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DIARY OF A SOCIAL WORKER.

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Home visits vs. office visits in case management effectiveness.


When it comes to client meetings, the ones we do as part of our housing case management can be divided into three categories: offices visits, home visits and telephone conversations (and sometimes, though rarely, communication via email messages.) In any event, communication with the client on a regular basis is very important. In some cases, clients may need intense case management due to the issues they are dealing with, and some clients may be what Ive termed "low maintenance" in that they are pretty well self-sufficient and require very little intervention on the part of the case manager. Since becoming a professional social worker, its always been my philosophy that clients who are doing what they need to do to maintain their service plan dont need a case manager constantly hovering over them. I keep my contact at a monthly basis (although I am always available for them to call) as I know they have lives to lead and may not always have the time to meet more than once a month. This is especially pertinent if they are working full time; I wouldnt want them to miss work just to visit with a case manager unless there is something serious to take care of. In the case of clients needing the intense case management, its a different story. Meetings (or at a minimum, contact by phone) are held weekly until the particular issue is resolved or on its way to being resolved. The issue is usually something that can potentially greatly affect their service plan, such as (in the case of our housing case

management) unemployment, inability to pay rent or utilities, medical or mental health emergencies, and so on. So its easy to see how important it is to manage the timing of client interaction, but what about the place where interactions happen? Is there really a difference whether you meet a client in their home or your office? To begin with, our case management starts out at the shelter to get into our program, clients are required to be homeless and living in a shelter, sometimes not always ours. The first few meetings will take place in the office so that the initial assessment and paperwork can be done to open the case. Sooner or later, if all goes well, the client will be in their new home. Initial home visits, once the client does move into housing, are mandatory as are monthly home visits for the first few months when clients are in HUD subsidized housing, but eventually the case manager gets to decide whether and how often to do a home visit. So again I propose the question: does it make that big of a difference where a case manager meets a client in continuing the case work? Is an office visit as effective as a home visit or vice-versa? Lets look at the advantages and disadvantages of each. Advantages, office visit:

Case manager (CM) has all their tools at their immediate disposal a computer to look up resources, rolodex of existing resources, access to case management supervisor if needed, etc. Also, copier, fax, etc. Safety of office (office set up, more people around, etc.) No travel for the CM, thus more time for other tasks. (Usually) less distractions for the meeting, as the office door can be closed if needed. Disadvantages, office visit:

The client has to take the time to travel. This can be especially difficult for disabled clients or clients unable to take the bus due to physical or psychological issues.

The client has to sit in a waiting room and be in the CMs environment, as opposed to their own. The client has to return to the shelter where the office is, which may dredge up unpleasant memories. The CM is unable to see the condition of the clients home which may be a problem. Advantages, home visit:

More convenient for the client, no travel time for them. More comfortable environment in terms of places to sit (if the client has furniture) and more relaxed for the client. Less sterile than an office environment. Usually less distractions than an office environment, but see disadvantages too. Client has more access to personal papers if needed by the CM (i.e., info from a lease.) CM is able to monitor the physical condition of the clients home as well as the environment (any drug dealers living there? Is the environment safe for the kids, if present?) Disadvantages, home visit

Could potentially be unsafe for the CM. May be other distractions that can interfere with the work rowdy kids, scary dogs, loud TVs. CM is away from their resources (unless they carry an iPhone or laptop.) Travel time for the CM. Also, what if the client isnt home at the appointed time? So there are obviously advantages and disadvantages to each type of visit. Where does effectiveness come into play? The answer seems to lie in the advantages of each and matching those up with where the client is in the case management process. If a client is getting more intense case management, perhaps home visits would work out better if, for example, the case manager needed to monitor the home environment more often. While clients who may be low maintenance

require less communication with the case worker, its still a good idea to analyze which of the two types of visits work out best, especially if a client happens to work or go to school particular hours of the day. I guess the thing to take away from this is that the social worker using discretion about the location of a scheduled visit with a client is an important part of being where a client is (no pun intended,) which is an important part of Social Work. Agency policies and other factors aside, it would be really easy for a case worker to just expect a client to show up at the office for every meeting and not make the effort to accommodate a client where they can. But you can bet they would have a lot of issues with client non-compliance like missed appointments and clients not following up on case plan goals. Tags: client preferences, home visits, office visits, Social work practice
This entry was posted on Sunday, August 8th, 2010 at 2:40 pm and is filed under Social work practice, The Social Worker as a human being. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

2 Responses to Home visits vs. office visits in case management effectiveness.


1.

Brandilynn says:
August 15, 2010 at 9:47 am Thank you for the useful information. I am collaborting information until I graduate. I am getting my Assocs in Early Childhood Development and just became intersted in Social Work.

2.

Dave says:

August 15, 2010 at 9:10 pm Hi Brandilynn, hopefully the blog can give you a good idea of what a social worker deals with and the kind of things social workers have to think about. If you do go to school for social work keep us posted on your progress and experiences.

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