Client perspectives on helpful ingredients of assertive community treatment

Clients in 6 assertive community treatment (ACT) programs describedfeatures they liked best about ACT Clients responded to an open-ended question embedded in an interview administered by their case managers. Responses were coded into an average of 1.56 categories per client. Clients mentioned non-specific ingredients most frequently (e.g., relationships with case managers); somewhat less frequently they mentioned ingredients considered by experts as integral to the ACT model (e.g., staff availability home visits). Clients mentioning more non-specific ingredients reported greater client satisfaction, Clients mentioning more ACT-specific ingredients recorded a greater reduction in days hospitalized during the first 6 months of treatment. Level of functioning was related to clients' responses. Compared to lower functioning clients, higher functioning clients were more likely to mention the helping relationship as a best feature. Although ACT services differ in many ways from traditional counseling or psychotherapy client-identified best aspects of ACT focused more strongly on features of the helping relationship that have been found to be important for counseling in general.