Clinicians’ Perceptions of Challenges and Strategies of Transition from Assertive Community Treatment to Less Intensive Services

Molly T. Finnerty, Jennifer I. Manuel, Ana Z. Tochterman, Candice Stellato, Linda H. Fraser, Cecily A.S. Reber, Hima B. Reddy, Angela D. Miracle

Research output: Contribution to journalArticle

Abstract

The study aimed to identify clinical strategies and challenges around transition from Assertive Community Treatment (ACT) to less intensive services. Six focus groups were conducted with ACT team leaders (n = 49). Themes were grouped under four intervention-focused domains: (1) client/clinical, (2) family and natural supports, (3) ACT staff and team, and (4) public mental health system. Barriers to transition included beliefs that clients and families would not want to terminate services (due to loss of relationships, fear of failure, preference for ACT model), clinical concerns that transition would not be successful (due to limited client skills, relapse without ACT support), systems challenges (clinic waiting lists, transportation barriers, eligibility restrictions, stigma against ACT clients), and staff ambivalence (loss of relationship with client, impact on caseload). Strategies to support transition included building skills for transition, engaging supports, celebrating success, enhanced coordination with new providers, and integrating and structuring transition in ACT routines.

Original languageEnglish (US)
Pages (from-to)85-95
Number of pages11
JournalCommunity mental health journal
Volume51
Issue number1
DOIs
StatePublished - 2014

Keywords

  • Assertive Community Treatment
  • Barriers to discharge
  • Facilitators of discharge
  • Mental illness
  • Transition

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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