Question:
hi there! <—is all happy cuz she wrote a huge paper on case mgmt stuff. if u live in the US, there *should* be a system in place in your area to help ppl in your situation. <boring stuff alert the process of deinstitutionalization (i had that programmed in Word so all i had to type was "deinst" and it filled in the rest. 
) in the 1960 resulted in a large number of ppl being released into society without adequate supports and/or skills in daily living. Thus the recidivism rate (*hee* i sound all smart. ) <good grief (*hee!*) was quite high, and a revolving door kinda system arose with former residents of m.h. facilities living on their own for a bit, decompensating, being readmitted and stabilized, then released again. Since this wasn’t helpful to anybody (and *still* cost a lotta loot, which is what the gov’t was trying to address with deinst in the first place), a plan was enacted to establish adequate support networks in the community. The plan for these support networks was to provide comprehensive assistance across a wide spectrum of problems, including thpy, crisis services, inpatient, outpatient stuff, addictions tx, assisted living stuff, and case mgmt stuff. A case manager is a person whose job it is to assist with the problems of day-to-day living that might otherwise quickly overwhelm someone with a disability. Types of services provided by case managers include: coordinating with social service organizations to provide needed services, assisting with paperwork, assistance with medication management (ie: "didja take yer meds today? Why not?" It is my understanding that the Case Managers themselves do not provide assistance with *taking* the meds; merely with ensuring that one has access to meds (ie: scheduling appts with a pdoc, making sure one gets scripts, providing suggestions and limited assistance with getting the scripts filled, ensuring that one understands the dosage schedule and side-effects, etc.), then following through to verify that they’ve been taken, etc.), and other kindsa useful stuff that we were *gonna* let Luc write, but that we decided was too darned boring. besides, we figgered out what Luc was *trying* to get at, and figgered we may’s well just say that. important thing to note abt CM’s, in my experience (as an intern in a CM dept), is that CMs provide assistance with planning and follow-through, *NOT* necessarily with execution of needed tasks. planning, follow-through, and linkage. Linkage is the practice of identifying and contacting community resources that offer support to persons with disabilities. So, while a CM might not go grocery-shopping for one, the CM *might* be able to locate a non-profit organization or something that *does* offer that service, and link one with said services. The CM might not necessarily go with one (or take one, or however you want to look at it) to get their meds filled (though they also *might* do this – depends on the agency, and the case-by-case needs), they might call the pharmacy, alert them to the fact that their client is coming in, alert them to any issues the client might encounter (ie: "my client is mute today. So expect someone to come up to the counter, hand u a script, and not say anything. It would help a lot if u could just fill the script without acting like anything’s wrong. If there’s a problem, you may call me here. This is the script. This is the amt it’s written for. This is the doc’s name and address. This is the client’s prescription coverage. How much will the script cost? <checks with client to ensure that client has that amt available Is there any other information you would need in order to fill the script that I can give you that would make it easier on my client to get the script filled?" Please note that said exchange would require a release form for the CM to identify hirself to the pharmacist as the CM of the client.), and then check in with the client to ensure that they got the script and were able to take the meds as needed. In my personal opinion, CMs may have only limited value to persons with much-higher-than-average intelligence. This statement is not meant to imply that there are not CMs out there who provide outstanding care and support to highly-intelligent clients, etc. Merely that one’s expectations might quickly exceed the capabilities of the vast majority of CMs and CM facilities out there. This is due primarily to budgetary restrictions, high case loads, and the overwhelming burnout rate amongst such caregivers. IOW: the reality often far-outstrips the intent. Regardless, one might locate a Case Manager by contacting the crisis hotline in one’s area, or checking the phone book for a Community Mental Health Center. Admittedly, perhaps the *easiest* way to get a CM is to go inpatient for a bit… *coughs delicately*. In theory, one might be assigned a CM as part of the discharge process. However, one might maintain a bit more control by seeking out CM services voluntarily. (ie: "Look, I came here *looking* for help. I wasn’t mandated into tx. So stop treating me like a naughty child, and please help me find a way to deal with this situation.") regarding my poorly disguised