Implementing the Strengths Model of Case Management: Assessing Practice Three Years After Initial Implementation.

Area of Science:

• Mental Health Services
• Healthcare Management
• Social Work Practice

Background:

• Recovery-oriented practice emphasizes client strengths, yet implementing such models, like the Strengths Model of Case Management (SMCM), presents significant challenges.
• Assessing the fidelity and staff perceptions of SMCM is crucial for understanding its real-world application and effectiveness in case management teams.

Approach:

• This study involved 11 case management (CM) teams implementing SMCM over 36 months.
• Fidelity of SMCM delivery and staff perceptions were evaluated using the SMCM fidelity scale and the Readiness Monitoring Tool.
• Paired sample t-tests and adjusted regression analyses were employed to assess changes in fidelity and compare staff survey responses.

Key Points:

• Fidelity ratings showed significant improvement across all domains after 36 months of SMCM implementation.
• However, fidelity remained suboptimal in supervision practices and the consistent use of model-specific tools.
• Staff perceptions of SMCM were generally positive, though front-line staff consistently reported lower perceptions than management staff.

Conclusions:

• Implementing the Strengths Model of Case Management with good fidelity into existing practices is feasible.
• Strong management support appears critical for enhancing staff motivation and improving model delivery.
• Regular reviews of practice during implementation are vital for identifying sustainability challenges and guiding ongoing support efforts.