Working with families in Assertive Community Treatment (ACT): the case manager's perspective

Area of Science:

• Mental Health Services Research
• Sociology of Health and Illness
• Clinical Psychology

Background:

• Limited family involvement in severe mental illness (SMI) care is a documented issue.
• Assertive Community Treatment (ACT) models aim for comprehensive client support.
• Understanding case manager perspectives on family engagement is crucial for improving care.

Observation:

• Grounded theory study exploring case manager (CM) interactions with families of SMI clients in ACT.
• CMs' conceptualization of families significantly shapes their engagement strategies.
• Client goals and family attributes influence CMs' assessment of family involvement.

Findings:

• Case managers perceive families primarily as sources of social connection, not direct care, for SMI clients.
• CMs' treatment goals dictate their assessment of family utility in achieving these goals.
• Strategies for family involvement are developed through ongoing assessment of client consent, family availability, and family desire for engagement.

Implications:

• ACT model's structure may influence CMs' family conceptualization and engagement practices.
• Findings highlight a need for training to broaden CMs' understanding of family roles in SMI treatment.
• Developing family-centered approaches within ACT can enhance client outcomes and support systems.