EXECUTIVE SUMMARY

Case managers are susceptible to stress from paperwork, deadlines, and a lack of resources. Practicing self-care can help manage this stress.

• Time management techniques can help keep phone calls shorter and improve scheduling.

• Technology can be a source of stress, so case managers should learn how to use it and take time out when frustrated.

• A good way to reduce interpersonal stressors is to avoid negative personalities when possible, and to stay positive when it’s not.


Case managers share many of the same causes of stress as other healthcare workers, including paperwork, deadlines, and lack of resources. But they also face additional stressors related to in-home work with patients and to help people find resources that are sometimes scarce.

“If people are receiving case management services and are not doing well with mental health and alcohol and drug management, then they can be a threat to themselves and others,” says Dennis Fisher, MM, a recently retired program director at Behavioral Health Training & Education Network in Philadelphia. Fisher speaks at national conferences about stress management and self-care.

Case managers deal with the stress of not always knowing what they are walking into, Fisher notes.

Other stressors might include uncertainty about whether they can find the resources they need, work crises, and unresolved disagreements with co-workers, he adds.

“You have disagreements all the time, but how do you handle the conflict?” he says. “Conflict is a normal part of the job. Resolving it can reduce stress.”

Fisher suggests case managers practice the following self-care strategies to reduce work and life stress:

• Use time management techniques. “If you’re a morning person, then protect your peak morning times, giving yourself time to complete tasks,” he says.

Another time management tip is to stand up when making phone calls — a strategy that helps to keep calls brief.

“Standing up while making phone calls will keep you from getting too comfortable, so you will end the phone call more quickly,” Fisher says. “It happens naturally that way.”

Another time management technique is to let people know up front that there is only a limited amount of time to talk about their issue. When case managers meet patients in person, they could offer to take a walk with them to talk it out. They also could offer patients a timetable, he says.

“A case manager can say, ‘Can you schedule time to talk about this?’” Fisher says. “Sometimes, people want to make their emergency your emergency, but if it’s a situation that can wait, they will either find someone else to resolve it for them, or they can wait that extra amount of time for the case manager to get back to them.”

A good time management technique for the morning is to lay out clothing the night before, Fisher suggests.

“I realized I’d be standing in my closet for five minutes, trying to figure out what I was going to wear, and nothing would come to mind,” Fisher says. “But if I’d lay them out the night before, getting ready in the morning would be quick.”

• Learn to use technology. Learning new technology takes time — but the alternative is to deal with frustrating situations.

Case managers and other healthcare professionals can save themselves time and avoid desk clutter if they lean how to enter their calendars and appointments on their computers and phones.

“Learning it will save some time, so take the time needed to learn the new technology,” Fisher suggests. “If you’re just starting with a technology, then rely on the value of teamwork.”

On every team there is at least one person who is more tech-savvy than others, and that person can show a case manager how to use the new technology, he says.

When a case manager encounters a technology problem that results in frustration and stress, the solution is to take a break, engage in positive self-talk, and find a co-worker who has experienced the same problem and worked it out, Fisher says.

“Mistakes are learning experiences,” he notes. “Stress isn’t all bad because it does motivate us to do better.”

• Know what can be controlled. Some of the things that case managers often cannot control involve their patients’ reactions to the work they do, co-workers’ attitudes, and obstacles encountered. When stress arises due to things that are out of the case manager’s control, one possible solution is to engage in a physical activity that reduces stress.

“Reward yourself,” Fisher says. “For me, it’s taking time to exercise because I’m obsessed with exercising every day, so that’s a reward.”

Some people might listen to music, read a book, eat a favorite food, shop, or take a five-minute mental vacation, daydreaming about something that is pleasant, he adds.

“We get into a vicious cycle of emotional-behavioral stress, and it impacts our physical state,” he says. “If you can just break that chain, break the pattern of events, it could be having a cup of tea, music, watching a movie or doing anything that can help.”

• Avoid negative personalities. “Avoidance is one possibility, but if you can’t avoid the negative person, then I would try to stay positive on my own because the only person we can change is ourselves,” Fisher says.

Another strategy is to handle the conflict straight-on, trying to resolve it by offering a suggestion to the team or negative person.

One of the reasons negative personalities can cause stress is because people anticipate the negativity and dread it.

“A person’s stress could be caused by having to deal with that negativity on an ongoing basis, and it just feels unrelenting,” Fisher says. “If you had a plan to resolve it, that would be helpful, and you can always go back and modify the plan.”

Sometimes the negative person is unaware of his or her effect on others. Perhaps there is a way to let people know when they are being negative.

“If everyone seems negative to you, then maybe the negative person is you. Be willing to look at that,” Fisher says. “Combat negative self-talk with other strategies, and accept that maybe you’re burned out.”

Mostly, case managers should keep in mind that it’s not a sign of weakness to provide self-care and focus on reducing stress.

“I know that we practice in our case management a strength-based model,” Fisher says. “It’s about looking for our own strengths and minimizing our own weaknesses at the same time.”

Case managers already do this for the people they serve, so now it is time to do it for themselves, as well, he adds.