Section 3: Conducting Case Management Meetings

A case management meeting is essentially a coordinated meeting of stakeholders designed to plan, review, or improve the case management plan (Seabury, 2010). It is important for all stakeholders to be fully aware of the details of the plan because “although each provider may be working on a particular piece, each piece must fit together into some general objective.” (Seabury, 2010, p. 318). A case management meeting will usually occur on a regular basis or may be arranged in the event of new or unforeseen circumstances that require adjustments to be made to the case plan.

Being equipped for a case management meeting involves preparation before the scheduled meeting. One of the fundamental steps in preparing for the meeting is determining the purpose or agenda of the meeting. Before a meeting begins, all participants must be clear on the reasons and the goals for the meeting.

For example, the purpose of a meeting might be to develop an initial plan, make changes to an existing plan, develop strategic objectives, resolve conflicts that are affecting the plan, or provide education on the client’s specific needs. It is important that all stakeholders are clear and agreeable regarding the agenda prior to the meeting taking place.

An established agenda also helps the case manager keep the meeting on track and ensure that the meeting is working toward its intended outcomes. The case manager will usually draw up an official agenda and distribute this before the meeting so that all participants are aware of the focus of the meeting and their role within it. However, provision should be made for other issues to be raised during the meeting if required.

Typical steps involved in preparing for and conducting a case management meeting include:

Facilitating Client Participation

All clients should be given the opportunity to participate in case management meetings – it can be an empowering process for clients to express their views and be consulted throughout the meeting. In situations where this is not possible due to the client’s circumstances (for example, the client's age or disability), a suitable client representative (for example, the client’s carers, guardians, or power of attorney) should be involved in the process to help make sure the client’s best interests remain at the centre of the meeting.

Preparing clients for the meeting is important so that they can feel supported. This typically involves having a discussion with the client about the agenda and purpose of the meeting, attending stakeholders and their roles, and what information will be discussed and shared in this private and confidential arena. Some clients may feel more comfortable having time to consider what they want or having it written down so that they can raise their opinions and questions during the meeting.

It is also important to check with the client how they feel about entering a meeting arena (as it can be triggering for some people who have social anxiety or if they have had previous negative experiences) and what can be done to help them feel safe and supported. Some clients may want to attend with a support person (whose role is to offer support instead of actively participating in the meeting) or an advocate (who can speak up for the client where necessary).

It should also be noted that a positive rapport with your client is likely to maximise client participation in the case meeting and increase the likelihood that the meeting will be productive. As previously noted, the process of rapport building begins at the initial assessment interview and continues throughout every interaction with your client. It is vital that case managers take the time to build rapport by utilising their basic communication skills and continue to work closely with their clients throughout the case management process.

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During a case management meeting the case manager typically acts as a chairperson or the facilitator of the meeting. This means that one of their central roles is to facilitate effective engagement of all stakeholders, by holding the ‘space’ for a respectful, positive atmosphere that focuses on the client’s best interests.

To do so, it is important for case managers to understand the nature and role of group dynamics and be skilled in managing interactions between group members. Consideration must be given to the role of each stakeholder, their impact and influence on the group, and how this might impact the effectiveness of the case meeting.

Establishing rapport is an important first step in facilitating an effective case management meeting. It may be the first time for your client to meet with prospective service providers, and the practitioners attending may not have known each other or worked together previously. Thus, case management meetings often begin with introductory and rapport-building activities where participants get to know each other, and importantly the client, a bit more.

For example, you may begin by introducing yourself and the role you play in the meeting (as well as in the context of supporting the client), and the client, and then invite other attendees to briefly introduce themselves. Establishing a basic understanding of each participant’s experience, skills, values and roles will assist with the subsequent discussion where decisions are made regarding how to best support the client.

Facilitating clear discussion and information sharing is another important function of a case manager in the meeting process. Whether the purpose of the meeting is to establish an initial plan or make changes to an existing plan, the case manager should facilitate an exploratory discussion of the case in which the stakeholders are encouraged to brainstorm a pool of ideas, options, and perspectives on the issue or concern.

