Stanhope Victoria, Tiderington Emmy, Henwood Benjamin, Padgett Deborah K
Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003-6654, USA.
Clin Soc Work J. 2012 Jun;40(2):261-267. doi: 10.1007/s10615-012-0385-2. Epub 2012 Mar 3.
Case managers are among the direct service providers responsible for engaging people with severe mental illnesses. Understanding how they interpret and respond to clinically difficult situations can inform ways to intervene and reduce service disengagement. This qualitative study explored clinically difficult situations when case managers invoked the term "sabotage". Interviews were conducted with 21 case managers and analyzed by co-coders focusing on how case managers used the term sabotage to describe service user behavior. Themes that emerged were attributing sabotage to; fear of success, fear of attaining what you desire, avoidance of responsibility and change, and a lack of structured support. Drawing on the concepts of clinical case management and mental health recovery, we consider implications for the training and supervision of case managers and how services are structured.
个案管理员是负责与重度精神疾病患者接触的直接服务提供者之一。了解他们如何解读和应对临床难题，可为干预措施及减少服务脱节提供思路。这项定性研究探讨了个案管理员提及“破坏行为”一词时的临床难题。对21名个案管理员进行了访谈，并由共同编码员进行分析，重点关注个案管理员如何使用“破坏行为”一词来描述服务使用者的行为。出现的主题包括将破坏行为归因于：害怕成功、害怕得到想要的东西、逃避责任和改变，以及缺乏结构化支持。借鉴临床个案管理和心理健康康复的概念，我们考虑了对个案管理员培训和监督的影响以及服务的组织方式。
