Evaluation: Assertive Community Therapy for Schizophrenia

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A level Psychology (Clinical Psychology) Mind Map on Evaluation: Assertive Community Therapy for Schizophrenia, created by Katie Greensted on 02/06/2019.
Katie Greensted
Mind Map by Katie Greensted, updated more than 1 year ago
Katie Greensted
Created by Katie Greensted almost 5 years ago
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Evaluation: Assertive Community Therapy for Schizophrenia
  1. ACT is a psycho-social multidisciplinary, person centred treatment. 24 hour care is provided to clients in their natural living environments, which is either at home or in a sheltered accommodation in the community.
    1. Studies have found that ACT seems to improve the quality of life for recipients as they feel that they are able to maintain a normal lifestyle (e.g. Trauer et al). This is perhaps because the treatment is carried out in their natural environment, and hopes to keep the individuals integrated into society, rather than isolated from it.
      1. However, although most patients find living in the community preferable to being in hospital, others may find that situation to be more overwhelming and challenging. Therefore, this form of treatment may not be successful for everyone.
    2. The main aim of the treatment is to focus on those that need help with independence, rehabilitation and recovery to avoid homelessness and reduce admissions to hospitals and shorten lengths of stay.
      1. Social integration has been found to be effective in reducing symptoms and the severity of these symptoms. Left found that those suffering from sz being cared for in the community in sheltered accommodation showed much lower symptoms and severity than those hospitalised, particularly with negative symptoms.
        1. However, proper integration into society may be found difficult due to the stigmatisation and prejudice surrounding sufferers of mental health in society. This is only exemplified by the media who report on the extremely rare cases were mentally unwell members of society have gone on to attack or murder others. This may make the aim of social integration hard to meet, and may put strain on both the individual attempting to be integrated into society and that individual's family.
      2. Patients are given lifelong care, even after stabilisation and outreach is promoted for those not wishing to engage with the therapy.
        1. Gomory argues that ACT is paternalistic and coercive, and that patients do not always feel as though they have a choice (particularly due to the outreach if the individual is not interested). 11% of patients feel forced to undertake treatment.
          1. Bond et al suggested, however, that the choice of freedom given by ACT, along with preventing hospitalisation and having an increased choice of treatment is more effective than standard community care.
        2. Medication is self-administered for many, however extra support is provided for those that may need it. Hospitalisation is given as a last resort if the individual feels as though they cannot cope.
          1. Leshner found that communication was poor between agencies and that there was no overall strategy for coordinating patient care. This suggests that although extra support is promoted, it may not be of the best quality, and therefore the treatment may not be as effective as it is suggested to be.
            1. Budget cuts make ACT difficult to sustain. Shepherd found that most programmes are severely underfunded, and therefore may not be the most effective form of treatment for an individual. Furthermore, the reluctance to provide and fund hospital beds may mean that someone who needs hospitalisation is not being admitted when needed.
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