The basis of self-confidence community therapy

Active Community Therapy (ACT) is a form of community-based mental health care for individuals with severe mental illnesses that affect their lives in the community, appointments with professionals in clinics and hospitals And the ability to manage mental health symptoms.

If you or someone you know is referred to a confident community treatment plan, you may wonder if this is the best option and what it will bring. Rest assured, ACT is an evidence-based practice that has been studied for decades and may be provided to you for specific reasons.

ACT aims to provide people-oriented and personalized mental health services to meet everyone’s needs.

Definition of ACT

The simple definition of confident community therapy is an intensive and comprehensive approach to community mental health services. This means that mental health services are provided in a community setting (rather than a more restrictive residential or hospital setting) for people with severe mental illness.

The mission of ACT is to help people become independent and integrate into the community during the recovery process.

Secondary goals include reducing homelessness and unnecessary hospitalization. In this way, ACT provides treatment in the “real world”, while professional teams use the “whole team” approach to help.

Many people suffer from symptoms of mental illness that can affect their ability of daily living and cause them to seek services in the emergency room of a hospital. The goal of ACT is to reduce reliance on hospitals by providing round-the-clock services to those who need it most. In this way, it can be expected that active community treatment will help reduce the preventable consequences of mental illness, such as homelessness and drug abuse.


How did confident community therapy begin? Back in the 1970s, a picture soon appeared, that is, far away from institutions housing patients with severe mental illness. At the same time, the settings of community services are also poor and cannot help those who no longer live in the institutional environment.

The founders of ACT are Leonard I. Stein, Mary Ann Test, Arnold J. Marx, Deborah J. Allness, William H. Knoedler, and other colleagues at the Mendota Institute of Mental Health in Madison, Wisconsin, a state mental hospital.

Although it sounds unusual, when confident community therapy first appeared, it was considered a radical approach. However, since then, it has become one of the most important delivery methods for patients with certain mental illnesses.

In addition, the National Alliance for Mental Illness (NAMI) also participated, publishing the ACT manual in 1998 and operating a training and advocacy center from 1998 to 2004.

Who is confident community therapy serving

If you or a member of your family have received ACT services, you may wonder why you chose to receive such services. The following is a list of the most common reasons a person will receive confident community therapy services:

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  • People with symptoms of severe mental illness
  • People with severe thought disorders such as schizophrenia
  • Young people with early schizophrenia
  • People with stigmatized mental illness
  • People with a high rate of drug abuse
  • People with obvious history of trauma
  • People who are often hospitalized
  • People who are homeless due to mental illness
  • People with overlapping physical and mental illnesses (for example, hearing impaired people with mental illness)
  • People experiencing mental crisis
  • Mental illness in the criminal justice system
  • Refugee with mental illness
  • People who are unlikely to go to a hospital or clinic
  • People who do not respond well to traditional outpatient treatment

ACT location

Countries such as the United States, Canada, Australia, and the United Kingdom have implemented self-confident community therapy. For example, especially in the United States, the Department of Veterans Affairs has implemented ACT nationwide.

The service is not provided in the clinic, but in the patient’s home, in a community place (such as a coffee shop, restaurant, or park), a homeless shelter, or any place that is most suitable and convenient for the person using the service.


If you are about to receive decisive community treatment, you may not be sure what will happen. Most ACT courses have a similar structure, so the following content may provide you with some guidance on what the course offers.

  • Your treatment plan will be centered on your own personal strengths, needs and expectations for the future
  • ACT is long-term, but not unlimited; the goal is to eventually transition you to other services or keep you learning
  • The focus of ACT is community integration, allowing you to return to a normal life
  • ACT follows a holistic approach, which means that all areas of your life are targets for improvement
  • The usual ratio of ACT is about 10:1, which means that every 10 customers will be assigned a team member
  • Most clients have multiple contacts with team members every week
  • ACT provides services 24 hours a day, 7 days a week, to ensure you always get the help you need
  • The ACT team usually includes psychiatrists, social workers, nurses, occupational therapists, peer support specialists, etc.
  • ACT is considered a non-residential service of medical monitoring, which is two levels lower than the highest level service (medical management residential service)
  • Whether you are homeless or imprisoned, team members will build a long-term relationship with you
  • When you do better, you will be transferred out of the ACT plan

