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Brief Reports   |    
Adding Evidence-Based Interventions to Assertive Community Treatment: A Feasibility Study
Sjoerd Sytema, Ph.D.; Frederike Jörg, Ph.D.; Roeline Nieboer, M.Sc.; Lex Wunderink, M.D., Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300143
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Except for Ms. Nieboer, the authors are with the University Center of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands (e-mail: s.sytema@umcg.nl). Dr. Jorg, Dr. Wunderink, and Ms. Nieboer are with the Department of Education and Research, Friesland Mental Health Services, Leeuwarden, Friesland, the Netherlands.

Copyright © 2014 by the American Psychiatric Association


Objective  This 24-month study, conducted in The Netherlands, examined the feasibility of enhancing the effectiveness of assertive community treatment (ACT) by adding evidence-based interventions.

Methods  A total of 159 patients were randomly assigned to two ACT teams, one providing standard ACT (N=85) and an ACT Plus team that also provided evidence-based interventions (N=74): psychoeducation, family interventions, individual placement and support, and cognitive-behavioral therapy. The interventions were conducted by psychologists and nurse practitioners working independently from the ACT team.

Results  Although most patients were judged eligible for each of the four interventions (range 65% to 89%), only 12 of the 74 patients (16%) successfully completed an intervention. Outcomes, such as use of inpatient care, for ACT Plus and standard ACT patients did not differ significantly.

Conclusions  Guidelines for the treatment of schizophrenia should consider the feasibility of delivering evidence-based interventions to difficult-to-engage patients.

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Table 1Delivery of evidence-based interventions to 74 patients receiving enhanced assertive community treatment
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a Percentage of 74

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b Percentage of eligible patients

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c Percentage of patients offered the intervention

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d Percentage of patients starting the intervention



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