Persons with primary, severe alcohol and drug use disorders, who have experienced multiple treatment admissions, no periods of sustained recovery, homelessness, poverty, high HIV-exposure risk, and co-occurring psychiatric disorders participated in this summative study of assertive community treatment (ACT), an innovative service model with proven effectiveness for persons with severe mental illness (SMI) and alcohol and drug disorders. Although previous federally-funded projects show ACT as effective for SMI, its impact on primary, severe AOD use disorders remains unknown. ACT is a comprehensive, interdisciplinary team approach that extends the flexibility, availability, and scope of substance abuse treatment, through integration of medical, relapse prevention, rehabilitative, and social services, delivered client’s natural environments with assertive outreach, structure, and intensive support. The South Carolina Department of Alcohol and Other Drug Abuse Services funded an ACT demonstration in 1998, to serve a two-county area with 30% African-Americans. An implementation and summative evaluation of the program indicates treatment effectiveness and good implementation adherence to national ACT standards. To date, 28 clients completed at least six months of ACT treatment; only two dropped out. This 93.4% retention rate dwarfs the 40% retention rate in other local authorities’ intensive outpatient programs. Outcomes are encouraging; however, they must be interpreted with caution, given the brief, six-month interval, small sample size, and absence of a comparison group: reduced substance use, criminal justice system involvement, and victimization from violent crime; and increased employment, housing, functioning, and quality of life. A CSAT-funded randomized trial is underway to formally test this program’s effectiveness.
Learning Objectives: 1. Describe the principles of Assertive Community Treatment (ACT), a novel community-based alternative treatment program to traditional inpatient, intensive outpatient, and residential alcohol and drug treatment. 2. List the operational characteristics of the highly integrated ACT services program and its critical elements to engage and retain individuals in alcohol and drug abuse treatment. 3. Identify the various social, criminal justice, mental health, and medical service authorities, with which the ACT coordinates its activities to ensure the synergistic effect of collaboration on treatment outcomes. 4. Articulate the key differences between the ACT service model and intensive outpatient case management for alcohol and drug abuse treatment, based on their treatment principles and practices. 5. List the professional disciplines, and clinical and rehabilitative roles taken by providers on the ACT team. Describe the organization of the daily ACT team services
Keywords: Community-Based Care, Drug Abuse
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.