cynicism and the afore-mentioned high burnout rate: there’s a reason I am not a practicing thpst. I was burned out b4 I finished my fieldwork. Merely was I smart enough to save myself and any clients I might have had the disappointment of discovering that I was useless to them. HTH jt (Luc, et al.) message t… – Hide quoted text — Show quoted text – Hi So I know from your posts that you’re a tpst and I’ve read how you came to asd and all. In another thread you said: I’m Miriam and I work as a case manager and therapist at a non-profit agency. Jill has mentioned this kind of work too. I don’t really understand how it works. How do people get a "case manager"? And do clients have any say in whether things are working out with that case manager or not? And can you get rid of one once you’ve got one or will you be obligated to work with them forever because now they’re assigned to you? I know I need additional assistance with things. Some days more than others. Therapists have been useless. -May sound harsh but it’s true. I know there are people (from what I’ve heard) who basically asess what you need and what you need help with and then try to fill those needs through referralls or networks or sometimes helping you themselves. I don’t know anything about how to get "one of those people" I"m also kind of affraid that if I did get someone it’d be someone who was a complete nightmare. I don’t completely understand how a case manager works (gets assigned, what power they have legally, medically etc.), but what if they wanted stuff for me that was detrimental (in my opinion) and insisted on it and then if I disagreed I’d lose benefits or I’d lose
credibility because of – Hide quoted text — Show quoted text – some strange note "in my file" or whatever. I’m concerned about these things because of negative experiences with therapists in the past and things people write on here that show that my experiences are not uncommon. And heck, my problems were with people I hired! -not people assigned to me. Sometimes I feel like what I’d need was a personal assistant who for whatever strange reason was totally comfortable and knowledgable about DID. -like THAT’s gonna happen! I mean that’s the problem… getting someone competent who can do what needs to be done (therapy, physical tasks like shopping if neccesary, research to find appropriate additional help if needed etc.),AND finding someone who will be ok with me as "me" without getting scared off or trying to commit me because they don’t know how to interpret what they’re seeing (a big fear of mine). I feel like no matter what I explain to people, no matter how I prepare them, no one could ever handle us
effectively. -From that – Hide quoted text — Show quoted text – description you’d think it’s some big scary thing where I sprout horns and start waving an axe around 
, but it’s not! More likely it’s the opposite. Complete withdrawl, Extreme agoraphobia, rocking and/or ticks and spasms (generally head/neck/wrist/arm) and going totally mute. THAT freaks people out. But I tell them. (if it’s a tpst I tell them probably everything. In a few rare cases I tried trusting "regular" people with small bits of information.) It generally happens gradually too. But people (and by that I mean mainly tpsts) don’t understand. I point out when its starting. It’s rarely a total suprise when it happens. It’s generally a stress/PTSD response. If things are getting overwhelming it’s usually not sudden. I see it coming. I tell them. If someone is ill or dying and it’s having an effect on me, that’s rarely sudden. I see that coming too. If two planes hit a building, I might no see it coming but it’s not too difficult to make an educated guess about how it’s going to affect me!!! But people don’t get it. They over react, they "under" react. I tell people what’s needed, and I think I’m very practical about it, but it doesn’t matter. I don’t have a family or friend support system that can fill in with daily help things when neccesary. Yes there’s asd and friends online and that’s helpful in certain areas, but I also need help with "non virtual" concrete practical things. Certainly there’s nobody who could make phone calls and find other resources or agencies or programs I might be entitled to get help from when needed. No one to help with forms or anything like that. I have to do all that. And I can’t always do it very well. It’s a lot of work. -it’s a *job* I’m sure there are places that do that, but I need someone who will make things easier in the end not turn my life upside down and make things
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Response:
