The Efficacy Of SMCM and Its Impact on Working Alliance Between Case Managers and Clients

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Introduction
The study by Roebuck et al. (2021) was a qualitative study that focused on the effectiveness of case management intervention in addressing mental health issues. Specifically, the study investigated the efficacy of the Strengths Model of Case Management (SMCM), an intensive case management intervention aimed at connecting people with severe mental health illness with community resources. In addition, the study also investigated the impact of the SMCM on the working alliance between case managers and clients, with a particular focus on clients' perception of the working alliance. Thus, the purpose of the study was identified.
The qualitative study was part of a more extensive study examining the implementation of SMCM in community mental health organizations. In their study, Roebuck et al. (2021) used three specific research questions: (1) How clients in the SMCM intervention describe the working alliance with their case managers; (2) the underlying characteristics that clients use to describe the working alliance with their case managers; (3) The clients' description of the role of the working alliance in creating change in clients' lives.
The research questions developed by Roebuck et al. (2021) were appropriate because they sought to answer the research problem being investigated. The questions were clearly defined such that the reader could also understand the direction of the research. Furthermore, they allowed the researcher to know how clients felt about the working alliance developed through the SMCM intervention. The research questions were also very focused, which ensured that the research was guided towards a conclusion.
The population of interest was adults with a severe mental illness (diagnosed or suspected) with homelessness or vulnerable housing history. The participants had to have been receiving the SMCM intervention for not less than six months. Focusing on the homeless population was appropriate because the intervention is meant to lead to change in the client's life in the health aspect and social aspects, and providing housing support is part of the social aspects of a client's life.
Methods
Roebuck et al. (2021) utilized a qualitative research method. First, non-numerical data is collected to help the researchers understand the opinions and perceptions of clients in the SMCM intervention on the relationship they had with their case managers. Specifically, the researchers conducted semi-structured interviews with participants, first in-person and later over the phone, due to COVID-19 restrictions. A sample size of 20 participants was used in the study.
Further, the researchers also disclosed that they used convenience sampling in selecting the participants. Specifically, they asked the case managers to provide referrals for clients who could participate in the study.
Although convenience sampling is an easy-to-use method, its suitability is questionable because of possible biases that researchers cannot reduce. For instance, even though the case managers had been asked to suggest participants with strong or weak working alliances, most case managers only told participants with a strong working alliance. This created a bias against participants who had different opinions or perceptions about their relationship with their case managers. In addition, using such a sampling method limited the generalizability of the data because clients with a weak relationship with their case managers were not well represented in the study. Also, specific characteristics such as race may not have been accounted for or sufficiently described in the study due to convenience sampling.
The data analysis strategies were also well described. The researchers outlined the steps taken in data analysis, from the thematic analysis of interview transcripts to data coding and then validation of data analysis. This description allows the audience to follow and identify patterns in the data as well.
Results
One of the key findings from the study results was that participants revealed that their relationship with their case manager accounted for the most significant changes in their lives. In addition, most participants indicated strong working relationships with their case managers and often compared their current case managers with their past case managers. These results should question because, as pointed out earlier, the researchers had received referrals of participants from case managers, and mo...