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Related Experiment Videos

Harbinger. I: The development and evaluation of the first PACT replication

C T Mowbray1, M E Collins, T B Plum

  • 1School of Social Work, University of Michigan, Ann Arbor 48109-1106, USA.

Administration and Policy in Mental Health
|September 4, 1998
PubMed
Summary
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Assertive Community Treatment (ACT) demonstrated effectiveness in improving independent living and employment for severe mental illness patients in its initial evaluation. Long-term effectiveness showed diminished differences, prompting further research into ACT mechanisms.

Area of Science:

  • Psychiatry
  • Mental Health Services Research
  • Rehabilitation Psychology

Background:

  • Assertive Community Treatment (ACT), formerly PACT, is a globally recognized rehabilitation model for severe mental illness.
  • Early adoption of ACT models faced challenges in demonstrating effectiveness and fidelity.
  • The Harbinger program in Michigan was the first replication of the PACT model with an experimental design.

Purpose of the Study:

  • To evaluate the effectiveness of the first PACT model replication (Harbinger) using an experimental design.
  • To assess the 30-month and 66-month outcomes of the Harbinger program.
  • To analyze factors influencing the observed differences in long-term effectiveness.

Main Methods:

  • An experimental design was employed to compare the Harbinger program with a control group.

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  • Data were collected over an initial 30-month period and a follow-up 66-month period.
  • Outcomes assessed included independent living, employment, and client functioning.

    • Main Results:

    • The 30-month evaluation revealed significant improvements favoring the Harbinger program in independent living, employment, and client functioning.
    • At 66 months, the differences between the experimental and control groups were less pronounced.
    • Analysis indicated potential influences from design limitations, data collection issues, and changes in the control group's treatment environment.

    Conclusions:

    • Initial ACT implementation showed significant short-term benefits for severe mental illness rehabilitation.
    • Longitudinal effectiveness may be influenced by various factors requiring further investigation.
    • Future ACT research should focus on program theory to elucidate mechanisms of successful intervention.