RESEARCH ARTICLE


Resource Group Assertive Community Treatment (RACT) as a Tool of Empowerment for Clients with Severe Mental Illness: A Meta-Analysis



Tommy Nordén 1, Ulf Malm 2, Torsten Norlander 3, *
1 Evidens Research and Development Center, Göteborg, Sweden
2 Inst. for Clinical Neuropsychiatry, Sahlgrenska University Hospital, Göteborg, Sweden
3 Depatment of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden and Evidens Research and Development Center, Göteborg, Sweden


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© Nordén et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Evidens Research and Development Center, Packhusplatsen 2, SE-411 13 Göteborg, Sweden. Tel: +46 70 662 11 89; Fax: +46 31 711 04 42; E-mail: at.norlander@mailbox.swipnet.se


Abstract

The aim of the current meta-analysis was to explore the effectiveness of the method here labeled Resource Group Assertive Community Treatment (RACT) for clients with psychiatric diagnoses as compared to standard care during the period 2001 – 2011. Included in the meta-analysis were 17 studies comprising a total of 2263 clients, 1291 men and 972 women, with a weighted mean age of 45.44 years. The diagnoses of 86 % of the clients were within the psychotic spectrum while 14 % had other psychiatric diagnoses. There were six randomized controlled trials and eleven observational studies. The studies spanned between 12 and 60 months, and 10 of them lasted 24 months. The results indicated a large effect-size for the ”grand total measure” (Cohen´s d = 0.80). The study comprised three outcome variables: Symptoms, Functioning, and Well-being. With regard to Symptoms, a medium effect for both randomized controlled trials and non-randomized studies was found, whereas Functioning showed large effects for both types of design. Concerning Well-being both large and medium effects were evident. The conclusions of the meta-analysis were that the treatment of clients with Resource Group Assertive Community Treatment yields positive effects for clients with psychoses and that the method may be of use for clients within the entire psychiatric spectrum.

Keywords: ACT, case manager, empowerment, optimal treatment, RACT, resource group.