1. CASE MANAGEMENT TRAINING PACKAGE
Module 5.
Network analysis for supporting
the Case Manager‟s work

2. Working in the Case Management perspective
CM uses a pro-active approach
(and not a reactive one)
An approach is action- That is: an action-
oriented when it is oriented approach
community-based
But…
what is COMMUNITY?
Case Management – module 5 – slide 2

3. The community
The COMMUNITY can be defined as
a “group of human beings with a common history”,
where continuous relationships and exchanges take
place based on economical, material, social and
cultural resources.
This group of people bases its relationship on trust,
and can cooperate
to create groups and networks to reach
common goals.
Case Management – module 5 – slide 3

4. The dimensions of a community culture (1)
The Community Culture is characterized by six dimensions:
1. Technological
2. Economic
3. Political
4. Institutional (social)
5. Aesthetic-value, and
6. Belief-conceptual.
• Each of these dimensions of culture is transmitted by symbols (not
genes) and consists of systems of learned ideas and behaviour.
• All of these are elements within every social (or cultural) system.
They are based on learned behaviour, which transcends the
individuals who learned each part. If any dimension of culture is
missing, by definition, all are missing.
Case Management – module 5 – slide 4

5. The dimensions of a community culture (2)
The Technological Dimension of Community:
The technological dimension of community is its capital,
its tools and skills, and ways of dealing with the physical
environment. It is the interface between humanity and
nature.
The Economic Dimension of Community:
The economic dimension of community is its various ways
and means of production and allocation of scarce and
useful goods and services (wealth), whether that is
through gift giving, obligations, barter, market trade, or
state allocations.
Case Management – module 5 – slide 5

6. The dimensions of a community culture (3)
The Political Dimension of Community:
The political dimension of community is its various ways and
means of allocating power, influence and decision making. It is
not the same as ideology, which belongs to the values dimension.
It includes, but is not limited to, types of governments and
management systems. It also includes how people in small bands
or informal groups make decisions when they do not have a
recognized leader.
The Institutional Dimension of Community:
The social or institutional dimension of community is composed
of the ways people act, interact between each other, react, and
expect each other to act and interact. It includes such
institutions as marriage or friendship, roles such as mother or
police officer, status or class, and other patterns of human
behaviour.
Case Management – module 5 – slide 6

7. The dimensions of a community culture (4)
The Aesthetic-Values Dimension of Community:
The aesthetic-values dimension of community is the
structure of ideas, sometimes paradoxical, inconsistent,
or contradictory, that people have about good and bad,
about beautiful and ugly, and about right and wrong,
which are the justifications that people cite to explain
their actions.
The Beliefs-Conceptual Dimension of Community:
The beliefs-conceptual dimension of community is
another structure of ideas, also sometimes
contradictory, that people have about the nature of the
universe, the world around them, their role in it, cause
and effect, and the nature of time, matter, and
behaviour.
Case Management – module 5 – slide 7

8. Another way to describe the community:
the different layers of the relationships of help
FORMAL
SERVICES
Professional service
providers
INFORMAL SERVICES
Citizens organised to a
certain extent (volunteers)
INDIVIDUAL SOCIAL NETWORKS
Family members and friends linked through
emotional and personal relationships
Case Management – module 5 – slide 8

9. Two different policies in the development of
social protection services
The more complex and developed a
community is, the more developed are the
top levels of our “help-pyramid”. In a very
!
re
he
e
ar
simple and primitive community, the level at
s
er
ag
an
FORMAL m
the base of the pyramid is usually enough to
se
SERVICES Ca
Professional service
providers ensure social safety. When a society begins
INFORMAL SERVICES
Citizens organised to a certain
to specialize the production system and
extent (volunteers) increase its social complexity, the other
INDI VIDUAL SOCIAL NETWORKS levels become more and more important.
Family members and friends linked through
In this process there is a danger or an opportunity: it depends on what
emotional and personal relationships
kind social policies the society (institutions) adopts.
There are two alternatives:
1. When an upper level is developed, it tends to impoverish and then replace
the lower ones (RE-ACTIVE APPROACH – traditional social work)
2. When an upper level is developed, it empowers and makes more effective
the lower ones (PRO-ACTIVE APPROACH – Case Management)
Case Management – module 5 – slide 9

10. Reactive (clinical) approach:
This provides services to individual cases when the
situation has already become an emergency and the
possibilities to get help from the community are
inadequate or no longer exist.
Proactive (community based) approach:
This starts before a social problem becomes an
emergency that cannot be handled by the community;
qualified roles are given to the community members
involved (teachers, community and religious leaders)
and other persons informally providing a social service
are involved.
Case Management – module 5 – slide 10

11. What is a social network?
Social and Cultural
Environment
Things to do to survive
Cognitive abilities,
behavioural skills
Things to do
Emotions, Tasks to feel good
identity, self-esteem about ourselves
Health Things to do
to feel accepted
by others
Physical Environment
Case Management – module 5 – slide 11

