Books on Assertive Community Treatment !
Two excellent American books appeared in 1998. You have to order them directly from the U.S.
Click on a title to see more detail:
1. Assertive Community Treatment of Persons with Severe Mental Illness
by Leonard I. Stein and Alberto B. Santos.
by Deborah J. Allness MSSW, and William H. Knoedler MD.
I (Jim Farquhar) advise buying BOTH books if you are starting up a PACT program.
An excellent book:
1. Assertive Community Treatment of Persons with Severe Mental Illness
by Leonard I. Stein and Alberto B. Santos.
Published by W.W. Norton, New York, 1998. 274 pages.
Price: $27 U.S. plus shipping charges.
This book gives a comprehensive view of the history, philosophy, and practical principles of Assertive Community Treatment. There are special sections about using this model in rural areas, for "double diagnosis" patient populations (that is, mentally ill persons who also abuse alcohol or drugs), and homeless populations. The chapter on financing and administering ACT programs is of important value for anyone who wants to set up an ACT program.
The last half of the book consists of a large set of forms used for assessment and intake of clients in an ACT program, based on the one in Madison, Wisconsin, where the model was developed.
Here is the table of contents:
Ch. 1 - Introduction
Ch. 2 - Stigma and Prejudice
Ch. 3 - Origins of Assertive Community Treatment
Ch. 4 - ACT Research and Dissemination
Ch. 5 - Characteristics of the Clinical Population
Ch. 6 - The Continuous Care Strategy
Ch. 7 - The ACT Team
Ch. 8 - Treatment Principles
Ch. 9 - Daily Program Operation
Ch. 10 - Rural, Dually Diagnosed, and Homeless Populations
Ch. 11 - ACT Financing and Administration
Appendix: forms for assessment and intake of clients in an ACT program
To order: the simplest way is by Internet. Print out this page and then go the "virtual bookstore", http://www.barnesandnoble.com . The Barnes and Noble company can easily deliver books in Canada, within 5 to 10 days, with no customs problems, since it has intelligently made an arrangement with the GST people.
Once you get the Barnes and Noble web-site, you have to find the book by typing the first three to five words of the title in the right box. I have found this company to be reliable and efficient, with no customs hassles in six deliveries this year to Montreal.
Go back to beginning of this page.
2. The PACT Model of Community-based Treatment for Persons with Severe and Persistent Mental Illnesses: A Manual for PACT Start-Up
by Deborah J. Allness MSSW, andWilliam H. Knoedler MD.
Published by NAMI (National Alliance for the Mentally Ill), Arlington, VA, 1998. 347 pages.
Price: $29.95 US for members of NAMI, or $39.95 US for non-members, plus 10 per cent for shipping. (For most ordinary Canadians, membership in NAMI, at $25 US per year, does not give a lot of advantages unless you will order a lot of books. This group does excellent lobbying in the U.S. for rights of the mentally ill and their families.)
This is a wonderful book for leaders and members of an ACT team just starting up, or even for well-established teams. It gives a reference point similar to the Bible for many fine points of "best practice" for ACT teams. These include the daily and weekly routines of the team.
Here is the complete Table of Contents. (Click here to skip to Ordering Information.)