Hi Luc et all for jt! I could have never explained it better!!!! I can tell you’ve really studied this in depth. I’ve been trying to figure the system out on my own (almost) for the years I’ve been working as a CM in this country. My training was in a different country, so it didn’t really help much regarding the way the system works here. Thanks! Miriam – Hide quoted text — Show quoted text – hi there! <—is all happy cuz she wrote a huge paper on case mgmt stuff. if u live in the US, there *should* be a system in place in your area to help ppl in your situation. <boring stuff alert the process of deinstitutionalization (i had that programmed in Word so all i had to type was "deinst" and it filled in the rest. ) in the 1960 resulted in a large number of ppl being released into society without adequate supports and/or skills in daily living. Thus the recidivism rate (*hee* i sound all smart. ) <good grief (*hee!*) was quite high, and a revolving door kinda system arose with former residents of m.h. facilities living on their own for a bit, decompensating, being readmitted and stabilized, then released again. Since this wasn’t helpful to anybody (and *still* cost a lotta loot, which is what the gov’t was trying to address with deinst in the first place), a plan was enacted to establish adequate support networks in the community. The plan for these support networks was to provide comprehensive assistance across a wide spectrum of problems, including thpy, crisis services, inpatient, outpatient stuff, addictions tx, assisted living stuff, and case mgmt stuff. A case manager is a person whose job it is to assist with the problems of day-to-day living that might otherwise quickly overwhelm someone with a disability. Types of services provided by case managers include: coordinating with social service organizations to provide needed services, assisting with paperwork, assistance with medication management (ie: "didja take yer meds today? Why not?" It is my understanding that the Case Managers themselves do not provide assistance with *taking* the meds; merely with ensuring that one has access to meds (ie: scheduling appts with a pdoc, making sure one gets scripts, providing suggestions and limited assistance with getting the scripts filled, ensuring that one understands the dosage schedule and side-effects, etc.), then following through to verify that they’ve been taken, etc.), and other kindsa useful stuff that we were *gonna* let Luc write, but that we decided was too darned boring. besides, we figgered out what Luc was *trying* to get at, and figgered we may’s well just say that. important thing to note abt CM’s, in my experience (as an intern in a CM dept), is that CMs provide assistance with planning and follow-through, *NOT* necessarily with execution of needed tasks. planning, follow-through, and linkage. Linkage is the practice of identifying and contacting community resources that offer support to persons with disabilities. So, while a CM might not go grocery-shopping for one, the CM *might* be able to locate a non-profit organization or something that *does* offer that service, and link one with said services. The CM might not necessarily go with one (or take one, or however you want to look at it) to get their meds filled (though they also *might* do this – depends on the agency, and the case-by-case needs), they might call the pharmacy, alert them to the fact that their client is coming in, alert them to any issues the client might encounter (ie: "my client is mute today. So expect someone to come up to the counter, hand u a script, and not say anything. It would help a lot if u could just fill the script without acting like anything’s wrong. If there’s a problem, you may call me here. This is the script. This is the amt it’s written for. This is the doc’s name and address. This is the client’s prescription coverage. How much will the script cost? <checks with client to ensure that client has that amt available Is there any other information you would need in order to fill the script that I can give you that would make it easier on my client to get the script filled?" Please note that said exchange would require a release form for the CM to identify hirself to the pharmacist as the CM of the client.), and then check in with the client to ensure that they got the script and were able to take the meds as needed. In my personal opinion, CMs may have only limited value to persons with much-higher-than-average intelligence. This statement is not meant to imply that there are not CMs out there who provide outstanding care and support to highly-intelligent clients, etc. Merely that one’s expectations might quickly exceed the capabilities of the vast majority of CMs and CM facilities out there. This is due primarily to budgetary restrictions, high case loads, and the overwhelming burnout rate amongst such caregivers. IOW: the reality often far-outstrips the intent. Regardless, one might locate a Case Manager by contacting the crisis hotline in one’s area, or checking the phone book for a Community Mental Health Center. Admittedly, perhaps the *easiest* way to get a CM is to go inpatient for a bit… *coughs delicately*. In theory, one might be assigned a CM as part of the discharge process. However, one might maintain a bit more control by seeking out CM services voluntarily. (ie: "Look, I came here *looking* for help. I wasn’t mandated into tx. So stop treating me like a naughty child, and please help me find a way to deal with this situation.") regarding my poorly disguised cynicism and the afore-mentioned high burnout rate: there’s a reason I am not a practicing thpst. I was burned out b4 I finished my fieldwork. Merely