Regular Articles

The Journal of Behavioral Health Services & Research

, Volume 30, Issue 3, pp 304-320

First online:

Is it ACT yet? real-world examples of evaluating the degree of implementation for assertive community treatment

  • Michelle P. SalyersAffiliated withDepartment of Psychology, LD 124, Indiana University Purdue University Indianapolis Email author 
  • , Gary R. BondAffiliated withPsychology at Indiana University Purdue University Indianapolis
  • , Gregory B. TeagueAffiliated withDepartment of Mental Health Law and Policy in Louis de la Parte Florida Mental Health Institute, University of South Florida
  • , Judith F. CoxAffiliated withNY State Office of Mental Health
  • , Mary E. SmithAffiliated withDepartment of Human Services, Office of Mental Health
  • , Mary Lou HicksAffiliated withDepartment of Human Services, Office of Mental Health
  • , Jennifer I. KoopAffiliated withDepartment of Psychology, Indiana University Purdue University Indianapolis

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Despite growing interest in assessment of program implementation, little is known about the best way to evaluate whether a particular program has implemented the intended service to a level that is minimally acceptable to a funding source, such as a state mental health authority. Such is the case for assertive community treatment (ACT), an evidence-based practice being widely disseminated. Using an exploratory, actuarial approach to defining program standards, this study applies different statistical criteria for determining whether or not a program meets ACT standards using the 28-item Dartmouth Assertive Community Treatment Scale. The sample consists of 51 ACT programs, 25 intensive case management programs, and 11 brokered case management programs which were compared to identify levels of fidelity that discriminated between programs, but were still attainable by the majority of ACT programs. A grading system based on mean total score for a reduced set of 21 items appeared to be most attainable, but still discriminated ACT programs from other forms of case management. Implications for setting and evaluating ACT program standards are discussed.