Fidelity and recovery-orientation in assertive community treatment.
ABSTRACT 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.
- SourceAvailable from: Mirella RuggeriEpidemiology and Psychiatric Sciences 06/2011; 20(2):107-11. DOI:10.1017/S2045796011000357 · 3.36 Impact Factor
- Journal of the American Psychiatric Nurses Association 03/2011; 17(1):13-5. DOI:10.1177/1078390310396708
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ABSTRACT: Practitioners variably use restrictive practices with assertive community treatment (ACT) consumers. Little is known about practitioner attributes, such as pessimistic attitudes and lack of advanced education, which may predict greater use of restrictive practices. To describe the frequency of restrictive practices in ACT and examine the relationship between practitioner attributes, particularly pessimistic attitudes and education, and the frequency with which restrictive practices are reportedly used in daily treatment of adults with severe mental illness. A cross-sectional study of 122 ACT practitioners in one state. More restrictive practices were rarely reported by practitioners. Pessimistic attitudes and lack of graduate-level training were associated with self-reported higher use of restrictive practices, even when controlling for select consumer caseload variables and ACT program fidelity. This study indicates the need to identify practitioner-related factors that may contribute to the high use of restrictive practices, and develop and implement relevant staff training.Journal of the American Psychiatric Nurses Association 03/2011; 17(1):80-9. DOI:10.1177/1078390310394360