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The Strengths Model - Charles A. Rapp

The strengths model of case management was first articulated in the early 1980's as a reaction to the inadequacy of existing ideas about case management. Specifically, case management models espoused laudable goals - community integration, enhanced quality of life and normalization - yet proposed a technology that was either inadequate or, in some cases, antagonistic to those very goals.

The strengths model of case management presents an alternative to brokered or therapist based case management. Its initial formulation begins with a consideration of the outcomes desired by case management: client must be integrated into the community, they must experience an improved quality of life and they must have a sense of being normal adults. Community integration is not the mere absence from hospital residence. To be truly integrated into the community, one would have to have relationships and resources that exist apart from the mental health system.

Within a strengths model, quality of life is largely defined by clients themselves. People suffering from persistent mental illness most frequently state that they desire adequate income, jobs, opportunities to contribute to others, independent living arrangements, and friends. Consequently, improved quality of life exist when people achieve their stated goals.

Generic case plans may well be a by-product of a pathology model of practice which promotes the homogenization of clients and prohibits individualization. In fact, when we think about individuals in terms of problems we find that there are a limited number of problems.

Consequently, if we are truly value the client as an individual, we will need to focus both our case planning and our thinking on an exploration of individual strengths. To do otherwise is to direct our minds and our practice towards "standardized" human beings. The strengths perspective of case management is based on six principles and a set of procedures which operationalize the principles throughout the helping process. The six principles act as the driving force of the model:

1. The focus is on individual strengths rather than pathology.

2. The case manager-client relationship is primary and essential.

3. Intervention are based on client-self determination.

4. The community is viewed as an oasis of resources, not as an obstacle.

5. Aggressive outreach is the preferred mode of intervention.6. People suffering from severe mental illness can continue to learn, grow ad change.

source: Charles Rapp: Theory, Principles and Methods of the Strengths Model of Case Management. In.: Harris M. and Bergman H.C. Case Management for Mentally Ill Patients. Harwood Academic Publishers, 1993

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