Abstract
Assertive community treatment (ACT) teams are linked to high quality outcomes for individuals with severe mental illness. This paper tests arguments that influence shared between team members is associated with better encounter preparedness, higher work satisfaction, and improved performance in ACT teams. Influence is conceptualized in three ways: the average level according to team members, the team’s evaluation of the dispersion of team member influence, and as the person-organization fit of individual perception of empowerment. The study design is a retrospective observational design using survey data from a longitudinal study of 26 ACT teams (approximately 275 team members total) over 18 months. This study finds that average team influence and person-organization fit are positively correlated with encounter preparedness and satisfaction. Dispersion of influence was not significantly correlated with study outcomes. Influence in ACT teams has multiple dimensions, each with differential effects on team outcomes. These findings provide guidance as to how one might encourage equal and substantive contribution from ACT team members.
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For a review of the comparison between kurtosis and variance: https://www.riskprep.com/all-tutorials/36-exam-22/145-understanding-kurtosis.
References
Allness, D. J., & Knoedler, W. H. (2003). A manual for ACT start-up: Based on the PACT model of community treatment for persons with severe and persistent mental illnesses. Arlington: National Alliance for the Mentally Ill.
Aarons, G. (2006). Transformational and transactional leadership: Association with attitudes toward evidence-based practice. Psychiatric Services, 57(8), 1162–1169.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. doi:10.1037/0033-295X.84.2.191.
Baron, R., & Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.
Bond, G. R., Salyers, M. P., Rollins, A. L., Rapp, C. A., & Zipple, A. M. (2004). How evidence-based practices contribute to community integration. Community Mental Health Journal, 40(6), 569–588.
Bond, G. R., McGrew, J. H., & Fekete, D. M. (1995). Assertive outreach for frequent users of psychiatric hospitals: A meta–analysis. The Journal of Mental Health Administration, 22(1), 4–16.
Burns, T. (2010). The rise and fall of assertive community treatment? International Review of Psychiatry, 22(2), 130–137. doi:10.3109/09540261003661841.
Burns, B. J., & Santos, A. B. (1995). Assertive community treatment: an update of randomized trials. Psychiatric Services (Washington, D. C.), 46(7), 669–675.
Conger, J. A., & Kanungo, R. N. (1988). The empowerment process: Integrating theory and practice. Academy of Management Review, 13(3), 471–482. doi:10.5465/amr.1988.4306983.
Cohen, S. G., & Bailey, D. E. (1997). What makes teams work: Group effectiveness research from the shop floor to the executive suite. Journal of management, 23(3), 239–290.
Deegan, P. E., & Drake, R. E. (2006). Shared decision making and medication management in the recovery process. Psychiatric Services (Washington, D. C.), 57(11), 1636–1639. doi:10.1176/appi.ps.57.11.1636.
Dixon, L. (2000). Assertive community treatment: twenty-five years of gold. Psychiatric Services (Washington, D. C.), 51(6), 759–765.
Edmondson, A. C., Bohmer, R. M., & Pisano, G. P. (2001). Disrupted routines: Team learning and new technology implementation in hospitals. Administrative Science Quarterly, 46(4), 685–717.
Friedkin, N. E., & Johnsen, E. C. (2011). Social influence network theory: A sociological examination of small group dynamics (Vol. 33). New York: Cambridge University Press.
Fukui, S., Salyers, M., Matthias, M., Collins, L., Thompson, J., Coffman, M., & Torrey, W. (2014). Predictors of shared decision making and level of agreement between consumers and providers in psychiatric care. Community Mental Health Journal, 50(4), 375–382. doi:10.1007/s10597-012-9584-0.
Goodman, S. A., & Svyantek, D. J. (1999). Person-organization fit and contextual performance: Do shared values matter. Journal of Vocational Behavior, 55(2), 254–275. doi:10.1006/jvbe.1998.1682.
Kozlowski, S. W. J., & Ilgen, D. R. (2006). Enhancing the effectiveness of work groups and teams. Psychological Science in the Public Interest, 7(3), 77–124. doi:10.1111/j.1529-1006.2006.00030.x.
Kurtessis, J. N., Eisenberger, R., Ford, M. T., Buffardi, L. C., Stewart, K. A., & Adis, C. S. (2015). Perceived organizational support: A meta-analytic evaluation of organizational support theory. Journal of Management,. doi:10.1177/0149206315575554.
Lawler, E. J., Thye, S. R., & Yoon, J. (2008). Social exchange and micro social order. American Sociological Review, 73, 519–542.
Lemieux-Charles, L., & McGuire, W. L. (2006). What do we know about health care team effectiveness? A review of the literature. Medical Care Research and Review, 63(3), 263–300.
