Layla is 15 years old and has recently been diagnosed with bipolar…

Layla is 15 years old and has recently been diagnosed with bipolar disorder. She also has an eating disorder (anorexia) which makes it difficult for her to take her medication with food. She has been seen to pretend to take her medication, then throw it out. She has not been attending school regularly and is falling behind in her school work. She says she is lonely and has no friends. She has difficulty trusting others and forming friendships due to childhood abuse by her parents. She has been hanging around with older kids and told you that an older guy who is 24 is interested in her and she says she may start to date him soon.

You must also include in the Individualised Support Plan, details about the factors that are affecting her physical, cognitive and emotional development.

Case Management Plan
Client Name: ________________________________________Contact no: ___________________
Ethnicity: (circle) Aboriginal Torres Strait Islander
Aboriginal and Torres Strait Islander Other culture: (please specify)
Primary Case Worker: _________________________________Contact no: ___________________
Support worker(s):
Other agencies: ________________________________________________
Other agencies: _________________________________________________
Nominated family support person: ______________________________________________________
Contact details for family support person: ________________________________________________
This Case Management Plan has been developed in consultation with: _________________________
_________________________________________________________________________________
What support will be provided?
Within the organisation: _____________________________________________
By other agencies: _____________________________________________
For approximately how long will support be required?
Within the organisation: _____________________________________________
By other agencies: _____________________________________________
Commencement date for plan: _____________________________________________
Review date for individual case plan: _____________________________________________

People to be involved in review meeting: _________________________________________________

__________________________________________________________________________________

INDIVIDUAL’S SUPPORT NEEDS
Individuals skills/knowledge/attributes/experience: __________________________________________
__________________________________________________________________________________
Physical and mental Health needs, e.g. medications, conditions: ______________________________
__________________________________________________________________________________
Behavioural needs, e.g. diagnosis and related medication: ___________________________________
__________________________________________________________________________________
Physical/transport needs, e.g. restricted mobility: ___________________________________________
__________________________________________________________________________________
Recreational needs, e.g. sporting interests: _______________________________________________
__________________________________________________________________________________
Relationships with partner/family: _______________________________________________________
__________________________________________________________________________________
Communication needs: _______________________________________________________________
__________________________________________________________________________________
Justice/Legal issues: _________________________________________________________________
__________________________________________________________________________________
Cultural needs: _____________________________________________________________________
__________________________________________________________________________________
Other needs: __________________________________________________________________________________

Client’s desired or expected outcomes:
__________________________________________________________________________________
__________________________________________________________________________________
Short-term (ST) goals:

1. ______________________________________________________________________________
______________________________________________________________________________
2. ______________________________________________________________________________
______________________________________________________________________________
3. ______________________________________________________________________________
______________________________________________________________________________

Long-term (LT) goals:
1. ______________________________________________________________________________
______________________________________________________________________________
2. ______________________________________________________________________________
______________________________________________________________________________

RISK MANAGEMENT PLAN
What are the safety concerns for the client? Consider environmental, physical and emotional safety. Mark the level of risk, e.g. high, medium and low.
__________________________________________________________________________________
__________________________________________________________________________________
How will risks be assessed and managed? ________________________________________________
__________________________________________________________________________________
What are some practical strategies to keep this client safe? _________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Who are the clients’ support networks? __________________________________________________
What is the clients’ motivation level for change? ____________________________________________
__________________________________________________________________________________
What are the barriers that may prevent change? ___________________________________________
What factors are affecting the clients’ physical, cognitive and emotional development?
Physical
Cognitive
Emotional
What is the impact of these delays on their opportunities?
Physical
Cognitive
Emotional
What developmental milestones have they missed?
Physical
Cognitive
Emotional

MEASURING AND EVALUATING PROGRESS IN ACHIEVEMENT OF INDIVIDUAL GOALS
The organisation will measure progression towards achieving these goals in the following manner:
Short-term (ST) goals:
1. Indicators: _____________________________________________________________________
______________________________________________________________________________
2. Indicators: _____________________________________________________________________
______________________________________________________________________________
3. Indicators: _____________________________________________________________________
______________________________________________________________________________
Long-term (LT) goals:
1. Indicators: _____________________________________________________________________
______________________________________________________________________________
2. Indicators: _____________________________________________________________________
______________________________________________________________________________

SUPPORT PROVIDED

AREA OF SUPPORT
Y/N
ID/BIRTH CERTIFICATE/OTHER DOCUMENTS
CLOTHING
FOOD/VOUCHER
ACCOMODATION OR SHORT TERM RESPITE
FINANCIAL ASSISTANCE OR ASSIST TO SECURE CENTRELINK BENEFITS
TRAVEL CARD/SMART RIDER
PREPARE FOR COURT APPEARANCES
MEDICAL NEEDS AND/OR DOCTOR APPOINTMENT
MENTAL HEALTH ASSESSMENT
SCHOOL ENGAGEMENT AND/OR ENROLMENT
ACCESS TO SCHOOL RECORDS
REFERRAL TO OTHER SERVICES
INVOLVEMENT IN RECREATION/SPORTS
CREATE SAFETY PLAN/PROTECTIVE BEHAVIOUR PLAN
ADVOCACY OR REPRESENTATION SERVICES
OTHER (PLEAASE SPECIFY)

CASE PLAN REVIEW
1. Reviewed by: ___________________________________________________________________
2. Proposed dates for review: ________________________________________________________

3. Actual date of review: ____________________________________________________________
4. Names and Signature of people involved in the review:
Name:___________________________________ Signature:_______________________________
Name:___________________________________ Signature:_______________________________
Name:___________________________________ Signature:_______________________________
POST REVIEW RECOMMENDATIONS:

1. _____________________________________________________________________________
2. _____________________________________________________________________________

Information collected, will be handled in accordance with our Privacy and Confidentiality Policy and the relevant State and Federal legislation.

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