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Family Support in Assertive Community Treatment: An Analysis of Client Outcomes

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Abstract

Assertive Community Treatment (ACT) is an outreach-based case management model that assists people with severe mental illness through an intensive and integrated approach. In this program, a multidisciplinary team provides medical and psychosocial services. The purpose of this study was to examine the effectiveness of the following two ACT intervention strategies: “replacement” (supporting the clients) versus “backup” (supporting family members who provide care to clients). Admission days, psychiatric symptoms, quality of life, self-efficacy, and service satisfaction ware evaluated as outcome variables. To identify effective methods of supporting family members, clients living with family were divided into two groups based on the amount and types of services received—the backup group and the replacement group. ANCOVA was used to compare the outcomes between the two groups. The replacement group displayed significantly better psychiatric symptoms, social functioning, self-efficacy, and service satisfaction scores. No differences in admission days or quality of life were found. Clients provided more support directly to clients themselves than to family members was found to have better client outcomes in improving psychiatric symptoms, social functioning, and self-efficacy, resulting in higher levels of service satisfaction. This indicates that society should reduce the responsibility of the family and share responsibility for the care of people with mental illness to effectively improve outcomes for people with mental illnesses.

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Acknowledgments

This research was part of a project supported by grant H14-Kokoro-009 and H17-Kokoro-006 from the Ministry of Health, Labor, and Welfare of Japan. I am grateful to the members of the ACT clinical team, research team, and the clients who made the evaluation possible. I would also like to thank Norito Kawakami and Wakate Kai, who were important advisors during the work.

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Authors and Affiliations

  1. Psilocybe Inc., 237 Sano, Higashi-Ohmi, Shiga, Japan

    Tamaki Sono

  2. Graduate School of Social Welfare, Japan College of Social Work, 3-1-30 Takeoka, Kiyose, Tokyo, Japan

    Iwao Oshima

  3. Department of Psychiatric Rehabilitation, Institute of Mental Health, National Center of Neurology and Psychiatry Japan, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo, Japan

    Junichiro Ito & Yutaro Setoya

  4. Faculty of Comprehensive Welfare, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, Miyagi, Japan

    Masaaki Nishio

  5. Department of Adult Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo, Japan

    Yuriko Suzuki

  6. Kohnodai Hospital, International Medical Center of Japan, 1-7-1 Kohnodai, Ichikawa, Chiba, Japan

    Kentaro Horiuchi & Kazumi Tsukada

  7. Social Work Research Institute, Japan College of Social Work, 3-1-30 Takeoka, Kiyose, Tokyo, Japan

    Nobuyuki Niekawa

  8. School of Nursing, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, Japan

    Masayo Ogawa

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  1. Tamaki Sono
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  2. Iwao Oshima
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  3. Junichiro Ito
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  4. Masaaki Nishio
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  5. Yuriko Suzuki
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  6. Kentaro Horiuchi
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  7. Nobuyuki Niekawa
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  8. Masayo Ogawa
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  9. Yutaro Setoya
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  10. Kazumi Tsukada
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Correspondence to Tamaki Sono.

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Sono, T., Oshima, I., Ito, J. et al. Family Support in Assertive Community Treatment: An Analysis of Client Outcomes. Community Ment Health J 48, 463–470 (2012). https://doi.org/10.1007/s10597-011-9444-3

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  • DOI: https://doi.org/10.1007/s10597-011-9444-3

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