Techniques used by assertive community treatment (ACT) teams to encourage adherence: patient and staff perceptions.
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.
Department of Psychiatry, Division of Psychiatry, Law and Ethics, Columbia University College of Physicians and Surgeons, New York, NY, USA. psa21@columbia.edu
Paul S
PS
Appelbaum
Stephanie
S
Le Melle
D000328:Adult; D001291:Attitude of Health Personnel; D003068:Coercion; D003156:Community Mental Health Services; D003299:Cooperative Behavior; D005260:Female; D017144:Focus Groups; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010349:Patient Compliance; D013808:Therapeutic Community