Program Fidelity and Beyond: Multiple Strategies and Criteria for Ensuring Quality of Assertive Community Treatment

2012 ◽  
Vol 63 (8) ◽  
pp. 743-750 ◽  
Author(s):  
Maria Monroe-DeVita ◽  
Gary Morse ◽  
Gary R. Bond
Keyword(s):  
Assertive Community Treatment ◽  
Community Treatment ◽  
Program Fidelity ◽  
Multiple Strategies

scholarly journals Setting up an assertive community treatment service

1996 ◽  
Vol 2 (4) ◽  
pp. 143-150 ◽  
Author(s):  
Andrew Kent ◽  
Tom Burns
Keyword(s):  
Assertive Community Treatment ◽  
Mentally Ill ◽  
Revolving Door ◽  
Community Treatment ◽  
Treatment Service ◽  
Flexible Support ◽  
Severely Mentally Ill ◽  
Functional Areas ◽  
Key Worker

The last 20 years have witnessed a surge of interest in assertive community treatment (ACT) for the severely mentally ill (Drake & Burns, 1995). ACT aims to help people who would otherwise be in and out of hospital on a ‘revolving door’ basis live in the community and enjoy the best possible quality of life. Services based on the ACT model seek to replace the total support of the hospital with comprehensive, intensive and flexible support in the community, delivered by an individual key worker or core services team. They are organised in a way that optimises continuity of care across different functional areas and across time.

scholarly journals S33. RELATIVES IN RESOURCE GROUP ASSERTIVE COMMUNITY TREATMENT (RACT): RELATIVES’ EXPERIENCES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S44-S44
Author(s):  
Nils Sjöström ◽  
Mats Ewertzon ◽  
Ola Johansson ◽  
Bente Weimand ◽  
Anita Johansson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Assertive Community Treatment ◽  
Psychotic Disorders ◽  
Healthcare Professionals ◽  
Self Report ◽  
Community Treatment ◽  
Family Burden ◽  
Next Of Kin ◽  
Resource Group

Abstract Background Relatives often provide extensive support to their next of kin suffering from psychotic disorders. However, they often experience lack of support from psychiatric services. While cooperation with relatives is a central component in Resource Group Assertive Community Treatment (RACT), little is known about relatives’ experiences of RACT. The aim was to investigate relatives’ experiences of encountering psychiatric care with and without RACT, in relation to quality of life, family burden and family stigma. Methods A total of 139 relatives of individuals suffering from psychotic disorders in the Region Västra Götaland, Sweden filled out the self-report instruments Family Involvement and Alienation Questionnaire – Revised (FIAQ-R), the Burden Inventory for Relatives of Persons with Psychotic Disturbances, the Inventory of Stigmatizing Experiences (family version), and RAND-36. Results Participants included 79 relatives with experience of RACT and 60 without. In the total group 70% were women. Mean age was 63 years (SD 12.4). A majority came from Sweden (91%), had >12 years of education (61%) and did not live together with the patient (76%). A majority were parents, (70%). These demographic characteristics did not differ in those with and without RACT. We found that relatives who participated RACT experienced a more positive approach from the healthcare professionals compared to those without RACT (p=.001). Furthermore, relatives who participated in RACT felt to a lower extent that they were alienated from the provision of care than did other relatives (p=.005). Relatives who did not participate in resource group were significantly more afraid that their ill next of kin would hurt someone. The association remained after adjustment for experience of approach and feeling of alienation. No other differences in family burden variables were found. Findings regarding mental Quality of Life scores and experiences of family stigmatization were similar in those both with and without RACT. Discussion The results suggest that participating in RACT may contribute to a higher level of satisfaction for relatives in their encounter with healthcare professionals.

scholarly journals Assertive community treatment in UK practice

2005 ◽  
Vol 11 (6) ◽  
pp. 388-397 ◽  
Author(s):  
Andrew Kent ◽  
Tom Burns
Keyword(s):  
Social Functioning ◽  
Assertive Community Treatment ◽  
Individual Case ◽  
Community Treatment ◽  
Team Members ◽  
Clozapine Treatment ◽  
Wide Range ◽  
The Uk ◽  
Poor Medication Adherence

