Methods of Delivering Case Mgt – Scenario PracticeHomework in WEEK 4
???? Sample Case Scenario for Intake Practice
Client Name: Ms. T.
Age: 26
Family Status: Single mother of two children, ages 4 and 7
Presenting Situation:
Ms. T. was recently evicted from her apartment due to falling behind on rent. She is currently staying with a cousin in a crowded two-bedroom home. She works part-time as a cashier but has missed several shifts because of childcare difficulties. Her employer has warned her about excessive absences, and she fears losing her job.
Worries about providing stability for her children.
- Reports feeling anxious and “like a burden” to her cousin.
- Requests information about affordable childcare and housing options.
Observation Notes:
Ms. T. appeared tired, anxious, and apologetic throughout the interview. She avoided eye contact at times but was cooperative and open when asked questions.
???? Student Instructions
Pretend you are the case manager and complete the form using the details above.
- In the "Additional Notes" or "Reflection" section, write 1–2 paragraphs explaining:
- Two supportive responses you would use to build trust with Ms. T.
- One poor response you would avoid, and why it could harm the client relationship.
ase Management Intake Form
Client Information
Client Name:
Client ID/Case Number:
Date of Birth:
Age:
Gender:
Address:
Phone Number:
Email:
Emergency Contact (Name & Phone):
Presenting Problem
Describe the client’s primary concerns or reasons for seeking services:
Background Information
Household/Family Composition:
Employment/Income Status:
Education:
Medical History:
Mental Health History:
Substance Use History:
Legal Issues (if any):
Support Systems (family, friends, community):
Client Strengths and Resources
Identify personal strengths, skills, or resources the client can draw upon:
Client Goals
List the client’s immediate and long-term goals:
Case Manager Observations
Record observations of client’s appearance, mood, and engagement during intake:
Plan / Next Steps
Outline agreed-upon next steps, referrals, or resources to be provided:
Signatures
Client Signature: ___________________________ Date: ____________
Case Manager Signature: _____________________ Date: ____________Client’s Concerns (from the interview):
