Case Management and Wrap-Around Services

Are both person-centered approaches designed to provide comprehensive and coordinated support to individuals with complex needs, particularly in the fields of addiction recovery and mental health. While closely related and often used in conjunction, they have distinct characteristics and philosophies.

Case Management:

Definition: Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.

Key Characteristics in Addiction Recovery/Mental Health:

• Individualized Plans: Case managers work with clients to develop personalized care plans based on their unique needs, strengths, challenges, and goals.

• Holistic Approach: They address not just the addiction or mental illness, but also other life domains that impact recovery, such as housing, employment, education, legal issues, physical health, social support, and family dynamics.

• Coordination of Services: A central function is to connect clients with various service providers (therapists, doctors, vocational trainers, housing agencies, legal aid) and ensure these services are integrated and work together effectively.

• Advocacy: Case managers advocate on behalf of their clients to navigate complex systems (healthcare, social services, legal) and access necessary resources.

• Monitoring and Adjustment: They continuously monitor the client's progress, identify any barriers or setbacks, and adjust the care plan as needed to ensure ongoing support and successful outcomes.

• Continuity of Care: Case managers often follow clients through different stages of their recovery journey, from initial assessment through treatment, aftercare, and long-term sobriety.

• Accountability and Support: They provide a consistent point of contact, offering emotional support, guidance, and holding clients accountable for their recovery goals.

Types of Case Management Models:

• Brokerage/Generalist: Focuses primarily on referring clients to appropriate services.

• Strengths-Based: Emphasizes identifying and building upon a client's inherent strengths and resources.

• Assertive Community Treatment (ACT): An intensive, community-based model for individuals with severe mental illness, involving a multidisciplinary team providing services directly in the community.

• Clinical/Rehabilitation: Combines case management functions with therapeutic interventions and skills training.

Wrap-Around Services (or Wraparound):

Definition: Wrap-Around is an intensive, individualized, team-based, and strength-based process designed to help individuals (often children, youth, and their families, but increasingly adults) with complex emotional, behavioral, or substance use challenges, achieve positive outcomes and remain in their homes and communities. It's a philosophy and a planning process, not a specific set of services.

Key Characteristics (Distinguishing it from traditional Case Management):

• Team-Based Approach: This is the hallmark of wraparound. A "Wraparound Team" is formed, including the individual (and family, if applicable), natural supports (friends, relatives, teachers, mentors), and formal service providers (therapists, doctors, probation officers). Everyone collaborates equally.

• Family Voice and Choice: The individual and family's perspectives, preferences, and cultural values are central to every decision. They are in the "driver's seat" of their own care plan.

• Strength-Based: The planning process explicitly focuses on identifying and leveraging the individual's and family's strengths, skills, and resources, rather than solely focusing on deficits.

• Individualized and Unconditional: The plan is completely customized to the unique needs of the individual and family, not a pre-packaged program. The team commits to supporting the family unconditionally, adapting strategies as needed, even in the face of challenges or setbacks.

• Community-Based: Services and supports are primarily delivered in natural community settings (home, school, neighborhood) rather than solely in clinical environments. This strengthens natural supports.

• Holistic and Comprehensive: Like case management, it addresses all life domains, but with an explicit focus on integrating formal services with informal, natural supports.

• Outcome-Based: The team sets clear, measurable goals and regularly monitors progress, adjusting the plan based on whether outcomes are being achieved.

• Phased Process: Wraparound typically follows distinct phases: engagement and team preparation, initial plan development, plan implementation, and transition planning.

• Care Coordinator/Facilitator: A trained "Wraparound Facilitator" or "Care Coordinator" guides the team process, ensuring fidelity to the wraparound principles.

Overlap and Synergy:

• Case management is often a component within a wrap-around service model. A wraparound facilitator might perform case management functions, but within the broader, team-driven, family-centered, and strengths-based framework of wraparound.

• Both aim for holistic support, improved outcomes, and reduced reliance on restrictive, expensive interventions (like hospitalization or incarceration).

• Both emphasize collaboration and coordination to prevent fragmentation of services.

In essence, while case management focuses on coordinating services for an individual, wrap-around services take that concept further by formally engaging a multi-disciplinary team, emphasizing the voice and choice of the individual/family, building upon strengths, and integrating natural supports for truly comprehensive, community-based, and sustainable change.