was I smart enough to save myself and any clients I might have had the disappointment of discovering that I was useless to them. HTH jt (Luc, et al.) message t… Hi So I know from your posts that you’re a tpst and I’ve read how you came to asd and all. In another thread you said: I’m Miriam and I work as a case manager and therapist at a non-profit agency. Jill has mentioned this kind of work too. I don’t really understand how it works. How do people get a "case manager"? And do clients have any say in whether things are working out with that case manager or not? And can you get rid of one once you’ve got one or will you be obligated to work with them forever because now they’re assigned to you? I know I need additional assistance with things. Some days more than others. Therapists have been useless. -May sound harsh but it’s true. I know there are people (from what I’ve heard) who basically asess what you need and what you need help with and then try to fill those needs through referralls or networks or sometimes helping you themselves. I don’t know anything about how to get "one of those people" I"m also kind of affraid that if I did get someone it’d be someone who was a complete nightmare. I don’t completely understand how a case manager works (gets assigned, what power they have legally, medically etc.), but what if they wanted stuff for me that was detrimental (in my opinion) and insisted on it and then if I disagreed I’d lose benefits or I’d lose credibility because of some strange note "in my file" or whatever. I’m concerned about these things because of negative experiences with therapists in the past and things people write on here that show that my experiences are not uncommon. And heck, my problems were with people I hired! -not people assigned to me. Sometimes I feel like what I’d need was a personal assistant who for whatever strange reason was totally comfortable and knowledgable about DID. -like THAT’s gonna happen! I mean that’s the problem… getting someone competent who can do what needs to be done (therapy, physical tasks like shopping if neccesary, research to find appropriate additional help if needed etc.),AND finding someone who will be ok with me as "me" without getting scared off or trying to commit me because they don’t know how to interpret what they’re seeing (a big fear of mine). I feel like no matter what I explain to people, no matter how I prepare them, no one could ever handle us effectively. -From that description you’d think it’s some big scary thing where I sprout horns and start waving an axe around , but it’s not! More likely it’s the opposite. Complete withdrawl, Extreme agoraphobia, rocking and/or ticks and spasms (generally head/neck/wrist/arm) and going totally mute. THAT freaks people out. But I tell them. (if it’s a tpst I tell them probably everything. In a few rare cases I tried trusting "regular" people with small bits of information.) It generally happens gradually too. But people (and by that I mean mainly tpsts) don’t understand. I point out when its starting. It’s rarely a total suprise when it happens. It’s generally a stress/PTSD
… read more »
Response:
Hi Luc et all for jt! I could have never explained it better!!!! I can tell you’ve really studied this in depth. I’ve been trying to figure the system out on my own (almost) for the years I’ve been working as a CM in this country. My training was in a different country, so it didn’t really help much regarding the way the system works here. Thanks! Miriam – Hide quoted text — Show quoted text – hi there! <—is all happy cuz she wrote a huge paper on case mgmt stuff. if u live in the US, there *should* be a system in place in your area to help ppl in your situation. <boring stuff alert the process of deinstitutionalization (i had that programmed in Word so all i had to type was "deinst" and it filled in the rest. ) in the 1960 resulted in a large number of ppl being released into society without adequate supports and/or skills in daily living. Thus the recidivism rate (*hee* i sound all smart. ) <good grief (*hee!*) was quite high, and a revolving door kinda system arose with former residents of m.h. facilities living on their own for a bit, decompensating, being readmitted and stabilized, then released again. Since this wasn’t helpful to anybody (and *still* cost a lotta loot, which is what the gov’t was trying to address with deinst in the first place), a plan was enacted to establish adequate support networks in the community. The plan for these support networks was to provide comprehensive assistance across a wide spectrum of problems, including thpy, crisis services, inpatient, outpatient stuff, addictions tx, assisted living stuff, and case mgmt stuff. A case manager is a person whose job it is to assist with the problems of day-to-day living that might otherwise quickly overwhelm someone with a disability. Types of services provided by case managers include: coordinating with social service organizations to provide needed services, assisting with paperwork, assistance with medication management (ie: "didja take yer meds today? Why not?" It is my understanding that the Case Managers themselves