Particularly, case managers are mindful of the common use of jargon or professional language among practitioners and service providers and always check with clients to make sure they fully understand the information discussed during the meeting. Occasionally, this means reiterating the information using plain English or developmentally appropriate language to promote the client’s understanding. Concurrently, case managers can support the client to share their story and opinion during the meeting, and help clarify details or information that may be ambiguous for the stakeholders.

Common strategies to facilitate discussion within a case management meeting include:

• Establish the purpose, objectives, and agenda of the meeting. As previously mentioned, doing so ensures clarity for all stakeholders about why the meeting is taking place and helps the participants stay on track.
• Make sure the meeting room allows all participants to be equally seen and heard. Consideration should be given to seating arrangements, making sure it is a safe and secure place for the client and other stakeholders, and shielded from external noise.
• Be a role model to others by using positive language and body language. For example, appropriate levels of assertion are sometimes required if the meeting is controlled by one member or faction, or if one of the stakeholders is not assertive in stating their opinion.
• Focus on one issue at a time. Facilitators should restrict discussion to the agreed agenda item (unless there are urgent items to add). Agendas are often written to delegate specific items or job roles to explicit stakeholders. Discussion of the agenda item should begin with that identified representative.
• Encourage and validate input from all participants. This will help all participants to engage in the case management process and feel that their views are respected.

In fact, case managers use many of the same techniques that a counsellor would use in their work. Some key communication skills that case managers use include:

• Attentive listening. Attentive listening is the process of giving somebody your full and undivided attention. When you are engaged in attentive listening, you are likely to demonstrate your interest in the person and their perspectives through nonverbal gestures such as nodding, smiling, and mirroring the client’s body language.
• Active listening. When you are engaged in active listening, you are both demonstrating attentive listening and responding to the client’s statements with summaries, clarification questions, and requests for elaboration. Examples of active listening:
  • “Let me see if I understand this right, you’re saying…”
  • “Can you tell me more about that?”
  • “When you said […] before, did you mean […]?”
  • “How did you react to that?”
  • “Is that what you would like to happen?”
• Affirmative listening. Affirmative listening involves listening for the emotions and feelings behind a person’s statement. Affirmative listening requires you to respond in a manner that validates the person’s experience, demonstrate empathy, care and respect, and search for a deeper level of meaning behind what is being said. Examples of affirmative listening:
  • “I appreciate your willingness to discuss this issue…”
  • “I can see how this may be frustrating for you…”
  • “It sounds as though you really care about…”
  • “It sounds like […] is very important to you.”
• Asking open-ended questions. It is important that you show clients that you are interested in their experiences, perspectives and goals by inviting them to share more information with you. This is accomplished by asking open-ended questions – questions that cannot be answered by a simple “yes” or “no”. Examples of open-ended questions:
  • “What was that experience like for you?”
  • “How did it make you feel when […]?”
  • “What was it about […] that caused you to react that way?”
  • “What is your favourite memory of […]?”
  • “What skills do you have that you think will help you to accomplish […]?”
• Probing. Probing involves asking questions designed to gather additional information about a specific topic or aspect of a person’s story or to follow up on a statement. Probing questions help the client to think more deeply about the issue at hand.
• Avoiding judgements. Case managers must refrain from expressing judgement, both verbally and nonverbally, and adopt a nonjudgemental attitude in all interactions with clients.
• Tuning in to body language. It is important that a case manager is able to tune in and be sensitive to their client’s nonverbal responses and cues during meetings. This will help you better understand the information that is being presented verbally.

From there, stakeholders work collaboratively to evaluate all of the proposed options in order to determine and agree upon the most appropriate strategies for implementation. Such decisions will nonetheless take into account the client’s rights and interests, their responsibilities and needs in their respective family and community, statutory requirements, as well as each service provider’s organisational requirements and delivery frameworks.

Case management meetings typically result in a set of clear action steps and division of responsibilities. Everything that is decided upon in a case management meeting must be clearly documented. Case managers must ensure the documentation is accurate, compliant with organisational standards, and easily understood by all stakeholders. The document must then be distributed in a timely fashion for all stakeholders to confirm that it is an accurate record, and to facilitate implementation.

