Coercion and Tenacious Treatment in the Community

Diamond, Ronald J.

doi:10.1007/978-1-4757-9727-5_4

Cited by 27 publications

(23 citation statements)

References 15 publications

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“…What can be practically coerced in the community is extremely limited (e.g., injectable medication). Outpatient commitment shifts the focus from other treatment and support that may have been accepted voluntarily, and moving from a collaborative to a controlling relationship has major interpersonal costs [62]. This conclusion is corroborated by Australian research that demonstrated that the statewide implementation of outpatient commitment or community orders, without ACT systems, did not improve outcomes [63].…”

Section: Use Of Community Commitment Laws To "Aid" Case Managementmentioning

confidence: 91%

“…Moser's formulation is that outpatient commitment is an aspect of coercion [57]. However, Diamond demonstrates that such legal coercion will not lead to more effective treatment if the treatment itself is inadequate [62]. The least adequate and most passive psychiatric treatment systems usually rely most on commitment, whether in the hospital or the community.…”

Section: Use Of Community Commitment Laws To "Aid" Case Managementmentioning

confidence: 99%

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Assertive community treatmentIssues from scientific and clinical literature with implications for practice

Rosen

Mueser²,

Teesson³

2007

JRRD

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Abstract-This review describes Assertive community treatment (ACT), an integral component of the care of persons with severe mental illness. Drawing on research from North America, Australasia, and Britain, we summarize the current evidence base for ACT and examine the trends and issues that may affect practice. Strong evidence supports the fidelity standardization, efficacy, effectiveness, and cost-effectiveness of ACT models in psychiatry. Yet, significant methodological problems and issues affect implementation. The evidence indicates that the ACT model is one of the most effective systematic models for organizing clinical and functional interventions in psychiatry. Effective systems based on the ACT model meet more ACT fidelity criteria; are often noncoercive; do not rely on compulsory orders; may rely on a wider range of interventions than just medication adherence, including vocational and substance abuse rehabilitation; contain other evidence-based interventions and more mobile in vivo interventions; involve individual and team case management; may involve consumers as direct service providers; and have an interdisciplinary workforce and support structure within the team, providing some protection from work-related stress or burnout.

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Section: Use Of Community Commitment Laws To "Aid" Case Managementmentioning

confidence: 91%

Section: Use Of Community Commitment Laws To "Aid" Case Managementmentioning

confidence: 99%

Assertive community treatmentIssues from scientific and clinical literature with implications for practice

Rosen

Mueser²,

Teesson³

2007

JRRD

View full text Add to dashboard Cite

show abstract

“…One of the earliest considerations of these issues occurred at a meeting sponsored by the MacArthur Research Network on Mental Health and the Law, and was embodied in a subsequent book drawn from the presentations at the meeting (Dennis and Monahan 1996). Ron Diamond, a psychiatrist who works in the original ACT program in Madison, frankly acknowledged that ACT staff may use access to resources such as housing and money as leverage to promote patients' adherence to treatment recommendations (Diamond 1996). He also noted that ACT workers may mobilize patients' social networks to increase the pressure placed on them.…”

Section: Introductionmentioning

confidence: 98%

Techniques Used by Assertive Community Treatment (ACT) Teams to Encourage Adherence: Patient and Staff Perceptions

Appelbaum

Melle

2008

Community Ment Health J

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Assertive community treatment (ACT) has become a cornerstone of care for people with serious mental illnesses. But it has also been suggested that ACT is an inherently coercive approach, with a variety of techniques, including leverage, frequently employed to encourage treatment adherence. Staff and patients of 4 ACT teams participated in focus groups exploring their experiences with and opinions about the use of these techniques in ACT. Little evidence was found of significant use of leverage or perceptions of coercion. Instead both groups reported that supporting patients and building relationships were the preferred mechanisms for promoting treatment goals. This study suggests that ACT need not appear to either staff or patients as an intrinsically coercive model for the delivery of mental health services.

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“…Par exemple, l'objectif que les clients puissent travailler et soient rémunérés pour leur travail reflète un penchant qui ne correspond pas toujours aux préférences du client (Diamond, 1996).…”

Section: L'éthique Relationnelleunclassified

Le suivi intensif dans la communauté et la consommation : quelques enjeux éthiques

Quintin

Côté

Guimarães³

2016

dss

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La relation entre les intervenants en milieu de soins et leurs clients est souvent le lieu de profondes incompréhensions et de tensions entre les valeurs de liberté et de sécurité. Cela est particulièrement perceptible dans la relation avec les personnes souffrant de problèmes de santé mentale et d’abus de substances. Le but de cet article est de fournir des pistes de réflexion sur les enjeux éthiques qui se présentent à l’intérieur du programme de suivi intensif dans la communauté autour de la coercition et des conduites abusives de consommation. Les principes de base qui organisent le suivi intensif dans la communauté sont fondés sur les concepts éthiques d’égalité, de respect et de recherche commune de la vérité. Chaque personne est susceptible d’avoir la sagesse de sa propre vie et les habiletés pour gérer ses propres expériences. Il s’agit de créer un espace respectueux de réflexion, qui permet un dialogue entre les différentes perspectives, afin de concilier diverses préférences. Les interventions doivent être discutées avec le client, car celui-ci est au coeur de la prise de décision. Le cadre souple du suivi intensif, en regard de la complexité de la clientèle avec une double problématique, permet d’intervenir en respectant le rythme du client dans le processus de rétablissement et dans le changement de ses habitudes de vie.

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Coercion and Tenacious Treatment in the Community

Cited by 27 publications

References 15 publications

Assertive community treatmentIssues from scientific and clinical literature with implications for practice

Assertive community treatmentIssues from scientific and clinical literature with implications for practice

Techniques Used by Assertive Community Treatment (ACT) Teams to Encourage Adherence: Patient and Staff Perceptions

Le suivi intensif dans la communauté et la consommation : quelques enjeux éthiques

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