The_Case_Management_pptx. Explain case management

Case management

1. Case Management Managing Gender-Based Violence Programmes in Emergencies 1

2. Objectives Understand the case management process for support of survivors of GBV Understand how case management services can be tailored to survivors of different ages and to address different forms of GBV Understand the responsibilities of a GBV Programme Manager regarding case management supervision Consider ways to improve service coordination and to effectively advocate for appropriate response to GBV

3. What is GBV Case Management? A structured method for providing help to a survivor. It involves one organization, usually a psychosocial support or social services actor, taking responsibility for making sure that survivors are informed of all the options available to them and that issues and problems facing a survivor and her/his family are identified and followed up in a coordinated way, and providing the survivor with emotional support throughout the process.

4. Principles of Case Management The survivor is the primary actor The case management process should empower the survivor and ensure s/he leads Plans must reflect a survivor’s wishes and choices This requires… Individualized service delivery based on an Assessment of needs that is used to Develop a case plan that ensures Good coordination of service delivery

5. Case Management Process Steps of Service Delivery

6. 1. Introduction & Engagement Have you put the survivor at ease, introduced yourself and the services you offer? Greet and comfort the survivor. Establish rapport and obtain informed consent to proceed with CM services.

7. Informed consent The voluntary agreement of an individual who has the legal capacity to give consent. The survivor must: Have the capacity and maturity to know about and Understand the services being offered, and Be legally able to give her consent

8. When do we obtain informed consent? Before case management services begin= before listening to a story or gathering information Throughout the case management process When making referrals Before sharing any information on a case or meeting with other service providers

9. Confidentiality “Informed” consent includes information on confidentiality practices Limitations on confidentiality must be disclosed during Step 1. Limitations might include: Mandatory reporting laws SEA policy Fear of imminent security risks Fear of self harm or harm to others Information sharing among GBV team

10. 2. Assessment Why is the individual seeking assistance? Collect information using a survivor-centred approach What problems is she facing? How does she see her situation? What supports does she have? What assistance does she want? Listen. And help a survivor identify her problems and needs.

11. 3. Case Action Planning What does the survivor want to happen next? Develop a case plan based on the assessment Ask questions about what a survivor wants This may include personal goals related to return to normal activities, seeking support from friends, etc. Provide information on service options Provide information on processes, and likely outcomes, of different available services Obtain consent for referrals and documentation

12. 4. Implementing the plan How can we help a survivor achieve her goals? Provide services within scope of work (PSS support) Refer to other services, as requested Advocate for services, support Lead case coordination

13. 5. Case Follow Up Is the survivor reaching her goals? Is she recovering? Monitor outcomes with survivor Identify any barriers to achieving goals Adapt plan as needed

14. 6. Case Closure How do we know when the work is finished? Assess with survivor if her goals are met Assess with survivor if her own (normal or new normal) support systems are functioning Ensure any ongoing services are in place Ensure survivor has means of contact for any future needs

15. Service Evaluation at Case Closure What was the quality of the service? Determine if the client feel satisfied with the service Reflect on the service provided and any challenges that arose Assess whether best practices were followed

16. Case Management & Individualized Psychosocial Support

17. Benefits of GBV Case Management Approach Holistic Survivor-centered Restores some measure of control to the person affected Attentive to specific needs, risks related to GBV Skills not credentials: caseworker profile can vary, is adaptable

18. Case Management & Individual PSS Support GBV case management services that include focused, individualized support from providers familiar with common consequences of GBV should be offered as a first line of support . GBV caseworkers should work with survivors to identify and access support from family and/or social networks.

19. Time for Practice!

20. Who drives the process?

21. Case Management Intimate Partner Violence

22. Definitions Intimate Partner Violence (IPV) is an abuse perpetrated by a current or former partner or spouse. The term domestic violence is often used interchangeably. May include: physical sexual psychological violence as well as the denial of resources, opportunities or services

23. IPV

24. IPV Consequences

25. IPV: Cycle of violence

26. IPV: Types & Severity

27. Challenges: Case Management & IPV Continued risks (survivor & children) Security concerns (including staff/volunteers) Limited services, options Community tolerance Interest in finding “solutions”

28. Through the case management process, a survivor of IPV can… Receive validation and support Acknowledge patterns of abuse in relationship Determine limits and explore options Identify available services Enlist help of community leaders, others Link to support networks Develop safety plan

29. Safety Plan Safety plan is a specialised type of case plan aimed at reducing an individual’s risk of future incidents of GBV. An IPV safety plan is developed with a survivor to help keep her (and her children) safe from an abusive partner.

