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HOT TOPIC OF THE MONTH
April 2011

Clinical Social Workers, Care Advocates and Life Coaches: Who Does What?

Mirean Coleman, MSW, LICSW, CT
Senior Practice Associate

NASW members contacted the Association to express concerns about care advocates and life coaches who instructed clinical social workers how to treat patients referred to them by OptumHealth Behavioral Solutions, formerly known as United Behavioral Solutions.  Members reported the care advocates and life coaches as conflicting and interfering with their role as mental health providers. 

NASW contacted OptumHealth for clarification of the roles of care advocates and life coaches.  Below is a summary of that communication.

Care Advocates
Care advocates employed by OptumHealth are licensed mental health professionals such as clinical social workers, nurses, and psychologists who facilitate quality care.  Their role includes utilization management, telephone assessment and triage, discharge planning, and case management for complex cases and conditions that may reveal risk factors preventing adherence to treatment plans. Care advocates help coordinate service, identify and fill in gaps of care.

In addition, care advocates serve as a referral source for providers seeking adjunct services or community supports to help compliment treatment plans.  They also serve as an historical resource for patients with high risk, chronic mental health conditions.

Life Coaches
The role of life coaches is to provide support and assistance to patients who have one or more chronic medical conditions and a co-morbid mental illness such as depression, anxiety, or somatic disorders.  Patients in this program are identified by claims algorithms, referrals from medical case managers, and positive findings for generalized health risk appraisals.  Services provided by life coaches are not a replacement for psychotherapy services when such treatment is indicated.  In cases where therapy is not indicated, life coaches promote health literacy empowerment, and motivation of patients.

Conclusion
OptumHealth has provided role delineations for case advocates and life coaches.  In some regions, care advocates and life coaches are used interchangeably.  There appears to be an overlap of mental health services between care advocates, life coaches, and clinical social workers.  All three providers, who may be of similar professional background, strive to provide quality care and ensure there are no treatment gaps. They differ in that clinical social workers provide the psychotherapy services.  If there appears to be conflict or interference that affects the quality of care that patients receive, it is important for clinical social workers to communicate this directly to the care advocates, life coaches, or provider relations of OptumHealth so that corrective actions can be taken to provide the best mental health care for patients with a mental illness.

Additional information about OptumHealth Behavioral Solutions and its providers is available online at www.optumhealth.com 

 

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