Psychiatric Case Management at Integrierte Psychiatrie Winterthur (IPW)
This study evaluates the case management of the Integrierte Psychiatrie Winterthur (IPW). It also investigates the effect of therapeutic alliance on the treatment outcome.
Since 2002, case management (CM) has been a part of outpatient services at Integrierte Psychiatrie Winterthur - Zürcher Unterland (ipw). CM aims to stabilize patients with complex, multiple problems and high use of inpatient care ("heavy users"). It coordinates all necessary support and services of the helper network and flexibly provides clients with daily life assistance whenever they need it.
Previous studies revealed that not all participating patients seem to profit from the CM. At the same time, the willingness of the study participants, who were randomly assigned to either the CM group or a control group, to cooperate with a case manager varied greatly. A possible explanation for this unfavorable circumstance is that there is not a good match between the method and the clientele of the study.
Based on that consideration, the ipw and the School of Applied Psychology decided to cooperate on another project: CM Study, 3rd generation (CM3). A follow-up, this study comprises two sub-projects and has a duration of six years.
The goal of the first sub-project was to found criteria that, already prior to entry into CM, yield indications as to whether a patient can benefit from CM or not. The sub-project also aimed to find out circumstances under which patients cannot benefit from CM. The criteria identified were used to create an improved match between patient needs and the CM method. This qualitative sub-project of the CM3 study was carried out in the framework of the Zurich Program for Sustainable Development of Mental Health Services (ZInEP).
After the retrospective analysis of the pilot phase (CM1) and the prospective RCT study (CM2), this third study (CM3) will examine external validity prospectively. It will also investigate the effect of the therapeutic alliance on the treatment outcome. So as not to go without an assessment of the effectiveness of the treatment but without at the same time endangering the external validity, the effectiveness of CM will be examined using a matched control group, built prospectively from patients at IPW.