When Is a Program Actually ACT

How do you know an ACT program when you see it? A validated and widely used "fidelity scale" is the Dartmouth Assertive Community Treatment Scale (DACTS; Teague, Bond & Drake, 1998). Fidelity, as introduced in Chapter 1, is about "faithfulness" to a particular treatment or rehabilitation model. DACTS has been used to assess fidelity of programs to the ACT model (Bond et al., 2001).

TABLE 7.2

Ten Principles of Assertive Community Treatment

1. Services are targeted to a specified group of individuals with severe mental illness, usually those at high risk for hospitalization, rehospitalization, or relapse.

2. Rather than brokering services, all treatment and rehabilitation services are provided directly by the assertive community treatment team.

3. Team members share responsibility for the individuals served by the team.

4. The staff-to-consumer ratio is small (approximately 1 to 10).

5. The range of treatment and services is comprehensive and flexible.

6. Interventions are carried out at the locations where problems occur and support is needed, "in vivo" (in real life), rather than in hospital or clinic settings.

7. There is no arbitrary time limit on receiving services.

8. Treatment and support services are individualized.

9. Services are available on a 24-hour basis.

10. The team is assertive in engaging individuals in treatment and monitoring their progress. Source: Based on Phillips et al., 2001.

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