Services provided by ACT

What specific services can you get from the ACT team? The following is a list of some of the main services provided by Confidence Community Therapy:

  • Initial and ongoing assessment
  • Psychiatric services, such as dealing with a mental illness or crisis
  • Drug Abuse Service
  • Help with employment and housing
  • Educate family members and you about your mental illness
  • Treatment planning and monitoring
  • Accompany you to see a doctor and dentist
  • Representatives at court hearings
  • Financial assistance (such as managing funds and paying bills)
  • Help you have confidence in housekeeping, shopping, cooking and transportation
  • Employment support, such as finding a job and keeping a job
  • Help order and manage medication

Key components of ACT

ACT aims to provide treatment that is unrestricted and accessible. The Confidence Community Therapy Association (ACTA) has developed many key principles that guide this form of treatment. These include:

  • Provide out-of-office treatment in a community setting or individual’s home
  • As the main service provider of a series of treatment services
  • Provide personalized treatments designed to meet everyone’s needs and help them achieve their goals
  • Help customers better integrate into the community and get the services they need
  • Help meet the needs of family members who are also affected by providing support
  • Provide psychological education so that people can better understand their own situation
  • Provide career support to help people acquire life and work skills

Because ACT is highly adaptable, it can be used to meet a wide range of needs.


Overall, the research evidence on self-confident community therapy has been positive, but there are some caveats. An evidence review in 2016 showed that ACT reduced self-reported psychiatric symptoms, length of hospital stay, and emergency department visits for patients with mental illness and substance abuse.

In general, from dozens of randomized controlled trials that have been conducted, it can be concluded that ACT is more effective than standard services in reducing hospital use, but the results of other results are not clear.

Although studies have shown improvements in ACT’s housing, symptom management, and quality of life, these findings are most obvious for people who return to the hospital frequently.

It has been noted that ACT may be most helpful in communities without a well-coordinated mental health care system, which leads to excessive use of hospitals by patients with severe mental illness.

For example, ACT may show better results in the United States than in the United Kingdom, because the former’s mental health care system is poorly coordinated, leading to longer hospital stays, while the latter’s well-coordinated system already includes many of the ACT’s in its standard care every aspect.

Other studies have shown that ACT is more effective than standard care in reducing the risk of hospitalization and incarceration, especially in impoverished inner-city communities, as well as reducing alcohol use or imprisonment for people with antisocial personality disorder.

In addition, among the homeless, it has been shown that ACT is more satisfied with care and more stable housing conditions than standard care. This is easy to understand when you consider the ACT model-homeless people who meet service providers in convenient places are more likely to benefit from services than those who must travel to get help.

Finally, a Cochrane review of 38 clinical trials from the United States, Canada, Europe, and Australia showed that ACT is more effective than standard care in reducing hospital stays and improving social functioning and independent living.At the same time, mental health and quality of life have not improved more than when standard care is provided.

Overall, research evidence shows that ACT is most helpful for people with severe mental illness, keeping them away from hospitals and communities.

Another benefit of the ACT model may also help reduce burnout among mental health professionals. Although providing services to individuals with strong needs, the study found that ACT case managers reported less work pressure and higher job satisfaction.The shared responsibility, abundant peer support, and clear job roles that come with being a member of the medical team may be the reasons why those who work in active community therapy are less prone to burnout.

Criticism of ACT

Overall, the ACT project has received some criticism. One is that ACT is just a compulsory system in which hospitals refuse admission to patients based on their participation in the ACT program.

At the same time, isn’t staying in the community the goal of all mental health initiatives? In this way, regardless of whether these strategies are mandatory, if patients can receive treatment in the community where they live, track through prisons and homeless shelters, and provide 24/7 care at their convenience, then these benefits may be is worth it. shortcoming.

Very good sentence

If you are assigned to receive decisive community treatment services, you may be nervous about what will happen or what support you will receive. Knowing that your team will answer questions and provide you with long-term support in the place where the community provides you with the best service. As a person with severe mental illness, ACT is an effective long-term support and should serve you well.