Social Work: Case Management & Advocacy

Case MGT begins w/ comprehensive BPS assessment — evaluate biological, psychological, & social dimensions of CLT functioning. Use standardized screening tools: PHQ-9 for depression, GAD-7 for anxiety, AUDIT for alcohol use, DAST-10 for substance misuse. Document findings in CLT record w/ clear clinical justification for SVC recommendations.

Intake & engagement: build therapeutic RAP through unconditional positive regard, empathic listening, & cultural HUM. First session establishes safety (SI/HI screening using Columbia Protocol), identifies immediate needs (housing, food, MED access), & sets collaborative treatment goals. CLT self-determination is paramount — we facilitate, not direct.

Biopsychosocial assessment structure: BIO (medical HX, current MEDs, substance use, sleep, nutrition, physical limitations), PSYCH (MH HX, trauma exposure using ACE score, coping mechanisms, cognitive functioning, current symptoms), SOCIAL (family systems, support network, employment, education, legal involvement, housing stability, financial resources, cultural identity, spiritual practices).

Treatment planning follows SMART goals: Specific, Measurable, Achievable, Relevant, Time-bound. Each goal links to identified problems from assessment. Interventions must be EBP — CBT for depression/anxiety, DBT for emotion dysregulation, MI for ambivalence about change, TF-CBT for childhood trauma, EMDR for PTSD. Document CLT's informed consent for each modality.

Crisis intervention uses the ABC model: Achieving rapport (active listening, validation), Boiling down the problem (identify precipitant, assess lethality), Coping (develop safety plan, mobilize resources). Safety planning includes warning signs, internal coping strategies, people/places for distraction, people to call for help, professionals/agencies to contact, & means restriction. Always document risk assessment & clinical decision-making.

Child welfare practice: mandatory RPT obligations vary by state — know your jurisdiction's requirements. Assess child safety using SDM (Structured Decision Making) tools. Family preservation SVC preferred when safe — connect families w/ in-home SVC, parenting education, substance TX, & concrete supports. Removal is last resort — document reasonable efforts to prevent placement. Foster care goal-setting follows ASFA timelines: permanency hearing by 12 months, TPR filing if child in care 15 of 22 months.

Substance use treatment: screen w/ SBIRT (Screening, Brief Intervention, Referral to TX). Understand stages of change (precontemplation, contemplation, preparation, action, maintenance) — match intervention to stage. MI techniques: OARS (Open questions, Affirmations, Reflections, Summaries). MAT (buprenorphine, methadone, naltrexone) is EBP for opioid use disorder — combat stigma, advocate for CLT access. Coordinate w/ prescribers & monitor TX adherence.

Housing-first approach: stable housing is prerequisite for addressing other needs. Know local COC (Continuum of Care) resources, HUD programs, Section 8 vouchers, rapid rehousing, & permanent supportive housing. Conduct VI-SPDAT for vulnerability assessment & housing prioritization. Advocate for CLT w/ landlords, navigate fair housing protections, & assist w/ reasonable accommodation requests for disability.

Domestic violence response: use power & control wheel framework. Safety planning is priority — assess lethality w/ Danger Assessment tool. Connect SRV w/ DV shelter, legal advocacy (PFA/restraining orders), safety planning for technology/stalking, & financial empowerment programs. Understand trauma bonding & avoid victim-blaming. Mandatory RPT requirements for DV vary — know your state law & ethical obligations.

Aging & gerontological SW: assess functional capacity (ADLs/IADLs), cognitive status (MMSE, MoCA), & caregiver burden (Zarit scale). Navigate Medicare/Medicaid systems, assist w/ benefits enrollment, coordinate home health SVC, & evaluate for adult protective SVC if abuse/neglect suspected. Advance care planning — facilitate discussions about POA, healthcare proxy, living will. Know guardianship/conservatorship processes & advocate for least restrictive alternatives.

Disability advocacy: understand ADA protections, IDEA for children, Section 504 accommodations. Person-first language unless CLT prefers identity-first. Assist w/ SSDI/SSI applications — understand 5-step sequential evaluation. Appeal denials at reconsideration & ALJ hearing levels. Connect CLT w/ vocational rehabilitation, independent living centers, & assistive technology resources.

Ethics & boundaries: NASW Code of Ethics guides practice. Dual relationships generally prohibited — assess power differential & potential for harm. Informed consent covers nature of SVC, risks/benefits, alternatives, confidentiality limits, & right to refuse. Confidentiality exceptions: danger to self/others, child/elder abuse, court order. Document ethical dilemmas & consultation w/ supervisor or ethics board.

Cultural competency & anti-oppressive practice: examine own biases through ongoing self-reflection. Understand intersectionality — CLTs hold multiple identities affecting their experience of oppression. Use ADDRESSING framework (Age, Developmental disability, Disability acquired, Religion, Ethnicity, Socioeconomic status, Sexual orientation, Indigenous heritage, National origin, Gender). Advocate at macro level for policy change addressing systemic barriers.

Documentation standards: progress notes follow DAP (Data, Assessment, Plan) or SOAP (Subjective, Objective, Assessment, Plan) format. Document CLT's own words in quotes. Include clinical reasoning for interventions. Record collateral contacts, referrals made, & coordination efforts. Maintain records per state retention requirements (typically 7 years post-termination, longer for minors). Timely documentation — complete notes within 24-48 hours.

Supervision & professional development: seek regular clinical supervision for licensure hours (typically 3000+ supervised hours for LCSW). Supervision addresses clinical skills, ethical dilemmas, countertransference, & vicarious trauma. Engage in ongoing CEU for license renewal. Recognize compassion fatigue & burnout — maintain self-care plan, set boundaries, utilize peer support.

Macro practice & community organizing: conduct needs assessments using quantitative (census data, surveys) & qualitative (focus groups, key informant interviews) methods. Coalition building requires identifying stakeholders, shared agenda, & collective action strategies. Policy advocacy: understand legislative process, write effective testimony, organize constituent contact campaigns. Grant writing follows standard structure: needs statement, goals/objectives, methods, evaluation plan, budget & justification.