Browsing by Subject "assertive community treatment"

Now showing 1 - 4 of 4
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    A Comparison of Phone-Based and On-Site Assessment of Fidelity for Assertive Community Treatment in Indiana
    (2011-06) McGrew, John H.; Stull, Laura G.; Rollins, Angela L.; Salyers, Michelle P.; Hicks, Lia J.
    Objective: This study investigated the reliability and validity of a phone-administered fidelity assessment instrument based on the Dartmouth Assertive Community Treatment Scale (DACTS). Methods: An experienced rater paired with a research assistant without fidelity assessment experience or a consultant familiar with the treatment site conducted phone-based assessments of 23 teams providing assertive community treatment in Indiana. Using the DACTS, consultants conducted on-site evaluations of the programs. Results: The pairs of phone raters revealed high levels of consistency [intraclass correlation coefficient (ICC)=.92] and consensus (mean absolute difference of .07). Phone and on-site assessment showed strong agreement (ICC=.87) and consensus (mean absolute difference of .07) and agreed within .1 scale point, or 2% of the scoring range, for 83% of sites and within .15 scale point for 91% of sites. Results were unaffected by the expertise level of the rater. Conclusions: Phone-based assessment could help agencies monitor faithful implementation of evidence-based practices. (Psychiatric Services 62:670–674, 2011)
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    Integrating Assertive Community Treatment and Illness Management and Recovery for Consumers with Severe Mental Illness
    (2010-08) Salyers, Michelle P.; McGuire, Alan B.; Rollins, Angela L.; Bond, Gary R.; Mueser, Kim T.; Macy, Veronica R.
    This study examined the integration of two evidence-based practices for adults with severe mental illness: Assertive community treatment (ACT) and illness management and recovery (IMR) with peer specialists as IMR practitioners. Two of four ACT teams were randomly assigned to implement IMR. Over 2 years, the ACT–IMR teams achieved moderate fidelity to the IMR model, but low penetration rates: 47 (25.7%) consumers participated in any IMR sessions and 7 (3.8%) completed the program during the study period. Overall, there were no differences in consumer outcomes at the ACT team level; however, consumers exposed to IMR showed reduced hospital use over time.
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    A Review of Consumer-provided Services on Assertive Community Treatment and Intensive Case Management Teams: Implications for Future Research and Practice
    (2011-01) Wright-Berryman, Jennifer L.; McGuire, Alan B.; Salyers, Michelle P.
    Background—Assertive community treatment (ACT) is an evidence-based practice that provides intensive, in vivo services for adults with severe mental illness. Some ACT and intensive case management teams have integrated consumers as team members with varying results. Methods—We reviewed the literature examining the outcomes of having consumer providers on case management teams, with attention devoted to randomized controlled trials (RCTs). Results—We identified 16 published studies, including 8 RCTs. Findings were mixed, with evidence supporting consumer-provided services for improving engagement, and limited support for reduced hospitalizations. However, evidence was lacking for other outcomes areas such as symptom reduction or improved quality of life. Conclusion—Including a consumer provider on an ACT team could enhance the outreach mechanisms of ACT, using a more recovery-focused approach to bring consumers into services and help engage them over time. More rigorous research is needed to further evaluate integrating consumer providers on teams.
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    Staff Turnover in Statewide Implementation of ACT: Relationship with ACT Fidelity and Other Team Characteristics
    (2010-09) Rollins, Angela L.; Salyers, Michelle P.; Tsai, Jack; Lydick, Jennifer M.
    Staff turnover on assertive community treatment (ACT) teams is a poorly understood phenomenon. This study examined annual turnover and fidelity data collected in a statewide implementation of ACT over a 5-year period. Mean annual staff turnover across all observations was 30.0%. Turnover was negatively correlated with overall fidelity at Year 1 and 3. The team approach fidelity item was negatively correlated with staff turnover at Year 3. For 13 teams with 3 years of follow-up data, turnover rates did not change over time. Most ACT staff turnover rates were comparable or better than other turnover rates reported in the mental health and substance abuse literature.