Case Management - Initial Assessment

This video provides a role-play on facilitating a case management meeting. Answer the questions that follow. 

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Before moving on, let’s consider a couple of common challenges faced in facilitating case management meetings and strategies to overcome them.

As the case management process often includes multiple practitioners and support services, a common challenge faced is confusion or conflict around professional roles and boundaries. It is not uncommon for practitioners’ areas of competency to overlap, and roles can be muddled – duplication of services is not ideal as it depletes the scarce resources within community services organisations and brings unnecessary pressure on clients (for example, having to attend excessive appointments and repeat themselves to multiple workers).

Where multiple services are involved, it is important to clarify what they can provide, the limitations of service (for example, budget, timeframe, location) and identify where they may overlap or if there is a gap. Essentially, each stakeholder’s role within the case management process must be identified and coordinated for the client’s best interests, and for the wellbeing of the case managers and other professionals involved (Guzys & Petrie, 2014).

Clearly defining roles, responsibilities, and boundaries from the beginning of the case management process is important to help prevent confusion and conflict. This includes at the agency/organisational level (for example, understanding what services will be provided and the limits of these services) and on a personal level (for example, understanding the limits of each practitioner’s expertise and how you will address value systems conflicts). This is often done in an initial case management meeting and revised as necessary in subsequent meetings.

In addition, Guzys and Petrie (2014) suggest the following strategies to help case managers establish and maintain boundaries and ensure more successful and collaborative case management:

• Facilitate discussion with the intention to draw out and acknowledge the experience, skills and values of each participant in the case management meeting. This will allow for more informed decisions regarding the interventions to be made.
• The rights, roles, responsibilities, accountabilities and intended outcomes should be outlined at the beginning of the case management process and then reviewed on an ongoing basis.
• Positive outcomes for the client usually come from the equal status of all participants in the case management process (for example, no one party should dominate the discussion or decision-making process).
• Effective communication requires a shared understanding of messages sent and received. This occurs when there is an understanding of the language used and when all participants practice active listening.
• Negotiation is an essential skill for all stakeholders in the case plan. There may be competing agendas, views on treatment, or views on the timing of interventions and reviews. By respecting the situation, remaining calm, and using direct “I-statements”, constructive and positive outcomes can be achieved for clients and practitioners.
• Working as a team requires all stakeholders to respect the team process and the client’s right to professional care and attention by each person involved in their case management plan.
• Problem-solving requires a process approach. When making changes to a case plan without following appropriate processes, there is the risk of ‘jumping to conclusions’, or solutions, which could result in serious consequences (for example, a mistake being made, or a critical aspect of the problem not being identified). The process of problem-solving should involve all stakeholders.

The Rights, Roles and Responsibilities of People Within the Decision-Making Process

Apart from clarifying and agreeing on what roles and responsibilities each stakeholder has in supporting the client as a whole, another important aspect to clarify is how decisions are to be made in this case management process. Whilst it is commonly acknowledged that the client has a right to and should be the main person making decisions about their own care or service, some decisions may be subject to the agreement and/or rights of others.

For instance, in a child protection case management scenario, the statutory requirement may grant the Child Safety Department final decision-making power in regard to the respective children’s arrangements. Where there is a mental health treatment order in place, some aspects of the client’s case management decisions may need to be reported to and reviewed by the Mental Health Tribunal.

In another case, an elderly client who is likely to lose decision-making capacity due to dementia may have appointed an attorney to make decisions on their behalf – this usually takes place only when the elderly person no longer has such capacity. As such, it is always important to make sure all stakeholders are clear, and on the same page, about which aspects of decision-making lie with the client and aspects that are not.

Due to the multidisciplinary nature of case management, and the complexity involved in most cases, it can be a challenging task to balance the needs and rights of all stakeholders. The needs and rights of the client and their family are usually gleaned from the intake process and understood through subsequent client interactions.