30. Through a Safety Plan a survivor of IPV can… Identify behaviors that precede a partner’s violent episodes Identify safest spaces in home Identify a person to tell, way to seek assistance Identify a safe space to go

31. Mediation Mediation is a voluntary process in which two or more parties involved in a dispute work with an impartial party , the mediator, to generate their own solutions in settling their conflict. Unlike a judge or an arbitrator whose decisions subject one party to win and the other party to lose, mediation is about finding a solution that works for both parties.

32. Mediation & IPV ? Key components of mediation   Risks represented in cases of IPV Requires equal power to bargain, discuss, compromise IPV is defined by unequal power, and the abuse of power over someone Impartial mediator Very difficult to find, particularly in contexts where men’s power over wives is expected. Solution found through compromise What should a survivor be asked to compromise? Seeks a solution that works for both parties The perpetrator seeks continued dominance and power. The survivor wants an end to the violence. What works here? Often done in private because it is considered a ‘private’ issue   Easier for the perpetrator to assert his power, blame survivor . Must not turn into a tactic for the perpetrator

33. Why mediation is not recommended for IPV Violence is ongoing but cyclical. Perpetrators may stop for long periods of time, where mediators will consider the issue “solved.” Safety risks heightened during/after process- for survivor and caseworker Process often blames the survivor for “causing” episodes. Survivor might be asked to adapt her behavious as condition to stop violence. Caseworkers involved risk losing trust of survivors, being perceived as siding with perpetrators. Involvement of GBV programmes can validate mediation as an appropriate intervention for IPV.

34. What if a survivor asks for mediation? Caseworkers should never mediate themselves. Caseworkers can act as advocates and support survivors before, during and after the mediation (depending on survivors’ interests, Caseworker’s comfort, safety, and organizational policies) Programmes can seek to influence mediators or mediation mechanisms, to improve process for survivors

35. More practice!

36. Case Management Child Sexual Abuse

37. Child Survivors of Sexual Violence Children experience different consequences to sexual violence than adults Children often express suffering differently than adults Reactions may be influenced by: Type of violence Duration Relationship to perpetrator Stage of development Support received

38. Definitions Child sexual abuse (CSA) is any form of sexual activity with a child by an adult or other child who has power over the child. Child sexual abuses often, but not always, involves bodily contact. Early/forced marriage (EFM) is a form of GBV that is linked to CSA (marital rape). Female genital cutting (FGC) is another form of GBV (and sexual violence) that is mainly perpetrated against children.

39. Child Sexual Abuse: Key Points Children face particular risks to GBV, due to their dependence, limited power, and vulnerability to exploitation, tricks, and coercion. Most CSA is perpetrated by people close to children Globally, girls are up to three times more likely to be victims of CSA Incidents involving survivors under 18 constitute roughly half the caseload of GBV programmes in humanitarian settings

40. Guiding Principles for Working with Child Survivors Promote the Child’s Best Interest Ensure the Safety of the Child Comfort the Child Ensure Appropriate Confidentiality Involve the Child in Decision- Making Treat Every Child Fairly and Equally Strengthen Children’s R esiliencies

41. Support for Young Children Is best provided by parents/ caregivers Requires special training The child’s wishes should be known Caseworkers can support parents/caregivers and offer tips on supporting children In cases of suspected abuse or neglect, the best interest of the child must be determined

42. Support for Adolescents Those working with adolescents should also be specially trained. Adolescents should be able to request and receive services. Adolescents should always be asked if they want a parent/ guardian present during any services. Adolescents should also be asked before disclosing any discussions to parents

43. Informed Consent & Informed Assent A child’s ability to provide consent on the use of the information and the credibility of the information will depend on their age, maturity and ability to express themselves freely. Informed assent is the expressed willingness to participate in services. This is sought when a child is too young to provide informed consent. If a decision is taken on behalf of the child, the best interests of the child shall be the overriding guide and the appropriate procedures should be followed.

