In Social Work case management, there are two levels of supports that we encourage our client’s to access in order to reach their goals (and overcome adversity), Informal and Formal supports. Formal supports refers to agencies, organizations and programs that are designed and usually funded with the express outcome of assisting individuals in the community. Informal supports refers to individuals, places, values or institution that assist a client in their everyday living, shape values/religious ideas and are usually identified through bonds of friendship or family.

One of the strongest contributors to a sense of contributions in the world is the knowledge that we are part of a family. The most fundamental institution in society is the family; its function is to support us, buffer us against outside stressors, and provide a base from which we move to integrate ourselves with the outside world. Our collective cultural believe in the importance of families is reflected in two commonly held notions; first, that when we behave in a laudatory way, we make our families proud. Second, we find ourselves in situation that would bring sadness or disappointment to our families, the pain that results from the realization that we have lost esteem in their eyes can be enormous.

In Part 1 of the exercise, you will increase your understanding of what it means to identify with a social stigma. The recognition of some sort of stigma can engender a crisis, cause isolation or shame. Thus, this exercise’s purpose is to not only increase your understanding of stigma, but what it means to have to ask for help and work through the case management process facing perceived stigma.

In Part 2 of the exercise, you will piece together the unique challenges clients may face when faced with stigma and the helping process through case management. Stigma can be pressuring and stressful to any person, but can cause unique challenges for the case management client. Recall the schematic model of case management intervention. Part of meeting goals requires a client to call upon their strengths, informal supports and formal supports as resources. All of these resources may require the client to explain their story/situation and "come out" about their potentially stigmatizing situation in order to ask for help. Examples include: lost a job, homeless, gay, disease, poverty, divorce, battered partner, sexually assaulted, disability, incarceration, substance addiction, etc.

1. In groups of four, each person should identify a common stigmatizing situation or characteristic (see examples above). Assign a ‘stigma’ to each group member. Once you have been assigned your "stigma", write a letter to your parent/child/partner/religious leader informing them of your stigma.
2. Take 20 minutes to complete your letter. Then exchange your letter with another group member. Read that person’s letter and respond in writing as if you were the recipient of the letter. State your own feelings, opinions or examples of how a recipient may respond.
3. Now take time in your group to discuss the process; what did you learn, what did it feel like to "reveal" yourself, and what you hope ahas been the response to the letter. What was in your mind about your family member’s response – what were your fears about their reaction? Willing persons should share their responses with the group.

1. Recall the situation wherein group members identified a stigmatizing situation or characteristic. Review empathetic feelings of a case manager in considering how a client might feel when revealing potentially stigmatizing things to family members and supports.
2. Review the schematic model of case management. Consider all of the steps that a client may be "channeled through" on the model during the helping process using the example of the client with the stigmatizing situation or characteristic. Recall that in this process, a client’s strengths might be assessed as well as the client’s supports and family. Moving through the process a client needs assistance or support in reaching his/her goals and overcoming challenges and stressful situations. In doing so, the case manager channels the client to identify informal and formal supports. As with many programs, the client is challenged to rely on strengths and informal supports before linkages to formal supports and/or formal programs are accessed.
3. Identify potential situations, fears, challenges, roadblocks, etc. might be met by a client who must "out" their stigmatizing feature to their family or informal supports to ask for help or assistance. What must this be like; how might this increase or decrease the bond or support? Is there potential to be a foundation for a deeper, better relationship with these supports? How so?
4. Brave group members might consider role-playing reaching out to informal supports for help and assistance in reaching goals or resource access.