12. What is a coping network?
The coping network includes all the persons of a social
network who are involved in fulfilling a specific need
(for example, assisting a child victim of abuse in the
family).
When the network is not strong enough to fulfil the
need, there is a “social problem”.
Case Management – module 5 – slide 12

13. The coping network
The coping network is composed of all the persons who
interact with the person/family in need, and can
positively contribute to provide protection and care
It is composed of public officers (local administrators,
police, magistrates) professionals (doctors, teachers,
counselors, sports trainers, NGOs operators) and
common people sharing their daily life with the individual
(family members, relatives, neighbours, friends,
members of religious groups)
All these people have to be involved in decision making,
until they are able to take care of the social case
without the guidance of the Case Manager
Case Management – module 5 – slide 13

14. Main characteristics of the networking methodology
There is a problem (social, health, protection); the
social network surrounding the person with the
problem cannot cope with the need in an adequate
way
Thus this is not only a problem for the single
beneficiary, but first and foremost a problem
of his/her social network
With the networking methodology the case manager
(expert) intervenes to strengthen the network,
helping and guiding it with the involvement of other
„informal‟ resources, and not only of professional
services
The goal for the case manager, or GUIDE of
the network, is to help the network to improve
and become self-sufficient in dealing with a
problem
Case Management – module 5 – slide 14

15. How does the network guide do this?
The guide:
- facilitates the communication within the network;
- mediates different points of view;
- takes into consideration the possibilities and the
expectations of everyone involved
The guide acts as a „resource centre‟ for
information sharing: he/she has to know the
community, and to share his/her knowledge to
help the network to strengthen itself
The guide mediates between the network
and other resources, without (never!)
giving „directions‟;
his/her role is based on trust
Case Management – module 5 – slide 15

16. A map for describing the social network of a person:
Todd‟s diagram
TODD‟s diagram is a
method for describing the
Practitioner of the whole social network of a
NGOs‟ members
public services
volunteers person/family. The plots
of the network are put
Five
different
into the diagram divided
social areas client into 5 categories and
located at a distance from
the subject proportional
School or job
mates
to closeness with him/her.
A social network has
points of strength and
Neighbours and friends weakness, both qualitative
and quantitative. There
can be a reciprocal
relatives knowledge between two
plots, or not. In the first
case this relationship can
be mutual (neither positive
or negative), or not.
Case Management – module 5 – slide 16

17. The social network of Judith when the taking in charge has begun
NGO’s members
volunteers
Practitioner of the
public services
7
9
8
6
Judith
School or job
mates
10 1
2
Plots list:
1. mother
3 2. father
4 3. sister
4. aunt
Neighbours 5. Other aunt
and friends
6. Dr Marcus
7. Case manager
5 8. First teacher
relatives 9. Second teacher
10. neighbour
Case Management – module 5 – slide 17

18. First network evaluation
NGO’s members
volunteers
Practitioner of the
public services
7
Within the red circle have been 9
placed the network plots involved in 8
6
the problem of Judith’s homework Judith
(the coping network). Some of 1
School or job
mates
these plots have a very negative
10
2
Plots list:
perception of the problem (i.e. the
1. mother
3 2. father
4 3. sister
teachers), someone is too involved
4. aunt
Neighbours
5. Other aunt
and friends
6. Dr Marcus
(the mother), and someone too little 5
relatives
7. Case manager
8. First teacher
(the aunt).
9. Second teacher
10. neighbour
Some plots of the network do not know each other and others probably
have reciprocal negative relations (parents vs. teachers).
Furthermore, the network is very weak, both because there are not
many members for such a difficult task, and because there is no
member belonging to three social areas out of the five who participate
to the coping network. At the beginning, the task of Judith’s homework
is only a question between parents and some discouraged practitioners.
Case Management – module 5 – slide 18

19. The social network of Judith when the taking in charge is established
NGO’s members
volunteers
Practitioner of the
public services
7
9 14 12
8
11
6 13
16 15
Plots list:
Friends of Judith 1. mother
Recreation 2. father
School or job
centre mates
3. sister
10 1 4 4. aunt
5. Other aunt
2 6. Dr Marcus
3 7. Case manager
8. First teacher
9. Second teacher
10. Neighbour
Neighbours
11. Monica
and friends
12. Cleric
5 13. Special teacher
14. Headmaster
relatives
15. Pedagogue
16. psychologist
Case Management – module 5 – slide 19

