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Understanding the role of individual consumer-provider relationships within assertive community treatment
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A change from an individual model of case management to a team model has occurred due to the broad adoption of assertive community treatment. The change has had implications for relationships between case managers and consumers, but still not much is known about how these relationships develop in teams. This exploratory mixed methods study investigated how case managers and consumers negotiate individual relationships within a team model. Quantitative methods identified both high and low service intensity relationships between case managers and consumers and qualitative methods examined and compared these relationships. Consumers in high service intensity relationships described a preference for certain case managers and the difficulty of working with multiple people. Case managers invested high service intensity relationships with special therapeutic value, articulated the challenges of coordinating care across the team, and utilized team limit setting techniques. In contrast, low service intensity relationships were more likely to reflect entire team integration. Findings suggest that teams need to consider how individual relationships enhance care for their consumers and how to nurture these relationships while maintaining the support necessary for case managers and consumers.
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A program of the U.S. Department of Health and Human Services Substance Abuse & Mental Health Services Administration, Center for Mental Health Services