However, client needs, rights and responsibilities need to be balanced against the needs, roles and responsibilities of service providers and their organisations (for example, resource availability and allocation), and the needs of the larger community (reflected in laws and regulations). Sometimes statutory considerations mean that the needs of the client must be impinged upon (for example, in cases where a client is subject to legal restrictions such as a court order).

The role of the case manager often requires striking a delicate balance between meeting the needs and rights of the client, their caregivers, the agency/organisation for whom the case manager works, and those of the community more broadly. It is important that case managers fully consider the needs and rights of all parties involved when managing a case plan. When developing specific strategies or interventions, the case manager must continuously ask themselves certain questions, such as:

• What is in the client’s best interests?
• What is the right choice ethically?
• Are there any statutory issues that I must consider?
• Am I operating within the guidelines of the organisation that employs me?

Case management meetings provide an opportunity for stakeholders to clarify and discuss the best way of striking such balance while putting the best interest of the client in the centre as much as practicable. At the same time, the client is also provided with an opportunity to clarify expectations on what can be achieved through the existing support system, so as to reduce misunderstandings and dissatisfaction down the track.

Where necessary, the case manager should facilitate negotiation and clarify communication in order to make sure all stakeholders are very clear, and agreeable to, the roles and responsibilities discussed. It is also important to document these clearly in the case management plan.

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Where two or more people work together, there is always the potential for conflict – working with helping professionals is no exception. Therefore, conflict management and resolution skills are vital for effective case management.

In the context of a case management meeting, conflict can occur between the:

• Client and their support people (for example, conflict over the ‘facts’ of the client’s narrative or conflict of values)
• Client or their support people and a service provider (for example, conflict surrounding a client’s participation in a particular intervention)
• Different service providers (for example, conflict over how an objective should be accomplished or what the outcome measures should be).

Conflict is not necessarily negative – it points out where potential differences lie and enables timely intervention. However, unresolved, ongoing conflict can have a negative impact on the working relationship between stakeholders and jeopardise the effectiveness of the case management plan.

For this reason, conflict should not be overlooked but explored and, wherever possible, resolved. Where conflict arises in a case management meeting, it becomes the responsibility of the case manager, as chairperson of the meeting, to use their skills in conflict resolution, negotiation, and mediation to address the conflict as soon as practically possible.

Some suggestions for managing conflict within a case management meeting include:

• Remain objective and always remember to bring the focus back to the client and the purpose of the meeting.
• Acknowledge and address the issue when it occurs – ignoring conflict will not make it go away. It is also important not to condemn the person who brings up an issue, as that may discourage genuine discussion in the future.
• Clarify the issue. Encourage each person to clearly state their viewpoint and their preferred outcome. Encourage “I” statements and ensure that everyone is allowed to voice themselves without interruption.
• Use active listening and communication techniques (for example, paraphrasing, reframing, summarising) effectively.
• Generate a variety of possible options before deciding how to proceed.

In the context of a case management meeting, conflict management is primarily about listening and facilitating understanding. Listening is not a passive activity – it also requires an active reply and response. You may have heard of the three A’s of listening:

1. Attentive listening. Attentive listening is the process of giving somebody your full and undivided attention. When you are engaged in attentive listening you are likely to demonstrate your interest through non-verbal gestures such as:
   • Nodding
   • Smiling
   • Mirroring body language.
2. Active listening. When you are engaged in active listening, you are
   • Demonstrating attentive listening
   • Responding with summaries, clarification questions and requests for elaboration. Examples of active listening:
     • “Let me see if I’ve got this right, you’re saying…”
     • “Can you tell me more about that?”
     • “When you said [….] before, did you mean […..]?’
     • “How did you react to that?”
     • “Is that what you would like to happen?”
3. Affirmative Listening. Affirmative listening involves listening for the emotions and feelings behind a person’s statement. To engage in affirmative listening you must:
   • Respond in a manner that validates the person’s experience
   • Demonstrate empathy, care and respect
   • Search for a deeper level of meaning behind what’s being said.
     Examples of affirmative listening:
     • “I appreciate your willingness to discuss this issue…”
     • “I can see how this may be frustrating for you…”
     • “It sounds as though you really care about ……..’s welfare….”
     • “It sounds like…..is very important to you…”

The following flow chart illustrates the process of using listening skills to encourage shared conflict resolution:

Step 1: Listen to both sides of the conflict.
Step 2: Find out what particular issues individuals agree on and disagree on.
Step 3: Identify and discuss where compromise or adjustment can be made.