Allness and Knoedler 1998: Table of Contents
A Word from NAMI
Introduction to the Manual
Chapter 1: Background and Introduction the PACT Model: Unique characteristics of the PACT Model; Effectiveness of the PACT Model: Research Findings and Conclusions; Dissemination
Chapter 2: PACT Clients: Whom is PACT For? Target population; PACT admission criteria; The PACT model and involuntary outpatient commitment; Other uses of the PACT model
Chapter 3: Starting a New Team: Who Participates in PACT Start-Up? Building the team: team composition; shared staff roles; Team size, ratios, and total caseload; Hours of operation, including on-call; Staff scheduling; Hiring staff; Administrative requirements; Program budget; PACT headquarters; Transportation or staff travel; Medical record management; Client funds management; Policies and procedures
Chapter 4: Teamwork: Organization and Communication Organization and communications structure; Daily organizational staff meeting and daily scheduling; Shift management; Coordination by the program assistant; The client's individual treatment team; Ongoing services and flexible service intensity; Clinical supervision
Chapter 5: The Role of the Psychiatrist: Getting the Right Psychiatrist for the PACT Team Medical specialization; Individual work with clients; The psychiatrist as a team member
Chapter 6: Client-Centered Approach to Individualized Services: The Comprehensive Assessment and the Individualized Treatment Plan Client admission; Comprehensive and ongoing assessment; Continuous treatment planning; Weekly client schedule
Chapter 7: PACT Services: Treatment, Rehabilitation and Support Treatment: psychopharmacologic treatment; Individual supportive therapy; Crisis intervention; Hospitalization; Substance abuse treatment; Rehabilitation: Structuring time and employment; Activities of daily living; Social and interpersonal relationships and use of leisure time; Support services: Collaboration with families and assistance to clients with children
Chapter 8: Managing Medications: How to Manage Medications in the PACT System PACT psychopharmacologic goals; Psychopharmacologic practices; Systematic Longitudinal medication treatment; Continuous medication treatment for clients with a high likelihood of relapse; Combining medication treatment with psychosocial interventions; The PACT medication system; Implementing medication treatment for the individual client; Organizing medication treatment for all clients; Strategies to improve medication adherence: Establishing and maintaining and strong therapeutic alliance; Assertiveness in providing medication to clients; Reducing the complexity of medication regimens
Chapter 9: Hospitalization: Collaborating with the inpatient psychiatric unit Acute hospitalization; Long-term hospitalization
Chapter 10: Providing Rehabilitation Services: How PACT provides rehabilitation services Rehabilitation services; Methods of rehabilitation services; Housing; Activities of daily living; Structuring time and employment; Social and interpersonal relationships and use of leisure time
Chapter 11: Issues for PACT Model Replication: Program Standards and Managing Program Costs Experience with PACT model dissemination; Program standards and managing costs
Appendix 1: Bibliography
Appendix 2: Glossary
Appendix 3: Position Descriptions: Team leader/supervisor; Psychiatrist; Psychiatric Nurse; Mental health professional; Bachelor's-Level Mental Health Worker; Paraprofessional Mental Health Worker; Program Assistant
Appendix 4: PACT Medical Record Forms PACT Longitudinal Face Sheet; Problem List; Physician Orders; Medication Administration Record; Chronological List of Client Medications; Health Data Form; Medical Consultation Information; Treatment Plan; Progress Notes
Appendix 5: Assessment Initial Assessment and Treatment Plan; Psychiatric/Social Functioning History Time Line; PACT Comprehensive Assessment: Part 1: Psychiatric History, Mental Status, and Diagnosis; Part 2: Physical Health; Part 3: Use of Drugs or Alcohol - CIDI-SAM and CIDI-SAM Response Booklet; Part 4: Education and Employment; Part 5: Social Development and Functioning; Part 6: Activities of Daily Living; Part 7: Family and Relationships
Appendix 6: Team Organization and Communication Forms Weekly Client Schedule; PACT Daily Staff Assignment Schedule
Appendix 7: PACT Policy Examples Medication and Pharmacy Policies and Procedures; Health Care Policies and Procedures
Appendix 8: PACT Program Standards
List of Illustrations: Treatment and rehabilitation practices used in the PACT model; Example of staff work schedule/time sheets; Floor plan of the PACT headquarters; The PACT headquarters - medication room; Order of the PACT medical record; Daily log or cardex; Sample weekly client schedule; Sample PACT daily staff assignment schedule; Intensity course of symptoms, impairment, and changes in team service; Moderate service needs; Low service needs; High service needs; Organization chart for the urban PACT team; Organization chart for the rural PACT team; Sample psychiatric/social functioning history time line; Sample treatment plan, pages 1-3; Weekly client schedule; PACT decision tree for the psychopharmacologic treatment of clients with first-episode or recurrent and previously treatable episodes of the psychotic symptoms of schizophrenia, pages 1-3; Medication prescription, documentation, and administration; Range of vocational options; PACT staff direct hourly rate determination
Ordering information for this book: I have not been able to order it by Internet. It is available only directly through NAMI, and the NAMI book-ordering website (seen through http://www.nami.org )does not include this book, although I am told there are a few thousand copies left to buy.
I have ordered about 10 copies reliably by using the NAMI order-by-phone number:
NAMI : 1- 301-932-9550 .
You have to specify the title and they will take your VISA or MASTERCARD number. Delivery took about two weeks for my orders, and there was no customs hassle in Montreal.