title: Clinicians' perceptions of challenges and strategies of transition from assertive community treatment to less intensive services.
abstract: The study aimed to identify clinical strategies and challenges around transition from Assertive Community Treatment (ACT) to less intensive services. Six focus groups were conducted with ACT team leaders (n = 49). Themes were grouped under four intervention-focused domains: (1) client/clinical, (2) family and natural supports, (3) ACT staff and team, and (4) public mental health system. Barriers to transition included beliefs that clients and families would not want to terminate services (due to loss of relationships, fear of failure, preference for ACT model), clinical concerns that transition would not be successful (due to limited client skills, relapse without ACT support), systems challenges (clinic waiting lists, transportation barriers, eligibility restrictions, stigma against ACT clients), and staff ambivalence (loss of relationship with client, impact on caseload). Strategies to support transition included building skills for transition, engaging supports, celebrating success, enhanced coordination with new providers, and integrating and structuring transition in ACT routines.
authors: Department of Child and Adolescent Psychiatry/Bureau of Evidence Based Services and Implementation Science, New York University/New York State Office of Mental Health, 1051 Riverside Drive, Unit 104, New York, NY, 10032, USA, Molly.Finnerty@omh.ny.gov.
authors: Molly T
authors: MT
authors: Finnerty
authors: Jennifer I
authors: JI
authors: Manuel
authors: Ana Z
authors: AZ
authors: Tochterman
authors: Candice
authors: C
authors: Stellato
authors: Linda H
authors: LH
authors: Fraser
authors: Cecily A S
authors: CA
authors: Reber
authors: Hima B
authors: HB
authors: Reddy
authors: Angela D
authors: AD
authors: Miracle
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D019090:Case Management; D003156:Community Mental Health Services / Q000379:methods*; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D009518:New York; D010465:Perception; D011369:Professional-Patient Relations; D057545:Social Stigma; D013240:Stereotyping