do not provide assistance with *taking* the meds; merely with ensuring that one has access to meds (ie: scheduling appts with a pdoc, making sure one gets scripts, providing suggestions and limited assistance with getting the scripts filled, ensuring that one understands the dosage schedule and side-effects, etc.), then following through to verify that they’ve been taken, etc.), and other kindsa useful stuff that we were *gonna* let Luc write, but that we decided was too darned boring. besides, we figgered out what Luc was *trying* to get at, and figgered we may’s well just say that. important thing to note abt CM’s, in my experience (as an intern in a CM dept), is that CMs provide assistance with planning and follow-through, *NOT* necessarily with execution of needed tasks. planning, follow-through, and linkage. Linkage is the practice of identifying and contacting community resources that offer support to persons with disabilities. So, while a CM might not go grocery-shopping for one, the CM *might* be able to locate a non-profit organization or something that *does* offer that service, and link one with said services. The CM might not necessarily go with one (or take one, or however you want to look at it) to get their meds filled (though they also *might* do this – depends on the agency, and the case-by-case needs), they might call the pharmacy, alert them to the fact that their client is coming in, alert them to any issues the client might encounter (ie: "my client is mute today. So expect someone to come up to the counter, hand u a script, and not say anything. It would help a lot if u could just fill the script without acting like anything’s wrong. If there’s a problem, you may call me here. This is the script. This is the amt it’s written for. This is the doc’s name and address. This is the client’s prescription coverage. How much will the script cost? <checks with client to ensure that client has that amt available Is there any other information you would need in order to fill the script that I can give you that would make it easier on my client to get the script filled?" Please note that said exchange would require a release form for the CM to identify hirself to the pharmacist as the CM of the client.), and then check in with the client to ensure that they got the script and were able to take the meds as needed. In my personal opinion, CMs may have only limited value to persons with much-higher-than-average intelligence. This statement is not meant to imply that there are not CMs out there who provide outstanding care and support to highly-intelligent clients, etc. Merely that one’s expectations might quickly exceed the capabilities of the vast majority of CMs and CM facilities out there. This is due primarily to budgetary restrictions, high case loads, and the overwhelming burnout rate amongst such caregivers. IOW: the reality often far-outstrips the intent. Regardless, one might locate a Case Manager by contacting the crisis hotline in one’s area, or checking the phone book for a Community Mental Health Center. Admittedly, perhaps the *easiest* way to get a CM is to go inpatient for a bit… *coughs delicately*. In theory, one might be assigned a CM as part of the discharge process. However, one might maintain a bit more control by seeking out CM services voluntarily. (ie: "Look, I came here *looking* for help. I wasn’t mandated into tx. So stop treating me like a naughty child, and please help me find a way to deal with this situation.") regarding my poorly disguised cynicism and the afore-mentioned high burnout rate: there’s a reason I am not a practicing thpst. I was burned out b4 I finished my fieldwork. Merely was I smart enough to save myself and any clients I might have had the disappointment of discovering that I was useless to them. HTH jt (Luc, et al.) message t… Hi So I know from your posts that you’re a tpst and I’ve read how you came to asd and all. In another thread you said: I’m Miriam and I work as a case manager and therapist at a non-profit agency. Jill has mentioned this kind of work too. I don’t really understand how it works. How do people get a "case manager"? And do clients have any say in whether things are working out with that case manager or not? And can you get rid of one once you’ve got one or will you be obligated to work with them forever because now they’re assigned to you? I know I need additional assistance with things. Some days more than others. Therapists have been useless. -May sound harsh but it’s true. I know there are people (from what I’ve heard) who basically asess what you need and what you need help with and then try to fill those needs through referralls or networks or sometimes helping you themselves. I don’t know anything about how to get "one of those people" I"m also kind of affraid that if I did get someone it’d be someone who was a complete nightmare. I don’t completely understand how a case manager works (gets assigned, what power they have legally, medically etc.), but what if they wanted stuff for me that was detrimental (in my opinion) and insisted on it and then if I disagreed I’d lose benefits or I’d lose credibility because