Staff and consumer perspectives on defining treatment success and failure in assertive community treatment.
OBJECTIVE
Although assertive community treatment (ACT) has been consistently recognized as effective, there has been little research as to what constitutes success in ACT. The purpose of this study was to understand how ACT consumers and staff define treatment success and failure and to examine whether definitions varied between staff and consumers.


METHODS
Investigators conducted semistructured interviews with 25 staff and 23 consumers from four ACT teams.


RESULTS
Across perspectives, success and failure were most clearly related to consumer factors. Other themes included having basic needs met, being socially involved, and taking medications. Reduced hospitalizations were mentioned infrequently. Consumers were more likely than staff to identify the level or type of treatment as defining success and failure, whereas staff were more likely than consumers to discuss substance abuse when defining failure and improved symptoms when defining success.


CONCLUSIONS
Success in ACT should be viewed more broadly than reduced hospitalizations and include domains such as social involvement.
Stull
Laura G
LG
Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA. lgc@iupui.edu
McGrew
John H
JH
Salyers
Michelle P
MP
D000328:Adult; D001291:Attitude of Health Personnel; D003156:Community Mental Health Services; D003258:Consumer Behavior; D005260:Female; D006801:Humans; D007196:Indiana; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care
Community Ment Health J. 2007 Dec;43(6):619-41
17514503
Psychiatr Rehabil J. 2005 Spring;28(4):395-7
15895925
Scand J Public Health Suppl. 2005 Oct;66:29-35
16214720
Psychiatr Serv. 2000 Nov;51(11):1410-21
11058189
Psychiatr Serv. 2003 Mar;54(3):370-6
12610246
Schizophr Bull. 1998;24(1):37-74
9502546