Abstract
Following a randomized trial of case manager delivered HIV prevention intervention to persons with severe mental illness (SMI), this study sought to document changes within the service environment and with case managers themselves as a result of their experience and skills training. Utilizing qualitative methods, researchers conducted focus groups and in-depth interviews with 22 case managers and 3 administrators at an urban community mental health center. Beyond confirming previously established barriers to case manager delivery of HIV prevention interventions for persons with SMI, most noteworthy was the finding that case managers were generally unskilled in conducting assessments and tended to focus on "spoiled identity" and illness parts of their consumers. Experimental case managers revealed that they had been transformed by the training experience in a manner permitting them to both understand and work from a recovery model. Implications and directions for further study are discussed.