Family-aided assertive community treatment: A comprehensive rehabilitation and intensive case management approach for persons with schizophrenic disorders

1992 ◽  
Vol 1992 (53) ◽  
pp. 43-54 ◽  
Author(s):  
William R. McFarlane ◽  
Peter Stastny ◽  
Susan Deakins
1993 ◽  
Vol 23 (1) ◽  
pp. 43-59 ◽  
Author(s):  
Steven S. Martin ◽  
Frank R. Scarpitti

The need for drug abuse treatment to reduce recidivism in prison systems has led to increasing interest in treatment alternatives for correctional clients. The research on the effectiveness of treatment alternatives, however, has lagged behind the interest in and implementation of new programs. This article reports on early findings from an ongoing longitudinal study of the efficacy of an intensive case management approach, Assertive Community Treatment (ACT), for treating parolees with past drug problems, compared with a group of parolees who were not offered this treatment program. Using follow-up data on 135 subjects interviewed at release from prison and then reinterviewed about six months later, the ACT group and comparison group are examined in terms of recidivism and relapse to drug use. Bivariate analyses suggest little difference between the two groups. Multivariate analyses, however, suggest several important variables that were not manipulated in this “quasi-experiment,” but are predictive of relapse and recidivism. Although the limited sample size available at present precludes any definitive conclusions, discussion focuses on the direction of findings and highlights the necessity for multivariate controls in assessing the effectiveness of any intervention with criminal justice clients.


2002 ◽  
Vol 53 (2) ◽  
pp. 207-210 ◽  
Author(s):  
Richard Schaedle ◽  
John H. McGrew ◽  
Gary R. Bond ◽  
Irwin Epstein

2007 ◽  
Vol 41 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Lucinda Smith ◽  
Richard Newton

The purpose of the present paper was to review the current state of evidence for types of case management, focusing on the last 10 years since publication of the Cochrane Systematic Reviews of case management and assertive community treatment. A literature review of electronic databases from 1995 to the present to identify recent research on psychiatric case management, both original studies and reviews, was carried out. Original articles were organized on basis of year of study, experimental group and outcome variables to determine patterns. Sixty relevant papers were located. Thirty-nine are reports of experimental trials of types of case management and 21 are reviews or discussion papers. The focus of research is on assertive community treatment or intensive case management, with only five papers on other forms of less intense case management. Numerous outcomes have been examined, of those examined often enough to draw meaningful conclusions only one, engagement with services, has been consistently positive. All other outcomes have produced mixed results. The strength of findings in favour of case management has weakened over time. A heterogeneous group of experimental designs limits comparisons. Numerous issues with methodology and definitions of types of case management have beset research in this field. Assertive types of case management (including assertive community treatment and intensive case management) are more effective than standard case management in reducing total number of days spent in hospital, improving engagement, compliance, independent living and patient satisfaction. More important than the type of service configuration is to understand the clinical criteria of the services provided and their effectiveness.


2008 ◽  
Vol 17 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Max Marshall

AbstractThe aims of the Editorial are to summarise what we know for certain from clinical trials of Intensive Case Management, and to highlight lessons for clinicians and researchers. I will upon two systematic reviews of trials of Intensive Case Management versus standard care or low intensity case management. Both incorporated a meta-regression which examined the effect of fidelity to the Assertive Community Treatment model on outcome. The effectiveness of Intensive Case Management was limited to improving patient satisfaction and reducing attrition. Intensive Case Management teams organised according to the Assertive Community Treatment model offered the additional benefit of reducing days in hospital, but only when the team's clients had been high users of hospital care over the previous 12 months. Four important lessons can be drawn: a) Changes to the process of care tend to affect process variables, not outcome variables. b) Complex interventions must be defined meticulously in clear terminology. c) Researchers must demonstrate that complex interventions have been properly implemented in clinical trials. d) It is important to remember that in a clinical trial a successful outcome is determined as much by the control group as by the intervention.


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