A Mixed Methods Analysis of Case Manager Stress at A Homelessness Services Center

Purpose: Extant literature has demonstrated connections between workplace environment and worker stress, as well as between worker stress and direct service provision. Current research on direct service provision to people experiencing homelessness, however, has not established a clear association between the workplace environment and the quality of direct services provided to clients receiving case management. This study extends the existing research by establishing connections between all of these constructs, specifically within the context of case management services to people experiencing homelessness. Method: For this mixed methods study, the authors sampled 16 case managers providing direct services to people experiencing homelessness in one homelessness services organization (HSO) in a large metropolitan area. Through focus group interviews and web-based surveys, the authors collected data on the workplace environment, worker stress, and direct service provision. The authors then analyzed the data using a concurrent nested approach for mixed methods analysis. Results: The results of this study suggest that case managers in homelessness HSOs often experience a stressful workplace environment due to workplace cultural norms, inefficient processes, and high expectations placed upon them by both clients and administrators. The stressful workplace environment can interact with client trauma to produce secondary traumatic stress in direct service providers, which then influences client-case manager rapport development. Discussion: Study findings point toward specific policies and practices that homelessness HSOs ought to adopt in order to mitigate case managers’ workplace stress and secondary traumatic stress, and negative influences of these stressors on rapport development between case managers and clients experiencing homelessness.