An exploratory study was undertaken to identify the practice skills needed to effectively deliver care management and explore the extent to which the identified skills influenced care managers' implementation of TCARE^®, a new care management protocol, and caregivers' use of recommended services. An additional goal of this study was to examine the extent to which care manager educational training affected the outcomes. An extensive review of three bodies of literature revealed that communication skills, supportive skills, and linking skills are essential to carry out the activities of care management and influence service use. Using the bodies of literature to identify the three skills, a conceptual model was developed and used to guide the study. The model posits a link between the skills and care manager and caregiver compliance. Care manager compliance was measured on two dimensions: mechanics and viability. Mechanics was conceptualized as accurate completion of the TCARE® forms and following steps of the protocol. Viability was conceptualized as the creation of usable plans. Caregiver compliance constituted use of recommended services.

The study included 21 care managers and 108 caregivers served by these care managers. Care managers completed a pilot questionnaire that included measures to assess levels of practice skills. Telephone interviews were conducted with caregivers three-months after they were initially served to obtain service use information. The information reported was compared with service recommendations made in initial care plans that were submitted by care managers. Bivariate correlation analyses were used to test the association between the skills and accurate implementation of TCARE^®. Multivariate linear regression techniques were used to test the association between practice skills and caregiver compliance.

The results revealed that the three skills were positively linked with the creation of viable care plans. The skills were not found, however, to be related to accurate completion of the TCARE^® forms nor with caregivers' use of services. The results also revealed that care manager educational training was related to caregiver compliance. Caregivers served by individuals with a social work degree were shown to have lower service use compliance scores. Implications for practice and future research are discussed.