of some strange note "in my file" or whatever. I’m concerned about these things because of negative experiences with therapists in the past and things people write on here that show that my experiences are not uncommon. And heck, my problems were with people I hired! -not people assigned to me. Sometimes I feel like what I’d need was a personal assistant who for whatever strange reason was totally comfortable and knowledgable about DID. -like THAT’s gonna happen! I mean that’s the problem… getting someone competent who can do what needs to be done (therapy, physical tasks like shopping if neccesary, research to find appropriate additional help if needed etc.),AND finding someone who will be ok with me as "me" without getting scared off or trying to commit me because they don’t know how to interpret what they’re seeing (a big fear of mine). I feel like no matter what I explain to people, no matter how I prepare them, no one could ever handle us effectively. -From that description you’d think it’s some big scary thing where I sprout horns and start waving an axe around , but it’s not! More likely it’s the opposite. Complete withdrawl, Extreme agoraphobia, rocking and/or ticks and spasms (generally head/neck/wrist/arm) and going totally mute. THAT freaks people out. But I tell them. (if it’s a tpst I tell them probably everything. In a few rare cases I tried trusting "regular" people with small bits of information.) It generally happens gradually too. But people (and by that I mean mainly tpsts) don’t understand. I point out when its starting. It’s rarely a total suprise when it happens. It’s generally a stress/PTSD
… read more »
Response:
*grins happily* yeah, every once in awhile i locate a stray factoid that i picked up in my 5 years of college, and i’m forced to acknowledge that perhaps i *did* learn *something* getting my 3 degrees. *grins happily again* *sigh* sometimes being co-conscious with a sprite is the pits. …great…now she’s dancing gaily in front of me to try to make me laugh… *lips quirk* i’d better lighten up quick – she’s about to pull out the big guns, and i don’t know what they are… Neither does she, for that matter, but it’s when she applies pressure to the "be a goof" part of the brain that truly bizzarre things start happening, so… good lerdy, i wasn’t fast enough… she’s riding a purple elephant in huge circles around me. she’s dressed in her white fringed cowgirl outfit and circling the hat in the air above her head. thanks, Glo…ya silly goof… later, ya’ll – blue n Gloriana fer jt 
*bounces happily* *good grief* *hee* *rolls eyes* [please, children, accept the fact that *somebody* has to get the last word...] *Glo and blue look at each other, look at Luc, look at each other again and grin, then tackle Luc and start tickling him* [ack! heav'n forfend!] *two huge grins*
– Hide quoted text — Show quoted text – Hi Luc et all for jt! I could have never explained it better!!!! I can tell you’ve really studied this in depth. I’ve been trying to figure the system out on my own (almost) for the years I’ve been working as a CM in this country. My training was in a different country, so it didn’t really help much regarding the way the system works here. Thanks! Miriam hi there! <—is all happy cuz she wrote a huge paper on case mgmt stuff. if u live in the US, there *should* be a system in place in your area to help ppl in your situation. <boring stuff alert the process of deinstitutionalization (i had that programmed in Word so all i had to type was "deinst" and it filled in the rest. ) in the 1960 resulted in a large number of ppl being released into society without adequate supports and/or skills in daily living. Thus the recidivism rate (*hee* i sound all smart. ) <good grief (*hee!*) was quite high, and a revolving door kinda system arose with former residents of m.h. facilities living on their own for a bit, decompensating, being readmitted and stabilized, then released again. Since this wasn’t helpful to anybody (and *still* cost a lotta loot, which is what the gov’t was trying to address with deinst in the first place), a plan was enacted to establish adequate support networks in the community. The plan for these support networks was to provide comprehensive assistance across a wide spectrum of problems, including thpy, crisis services, inpatient, outpatient stuff, addictions tx, assisted living stuff, and case mgmt stuff. A case manager is a person whose job it is to assist with the problems of day-to-day living that might otherwise quickly overwhelm someone with a disability. Types of services provided by case managers include: coordinating with social service organizations to provide needed services, assisting with paperwork, assistance with medication management (ie: "didja take yer meds today? Why not?" It is my understanding that the Case Managers themselves do not provide assistance with *taking* the meds; merely with ensuring that one has access to meds (ie: scheduling appts with a pdoc, making sure one gets scripts, providing suggestions and limited assistance with getting the scripts filled, ensuring that one understands the dosage schedule and side-effects, etc.), then