Case-management was introduced in 2004 in the "Abrigado" due to the high demand for advice and the efficiency of this form of assistance.
Case-management is a methodology for linking individual support needs of clients with the available help system. The Case - Manager is the interface between the client and the help system and should be able to provide the optimal care of the client. The Case Manager detects in cooperation with the clientele systematically the overall situation and the need for assistance to the client (erg with a documented care plan). The goals are shared by Case - developed managers and their clients.
The Case - manager should know the social assistance system in detail and has network or cooperation partners available to offer assistance to the clientele. Clients are actively involved in every phase of the helping process.
For the target group the development of a help-oriented, person - and situation-related network is planned, in which the client, its environment and the social services are involved. This Harburg network could be established already thanks to years of preparatory and widely accepted engagement. Other objectives of the work are:
The constant improvement of the supporting network, strengthening the personal ability of the client to find support and share resources .
The Case - manager has, among other tasks, to establish strong relationships with clients, to motivate the client to accept assistance, to carry out care planning with the client and to cooperate with professionals from services and facilities.
The care process is divided into 6 steps:
- Assessment (assessing and clarifying the client's situation)
- Planning (planning how to proceed)
- Intervention (implementation of interventions)
- Monitoring (controlling and monitoring of measures to be taken)
- Evaluation (assessment, care planning and evaluation of possible future requirements - if the course ends up not having been successful)
- Re - Assessment made in a new attempt (1st - 5th)
More information about case-management
The difference to classical casework is, according to Oliva, lies for example in BMG 2001, page 15, ' that "case managers shall provide necessary assistance rather than to fulfill such assistance itself".
Another principle of case management is working user-orientate. The Case Manager is responsible for achieving the groups goal, like a visiting structure - unfavorable opening times etc. in favor of providing a structure or at least supplement concepts."
The flow model of the national model project case-management roughly corresponds to the Phase modeling structure as described above.
- Step 1 here is meant as opening access as well as case opening.
- In step 2, the assessment. A comprehensive picture of biographical, psychological, social and medical aspects put together into an overall picture.
- In step 3, it comes to goal setting and care planning. "The care plan is the result of negotiated agreements between case manager and client." The care plan is a key tool of case-management.
- In step 4, we implement all measures to be taken.
- Step 5 is monitoring. Receives the client the agreed services? Does the client keep all agreements?
- In step 6, is the re–assessment, If required, a reassessment of the situation will be made. (Is a new target agreement required?)
The task of the case-management is to build and to ensure a "Help - person - and situation –related" network. The necessary assistance when the condition of the client is permitting it, less rendered itself, but rather organized. The need of help shall be user -oriented.
Case-management should have the aim to help the ones in need to motivate and to start changes.
Care planning is to achieve an important means to agreements and objectives as defined by the client.
Cooperation with other institutions and provision of assistance is required to Case - perform management.
The aim should be, among many others, the independent living, and improving overall situation of the clients.
See: Oliva and others, in BMG , Case Management in addicts and drug assistance, Baden -Baden 2001
2 supra p. 15
3 supra, p 17
11 supra p. 17
Elements of the work of case-management are advice, help in coping with everyday problems, suggestions for recreational activities, crisis intervention, relapse prevention, outreach, follow-up and family contact.
A detailed, transparent documentation is required for the work.
The target group besides alcohol abusers in the pilot project were, chronic multiple affected dependent female drug consumer. (CASE - management) The CASE - management - Definition of FOGS besides the diagnosis according to ICD-10 (dependency syndrome) it also includes at least 3 points from the following areas mentioned:
- Consumption behavior (5 years use of opiates & last 4 weeks)
- Treatment experience (detoxification / withdrawal / substitution)
- Health (Somali diseases / Psychological Disorders)
- Social and legal situation (irregular income, social assistance, acquisitive crime, - prostitution, - in the last 2 years)
- Without solid partnership, and addiction-related contacts during the last 2 years.
- Homeless, neglected housing, or institutional housing types during the last 2 years,
- Judicial burden, 2 years imprisonment or more than 5 sentences.
- Oliva, Hans ( BMG and FOGS ) and others, case-management in the drug and Addiction help, Baden - Baden 2001
- Wendt, R. Wolf. Case management in social and health care. Freiburg 1997