Format

Send to:

Choose Destination

Similar articles for PubMed (Select 19039510)

See comment in PubMed Commons below
Soc Psychiatry Psychiatr Epidemiol. 2009 Jul;44(7):532-40. doi: 10.1007/s00127-008-0472-4. Epub 2008 Nov 27.

Successful engagement: a mixed methods study of the approaches of assertive community treatment and community mental health teams in the REACT trial.

Author information

  • 1Dept. of Mental Health Sciences, Royal Free Campus, University College London, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK. h.killaspy@medsch.ucl.ac.uk

Abstract

BACKGROUND:

The only randomised trial of assertive community treatment (ACT) carried out in England (the "REACT" study: randomised evaluation of assertive community treatment in North London) found no clinically significant advantage over usual care from community mental health teams (CMHTs). However, ACT clients were more satisfied and better engaged with services. To understand these findings better, we investigated the content of care and interventions offered to study participants.

METHOD:

Quantitative data were collected to compare team structures and processes. Qualitative interviews with care co-ordinators of 40 of the 251 REACT study participants (20 ACT, 20 CMHT clients) were carried out and thematic analysis was used to explore differences in the approaches of the two types of team.

RESULTS:

CMHTs scored low for ACT model fidelity and ACTTs scored high or ACT-like. All staff cited client engagement as their primary aim, but ACT approaches were less formal, more frequent and more successful than CMHTs'. Two aspects of ACT appeared important for engagement: small case loads and the team approach. Successful client engagement appeared to be associated with greater staff satisfaction.

CONCLUSIONS:

The findings from this study assist in understanding why the ACT approach is more acceptable to clients deemed by CMHTs as "hard to engage". The key elements of ACT that facilitate client engagement may not be easily replicated within CMHTs due to their larger, varied caseloads.

PMID:
19039510
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Write to the Help Desk