Assertive Community TreatmentAn Evidence-based Practice
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Assertive Community Assertive Community Treatment Treatment has different nameshas different names
ACTACT
PACTPACT
Assertive OutreachAssertive Outreach
Mobile Treatment TeamsMobile Treatment Teams
Continuous Treatment TeamsContinuous Treatment Teams
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ACT practice principlesACT practice principles
ACT is a service delivery model, ACT is a service delivery model,
not a case management programnot a case management program
ACT’s primary goal is recovery ACT’s primary goal is recovery through community treatment and through community treatment and habilitationhabilitation
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A team approachA team approach
In vivo servicesIn vivo services
A small caseloadA small caseload
Time-unlimited Time-unlimited servicesservices
A shared caseload A shared caseload
Flexible service Flexible service deliverydelivery
Fixed point of Fixed point of responsibilityresponsibility
Crisis management Crisis management available 24 hours a available 24 hours a day, day, 7 days a week 7 days a week
ACT practice principlesACT practice principles
ACT is characterized by:ACT is characterized by:
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ACT practice principlesACT practice principles
ACT is for consumers with the ACT is for consumers with the most challenging and persistent most challenging and persistent problemsproblems
Programs that adhere most Programs that adhere most closely to closely to the ACT model are more likely to the ACT model are more likely to get get the best outcomesthe best outcomes
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Primary responsibilityPrimary responsibilityfor all servicesfor all services
ACT team members are experienced ACT team members are experienced in psychiatry, psychology, in psychiatry, psychology, nursing, social work, nursing, social work, rehabilitation, substance-abuse rehabilitation, substance-abuse treatment, and employment treatment, and employment
Rather than referring consumers Rather than referring consumers to multiple programs and to multiple programs and services, services, the ACT teamthe ACT team provides the provides the treatment and services consumers treatment and services consumers needneed
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Help is provided where it is Help is provided where it is neededneeded
Rather than working with Rather than working with consumers in consumers in an office or hospital, ACT team an office or hospital, ACT team members work with consumers in members work with consumers in their homes, neighborhoods, and their homes, neighborhoods, and other places where their problems other places where their problems and stresses arise and where they and stresses arise and where they need support and skillsneed support and skills
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Help is provided where it is Help is provided where it is neededneeded
Rather than seeing consumers Rather than seeing consumers only a few times a month, ACT only a few times a month, ACT team members with different team members with different types of expertise contact types of expertise contact consumers as often as necessaryconsumers as often as necessary
Help and support are available Help and support are available 24 hours a day, 7 days a week, 24 hours a day, 7 days a week, 365 days a year, 365 days a year, if neededif needed
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Shared caseloadShared caseload
ACT team members do not have ACT team members do not have individual caseloads. Instead, individual caseloads. Instead, the team shares responsibility the team shares responsibility for consumers in the programfor consumers in the program
Each consumer gets to know Each consumer gets to know multiple members of the team. If multiple members of the team. If a team member goes on vacation, a team member goes on vacation, gets sick, or leaves the gets sick, or leaves the program, consumers know the program, consumers know the other team membersother team members
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No preset time limits on No preset time limits on servicesservices
ACT has no preset limit on how ACT has no preset limit on how long consumers receive services. long consumers receive services. Over time, team members may have Over time, team members may have less contact with consumers, but less contact with consumers, but still remain available for still remain available for support if it’s neededsupport if it’s needed
Consumers are never discharged Consumers are never discharged from ACT programs because they from ACT programs because they are “noncompliant”are “noncompliant”
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Close attention to Close attention to consumers’ needsconsumers’ needs
ACT team members work closely ACT team members work closely with consumers to develop plans with consumers to develop plans to help them reach their goalsto help them reach their goals
Every day, ACT teams review each Every day, ACT teams review each consumer’s progress in reaching consumer’s progress in reaching those goals. If consumers’ needs those goals. If consumers’ needs change or a plan isn’t working, change or a plan isn’t working, the team responds immediatelythe team responds immediately
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Close attention to Close attention to consumers’ needsconsumers’ needs
Careful attention is possible Careful attention is possible because the team works with because the team works with only a small number of only a small number of consumers — about 10 consumers consumers — about 10 consumers for each team member for each team member
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ACT provides assistance ACT provides assistance with…with…
Activities of daily Activities of daily livingliving
HousingHousing
Family lifeFamily life
EmploymentEmployment
BenefitsBenefits
Managing financesManaging finances
Health careHealth care
MedicationsMedications
Co-Occurring Co-Occurring disorders integrated disorders integrated treatment (substance treatment (substance use) use)
CounselingCounseling
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ACT targets consumers with:ACT targets consumers with:
Severe and persistent mental Severe and persistent mental illnessillness
Significant difficulty doing the Significant difficulty doing the everyday things needed to live everyday things needed to live independently in the community, independently in the community, oror
Continuously high-service needContinuously high-service need
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ACT team staffingACT team staffing
Team approach: Team approach: 90% or more of consumers have 90% or more of consumers have contact with more than 1 team contact with more than 1 team member per weekmember per week
Practicing team leader: Practicing team leader: A full-time program supervisor A full-time program supervisor (also called the team leader) (also called the team leader) provides direct services at provides direct services at least 50% of the timeleast 50% of the time
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ACT team staffingACT team staffing
A program serving 100 consumers has at A program serving 100 consumers has at least:least:
1 or more full-time psychiatrists 1 or more full-time psychiatrists
2 full-time nurses2 full-time nurses
2 full-time substance-abuse specialists2 full-time substance-abuse specialists
2 full-time employment specialists2 full-time employment specialists
Peer specialists:Peer specialists: Consumers hold team positions (sometimes Consumers hold team positions (sometimes
called peer specialists) or other positions called peer specialists) or other positions for which they are qualified with full for which they are qualified with full professional statusprofessional status
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Organizational boundariesOrganizational boundaries
Explicit admission criteriaExplicit admission criteria
No more than 6 new admissions per No more than 6 new admissions per monthmonth
24-hour coverage24-hour coverage
Responsibility for coordinating Responsibility for coordinating hospital admissions and dischargehospital admissions and discharge
Full responsibility for treatment Full responsibility for treatment servicesservices
Time-unlimited servicesTime-unlimited services
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