COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Nine Essential Features of ACT
Controlled Act Research
1. Services provided in the community, most frequently in
the client’s living environment.
2. Assertive engagement with active outreach.
20
17
ACT better than Standard
ACT not better than Standard
3. High intensity of services.
15
4. Small caseloads.
5. Continuous 24-hour responsibility.
6. Team approach (the full team takes responsibility for all
clients on the caseload).
Number of Studies
10
5
6
8
7 7
5
7. Multidisciplinary team, reflecting integration of services.
8. Close work with support systems.
9. Continuity of staffing.
0
Time in
Hospital
3
Housing
Stability
Quality of
Life
Client
Satisfaction
1
Adapted from Substance Abuse Treatment for Persons With Co-Occurring Disorders TIP, 2005b
Sacks, S. & Osher, F. 2003. [original reference to follow]
Percent inRemission
Fidelity Improves Outcomes
*** If current & subsequent points = 1 then the current score = 1
Assessment Figure Points 1. Percent Baseline of 6 Participants mo. 12 mo. in Stable 18 mo. Remission 24 mo. 30 for mo. High-Fidelity 36 mo. ACT
Hi-Fidelity Programs (E; 0n=61) 19.67vs. Low-Fidelity 26.23 29.51 ACT Programs 37.7 42.62 (G; n=26). 55.74
Low-Fidelity 0 3.85 3.85 7.69 7.69 15.38 15.38
60
50
40
30
to structure
more flexible activities
shorter meetings &
activities
more staff guidance
Modified TC
Key Modifications
to process
fewer sanctions
engagement
emphasis
to elements
accent on orientation &
instruction
individualized task
assignments
20
10
0
Baseline 6 mo. 12 mo. 18 mo. 24 mo. 30 mo. 36 mo.
McHugo, et al., 1999
more staff
responsibility as role
models
individually paced
progress in program
flexible criteria for
moving to next stage
Adapted from Substance Abuse Treatment for Persons With Co-Occurring Disorders TIP, 2005b
live-out re-entry
(aftercare) essential
engagement emphasis
throughout
activities proceed at a
slower pace
counseling to assist use
of community
Summary
Outcomes baseline vs 2-year follow-up
The Modified TC is
more flexible
less intense
more individualized
3.5
3
2.5
2
1.5
Modified TC 2
TAU
The quintessential elements remain
peer self-help
community-as-method
Adapted from Substance Abuse Treatment for Persons With Co-Occurring Disorders TIP, 2005b
1
0.5
0
Drug
Use
De Leon, G., Sacks, S., et al. 2000.
Alcohol
# of
Drugs
Employment
Drug
Use
Alcohol
# of
Drugs
Employment
baseline
2-year
follow-up
3