Since 2000 assertive outreach has been a requirement of community mental health provision in the UK. This has led to rapid proliferation of assertive community treatment teams offering a pure form of clinical case management to people with severe mental illness. The teams provide intensive support in obtaining material essentials such as food and shelter and place a greater emphasis on social functioning and quality of life than on symptoms. People with psychotic illness with fluctuating mental state and social functioning and poor medication adherence are most likely to benefit. Teams are ideally placed to monitor clozapine treatment in the community. Teams require a broad skills mix, and team members need some competence across a wide range of areas. Teams should include a psychiatrist or have regular access to one. Ideal individual case-loads are 10–12 patients. Around-the-clock availability is no longer considered essential, particularly in view of the rise of crisis resolution/home treatment teams.

scholarly journals 520 - Benefits of Assertive Community Treatment for Persons with Severe Mental Illness and Cancer

2021 ◽  
Vol 33 (S1) ◽  
pp. 69-69
Author(s):  
Monica Taylor-Desir
Keyword(s):  
Breast Cancer ◽  
Mental Illness ◽  
Cancer Treatment ◽  
Severe Mental Illness ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Case Vignette ◽  
Treatment Team ◽  
Assertive Community Treatment Team

Breast cancer, the most commonly diagnosed cancer in women worldwide, is responsible for one in six cancer deaths (Sung, H. et al., 2021). Women with schizophrenia have an associated increased incidence of breast cancer compared to the general population (Grassi & Riba, 2020). Patients with severe mental illness are noted to have disparities in accessing and initiating cancer treatment especially among those who are older (Iglay et al., 2017). A case vignette will be presented to illustrate the care and interventions provided by an American Assertive Community Treatment team which fostered supportive treatment engagement and improved the quality of life for a patient that chose to forgo recommended cancer treatment. This presentation will highlight the essential nature of the Assertive Community Treatment team in supporting decisional capacity, facilitation of a patient’s grief and acknowledgement of one’s own mortality as well as incorporation of medical and palliative care. The attendee will appreciate the importance of the multidisciplinary approach for persons with chronic mental illness and co-morbid cancer diagnoses.

Effectiveness of an Assertive Community Treatment program for people with severe schizophrenia in mainland China – a 12-month randomized controlled trial

2018 ◽  
Vol 49 (6) ◽  
pp. 969-979 ◽  
Author(s):  
Xingwei Luo ◽  
Samuel F. Law ◽  
Xiang Wang ◽  
Jingzheng Shi ◽  
Wu Zeng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Treatment Program ◽  
Assertive Community Treatment ◽  
Controlled Trial ◽  
Mainland China ◽  
Community Treatment ◽  
Exact Test ◽  
Randomized Controlled

AbstractBackgroundAssertive Community Treatment (ACT) is an evidence-based treatment program for people with severe mental illness developed in high-income countries. We report the first randomized controlled trial of ACT in mainland China.MethodsSixty outpatients with schizophrenia with severe functional impairments or frequent hospitalizations were randomly assigned to ACT (n = 30) or standard community treatment (n = 30). The severity of symptoms and level of social functioning were assessed at baseline and every 3 months during the 1-year study. The primary outcome was the duration of hospital readmission. Secondary outcomes included a pre-post change in symptom severity, the rates of symptom relapse and gainful employment, social and occupational functioning, and quality of life of family caregivers.ResultsBased on a modified intention-to-treat analysis, the outcomes for ACT were significantly better than those of standard community treatment. ACT patients were less likely to be readmitted [3.3% (1/30) v. 25.0% (7/28), Fisher's exact test p = 0.023], had a shorter mean readmission time [2.4 (13.3) v. 30.7 (66.9) days], were less likely to relapse [6.7% (2/30) v. 28.6% (8/28), Fisher's exact test p = 0.038], and had shorter mean time in relapse [3.5 (14.6) v. 34.4 (70.6) days]. The ACT group also had significantly longer times re-employed and greater symptomatic improvement and their caregivers experienced a greater improvement in their quality of life.ConclusionOur results show that culturally adapted ACT is both feasible and effective for individuals with severe schizophrenia in urban China. Replication studies with larger samples and longer duration of follow up are warranted.

scholarly journals Associations Between Quality of Life and Functioning in an Assertive Community Treatment Population

2015 ◽  
Vol 66 (11) ◽  
pp. 1249-1252 ◽  
Author(s):  
Hanne Clausen ◽  
Anne Landheim ◽  
Sigrun Odden ◽  
Kristin Sverdvik Heiervang ◽  
Hanne Kilen Stuen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Treatment Population
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