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

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Abstract

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.

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Author information

Authors and Affiliations

  1. Department of Psychology, LD 124, Indiana University Purdue University Indianapolis, 402 N. Blackford St, 46202-3275, Indianapolis, IN

    Michelle P. Salyers PhD (Assistant Scientist)

  2. Psychology at Indiana University Purdue University Indianapolis, USA

    Gary R. Bond PhD (Chancellor's Professor)

  3. Department of Mental Health Law and Policy in Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa

    Gregory B. Teague PhD (Associate Professor)

  4. NY State Office of Mental Health, Albany

    Judith F. Cox MA (Director of Assertive Community Treatment and Case Management)

  5. Department of Human Services, Office of Mental Health, Chicago

    Mary E. Smith PhD (Chief of Bureau of Evaluation and Services Research in Illinois)

  6. Department of Human Services, Office of Mental Health, Springfield

    Mary Lou Hicks MA (Chief of Bureau of Services Design in Illinois)

  7. Department of Psychology, Indiana University Purdue University Indianapolis, USA

    Jennifer I. Koop MS (doctoral candidate)

Authors
  1. Michelle P. Salyers PhD
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  2. Gary R. Bond PhD
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  3. Gregory B. Teague PhD
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  4. Judith F. Cox MA
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  5. Mary E. Smith PhD
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  6. Mary Lou Hicks MA
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  7. Jennifer I. Koop MS
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Corresponding author

Correspondence to Michelle P. Salyers PhD.

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She has now retired.

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Salyers, M.P., Bond, G.R., Teague, G.B. et al. Is it ACT yet? real-world examples of evaluating the degree of implementation for assertive community treatment. The Journal of Behavioral Health Services & Research 30, 304–320 (2003). https://doi.org/10.1007/BF02287319

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