Evidence-Based Practices Within PACT
While Assertive Community Treatment is considered an evidence-based treatment in and of itself, it ideally also serves as a platform from which a variety of evidence-based practices can be delivered. Below is a list of the 7 broad domains of services delivered by ACT teams, as well as who on the team generally delivers these services:
- Pharmacological and Integrated Care – ACT psychiatric care providers take the lead in psychopharmacological interventions. High fidelity ACT marries best practice in prescribing with honoring individual choice and autonomy, exploring together with people served how medication can best support their recovery. Nurses assist in the management and delivery of medications, monitoring of side effects, and increasing individual independence in managing their own medical care. Additionally, both psychiatric care providers and nurses on the team seek to promote whole body wellness in people served in ACT and may work independently or in collaboration with outside primary care and specialty care providers to screen for and treat medical comorbidities, provide health education, and to promote healthy lifestyle choices.
- Wellness Management Services – ACT teams are person-centered and should encourage the people they serve to recognize and honor their own self-determination to drive their own recovery. A variety of manualized Wellness Management and Recovery Services (i.e., IMR, WRAP) exist to aid in structuring these conversations around recovery and autonomy, which can occur in group or individual settings. Given their particular expertise and own experiences with recovery, Peer Specialists are the ideal staff member to deliver these services, though all team members benefit from a fluency in these interventions and can support their work. Ideally, these conversations connect people served by ACT with a broader community of people living their own journey of recovery.
- Evidence-Based Psychotherapy – ACT teams are responsible for delivering psychotherapy that addresses the distress and impairment related to psychiatric symptoms as well as any other comorbid psychiatric conditions. These services are often delivered by masters-level mental health practitioners on the team with specialized training in evidence-based therapies, but all team members can support this work. Though able to provide consultation and recommendations in a variety of psychotherapeutic interventions, the SPIRIT lab has particular expertise in the use of Cognitive Behavioral Therapy for psychosis– more information can be found here.
- Supported Employment and Education – ACT recognizes the role that meaningful work can play in recovery and independence, so one of the central goals of ACT services is to prepare interested individuals for employment and/or formal education that aligns with their preferences, skills, and goals. The team’s Employment and Education Specialist, with support of the rest of the team, does this via brief vocational assessment, job development, direct job coaching, and ongoing benefits counseling.
- Integrated Dual Disorders Treatment – It is not uncommon for people served by ACT teams to engage in substance use. When that use is distressing or impairing for the individual, ACT teams provide comprehensive, integrated treatment not just for their primary mental health diagnosis but also for the co-occurring substance use. These services are delivered in a person-centered, harm reduction model primarily by the team’s Co-Occurring Disorder Specialist, though all team members play a role in supporting this work. Teams may also connect the people they serve with broader outside communities of people in recovery from substance abuse.
- Family Education and Support – Community-based work like ACT recognizes that the people they serve have others in their lives that play key roles in their recovery. As such, ACT services often involve providing education, teaching skills, and extending support to these important figures, whether they be parents, children, partners, close friends, or anyone else. This work is critical in helping those served by ACT to establish and maintain the meaningful relationships that make life better, especially as these people in their lives may lack a frame of reference for understanding recovery from a mental illness. These services can be delivered in a variety of ways by the team: via specialized mental health practitioners, as part of psychiatric or nursing care, during group sessions, and beyond.
- Psychiatric Rehabilitation and Case Management – A key component of ACT is ensuring that the people served have everything in place to meet their basic needs. At times, this may look like traditional case management services, where staff assist in filing important paperwork, tracking appointments, and completing important chores. However, ACT is a recovery-oriented model that recognizes the innate ability of people served to develop the skills that they need in order to lead a fulfilling, independent life. It is essential, then, that ACT teams employ evidence-based, psychiatric rehabilitation strategies to assist in identifying and developing the competencies needed to move the people they serve towards their goals. These services are often delivered by the entire team, though certain team members may be designated as taking the lead on providing psychiatric rehabilitation assessment and interventions.
Please visit our staff page to see which Evidence-Based Practices our team members specialize in if you are interested in more information or consultation.