Case management is a component of managed healthcare and is defined as a "collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs, using communication and available resources to promote quality, costeffective outcomes" 1: 792. Case management originated in the 19 th century in the provision of services for impoverished people, followed by coordinated services in the 1970's, targeted towards people with mental health problems and deinstitutionalisation 2. Case management has been used and applied in various settings such as public health, mental health, social services and the insurance sector; and in the health care setting is generally driven by a nurse case manager 3. A range of health care professionals are designated as the case manager depending on the setting and the nature of the case. Occupational therapists are showing an interest in case management and are being challenged to adopt this role in order to succeed in the current health care environment 4. In this context case management in South Africa is being employed by occupational therapists within different areas of practice such as the insurance sector and health consulting as an approach to manage long term incapacity and disability in the workplace. A need for this service is likely to increase considering the upsurge in disability claims, incapacity and absenteeism in South Africa 5. Furthermore, the incidence of sick leave in South Africa has risen continuously over the past decade and sickness-related absenteeism has increased four-fold since 2007 6. Case management is further being utilised within the Road Accident Fund to aid motor vehicle accident vic

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Background: This qualitative study set in an acute inpatient psychiatric clinic investigates the efficacy of occupational therapy groups targeting interpersonal relationships, from the clients' perspective. Purpose: This study was designed to explore the effect of occupational therapy groups on clients' interpersonal relationships. Method: Four, sixty-minute focus groups were used to ascertain the participants' experiences of groups, and the effect of these on relationships. These sessions were audio-recorded and transcribed. Thematic analysis was used to analyse the data. Findings: This article tells the story of the development of the participants' relationships through the journey of attending group therapy, from the initial struggles in their personal relationships, through the development of insight into these difficulties, the learning of skills and problem-solving solutions, to the application of some of the skills and hope for future relationship development. Four emerging themes are discussed in this article. "We all have relationship problems" outlines the participants understanding of their relationship problems. The second theme "we were given the skills and applied them" describes how group therapy helped them develop further insight and acquire greater relational skills. "I am less demanding now" describes how developing insight and skills have impacted the participants' actual relationships and their hopes for their relationships. Conclusions: Participants gained significant benefit from group work, on both a personal and a relational level. Group therapy provided a safe place to learn and then practice the skills that participants had learnt. The insights gained into adaptive and maladaptive relationships and participants' interpersonal styles through group therapy assisted participants in strengthening their relationships with group members and others. Despite improved knowledge, insight and skills, participants were not always able to use their skills consistently. One factor that improved their confidence to apply skills was consistent group attendance.

Introduction. The Kawa Model is a conceptual occupational therapy model of practice that uses the metaphor of a river as a medium to support the exploration of self, life events, and environment. In this study, the Kawa Model was used by occupational therapy students during a practice placement in a remote community setting as a tool to support learning, build self-awareness, and promote reflection on personal and professional development. Method. The study used an exploratory qualitative research design. Six student participants were purposively recruited and orientated to the use of the Kawa Model at the beginning and throughout their remote community practice placement. Semistructured interviews were used to collect data which were analysed thematically using interpretative phenomenological analysis (IPA). Findings. Analysis of the student transcripts revealed three overarching themes: self-awareness, the development of personal and professional skills, and working with metaphor. All students identified the model as a reflective tool that enhanced their understanding of their student selves in a remote setting. The students described the growth of various professional skills including communication, goal planning, and confidence. Whilst initially students found the metaphor challenging to fathom, throughout their placement, they found it impactful for comprehending their development of self. Conclusion. This study revealed that the students’ self-awareness and personal and professional development were influenced by their engagement with and application of the Kawa Model. Repeated engagement with the Kawa Model enhanced the students’ journey of personal and professional skill development.