20. Established
network evaluation
NGO’s members
volunteers
Practitioner of the
Within the red circle have been
public services
7
9 14 12
placed the plots involved in the 8
6 13
11
problem of Judith’s homework and
16 15
Plots list:
socialisation (the coping network).
Friends of Judith 1. mother
Recreation centre 2. father
School or job
mates 3. sister
10 1
All of the people involved have a
4 4. aunt
5. Other aunt
2 6. Dr Marcus
more positive perception of the
3 7. Case manager
8. First teacher
9. Second teacher
10. Neighbour
problem compared with the
Neighbours
and friends
11. Monica
12. Cleric
5 13. Special teacher
beginning of the project.
14. Headmaster
relatives
15. Pedagogue
16. psychologist
The number of the involved members is much higher, they are more
cooperative amongst each other, belong to four social areas out of five (but
we can consider that the improvement of the school relational climate has
promoted new friendships in the school setting as well), and everyone is
closer to Judith than in the past.
The enlargement of the coping network (before involving other informal
members, and then other formal ones) has not only allowed the first task
(Judith's homework) to be better addressed, but also to take further into
consideration the following: socialisation, sport, improvement of school
climate, psychological well-being of Judith and her parents.
Case Management – module 5 – slide 20

21. POLICE
LEGAL SERVICES
Case
Manager
NEIGHBOURS
TEACHERS
Family RELATIVES
WRONG NETWORKING! SOCIAL
SERVICES
COMMUNITY
RELATIVES LEADERS
Family HEALTH SERVICES
NEIGHBOURS
LEGAL SERVICES COMMUNITY
RESOURCES
Case
Manager RELATIVES
POLICE
RIGHT NETWORKING!
EDUCATION
SERVICES
HEALTH SERVICES
COMMUNITY
RESOURCES
Case Management – module 5 – slide 21

22. A multilevel description of social network:
the “bubble” model (1)
? Home care Service
Abroad ? Hospital
?
Family Doctor
Anne Nelson’s psychiatrist
? School
Nelson Rose
? Social Activities Centre
English teacher
Peter Lisa Maria ………………………..
John
Luis Sylvie
Bureaucratic
offices
Families network
Association
Case Management – module 5 – slide 22

23. A multilevel description of social network:
the “bubble” model (2)
The “bubble” model offers some
important advantages compared to
Todd’s Diagram.
First, it is easily drawn by pencil on a
sheet, during a meeting or an
interview.
Secondly, it allows the creation of a
map of the community around the
case before building the coping
network.
The model can be enriched step by step, and it becomes not only a
geographic map of the network, but also a historical representation of the
project. The example illustrates the case of Nelson, a family father, who
has problems of mental health and alcohol dependence. The model tells us,
for example, that Nelson’s wife (Rose) was adopted by Anne, while Nelson’s
parents are likely abroad.
This model also shows the second level networks, i.e. the partial network of
a member of the coping network (for example, the friends of Nelson’s son,
Luis). The representation of this network can significantly help the CM’s
work.
Case Management – module 5 – slide 23

24. A small dictionary of the social network
Primary network: this is constituted by the members of the family
(who cannot be chosen) and by friends (who can instead be chosen).
The primary network is characterized by affective relationships
which provide safety and the sense of belonging and identity.
Secondary formal network: this is constituted by the public/private
institutions which have been created for providing eligible services.
The relationships with them and their practitioners are only
professional.
Secondary informal network: this is constituted by NGOs,
associations, social groups, volunteers; all these subjects have been
created for reaching specific goals of public utility, but it is usual
that some members of this network become members of the primary
network.
Case Management – module 5 – slide 24

25. Main variables describing social relations
in a social network
Plexity: describes the type of a relationship (friendship, relationship,
neighbourliness, work, professional). A relation is called Uniplex if it
belongs to only one kind, and Multiplex if belongs to more than one
(e.g. a colleague who is also a friend or a relative).
Symmetry: a relationship is symmetric if it is described in the same
way by both the subjects of the relationship itself (for example, a
good or bad relationship); otherwise it is asymmetric.
Intensity, Intimacy, Lasting : although these variables describe
different aspects of a relationship, they are usually directly
proportional: the more the intensity, the more intimacy and longevity
there is, and so on.
The second level networks: these are constituted by people who the
subject does not know (or knows slightly), but who can be a potential
source of help and/or information (for example, own friends’ friends
or colleagues or relatives).
Case Management – module 5 – slide 25

26. Main variables describing the structure
of a social network
Homogeneity and Heterogeneity: a social network can be
constituted by people, relatives excluded, having (or not) in common
some features: the same age, sex, policy or religious beliefs,
behavioural habits, and so on.
Density: this variable measures how many dyadic relationships the
members of the network have, on average, by comparison with the
other members: the higher the density is, the higher is the chance
to build shared projects.
Cluster: a network can be constituted by some sub-networks (called
clusters) which can be very strong, but which have no relationship
with each other, sometimes for distance reasons, sometimes
because the clusters belongs to very different cultural worlds.
Typically, this is the situation of immigrant people, or people who
have had an important experience elsewhere (for example, in a
recovery community for drugs abusers).
Case Management – module 5 – slide 26