Author:
Fiander Matthew,Burns Tom,Mchugo Gregory J.,Drake Robert E.
Abstract
BackgroundThe significant reductions in hospital admission demonstrated in US assertive community treatment (ACT) studies have not been replicated in the UK. Explanations cite poor UK ‘model fidelity’ and/or better UK standard care. No international model-fidelity comparisons exist.AimsTo compare high-fidelity US ACT teams with a UK team.MethodThe UK700's ACT team (n=97) was compared with high-fidelity US ACT teams (n=73) by using two measures: a forerunner of the Dartmouth Assertive Community Treatment schedule (to assess adherence to ACT principles) and 2-year prospective activity data.ResultsThe UK and US teams had similar high-fidelity scores. Although significant differences were found in the amount and type of activity, practice differences in areas central to ACT were not great.ConclusionsThe failure of UK ACT studies to demonstrate the outcome differences of early US studies cannot be attributed entirely to the lack of ACT fidelity.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
71 articles.
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