There has been increasing commentary about the degree to which Assertive Community Treatment (ACT) teams provide recovery-oriented services, often centered around the question of the use of coercion. The present study was designed to contribute to this discussion through an examination of recovery-oriented service provision and ACT fidelity among 67 teams in the province of Ontario, Canada. The findings indicated a moderate to high degree of recovery orientation in service provision, with no significant relationship between ACT fidelity and consumer and family/key support ratings of recovery orientation. A significant relationship was found, however, between the 'nature of services' domain of the Dartmouth Assertive Community Treatment Scale (DACTS) and ratings of recovery orientation provided by staff and ACT coordinators. These findings extend the existing dialogue regarding the evaluation of ACT intervention process factors and indicate that current measures of fidelity may not be adequately addressing dimensions of recovery-oriented service provision.
"The Recovery Self-Assessment has been used to test staff change after a year-long training effort on recovery.17 In a study of 67 Canadian ACT programs, the Recovery Self-Assessment was used to assess the relationship between recovery-orientation and outcomes and recovery-orientation and ACT fidelity.18, 19 "
[Show abstract][Hide abstract] ABSTRACT: Three linked instruments for measuring the recovery-orientation of mental health program culture are introduced as the Recovery Centered Measures (RCM). Two scales assess the views of staff and of consumers, respectively, regarding staff-consumer interactions. A third scale measures staff culture. The RCM scales are quick, easy to understand (reading level of grade 5.4), and internally consistent. Test-retest correlations ranged from 0.81 to 0.67. Convergent validity with three related instruments was appropriate. The scales discriminate ACT from residential programs. The RCM scales show strong potential to be useful to program administrators and researchers working to increase the recovery-orientation of programs.
The Journal of Behavioral Health Services & Research 06/2013; 41(2). DOI:10.1007/s11414-013-9348-9 · 1.37 Impact Factor
"Oppure, nel caso in cui le valutazioni di fidelity non vengano condotte, può non essere possibile comprendere se trattamenti che risultano inefficaci lo sono per mancanza reale di efficacia o per scarsa fidelity , il che può indurre a scartare prematuramente trattamenti potenzialmente efficaci. I fattori che potenzialmente limitano la generalizzabilità dei dati ottenuti nei contesti di ricerca sono molteplici, ed è certamente più semplice standardizzare le psicoterapie nei contesti di ricerca che nel mondo reale (Kidd et al. 2010). Nonostante i Manuali Operativi siano considerati il veicolo principale per trasferire le evidenze ottenute in setting sperimentali nella pratica clinica, la reale validità della generalizzazione dei requisiti richiesti per una adesione completa al Manuale è cosa assai discussa. "
"Evidence aside, the ACT model has increasingly been the subject of critical commentaries. Knowledgeable authors raise legitimate questions about ACT because of scientific philosophy , cost, and model limitations (Burns, 2010; Kidd et al., 2010). Individuals critical of the model point out that the ACT model is far from perfect and may not be in final form (Kortrijk, Mulder, Roosenschoon, & Wiersma, 2010). "
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