OBJECTIVE: Continuous treatment teams serving persons with co-occurring
severe mental disorders and substance abuse disorders at seven sites in New
Hampshire were evaluated to determine their fidelity to a model based on
the Program for Assertive Community Treatment. METHODS: Continuous
treatment teams and standard case management programs at the seven sites
were evaluated on 13 criteria for fidelity to the continuous treatment team
model over a 27-month period. Data sources included clinicians' activity
logs, agencies' management information systems, interviews, observation of
staff activity and practices, and clinical records and other documents.
RESULTS: The continuous treatment teams scored significantly higher than
the case management programs on ten of the 13 criteria. The teams were more
effective than the case management programs in implementing substance abuse
treatment. CONCLUSIONS: Evaluation of the programs' fidelity to the model
criteria allowed differentiation of successfully implemented continuous
treatment teams from standard case management and from an unsuccessfully
implemented team. The results confirm the need for careful measurement of
model implementation and for investigation of organizational issues such as
administrative support and clarity of program mission.
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