Vanderplasschen Wouter, Rapp Richard C, Wolf Judith R, Broekaert Eric
Department of Orthopedagogics, Ghent University, H. Dunantlaan 2, B-9000, Ghent, Belgium.
Psychiatr Serv. 2004 Aug;55(8):913-22. doi: 10.1176/appi.ps.55.8.913.
Because of the multifaceted, chronic, and relapsing nature of substance use disorders, case management has been adapted to work with persons who have these disorders. Deliberate implementation has been identified as a powerful determinant of successful case management. This article focuses on six key questions about implementation of case management services on the basis of a comparison of experiences from the United States, the Netherlands, and Belgium. It was found that case management has been applied in various populations with substance use disorders, and distinct models have been associated with positive effects, such as increased treatment participation and retention, greater use of services, and beneficial drug-related outcomes. Program fidelity, robust implementation, extensive training and supervision, administrative support, a team approach, integration in a comprehensive network of services, and minimal continuity have all been linked to successful implementation.
由于物质使用障碍具有多方面、慢性和复发性的特点,个案管理已被调整以适用于患有这些障碍的人群。经认定,审慎实施是成功进行个案管理的有力决定因素。本文基于对美国、荷兰和比利时经验的比较,重点探讨了关于实施个案管理服务的六个关键问题。研究发现,个案管理已应用于各类患有物质使用障碍的人群,不同模式都产生了积极效果,如治疗参与度和留存率提高、服务利用率增加以及与药物相关的有益结果。项目保真度、有力实施、广泛培训与监督、行政支持、团队协作方式、融入综合服务网络以及最小化连续性等都与成功实施相关联。