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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
View Author and Article Information

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

Abstract

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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References

Sytema  S;  Wunderink  L;  Bloemers  W  et al:  Assertive community treatment in the Netherlands: a randomized controlled trial.  Acta Psychiatrica Scandinavica 116:105–112, 2007
[CrossRef] | [PubMed]
 
Killaspy  H;  Bebbington  P;  Blizard  R  et al:  The REACT study: Randomised Evaluation of Assertive Community Treatment in north London.  BMJ (Clinical Research Edition) 332:815–820, 2006
[CrossRef]
 
Killaspy  H;  Kingett  S;  Bebbington  P  et al:  Randomised Evaluation of Assertive Community Treatment: 3-year outcomes.  British Journal of Psychiatry 195:81–82, 2009
[CrossRef] | [PubMed]
 
Bond  GR;  McGrew  JH;  Fekete  DM:  Assertive outreach for frequent users of psychiatric hospitals: a meta-analysis.  Journal of Mental Health Administration 22:4–16, 1995
[CrossRef] | [PubMed]
 
Burns  T:  The rise and fall of assertive community treatment? International Review of Psychiatry 22:130–137, 2010
[CrossRef] | [PubMed]
 
Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. London, National Institute for Clinical Excellence, National Collaborating Centre for Mental Health, 2002
 
Pilling  S;  Bebbington  P;  Kuipers  E  et al:  Psychological treatments in schizophrenia: I. meta-analysis of family intervention and cognitive behaviour therapy.  Psychological Medicine 32:763–782, 2002
[PubMed]
 
Pekkala  E;  Merinder  L:  Psychoeducation for schizophrenia.  Cochrane Database of Systematic Reviews 2:CD002831, 2002
[PubMed]
 
Salkever  D:  Social costs of expanding access to evidence-based supported employment: concepts and interpretive review of evidence.  Psychiatric Services 64:111–119, 2013
[CrossRef] | [PubMed]
 
Teague  GB;  Bond  GR;  Drake  RE:  Program fidelity in assertive community treatment: development and use of a measure.  American Journal of Orthopsychiatry 68:216–232, 1998
[CrossRef] | [PubMed]
 
Petersen  L;  Jeppesen  P;  Thorup  A  et al:  A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness.  BMJ (Clinical Research Edition) 331:602, 2005
[CrossRef]
 
Craig  TK;  Garety  P;  Power  P  et al:  The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis.  BMJ (Clinical Research Edition) 329:1067, 2004
[CrossRef]
 
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