44. Source: IRC, Caring for Child Survivors of Sexual Abuse

45. The BEST INTERESTS OF THE CHILD shall be a primary consideration in all actions affecting children. This means that when a course of action affecting a child is taken, that course of action should reflect what is best for that child. – Convention on the Rights of the Child

46. Legal Considerations Understand mandatory reporting requirements Does your country have mandatory reporting laws for child abuse cases? What information needs to be shared? How is confidentiality protected? What are the legal implications of not reporting? When is the obligation to report triggered? Be sure limits to confidentiality are disclosed during the first step of the case management process.

47. More practice!

48. Case Management Early/ Forced Marriage

49. Definitions Early marriage is a formal or informal union where one or both parties is under the age of 18. Forced marriage occurs at any age when at least one spouse does not offer full consent.

50. Early/Forced Marriage: Key Points In developing countries, one out of every three girls is married before age 18. Health risks of EFM (and early pregnancy) are severe. - Increased maternal mortality - Increased child mortality - Increased fistula - Increased HIV and STIs Relationships initiated through EFM are more likely to involve IPV.

51. Early Marriage Prevalence: Girls

52. Challenges: Case Management & EFM The practice is socially promoted and sometimes legally sanctioned Limited services, options Limited guidance for Caseworkers

53. Case Management: Imminent risk of EFM Apply appropriate informed consent procedures Assess Feelings about marriage Knowledge of possible consequences Family situation Engage supportive caregiver, if possible Approach in non-judgmental manner Provide information Link to other services, where relevant

54. Case Management: EFM Proceeding Maintain relationship with survivor Engage survivor to assess potential risks Develop safety plan Share SRH information, referrals Help to identify supportive person Help to develop coping strategies Help to maintain routines, connections– school, family, etc.

55. Case Management: EFM Has Occurred Assess situation and specific risks Develop safety plan Share information on consequences of early marriage, including SRH information and referrals Help survivor identify supportive person Help survivor develop coping strategies Link survivor to services, including group PSS activities

56. EFM: Additional programme options Target likely survivors of EFM through group activities Address risks of EFM through community prevention work Engage community leaders as allies Partner with SRH (ASRHR) programmes for prevention & response Partner with legal/advocacy actors to address laws/procedures

57. Case Management Service Coordination

58. Establishing Referral Systems Map and collect information on services Identify lead service providers per sector Establish focal points Establish agreements, SOPs Train and inform Collect feedback, review, and update systems

59. Service Referrals Caseworkers must understand the services available from other providers Programmes can ask other providers (focal points) to share brief points on services to relay to survivors Caseworkers must offer all options to survivors and help them weigh benefits and drawbacks, then respect their choices Caseworkers can coordinate with chosen service providers to support a client’s action plan, also according to a survivor’s wishes

60. Spaces for Coordination Protection Cluster/WG GBV Sub-Cluster/WG Referral pathway working groups (focal points) Case management meetings (ad hoc) Bilateral meetings between service providers

61. The GOAL of GBV Coordination To provide accessible, prompt, confidential and appropriate services to survivors according to a basic set of guiding principles and put in place mechanisms to prevent GBV. – GBV AoR Coordination Handbook

62. How to apply guiding principles when a survivor’s environment looks something like this?

63. More practice!

64. Case Management Supervision

65. To whom are GBV Programme Managers accountable? To whom are GBV Caseworkers accountable?

66. The core of GBV case management supervision is ensuring the physical and emotional safety of survivors, as well as caseworkers.

67. GBV Case Work Supervision Requires: Building case management systems that are safe, accessible and adapted to the environment Building and supporting case management teams with appropriate profile, skills and attitudes

68. Case Management: Strong Systems Entry points Service points Documentation procedures Referral and information-sharing procedures Monitoring, quality control Plans for close-out/handover/evacuation

69. Case Management: Strong Teams Recruitment Initial Training Continued learning and coaching Dedicated supervision Monitoring, quality control Team support and self-care

70. Review

71. Objectives Understand the case management process for support of survivors of GBV Understand how case management services can be tailored to survivors of different ages and to address different forms of GBV Understand the responsibilities of a GBV Programme Manager regarding case management supervision Consider ways to improve service coordination and to effectively advocate for appropriate response to GBV