Lowe, K. B., Kroeck, K. G., & Sivasubramaniam, N. (1996). Effectiveness correlates of transformational and transactional leadership: A meta-analytic review of the MLQ literature. The Leadership Quarterly, 7(3), 385–425.
Marx, A. J., Test, M., & Stein, L. I. (1973). Extrohospital management of severe mental illness: Feasibility and effects of social functioning. Archives of General Psychiatry, 29(4), 505–511. doi:10.1001/archpsyc.1973.04200040051009.
Maynard, M. T., Gilson, L. L., & Mathieu, J. E. (2012). Empowerment—Fad or fab? A multilevel review of the past two decades of research. Journal of Management, 38(4), 1231–1281. doi:10.1177/0149206312438773.
Monroe-DeVita, M., Morse, G., & Bond, G. R. (2012). Program fidelity and beyond: Multiple strategies and criteria for ensuring quality of assertive community treatment. Psychiatric Services, 63, 743–750.
Monroe-DeVita, M., Teague, G. B., & Moser, L. L. (2011). The TMACT: A new tool for measuring fidelity to assertive community treatment. Journal of the American Psychiatric Nurses Association, 17(1), 17–29. doi:10.1177/1078390310394658.
Moody, J., & White, D. R. (2003). Structural cohesion and embeddedness: A hierarchical concept of social groups. American Sociological Review, 68(1), 103–127.
Morse, G., Salyers, M., Rollins, A., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 341–352. doi:10.1007/s10488-011-0352-1.
O’Reilly, C. A., Chatman, J., & Caldwell, D. F. (1991). People and organizational culture: a profile comparison approach to assessing person-organization fit. Academy of Management Journal, 34(3), 487–516. doi:10.2307/256404.
Salyers, M. P., McGuire, A. B., Rollins, A. L., Bond, G. R., Mueser, K. T., & Macy, V. R. (2010). Integrating assertive community treatment and illness management and recovery for consumers with severe mental illness. Community Mental Health Journal, 46(4), 319–329. doi:10.1007/s10597-009-9284-6.
Seibert, S. E., Wang, G., & Courtright, S. H. (2011). Antecedents and consequences of psychological and team empowerment in organizations: a meta-analytic review. Meta-analysis review. Journal of Applied Psychology, 96(5), 981–1003. doi:10.1037/a0022676.
Shah, P. P., Dirks, K. T., & Chervany, N. (2006). The multiple pathways of high performing groups: the interaction of social networks and group processes. Journal of Organizational Behavior, 27(3), 299–317. doi:10.1002/job.368.
Stein, L. I., & Santos, A. B. (1998). ACT: Assertive community treatment of persons with severe mental illness. New York: W.W. Norton & Company.
Tannenbaum, A. S. (1962). Control in organizations: individual adjustment and organizational performance. Administrative Science Quarterly, 7(2), 236–257. doi:10.2307/2390857.
Teague, G. B., Bond, G. R., & Drake, R. E. (1998). Program fidelity in assertive community treatment: development and use of a measure. American Journal of Orthopsychiatry, 68(2), 216–232.
Teague, G. B., Drake, R. E., & Ackerson, T. H. (1995). Evaluating use of continuous treatment teams for persons with mental illness and substance abuse. Psychiatric Services (Washington, D. C.), 46(7), 689–695.
Thomas, K. W., & Velthouse, B. A. (1990). Cognitive elements of empowerment: An “Interpretive” model of intrinsic task motivation. Academy of Management Review, 15(4), 666–681. doi:10.5465/amr.1990.4310926.
Turner, J. C. (1991). Social influence. Thomson Brooks/Cole Publishing Co.
Wholey, D. R., Zhu, X., Knoke, D., Shah, P., Zellmer-Bruhn, M., & Witheridge, T. F. (2012). The teamwork in assertive community treatment (TACT) scale: Development and validation. Psychiatric Services, 63(11), 1108–1117. doi:10.1176/appi.ps.201100338.
Witheridge, T. F. (2010). Monitoring ACT fidelity on a routine basis: One state’s experience. St. Paul.
Acknowledgments
This material is based on work supported by National Science Foundation grant SES 0719257. The assistance of the Minnesota Department of Human Services and the 26 ACT teams and their sponsors were invaluable in informing and supporting this research.
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The authors report no competing interests.
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This paper is based on a Health Services Research Policy and Administration Master’s Thesis by Andrew Pisansky in 2014.
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Pisansky, A.J., Wholey, D.R., Cain, C. et al. Encounter Preparedness, Satisfaction, and Performance Effects of Influence in Assertive Community Treatment (ACT) Teams. Adm Policy Ment Health 44, 441–451 (2017). https://doi.org/10.1007/s10488-015-0659-4
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DOI: https://doi.org/10.1007/s10488-015-0659-4