Staff and Consumer Perspectives on Defining Treatment Success and Failure in Assertive Community Treatment

Abstract

OBJECTIVE: Although assertive community treatment (ACT) has been consistently recognized as effective, there has been little research as to what constitutes success in ACT. The purpose of this study was to understand how ACT consumers and staff define treatment success and failure and to examine whether definitions varied between staff and consumers. METHODS: Investigators conducted semistructured interviews with 25 staff and 23 consumers from four ACT teams. RESULTS: Across perspectives, success and failure were most clearly related to consumer factors. Other themes included having basic needs met, being socially involved, and taking medications. Reduced hospitalizations were mentioned infrequently. Consumers were more likely than staff to identify the level or type of treatment as defining success and failure, whereas staff were more likely than consumers to discuss substance abuse when defining failure and improved symptoms when defining success. CONCLUSIONS: Success in ACT should be viewed more broadly than reduced hospitalizations and include domains such as social involvement.