Possible outcomes to conflict management include:

Ultimately, the goal is to come to a ‘win, win’ solution – one that best meets the needs of the client within the boundaries of services and systems at play.

A common cause of conflict in the case management team is a clash of value systems between stakeholders. Value conflicts occur when the different parties have different beliefs or ideals about what is good or bad, desirable or undesirable. In such cases, different stakeholders may be (consciously or unconsciously) pushing for their own agenda. This can be extremely detrimental to the development of an effective case management plan that is supposed to have the needs and goals of the client at its core.

Summers (2016) provides the following strategies to help avoid values conflict and ensure best practice for clients:

1. Be respectful of attitudes and lifestyles that differ from your own.
2. Never practice prejudice toward minorities, those with disabilities, or those differing in sexual preferences.
3. Always give your best service to a person, even when you disagree with the person.
4. Never attempt to change the individual’s values to coincide with your own.

Developing a strong sense of self-awareness can help you avoid conflicts arising from clashing values. If you are ever in a situation where you have a severe conflict of values and you believe that you can no longer be objective and/or feel compelled to impose your own values onto your client, it will be important to discuss the matter with your supervisor. In such cases, it may be ethically appropriate to refer your client to another professional.

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Like all other contacts with your client, keeping accurate records of a case management meeting is important for both legal and administrative purposes. Legally you may be required to provide evidence of the work you and other relevant parties have completed. Administratively, it also means that you are not reliant on your memory to recall what happened during the meeting, including the roles and responsibilities assigned to all involved (Summers, 2016).

Documenting the outcomes of a case management meeting can be done in a number of formal and informal ways – depending on the organisational requirements and contexts in which case management processes take place. For example, you might document the outcomes as case notes to be included in the client’s file; you might send an email to relevant stakeholders to advise them of the meeting outcomes; you might document minutes of the meeting; or you might construct an updated case management plan to be distributed to all relevant stakeholders.

Regardless of the form that the documentation takes, it is important to outline the roles, responsibilities, and accountabilities of all relevant stakeholders clearly and accurately. It is the responsibility of the case manager to ensure that all participants are completing the tasks assigned to them under the case management plan. This process is made much easier if all participants are given specific action plans and all participants are aware of their roles and responsibilities.

Different agencies and organisations will have their own policies and procedures for documentation, but they will generally require all information to be stored in a secure manner (for example, accessible only by authorised staff) and in line with all statutory privacy requirements.

Check your understanding of the content so far!

In this section of the module, you learned about some of the key considerations involved in conducting a case management meeting, including how to plan and facilitate a case conference involving all stakeholders in the case management process. You also learned about important strategies for effective information sharing with clients in the context of both giving and receiving information, key processes for managing roles and boundaries, and the importance of respecting the rights of different parties within the case management process. You also learned some tips to help resolve conflict and how to document the outcomes of case management meetings. In the next section of this module, you will learn about monitoring and reviewing case work activities and processes.

Guzys, D. & Petrie, E. (2014). An introduction to community and primary health care in Australia. Cambridge University Press.

Laird, E., & Holcomb, P. (2011). Effective Case Management: Key elements and practices from the field. Washington, DC: United States Department of Labor.

Mullahy, C. (2010). The case manager’s handbook. Burlington, MA: Jones & Barlett.

Seabury, B., (2010). Foundations of Interpersonal Practice in Social Work: Promoting Competence in Generalist Practice. Sage.

Summers, N. (2016). Fundamentals of Case Management Practice: Skills for the Human Services. (5th ed.). Boston, MA: Cengage Learning.