Category: Dissemination / Implementation

Symposium

An Integrated Model of Illness Management and Recovery and Assertive Community Treatment for People With Serious Mental Illness

Friday, November 17
4:15 PM - 5:45 PM
Location: Indigo Ballroom A, Level 2, Indigo Level

Keywords: Community-Based Assessment / Intervention | Severe Mental Illness
Presentation Type: Symposium

Background: While Assertive Community Treatment (ACT) can improve several important outcomes, it has been less effective at improving functioning, symptoms, and symptom management.  Illness Management and Recovery (IMR) has been shown to improve illness self-management, symptoms, and functioning in persons with severe mental illness (SMI). Accordingly, we adapted and integrated IMR into the delivery of ACT services in order improve the recovery, symptom, and functional outcomes of people served by ACT teams.


Methods: We used a cluster randomized controlled design to examine the effectiveness of integrating IMR into ACT, with 8 ACT teams across 2 states. Four ACT teams were randomly assigned to provide IMR (ACT+IMR) and were provided with training, consultation, and implementation strategies; 4 teams provided ACT without IMR (ACT-only). Randomly-selected ACT clients with schizophrenia spectrum or bipolar disorder (N=101) participated. Assessments were administered at baseline, 6-mos and 1-yr follow-ups.


Results: Despite implementation barriers and modest exposure to IMR, the ACT+IMR condition showed significantly better outcomes in clinician-rated illness management and recovery (F=16.27, p<.001) and psychosocial functioning (F=4.04, p=.047). No significant differences were found in the other six outcome measures. The correlation between the number of IMR sessions attended and change was significant for the Client (r=.462, p<.001) and Clinician (r=.267, p=.007) IMR scales. The correlation between the number of IMR modules completed and change was significant for the Client (r=.507, p<.001) and Clinician (r=.381, p=.004) IMR scales, the QLSA (r=.266, p=.043), and the DLA-20 (r=.370, p=.006).

Conclusions: Integrating IMR into ACT is a promising method for improving recovery outcomes of people with SMI. Given that exposure to IMR varied widely among participants and was associated with several of the primary outcomes, studies should focus on implementation strategies that enhance the delivery of IMR by ACT clinicians serving people with SMI. 

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