"You don't want anyone who hasn't been through anything telling you what to do,because how do they know?": Qualitative analysis of case managers in a hospital-based violence intervention program

• Authors: Hannah C. Decker, University of California San Francisco; Gwendolyn Hubner, University of California San Francisco; Adaobi Nwabuo, University of California San Francisco; Leslie Johnson, Emory University; Michael Texada, University of California San Francisco; Ruben Marquez, University of California San Francisco; Julia Orellana, University of California San Francisco; Terrell Henderson, University of California San Francisco; Rochelle Dicker, University of California Los Angeles; Rebecca E. Plevin, University of California San Francisco; Catherine Juillard, University of California Los Angeles
• Journal Title: PLOS ONE
• Volume: Volume 15, Number 6
• Publisher: PUBLIC LIBRARY SCIENCE | 2020-06-24, Pages e0234608-e0234608
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1371/journal.pone.0234608
• Subjects: Health Sciences, Medicine and Surgery; Health Sciences, Health Care Management
• Keywords: Science & Technology; Multidisciplinary Sciences; Science & Technology - Other Topics; REINJURY; INJURY

Abstract

STATEMENT OF PURPOSE: Intentional violent injury is a leading cause of disability and death among young adults in the United States. Hospital-based violence intervention programs (HVIPs), which strive to prevent re-injury through intensive case management, have emerged as a successful and cost-effective strategy to address this issue. Despite the importance of strong therapeutic relationships between clients and their case managers, specific case manager behaviors and attributes that drive the formation of these relationships have not been elucidated. METHODS: A qualitative analysis with a modified grounded theory approach was conducted to gain insight into what clients perceive to be crucial to the formation of a strong client-case manager relationship. Twenty-four semi-structured interviews were conducted with prior clients of our hospital's HVIP. The interviews were analyzed using constant comparison method for recurrent themes. RESULTS: Several key themes emerged from the interviews. Clients emphasized that their case managers must: 1) understand and relate to their sociocultural contexts, 2) navigate the initial in-hospital meeting to successfully create connection, 3) exhibit true compassion and care, 4) serve as role models, 5) act as portals of opportunity, and 6) engender mutual respect and pride. CONCLUSIONS: This study identifies key behaviors of case managers that facilitate the formation of strong therapeutic relationships at the different stages of client recovery. This study's findings emphasize the importance of case managers being culturally aligned with and embedded in their clients' communities. This work can provide a roadmap for case managers to form optimally effective relationships with clients.