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Full-Text Articles in Medicine and Health Sciences
Tautology And Coercion In Assertive Community Treatment (Act): The "Treatment Effect" Of Assertive Community Treatment Deconstructed., Tomi Gomory
Tomi Gomory
Assertive Community Treatment (ACT) has been identified as one of only six evidence-based practices for the severely mentally ill by federal, private foundation, and professional mental health experts. This article reviews the research of the inventors of ACT (the Madison Wisconsin ACT group) because their model is the criterion for all ACT replications. The focus is on the well known, but mysterious “disappearance” of ACT effect when ACT “interventions” cease. The analysis concludes provocatively that there is no ACT clinical effect in the first place. What actually is measured by these researchers and claimed incorrectly as “clinical” treatment effect is …
The Origins Of Coercion In Assertive Community Treatment: A Review Of Early Publications From The Special Treatment Unit Of Mendota State Hospital., Tomi Gomory
Tomi Gomory
This article argues that Assertive Community Treatment (ACT) is fundamentally and historically based on the uncritical but societally well accepted view that medically justified coercion (punishment or unwanted treatment) is therapeutic. It documents this claim by reviewing the early professional history and the resultant publications of the inventors of ACT (originally known as Training in Community Living), consisting of psychiatrists, social workers, and psychologists who trained and worked during the 1960s through the 1980s, at Mendota State Hospital (eventually renamed Mendota Mental Health Institute) in Wisconsin.
Programs Of Assertive Community Treatment (Pact): A Critical Review, Tomi Gomory
Programs Of Assertive Community Treatment (Pact): A Critical Review, Tomi Gomory
Tomi Gomory
Advocates of Programs of Assertive Community Treatment (PACT) make numerous claims for this intensive intervention program, including reduced hospitalization, overall cost, and clinical symptomatology, and increased client satisfaction, and vocational and social functioning. However, a reanalysis of the controlled experimental research finds no empirical support for any of these claims. Instead, there is evidence that the program is both coercive and potentially harmful. The current promotion of PACT appears to be based more on professional enthusiasm for the medical model than upon any benefit to the clients.
Coercion Justified?-Evaluating The Training In Community Living Model (The Original Assertive Community Treatment Model) A Dissertation, Tomi Gomory
Tomi Gomory
This dissertation examines the research and theory offered for Programs of Assertive Community Treatment, the model that is supported by Institutional Psychiatry as the most well validated and best model of intervention applicable to the psychiatric population labeled the Severely and Persistently Mentally Ill. Although this program has been researched for over 25 yrs. and the extensive literature on this model claims to have established it’s efficacy on both the systems and patient level, the findings of my critical review dispute these claims based on the examination of the empirical evidence of all available randomized controlled trials of this intervention …