Hostname: page-component-7c8c6479df-94d59 Total loading time: 0 Render date: 2024-03-29T01:22:38.395Z Has data issue: false hasContentIssue false

Assertive community treatment

Published online by Cambridge University Press:  02 January 2018

Leonard I. Stein
Affiliation:
Department Psychiatry, University of Wisconsin, 6001 Research Park Blvd, Madison, Wisconsin 53719 USA
Ronald J. Diamond
Affiliation:
Department of Psychiatry, University of Wisconsin
Alan Rosen
Affiliation:
Royal North Shore Hospital and Community Mental Health Services, Department of Psychological Medicine, University of Sydney, Sydney, Australia
Rights & Permissions [Opens in a new window]

Abstract

Type
Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2003

We are grateful to T. Burns and J Catty for calling attention to the importance of ‘Defining the comparator and identifying active ingredients’ of the conditions being studied (Psychiatric Bulletin, September 2002, 26, 324-327). We agree on the importance of the accurate use of the terms used to describe treatment models when making comparisons. We applaud their call to be more rigorous in this regard and want to point out an example of how difficult this seems to be. In their paper, they assert that the impressive advantages of assertive community treatment (ACT) reported in earlier studies are not being repeated in later studies. To support their assertion, they then reference two UK studies (Reference Thornicroft, Wykes and HollowayThornicroft et al, 1998, UK 700 group, 1999). Unfortunately neither of these are studies of ACT.

This error is particularly egregious because it has been pointed out previously in the literature that these are not studies of ACT (Marshall et al, 2000; Rosen & Teesson, 2001). It is clearly misleading to label these as ACT studies, and yet they continue to perpetuate this misrepresentation. By mis-labelling studies as ACT, even though clear criteria have been developed to identify and measure ACT's essential elements (Reference Teague, Bond and DrakeTeague et al, 1998), the authors demonstrate that it is difficult for them to practise what they so rightly preach. As they point out, these kinds of errors cloud rather than clarify our understanding of the role various models could play in a system of care.

References

Marshall, M., Bond, G., Stein, L. I., et al (1999) PRiSM Psychosis Study. Design limitations, questionable conclusions. British Journal of Psychiatry, 175, 501503.Google Scholar
Rosen, A. & Teesson, M. Does case management work? The evidence and the abuse of evidence based medicine. Australian and New Zealand Journal of Psychiatry, 35, 731746.Google Scholar
Teague, G. B., Bond, G. R. & Drake, R. E. (1998) Program fidelity in assertive community treatment. American Journal of Orthopsychiatry, 68, 216232.Google Scholar
Thornicroft, G., Wykes, T., Holloway, F., et al (1998) From efficacy to effectiveness in community mental health services. PRiSM psychosis study, 10. British Journal of Psychiatry, 173, 423427.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.