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1. Year 13 Clinical Psychology -AJW 2010 Treating Schizophrenia: A social Approach Evaluating ACT Imagine you are a community mental health team manager, what questions…
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  • 1. Year 13 Clinical Psychology -AJW 2010 Treating Schizophrenia: A social Approach Evaluating ACT Imagine you are a community mental health team manager, what questions would you want to ask before investing in ACT training for your team? Cut out your speech bubbles and make a brain-map. Consider the evidence on the following page and match it to your questions. Use the final image and speech bubble to draw a conclusion about ACT.
  • 2. Year 13 Clinical Psychology -AJW 2010 One of the most extensively researched models If targeted on high users of in-patient care, ACT of community care for people with severe can substantially reduce the costs of hospital care mental illness; evidence suggests ACT is whilst improving outcomes and patient consistent across numerous reviews studies satisfaction. and is effective in managing the care of severely mentally ill people in the community Bond et al. (2001) summarized outcomes from Marshall and Lockwood (1998): found very similar 25 randomized controlled trials: compared with results including improved employment and standard community care, ACT is highly patient satisfaction however there were no successful in engaging clients in treatment, significant differences regarding to mental state or substantially reduces psychiatric hospital use, social functioning. increases housing stability, and moderately improves symptoms and subjective quality of life increased continuity of care over time and greater client satisfaction than standard services reduce staff burnout as patients works with and satisfaction is similar across genders, age and large multidisciplinary teams where background responsibility for patients well being is shared. Gomory, (2001) argues that ACT programs are Apparently only a small minority of ACT clients – coercive or paternalistic and that conversely, 11% in one study believe ACT services are too they are not based on client choice. This intrusive or confining, or that they foster criticism is based mostly on anecdotes and dependency. theoretical arguments, rather than empirical studies. complaints about ACT services are more One large-scale survey examined strategies for frequent in ACT programs that are low in therapeutic limit setting (interventions to pressure fidelity (deviate significantly from standard ACT clients to change disturbing or destructive model) behaviour or to stay in treatment); techniques, ranged from simply ignoring a behaviour or using verbal encouragement to involuntary hospital admission; while verbal persuasion was widely used, more coercive interventions were used with less than 10% of the clients; limit setting was more common when clients had extensive hospitalization histories, more symptoms, more arrests, and more recent substance use.
  • 3. Year 13 Clinical Psychology -AJW 2010 helps clients avoid hospitalization (including specifically targets individuals with the most involuntary commitments) and enables them to complex and severe problems who do not live more normal lives respond well to less intensive treatments and who are frequent users of emergency psychiatric services, especially inpatient care. Outreach can be used to help people with very flexible across a wide range of clients schizophrenia who are homeless, substance from many different cultural backgrounds; age, abusers and those in the criminal justice system gender, education, and other such background characteristics have not been reported as factors limiting the effectiveness of ACT In conclusion it would appear that ACT....
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