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Meeting People “Where They Are”: Case Managers Empower and Motivate Clients to Pursue Their Health Goals

Harkey, Jane RN-BC, MSW, CCM; Sortedahl, Charlotte DNP, MPH, MS, RN, CCM; Crook, Michelle M. RN, BSN, CRRN, CCM; Sminkey, Patrice V. RN

doi: 10.1097/NCM.0000000000000193

Purpose: The propose of this discussion is to explore the role of the case manager to empower and motivate clients, especially those who appear “stuck” or resistant to change. Drawing upon the experiences of case managers across many different practice settings, the article addresses how case managers can tap into the individual's underlying and sometimes deep-seated desires in order to foster buy-in for making even small steps toward achieving their health goals. The article also addresses how motivational interviewing can be an effective tool used by case managers to uncover blocks and barriers that prevent clients from making changes in their health or lifestyle habits.

Primary Practice Settings: This discussion applies to case management practices and work settings across the full continuum of health care.

Implications for Case Management Practice: The implication for case managers is deeper understanding of the importance of motivation to help clients make positive steps toward achieving their health goals. This understanding is especially important in advocating for clients who appear to be unmotivated or ambivalent, but who are actually “stuck” in engrained behaviors and habits because of a variety of factors, including past failures. Without judgment and by establishing rapport, case managers can tap into clients' desires, to help them make incremental progress toward their health goals.

Jane Harkey, RN-BC, MSW, CCM, is the chair of the Commission for Case Manager Certification (CCMC), and also operates a private geriatric care management practice based in New Jersey.

Charlotte Sortedahl, DNP, MPH, MS, RN, CCM, is the chair-elect of the CCMC. She is an associate professor of nursing at the University of Wisconsin Eau Claire, teaching in undergraduate and graduate programs.

Michelle M. Crook, RN, BSN, CRRN, CCM, is a Commissioner of the CCMC, and a Business Project Program Manager for Aetna Inc.

Patrice V. Sminkey, RN, was the CEO of the CCMC, the first and oldest nationally accredited organization that certifies case managers. To date, more than 60,000 individuals have achieved board certification as Certified Case Managers (CCM).

Address correspondence to Jane Harkey, RN-BC, MSW, CCM, Commission for Case Manager Certification, Mt Laurel, NJ 08054 (

The authors report no conflicts of interest.

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