Adapting ACT to Serve Culturally Diverse Communities: A Comparison of a Japanese and a Canadian ACT Team

Objective:

The assertive community treatment (ACT) teams of Mount Sinai Hospital in Toronto and the KUINA Center, Hitachinaka, Japan, were compared with regard to ACT fidelity, organizational structure, populations served, and treatment outcomes. Ethnocultural adaptations to the ACT model made by both teams included enhanced family support and intervention, culturally and linguistically matched staff and patients when possible, culturally informed therapy, routine cultural assessments, culturally matched housing and community support, and flexible funding models.

Methods:

Data were gathered by chart reviews (66 patients in Toronto and 40 patients in Japan), a satisfaction measure, a standard measure of ACT fidelity, and a pre-post measure of treatment outcomes (the Brief Psychiatric Rating Scale), and hospitalization days.

Results:

Both teams achieved good fidelity to ACT and reductions in hospitalization and symptom severity. Family satisfaction scores were high.

Conclusions:

With culturally informed adaptations, ACT can be effective in a Canadian mixed ethnocultural population and a homogeneous Japanese population. (Psychiatric Services 62:971–974, 2011)