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Implementing the Strengths Model of Case Management: Assessing Practice Three Years After Initial Implementation

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While strengths approaches are important to recovery-oriented practice, implementation can be challenging. This study implemented the strengths model of case management (SMCM) in 11 CM teams and assessed the fidelity of delivery and staff perceptions of the model after 36 months using the SMCM fidelity scale and the Readiness Monitoring Tool. Paired sample t-tests assessed change in fidelity from baseline to 36 months. Adjusted regression analyses compared survey responses of direct and management staff. While fidelity ratings significantly improved across all domains, at 36 months they remained suboptimal in supervision practices and use of model tools. Staff perceptions were generally positive but consistently lower for front-line than management staff. Implementing SMCM into existing case management practice with good fidelity is feasible. However, clear support from management may strengthen staff motivation and delivery. A review of practice later in implementation can flag challenges for sustainability and guide implementation support.

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  1. While two of the three Quebec sites are funded and managed by the provincial government, they operate in different locations with different local management teams and so were considered separate organizations for this study.


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We thank the people who participated in the study. We acknowledge the individuals who supported project implementation including Christian Méthot, Nhi Vu, Francois Neveu and staff at each of the study sites where the strengths model was implemented.


Funding was provided by Canadian Health Services Research Foundation (Grant No. 312666).

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Correspondence to Janet Durbin.

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There are no conflicts of interest to disclose for this study.

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Ethics approval was obtained individually for each participating site in Ontario and Newfoundland, and centrally, as prescribed by the government of Québec, for sites in that province. Participants provided informed consent prior to the baseline interview.

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Durbin, J., Aubry, T., Barrett, B. et al. Implementing the Strengths Model of Case Management: Assessing Practice Three Years After Initial Implementation. Community Ment Health J 58, 1535–1543 (2022).

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