The Netherlands Drug Situation 2010 - Trimbos-instituut

tion transfer between physicians and nurses, about the DSM-IV- and ICD-10 criteria forsubstance dependence, and about urine testing. Finally, the reports of four literature reviewsare added, two on maintenance substances, and a third and fourth review onmaintenance treatment for patients with comorbid psychiatric disorders and polydruguse.11.2.5 Case managementTwo publications preceded the guideline for case management: a literature review (Wolfet al. 2002) and an 'assistance document' (handreiking) (Wolf et al. 2003). The reviewpresents an overview of the results of effect studies on case management for chronicdrug dependent patients. The assistance document is meant to support the professionalwork of case managers with regard to what should be done.The guideline for case management has been produced by four institutes for addictioncare. It describes how case management can best be realized, what methods and interventionscan be used, and how an effective relationship of the case manager with thepatient should be built. It is written from the perspective of the individual case manager(Tielemans et al. 2007). The authors assume that case managers should be part of amultidisciplinary team. They further state that basic conditions within the organizationshould be met in order to enable working with target groups with complex problems.These target groups not only have addition problems.Chapter one of the guideline briefly describes the theoretical backgrounds, the pointsof departure (important targets), and the models of case management. The second chapterdescribes the target group and the inclusion- and release criteria for case management.In the following chapter the six-phases model of case management is described,offering support for the decision making by the case managers. These six phases are:1. entry phase: sharing information, building a working relationship, and registration;2. inventory phase: focusing on urgent problems, network analysis, description of lifecourse;3. analysis: planning an individual program of care;4. execution of the individual case management program;5. evaluation: regular evaluation of quality of life and;6. release phase: reducing case management activities, transfer of activities to otherprofessionals and determining types of after care.In the final chapter of the guideline several areas of attention are specified andworked out, for example psycho-education and medication, self care, social contacts,daily activities, coping skills related to housing and living, and financial and judicial problemsolving. A Compact Disk is added with the data from the literature review, an educationmodule for case managers in the addiction care and measurement instruments.11.2.6 Client profilesThe guideline for client profiles is based on an instrument for setting up profiles, especiallyfor clients with chronic addiction and many other problems (Wits et al. 2007). Thisinstrument was developed by the Rotterdam addiction research institute IVO in collaborationwith three institutes for addiction care. The guideline construction was funded by theNetherlands Organisation for Health Research and Development (ZonMw).The main target of the guideline is to improve the fit between the supply of care andthe need of care among the patients. Target group analysis is considered fundamental for164