One Psychological Treatment for Sz - Assertive Community Therapy (ACT)

Question 1

What is ACT used for?

Answer 1

Used to help patients with Sz who have regular relapses and would need to go back into hospital

Question 2

What is the aim of ACT?

Answer 2

Aims to help patients live independently

Question 3

What is a multidisciplinary approach?

Answer 3

Where a team of professionals work together

Question 4

What is available to patients 24/7 during ACT?

Answer 4

24 hour care available

Crisis intervention available all day and night

Individual care plan (ICP)

Question 5

What types of practical support are available through ACT?

Answer 5

Making sure attending medical appointments

Taking medication

Shopping

Paying bills

Question 6

What types of emotional support are available through ACT?

Answer 6

Organising group meeting

Social events

Counselling

Family therapy

Question 7

What is the supporting evidence/strengths of ACT as a psychological treatment for Sz?

Answer 7

Bond et al (2001)

Bond (2002)

Leff (1997)

Holistic approach

Ethics

Question 8

What is the refuting evidence/weaknesses of ACT as a psychological treatment for Sz?

Answer 8

Gomory (2001)

High staff turnover

Medication

Independence

Underfunded

Question 9

Why is Bond et al (2001) supporting evidence of ACT as a psychological treatment for Sz?

Answer 9

Bond et al analysed 25 studies compared with standard community care, ACT is highly effective

It engages patients, prevents re-hospitalisation and increases housing stability

Question 10

Why is Bond (2002) supporting evidence of ACT as a psychological treatment for Sz?

Answer 10

Bond found that ACT is effective across gender, age and culture

Only 11% of patients in surveys said they find their care restricting

Question 11

Why is Leff (1997) supporting evidence of ACT as a psychological treatment for Sz?

Answer 11

Leff found that symptoms/problems of institutionalisation tend to be reduced as a result of living and being treated in the community

e.g. patients are no longer isolated and restricted by strict routines

Question 12

Why is holistic approach a strength of ACT as a psychological treatment for Sz?

Answer 12

ACT provides holistic approach to treatment and involves the client in decision making

Treatment don’t simply rely upon medication; it incorporates social support, practical help and family therapy

Attempt to tackle root cause of Sz, namely, social adversity factors

Question 13

Why is ethics a strength of ACT as a psychological treatment for Sz?

Answer 13

Removes ethical issues associated with earlier, invasive treatments for Sz given to patients in institutions e.g. lobotomies and electroconvulsive therapy

This makes ACT more ethical approach to treating patients with Sz

Question 14

Why is Gomory (2001) refuting evidence of ACT as a psychological treatment for Sz?

Answer 14

Gomory proposed that ACT patients are often forced to surrender all responsibility for making their own decisions and taking case of themselves

This poses an ethical debate regarding a person having control over decisions and may be viewed as a form of social control

Question 15

Why is high staff turnover a weakness of ACT as a psychological treatment for Sz?

Answer 15

ACT programs often underfunded, and private companies are often used for home care sometimes leading to high staff turnover

This is an issue when consistency of care and positive interpersonal relationships between the client and career are essential for such people

Question 16

Why is medication a weakness of ACT as a psychological treatment for Sz?

Answer 16

ACT doesn’t have an effect on actual functioning such as reducing positive and negative symptoms of Sz therefore there is still a need for medication

May mean patients still experiences side effects which may lead to poor compliance to medication regime

Question 17

Why is independence a weakness of ACT as a psychological treatment for Sz?

Answer 17

Some critics of ACT argue that these programs don’t effectively encourage the patient to live independently

Despite the patient not being hospitalised they are still subject to strict routines and rules and may developed dependence on carers

Question 18

Why is underfunded a weakness of ACT as a psychological treatment for Sz?

Answer 18

Many ACT programs are expensive to run but are underfunded

ACT programs more common in urban areas meaning funding may be even tighter

Some criticised ACT programs for taking funding away from hospitals where the patient could ultimately end up if ACT fails