The Looking-Glass Self: Looking at Relationship as the Mechanism of Change in Case Management of Persons with Severe Mental Illness

Abstract

Community mental health case management has been an important source of support for persons living with a severe mental illness (SMI) since the shift from hospital-based to community-based services, and it is considered to be a central component of the recovery-based model of care. Fostering a strong and positive relationship between case managers and consumers is important to good case management practice. The ascendance of recovery in the mental health paradigm has invigorated the need for collaborative relationships that open up space for consumers to move toward recovery. UsingCooley's metaphor of the looking-glass self, we examine the consumer-<ase manager relationship and how it helps create a new, recovery-oriented self in SMI consumers. Understanding this relationship as an important mechanism of change provides a useful model for understanding the impact of case managers on the lives of SMI consumers.

Community Mental Health Services for Frequent Emergency Department Users

“…The therapeutic relationship was characterized as being relationally warm, compassionate, authentic, trusting, nonjudgmental, patient, and consistent. This conforms to long-standing research findings regarding the importance of therapeutic alliance and other interpersonal relationships in the lives of mental health service users (Crits-Christoph & Connolly Gibbons, 2021; Kidd et al., 2017; Kondrat & Teater, 2012; Napierala et al., 2022; Roebuck et al., 2022). Furthermore, practical skills development (e.g., stress management, coping strategies, problem-solving) is a common mechanism of change identified in outcome studies (Crits-Christoph & Connolly Gibbons, 2021; Mueser et al., 2002).…”

Tangible Needs and External Stressors Faced by Chinese American Families with a Member Having Schizophrenia

“…Intervening at this level not only alleviates the families' immediate stress, but also increases their confidence in the clinicians' helpfulness and competence, thereby increasing their openness to address other psychosocial issues, which would facilitate patient recovery ( Kondrat & Teater, 2012).…”

Walking a Tightrope: Case Management Services and Outpatient Commitment

“…Likewise, Angell and Mahoney (2007), again drawing a contrast, suggested, ''Unlike psychotherapists, case managers may perceive that the mental health system assigns them full responsibility for the safety and wellbeing of their clients, which translates into pressure to ensure that clients follow treatment recommendations'' (p. 174). These observations underscore that the functions and responsibilities entrusted to case managers are broad, and accordingly, the relationship skills needed in daily practice are highly nuanced (Angell & Mahoney, 2007;Kondrat & Teater, 2012;Sullivan & Floyd, 2012). Successful case managers must first engage clients in service, form a relationship, and from there, some would posit that the primary task is to follow the lead of the client (Rapp & Goscha, 2006).…”