CCSM – Definitions and principles

People living with chronic conditions and their carers, have become principal health care providers and funders in their own right. A significant proportion of day-to-day management of their conditions can be under their direct control.

Everyday living with a chronic condition pie graph - smallest area clinical care, third of day showing sleep and a little under two thirds showing daily living - an arrow wraps around the image with the text self-management

Health care providers all along the continuum of care, as well as providing clinical care, can support patients to optimise how they self-manage when they return to home.

Diagram displaying flow chart of condition stages


What is a chronic condition?

Chronic conditions are characterised by:

  • complex causes
  • multiple risk factors
  • long latency periods
  • a prolonged course of illness
  • functional impairment or disability.

Most chronic diseases or conditions do not resolve spontaneously and are generally not cured completely.

Some chronic conditions:

  • can be immediately life-threatening, for example stroke
  • can persist over time and can be intensive in terms of management, for example: diabetes
  • .are not always the cause of death, for example arthritis.

What is chronic condition self-management?

Self-Management is defined in the National Chronic Disease Strategy and the WA Chronic Conditions Self-Management Strategic Framework as simply ‘the active participation by people in their own health care’.

girl and guy eating apples – guy leaning against bike

Self-managing a condition

People living with chronic conditions already manage their conditions on a daily basis and to varying degrees. Self-managing involves:

  • knowing about your condition
  • sharing in decision-making
  • following an agreed care plan
  • monitoring and managing signs and symptoms
  • managing the impact on physical, emotional and social life
  • adopting a healthy lifestyle and
  • having the confidence and ability to access to community support services.

What is chronic condition self-management support?

Self-management support is what health care providers, organisations, systems and the community do to support people living with a chronic condition to be actively involved in their own health care.

Principles of CCSM support

man and woman looking at a model of brain

At the core of self-management support is a partnership between health providers and consumers. Commonly accepted principles for self-management support are:

  • person-centred care
  • consumer empowerment and enhanced capacity
  • participation by consumer and carers
  • partnership between health provider and consumer
  • shared responsibility for outcomes
  • coordination of support
  • access to appropriate, timely and understandable information
  • holistic, lifelong approach to health.

What is a self-management approach?

The self-management approach emphasises the person’s central role in managing their health.

It includes strategies of assessment, collaborative care, client empowerment and enhanced capacity, links them to community resources, and employs a holistic, lifelong approach to health and self-care.

The self-management approach can be utilised anywhere along the healthcare continuum.

Principles of person-centred care

woman with clipboard talking to a man and woman

  • respect for patients’ values, preferences and expressed needs
  • coordination and integration of care
  • information, communication and education
  • physical comfort
  • emotional support and alleviation of fear and anxiety
  • involvement of family and friends
  • transition and continuity
  • access to care.

What is a chronic condition self-management program?

Self-management programs offer people with chronic conditions the knowledge, skills and resources to help them better manage their health.

CCSM programs are not:

  • educational programs
  • cognitive behaviour therapy (CBT)
  • peer support groups on their own.


Information sheets

Produced by

Chronic Condition Self-Management