By Chris Baker
Posted in Mental Health Resources
In the world of behavioral health management and navigation, many words, titles, and phrases are commonly utilized that may be confusing to the untrained ear. It is often the case that professionals working within this area of work so commonly use industry-specific terminology because they are trained to understand the definition(s). An unintended consequence of “throwing around” terms such as “case management” or “therapy” may be that the persons utilizing such services may not fully understand the distinction between the two.
Any quick internet such can produce varying definitions of the terms case management and therapy (or talk therapy more specifically). Generally, the same is true of any professional working within the field; you can ask one case manager or therapist their definition of the term/title, and it is more likely than not that you’ll receive two different answers. Being in a position where I have worked both as a case manager and a therapist, it is important to explain the differentiation of the two.
What is Therapy?
Therapy is the exchange of conversation with a trained mental health clinician and a client where the client is assisted in the navigation of feelings, processing of thoughts, mitigation of inter or intrapersonal dilemmas, exploration of new ways to cope, as well as, other conversational processes.
Specifically, licensed and trained therapists utilize psychological methods and treatment modalities that are evidence-based and proven to help mitigate specific symptoms related to diagnoses or the co-morbid relationship between specifics diagnoses. For example, a therapist may utilize Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy, Acceptance and Commitment Therapy (ACT), Motivational Interviewing (MI), Cognitive Processing Therapy (CPT), Trauma-informed narrative therapies, among many other treatment approaches. Some therapists specialize in one treatment modality and work specifically with clients with particular diagnoses where others are cross-trained and can generally utilize different modalities.
Therapy is provided by licensed and trained clinical practitioners who have gone through extensive academic and experiential training. To provide therapy in a professional setting requires licensure and is one of the most significant factors that separate therapists from case managers. For example, a therapist who can provide direct 1:1, group therapy, couples, family, etc. must hold a clinical license of some sort (e.g., Ph.D., PsyD, LICSW, LMHC, LCDP, etc.). Whereas, a case manager may not hold a formal degree that specifies that they are a case manager; rather, they are likely the recipient of an associate or bachelor’s degree and receive extensive training in the case management realm.
What is Case Management?
Case management is as the coordination of services within a community or communities that a trained professional assists an individual or family with navigating and acquiring. Case managers work with their clients to explore what resources they may need, want, or be required to access. The case manager helps that person optimize their health, whether or not it is their psychosocial health, behavioral and emotional health (including substance use issues), or medical health. It sometimes is a combination of resource acquisition that a case manager assists their client with. It is essential to point out, however, that much like therapy, individual case managers are experts and trained in areas whether others with the same title may not be. For example, within hospitals and healthcare organizations, Registered Nurses (RN) may function as a nurse case manager who is responsible solely for the navigation of the medical system for their patients. Case Management is a role that requires creativity, resourcefulness, and skillful networking.
The Differences between Case Management and Therapy
- In case management, the provider can be a bit more directive in their approach to working with the client whereas in therapy, the clinician helps guide the process but is oftentimes less directive.
- Case Managers are often the “glue” that holds the client team and team member(s) together (i.e., case managers often facilitate conversations among providers, coordinate care, etc.). Therapists, in most cases, although they often interface with case managers, may not be the central “player” in facilitating communication on behalf of their client.
- Case Managers often develop a case management plan that envelops multiple layers or “buckets” in their client’s life (e.g., emotional, mental, physical, occupational, relational, etc.).
- Therapists work with their clients to help identify very specifics feelings, thoughts, behaviors, symptoms, and processes in an attempt to assist the client in processing these. The aim of both these services is to improve overall functioning in personal life, family life, and within relationships.
The Similarities Case Management and Therapy
- Case managers and therapists should operate from a client-centered or person-centered perspective. For example, the case manager or therapist should not develop plans or courses of action based solely on their (the provider’s) perspective. Engagement with clients must put the client first. Collaboration is a central theme for case managers and therapists.
- Case managers and therapists work on the client’s behalf to assist with living their best life through specific processes that the respective provider is trained to utilize.
- Case managers and therapists can both navigate behavioral health systems and, although sometimes from different vantage points, both bring unique approaches to connecting their clients to “resources”.
In a rather simple form, a case manager is trained to help clients access “external resources,” whereas a therapist is trained to help clients access “internal resources.” Although case management can feel very therapeutic, it is not therapy.
Case managers and therapists both play an integral role in the life of the individuals with whom they work, and the work conducted by both professions is, at the very least, commendable.
Meet the Author
Christopher Baker, LICSW, is OPG’s Assistant Chief of Clinical Operations. Chris received his undergraduate education at The University of Rhode Island where he double majored in Political Science and Sociology. Upon completion of his undergraduate studies, Chris pursued a Master’s degree in Clinical Social Work from Rhode Island College where he completed field work at the Rhode Island Public Defender and worked with clients suffering from chronic substance use and other behavioral health disorders. In Providence, Chris completed further clinical training through the United States Department of Veterans Affairs, Providence VA Medical Center where he studied and was trained in working with individuals suffering from severe and persistent psychiatric diagnoses including, but not limited to, Schizophrenia, Bipolar Disorder, and Major Depressive Disorder. After graduate school, Chris provided consultation to a private health care company on managing the clinical care of the veteran population within their facilities. While in this position, Chris developed systems processes to coordinate veteran care in a clinically-appropriate and policy-informed manner. Chris has professional experience in inpatient psychiatric settings, partial hospitalization settings, community mental health and most recently as a therapist in private practice. In order to best assist individuals in improving their lives, Chris believes that individual evolution is the product of a collective process. In his work, Chris is a strengths-based and client-centered provider who utilizes treatment modalities that include Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Motivational Interviewing. When Chris is not fully engaged in his work, he enjoys playing golf, being outdoors and valuing the time that he spends with his family and friends.