This volume, a collection of six extended case reports, is an attempt to describe the marathon of the case management process as it unfolds over many years. Each of these case reports is followed by a commentary by a distinguished discussant with extensive clinical experience. The purpose of these commentaries is to initiate a dialogue about the following issues: in a field characterized by outreach and informality, what sort of professional boundaries in the case management relationship are required? When should case managers be assertive and when should they play a more passive role, allowing clients to set the pace of involvement? As case management values client self-determination, are coercive interventions ever warranted? If so, when and how should they be used? When should case managers persist in their intervention strategies and when should they change gears and try another approach? This is the 65th issue of the quarterly journal New Directions for Mental Health Services. Read Less