Adding evidence-based interventions to assertive community treatment: A feasibility study

OBJECTIVE: This 24-month study, conducted in The Netherlands, examined the feasibility of enhancing the effectiveness of assertive community treatment (ACT) by adding evidence-based interventions.

METHODS: A total of 159 patients were randomly assigned to two ACT teams, one providing standard ACT (N585) and an ACT Plus team that also provided evidence-based interventions (N574): psychoeducation, family interventions, individual placement and support, and cognitive behavioral therapy. The interventions were conducted by psychologists and nurse practitioners working independently from the ACT team.

RESULTS: Although most patients were judged eligible for each of the four interventions (range 65% to 89%), only 12 of the 74 patients (16%) successfully completed an intervention. Outcomes, such as use of inpatient care, for ACT Plus and standard ACT patients did not differ significantly.

CONCLUSIONS: Guidelines for the treatment of schizophrenia should consider the feasibility of delivering evidence-based interventions to difficult-to-engage patients.