Case management: M4 Discussion: Crisis Intervention


Please be sure to read the M4 Meet Johncontent guide along with the assigned readings before beginning this discussion.

Your client John is in crisis. You have been asked to step in and assess the situation and refer your client to a safe situation. There are challenges when dealing with a crisis. This module assists you in understanding your role and responsibility as the case manager while ensuring your client’s safety. Please be sure to review all readings and Instructor Commentary before completing this task.The Scene

You return to work on Monday to find two messages from John’s wife, Melissa. The first message which on Friday is:

“Hi ___________, this is Melissa. I wanted to call you to let you know that John has been really funky lately. So much so that I felt like I needed to get my kids out of here. They are with family. He has been really down lately and has not been sleeping. I wanted to call and let you know that I am going to call the VA and he will probably be there on Monday. He has been really weird and I have never seen him like this before. I will call you after I take him to the hospital.”

Sunday, Melissa leaves another message:

“Hi _________, this is Melissa. I just wanted to let you know that I called the VA and they said they had no beds and that I should take John to the ER. John refused to go and said that he just needed some sleep and he didn’t need to be with a bunch of crazy people. All day yesterday he really tried to be a little upbeat and things seemed okay. I just wanted to let you know that he didn’t go to the hospital.”

As you get ready to return Melissa’s phone call, your phone rings. It is Melissa, and she states that John never went to bed that night, and in the morning she found him in a daze in his underwear sitting on the front stoop in the pouring rain. She tried to talk to him but he just shook her off, saying he just wanted to think about things and that it was too hot in the house. The outside temperature is 60 degrees. She is crying and she does not know what to do. As she talks on the phone with you, John comes into to the house and goes to sleep on the couch.

You figure you have some time to get there. She asks you to come over to talk with him. You decide to go there.

Once you get there John is angry, stating that no one is helping him that the more he tries to help himself the less anything gets done. He rants that his wife is demeaning to him and puts him down and blows everything out of proportion. That you, his case manager believe everything his wife says and give no value to his input. Utilizing concepts in the text of offering point of view and empathy and respect try to diffuse the situation:

  • How might you become defensive? Based on the text, how would you deal with feeling defensive?
  • According to the text, what should you “not ” do in trying to deescalate the situation?
    • What discrepancies might you anticipate in the future and how might you address them?
  • What are some ethical considerations (privacy, confidentiality and others) that apply to this case and generally, to the field of Case Management?
  • Please examine John’s anger and how your own personal perceptions (counter transference) could influence the services provided.