Psychology In Seattle Podcast Case Management vs Therapy (2017 Rerun)
Sep 18, 2025
Michelle Finley, a seasoned faculty member at Antioch University Seattle with a wealth of experience in community mental health, joins to discuss the nuanced differences between case management and psychotherapy. They delve into how privilege and training impact therapeutic focus. The conversation highlights specific case management tasks such as advocacy and coordination while exploring the spectrum between case managers and therapists. They also address the challenges of heavy coordination cases and stress the importance of self-care and personal boundaries in the profession.
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Therapy Versus Practical Survival Needs
- Therapists often feel torn between psychotherapy and helping with practical survival needs for multi-problem clients.
- Kirk frames that practical help (Medicaid, housing, bills) is commonly called case management and is distinct from talk therapy.
Privilege Shapes Therapy's Focus
- Michelle highlights that agency clients often face structural barriers that complicate purely psychotherapeutic work.
- She connects the therapist/case manager line to social justice and privilege in training and access.
Choose A Role And Own The Responsibilities
- Decide where you sit on a spectrum from full case manager to pure therapist and accept the responsibilities of that choice.
- If you choose heavy case management, become competent in systems (Medicaid, CPS, courts) and learn ethics around collateral contacts.
