A Review of Assertive Community Treatment (ACT) And Employment, Article Review Example

Introduction

The below article review will focus on two studies focusing on the effectiveness of evidence-based interventions and practices aiming to improve mental health and social functioning. While the research completed by Gao and Dolce (2005) is aimed at determining the effectiveness of one particular intervention, Assertive Community Treatment (ACT) to improve employment outcomes, the 2005 randomized trial by Gold et al. (2005) examined more than two variables, such as ethnic minority status, age, and educational attainment.

Article Reviews

ACT and Employment Outcomes in Urban and Suburban Areas

The authors of the research article (Gao & Dolce, 2015) studied the impact of ACT on participating individuals’ life. The researchers work at the Department of Psychiatric Rehabilitation and Counseling Professions, at the Department of Psychiatric Rehabilitation and Counseling Professions. Their research is focused on the effectiveness of the intervention method, and they have a wide knowledge about the strategy and related studies examining its impact on communities. The main finding of the study is that participation in the program resulted in a rise in a rise of employment levels within the researched group within a 12-month period. Employment rate rose from 5 percent to 24 percent.

The main research question of the authors was: “how can ACT teams commit to providing employment services while maintaining good clinical services?” (Gao & Dolce, 2015, p. 95). The focus of the study was the long-term outcome of the ACT evidence-based practice on employment rates. The main hypothesis the authors used was that increasing employment rate reduced reliability on social security, improved mental health outcomes, and social functioning.

The study was carried out in New Jersey, within a community mental health agency, serving urban and suburban patients. The selection criteria was that recipients of the service had at least one admission to the state, or multiple admissions to the county psychiatric hospital in the past. The baseline for the study was determined as 5 percent of competitive employment prior to the introduction of ACT. The sample size was limited to 60 people, and the demographic characteristics of participants were not considered when measuring results. The quantitative research confirmed the initial assumption of the authors that the implementation of ACT would increase competitive employment outcomes over a period of a year. However, the impact of individual intervention factors, such as employment support, self-directed research were not measured. Further, the sample size and lack of demographic diversity limit the applicability of the results on a nationwide sample.

Randomized Trial in a Rural Setting Measuring the Impact of ACT-IPS Evidence Based Practice

The research created by Gold et al. (2005) aimed at measuring the outcomes of ACT-IPS (Assertive Community Treatment and Individual Placement and Support) combined evidence based intervention in a community that had characteristics different from those that have been studied previously. Therefore, the main aim of the study was to find evidence that the program would not only work in urban communities, but also benefit individuals who live in rural areas with limited access to work, education, and support services. As the authors confirm,  community services like the one researched (rural South Carolina) are “loosely arrayed, weakly linked, understaffed, and geographically dispersed” (Gold et al., 2005, p. 1).

The authors used a selection criteria to identify the population to be included in the study. The criteria included being a client of SWCMHC for at least 6 months, unemployed, over the age off 18, and having an interest in competitive employment. The study had to be redesigned at an early stage, due to the lack of qualified providers. The randomized trial included the creation of three project teams, consisting of a total of 177 participants, assigned to ACT-IVR, traditional, and IPS programs. The main goal was to determine which evidence based practice delivers more positive results for individuals with mental illnesses.

Measuring the long-term (24 months) employment and mental health outcomes revealed that those assigned to the Supported Employment (SEP) programs were less likely to be in employment after 24 months, however, they were also less likely to be in mental health services. At the same time, the proportion of participants holding on to one job for 24 months was 36.4 percent in the ACT-IPS program, compared with 28.6 percent of those in the SEP program. Further, competitive employment was higher among participants of ACT-IPS. The total earned income among participants in the ACT-IPS programs was higher. The main finding of the study is that while SEP provides almost immediate job placements, it does not support individuals in securing competitive employment. The main limitation of the study is that the ACT and IPS teams worked independently, instead of alongside with other mental health services teams. This might have hindered the validity of the results.

Conclusion

From the above review of studies, it is clear that employment focused mental health evidence based interventions have the potential of supporting patients finding suitable jobs. This could positively impact not only their social and coping skills, but also reduce the level of stress that can trigger further admissions to psychiatric hospitals. Therefore, it is recommended that the above discussed ACT, SEP, and IPS programs are implemented by community hospitals.

References

Gao, N., & Dolce, J. N. (2010). A case illustration of strategies to improve employment outcomes among individuals receiving ACT services. American Journal of Psychiatric   Rehabilitation, 13(2), 94-104.

Gold, P. B., Meisler, N., Santos, A. B., Carnemolla, M. A., Williams, O. H., & Keleher, J. (2005). Randomized trial of supported employment integrated with assertive community treatment for rural adults with severe mental illness. Schizophrenia bulletin. 32(2):378-95