title: The assertive community treatment team as a complex dynamic system of care.
abstract: This paper presents a dynamic systems view of assertive community treatment (ACT), a recognized evidence-based treatment for adults with severe and persistent mental illness (SPMI). It is argued that because an ACT team operates as a complex adaptive system (CAS), it engages in the organizational processes of "sensemaking" and self-organization, which help to bring order to the actions of team members and sustainability of the intervention itself. Consequently, successful implementation of ACT requires that management technologies such as meaning-creation and design are used in conjunction with traditional "command and control" technologies of policies, procedures, processes, and structures.
authors.affiliation: Services Effectiveness Research Program, National Center for Child Traumatic Stress, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 3438, Durham, NC 27710, USA. callred@psych.duhs.duke.edu
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Allred
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Burns
authors.forename: Susan D
authors.initials: SD
authors.lastname: Phillips
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D014481:United States