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      Involving clients and their relatives and friends in psychiatric care: Case managers' experiences of training in resource group assertive community treatment

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          Abstract

          The purpose of this project was to do a qualitative study of an integrated and flexible ACT model, the Resource Group Assertive Community Treatment (RACT), as seen from the perspective of case managers in training. The resource group normally consists of the client, the case manager and other available personnel in the medical and support areas, as well as family members. Nineteen theses were randomly chosen from a set of 80 theses written by a group of Swedish trainee case managers. The exams were conducted as case studies and concerned 19 clients with psychotic problems, 11 men and 8 women. “The Empirical Phenomenological Psychological Method” was used in the analysis, which generated five overarching themes: (a) the RACT program; (b) the resource group; (c) the empowerment of the client; (d) progress in treatment; and (e) the case manager. These together constituted a “therapeutic circle,” in which methods and tools used within the RACT made it possible for the resource group to empower the clients who, as a result, experienced progress with treatment, during which the case manager was the unifying and connecting link.

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          FACT: a Dutch version of ACT.

          Peter Veldhuizen (2007)
          Assertive Community Treatment (ACT) is a well-defined service delivery model for the care and treatment of the most severely mentally ill in the community. We have opted for a Dutch version named 'Function' ACT or FACT. In a FACT team, ACT is one of the functions that the team can perform. For more stable long-term patients FACT provides coordinated multidisciplinary treatment and care by individual case management. Unstable patients at risk of relapse are followed with assertive outreach care by the same team, working with a shared caseload for this subgroup. This article describes the service model and everyday practice in FACT.
          Article 0 comments Cited 98 times – based on 0 reviews     Review now
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            Integrated care in schizophrenia: a 2-year randomized controlled study of two community-based treatment programs.

            B Ivarsson, I R Falloon, Ulf Malm … (2003)
            To evaluate the efficacy of two community-based programs that combined antipsychotic medication, family interventions and social skills training. A randomized controlled trial with 2 years follow-up. The study included 84 patients with schizophrenic disorders, continuously managed in terms of care and treatment, and regularly assessed. Analysis was by intention-to-treat. Between-program comparisons showed significantly improved social function and consumer satisfaction in favour of the program 'Integrated Care' (IC) at the 2-year follow-up. The main clinically important differences between the two treatment programs studied were the procedures for shared decision making and patient empowerment in IC. The implementation of IC in clinical practice can improve social recovery and increase consumer satisfaction for patients with schizophrenic disorders. We identified specific procedures that might be added to improve the effectiveness of any program for severely mental ill people.
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              Performance-based measurement of functional disability in schizophrenia: a cross-national study in the United States and Sweden.

              Larissa B. Patterson, Anna Olsson, Fredrik Hjärthag … (2009)
              Recent advances in the assessment of disability in schizophrenia have separated the measurement of functional capacity from real-world functional outcomes. The authors examined the similarity of performance-based assessments of everyday functioning, real-world disability, and achievement of milestones in people with schizophrenia in the United States and Sweden. The UCSD Performance-Based Skills Assessment-Brief Version (UPSA-B) and a neuropsychological assessment were administered to schizophrenia patients living in rural areas in Sweden (N=146) and in the New York City area (N=244), and patients' functioning was rated by their case managers. Information from records and case managers was used to determine the frequency of living independently, working, and having ever experienced a stable romantic relationship. Performance on the UPSA-B was essentially identical in the two samples (New York, mean score=13.84; Sweden, mean score=13.30), as were scores on the case manager ratings of everyday activities (New York, mean=49.0; Sweden, mean=48.8). The correlations between UPSA-B score, neuropsychological test performance, and case manager ratings did not differ across the two samples. The proportion of patients who had never had a close relationship and the rate of vocational disability were also nearly identical. However, while 80% of the Swedish patients were living independently, only 46% of the New York patients were. While scores on performance-based measures of everyday living skills were similar in people with schizophrenia across cultures, real-world residential outcomes were very different. These data suggest that cultural and social support systems can lead to divergent real-world outcomes among individuals who show evidence of the same levels of ability and potential.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Psych J
                Journal ID (iso-abbrev): Psych J
                Journal ID (publisher-id): pchj
                Title: Psych Journal
                Publisher: Blackwell Publishing Ltd
                ISSN (Print): 2046-0252
                ISSN (Electronic): 2046-0260
                Publication date (Print): June 2012
                Publication date (Electronic): 10 June 2012
                Volume: 1
                Issue: 1
                Pages: 15-27
                Affiliations
                [1 ]Evidens Research and Development Center Göteborg, Sweden
                [2 ]Department of Psychology, Karlstad University Karlstad, Sweden
                Author notes
                Prof Torsten Norlander, Department of Psychology, Karlstad University, SE-651 88 Karlstad, Sweden. Email: torsten.norlander@ 123456kau.se

                Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen#OnlineOpen_Terms

                Article
                DOI: 10.1002/pchj.1
                PMC ID: 3832238
                PubMed ID: 24294489
                SO-VID: a10206a4-4ed3-4216-b676-08a00c403f29
                Copyright © Copyright © 2012 Institute of Psychology, Chinese Academy of Sciences and Blackwell Publishing Asia Pty Ltd
                License:

                Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.

                History
                Date received : 30 October 2011
                Date accepted : 29 January 2012
                Categories
                Subject: Original Articles

                Keywords: act,case manager,optimal treatment,ract,resource group
                Data availability:
                Keywords: act, case manager, optimal treatment, ract, resource group

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