Singin' the Texas Blues
A ship in harbour is safe - but that is not what ships are for - Unknown
My favorite moment at the AOTA Conference this past week was when a student told me that she and one of her classmates are so excited about what they'd learned in school about case management, they're going to make sure their OT jobs prepare them for that advanced practice specialty.
I wish every OT practitioner had such enthusiasm for case management, even if "only" as an integral part of his/her practice at any stage of his/her OT career. Many of the practitioners who spoke with me at the exhibit for the Commissioner for Certification of Case Managers (CCMC) indicated that they might consider case management when they get "too old" for the physical demands of their current OT practices. Although that's certainly a worthwhile consideration - sort of an "aging in OT place" strategy, I suppose - I felt kind of sad that case management would be considered a "last resort" full-time practice instead of something an OT would do while still in his/her professional prime.
Perhaps some of the differences in perspectives can be attributed to how one interprets the "doing" of case management, and therefore, who "does" what in any given multi-/inter-disciplinary intervention plan. An OT clinician might not "do" the same case management tasks as the "actual" case manager(s) involved in a case; but that doesn't mean the clinician isn't doing any case management. There can be multiple case managers involved in with an individual client; and each CM can have different roles and responsibilities. Hopefully they all talk to each other to determine who is in the best position to "do" whatever needs to be done within each one's particular CM context.
Even if there is only one CM involved, s/he can delegate many "doings" to other team members. Why can't some of the delegation be in the other direction: from an OT who has identified certain case management issues and works it out with other team members throughout the service continuum - on who is in the best position to follow through on addressing the issues? An OT's case management approach to issues can be particularly effective if no "official" case manager happens to be involved. But even when one or more CM is involved, an OT communicating with them in CM terms and contexts can often get more across about the significance of occupation than when staying within one's traditional activity patterns.
Gupta & Wallock (2006)1 emphasized that OTs can [and should] deliver services that "...transcend...systemic barriers...." Incorporating the core components of case management into all practices increases the transcendent effectiveness of OT.
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1 Gupta, J. & Walloch, C. (2006) Process of Infusing Social Justice Into the Practice Framework: A Case Study OT Practice, August 28: CE-1-CE-8.