Abstract
Assertive community treatment (ACT) has become a cornerstone of care for people with serious mental illnesses. But it has also been suggested that ACT is an inherently coercive approach, with a variety of techniques, including leverage, frequently employed to encourage treatment adherence. Staff and patients of 4 ACT teams participated in focus groups exploring their experiences with and opinions about the use of these techniques in ACT. Little evidence was found of significant use of leverage or perceptions of coercion. Instead both groups reported that supporting patients and building relationships were the preferred mechanisms for promoting treatment goals. This study suggests that ACT need not appear to either staff or patients as an intrinsically coercive model for the delivery of mental health services.
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Acknowledgments
This study was supported by a grant from the John D. and Catherine T. MacArthur Foundation Research Network on Mandatory Outpatient Treatment. The authors thank the members of the Network for their comments on this study, and the staff and patients of the ACT teams who participated in this project.
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Appelbaum, P.S., Le Melle, S. Techniques Used by Assertive Community Treatment (ACT) Teams to Encourage Adherence: Patient and Staff Perceptions. Community Ment Health J 44, 459–464 (2008). https://doi.org/10.1007/s10597-008-9149-4
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DOI: https://doi.org/10.1007/s10597-008-9149-4