following through to verify that they’ve been taken, etc.), and other kindsa useful stuff that we were *gonna* let Luc write, but that we decided was too darned boring. besides, we figgered out what Luc was *trying* to get at, and figgered we may’s well just say that. important thing to note abt CM’s, in my experience (as an intern in a CM dept), is that CMs provide assistance with planning and follow-through, *NOT* necessarily with execution of needed tasks. planning, follow-through, and linkage. Linkage is the practice of identifying and contacting community resources that offer support to persons with disabilities. So, while a CM might not go grocery-shopping for one, the CM *might* be able to locate a non-profit organization or something that *does* offer that service, and link one with said services. The CM might not necessarily go with one (or take one, or however you want to look at it) to get their meds filled (though they also *might* do this – depends on the agency, and the case-by-case needs), they might call the pharmacy, alert them to the fact that their client is coming in, alert them to any issues the client might encounter (ie: "my client is mute today. So expect someone to come up to the counter, hand u a script, and not say anything. It would help a lot if u could just fill the script without acting like anything’s wrong. If there’s a problem, you may call me here. This is the script. This is the amt it’s written for. This is the doc’s name and address. This is the client’s prescription coverage. How much will the script cost? <checks with client to ensure that client has that amt available Is there any other information you would need in order to fill the script that I can give you that would make it easier on my client to get the script filled?" Please note that said exchange would require a release form for the CM to identify hirself to the pharmacist as the CM of the client.), and then check in with the client to ensure that they got the script and were able to take the meds as needed. In my personal opinion, CMs may have only limited value to persons with much-higher-than-average intelligence. This statement is not meant to imply that there are not CMs out there who provide outstanding care and support to highly-intelligent clients, etc. Merely that one’s expectations might quickly exceed the capabilities of the vast majority of CMs and CM facilities out there. This is due primarily to budgetary restrictions, high case loads, and the overwhelming burnout rate amongst such caregivers. IOW: the reality often far-outstrips the intent. Regardless, one might locate a Case Manager by contacting the crisis hotline in one’s area, or checking the phone book for a Community Mental Health Center. Admittedly, perhaps the *easiest* way to get a CM is to go inpatient for a bit… *coughs delicately*. In theory, one might be assigned a CM as part of the discharge process. However, one might maintain a bit more control by seeking out CM services voluntarily. (ie: "Look, I came here *looking* for help. I wasn’t mandated into tx. So stop treating me like a naughty child, and please help me find a way to deal with this situation.") regarding my poorly disguised cynicism and the afore-mentioned high burnout rate: there’s a reason I am not a practicing thpst. I was burned out b4 I finished my fieldwork. Merely was I smart enough to save myself and any clients I might have had the disappointment of discovering that I was useless to them. HTH jt (Luc, et al.) message e t… Hi So I know from your posts that you’re a tpst and I’ve read how you came to asd and all. In another thread you said: I’m Miriam and I work as a case manager and therapist at a non-profit agency. Jill has mentioned this kind of work too. I don’t really understand how it works. How do people get a "case manager"? And do clients have any say in whether things are working out with that case manager or not? And can you get rid of one once you’ve got one or will you be obligated to work with them forever because now they’re assigned to you? I know I need additional assistance with things. Some days more than others. Therapists have been useless. -May sound harsh but it’s true. I know there are people (from what I’ve heard) who basically asess what you need and what you need help with and then try to fill those needs through referralls or networks or sometimes helping you themselves. I don’t know anything about how to get "one of those people" I"m also kind of affraid that if I did get someone it’d be someone who was a complete nightmare. I don’t completely understand how a case manager works (gets assigned, what power they have legally, medically etc.), but what if they wanted stuff for me that was detrimental (in my opinion) and insisted on it and then if I disagreed I’d lose benefits or I’d lose credibility because of some strange note "in my file" or whatever. I’m concerned about these things because of negative experiences with therapists in the past and things people write on here that show that my experiences are not uncommon. And heck, my problems were with people I
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