills. Clients and family members can use the book as an advocacy guide and a template for the services that they deserve. In all, it's a book that needs to be read and that advocates methods that must be used.
1.Deitchman WS: How many case managers does it take to screw in a light bulb? Hospital and Community Psychiatry 31:788—789, 1980