Development of a fidelity scale for function assertive community treatment (FACT)

BACKGROUND: Assertive community treatment (ACT) is one of the most important models for the care and treatment, in the community, of people with severe mental illness (SMI). ACT is concerned primarily with SMI-patients who have the most complex problems and it provides care by means of intensive assertive outreach. Function ACT (FACT) provides care for the entire group of SMI-patients and combines the principles of case management and ACT. For a long time it has been possible to measure the degree of ACT model reliability using the FACTS reliability scale. Throughout this time, however, a reliability scale for FACT was not available. AIM: To develop a reliability scale for FACT teams. METHOD: Using the knowledge of experts and feedback from FACT teams it has been possible to develop a reliability scale for FACT teams. The scale was tested and subsequently adapted as a result of 10 pilot trials performed by 10 FACT teams. RESULTS: The definitive version of the scale was confirmed in 2008 and is currently used in the field. CONCLUSION: With the ACT and FACT reliability scales the research field now have two instruments with which teams working with SMI-patients can measure model reliability. The DACTS and FACTS provide opportunities for quality improvement and transparency.

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